Applying Duchscher\u27s Role Transition Theory to Reduce Novice Nurse Turnover

The identified gap in practice was teaching graduate nurses about the phases and barriers outlined in Duchscher’s role transition theory. The practice-focused question that guided the project addressed whether a staff education program applying Duchscher’s role transition theory would provide the needed knowledge in preparing the graduate nurse for transition to novice nurse. The project included identical pre- and post surveys and a staff education program. Twenty participants selected a Likert response to each of the four questions: I feel prepared for the transition from graduate nurse to novice nurse, I feel knowledgeable about the developmental barriers I can expect to navigate during my transition from graduate nurse to novice nurse, I understand the importance of maintaining a healthy self-care routine, and I feel comfortable asking for feedback. For each question, score range, improvement in response scores, score frequency, totals, standard deviation, and z scores were calculated. An overall increase in score total after the program was noted for each question. For the first question, the total increased from 70 to 81. For the second question, the total increased from 73 to 85. For the third question, the total increased from 89 to 95. For the fourth question, the total increased from 85 to 91. These results indicate that the education program was effective in helping graduate nurses feel more comfortable and knowledgeable about their transition to novice nurses

WATER QUALITY AND WATERBORNE DISEASE ALONG THE NIGER RIVER, MALI: A STUDY OF LOCAL KNOWLEDGE AND RESPONSE

This paper presents the findings of a study to assess patterns in local knowledge of and response to water quality and waterborne diseases in relation to seasonal changes in the Niger River Inland Delta. The study draws on field data collected in four villages along the Niger River in the Mopti district of Mali during September 2008. The major findings suggest: (1) water use behaviors and diarrheal disease management are influenced by the tremendous seasonal fluctuations in the riverine environment; (2) local awareness of the relationship between poor water quality, oral-fecal disease transmission, and waterborne disease is low; (3) interventions to mitigate the high incidence of childhood diarrhea and degraded water quality are limited by ongoing socio-economic, cultural, and institutional factors; and (4) women’s level of health knowledge is socially and culturally dependent

The Current State of Healthcare in The United States: Barriers to Healthcare, Quality of Care, and Self-Reported Health

A primary goal of the Affordable Care Act (ACA) was to increase health insurance coverage, reduce health care costs, and improve quality of care. Insurance coverage expanded, however, the effect of the ACA on barriers to accessing care and quality of care is less apparent. Outcome variables related to barriers (having a usual source of care, delaying care due to cost, forgoing care due to cost) and quality (whether healthcare providers always: showed respect, spent enough time listened, explained; and an overall rating of providers) from the Medical Expenditure Panel Survey (MEPS) were examined to evaluate whether barriers to healthcare and quality of care have changed since the implementation of the ACA. The analysis was performed on all adults who participated in MEPS aged 18-64 and on subgroups: young adults aged 18-25 due to the provision expanding coverage from their parents’ insurance; and adults aged 18-64 with a chronic condition and private insurance to assess secular background changes. In all groups, having a usual source of care decreased from 2009 to 2019 while delaying and forgoing care due to cost rose significantly. Quality of care showed differences across race; Whites reported no improvements or slight declines while all other races reported improvements. Results show that barriers to accessing care may have worsened from 2009 to 2019, however, some evidence suggests that the quality of care reported by minority racial groups have improved. It is unknow to what extent barriers to accessing care and quality of care impact health. Mental and physical self-reported health were examined as outcomes associated with barriers to accessing care and quality of care in all adults aged 18 and over who participated in the 2019 MEPS. Most of the sample reported good self-reported health, although the impact of barriers on self-reported health were largely negative, suggesting delaying or forgoing care due to cost is done at the expense of health. High quality of care was positively associated with good self-reported health in Whites. Results suggest that exposure to barriers to accessing care and a negative quality of care may have a negative impact on health

Reducing Our Waste in Bloomington-Normal, IL

The purpose of this report is to inform public officials, the Ecology Action Center, and Bloomington/Normal residents of current habits, unmet needs and areas for improvement concerning community recycling programs. The findings are based on a survey of 290 Bloomington/Normal households, as well as interviews conducted with key stakeholders in the community. One of the more significant findings was the almost universal support for the expansion of the curbside recycling program in the area. Respondents also reported a general dissatisfaction with the current state of apartment recycling efforts, and support of the implementation of mandatory recycling in school districts. To conclude, we make recommendations for improvement of the Bloomington/Normal recycling programs

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts

Pan-cancer Alterations of the MYC Oncogene and Its Proximal Network across the Cancer Genome Atlas

Although theMYConcogene has been implicated incancer, a systematic assessment of alterations ofMYC, related transcription factors, and co-regulatoryproteins, forming the proximal MYC network (PMN),across human cancers is lacking. Using computa-tional approaches, we define genomic and proteo-mic features associated with MYC and the PMNacross the 33 cancers of The Cancer Genome Atlas.Pan-cancer, 28% of all samples had at least one ofthe MYC paralogs amplified. In contrast, the MYCantagonists MGA and MNT were the most frequentlymutated or deleted members, proposing a roleas tumor suppressors.MYCalterations were mutu-ally exclusive withPIK3CA,PTEN,APC,orBRAFalterations, suggesting that MYC is a distinct onco-genic driver. Expression analysis revealed MYC-associated pathways in tumor subtypes, such asimmune response and growth factor signaling; chro-matin, translation, and DNA replication/repair wereconserved pan-cancer. This analysis reveals insightsinto MYC biology and is a reference for biomarkersand therapeutics for cancers with alterations ofMYC or the PMN

Spatial Organization and Molecular Correlation of Tumor-Infiltrating Lymphocytes Using Deep Learning on Pathology Images

Beyond sample curation and basic pathologic characterization, the digitized H&E-stained images of TCGA samples remain underutilized. To highlight this resource, we present mappings of tumorinfiltrating lymphocytes (TILs) based on H&E images from 13 TCGA tumor types. These TIL maps are derived through computational staining using a convolutional neural network trained to classify patches of images. Affinity propagation revealed local spatial structure in TIL patterns and correlation with overall survival. TIL map structural patterns were grouped using standard histopathological parameters. These patterns are enriched in particular T cell subpopulations derived from molecular measures. TIL densities and spatial structure were differentially enriched among tumor types, immune subtypes, and tumor molecular subtypes, implying that spatial infiltrate state could reflect particular tumor cell aberration states. Obtaining spatial lymphocytic patterns linked to the rich genomic characterization of TCGA samples demonstrates one use for the TCGA image archives with insights into the tumor-immune microenvironment

Rockport Comprehensive Plan

This document was developed and prepared by Texas Target Communities (TxTC) at Texas A&M University in partnership with the City of Rockport, Texas Sea Grant, Texas A&M University - Corpus Christi, Texas A&M University - School of Law and Texas Tech University.Founded in 1871, the City of Rockport aims to continue growing economically and sustainably. Rockport is a resilient community dedicated to sustainable growth and attracting businesses to the area. Rockport is a charming town that offers a close-knit community feel and is a popular tourist destination for marine recreation, fairs, and exhibitions throughout the year. The Comprehensive Plan 2020-2040 is designed to guide the city of Rockport for its future growth. The guiding principles for this planning process were Rockport's vision statement and its corresponding goals, which were crafted by the task force. The goals focus on factors of growth and development including public participation, development considerations, transportation, community facilities, economic development, parks, and housing and social vulnerability