The Providence St. Vincent Emergency Department implementation of a standardized communication tool in patient’s rooms

https://digitalcommons.psjhealth.org/stvincent-bootcamp/1018/thumbnail.jp

Time Under the Curve: Assessing the Impact of Regional Lead Treatment Center Home Visit on the Length of Exposure in Lead Poisoned Children

A high proportion of Connecticut residents are at risk of health effects due to lead exposure, especially children under the age of six. The Yale Regional Lead Treatment Center (YRLTC) assists families of children with blood lead levels (BLL) exceeding the Centers for Disease Control and Prevention (CDC) maximum BLL of 5 µg/dL. YRLTC incorporates home visits of lead-exposed children living in Southern Connecticut to mitigate lead poisoning by emphasizing public health initiatives and social work, rather than using a clinic-only approach. This project aimed to evaluate the merits of this new interdisciplinary approach and its tangible effects on health outcomes. Key informant interviews provided perspectives on the value and themes of home visits. Questions focused on physiological measures of lead poisoning and cognitive development, patient interactions during home visits as well as legal, and logistical challenges to lead abatement. The team also shadowed home visits in order to understand the intervention.https://elischolar.library.yale.edu/ysph_pbchrr/1029/thumbnail.jp

A Proposed Astronomy Learning Progression For Remote Telescope Observation

Providing meaningful telescope observing experiences for students who are deeply urban or distantly rural place-bound—or even daylight time-bound—has consistently presented a formidable challenge for astronomy educators.  For nearly 2 decades, the Internet has promised unfettered access for large numbers of students to conduct remote telescope observing, but it has only been in recent years that the technology has become readily available.  Now that this once fanciful possibility is becoming a reality, astronomy education researchers need a guiding theory on which to develop learning experiences.  As one departure point, we propose a potential learning progression anchored on one end with recognizing that stars visible at night have describable locations and predictable motions, and anchored at the other with distant robotic telescopes can be programmed to record specific astronomical data for later analysis

7. Development And Initial Validation Of The Multicultural Counseling Awareness Scale

In recent years counseling programs have devoted increasing attention to multicultural issues in the curriculum. The counseling profession\u27s initial interest in multicultural training (or development) was buoyed by the Division of Counseling Psychology (Division #17 of the American Psychological Association [APA]) position paper on multicultural competencies (Sue et al., 1982). This position paper delineated 11 cross-cultural counseling competencies organized within the categories of awareness (beliefs/attitudes), knowledge, and skills. The Awareness category refers to the counselor\u27s awareness of his or her own value biases and how these biases may translate into culturally insensitive counseling; to the need to check biases and stereotypes; and to the need to develop a positive orientation towards multiculturalism. Knowledge refers to the counselor\u27s knowledge of his or her own worldview as well as the worldview of his or her clients; and to additional culture- specific information such as the impact of racism on clients, models of acculturation and racial identity development, and so forth. Finally, Skills refers to the counselor\u27s ability to translate awareness and knowledge into culturally sensitive and relevant interventions (Pedersen, 1988; Sue et al., 1982; Sue, Arredondo, & McDavis, 1992). Since the Sue et al. (1982) position paper was published, numerous professional preparation programs have added multicultural components to their curriculum. According to the Hollis and Wantz (1990, 1994) national surveys of counseling programs, 76 new multicultural courses were developed and added to existing curriculums from 1989 to 1991, and another 27 programs added a course from 1993 to 1995. In a survey of APA-accredited counseling psychology programs, Hills and Strozier (1992) found that 87% of the programs offered a multicultural course, and 59% of the programs required the course. Also surveying APA-accredited counseling psychology programs, Quintana and Bernal (1995) found that 73% of the programs offered at least one multicultural course and 42% required one course. In the most recent survey to date, of both APA accredited and non-accredited counseling psychology programs, Ponterotto (in press) found that 89% of responding programs have a required multicultural counseling course, and 58% of programs integrate multicultural issues into all courses

BREAST MOVEMENT ASYMMETRY DURING RUNNING: IMPLICATIONS ON BREAST SUPPORT

This study aimed to investigate 1) the prevalence and magnitude of breast movement asymmetry, 2) the interaction between static and dynamic breast asymmetry during running and 3) the influence of sports bras on breast asymmetry. Nipple position data were collected from 167 female participants whilst treadmill running and then from a sub-group of twelve participants running in different bra conditions. Breast movement asymmetry was present in 74% of participant during running, with greater resultant static breast position asymmetry for participants that displayed asymmetry whilst running. Asymmetry was most commonly caused (65 - 80%) by greater movement of the left than right breast. Sports bras reduced asymmetry prevalence to as few as 17% of participants in the antero-posterior direction but only 58% in the infero-superior direction

Aspects of generic entanglement

We study entanglement and other correlation properties of random states in high-dimensional bipartite systems. These correlations are quantified by parameters that are subject to the "concentration of measure" phenomenon, meaning that on a large-probability set these parameters are close to their expectation. For the entropy of entanglement, this has the counterintuitive consequence that there exist large subspaces in which all pure states are close to maximally entangled. This, in turn, implies the existence of mixed states with entanglement of formation near that of a maximally entangled state, but with negligible quantum mutual information and, therefore, negligible distillable entanglement, secret key, and common randomness. It also implies a very strong locking effect for the entanglement of formation: its value can jump from maximal to near zero by tracing over a number of qubits negligible compared to the size of total system. Furthermore, such properties are generic. Similar phenomena are observed for random multiparty states, leading us to speculate on the possibility that the theory of entanglement is much simplified when restricted to asymptotically generic states. Further consequences of our results include a complete derandomization of the protocol for universal superdense coding of quantum states.Comment: 22 pages, 1 figure, 1 tabl

The application of antimicrobial stewardship knowledge to nursing practice : A national survey of United Kingdom pre-registration nursing students

© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/AIM: To assess student nurses understanding and skills in the application of antimicrobial stewardship knowledge to practice. DESIGN: Quantitative. METHODS: Cross-sectional survey. RESULTS: Five hundred and twenty three student nurses responded across 23 UK universities. Although students felt prepared in competencies in infection prevention and control, patient-centred care and interprofessional collaborative practice, they felt less prepared in competencies in which microbiological knowledge, prescribing and its effect on antimicrobial stewardship is required. Problem-based learning, activities in the clinical setting and face-to-face teaching were identified as the preferred modes of education delivery. Those who had shared antimicrobial stewardship teaching with students from other professions reported the benefits to include a broader understanding of antimicrobial stewardship, an understanding of the roles of others in antimicrobial stewardship and improved interprofessional working. CONCLUSION: There are gaps in student nurses' knowledge of the basic sciences associated with the antimicrobial stewardship activities in which nurses are involved, and a need to strengthen knowledge in pre-registration nurse education programmes pertaining to antimicrobial management, specifically microbiology and antimicrobial regimes and effects on antimicrobial stewardship. Infection prevention and control, patient-centred care and interprofessional collaborative practice are areas of antimicrobial stewardship in which student nurses feel prepared. Interprofessional education would help nurses and other members of the antimicrobial stewardship team clarify the role nurses can play in antimicrobial stewardship and therefore maximize their contribution to antimicrobial stewardship and antimicrobial management. IMPLICATIONS FOR THE PROFESSION: There is a need to strengthen knowledge from the basic sciences, specifically pertaining to antimicrobial management, in pre-registration nurse education programmes. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. IMPACT: What Problem Did the Study Address? Nurses must protect health through understanding and applying antimicrobial stewardship knowledge and skills (Nursing and Midwifery Council 2018); however, there is no research available that has investigated nurses understanding and skills of the basic sciences associated with the antimicrobial stewardship activities in which they are involved. What Were the Main Findings? There are gaps in student nurses' knowledge of the basic sciences (specifically microbiology and prescribing) associated with the antimicrobial stewardship activities in which nurses are involved. Problem-based learning, and activities in the clinical setting, were reported as useful teaching methods, whereas online learning, was seen as less useful. Where and on Whom Will the Research Have an Impact? Pre-registration nurse education programmes. REPORTING METHOD: The relevant reporting method has been adhered to, that is, STROBE.Peer reviewe

Single site-specific integration targeting coupled with embryonic stem cell differentiation provides a high-throughput alternative to in vivo enhancer analyses

Comprehensive analysis of cis-regulatory elements is key to understanding the dynamic gene regulatory networks that control embryonic development. While transgenic animals represent the gold standard assay, their generation is costly, entails significant animal usage, and in utero development complicates time-course studies. As an alternative, embryonic stem (ES) cells can readily be differentiated in a process that correlates well with developing embryos. Here, we describe a highly effective platform for enhancer assays using an Hsp68/Venus reporter cassette that targets to the Hprt locus in mouse ES cells. This platform combines the flexibility of Gateway® cloning, live cell trackability of a fluorescent reporter, low background and the advantages of single copy insertion into a defined genomic locus. We demonstrate the successful recapitulation of tissue-specific enhancer activity for two cardiac and two haematopoietic enhancers. In addition, we used this assay to dissect the functionality of the highly conserved Ets/Ets/Gata motif in the Scl+19 enhancer, which revealed that the Gata motif is not required for initiation of enhancer activity. We further confirmed that Gata2 is not required for endothelial activity of the Scl+19 enhancer using Gata2(−/−) Scl+19 transgenic embryos. We have therefore established a valuable toolbox to study gene regulatory networks with broad applicability

Effects of S1 Cleavage on the Structure, Surface Export, and Signaling Activity of Human Notch1 and Notch2

Notch receptors are normally cleaved during maturation by a furin-like protease at an extracellular site termed S1, creating a heterodimer of non-covalently associated subunits. The S1 site lies within a key negative regulatory region (NRR) of the receptor, which contains three highly conserved Lin12/Notch repeats and a heterodimerization domain (HD) that interact to prevent premature signaling in the absence of ligands. Because the role of S1 cleavage in Notch signaling remains unresolved, we investigated the effect of S1 cleavage on the structure, surface trafficking and ligand-mediated activation of human Notch1 and Notch2, as well as on ligand-independent activation of Notch1 by mutations found in human leukemia.The X-ray structure of the Notch1 NRR after furin cleavage shows little change when compared with that of an engineered Notch1 NRR lacking the S1-cleavage loop. Likewise, NMR studies of the Notch2 HD domain show that the loop containing the S1 site can be removed or cleaved without causing a substantial change in its structure. However, Notch1 and Notch2 receptors engineered to resist S1 cleavage exhibit unexpected differences in surface delivery and signaling competence: S1-resistant Notch1 receptors exhibit decreased, but detectable, surface expression and ligand-mediated receptor activation, whereas S1-resistant Notch2 receptors are fully competent for cell surface delivery and for activation by ligands. Variable dependence on S1 cleavage also extends to T-ALL-associated NRR mutations, as common class 1 mutations display variable decrements in ligand-independent activation when introduced into furin-resistant receptors, whereas a class 2 mutation exhibits increased signaling activity.S1 cleavage has distinct effects on the surface expression of Notch1 and Notch2, but is not generally required for physiologic or pathophysiologic activation of Notch proteins. These findings are consistent with models for receptor activation in which ligand-binding or T-ALL-associated mutations lead to conformational changes of the NRR that permit metalloprotease cleavage