Looking Through a Community Lens: Innovative Ways to Integrate Community Health Nursing Competencies into All Settings of Care

Community nursing is not a new. In fact, nursing practice in the home and community is the oldest form of nursing care. Yet, nursing education's move to the university from hospital-based programs coupled with advances in health care technology located in hospitals has contributed to community nursing being overshadowed by the perceived need for nursing students to spend more clinical time in an acute-care setting. In the 1980s, the introduction of Diagnostic Related Groups (DRGs) in the acute care setting resulted in community nursing being viewed as a vital part of the healthcare continuum. Nonetheless, in today's schools of nursing, community health nursing is viewed by some faculty members as a practice that takes place solely outside the walls of the hospital and one that requires less nursing skill and knowledge—or at least less than a student needs to be successful on the National Council Licensure (NCLEX) licensure examination. Nursing students will occasionally say community health nursing is a waste of time since “it is not even on the Boards.” This viewpoint fails to recognize the competencies of nursing practice in the community and sets the stage for a us-versus-them attitude between nursing faculty who teach in medical-surgical hospital settings and those who teach in community settings

Multi-domain training enhances attentional control

Multi-domain cognitive training potentially increases the likelihood for an overlap in processing component with transfer tasks and everyday life, and hence is a promising training approach for older adults. To empirically test this, 84 healthy older adults aged 65 to 75 years were randomly assigned to one of three single-domain training conditions (inhibition, visuomotor function, spatial navigation) or to the simultaneous training of all three cognitive functions (multi-domain training condition). All participants trained on an iPad at home for 50 training sessions. Before and after the training, and at a six-month follow-up measurement, cognitive functioning and training transfer were assessed with a neuropsychological test battery including tests targeting the trained functions (near transfer) and transfer to executive functions (far transfer: attentional control, working memory, speed). Participants in all four training groups showed a linear increase in training performance over the 50 training sessions. Using a latent difference score model, the multi-domain training group, compared to the single-domain training groups, showed more improvement on the far transfer, executive attentional control composite. Individuals with initially lower baseline performance showed higher training-related improvements, indicating that training compensated for lower initial cognitive performance. At the six-month follow-up, performance on the cognitive test battery remained stable. This is one of the first studies that systematically investigated multi-domain training including comparable single-domain training conditions. Our findings suggest that multi-domain training enhances executive attentional control involved in handling several different tasks at the same time, an aspect in everyday life that is particularly challenging for older people

Robust mouse tracking in complex environments using neural networks.

The ability to track animals accurately is critical for behavioral experiments. For video-based assays, this is often accomplished by manipulating environmental conditions to increase contrast between the animal and the background in order to achieve proper foreground/background detection (segmentation). Modifying environmental conditions for experimental scalability opposes ethological relevance. The biobehavioral research community needs methods to monitor behaviors over long periods of time, under dynamic environmental conditions, and in animals that are genetically and behaviorally heterogeneous. To address this need, we applied a state-of-the-art neural network-based tracker for single mice. We compare three different neural network architectures across visually diverse mice and different environmental conditions. We find that an encoder-decoder segmentation neural network achieves high accuracy and speed with minimal training data. Furthermore, we provide a labeling interface, labeled training data, tuned hyperparameters, and a pretrained network for the behavior and neuroscience communities

Dust-Bounded ULIRGs? Model Predictions for Infrared Spectroscopic Surveys

The observed faintness of infrared fine-structure line emission along with the warm far-infrared (FIR) colors of ultraluminous infrared galaxies (ULIRGs) is a long-standing problem. In this work, we calculate the line and continuum properties of a cloud exposed to an Active Galactic Nucleus (AGN) and starburst spectral energy distribution (SED). We use an integrated modeling approach, predicting the spectrum of ionized, atomic, and molecular environments in pressure equilibrium. We find that the effects of high ratios of impinging ionizing radiation density to particle density (i.e. high ionization parameters, or U) can reproduce many ULIRG observational characteristics. Physically, as U increases, the fraction of UV photons absorbed by dust increases, corresponding to fewer photons available to photoionize and heat the gas, producing what is known as a "dust-bounded" nebula. We show that high U effects can explain the "[C II] deficit", the ~1 dex drop in the [C II] 158 micron /FIR ratio seen in ULIRGs when compared to starburst or normal galaxies. Additionally, by increasing U through increasing the ionizing photon flux, warmer dust and thus higher IRAS F(60)/F(100) ratios result. High U effects also predict an increase in [O I]63 micron /[C II] 158 micron and a gradual decline in [O III] 88 micron /FIR, similar to the magnitude of the trends observed, and yield a reasonable fit to [Ne V]14 micron /FIR ratio AGN observations.Comment: 34 pages, 13 figures, accepted for publication in the Astrophysical Journa

The Gallery 2012

This is a digital copy of the print book produced by the Gallery 2012 team. Contents: Preface p. 3, Core p. 5, Graphic Design p. 23, Illustration p. 55, Painting p. 73, Photography p. 87, Printmaking p. 105, Metals & Jewelry p. 129, Sculpture & Ceramics p.147. Files for individual sections may be viewed on the detailed metadata page by clicking on the book title.https://rdw.rowan.edu/the_gallery/1004/thumbnail.jp

Evaluation of the nutrition knowledge of sports department students of universities

<p>Abstract</p> <p>Background</p> <p>Individuals who have knowledge on the importance of adequate and balanced diet and reflect this knowledge to their behaviors are considered to be more successful in sports life. The present study aims to evaluate the nutrition knowledge of students receiving sports education in universities.</p> <p>Methods</p> <p>The study sample consists of 343 voluntary students from the Sports Departments of Hacettepe, Gazi and Ankara Universities in Ankara. The questionnaire used in the study included a demographic section, and 30 questions on true-false nutrition knowledge. For the reliability of the questionnaire, the internal consistency coefficient was calculated and the Kuder Richardson (KR-20) value was found to be 0.71. For higher reliability, 9 dysfunctional questions were excluded from the questionnaire. The research data were collected through a questionnaire form and face-to-face interviews. For the statistical analyses of the data, tables were prepared to show mean, standard deviation (<inline-formula><m:math xmlns:m="http://www.w3.org/1998/Math/MathML" name="1550-2783-8-11-i1"><m:mover accent="true"><m:mrow><m:mi>X</m:mi></m:mrow><m:mo class="MathClass-op">̄</m:mo></m:mover><m:mo class="MathClass-bin">±</m:mo><m:mi>S</m:mi><m:mi>D</m:mi></m:math></inline-formula>) and percentage (%) values. In order to determine the nutrition knowledge of students, the "independent t test" was used for nutrition lesson and gender.</p> <p>Results</p> <p>University students receiving sports education and expected to continue their professional lives on sport-related fields were determined to have the lack of knowledge on nutrition. The mean value about the nutrition knowledge of the first year students was found 11.150 ± 2.962, while the mean value of the fourth year students was 13.460 ± 3.703, and the difference is statistically significant (p = .000).</p> <p>Conclusion</p> <p>Students, coaches and teachers in physical education were found not to give the necessary importance to their diets, and they were still not aware of the importance of nutrition on performance.</p

Hemizygous Deletion on Chromosome 3p26.1 Is Associated with Heavy Smoking among African American Subjects in the COPDGene Study

Many well-powered genome-wide association studies have identified genetic determinants of self-reported smoking behaviors and measures of nicotine dependence, but most have not considered the role of structural variants, such as copy number variation (CNVs), influencing these phenotypes. Here, we included 2,889 African American and 6,187 non-Hispanic White subjects from the COPDGene cohort (http://www.copdgene.org) to carefully investigate the role of polymorphic CNVs across the genome on various measures of smoking behavior. We identified a CNV component (a hemizygous deletion) on chromosome 3p26.1 associated with two quantitative phenotypes related to smoking behavior among African Americans. This polymorphic hemizygous deletion is significantly associated with pack-years and cigarettes smoked per day among African American subjects in the COPDGene study. We sought evidence of replication in African Americans from the population based Atherosclerosis Risk in Communities (ARIC) study. While we observed similar CNV counts, the extent of exposure to cigarette smoking among ARIC subjects was quite different and the smaller sample size of heavy smokers in ARIC severely limited statistical power, so we were unable to replicate our findings from the COPDGene cohort. But meta-analyses of COPDGene and ARIC study subjects strengthened our association signal. However, a few linkage studies have reported suggestive linkage to the 3p26.1 region, and a few genome-wide association studies (GWAS) have reported markers in the gene (GRM7) nearest to this 3p26.1 area of polymorphic deletions are associated with measures of nicotine dependence among subjects of European ancestry

Feedback-informed treatment versus usual psychological treatment for depression and anxiety : a multisite, open-label, cluster randomised controlled trial

Background: Previous research suggests that the use of outcome feedback technology can enable psychological therapists to identify and resolve obstacles to clinical improvement. We aimed to assess the effectiveness of an outcome feedback quality assurance system applied in stepped care psychological services. Methods: This multisite, open-label, cluster randomised controlled trial was done at eight National Health Service (NHS) Trusts in England, involving therapists who were qualified to deliver evidence-based low-intensity or high-intensity psychological interventions. Adult patients (18 years or older) who accessed individual therapy with participating therapists were eligible for inclusion, except patients who accessed group therapies and those who attended less than two individual therapy sessions. Therapists were randomly assigned (1:1) to an outcome feedback intervention group or a treatment-as-usual control group by use of a computer-generated randomisation algorithm. The allocation of patients to therapists was quasi-random, whereby patients on waiting lists were allocated sequentially on the basis of therapist availability. All patients received low-intensity (less than eight sessions) or high-intensity (up to 20 sessions) psychological therapies for the duration of the 1-year study period. An automated computer algorithm alerted therapists in the outcome feedback group to patients who were not on track, and primed them to review these patients in clinical supervision. The primary outcome was symptom severity on validated depression (Patient Health Questionnaire-9 [PHQ-9]) and anxiety (Generalised Anxiety Disorder-7 [GAD-7]) measures after treatment of varying durations, which were compared between groups with multilevel modelling, controlling for cluster (therapist) effects. We used an intention-to-treat approach. This trial was prospectively registered with ISRCTN, number ISRCTN12459454. Findings: In total, 79 therapists were recruited to the study between Jan 8, 2016, and July 15, 2016, but two did not participate. Of these participants, 39 (51%) were randomly assigned to the outcome feedback group and 38 (49%) to the control group. Overall, 2233 patients were included in the trial (1176 [53%] were treated by therapists in the outcome feedback group, and 1057 [47%] by therapists in the control group). Patients classified as not on track had less severe symptoms after treatment if they were allocated to the outcome feedback group than those in the control group (PHQ-9 d=0·23, B=–1·03 [95% CI −1·84 to −0·23], p=0·012; GAD-7 d=0·19, B=–0·85 [–1·56 to −0·14], p=0·019). Interpretation: Supplementing psychological therapy with low-cost feedback technology can reduce symptom severity in patients at risk of poor response to treatment. This evidence supports the implementation of outcome feedback in stepped care psychological services. Funding: English NHS and Department of Health Sciences, University of York, York, UK

A paired-kidney allocation study found superior survival with HLA-DR compatible kidney transplants in the Eurotransplant Senior Program

The Eurotransplant Senior Program (ESP) has expedited the chance for elderly patients with kidney failure to receive a timely transplant. This current study evaluated survival parameters of kidneys donated after brain death with or without matching for HLA-DR antigens. This cohort study evaluated the period within ESP with paired allocation of 675 kidneys from donors 65 years and older to transplant candidates 65 years and older, the first kidney to 341 patients within the Eurotransplant Senior DR-compatible Program and 334 contralateral kidneys without (ESP) HLA-DR antigen matching. We used Kaplan-Meier estimates and competing risk analysis to assess all cause mortality and kidney graft failure, respectively. The log-rank test and Cox proportional hazards regression were used for comparisons. Within ESP, matching for HLA-DR antigens was associated with a significantly lower five-year risk of mortality (hazard ratio 0.71; 95% confidence interval 0.53-0.95) and significantly lower cause-specific hazards for kidney graft failure and return to dialysis at one year (0.55; 0.35-0.87) and five years (0.73; 0.53-0.99) post-transplant. Allocation based on HLA-DR matching resulted in longer cold ischemia (mean difference 1.00 hours; 95% confidence interval: 0.32-1.68) and kidney offers with a significantly shorter median dialysis vintage of 2.4 versus 4.1 yrs. in ESP without matching. Thus, our allocation based on HLA-DR matching improved five-year patient and kidney allograft survival. Hence, our paired allocation study suggests a superior outcome of HLA-DR matching in the context of old-for-old kidney transplantation.</p

The ALMA Spectroscopic Survey in the HUDF: Nature and Physical Properties of Gas-mass Selected Galaxies Using MUSE Spectroscopy

We discuss the nature and physical properties of gas-mass selected galaxies in the ALMA spectroscopic survey (ASPECS) of the Hubble Ultra Deep Field (HUDF). We capitalize on the deep optical integral-field spectroscopy from the Multi Unit Spectroscopic Explorer (MUSE) HUDF Survey and multiwavelength data to uniquely associate all 16 line emitters, detected in the ALMA data without preselection, with rotational transitions of carbon monoxide (CO). We identify 10 as CO(2–1) at 1 < z < 2, 5 as CO(3–2) at 2 < z < 3, and 1 as CO(4–3) at z = 3.6. Using the MUSE data as a prior, we identify two additional CO(2–1) emitters, increasing the total sample size to 18. We infer metallicities consistent with (super-)solar for the CO-detected galaxies at z „ 1.5, motivating our choice of a Galactic conversion factor between CO luminosity and molecular gas mass for these galaxies. Using deep Chandra imaging of the HUDF, we determine an X-ray AGN fraction of 20% and 60% among the CO emitters at z ∼ 1.4 and z ∼ 2.6, respectively. Being a CO-flux-limited survey, ASPECS-LP detects molecular gas in galaxies on, above, and below the main sequence (MS) at z ∼ 1.4. For stellar masses …1010 (1010.5) M, we detect about 40% (50%) of all galaxies in the HUDF at 1 < z < 2 (2 < z < 3). The combination of ALMA and MUSE integral-field spectroscopy thus enables an unprecedented view of MS galaxies during the peak of galaxy formation