Identifying Elements of a Climate for Sustainability

Sustainability as an area of research is growing in importance not only among academicians, but practitioners as well. A 2010 Accenture study of 700 CEOs found that 93% identified sustainability as important to the long term future success of their organizations. Utilizing CEO sustainability statements Content Analysis was conducted to understand and identify those key elements necessary for a climate for sustainability. A climate for sustainability is one in which sustainability policies, practices, and procedures drive behaviors that are rewarded, supported, and expected within an organization. Content analysis of CEO statements from organizations recognized for both their sustainability practices as CRO’s 100 Best Corporate Citizens and as CEO members of the Sustainability Business Roundtable (BRT) were evaluated to better understand and identify these key elements necessary for a climate for sustainability. For organizations practicing sustainability and for those wishing to practice sustainability both identify that knowing where to begin or what to measure is still relatively unknown. This research seeks to identify the key elements necessary for a climate for sustainability through the development of a sustainability assessment tool. This tool will provide researchers and organizations alike with the foundation for further study and analysis

Implementing Person Centered Care in Nursing Homes

Nursing homes are likely the most complex of all the healthcare organizations in the United States. Charged with caring for frail and disabled elders, nursing homes operate under high regulatory scrutiny and low public opinion. Despite efforts to improve, many nursing home residents receive poor care. By focusing on residents' needs and preferences rather than operational efficiency, person centered care represents an innovation in nursing home care. This dissertation applies innovation implementation theory to understand what might help or hinder the implementation of person centered care in nursing homes. The theoretical framework posits that the constructs of management support, financial resources, implementation policies and procedures, and implementation climate are positively related to the implementation effectiveness of the innovation. Because of factors specific to the nursing home setting, the framework was adapted by adding four constructs: 1) innovation characteristics; 2) organizational stability; 3) innovation-values fit; and 4) innovation-operations fit. Data for this research come from the Person Centered Care (PCC) Program, conducted by The Carolina's Center for Medical Excellence and funded by the Centers for Medicare & Medicaid Services. Eight North Carolina nursing homes participated in the PCC Program from Sept 2004 to August 2005. Using complementary methodologies, two studies were carried out. Study 1 used 24 semi-structured interviews and content analytic methods to understand direct caregivers' views about the climate for the implementation of person centered care in their nursing home. Study 2 employed a multiple case study design and pattern matching logic to determine why some nursing homes were more effective than others in implementing person centered care. Rival hypotheses were tested to examine if the presence of electronic communications or if knowledge experts' and nursing homes leaders' confidence to accomplish PCC Program goals were associated with implementation effectiveness. Implementation effectiveness was positively associated with one aspect of implementation policies and practices - management communications. Implementation effectiveness was also positively associated with implementation climate as viewed by direct caregivers. Counter to theoretical predictions, implementation effectiveness was positively associated with an innovation characteristic - scope of the project. Implementation effectiveness was not associated with the presence of financial resources, management support, organizational stability, or other implementation policies and practices, including the amount of time and training offered to workers to learn about person centered care. Rival hypothesis testing demonstrated that knowledge experts' and facility leaders' confidence to achieve PCC Program goals was associated with implementation effectiveness. This research demonstrates that implementation was more effective when characteristics of the innovation fostered smooth operations in the daily routines of direct caregivers, the worker group most responsible for the implementation of person centered care. Implementation was also more effective when leaders communicated about the innovation in a way that demonstrated cultural sensitivity to the attributes of key worker groups. Based on their confidence to achieve PCC Program goals, knowledge experts and facility leaders could accurately forecast their homes' implementation effectiveness early in the change process. This finding suggests that a more fine-grained understanding of implementation effectiveness may lie in understanding leaders' and workers' perceptions about their organization's readiness and capacity to implement broad-based change

Biogeochemical implications of biodiversity and community structure across multiple coastal ecosystems

Small-scale experiments and theory suggest that ecological functions provided by communities become more stable with increased species richness. Whether these patterns manifest at regional spatial scales and within species-rich communities (e.g., coral reefs) is largely unknown. We quantified five biogeochemical processes, and an aggregate measure of multifunctionality, in species-rich coastal fish communities to test three questions: (1) Do previously predicted biodiversity-ecosystem-function relationships hold across large spatial scales and in highly diverse communities? (2) Can additional covariates of community structure improve these relationships? (3) What is the role of community biomass and functional group diversity in maintaining biogeochemical processes under various scenarios of species loss across ecosystem types? These questions were tested across a large regional gradient of coral reef, mangrove and seagrass ecosystems. Statistical models demonstrated that species richness and the mean maximum body size per species strongly predicted biogeochemical processes in all ecosystem types, but functional group diversity was only a weak predictor. Simulating three scenarios of species loss demonstrated that conserving community biomass alone increased the ability for communities to maintain ecosystem processes. Multifunctionality of biogeochemical processes was maintained least in simulations that conserved biomass and community structure, underscoring the relative lack of importance of community structure in maintaining multiple simultaneous ecosystem functions in this system. Findings suggest that conserving community biomass alone may be sufficient to sustain certain biogeochemical processes, but when considering conservation of multiple simultaneous biogeochemical processes, management efforts should focus first on species richness

A drug-incorporated-microparticle-eggshell-membrane-scaffold (DIMES) dressing: a novel biomaterial for localised wound regeneration

Chronic wounds affect millions of people annually and have emotional and financial Implications in addition to health issues. The current treatment for chronic wounds involves the repeated use of bandages and drugs such as antibiotics over an extended period. A cost-effective and convenient solution for wound healing is the development of drug-incorporated bandages. This study aimed to develop a biocompatible bandage made of drug-incorporated poly (lactic-co-glycolic acid) (PLGA) microparticles (MPs) and eggshell membrane (ESM) for cornea wound healing. ESM has desirable properties for wound healing and can be isolated from eggshells using acetic acid or ethylenediaminetetraacetic acid (EDTA) protocols. Fluorescein isothiocyanate-labelled Bovine Serum Albumin (FITC-BSA) was used as a model drug, and the PLGA MPs were fabricated using a solvent extraction method. The MPs were successfully attached to the fibrous layer of the ESM using NaOH. The surface features of the ESM samples containing MPs were studied using a field emission scanning electron microscope (FESEM) and compared with blank ESM images. The findings indicated that the MPs were attached to the ESM fibres and had similar shapes and sizes as the control MPs. The fibre diameters of the MPs samples were assessed using Fiji-ImageJ software, and no significant changes were observed compared to the blank ESM. The surface roughness, Ra values, of the MPs incorporated ESM samples were evaluated and compared to the blank ESM, and no significant changes were found. Fourier transform infrared (FTIR) spectroscopy was used to analyse the chemical Composition of the bandage, and the spectra showed that the FBM were effectively incorporated into the ESM. The FTIR spectra identified the major peaks of the natural ESM and the PLGA polymer in the bandage. The bandage was transparent but had a reduced visibility in the waterproof test card method. The bandage achieved sustained drug release up to 10 days and was found to be biocompatible and non-toxic in a chorioallantoic membrane (CAM) assay. Overall, the drug-incorporated PLGA MPs-ESM bandage has great potential for treating chronic wounds

The chicken eggshell membrane: a versatile, sustainable, biological material for translational biomedical applications

Naturally derived materials are often preferred to than synthetic materials for biomedical applications due to their innate biological characteristics, relative availability, sustainability, and agreement with conscientious end-users. The chicken eggshell membrane (ESM) is an abundant resource with a defined structural profile, chemical composition, and validated morphological and mechanical characteristics. These unique properties have not only allowed the ESM to be exploited within the food industry, but has also led to it be considered for other novel translational applications such as tissue regeneration and replacement, filtration aids and barrier devices, and environmental health engagement. However, challenges still exist in order to enhance the native ESM: the need to improve its mechanical properties, the ability to combine/join fragments of ESM together, and the addition or incorporation of drugs/growth factors to advance its therapeutic capacity. This review article provides a succinct background to the native ESM, its extraction, isolation, and consequent physical, mechanical and biological characterisation including possible approaches to enhancement. Moreover, it also highlights current applications of the ESM in regenerative medicine and hints at future novel applications in which this novel biomaterial could be exploited to beneficial use

Leaf litter nutrient uptake in an intermittent blackwater river : influence of tree species and associated biotic and abiotic drivers

Author Posting. © The Author(s), 2014. This is the author's version of the work. It is posted here by permission of British Ecological Society for personal use, not for redistribution. The definitive version was published in Functional Ecology 29 (2015): 849-860, doi:10.1111/1365-2435.12399.Organic matter may sequester nutrients as it decomposes, increasing in total N and P mass via multiple uptake pathways. During leaf litter decomposition, microbial biomass and accumulated inorganic materials immobilize and retain nutrients, and therefore both biotic and abiotic drivers may influence detrital nutrient content. We examined the relative importance of these types of nutrient immobilization and compared patterns of nutrient retention in recalcitrant and labile leaf litter. Leaf packs of water oak (Quercus nigra), red maple (Acer rubrum) and Ogeechee tupelo (Nyssa ogeche) were incubated for 431 days in an intermittent blackwater stream and periodically analyzed for mass loss, nutrient and metal content, and microbial biomass. These data informed regression models explaining temporal changes in detrital nutrient content. Informal exploratory models compared estimated biologically-associated nutrient stocks (fungal, bacterial, leaf tissue) to observed total detrital nutrient stocks. We predicted that (1) labile and recalcitrant leaf litter would act as sinks at different points in the breakdown process, (2) plant and microbial biomass would not account for the entire mass of retained nutrients, and (3) total N content would be more closely approximated than total P content solely from nutrients stored in leaf tissue and microbial biomass, due to stronger binding of P to inorganic matter. Labile litter had higher nutrient concentrations throughout the study. However, lower mass loss of recalcitrant litter facilitated greater nutrient retention over longer incubations, suggesting that it may be an important long-term sink. N and P content were significantly related to both microbial biomass and metal content, with slightly stronger correlation to metal content over longer incubations.This work was funded by the USDA-CSREES Integrated Research, Education, and Extension Competitive Grants Program’s National Integrated Water Quality Program (Award No. 2004-5113002224), Hatch & State funds allocated to the Georgia Agricultural Experiment Stations, USDA-ARS CRIS project funds, and a Student Research Grant awarded to Andrew Mehring from the Odum School of Ecology, University of Georgia.2016-01-2

A Sustainable, Green-Processed, Ag-Nanoparticle-Incorporated Eggshell-Derived Biomaterial for Wound-Healing Applications

The eggshell membrane (ESM) is a natural biomaterial with unique physical and mechanical properties that make it a promising candidate for wound-healing applications. However, the ESM’s inherent properties can be enhanced through incorporation of silver nanoparticles (AgNPs), which have been shown to have antimicrobial properties. In this study, commercially produced AgNPs and green-processed AgNPs were incorporated into ESM and evaluated for their physical, biological, and antimicrobial properties for potential dermal application. The ESM was extracted using various techniques, and then treated with either commercially produced AgNPs (Sigma-Aldrich, Poole, UK) or green-synthesized AgNPs (Metalchemy, London, UK) to produce AgNPs-ESM samples. The physical characteristics of the samples were evaluated using scanning electron microscopy (SEM), Fourier Transform Infrared (FTIR) spectroscopy, and the biological properties were assessed through in vitro studies using human dermal fibroblasts (HDFs) and BJ cells. The SEM analysis of the AgNPs-ESM samples showed localization of AgNPs on the ESM surface, and that the ESM maintained its structural integrity following AgNP incorporation. The FTIR confirmed loading of AgNPs to ESM samples. The biological studies showed that the 5 μg/mL AgNPs-ESM samples were highly biocompatible with both HDFs and BJ cells, and had good viability and proliferation rates. Additionally, the AgNPs-ESM samples demonstrated pro-angiogenic properties in the CAM assay, indicating their potential for promoting new blood vessel growth. Assessment of the antimicrobial activity of the enhanced AgNPs/ESMs was validated using the International Standard ISO 16869:2008 methodology and exploited Cladosporium, which is one of the most commonly identified fungi in wounds, as the test microorganism (≥5 × 106 cells/mL). The AgNPs-ESM samples displayed promising antimicrobial efficacy as evidenced by the measured zone of inhibition. Notably, the green-synthesized AgNPs demonstrated greater zones of inhibition (~17 times larger) compared to commercially available AgNPs (Sigma-Aldrich). Although both types of AgNP exhibited long-term stability, the Metalchemy-modified samples demonstrated a slightly stronger inhibitory effect. Overall, the AgNPs-ESM samples developed in this study exhibited desirable physical, biological, and antimicrobial properties for potential dermal wound-dressing applications. The use of green-processed AgNPs in the fabrication of the AgNPs-ESM samples highlights the potential for sustainable and environmentally friendly wound-healing therapies. Further research is required to assess the long-term biocompatibility and effectiveness of these biomaterials in vivo

Therapeutic Application of an Ag-Nanoparticle-PNIPAAm-Modified Eggshell Membrane Construct for Dermal Regeneration and Reconstruction

Current therapeutic treatments for the repair and/or replacement of damaged skin following disease or traumatic injury is severely limited. The chicken eggshell membrane (ESM) is a unique material: its innate physical and mechanical characteristics offer optimal barrier properties and, as a naturally derived extract, it demonstrates inherent biocompatibility/biodegradability. To further enhance its therapeutic and clinical potential, the ESM can be modified with the thermo-responsive polymer, poly(N-isopropylacrylAmide) (PNIPAAm) as well as the incorporation of (drug-loaded) silver nanoparticles (AgNP); essentially, by a simple change in temperature, the release and delivery of the NP can be targeted and controlled. In this study, ESM samples were isolated using a decellularization protocol, and the physical and mechanical characteristics were profiled using SEM, FT-IR, DSC and DMA. PNIPAAm was successfully grafted to the ESM via amidation reactions and confirmed using FT-IR, which demonstrated the distinctive peaks associated with Amide A (3275 cm−1), Amide B (2970 cm−1), Amide I (1630 cm−1), Amide II (1535 cm−1), CH2, CH3 groups, and Amide III (1250 cm−1) peaks. Confirmation of the incorporation of AgNP onto the stratified membrane was confirmed visually with SEM, qualitatively using FT-IR and also via changes in absorbance at 380 nm using UV-Vis spectrophotometry during a controlled release study for 72 h. The biocompatibility and cytotoxicity of the novel constructs were assessed using human dermal fibroblast (HDFa) and mouse dermal fibroblast (L929) cells and standard cell culture assays. Metabolic activity assessment (i.e., MTS assay), LDH-release profiles and Live/Dead staining demonstrated good attachment and spreading to the samples, and high cell viability following 3 days of culture. Interestingly, longer-term viability (>5 days), the ESM-PNIPAAm and ESM-PNIPAAm (AgNP) samples showed a greater and sustained cell viability profile. In summary, the modified and enhanced ESM constructs were successfully prepared and characterized in terms of their physical and mechanical profiles. AgNP were successfully loaded into the construct and demonstrated a desirable release profile dependent on temperature modulation. Fibroblasts cultured on the extracted ESM samples and ESM-PNIPAAm demonstrated high biocompatibility in terms of high cell attachment, spreading, viability and proliferation rates. As such, this work summarizes the development of an enhanced ESM-based construct which may be exploited as a clinical/therapeutic wound dressing as well as a possible application as a novel biomaterial scaffold for drug development

Reduced T2* Values in Soleus Muscle of Patients with Type 2 Diabetes Mellitus

Tissue water transverse relaxation times (T2) are highly sensitive to fluid and lipid accumulations in skeletal muscles whereas the related T2* is sensitive to changes in tissue oxygenation in addition to factors affecting T2. Diabetes mellitus (DM) affects muscles of lower extremities progressively by impairing blood flow at the macrovascular and microvascular levels. This study is to investigate whether T2 and T2* are sensitive enough to detect abnormalities in skeletal muscles of diabetic patients in the resting state. T2 and T2* values in calf muscle of 18 patients with type 2 DM (T2DM), 22 young healthy controls (YHC), and 7 age-matched older healthy controls (OHC) were measured at 3T using multi-TE spin echo and gradient echo sequences. Regional lipid levels of the soleus muscle were also measured using the Dixon method in a subset of the subjects. Correlations between T2, T2*, lipid levels, glycated hemoglobin (HbA1c) and presence of diabetes were evaluated. We found that T2 values were significantly higher in calf muscles of T2DM subjects, as were T2* values in anterior tibialis, and gastrocnemius muscles of T2DM participants. However, soleus T2* values of the T2DM subjects were significantly lower than those of the older, age-matched HC cohort $(22.9\pm 0.5 vs 26.7\pm 0.4 ms, p<0.01)$. The soleus T2* values in the T2DM cohort were inversely correlated with the presence of diabetes (t = −3.46, p<0.001) and with an increase in HbA1c, but not with body mass index or regional lipid levels. Although multiple factors may contribute to changes in T2* values, the lowered T2* value observed in the T2DM soleus muscle is most consistent with a combination of high oxygen consumption and poor regional perfusion. This finding is consistent with results of previous perfusion studies and suggests that the soleus in individuals with T2DM is likely under tissue oxygenation stress