Synopsis Photoprocesses of the endohedral fullerene ions Sc3N@C80+ and Sc3N@C80− in the gas phase have been experimentally investigated with emphasis on the specific effects of the encapsulated ...trimetallic nitride cluster Sc3N on the observed reaction yields. Clear evidence of photoexcitation near the Sc L edge is obtained with the dominating contributions visible in the one- and two-electron-removal channels. The experiments are accompanied by model calculations employing density functional theory (DFT).
Since many of the frailest and most vulnerable Americans reside in nursing homes, medical students need focused education and training pertaining to this setting. A unique cooperative learning ...experience utilizing the jigsaw method was developed to engage and expose students to the institutional long-term and postacute care (LTPAC) setting and the roles of personnel there. To accomplish these goals, small groups of medical students interviewed LTPAC personnel about their role, generally, and in relation to a specific patient case. These groups were then rearranged into new groups containing 1 student from each of the original groups plus a faculty facilitator. Each student in the new groups taught about the role of the LTPAC professional they interviewed. To assess the effectiveness of this learning experience, students and LTPAC personnel provided written feedback and rated the activity using a 5-point Likert scale (1 = worst; 5 = best). Students also took a knowledge test. The activity received ratings from students of 3.65 to 4.12 (mean = 3.91). The knowledge test results indicated that students understood the roles of the LTPAC personnel. In general, the jigsaw exercise was well-received by participants and provided an effective means of introducing medical students to the nursing home environment.
Aims
To develop test methods and evaluate survival of Bacillus anthracis Ames, B. anthracis ∆Sterne and B. thuringiensis Al Hakam spores after exposure to PES‐Solid (a solid source of peracetic ...acid), including PES‐Solid formulations with bacteriostatic surfactants.
Methods and Results
Spores (≥7 logs) were dried on seven different test materials and treated with three different PES‐Solid formulations (or preneutralized controls) at room temperature for 15 min. There was either no spore survival or less than 1 log (<10 spores) of spore survival in 56 of 63 test combinations (strain, formulation and substrate). Less than 2·7 logs (<180 spores) survived in the remaining seven test combinations. The highest spore survival rates were seen on water‐dispersible chemical agent resistant coating (CARC‐W) and Naval ship topcoat (NTC). Electron microscopy and Coulter analysis showed that all spore structures were intact after spore inactivation with PES‐Solid.
Conclusions
Three PES‐Solid formulations inactivated Bacillus spores that were dried on seven different materials.
Significance and Impact of the Study
A test method was developed to show that PES‐Solid formulations effectively inactivate Bacillus spores on different materials.
Photoionization of endohedral \({{\rm{Sc}}}_{3}{{\rm{N@C}}}_{80}^{+}\) fullerene ions is investigated using synchrotron radiation in the energy range 280 to 420 eV. In the product channels ...\({{\rm{Sc}}}_{3}{{\rm{N@C}}}_{80}^{2+}\) and \({{\rm{Sc}}}_{3}{{\rm{N@C}}}_{78}^{2+}\) clear signaiures of the cross section contributions arising from L-shell photoabsorption by the encapsulated Sc atoms have been detected.
Synopsis Absolute cross sections for photoprocesses near the K edge of Ne+ ions and neutral Ne atoms have been determined at resolving powers up to 27000 facilitating the precise determination of ...natural widths of the most prominent resonances as well as the associated transition probabilities and branching ratios.
To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care.
The study design was a qualitative, observational study of nursing home staff ...perceptions of the implementation of culture change in each of 3 nursing homes. We conducted 7 focus groups of licensed and unlicensed nursing staff, medical care providers, and administrators. Questions explored perceptions of facilitators and barriers to culture change. Using a template organizing style of analysis with immersion/crystallization, themes of barriers and facilitators were coded for adaptive challenges and leadership.
Six key themes emerged, including relationships, standards and expectations, motivation and vision, workload, respect of personhood, and physical environment. Within each theme, participants identified barriers that were adaptive challenges and facilitators that were examples of adaptive leadership. Commonly identified challenges were how to provide person-directed care in the context of extant rules or policies or how to develop staff motivated to provide person-directed care.
Implementing culture change requires the recognition of adaptive challenges for which there are no technical solutions, but which require reframing of norms and expectations, and the development of novel and flexible solutions. Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges.
Multiple ionization of ions subsequent to absorption of a single photon has been studied employing a photon-ion merged-beam setup at the PETRA III synchrotron radiation facility of DESY in Hamburg. ...Absolute cross sections for single, double and triple ionization of C+ ions were measured with emphasis on specific well defined terms of K-shell excited C+. In particular, the terms C+ (1s2s22p2 2D,2P) were excited from the ground level of C+. Subsequent autoionization processes resulted in the production of C2+, C3+ and C4+ ions. The associated decay mechanisms are single-Auger, double-Auger and triple-Auger decay. The observation of C4+ products arising from C+(1s2s22p2 2D,2P) unambiguously confirmed the existence of triple-Auger decay, i.e., a process in which 4 electrons interact with one another such that one fills the K-shell vacancy and the others are simultaneously ejected. The experiment yields branching ratios for the Auger decay channels as well as individual decay rates for autoionization and radiative stabilization of the C+(1s2s22p2 2D,2P) terms.
OBJECTIVES
To identify and describe geriatric scholarly concentration programs (GSCPs) among U.S. medical schools.
DESIGN
Survey and interview.
SETTING
Allopathic and osteopathic medical schools in ...the United States.
PARTICIPANTS AND METHODS
We used a systematic internet search, forum postings, and word of mouth to identify all U.S. allopathic and osteopathic medical schools with existing GSCPs. GSCP directors completed an online survey. We conducted interviews with key faculty of two representative programs.
MEASUREMENTS
GSCP size, goals, duration of activity, requirements, funding sources, and student outcomes.
RESULTS
Nine GSCPs were identified, and eight responded to the survey. The number of current medical student participants ranged from 0 to 28, with a mean cohort size of 23. All programs included the following components: formal mentoring, clinical experiences in geriatric medicine beyond the standard medical school curriculum, and research. Half required students to complete an independent research project. GSCPs reported challenges, including low student interest, lack of availability of faculty mentors, and budget constraints; however, student satisfaction was high. Among three programs that reported on the residency matches of their graduates, half matched into a residency with a geriatric subspecialty training option.
CONCLUSIONS
Among U.S. medical schools, there are few GSCPs. The GSCP model may help compensate for limited exposure to geriatric competencies in the standard medical school curriculum for a subset of interested students and may increase interest in geriatrics subspecialty training.
Urinary tract infection (UTI) is common in long-term care (LTC) residents; however, most infections are asymptomatic and do not require treatment. Differentiating asymptomatic from symptomatic UTI is ...challenging, because LTC residents typically have chronic genitourinary complaints, multiple comorbid illnesses, and communication barriers. Although consensus guidelines have been proposed to improve the accuracy of identifying symptomatic UTIs and minimize treatment of asymptomatic UTIs, diagnostic accuracy is not yet optimized. Strategies for prevention of UTI are unsatisfactory and require further study; nevertheless, there is some evidence for the efficacy of cranberry products and vaginal estrogen to prevent recurrent UTI in women.
Difficult behaviors are relatively common challenges that can occur throughout the natural progression of dementia, but are particularly common in the mid to late stages of disease. These behaviors ...can be challenging to manage in nursing and assisted care facilities, and can cause distress to the caregivers and to the patients themselves. Our ability to manage these symptoms can have a profound effect on the patient's quality of life. This article reviews the appropriate assessment of behavioral and psychological symptoms of dementia (BPSD) and the literature supporting various nonpharmacologic and pharmacologic treatments. Nonpharmacologic approaches should be the initial focus for treatment of most BPSD, but should these prove inadequate, a variety of medications are available with varying degrees of clinical research to support their use in ameliorating BPSD.
PDF
