There is a global shortage of health care providers needed to address all levels of primary and specialty care. The recent COVID-19 pandemic also highlights the importance and added value of health professionals with specialty training in infectious diseases. In the United States, advanced practice providers (APPs) are being engaged to meet the expanding demand for generalist and specialist patient care. The history and development of advanced practice registered nurses (APRNs) and physician assistants (PAs), are discussed as collaborative healthcare providers to promote better understanding of the ways they can be incorporated into a healthcare system. An example of how APPs are utilized to provide both inpatient and outpatient care of persons with infectious diseases is illustrated at our midwestern United States regional medical center. Especially relevant for regions of the world where both nurses and physicians are in short supply, this paper identifies ways that healthcare leaders can support, develop and strategically utilize APPs to provide critically necessary functions and achieve excellent outcomes. Challenges to future healthcare administration are articulated and compared with World Health Organization roadmap objectives for nursing that can be expanded to better utilize all APPS as valuable healthcare professionals.
This article examines and proposes a dietary chain model with a prey shelter and alternative food sources. It is anticipated that mid-predators' availability is positively correlated with the number of refuges. The solution's existence and exclusivity are examined. It is established that the solution is bounded. It is explored whether all potential equilibrium points exist and are locally stable. The Lyapunov approach is used to investigate the equilibrium points' worldwide stability. Utilizing a Sotomayor theorem application, local bifurcation is studied. Numerical simulation is used to better comprehend the dynamics of the model and define the control set of parameters.
In this study, the optical and thermal performance of a Parabolic Trough Collector PTC system is investigated theoretically. A series of numerical simulations and theoretical analysis has been conducted to investigate the effect of the receiver geometry and location relative to the focal line on its optical performance. The examined receiver geometries are circular, square, triangular, elliptical and a new design of circular‐ square named as channel receiver. The thermal performance of PTC is studied for different flow rates from (0.27 to 0.6 lpm) theoretically. Results showed that the best optical design is the channel receiver with an optical efficiency of 84% while the worst is the elliptical
This paper reports test results and describes a numerical investigation of the effectiveness of using carbon fibre reinforced polymer (CFRP) fabrics for strengthening concrete cylinders that have been undamaged and damaged due to heating under preload. The purpose of this research was to investigate whether there is any difference in the performance of CFRP-wrapped cylinders if the wrapping is done under preload, and those for which neither heating, cooling nor wrapping was done under preload. The cylinders were exposed to 30% of maximum load at ambient temperature during heating and cooling before being wrapped under preload. Of 18 Ø 100 × 200 mm identical cylinders, 6 were left as control samples without heating, 12 were exposed t
... Show MorePermanent deformation, fatigue and thermal cracking are the three typical distresses of flexible pavement. Using hydrated lime (HL) into the conventional limestone mineral additive has been widely practiced, including in Europe, to improve the mechanical properties of hot mix asphalt (HMA) concrete and as the result the durability of the constructed pavement. Large number of experimental studies have been reported to find the optimum addition of HL for the improvement on HMA concrete mechanical properties, moisture susceptibility and fatigue resistance. Pavement in service is under complex thermomechanical stress-strain conditions due to coupled atmospheric and surrounding environment temperature variation and the traffic loading. To predic
... Show MoreThe trade war, of course, leads to a sharp tension in international relations because the economy is the lifeblood of the states. In the world of trade and economy, countries began to lean towards cooperation. Economic relations after World War II were more liberal, trade barriers were removed and global trade became more flexible and smooth
Electrochemical Grinding (ECG) process is a mechanically assisted electrochemical process for material processing. The process is able to successfully machine electrically conducting harder materials at faster rate with improved surface finish and dimensional control. This research studies the effect of applied current, electrolyte concentration, spindle speed and the gap between workpiece and tool on hardness and material removal rate during electrochemical grinding for stainless steel 316. The characteristic features of the electrochemical grinding process are explored through Taguchi-design-based experimental studies. The better hardness can be obtained at 10 A of the current, 150 g/l of the electrolyte concentration, 0.3 mm of gap an
... Show MoreMO Khudhair, 2020
The results of the analysis showed that there is a correlation between ISO 9001 and the competitive advantage, which shows that the implementation of ISO 9001 in the private colleges achieves a competitive advantage through its ability to employ the entrance of quality systems management according to ISO 9001, By focusing on improving the quality of its educational services in accordance with a clear and understandable policy for all and its ability to meet the expectations, expectations and wishes of students and beneficiaries, which leads to lower costs of operations compared to other colleges and achieve a higher level of reliability and quality and value of services provided and rapid respon
... Show MoreType 2 diabetes mellitus is often characterized by hyperglycemia as a result of increased insulin resistance in hepatic/peripheral tissues and pancreactic B-cell dysfunction. Approximately 92% of patients with type 2 diabetes mellitus demonstrate insulin resistance, however hyperglycemia is always a consequence of insulin deficiency. This study was done on 120 patients newly diagnosed diabetes type 2 characterized by dyslipidemia that is increased triglycerides and decreased HDL. Hypoglycemia and weight gain are common problem with oral sulfonyl urea drugs. In this work three different oral hypoglycemic drugs repaglinide and glibenclamide (insulin secretagogues) and rosiglitazone (insulin sensitizer) were used for treatment of patients w
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