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.
Braces in straight bridge systems improve the lateral-torsional buckling resistance of the girders by reducing the unbraced length, while in horizontally curved and skew bridges, the braces are primary structural elements for controlling deformations by engaging adjacent girders to act as a system to resist the potentially large forces and torques caused by the curved or skewed geometry of the bridge. The cross-frames are usually designed as torsional braces, which increase the overall strength and stiffness of the individual girders by creating a girder system that translates and rotates as a unit along the bracing lines. However, when they transmit the truck’s live load forces, they can produce fatigue cracks at their connection
... Show MoreThe CuInSe2 (CIS) nanocrystals are synthesized by arrested precipitation from molecular precursors are added to a hot solvent with organic cap- ping ligands to control nanocrystal formation and growth. CIS thin films deposited onto glass substrate by spray - coating, then selenized in Ar- atmosphere to form CIS thin films. PVs were made with power conversion efficiencies of 0.631% as -deposited and 0.846% after selenization, for Mo coated, under AM 1.5 illumination. X-ray diffraction (XRD) and energy dispersive spectroscopy (EDS) analysis it is evident that CIS have the chalcopyrite structure as the major phase with a preferred orientation along (112) direction and the atomic ratio of Cu : In : Se in the nanocrystals is nearly 1 : 1 : 2
The taxonomy of Ficus L., 1753 species is confusing because of the intense morphological variability and the ambiguity of the taxa. This study handled 36 macro-morphological characteristics to clarify the taxonomic identity of the taxa. The study revealed that Ficus is represented in the Egyptian gardens with forty-one taxa; 33 species, 4 subspecies and 4 varieties, and classified into five subgenera: Ficus Corner, 1960; Terega Raf., 1838; Sycomorus Raf., 1838; Synoecia (Miq.) Miq., 1867, and Spherosuke Raf.,1838; out of them seven were misidentified. Amongst, four new Ficus taxa were recently introduced to Egypt namely: F. lingua subsp. lingua Warb. ex De Wild. & T. Durand, 1901; F. pumila L., 1753; F. rumphii Blume, 1825, and F. su
... Show MoreCase Report.
To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result.
A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal spli
Objective: The study aimed to assess the postoperative nurses' intervention for the patients with laparoscopic
cholecystectomy and to determine the relationship between Nurses' interventions and their demographic
characteristics.
Methodology: Quantitative design (a descriptive study) was started from 20th November 2012 up to 1st
September 2013. Non-probability (purposive sample) of (50) nurses, who were working in surgical wards, were
selected from Baghdad teaching hospitals (Baghdad Teaching Hospital, Digestives System and Liver Teaching
Hospital, AL-Kindy Teaching Hospital, and AL-Kadhimiyia Teaching Hospita). The data were collected through
the use of a constructed questionnaire, which consisted of two parts; the
The present study focuses on synthesizing solar selective absorber thin films, combining nanostructured, binary transition metal spinel features and a composite oxide of Co and Ni. Single-layered designs of crystalline spinel-type oxides using a facile, easy and relatively cost-effective wet chemical spray pyrolysis method were prepared with a crystalline structure of MxCo3−xO4. The role of the annealing temperature on the solar selective performance of nickel-cobalt oxide thin films (∼725 ± 20 nm thick) was investigated. XRD analysis confirmed the formation of high crystalline quality thin films with a crystallite si