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.
In this study, the effect of intersecting ribs with inclined ribs on the heat transfer and flow characteristics of a high aspect ratio duct has been numerically investigated. The Relative roughness pitch (P/e) is 10 and the Reynolds number range from 35,700 to 72,800. ANSYS (Fluent-Workbench 18.0) software has been utilized to solve the Reynolds averaged Navier-Stokes (RANS) equations with the Standard k-ε turbulence model. Three ribbed models have been used in this study. Model 1 which is a just inclined ribs, Model 2 which has a single longitudinal rib at the center with inclined ribs and Model 3 which has two longitudinal ribs at the sides. The results showed that the heat transfer rate has been enhanced when the int
... Show MoreBackground This study aimed to evaluate the efficacy of once-daily liraglutide as an add-on to oral antidiabetics (OADs) on glycemic control and body weight in obese patients with inadequately controlled type 2 diabetes (T2D). Methods A total of 27 obese T2D patients who received 7 months (0.6 mg/day for the first month, 1.2 mg/day for 3 months, and 1.8 mg/day for 3 months) of liraglutide treatment as an add-on to OADs were included. Data on body weight (kg), fasting plasma glucose (FPG, mg/dL), postprandial glucose (PPG, mg/dL), and HbA1c (%), were recorded. Results Liraglutide doses of 1.2 mg/day and 1.8 mg/day were associated with significant decreases in body weight (by 8.0% and 11.9%, respectively, p < 0.01 for each) and HbA1c (by 20.0
... Show MoreThe research aims to focus on the human rights guarantees as they are subjected to continuous violations due to changes, wars and conflicts between nations and people, especially in the Arab world and the third world due to political, social, economic and environmental conditions and the failure of democratic tracks under the current reality.
Keyword: Human rights, Reality, Ambition.
Melatonin, a hormone synthesized mainly by the pineal gland, has been found in extra-pineal organs as well. It’s known as an organizer of circadian rhythms and more recently as an anti-oxidant. In addition to its role in maintaining immunity, pathophysiology of cardiovascular and neurological diseases, and as an anti-cancer agent, evidence has demonstrated that melatonin exerts a positive impact on male and female fertility primarily through oxygen scavenging effects. In In Vitro Fertilization (IVF) programs, supplementation of melatonin may be associated with better outcomes in terms of sperm quality, oocyte quality, embryo quality and pregnancy rates. This review summarizes various actions of melatonin on the body focusing on ma
... Show MoreReduction represents a form of artistic abstraction to express things with formal symbols that suggest the content of the idea, as the beauty of the design artwork cannot be unique in the form only, but in revealing its meaning as well. He resorts to shorthand to express the content of his idea related to design necessities and needs to achieve a specific function whose role is crystallized through the form that follows the function. The importance of the research was also represented in: Benefiting workers and scholars in the field of design with regard to shorthand and implicit in graphic design. The aim of the research: to identify the relationship between implicit meaning and reduced forms in graphic design. And the aesthetic of fo
... Show MoreThe development issue is considered as one of the most important matters of concern to governments, intellectuals and specialists in the contemporary world, especially in developing countries that are trying hard to move out of the afflicting underdevelopment domain to a brighter future and achieve the aspirations of those countries through organized planning which take advantage of available resources, whether material or humanitarian, in the best way possible.
The development process are taking place at multiple levels ranging from national to regional to local where the community is stimulated and excited for the cooperation, participation and preparation to perform planned change in the methods of thinking, acting and production.<
Hedging is a linguistic phenomenon used to convey interpersonal messages in spoken interaction. It is a communicative strategy which enables speakers to soften the force of utterances or moderate the assertive force of utterances. It is resulted from different features such as uncertainty, doubt, tentativeness, ambiguity, neutrality, mitigation, and subjectivity. Hedging is used widely in TV debates to make utterances more acceptable to the interlocutors. Hedges are expressions used to communicate the speaker's weak commitment to information conveyed. The utterances in debates are often hedged because in an unhedged form might sound threatening to the addressees, and, therefore, be likely to be rejected.
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