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.
Background: Crohn's disease (CD) is an immunological disorder associated with chronic inflammatory process of several unspecific regions of gastrointestinal tract but frequently detected in the terminal Ilium and proximal colon or both. This disease frequently presented with various oral manifestations as a consequence of inflammatory process of the disease, nutritional deficiency or medications side effects. Several therapeutic approaches have been developed for CD management that are targeting the inflammatory process and directed at controlling the host immune response. Immunosuppressants such as Azathioprine and anti-TNF α agents as well as the combination of them have been widely used as an effective therapeutic modality with a bett
... Show MoreThe research aims mainly to the role of the statement style costs on the basis of activity based on performance (PFABC) to reduce production cost and improve the competitive advantage of economic units and industrial under the modern business environment dominated by a lot of developments and changes rapidly, which necessitates taking them and criticize them to ensure survival and continuity. The research problem is the inability of traditional cost methods of providing useful information to the departments of units to take many administrative decisions, particularly decisions related to the product and calculating the costs of the quality of the sound and the availability of the need and the ability to replace methods capa
... Show MoreBackground: Chronic kidney disease is a gradual loss of kidney function with diabetes and hypertension as the leading cause. Chronic kidney disease is one of these systemic diseases that can affect salivary contents. Aims: This study aimed to assess salivary immunoglobulin A, interleukin-6 and C- reactive protein in chronic kidney disease patients on hemodialysis and those on conservative treatment in comparison with control subjects. Materials and methods: Ninety subjects were included in this study divided into three groups: 30 patients with chronic kidney disease on hemodialysis for at least 6 months ago; 30 patients with chronic kidney disease on conservative treatment and 30 healthy control subjects. Secretory immunoglobulin A, inte
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All central air conditioning systems contain piping system with various components, sizes, material, and layouts. If such systems in operating mode, the flow in piping system and its component such as valves can produce severe vibration due to some flow phenomenon’s. In this research, experimental measurements and numerical simulation are used to study the flow-induced vibration in valves. Computational fluid dynamics (CFD) concepts are included with one-way and two-way fluid-structure interaction concepts by using finite element software Package (ANSYS 14.57). Detection analysis is performed on flow characteristics under operation conditions and relations with structural vibration. Most of
... Show MoreExperimental and numerical investigations of the centrifugal pump performance at non-cavitating and cavitating flow conditions were carried out in the present study. Experiments were performed by applying a vacuum to a closed-loop system to investigate the effects of the net positive suction head available (NPSHa), flow rate, water temperature and pump speed on the centrifugal pump performance. Accordingly, many of the important parameters concerning cavitation phenomenon were calculated. Also, the noise which is accompanied by cavitation was measured. Numerical analysis was implemented for two phase flow (the water and its vapor) using a 2-D simulation by ANSYS FLUENT software to investigate the internal flow of centrifugal pump under c
... Show MoreGlobal warming has had considerable effects on vital ecosystems, which has also been caused by increased temperatures and CO2 that follow changes in different abiotic factors, which poses threats to mangrove forests environment. This research was conducted to examine the physiological and morphological characteristics of the Rhizophora apiculata mangrove regarding higher air temperature for the variety of tree species that respond to climate change. Seedlings were cultivated for three months in regulated growth chambers with three varying temperatures of 38°C, 21°C under CO2 at 450 ppm, and ambient CO2 concentration i.e., 450 ± 20 ppm under average temperature at 28°C as the control condition
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