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 study introduces a series of single and pile group model tests subjected to lateral loads in . multilayered sand from Karbala, Iraq. The aim of this study is to investigate: the performance of the pile groups subjected to lateral loads; in which the pile batter inclination angle is changed; the effect of pile spacing (s/d) ratio, the influence of using different number of piles and pile group configuration. Results revealed that the performance of single negative (Reverse) Battered piles with inclination of 10° and 20° show a gain of 32% and 76 % in the ultimate lateral capacity over the regular ones. For pile groups, the use of a combination of regular, negative and positive battered piles in
... Show MoreForty six Iraqi women with PCOS were involved in this study . They were treated with metformin alone and with antioxidant agents (vitamin E or C).It was found that all patients who treated with metformin or with combination of metformin with antioxidant agents showed significant decrease in hirsutism score. The treatment of metformin with antioxidant agents is of great benefit in treatment of hirsutism in PCOS due to that there was no worsening effect after treatment. This may indicate that antioxidant agents may participate in alleviation of hirsutism so it can be said that oxidative stress may play an important role in developing of hirsutism in PCOS.
This work examines numerically the effects of particle size, particle thermal conductivity and inlet velocity of forced convection heat transfer in uniformly heated packed duct. Four packing material (Aluminum, Alumina, Glass and Nylon) with range of thermal conductivity (from200 W/m.K for Aluminum to 0.23 W/m.K for Nylon), four particle diameters (1, 3, 5 and 7 cm), inlet velocity ( 0.07, 0.19 and 0.32 m/s) and constant heat flux ( 1000, 2000 and 3000 W/ m 2) were investigated. Results showed that heat transfer (average Nusselt number Nuav) increased with increasing packing conductivity; inlet velocity and heat flux, but decreased with increasing particle size.Also, Aluminum average Nusselt number is about (0.85,2.
... Show MoreOsteoblast and osteoclast activity is disrupted in post-menopausal osteoporosis. Thus, to fully address this imbalance, therapies should reduce bone resorption and promote bone formation. Dietary factors such as phyto-oestrogens and Zn have beneficial effects on osteoblast and osteoclast activity. However, the effect of combinations of these factors has not been widely studied. We therefore examined the effect of coumestrol, daidzein and genistein in the presence or absence of zinc sulphate (Zn) on osteoclast and osteoblast activity. Osteoclast differentiation and bone resorption were significantly reduced by coumestrol (10- 7 m), daidzein (10- 5 m) and genistein (10- 7 m); and this direct anti-osteoclastic action was unaffected by Zn (10-
... Show MoreThe study aimed to effect of speed and die holes diameter in the machine on feed pellets quality. In this study was measured pellet direct measurement (%), pellet lengths (%), pellet durability (%) and pellet water absorption (%). Three die speeds 280, 300, and 320 rpm, three diameters of die holes in the machine 3, 4, and 5 mm, have been used. The results showed that increasing the pellet die speeds from 280 to 300 then to 320 rpm led to a significant decrease in direct measurement, pellet durability, and pellet water absorption was increased, whereas it did not significantly affect the pellet lengths. Increasing the die holes diameter from 3 to 4 then to 5 mm led to a significant de
Background: Interleukine-2 is a multifunctional cytokine, considered a central regulator of host resistance against a variety of pathogens and has been recently demonstrated to exert an active role in the pathogenesis of periodontal diseases. The purpose of this study was to evaluate the effect of scaling and root planning on level of IL-2 in serum and saliva of patients with chronic generalized periodontitis, in relation to clinical parameters. Materials and Methods: A total of 50 subjects were enrolled, of which 25 had chronic generalized periodontitis and 25 periodontally healthy subjects as control. The clinical parameters included: gingival index, pocket probing depth, clinical attachment level and bleeding on probing. The level of
... Show MoreThat the structural changes in the environment, business and finance and the spread of business and the diversity of transactions between economic organizations and breadth of a commercial scale in the world have left their clear on the need to keep up with the accounting for these variables as one of the social sciences affect and are affected by the surrounding environment because of the various economic and social factors, technical, legal and others.
As a result of these variables emerged a new field of accounting called Forensic Accounting, which involves the use of expertise of multiple pour in the end to the accounting profession, where the Forensic Accounting cover a large area of disciplines including strengthening
... Show MoreIntroduction: Salivary melatonin is a critical antioxidant that contributes to oral health by mitigating oxidative stress. Psychological stress linked to thumb sucking may disrupt oral homeostasis, leading to conditions such as dental caries and fungal infections. Aim: This study explores the relationships between thumb sucking, salivary melatonin levels, dental caries, and the presence of Candida albicans (CA) in children. Materials and methods: A case-control study was conducted with 60 children aged 4-5 years at the University of Baghdad’s College of Dentistry. Participants were divided into thumb-sucking (n=30) and non-thumb-sucking (n=30) groups. Salivary melatonin levels were measured using enzyme-linked immunoso
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