Consortium Training Research Articles

Determination of Concentration of Heavy Metals in Wood Ash

Heavy Metals such as lead, chromium, and arsenic are thought to be present in wood ashes. As many people use wood ash in gardens, we decided to test how easily these metals can be extracted from wood ash. Metals were extracted from 10-gram samples of ash by mixing with 100 ml of 2.0% trace metal nitric acid, gravity filtering, and final filtering with a 0.22 um. nylon syringe. Absorption data for the extracted samples was compared to a calibration curve of absorption versus concentration constructed from data obtained with a Shimadzu AA7000. Initial results indicate that the concentration of the metals are below the lower limit of detection for Cr, As, and Pb which are 0.2 ppm, 2.0 ppm, and 0.5 ppm respectively. However, the laboratory-fortified matrix sample for each metal failed, thus we will need to perform standard addition tests to certify these results. This work was supported by NASA WV Space Grant Consortium training grant number 80NSSC20M0055.

Emergency Nurses’ Perceived Barriers and Solutions to Engaging Patients With Life-Limiting Illnesses in Serious Illness Conversations: A United States Multicenter Mixed-Method Analysis

IntroductionThis study aimed to assess emergency nurses’ perceived barriers toward engaging patients in serious illness conversations. MethodsUsing a mixed-method (quant + QUAL) convergent design, we pooled data on the emergency nurses who underwent the End-of-Life Nursing Education Consortium training across 33 emergency departments. Data were extracted from the End-of-Life Nursing Education Consortium post-training questionnaire, comprising a 5-item survey and 1 open-ended question. Our quantitative analysis employed a cross-sectional design to assess the proportion of emergency nurses who report that they will encounter barriers in engaging seriously ill patients in serious illness conversations in the emergency department. Our qualitative analysis used conceptual content analysis to generate themes and meaning units of the perceived barriers and possible solutions toward having serious illness conversations in the emergency department. ResultsA total of 2176 emergency nurses responded to the survey. Results from the quantitative analysis showed that 1473 (67.7%) emergency nurses reported that they will encounter barriers while engaging in serious illness conversations. Three thematic barriers—human factors, time constraints, and challenges in the emergency department work environment—emerged from the content analysis. Some of the subthemes included the perceived difficulty of serious illness conversations, delay in daily throughput, and lack of privacy in the emergency department. The potential solutions extracted included the need for continued training, the provision of dedicated emergency nurses to handle serious illness conversations, and the creation of dedicated spaces for serious illness conversations. DiscussionEmergency nurses may encounter barriers while engaging in serious illness conversations. Institutional-level policies may be required in creating a palliative care-friendly emergency department work environment.

PdpC, a Type Six Secretion System Substrate, is Required for Erythrocyte Invasion in Francisella tularensis LVS

Francisella tularensis is an intracellular pathogen and the causative agent of tularemia. The F. tularensis type six secretion system (T6SS) is required for phagolysosomal escape and invasion of erythrocytes. An effector of the T6SS, PdpC, is required for phagosomal escape and we wanted to test if PdpC was also required for erythrocyte invasion. We constructed a pdpC-null mutant in the live vaccine strain, F. tularensis LVS. The pdpC-null strain is required for invasion of both human and sheep erythrocytes and reintroduction of a copy of pdpC, in trans, rescues this phenotype. Differential Immuno-Fluorescence Microscopy (DIFM) showed that the pdpC-null strain is affected in attachment as well as invasion. Further, a fluorescently labelled pdpC-null strain of F. tularensis LVS was unable to proliferate in THP-1 human peripheral blood monocyte cells. Finally, we constructed a fluorescent fusion of pdpC to emgfp and the resulting PdpC-EmGFP fusion protein localizes as discrete foci in a subset of broth cultured F. tularensis LVS cells. Our results confirm previous observations that PdpC is required for infection and virulence in phagocytic host cells and are the first description of an effector of the Type Six Secretion System that is required for erythrocyte invasion. The pdpC-emgfp strain will be a useful tool to further characterize the role of PdpC in both macrophage infection and red blood cell invasion. (This research was made possible by NASA West Virginia Space Grant Consortium Training Grant #NNX15A101H and by NIH Grant P20GM103434 to the West Virginia IDeA Network for Biomedical Research Excellence).

OpiA, a Type Six Secretion System Substrate, localizes to the cell pole and plays a role in bacterial growth and viability in Francisella tularensis LVS.

Francisella tularensis is an intracellular pathogen and the causative agent of tularemia. The F. tularensis type six secretion system (T6SS) is required for a number of host-pathogen interactions including phagolysosomal escape and invasion of erythrocytes. One known effector of the T6SS, OpiA, has recently been shown to be a phosphatidylinositol-3 kinase. To investigate the role of OpiA in erythrocyte invasion, we constructed an opiA-null mutant in the live vaccine strain, F. tularensis LVS. OpiA was not required for erythrocyte invasion, however, deletion of opiA affected growth of F. tularensis LVS in broth cultures in a medium-dependent manner. We also found that opiA influenced cell size, gentamicin sensitivity, bacterial viability, and the lipid content of F. tularensis. A fluorescently tagged OpiA (OpiA-EmGFP) accumulated at the cell poles of F. tularensis which is consistent with the location of the T6SS. However, OpiA-EmGFP also exhibited a highly dynamic localization and this fusion protein was detected in erythrocytes and THP-1 cells in vitro further supporting that OpiA is secreted. Similar to previous reports using F. novicida, our data demonstrated that opiA had a minimal effect on intracellular replication of F. tularensis in host immune cells in vitro. However, THP-1 cells infected with the opiA mutant produced modestly (but significantly) higher levels of the pro-inflammatory cytokine TNF-α compared to these host cells infected with wild-type bacteria. Together, our results support previous observations that implicate opiA in infection and virulence, but also reveal an additional role for opiA central to the biology of F. tularensis bacteria. (This research was made possible by NASA West Virginia Space Grant Consortium Training Grant #NNX15A101H and by NIH Grant P20GM103434 to the West Virginia IDeA Network for Biomedical Research Excellence).

Effectiveness of an End-of-Life Nursing Education Consortium Training on Registered Nurses' Educational Needs in Providing Palliative and End-of-Life Patient Care.

Registered nurses play a critical role in delivering effective palliative and end-of-life patient care. Previous literature has cited that registered nurses report a lack of adequate palliative care training in academic and continuing education programs. Providing care to patients at the end of life requires knowledge in a variety of areas such as nonpharmacologic symptom management, cultural considerations, and pain management. This study aimed to investigate the impact of a professional development intervention among registered nurses on their educational needs in providing palliative care. Using a 1-group pretest-posttest design, a convenience sample of registered nurses completed an electronic survey containing demographic questions and the End-of-Life Professional Caregiver Survey. The professional development intervention consisted of an 8-hour training conducted by a content expert on palliative patient care addressing the competencies developed by the End-of-Life Nursing Education Consortium. The results revealed a significant increase in participant knowledge in providing quality palliative care to patients (P < .001). Education programs on quality palliative and end-of-life patient care can effectively improve the care delivered to this patient population.

OpiA, a Type Six Secretion System Substrate, localizes to the cell pole and plays a role in bacterial growth and viability in Francisella tularensis LVS.

Francisella tularensis is an intracellular pathogen and the causative agent of tularemia. The F. tularensis type six secretion system (T6SS) is required for a number of host-pathogen interactions including phagolysosomal escape and invasion of erythrocytes. One known effector of the T6SS, OpiA, has recently been shown to be a phosphatidylinositol-3 kinase. To investigate the role of OpiA in erythrocyte invasion, we constructed an opiA-null mutant in the live vaccine strain, F. tularensis LVS. OpiA was not required for erythrocyte invasion, however, deletion of opiA affected growth of F. tularensis LVS in broth cultures in a medium-dependent manner. We also found that opiA influenced cell size, gentamicin sensitivity, bacterial viability, and the lipid content of F. tularensis. A fluorescently tagged OpiA (OpiA-EmGFP) accumulated at the cell poles of F. tularensis which is consistent with the location of the T6SS. However, OpiA-EmGFP also exhibited a highly dynamic localization and this fusion protein was detected in erythrocytes and THP-1 cells in vitro further supporting that OpiA is secreted. Similar to previous reports using F. novicida, our data demonstrated that opiA had a minimal effect on intracellular replication of F. tularensis in host immune cells in vitro. However, THP-1 cells infected with the opiA mutant produced modestly (but significantly) higher levels of the pro-inflammatory cytokine TNF-α compared to these host cells infected with wild-type bacteria. Together, our results support previous observations that implicate opiA in infection and virulence, but also reveal an additional role for opiA central to the biology of F. tularensis bacteria. (This research was made possible by NASA West Virginia Space Grant Consortium Training Grant #NNX15A101H and by NIH Grant P20GM103434 to the West Virginia IDeA Network for Biomedical Research Excellence).

Localization of the key cell division determinant FtsZ in Francisella tularensis.

Francisella tularensis, the causative agent of tularemia, is a highly infectious gram-negative bacterium capable of replicating within macrophages, leukocytes, dendritic cells and epithelial cells. In addition, F. tularensis also invades erythrocytes. FtsZ, a homologue of eukaryotic tubulin, is an essential cell division protein in almost all bacteria. Polymerization of FtsZ into a contractile ring is a critical first step in division and the FtsZ ring acts in recruiting the cell wall synthesis machinery to the nascent septum. We have generated a recombinant fusion of ftsZftto emgfp (Emerald Green Fluorescent Protein) which can be expressed, in trans, under its presumed native promotor or a strong Francisella promoter (pGRP). As expected, FtsZft-Emgfp can be seen localizing as rings in F. tularensis. Our aim is to utilize fluorescently tagged FtsZ to investigate replication of F. tularensis in a range of in vitro host cell invasion assays and as a marker for viability to study the morphological and physiological differentiation of F. tularensis as it transitions into a viable but non-culturable (VBNC) state. (This research was made possible by NASA West Virginia Space Grant Consortium Training Grant #NNX15A101H and by NIH Grant P20GM103434 to the West Virginia IDeA Network for Biomedical Research Excellence).

Continuum, the continuing education platform based on a competency matrix

Competency-Based Education is a learning method that has changed the traditional teaching-based focus to a learning-based one. Students are the centre of the process, in which they must learn to learn, solve problems, and adapt to changes in their environment. The goal is to provide learning based on knowledge, skills (know-how), attitude and behaviour. These sets of knowledge are called competencies. It is essential to have a reference of the required competencies in order to identify the need for them. Their acquisition is approached through teaching modules, in which one or more skills can be acquired. This teaching strategy has been adopted by Continuum, the distance learning platform of the Spanish Paediatric Association, which has developed a competency matrix based on the Global Paediatric Education Consortium training program. In this article, a review will be presented on the basics of Competency-Based Education and how it is applied in Continuum.

Continuum, la plataforma de Formación Basada en Competencias

Competency-Based Education is a learning method that has changed the traditional teaching-based focus to a learning-based one. Students are the centre of the process, in which they must learn to learn, solve problems, and adapt to changes in their environment. The goal is to provide learning based on knowledge, skills (know-how), attitude and behaviour. These sets of knowledge are called competencies. It is essential to have a reference of the required competencies in order to identify the need for them. Their acquisition is approached through teaching modules, in which one or more skills can be acquired. This teaching strategy has been adopted by Continuum, the distance learning platform of the Spanish Paediatric Association, which has developed a competency matrix based on the Global Paediatric Education Consortium training program. In this article, a review will be presented on the basics of Competency-Based Education and how it is applied in Continuum.

A Multisite Initiative to Increase the Use of Alcohol Screening and Brief Intervention Through Resident Training and Clinic Systems Changes.

Screening and brief intervention (SBI) is a seldom-used evidence-based practice for reducing unhealthy alcohol use among primary care patients. This project assessed the effectiveness of a regional consortium's training efforts in increasing alcohol SBI. Investigators combined alcohol SBI residency training efforts with clinic SBI implementation processes and used chart reviews to assess impact on SBI rates in four residency clinics. Data were derived from a random sample of patient charts collected before (2010; n = 662) and after (2011; n = 656) resident training/clinic implementation. Patient charts were examined for evidence that patients were asked about alcohol use by a validated screening instrument, the screening result (positive or negative), evidence that patients received a brief intervention, prescriptions for medications to assist abstinence, and referrals to alcohol treatment. Chi-square analyses identified differences in pre- and posttraining implementation of SBI practices. Following program implementation, screening with validated instruments increased from 151/662 (22.8%) at baseline to 543/656 (82.8%, P < .01), and identification of unhealthy alcohol use increased from 12/662 (1.8%) to 41/656 (6.3%, P < .01). Performance of brief interventions more than doubled (10/662 [1.5%] versus 24/656 [3.7%], P < .01). There were no increases in the use of medications or referrals to treatment. Resident training combined with clinic implementation efforts can increase the delivery of evidence-based practices such as alcohol SBI in residency clinics.

Studying the Effects of the End-of-Life Nursing Education Consortium at the Institutional Level

The purpose of this study was to assess the ongoing impact of the End-of-Life Nursing Education Consortium training program on RNs' death anxiety, concerns about dying, and knowledge of the dying process utilizing the principles of the Comfort Theory and Practice by Kolcaba (New York: Springer Publi

The Diagnostic Analysis of Consortium Training Programs for Small and Middle-Sized Corporations, Using CIPP Evaluation Model

The Diagnostic Analysis of Consortium Training Programs for Small and Middle-Sized Corporations, Using CIPP Evaluation Model

Appraisal of the Pediatric End-of-Life Nursing Education Consortium Training Program

Major deficiencies continue to exist in pediatric palliative and end-of-life nursing education. The End-of-Life Nursing Education Consortium (ELNEC)-Pediatric Palliative Care (PPC) train-the-trainer curriculum was developed to create a nursing education program to improve care for children and their families confronted with life-threatening illnesses (www.aacn.nche.edu/ELNEC). Two ELNEC-PPC training programs were held in August 2005 and August 2006. The purpose of this article is to present data from the precourse and 12-month postcourse follow-up of participants who attended the two courses. Findings from these assessments demonstrate a positive link between educational initiatives and clinical outcomes.

Global efforts to improve palliative care: the International End‐of‐Life Nursing Education Consortium Training Programme

This paper is a report of an evaluation study to determine the feasibility and effectiveness of the End-of-Life Nursing Education Consortium-International training conference in providing education and support materials to participants so they might return to their home countries and disseminate palliative care information. More than 50 million people die each year, many without access to adequate pain control or palliative care. Numerous barriers to implementation of palliative care exist, including lack of education provided to healthcare professionals regarding these principles. Because they spend the most time with patients and their families, nurses have the greatest potential to change the way palliative care is provided. A Course Evaluation Form and a Postcourse Activity Evaluation was completed by a convenience sample of 38 nurses from 14 Eastern and Central European, former Soviet, and Central Asian countries. The data were collected in 2006 using Likert scales and open-ended questions. Evaluations of speakers ranged from a mean of 4.4 to 4.9 on the 5-point scale, with five denoting the highest level. The mean rating of the conference overall was 4.9. Strengths included the professional level of presentations, practical, clinically based content, extensive resources and availability of the educators. The first End-of-Life Nursing Education Consortium-International training programme demonstrated the feasibility of providing high-quality, essential education to nurses from a variety of countries. Because End-of-Life Nursing Education Consortium is designed as a train-the-trainer programme, assistance with translation to native languages, along with textbooks and other resources, is needed to allow participants to fully implement this curriculum.

Oncology End-of-Life Nursing Education Consortium Training Program: Improving Palliative Care in Cancer

To describe an evaluation of the oncology version of the End-of-Life Nursing Education Consortium (ELNEC-Oncology) training program, which is designed to provide oncology nurses with the knowledge and materials necessary to disseminate palliative care information to their colleagues in local chapters of the Oncology Nursing Society (ONS). Participant reports. 124 nurses representing 74 ONS chapters attended the first two courses. Dyads of ONS members from local chapters applied to attend ELNEC and completed surveys regarding their goals and expectations for implementing end-of-life (EOL) education and training after completion of the program. Participants educated more than 26,000 nurses after attending the program, including 7,593 nurses within their ONS chapters and 18,517 colleagues within their workplaces. Barriers to implementation included a lack of funding and time constraints. Participants sought additional palliative care learning opportunities, including attending other workshops, subscribing to palliative care journals, and becoming involved in committees focused on palliative care. The ELNEC-Oncology program is a national collaboration with ONS that provides oncology nurses with the tools and expertise to effectively disseminate palliative care content to colleagues within their local chapters and work settings. EOL care information remains critical to the science of oncology nursing, and ELNEC-Oncology provides an effective strategy for disseminating the information.

Appraisal of the Graduate End-of-Life Nursing Education Consortium Training Program

Advanced practice nurses (APNs) are crucial in the provision of quality end-oflife care. However, little attention is devoted to palliative care in most graduate nursing curricula, leaving advanced practice nurses poorly prepared to meet the needs of those approaching the end of their lives. The purpose of the graduate version of the End-of-Life Nursing Education Consortium (ELNEC-Graduate) Training Program is to provide nursing faculty with the knowledge and materials necessary to include palliative care throughout the graduate nursing curriculum. Sixty graduate nursing faculty members attended the first ELNECGraduate training course. Prior to attending the course, each participant completed surveys regarding the adequacy of end-of-life (EOL) content within their curriculum, as well as overall perceptions of EOL education in their university. Participants were asked to respond to these same questions immediately and at 12 months after completion of the course. Respondents reported significant improvements in the adequacy of eight areas of EOL content taught within their settings. Participants noted improved effectiveness in their ability to teach EOL care, of their curriculum in including EOL care, and of their graduate nursing students in providing care to the dying. The total hours of EOL content added to graduate nursing curricula as a result of attending ELNEC-Graduate was 18.4 +/- 17.4 standard deviation (SD) hours. Additional unintended consequences were noted. The ELNEC-Graduate Program is a national initiative that effectively improves faculty expertise in EOL care and expands palliative care content within graduate nursing curricula.

Mental Health, the Poor, and the Promised Land—The Houston Consortium Training Program

The title of this paper reflects the contradictory implicit premises and real difficulties that confront health and mental health professionals in their efforts to redress past shortcomings, meet current challenges, and set realistic goals for the provision of comprehensive care to the poorer segments of United States society. Born out of the optimism of the early 1960s, the community mental health