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- Creators: Spence, John
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Description
Aim: To evaluate the impact transformational leadership (TFL) behaviors and What Matters to You conversations have on RNs finding meaning and joy in work (MJW) and turnover. Background: The nursing profession is plagued by burnout - a precursor to loss of MJW. Loss of MJW was exhibited as low morale and increased turnover among acute care RNs at a small hospital in Southwest Arizona. Addressing loss of MJW aligns with caring for the caregiver, the fourth aim of the quadruple aim initiative. Methods: This was a quasi?experimental mixed methodology evidence-based project. The target populations were core RNs and leaders working in the intensive care unit, care unit, and emergency department. Intervention was multimodal – survey using Meaning and Joy in Work Questionnaire, TFL education, and steps one and two of the IHI four steps for leaders model. Results: Final sample was 18 RNs. Statistical analyses did not reveal significant impact; pre- and post-survey MJWQ scores remained above four. Themes from the What Matters to You conversations included making a difference, coworkers/connections, staffing, and negativity. Turnover trended positively in two of the three units. Conclusion: This project heightened awareness about MJW and illuminated the impact TFL behaviors can have on RNs finding MJW and turnover. The coronavirus pandemic and acute nursing shortage were significant limitations of the project. Implications: Healthcare organizations are encouraged to view MJW as a system asset, embed it in their cultures, invest in innovative solutions, and continually evaluate outcome measures of MJW.
ContributorsSalmon, P. Melisa (Author) / Mangold, Kara (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
Description
The purpose of this project is to look at the relationship between education about Autism Spectrum Disorder (ASD) and knowledge, attitudes and beliefs in adult primary care providers. The project addresses the transition challenges adults with ASD have in finding a primary care provider who is comfortable and competent with ASD. Education was provided to adult primary care providers in a multi-site primary care clinic in a large metropolitan city in the Southwestern United States. The Modified Knowledge/Attitudes/Belief instrument was used. A pre-test was administered prior to the education session, then a post-test and a one-month post-test were given afterward.
The results of the education program showed that attitudes and beliefs increased after the education and continued to increase more in the month following. Knowledge improved after the education session but declined after a month although scores were not back to the pre-education level. Primary care providers who receive education about ASD may be more comfortable in caring for this population and more likely to welcome adults with ASD into their practice. Education for primary care providers is key to improving health outcomes for adults with ASD.
ContributorsChesebrough, Geri Anne (Author) / Mangold, Kara (Thesis advisor)
Created2018-04-30
Description
Advance care planning (ACP) is the act of deciding ones wishes at the end-of-life and making those wishes known. Healthcare providers rely on these wishes to provide end-of-life care. Despite the impact ACP has on quality of life at the end-of-life, most conversations remain undocumented. Even when ACP conversations take place, completion rates remain at an all-time low. This report explored the impact of appointment call reminders and patient portal messages on advance directive (AD) completion and documentation in the EHR. Following completion, a primary care practice experienced an increase in ACP conversation and ACP completion in the EHR. This report will discuss the methods utilized to improve ACP completion.
ContributorsDaily, Stephanie M. (Author) / Mangold, Kara (Thesis advisor)
Created2019-04-28
Description
The health benefits of breastfeeding are well documented and exclusive breastfeeding for at least the first six months of life is the target of national and global health care organizations. Although initial breastfeeding is on the rise, the percentage of infants still breastfeeding at six months drops significantly. In the population of newly delivered mothers of an obstetric practice, there is no readily accessible breastfeeding support offered following hospital discharge. A review of relevant literature revealed that lack of support is often cited as a key factor in the discontinuation of breastfeeding, whereas the evidence shows that participation in peer support has a positive effect on breastfeeding self-efficacy, which can have a positive effect on breastfeeding duration.
To address this problem, the initiation of a breastfeeding closed social network Facebook group for this practice setting population was developed and implemented to provide readily accessible peer support and have a positive effect on the outcome of breastfeeding self-efficacy. Three months after initiation of the Facebook group, an anonymous voluntary survey was offered to group members, and 25 members participated in the survey. Responses demonstrated that peer support is helpful with breastfeeding confidence and that, following participation in the group, the respondents wanted to continue breastfeeding.
ContributorsStorto, Pamela (Author) / Mangold, Kara (Thesis advisor)
Created2018-05-03
Description
Intense femtosecond x-ray pulses from free-electron laser sources allow the imaging of individual particles in a single shot. Early experiments at the Linac Coherent Light Source (LCLS) have led to rapid progress in the field and, so far, coherent diffractive images have been recorded from biological specimens, aerosols, and quantum systems with a few-tens-of-nanometers resolution. In March 2014, LCLS held a workshop to discuss the scientific and technical challenges for reaching the ultimate goal of atomic resolution with single-shot coherent diffractive imaging. This paper summarizes the workshop findings and presents the roadmap toward reaching atomic resolution, 3D imaging at free-electron laser sources.
ContributorsAquila, A. (Author) / Barty, A. (Author) / Bostedt, C. (Author) / Boutet, S. (Author) / Carini, G. (Author) / dePonte, D. (Author) / Drell, P. (Author) / Doniach, S. (Author) / Downing, K. H. (Author) / Earnest, T. (Author) / Elmlund, H. (Author) / Elser, V. (Author) / Guhr, M. (Author) / Hajdu, J. (Author) / Hastings, J. (Author) / Hau-Riege, S. P. (Author) / Huang, Z. (Author) / Lattman, E. E. (Author) / Maia, F. R. N. C. (Author) / Marchesini, S. (Author) / Ourmazd, A. (Author) / Pellegrini, C. (Author) / Santra, R. (Author) / Schlichting, I. (Author) / Schroer, C. (Author) / Spence, John (Author) / Vartanyants, I. A. (Author) / Wakatsuki, S. (Author) / Weis, W. I. (Author) / Williams, G. J. (Author) / College of Liberal Arts and Sciences (Contributor) / Department of Physics (Contributor)
Created2015-04-21
Description
The advent and application of the X-ray free-electron laser (XFEL) has uncovered the structures of proteins that could not previously be solved using traditional crystallography. While this new technology is powerful, optimization of the process is still needed to improve data quality and analysis efficiency. One area is sample heterogeneity, where variations in crystal size (among other factors) lead to the requirement of large data sets (and thus 10–100 mg of protein) for determining accurate structure factors. To decrease sample dispersity, we developed a high-throughput microfluidic sorter operating on the principle of dielectrophoresis, whereby polydisperse particles can be transported into various fluid streams for size fractionation. Using this microsorter, we isolated several milliliters of photosystem I nanocrystal fractions ranging from 200 to 600 nm in size as characterized by dynamic light scattering, nanoparticle tracking, and electron microscopy. Sorted nanocrystals were delivered in a liquid jet via the gas dynamic virtual nozzle into the path of the XFEL at the Linac Coherent Light Source. We obtained diffraction to ∼4 Å resolution, indicating that the small crystals were not damaged by the sorting process. We also observed the shape transforms of photosystem I nanocrystals, demonstrating that our device can optimize data collection for the shape transform-based phasing method. Using simulations, we show that narrow crystal size distributions can significantly improve merged data quality in serial crystallography. From this proof-of-concept work, we expect that the automated size-sorting of protein crystals will become an important step for sample production by reducing the amount of protein needed for a high quality final structure and the development of novel phasing methods that exploit inter-Bragg reflection intensities or use variations in beam intensity for radiation damage-induced phasing. This method will also permit an analysis of the dependence of crystal quality on crystal size.
ContributorsAbdallah, Bahige (Author) / Zatsepin, Nadia (Author) / Roy Chowdhury, Shatabdi (Author) / Coe, Jesse (Author) / Conrad, Chelsie (Author) / Dorner, Katerina (Author) / Sierra, Raymond G. (Author) / Stevenson, Hilary P. (Author) / Camacho Alanis, Fernanda (Author) / Grant, Thomas D. (Author) / Nelson, Garrett (Author) / James, Daniel (Author) / Calero, Guillermo (Author) / Wachter, Rebekka (Author) / Spence, John (Author) / Weierstall, Uwe (Author) / Fromme, Petra (Author) / Ros, Alexandra (Author) / Department of Chemistry and Biochemistry (Contributor) / College of Liberal Arts and Sciences (Contributor) / School of Molecular Sciences (Contributor) / Biodesign Institute (Contributor) / Applied Structural Discovery (Contributor) / Department of Physics (Contributor)
Created2015-08-19
Description
Toward the end of his career, Zewail developed strong interest in fast electron spectroscopy and imaging, a field to which he made important contributions toward his aim of making molecular movies free of radiation damage. We therefore compare here the atomistic mechanisms leading to destruction of protein samples in diffract-and-destroy experiments for the cases of high-energy electron beam irradiation and X-ray laser pulses. The damage processes and their time-scales are compared and relevant elastic, inelastic, and photoelectron cross sections are given. Inelastic mean-free paths for ejected electrons at very low energies in insulators are compared with the bioparticle size. The dose rate and structural damage rate for electrons are found to be much lower, allowing longer pulses, reduced beam current, and Coulomb interactions for the formation of smaller probes. High-angle electron scattering from the nucleus, which has no parallel in the X-ray case, tracks the slowly moving nuclei during the explosion, just as the gain of the XFEL (X-ray free-electron laser) has no parallel in the electron case. Despite reduced damage and much larger elastic scattering cross sections in the electron case, leading to not dissimilar elastic scattering rates (when account is taken of the greatly increased incident XFEL fluence), progress for single-particle electron diffraction is seen to depend on the effort to reduce emittance growth due to Coulomb interactions, and so allow formation of intense sub-micron beams no larger than a virus.
ContributorsSpence, John (Author) / College of Liberal Arts and Sciences (Contributor) / Department of Physics (Contributor)
Created2017-06-01
Description
Current hard X-ray free-electron laser (XFEL) sources can deliver doses to biological macromolecules well exceeding 1 GGy, in timescales of a few tens of femtoseconds. During the pulse, photoionization can reach the point of saturation in which certain atomic species in the sample lose most of their electrons. This electronic radiation damage causes the atomic scattering factors to change, affecting, in particular, the heavy atoms, due to their higher photoabsorption cross sections. Here, it is shown that experimental serial femtosecond crystallography data collected with an extremely bright XFEL source exhibit a reduction of the effective scattering power of the sulfur atoms in a native protein. Quantitative methods are developed to retrieve information on the effective ionization of the damaged atomic species from experimental data, and the implications of utilizing new phasing methods which can take advantage of this localized radiation damage are discussed.
ContributorsGalli, L. (Author) / Son, S.-K. (Author) / Klinge, M. (Author) / Bajt, S. (Author) / Barty, A. (Author) / Bean, R. (Author) / Betzel, C. (Author) / Beyerlein, K. R. (Author) / Caleman, C. (Author) / Doak, R. B. (Author) / Duszenko, M. (Author) / Fleckenstein, H. (Author) / Gati, C. (Author) / Hunt, B. (Author) / Kirian, R. A. (Author) / Liang, M. (Author) / Nanao, M. H. (Author) / Nass, K. (Author) / Oberthur, D. (Author) / Redecke, L. (Author) / Shoeman, R. (Author) / Stellato, F. (Author) / Yoon, C. H. (Author) / White, T. A. (Author) / Yefanov, O. (Author) / Spence, John (Author) / Chapman, H. N. (Author) / College of Liberal Arts and Sciences (Contributor) / Department of Physics (Contributor)
Created2015-04-29
Description
CTB-MPR is a fusion protein between the B subunit of cholera toxin (CTB) and the membrane-proximal region of gp41 (MPR), the transmembrane envelope protein of Human immunodeficiency virus 1 (HIV-1), and has previously been shown to induce the production of anti-HIV-1 antibodies with antiviral functions. To further improve the design of this candidate vaccine, X-ray crystallography experiments were performed to obtain structural information about this fusion protein. Several variants of CTB-MPR were designed, constructed and recombinantly expressed in Escherichia coli. The first variant contained a flexible GPGP linker between CTB and MPR, and yielded crystals that diffracted to a resolution of 2.3 Å, but only the CTB region was detected in the electron-density map. A second variant, in which the CTB was directly attached to MPR, was shown to destabilize pentamer formation. A third construct containing a polyalanine linker between CTB and MPR proved to stabilize the pentameric form of the protein during purification. The purification procedure was shown to produce a homogeneously pure and monodisperse sample for crystallization. Initial crystallization experiments led to pseudo-crystals which were ordered in only two dimensions and were disordered in the third dimension. Nanocrystals obtained using the same precipitant showed promising X-ray diffraction to 5 Å resolution in femtosecond nanocrystallography experiments at the Linac Coherent Light Source at the SLAC National Accelerator Laboratory. The results demonstrate the utility of femtosecond X-ray crystallography to enable structural analysis based on nano/microcrystals of a protein for which no macroscopic crystals ordered in three dimensions have been observed before.
ContributorsLee, Ho-Hsien (Author) / Cherni, Irene (Author) / Yu, HongQi (Author) / Fromme, Raimund (Author) / Doran, Jeffrey (Author) / Grotjohann, Ingo (Author) / Mittman, Michele (Author) / Basu, Shibom (Author) / Deb, Arpan (Author) / Dorner, Katerina (Author) / Aquila, Andrew (Author) / Barty, Anton (Author) / Boutet, Sebastien (Author) / Chapman, Henry N. (Author) / Doak, R. Bruce (Author) / Hunter, Mark (Author) / James, Daniel (Author) / Kirian, Richard (Author) / Kupitz, Christopher (Author) / Lawrence, Robert (Author) / Liu, Haiguang (Author) / Nass, Karol (Author) / Schlichting, Ilme (Author) / Schmidt, Kevin (Author) / Seibert, M. Marvin (Author) / Shoeman, Robert L. (Author) / Spence, John (Author) / Stellato, Francesco (Author) / Weierstall, Uwe (Author) / Williams, Garth J. (Author) / Yoon, Chun Hong (Author) / Wang, Dingjie (Author) / Zatsepin, Nadia (Author) / Hogue, Brenda (Author) / Matoba, Nobuyuki (Author) / Fromme, Petra (Author) / Mor, Tsafrir (Author) / ASU Biodesign Center Immunotherapy, Vaccines and Virotherapy (Contributor) / Department of Chemistry and Biochemistry (Contributor) / College of Liberal Arts and Sciences (Contributor) / School of Life Sciences (Contributor) / Biodesign Institute (Contributor) / Infectious Diseases and Vaccinology (Contributor) / Department of Physics (Contributor)
Created2014-08-20
Description
Crystallographic auto-indexing algorithms provide crystal orientations and unit-cell parameters and assign Miller indices based on the geometric relations between the Bragg peaks observed in diffraction patterns. However, if the Bravais symmetry is higher than the space-group symmetry, there will be multiple indexing options that are geometrically equivalent, and hence many ways to merge diffraction intensities from protein nanocrystals. Structure factor magnitudes from full reflections are required to resolve this ambiguity but only partial reflections are available from each XFEL shot, which must be merged to obtain full reflections from these `stills'. To resolve this chicken-and-egg problem, an expectation maximization algorithm is described that iteratively constructs a model from the intensities recorded in the diffraction patterns as the indexing ambiguity is being resolved. The reconstructed model is then used to guide the resolution of the indexing ambiguity as feedback for the next iteration. Using both simulated and experimental data collected at an X-ray laser for photosystem I in the P63 space group (which supports a merohedral twinning indexing ambiguity), the method is validated.
ContributorsLiu, Haiguang (Author) / Spence, John (Author) / College of Liberal Arts and Sciences (Contributor) / Department of Physics (Contributor)
Created2014-09-23