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Articles 49711 - 49740 of 53373
Full-Text Articles in Entire DC Network
Employee Wellness Model For Obesity, Barbara Siebold
Employee Wellness Model For Obesity, Barbara Siebold
Walden Dissertations and Doctoral Studies
Obesity, a condition of having a body mass index (BMI) greater than 30, is a universal epidemic with the greatest prevalence in the United States. The greatest concern with this epidemic health problem is that it presents with many comorbidities and is a risk factor for other chronic diseases. Employee wellness programs (EWP) have been in place for years and incorporate programs on weight management, nutritional education, and smoking cessation to reduce risk factors associated with chronic diseases. These programs utilize the concept of empowerment, often guided by Pender's self-management theory, to encourage employees to take onus for their health …
The Role Of Sociodemographic Characteristics And Antiretroviral Prophylaxis On Risky Sexual Behavior Among Men Who Have Sex With Men, Leonard Obodo
The Role Of Sociodemographic Characteristics And Antiretroviral Prophylaxis On Risky Sexual Behavior Among Men Who Have Sex With Men, Leonard Obodo
Walden Dissertations and Doctoral Studies
Recent multicenter, randomized, double blind clinical trials have shown no association between HIV preexposure prophylaxis (PrEP) and increased sexual risk behavior among high-risk men who have sex with men (MSM). However, little research has been conducted under natural conditions devoid of clinical trial controlled environment to confirm the lack of association between PrEP and increased sexual risk behavior. Also, research has shown conflicting associations between sociodemographic characteristics and sexual risk behavior among MSM. In this cross-sectional, web-based, primary data analysis, MSM who reside in United States of America (USA) and who make use of PrEP for HIV prevention were examined …
Class Schedule - Spring 2015, Office Of Registrar
Class Schedule - Spring 2015, Office Of Registrar
Semester Schedules and Information
No abstract provided.
Community College Leaders' Experiences In Adapting To Changing Student Demographics, Joyce Hewett
Community College Leaders' Experiences In Adapting To Changing Student Demographics, Joyce Hewett
Walden Dissertations and Doctoral Studies
The demographics of community colleges are rapidly changing. The culture composition of the student population in community colleges has expanded, and includes larger percentages of African Americans, Asian/Pacific Islanders, Hispanic Americans, and Native Americans than are found in other higher education institutions. The purpose of this phenomenological study was to examine the lived experiences of 10 community college leaders, consisting of 4 administrators, 5 faculty members, and 1 faculty/administrator, in their attempt to adapt to the changing demographics of the student population. Multicultural lens, the conceptual framework for the study, helped guide leaders in assessing their levels of multicultural sensitivity …
Interrupting The Sepsis Process With An Evidence-Based Education Intervention, Martha Olson
Interrupting The Sepsis Process With An Evidence-Based Education Intervention, Martha Olson
Walden Dissertations and Doctoral Studies
Interrupting the Sepsis Process with an Evidence-Based Education Intervention
by
Martha Olson
MSN, Walden University, 2013
MS, Southwest Minnesota State University, 2003
BSN, The University of Iowa, 1998
Project Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Nursing Practice
Walden University
May 2015
Abstract
Sepsis is a concern, especially for the vulnerable populations. The early signs of sepsis are vague and often difficult to detect, but when detected early, are treatable with antibiotics and fluid resuscitation. When a nurse is unaware of the early signs, treatment is delayed and multiorgan failure may progress quickly. To …
Reliability And Validity Of A Tool Measuring Preceptor Evaluations Of Competencies Among New Rn Graduates In A Transition-To-Practice Program, Susan K. Prion, A Berman, Arthur Karshmer, P Van, J Wallace, N West
Reliability And Validity Of A Tool Measuring Preceptor Evaluations Of Competencies Among New Rn Graduates In A Transition-To-Practice Program, Susan K. Prion, A Berman, Arthur Karshmer, P Van, J Wallace, N West
Nursing and Health Professions Faculty Research and Publications
Four transition-to-practice programs for new RN graduates who had not yet found employment in nursing were based on the Quality and Safety Education for Nurses (QSEN) competencies of knowledge, skills, and attitudes (KSAs). To support consistent evaluation of participants by preceptors, a 35-item tool was developed that used a 4-point scale to assess selected behaviors. This article describes the initial reliability and validity testing of the tool, which had good internal consistency, with a Cronbach's alpha of 0.92 for preceptor evaluation of participants and 0.82 when used as a self-evaluation tool. Six content experts evaluated the tool's face validity; it …
Critical Cultural Awareness And Diversity In Nursing: A Minority Perspective, Chenit Ong-Flaherty
Critical Cultural Awareness And Diversity In Nursing: A Minority Perspective, Chenit Ong-Flaherty
Nursing and Health Professions Faculty Research and Publications
Increasing multiculturalism and ongoing issues related to poor patient-centered care, teamwork, and safety call for urgent readdressing of cultural competency training. Critical cultural awareness education is needed to improve diversity in the nursing profession. Using Hofstede’s cultural dimension of Invidualism-Collectivism, this paper proposes that the dominance of one culture may be the contributory factor in the slow acceptance of change towards critical cultural awareness education. Experiential learning by way of gaming and critical reflection on cross-cultural interactions can contribute to the development of critical cultural awareness.
Job Satisfaction And Horizontal Violence In Hospital Staff Registered Nurses: The Mediating Role Of Peer Relationships, Christina Purpora, Mary A. Blegen
Job Satisfaction And Horizontal Violence In Hospital Staff Registered Nurses: The Mediating Role Of Peer Relationships, Christina Purpora, Mary A. Blegen
Nursing and Health Professions Faculty Research and Publications
Aims and objectives
To describe the association between horizontal violence and job satisfaction in hospital staff registered nurses and the degree to which peer relationships mediates the relationship. Additionally, the association between nurse and work characteristics and job satisfaction were determined.
Background
Horizontal violence is a major predictor of nurses' job satisfaction. Yet, not enough is known about the relationship between these variables. Job satisfaction is an important variable to study because it is a predictor of patient care quality and safety internationally. Peer relationships, a job satisfier for nurses, was identified as a potential mediator in the association between …
A Cross Sectional Exploration Of Emotional Intelligence In Us Baccalaureate Nursing Students, Marcianna Nosek
A Cross Sectional Exploration Of Emotional Intelligence In Us Baccalaureate Nursing Students, Marcianna Nosek
Nursing and Health Professions Faculty Research and Publications
Objective: New nurses may be vulnerable to bullying as they often lack confidence or do not have the skills or maturity to communicate their needs or those of their patients. Increasing emotional intelligence particularly in at-risk nursing students may be one way to foster resiliency. This exploratory cross sectional study aimed to exam the overall level and specific components of emotional intelligence as well as associations with age, ethnicity, gender, or academic standing in baccalaureate nursing students.
Methods: A cross sectional analytical study was conducted using a paper demographic survey and an online emotional intelligence (EI) instrument, the …
Recommendations For Enhancing Psychosocial Support Of Nicu Parents Through Staff Education And Support, S L. Hall, J Cross, Nancy Selix, C Patterson, L Segre, R Chuffo-Siewert, P A. Geller, M L. Martin
Recommendations For Enhancing Psychosocial Support Of Nicu Parents Through Staff Education And Support, S L. Hall, J Cross, Nancy Selix, C Patterson, L Segre, R Chuffo-Siewert, P A. Geller, M L. Martin
Nursing and Health Professions Faculty Research and Publications
Providing psychosocial support to parents whose infants are hospitalized in the neonatal intensive care unit (NICU) can improve parents’ functioning as well as their relationships with their babies. Yet, few NICUs offer staff education that teaches optimal methods of communication with parents in distress. Limited staff education in how to best provide psychosocial support to families is one factor that may render those who work in the NICU at risk for burnout, compassion fatigue and secondary traumatic stress syndrome. Staff who develop burnout may have further reduced ability to provide effective support to parents and babies. Recommendations for providing NICU …
Use Of Root Cause Analysis In Nursing Education: Best Practice From The Quality And Safety Officer, Elizabeth E. Cooper, Susan Pauly-O’Neill
Use Of Root Cause Analysis In Nursing Education: Best Practice From The Quality And Safety Officer, Elizabeth E. Cooper, Susan Pauly-O’Neill
Nursing and Health Professions Faculty Research and Publications
Teaching nursing students to be safe in practice is a key element to any nursing curriculum. This article will discuss the use of a Root Cause Analysis (RCO) framework with prelicensure nursing students, by the Quality and Safety Officer (QSO) in a School of Nursing and Health Professions, as a method to enhance transparency and improve patient safety. The aim is to provide a rationale for using this strategy, to identify the steps of a root cause analysis, to disclose barriers to its successful use, and to explore dissemination to the partnering healthcare environments.
Internal Attributes That Mitigate Perceived Job Insecurity: Improving Employee Satisfaction, Shelly Leigh Rogers-Sharer
Internal Attributes That Mitigate Perceived Job Insecurity: Improving Employee Satisfaction, Shelly Leigh Rogers-Sharer
Walden Dissertations and Doctoral Studies
Employee satisfaction has been found to have a strong relationship with perceived job security. This study explored job insecurity in an unstable global economy. Specifically, it examined internal attributes of employees, hypothesizing that such attributes would enable employees to better cope with work-related stressors such as job insecurity. Specific attributes of personality and employability were assessed as potential moderators of job satisfaction and security, utilizing the theory of work adjustment and person-environment correspondence as theoretical frameworks. The specific attributes included facets of conscientiousness and neuroticism as well as dispositions of employability including openness to change at work, work and career …
Impact Of Fiscal Decentralization On Quality Financial Reporting At The Districts In Ghana, Abdul-Malik Seidu Zakaria
Impact Of Fiscal Decentralization On Quality Financial Reporting At The Districts In Ghana, Abdul-Malik Seidu Zakaria
Walden Dissertations and Doctoral Studies
This study examined the impact of fiscal decentralization on quality financial reporting at the local government level in Ghana. The study is important because it provides development partners with the assurance that Metropolitan, Municipal, and District Assemblies (MMDAs) funds are used for their intended purposes. The study was based on the theory of local public expenditures, which posits that fiscal decentralization may enhance local capacities for service delivery. The key research question examined the extent to which fiscal decentralization has influenced quality financial reporting at the local level. The research design was quantitative, randomly sampling stakeholders in the local government …
A Novel Cardiac Muscle-Derived Biomaterial Reduces Dyskinesia And Postinfarct Left Ventricular Remodeling In A Mouse Model Of Myocardial Infarction, Daniel M. O'Connor, Nivedita K. Naresh, Bryan A. Piras, Yaqin Xu, Robert S. Smith, Roy C. Ogle
A Novel Cardiac Muscle-Derived Biomaterial Reduces Dyskinesia And Postinfarct Left Ventricular Remodeling In A Mouse Model Of Myocardial Infarction, Daniel M. O'Connor, Nivedita K. Naresh, Bryan A. Piras, Yaqin Xu, Robert S. Smith, Roy C. Ogle
School of Medical Diagnostics & Translational Sciences Publications
Extracellular matrix (ECM) degradation after myocardial infarction (MI) leaves the myocardium structurally weakened and, as a result, susceptible to early infarct zone dyskinesia and left ventricular (LV) remodeling. While various cellular and biomaterial preparations have been transplanted into the infarct zone in hopes of improving post-MI LV remodeling, an allogeneic cardiac muscle-derived ECM extract has yet to be developed and tested in the setting of reperfused MI. We sought to determine the effects of injecting a novel cardiac muscle-derived ECM into the infarct zone on early dyskinesia and LV remodeling in a mouse model of MI. Cardiac muscle ECM was …
Designing A Broad-Spectrum Integrative Approach For Cancer Prevention And Treatment, Keith I. Block, Charlotte Gyllenhaal, Leroy Lowe, Amedeo Amedei, A.R.M. Ruhul Amin, Amr Amin, Katia Aquilano, Jack Arbiser, Alexandra Arreola, Alla Arzumanyan, Patricia Hentosh
Designing A Broad-Spectrum Integrative Approach For Cancer Prevention And Treatment, Keith I. Block, Charlotte Gyllenhaal, Leroy Lowe, Amedeo Amedei, A.R.M. Ruhul Amin, Amr Amin, Katia Aquilano, Jack Arbiser, Alexandra Arreola, Alla Arzumanyan, Patricia Hentosh
School of Medical Diagnostics & Translational Sciences Publications
Targeted therapies and the consequent adoption of “personalized” oncology have achieved notable successes in some cancers; however, significant problems remain with this approach. Many targeted therapies are highly toxic, costs are extremely high, and most patients experience relapse after a few disease-free months. Relapses arise from genetic heterogeneity in tumors, which harbor therapy-resistant immortalized cells that have adopted alternate and compensatory pathways (i.e., pathways that are not reliant upon the same mechanisms as those which have been targeted). To address these limitations, an international task force of 180 scientists was assembled to explore the concept of a low-toxicity “broad-spectrum” therapeutic …
Bioactive Lipid Coating Of Bone Allografts Direct Engraftment And Fate Determination Of Bone Marrow-Derived Cells In Rat Gfp Chimeras, Anusuya Das, Claire E. Segar, Yihsuan Chu, Tiffany W. Wang, Yon Lin, Chunxi Yang, Roy C. Ogle
Bioactive Lipid Coating Of Bone Allografts Direct Engraftment And Fate Determination Of Bone Marrow-Derived Cells In Rat Gfp Chimeras, Anusuya Das, Claire E. Segar, Yihsuan Chu, Tiffany W. Wang, Yon Lin, Chunxi Yang, Roy C. Ogle
School of Medical Diagnostics & Translational Sciences Publications
Bone grafting procedures are performed to treat wounds incurred during wartime trauma, accidents, and tumor resections. Endogenous mechanisms of repair are often insufficient to ensure integration between host and donor bone and subsequent restoration of function. We investigated the role that bone marrow-derived cells play in bone regeneration and sought to increase their contributions by functionalizing bone allografts with bioactive lipid coatings. Polymer-coated allografts were used to locally deliver the immunomodulatory small molecule FTY720 in tibial defects created in rat bone marrow chimeras containing genetically-labeled bone marrow for monitoring cell origin and fate. Donor bone marrow contributed significantly to both …
Full Issue, Socio-Legal Review
Bulletin 2015-2016, Seattle University School Of Law
Guest Editorial, H S. Ballal Dr
Guest Editorial, H S. Ballal Dr
Manipal Journal of Nursing and Health Sciences
No abstract provided.
Use Of An Electronic Educational Module To Educate Advanced Practice Nurses On Preventive Care Protocol For Immunocompromised Patients, Simi Jesto Joseph Dr, Audrey Klopp Dr
Use Of An Electronic Educational Module To Educate Advanced Practice Nurses On Preventive Care Protocol For Immunocompromised Patients, Simi Jesto Joseph Dr, Audrey Klopp Dr
Manipal Journal of Nursing and Health Sciences
Immunocompromised patients are at increased risk of infections and certain cancers due to the immunosuppressed body as well as the immunosuppressive agents. Despite American national organizations’ specific guidelines for immunocompromised patients, reported vaccination rates and provider compliance on preventive services is low. The aim of this study was to assess knowledge, attitude and clinical practice among Advanced Practice Nurses (APN) in preventive care for immunocompromised patients and educating APNs to improve their knowledge and practice skills using an evidence-based preventive care protocol. Methods: APN members of Illinois Society of Advanced Practice Nurses (ISAPN) organization were surveyed by a needs assessment …
Clinico Epidemiological Profile Of Hiv-Tb Co-Infected Patients In Coastal South India, Bhaskaran Unnikrishnan Dr, Ramesh Holla Dr, Darshan B. B Dr, Arjun B. Y Dr
Clinico Epidemiological Profile Of Hiv-Tb Co-Infected Patients In Coastal South India, Bhaskaran Unnikrishnan Dr, Ramesh Holla Dr, Darshan B. B Dr, Arjun B. Y Dr
Manipal Journal of Nursing and Health Sciences
Introduction: Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) co-infection is considered to be one of the important public health problems globally. Tuberculosis is a leading cause of mortality among people living with HIV/AIDS. Objectives: To find out the trends of HIV and TB co-infection, socio-demographic and clinical profile of HIV and TB co-infected patients. Methods: A hospital based descriptive study was done at a tertiary care teaching hospital in Mangalore. The hospital records of all HIV-TB co-infected patients admitted between January 2008 and December 2013 were reviewed and data were captured in data capture sheet. The data obtained was analysed …
Effectiveness Of Video Assisted Diversional Therapy And Application Of Local Anaesthetic Agent On Pain, Behavioural Response And Physiological Parameters Among Children During Intravenous (Iv) Cannulation, Litna George Ms, Anjalin D'Souza Mrs, Anice George Dr
Effectiveness Of Video Assisted Diversional Therapy And Application Of Local Anaesthetic Agent On Pain, Behavioural Response And Physiological Parameters Among Children During Intravenous (Iv) Cannulation, Litna George Ms, Anjalin D'Souza Mrs, Anice George Dr
Manipal Journal of Nursing and Health Sciences
Intravenous (IV) cannulation is a common procedure done in hospitals. Although it is an essential procedure providing easy access for IV hydration or medication, its insertion leads to pain, anxiety and distress in children. The study was undertaken with the objective of comparing the effectiveness of video assisted diversional (VAD) therapy and application of local anaesthetic (LA) agent on pain relief, behavioural response and physiological parameters among children. Methods: The study was done using an experimental post-test only control group design. The participants were randomized to one of the three groups, with 25 subjects in each group: experimental group 1 …
Effectiveness Of Dance Movement Therapy On Attention Deficit Hyperactivity Disorder Children Aged Between 6-12 Years, Shilpa J Ms, Asha P. Shetty Dr
Effectiveness Of Dance Movement Therapy On Attention Deficit Hyperactivity Disorder Children Aged Between 6-12 Years, Shilpa J Ms, Asha P. Shetty Dr
Manipal Journal of Nursing and Health Sciences
Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common behaviour disorders of childhood. Mental health and school practitioners are increasingly faced with the challenge of assessing children and adolescents who might have ADHD. The purpose of the study was to assess the effectiveness of dance movement therapy (DMT) among ADHD children. Methods: Data collection was done using demographic proforma; SNAP IV rating scale and an opinionnaire. Results: Analysis revealed post-test teacher and parent mean scores were significantly lower than the pre-test teacher and parent mean scores i.e. the t-value for teacher is t(29)=16.81 and for parent is …
Effectiveness Of A Structured Counselling Program On The Knowledge Of Self-Care Behaviour And Coping Strategies Among Hiv Infected Post-Natal Mothers, Raddi S. A Dr, Prakash R, Dandagi S. R
Effectiveness Of A Structured Counselling Program On The Knowledge Of Self-Care Behaviour And Coping Strategies Among Hiv Infected Post-Natal Mothers, Raddi S. A Dr, Prakash R, Dandagi S. R
Manipal Journal of Nursing and Health Sciences
Introduction: Motherhood represents a time of great change that challenges women in many ways. Objectives: The objectives of the study were to evaluate the effectiveness of a structured counselling program in terms of gain in knowledge on Human Immunodeficiency Virus (HIV) and self-care behaviour and increase in use and effectiveness of coping strategies and to find the association between pretest levels of knowledge and coping strategies with selected socio demographic variables. Methods: An evaluative study was carried out to assess the effectiveness of a structured counselling program on knowledge of self care behaviour and coping strategies among HIV infected post-natal …
Effectiveness Of Yoganidra On Quality Of Sleep Among Cancer Patients, Divya N. Anand Ms, Linu Sara George Dr, Anil Raj Mr
Effectiveness Of Yoganidra On Quality Of Sleep Among Cancer Patients, Divya N. Anand Ms, Linu Sara George Dr, Anil Raj Mr
Manipal Journal of Nursing and Health Sciences
Introduction: Cancer is one of the major health problems that occur in people of all races and cultures. There is a dearth of literature on implementing non-pharmacological measures to improve quality of sleep among cancer patients. Objectives: This study assessed quality of sleep among cancer patients and the effectiveness of Yoganidra intervention on quality of sleep in terms of improvement using Pittsburgh Sleep Quality Index (PSQI). Methods: A survey was used in Phase I (n=25) to assess the quality of sleep using PSQI. In phase II, an evaluative approach was used through one group pre-test post-test design (n=19).The participants with …
Effectiveness Of Choice Music And Anandabhairavi Raga On Adult Patients’ Pre-Procedural Anxiety, Jomon C. U Mr, Raja A
Effectiveness Of Choice Music And Anandabhairavi Raga On Adult Patients’ Pre-Procedural Anxiety, Jomon C. U Mr, Raja A
Manipal Journal of Nursing and Health Sciences
Introduction: Patients become anxious prior to any invasive procedures. In an attempt to relieve anxiety among the patients undergoing invasive endoscopic interventions, music has been proposed as safe and inexpensive antianxiety intervention. Methods: The study aimed to compare the effectiveness of Choice music and Anandabhairavi raga on adult patients’ pre-procedural anxiety in Kasturba Medical College and Hospital (KMCH), Mangalore. Trueexperimental pre-test post-test design was used. Using purposive sampling technique with random assignment, 30 samples each were assigned to both the Choice music and Anandabhairavi raga groups. Pre-procedural anxiety was assessed in both the groups before and after music intervention. Results: …
Stress Factors Among Caregivers Of Children With Thalassemia, Valliammal _. Shanmugam Ms, Ramachandra
Stress Factors Among Caregivers Of Children With Thalassemia, Valliammal _. Shanmugam Ms, Ramachandra
Manipal Journal of Nursing and Health Sciences
Introduction: Thalassemia is one of the most common genetic diseases known to mankind. Children with Thalassemia require medical, surgical and nursing care. Family members and caregivers of the affected children play a vital role during treatment. Moreover, they also undergo abundant stress and emotional changes concerning their children’s lives. Objective: To identify factors associated with stress and to correlate the factors with selected demographic variables in caregivers of children with Thalassemia. Materials and Methods: A descriptive survey was conducted among sixty caregivers of children with Thalassemia, admitted in the Thalassemia ward of a selected hospital in Bangalore. Demographic data of …
Statistical And Methodological Challenges In Cochrane Public Health Systematic Reviews: An Overview, Melissa Glenda Lewis Ms, Ravishankar N Mr, Anusha Mujja Ms, Sreekumaran Nair N Dr
Statistical And Methodological Challenges In Cochrane Public Health Systematic Reviews: An Overview, Melissa Glenda Lewis Ms, Ravishankar N Mr, Anusha Mujja Ms, Sreekumaran Nair N Dr
Manipal Journal of Nursing and Health Sciences
Background: The article aims to investigate the suitability of Cochrane handbook for the preparation of systematic reviews of public health importance. Methods: The information about various aspects of a systematic review was extracted from all 39 Cochrane public health systematic reviews, independently by three reviewers. This was carried out by means of a data extraction form and was examined if the methodological constructs used by the reviews have been furnished in the Cochrane handbook. Results and Discussion: It was observed that17 (44%) of the 39 reviews adopted meta-analysis and 20(52%) of the systematic reviews used the risk of bias assessment …
Significance Of Herb-Drug Interactions In Clinical Practice: A Narrative Review, K J. Malagi Dr, Kamath Madhusudhana Dr
Significance Of Herb-Drug Interactions In Clinical Practice: A Narrative Review, K J. Malagi Dr, Kamath Madhusudhana Dr
Manipal Journal of Nursing and Health Sciences
Background: There has been a drastic increase in herb-drug interactions day-by-day as a result of an increase in the population using herb and its supplements along with the contemporary medicines. Objectives: To discuss the safety of usage of herbal medicines along with contemporary medicines in the management of lifestyle disorders. Method: This is a systemic review with narrative analysis. A study was carried out to understand the mode of herb-drug interaction in lifestyle disorders. Literature search was conducted with various titles and reports on medical indexed journals, focusing on herb-drug interaction on selected lifestyle disorders. Conclusion: The issue like herb-drug …
Multiple Fungal Brain Abscesses In A Neonate: Successful Treatment With Liposomal Amphotericin B, Leslie Lewis Dr, Jayashree P Dr, Y Ramesh Bhat Dr
Multiple Fungal Brain Abscesses In A Neonate: Successful Treatment With Liposomal Amphotericin B, Leslie Lewis Dr, Jayashree P Dr, Y Ramesh Bhat Dr
Manipal Journal of Nursing and Health Sciences
Invasive fungal infections are common among infants hospitalized in the Neonatal Intensive Care Unit (NICU). Central Nervous System (CNS) involvement occurs in two third of the disseminated fungal sepsis. Fungal cerebral abscess is one of the severe complications of disseminated fungal sepsis. We report a case of multiple fungal brain abscesses in a term neonate, which was successfully treated with Liposomal Amphotericin B.