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Articles 3301 - 3330 of 5586
Full-Text Articles in Entire DC Network
The Rider (2021-03-29), Jacqueline Peraza
Forecasting Of The Covid-19 Epidemic: A Scientometric Analysis, Pandri Ferdias, Ansari Saleh Ahmar
Forecasting Of The Covid-19 Epidemic: A Scientometric Analysis, Pandri Ferdias, Ansari Saleh Ahmar
Library Philosophy and Practice (e-journal)
This study presented a scientometric analysis of scientific publications with discussions of forecasting and COVID-19. The data of this study were obtained from the Scopus database using the keywords: ( TITLE-ABS-KEY (forecast) AND TITLE-ABS-KEY (covid)) and the data were taken on March 26, 2021. This study was a scientometric study. The data were subsequently analyzed using the VosViewer and Bibliometrix R Package. The results showed that “COVID-19” was the keyword most frequently used by researchers, followed by “forecasting” and “human”. Authors who discussed the topic of forecasting COVID-19 come from 83 different countries/regions, with the most articles sent by authors …
Mechanisms And Mitigation: Effects Of Light Pollution On West Nile Virus Dynamics, Meredith E. Kernbach
Mechanisms And Mitigation: Effects Of Light Pollution On West Nile Virus Dynamics, Meredith E. Kernbach
USF Tampa Graduate Theses and Dissertations
Light pollution, or the presence of unnatural light at night, is a pervasive and growing problem across the globe. While often pictured in urban centers, light pollution is far reaching and can affect seemingly safe and minimally developed environments. For example, agricultural communities with artificial lighting near facilities can generate such light pollution in rural areas. Further, streetlights and illuminated billboards along roads and highways can generate light pollution far from cities. Given how pervasive this anthropogenic stressor is, it is surprising that not much is known about how artificial light at night, or ALAN, affects humans or wildlife, especially …
A New Chapter In The Life Of The Journal, Julio A. Ramirez
A New Chapter In The Life Of The Journal, Julio A. Ramirez
The University of Louisville Journal of Respiratory Infections
No abstract provided.
A Transition Of Uljri Leadership, Forest W. Arnold, Jose Bordon
A Transition Of Uljri Leadership, Forest W. Arnold, Jose Bordon
The University of Louisville Journal of Respiratory Infections
No abstract provided.
2021-03-27_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services
2021-03-27_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services
Michigan COVID-19 Syndromic Surveillance System Data
The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.
Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …
Slowing The Spread Of Covid-19: Review Of “Social Distancing” Interventions Deployed By Public Transit In The United States And Canada, Camille Kamga, Penny Eickemeyer
Slowing The Spread Of Covid-19: Review Of “Social Distancing” Interventions Deployed By Public Transit In The United States And Canada, Camille Kamga, Penny Eickemeyer
Publications and Research
This paper presents a review of social distancing measures deployed by transit agencies in the United States and Canada during the COVID-19 pandemic and discusses how specific operators across the two countries have implemented changes. Challenges and impacts on their operations are also provided.
Social distancing is one of the community mitigation measures traditionally implemented during influenza pandemics and the novel coronavirus pandemic. Research has shown that social distancing is effective in containing the spread of disease. This is applicable to the current situation with the novel coronavirus, given the lack of effective vaccines and treatments in the United States …
Soft Power And Its Impact On Relations Between Countries In Light Of The Corona Pandemic, Names Of Khaled Gerges
Soft Power And Its Impact On Relations Between Countries In Light Of The Corona Pandemic, Names Of Khaled Gerges
Uruk Journal of Human Sciences
The study seeks to demonstrate the extent of the impact of soft power on the foreign relations of countries in light of the Corona pandemic (Covid-19), and how soft power tools enabled the great countries (the United States of America, China, Russia, and some European Union countries) to achieve their strategy to influence structural changes in the Map of the world in light of the Corona pandemic, reaching an analysis and evaluation of the effects of soft power within the organized strategic framework to achieve the foreign policy goals of the countries of the United States of America, Russia and …
Network-Based Analysis Of Early Pandemic Mitigation Strategies: Solutions, And Future Directions, Pegah Hozhabrierdi, Raymond Zhu, Maduakolam Onyewu, Sucheta Soundarajan
Network-Based Analysis Of Early Pandemic Mitigation Strategies: Solutions, And Future Directions, Pegah Hozhabrierdi, Raymond Zhu, Maduakolam Onyewu, Sucheta Soundarajan
Northeast Journal of Complex Systems (NEJCS)
Despite the large amount of literature on mitigation strategies for pandemic spread, in practice, we are still limited by naive strategies, such as lockdowns, that are not effective in controlling the spread of the disease in long term. One major reason behind adopting basic strategies in real-world settings is that, in the early stages of a pandemic, we lack knowledge of the behavior of a disease, and so cannot tailor a more sophisticated response. In this study, we design different mitigation strategies for early stages of a pandemic and perform a comprehensive analysis among them. We then propose a novel …
Flattening The Curve: The Effects Of Intervention Strategies During Covid-19, Kelly A. Reagan, Rachel J. Pryor, Gonzalo M. Bearman, David M. Chan
Flattening The Curve: The Effects Of Intervention Strategies During Covid-19, Kelly A. Reagan, Rachel J. Pryor, Gonzalo M. Bearman, David M. Chan
Spora: A Journal of Biomathematics
COVID-19 has plagued countries worldwide due to its infectious nature. Social distancing and the use of personal protective equipment (PPE) are two main strategies employed to prevent its spread. A SIR model with a time-dependent transmission rate is implemented to examine the effect of social distancing and PPE use in hospitals. These strategies’ effect on the size and timing of the peak number of infectious individuals are examined as well as the total number of individuals infected by the epidemic. The effect on the epidemic of when social distancing is relaxed is also examined. Overall, social distancing was shown to …
Medical School Watercooler Newsletter - March 26, 2021, Lindsey Lyle
Medical School Watercooler Newsletter - March 26, 2021, Lindsey Lyle
Watercooler Newsletter
This is the March 26, 2021 edition of the Frederick P. Whiddon College of Medicine's newsletter - Watercooler.
Contents Include:
- Med School Café video online: 'Colorectal Cancer Awareness'
- Medical student launches partnership with PASSAGE USA program
- Med School Café to address colorectal cancer surgery
- Meet a Med Student: Marley Lee
- USA to host lecture on the ethics of global health research
- Sports medicine specialist joins family medicine faculty
2021-03-26_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services
2021-03-26_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services
Michigan COVID-19 Syndromic Surveillance System Data
The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.
Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …
Childhood Abuse, Invalidation, And Personality In A College Population, Kayleigh M. Heard
Childhood Abuse, Invalidation, And Personality In A College Population, Kayleigh M. Heard
Honors College Theses
Studies show the detrimental effects of childhood maltreatment (i.e., childhood physical abuse, childhood sexual abuse, invalidation, and multiple forms of maltreatment; Afifi et al., 2016). Research demonstrates individuals with a history of childhood maltreatment have distinct patterns of personality characteristics (Allen & Lauterbach, 2007). Specifically, individuals with history of childhood maltreatment typically report high neuroticism, high openness, and low agreeableness compared to those with no history of maltreatment (Distel et al., 2009; Huang et al., 2012). Less is known about personality differences among individuals with different forms of childhood maltreatment (e.g., physical abuse vs. sexual abuse vs. invalidation vs. multiple …
Exploring Anti-Schistosoma Analog Sa01, Sarah Alsuleiman
Exploring Anti-Schistosoma Analog Sa01, Sarah Alsuleiman
UNO Student Research and Creative Activity Fair
Schistosomiasis is a waterborne parasitic worm infection able to infect in the larval stage through direct skin penetration. This disease affects approximately 270 million people worldwide and is widespread in tropical as well as subtropical regions with higher distribution in areas lacking sufficient sanitation and safe drinking water. Although some possible alternatives are emerging, currently, the most effective drug treatment is praziquantel (PZQ). However, PZQ is only effective against the adult stage of the worm, allowing juvenile worms to progress in the infection. Furthermore, Schistosoma is developing resistance to this drug as reduced efficacy has been noted. As a result, …
Metabolism And Oncology: The Role Of Nutrition In Improving Cancer Outcomes, Michael A. Chapek
Metabolism And Oncology: The Role Of Nutrition In Improving Cancer Outcomes, Michael A. Chapek
University Honors Theses
Despite significant advances in oncologic treatment, underlying cancer-associated metabolic derangements and nutritional needs remain largely neglected in cancer care. Cancer cachexia and protective metabolic changes exhibited by cancerous cells continue to pose formidable barriers to improving therapeutic outcomes and quality of life for patients. Cancer has traditionally been viewed as a proliferative disease caused by genetic mutations, but newer perspectives suggest that it is primarily a metabolic disease. The present paper discusses the etiology of cachexia and sarcopenia, and nutritional interventions that can be offered to patients suffering from these wasting disorders. The role of inflammation in cancer and the …
Covid-19 Vaccine And Hyperosmolar Hyperglycemic State, Mohammed A. Abu-Rumaileh, Ahmad M. Gharaibeh, Naser Eddin Gharaibeh
Covid-19 Vaccine And Hyperosmolar Hyperglycemic State, Mohammed A. Abu-Rumaileh, Ahmad M. Gharaibeh, Naser Eddin Gharaibeh
Faculty and Staff Publications
Coronavirus disease 2019 (COVID-19) is a multi-system disease that causes multiple complications. It is linked to the development of new-onset diabetes or unmasking of underlying diabetes. Despite the uncertain exact mechanism, pancreatic angiotensin-converting enzyme 2 (ACE2) receptor, the main enzyme related to COVID-19 pathophysiology has been implied. COVID-19 vaccine was authorized to help control the rapid spread of COVID-19 disease. We report a case of new-onset diabetes type 2 presenting as hyperosmolar hyperglycemic state (HHS) in a patient after receiving COVID-19 vaccine with some literature review of the potential mechanisms by which COVID-19 may cause new-onset diabetes type 2.
Screening Of Pregnant Women With Opioid Use Disorder: Identifying Factors Impacting Implementation Of Screening Recommendations Using The Theoretical Domains Framework, Tara R. Foti
USF Tampa Graduate Theses and Dissertations
Background: Prenatal opioid exposure is a growing problem in the United States with high and increasing rates of opioid use and opioid use disorder during pregnancy. Almost 23% of pregnant women enrolled in Medicaid programs filled an opioid prescription during pregnancy in 2007, marking a 21.1% increase since 2000. Maternal opioid use during pregnancy is associated with a variety of poor maternal, pregnancy and infant outcomes, including overdose, pregnancy-associated death, prematurity, low birth weight and Neonatal Opioid Withdrawal Syndrome. To optimize prenatal care and pregnancy-associated outcomes, the Alliance for Innovation in Maternal Health, in collaboration with The American College of …
An Inactivated Bacterium (Paraprobiotic) Expressing Bacillus Thuringiensis Cry5b As A Therapeutic For Ascaris And Parascaris Spp. Infections In Large Animals, Joseph F. Urban, Martin K. Nielsen, David Gazzola, Yue Xie, Ethiopia Beshah, Yan Hu, Hanchen Li, Florentina Rus, Kelly Flanagan, Austin Draper, Sridhar Vakalapudi, Robert W. Li, Gary R. Ostroff, Raffi V. Aroian
An Inactivated Bacterium (Paraprobiotic) Expressing Bacillus Thuringiensis Cry5b As A Therapeutic For Ascaris And Parascaris Spp. Infections In Large Animals, Joseph F. Urban, Martin K. Nielsen, David Gazzola, Yue Xie, Ethiopia Beshah, Yan Hu, Hanchen Li, Florentina Rus, Kelly Flanagan, Austin Draper, Sridhar Vakalapudi, Robert W. Li, Gary R. Ostroff, Raffi V. Aroian
Maxwell H. Gluck Equine Research Center Faculty Publications
Ascaris and Parascaris are important parasites in the family Ascarididae, large, ubiquitous intestinal-dwelling nematodes infecting all classes of vertebrates. Parasitic nematode drug resistance in veterinary medicine and drug recalcitrance in human medicine are increasing worldwide, with few if any new therapeutic classes on the horizon. Some of these parasites are zoonotic, e.g., Ascaris is passed from humans to pigs and vice versa. The development of new therapies against this family of parasites would have major implications for both human and livestock health. Here we tested the therapeutic ability of a paraprobiotic or dead probiotic that expresses the Bacillus …
Caring For Patients, Blazers Through Covid-19, Reporter Staff
Caring For Patients, Blazers Through Covid-19, Reporter Staff
Browse All News
No abstract provided.
Daily Eastern News: March 25 2021, Eastern Illinois University
Daily Eastern News: March 25 2021, Eastern Illinois University
March
No abstract provided.
Warm Autoimmune Hemolytic Anemia Associated With Asymptomatic Sars-Cov-2 Infection., Joseph R Liput, Kim Jordan, Rini Patadia, Elizabeth Kander
Warm Autoimmune Hemolytic Anemia Associated With Asymptomatic Sars-Cov-2 Infection., Joseph R Liput, Kim Jordan, Rini Patadia, Elizabeth Kander
Ambulatory and Primary Care Articles
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the resultant coronavirus disease 2019 (COVID-19) are associated with several hematologic abnormalities, including immune thrombocytopenia, antiphospholipid syndrome, and autoimmune hemolytic anemia (AIHA). Initial case reports suggested immune dysregulation to be the underlying etiology of SARS-CoV-2-associated AIHA, as all reported cases involved patients with moderate to severe COVID-19, many of whom had underlying lymphoproliferative disorders. More recently, AIHA has been reported in patients with mildly symptomatic SARS-CoV-2 infection. Here, we detail a patient with asymptomatic SARS-CoV-2 infection who presented with severe, symptomatic anemia. Workup was consistent with warm autoimmune hemolytic anemia (WAIHA) secondary …
Inactivated Rabies Virus Vectored Sars-Cov-2 Vaccine Prevents Disease In A Syrian Hamster Model., Drishya Kurup, Delphine C Malherbe, Christoph Wirblich, Rachael Lambert, Adam J Ronk, Leila Zabihi Diba, Alexander Bukreyev, Matthias J. Schnell
Inactivated Rabies Virus Vectored Sars-Cov-2 Vaccine Prevents Disease In A Syrian Hamster Model., Drishya Kurup, Delphine C Malherbe, Christoph Wirblich, Rachael Lambert, Adam J Ronk, Leila Zabihi Diba, Alexander Bukreyev, Matthias J. Schnell
Department of Microbiology and Immunology Faculty Papers
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emergent coronavirus that has caused a worldwide pandemic. Although human disease is often asymptomatic, some develop severe illnesses such as pneumonia, respiratory failure, and death. There is an urgent need for a vaccine to prevent its rapid spread as asymptomatic infections accounting for up to 40% of transmission events. Here we further evaluated an inactivated rabies vectored SARS-CoV-2 S1 vaccine CORAVAX in a Syrian hamster model. CORAVAX adjuvanted with MPLA-AddaVax, a TRL4 agonist, induced high levels of neutralizing antibodies and generated a strong Th1-biased immune response. Vaccinated hamsters were protected from …
Viral Infection Modulates Qa-1b In Infected And Bystander Cells To Properly Direct Nk Cell Killing., Maria Ferez, Cory J. Knudson, Avital Lev, Eric B. Wong, Pedro Alves-Peixoto, Lingjuan Tang, Colby Stotesbury, Luis J. Sigal
Viral Infection Modulates Qa-1b In Infected And Bystander Cells To Properly Direct Nk Cell Killing., Maria Ferez, Cory J. Knudson, Avital Lev, Eric B. Wong, Pedro Alves-Peixoto, Lingjuan Tang, Colby Stotesbury, Luis J. Sigal
Department of Microbiology and Immunology Faculty Papers
Natural killer (NK) cell activation depends on the signaling balance of activating and inhibitory receptors. CD94 forms inhibitory receptors with NKG2A and activating receptors with NKG2E or NKG2C. We previously demonstrated that CD94-NKG2 on NK cells and its ligand Qa-1b are important for the resistance of C57BL/6 mice to lethal ectromelia virus (ECTV) infection. We now show that NKG2C or NKG2E deficiency does not increase susceptibility to lethal ECTV infection, but overexpression of Qa-1b in infected cells does. We also demonstrate that Qa-1b is down-regulated in infected and up-regulated in bystander inflammatory monocytes and B cells. Moreover, NK cells activated …
Facial Mask Use And Covid-19 Protection Measures In Jefferson County, Kentucky: Results From An Observational Survey, November 5−11, 2020, Seyed M. Karimi, Sonali S. Salunkhe, Kelsey B. White, Sahal A. Alzahrani, Bert Little, William P. Mckinney, Natalie Dupre, Riten Mitra, Yuting Chen, Martha M Popescu, Emily R. Adkins, Julia A. Barclay, Emmanuel Ezekekwu, Caleb.He X. He, Dylan M Hurst, Aravindreddy Kothagadi, Shaminul H. Shakib, Devin N. Swinney, David A. Johnson, Rebecca Hollenbach, Sarah Moyer
Facial Mask Use And Covid-19 Protection Measures In Jefferson County, Kentucky: Results From An Observational Survey, November 5−11, 2020, Seyed M. Karimi, Sonali S. Salunkhe, Kelsey B. White, Sahal A. Alzahrani, Bert Little, William P. Mckinney, Natalie Dupre, Riten Mitra, Yuting Chen, Martha M Popescu, Emily R. Adkins, Julia A. Barclay, Emmanuel Ezekekwu, Caleb.He X. He, Dylan M Hurst, Aravindreddy Kothagadi, Shaminul H. Shakib, Devin N. Swinney, David A. Johnson, Rebecca Hollenbach, Sarah Moyer
The University of Louisville Journal of Respiratory Infections
Introduction: The transmission of respiratory infectious diseases such as COVID-19 can significantly decrease by mask-wearing. However, accurate information about the extent and proper use of the facial mask is scarce. This study’s main objective was to observe and analyze mask-wearing behavior and the level of COVID-19 protection measures in indoor public areas (PAs) of Jefferson County, Kentucky.
Methods: For conducting the observational survey study, targets were indoor PAs, and zip codes were defined as surveying clusters. The number of selected PAs in each zip code was proportional to the population and the total number of PAs in that zip code. …
Sars-Cov-2 Transmission In Alberta, British Columbia, And Ontario, Canada, December 25, 2019, To December 1, 2020, Isaac Chun-Hai Fung, Yuen Wai Hung, Sylvia Ofori, Kamalich Muniz-Rodriguez, Po-Ying Lai, Gerardo Chowell
Sars-Cov-2 Transmission In Alberta, British Columbia, And Ontario, Canada, December 25, 2019, To December 1, 2020, Isaac Chun-Hai Fung, Yuen Wai Hung, Sylvia Ofori, Kamalich Muniz-Rodriguez, Po-Ying Lai, Gerardo Chowell
Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications
Objective:
This study aimed to investigate coronavirus disease (COVID-19) epidemiology in Alberta, British Columbia, and Ontario, Canada.
Methods:
Using data through December 1, 2020, we estimated time-varying reproduction number, R t , using EpiEstim package in R, and calculated incidence rate ratios (IRR) across the 3 provinces.
Results:
In Ontario, 76% (92 745/121 745) of cases were in Toronto, Peel, York, Ottawa, and Durham; in Alberta, 82% (49 878/61 169) in Calgary and Edmonton; in British Columbia, 90% (31 142/34 699) in Fraser and Vancouver Coastal. Across 3 provinces, R t dropped to ≤ 1 after April. …
2021-03-24_Michiganoverview_Covidtestingtimes, Michigan Department Of Health & Human Services
2021-03-24_Michiganoverview_Covidtestingtimes, Michigan Department Of Health & Human Services
Michigan COVID-19 Testing Turnaround Data
The COVID Testing Turnaround Time page was obtained from Michigan's COVID-19 data page: https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173-545615--,00.html.
This report was created by the Michigan Department of Health & Human Services, providing data for the past 14 days on the average time it takes for a diagnostic COVID-19 laboratory test to be reported to the state health department. Testing turnaround time data will be updated weekly on Friday mornings.
MDHHS receives results from commercial labs, hospitals, and public health labs. However, public health laboratories perform limited diagnostic testing and disease surveillance for infectious diseases. Total turnaround time is calculated from the difference of …
Ecological Physiology Of Rafinesque’S Big-Eared Bats (Corynorhinus Rafinesquii) Roosting In An Anthropogenic Structure In Arkansas, Benjamin N. Spitz
Ecological Physiology Of Rafinesque’S Big-Eared Bats (Corynorhinus Rafinesquii) Roosting In An Anthropogenic Structure In Arkansas, Benjamin N. Spitz
Student Theses and Dissertations
Rafinesque’s big-eared bats (Corynorhinus rafinesquii) are suffering habitat loss due to deforestation of bottomland hardwoods which an increase in agriculture forces maternity colonies to roost in anthropogenic structures. In Arkansas I explore how bats from maternity colonies in anthropogenic structures use torpor and how torpor is affected by chronic stress and ectoparasites. During June- August of 2018-2019, I surveyed a maternity colony inside a barn. Captured bats were tagged with temperature-sensitive transmitters and tracked to roost trees and the barn daily confirming day roosts. Using Lotek data loggers, data from transmitters were collected as skin temperature and compared to ambient …
Recent Lindenwood Graduate Is Accepted Into Top Public Health School In Uk, Lindenwood University
Recent Lindenwood Graduate Is Accepted Into Top Public Health School In Uk, Lindenwood University
Archived Lindenwood Press Releases
No abstract provided.
Implementing Interdisciplinary Team Rounding To Reduce External Ventricular Drain-Associated Infections, Laura Reiter
Implementing Interdisciplinary Team Rounding To Reduce External Ventricular Drain-Associated Infections, Laura Reiter
Student Scholarly Projects
External ventricular drains (EVD) are a common intervention in critical care areas for the management of hydrocephalus. The most common complication of this life-saving intervention is infection, which negatively impacts patient outcomes and overall healthcare costs. Current evidence shows that interdisciplinary team rounding improves compliance with evidence-based practice and reduces hospital-associated infection rates. The PICOT question that guided this project is: For patients with an external ventricular drain (EVD), what is the effect of interdisciplinary team rounding compared with the current practice of informal rounding, on compliance with an EVD care bundle and EVD-associated cerebrospinal fluid infections over two months? …
[Exceprt] Johns Hopkins Evidence-Based Practice For Nurses And Healthcare Professionals (4th Ed.), Deborah Dang, Sandra L. Dearholt, Kim Bissett, Madeleine Whalen, Judith Ascenzi
[Exceprt] Johns Hopkins Evidence-Based Practice For Nurses And Healthcare Professionals (4th Ed.), Deborah Dang, Sandra L. Dearholt, Kim Bissett, Madeleine Whalen, Judith Ascenzi
Sigma Publications: Book Excerpts
This item record pertains to an excerpt from Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals, Fourth Edition, which is provided free of charge by the publisher.
About this book: Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals has proven to be one of the most foundational books on EBP in nursing and healthcare. Building on the strength of previous versions, the fourth edition is fully revised to include updated content based on more than a decade of the model's use, refinement in real-life settings, and feedback from nurses and other healthcare professionals around the world.