University of Southern Mississippi
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Reducing Congestive Heart Failure Readmissions through Discharge Planning and Education
Get PDFChronic heart failure (CHF) is a widespread problem among individuals, which, at the same time, consumes a considerable share of global healthcare demand. CHF management poses a persistent issue mainly due to the short interval of hospital readmissions four weeks after discharge, which indicates deficiencies in care transitions and patient education. This doctoral project addresses this topic and evaluates whether implementing patient-specific education and discharge planning programs can decrease CHF-associated hospital readmissions. To investigate the phenomenon, the DNP student completed a retrospective chart review, found an intervention, implemented said intervention, and then evaluated the intervention\u27s effectiveness versus interventions already in place. The doctoral project outcomes are anticipated to bring meaningful insights into implementing evidence-based strategies to better manage CHF, improve patient outcomes, reduce hospital readmissions by 25%, and reduce healthcare costs. The doctoral project seeks to improve quality and patient outcomes through patient care and education and lessen the economic impact of hospital readmissions related to chronic heart failure. Providing comprehensive discharge education to patients and their family members helps close the gap in the transition of care between hospital and home, ultimately reducing CHF readmissions
Lithotomy and Sitting Positioning: An Objective Structured Clinical Examination
Get PDFA foundational skill for anesthesia providers is the ability to safely position surgical patients in a wide variety of surgical positions. Two commonly used surgical positions are the lithotomy and sitting positions. These positions have potential complications that include loss of control of the airway, accidental removal of invasive lines, physiological derangements, soft tissue injury, and nerve injury (Barash et al., 2017). Chui et al. (2018) identified that peripheral nerve injury accounted for 12% of closed claims relating to procedures done under general anesthesia and the most common identifiable event is positioning. The median payout for a peripheral nerve injury claim was calculated to be $80,250 (Chui et al., 2018). Due to how commonly these positions are used, with the potential physiological and financial complications, it is imperative that anesthesia providers receive extensive training in the positioning of surgical patients.
Objective Structured Clinical Examination (OSCE) is a common education tool that is used to teach and empirically test students in clinical simulation scenarios. The University of Southern Mississippi (USM) Nurse Anesthesia Program (NAP) did not have OSCEs developed for the lithotomy and sitting position as part of its curriculum. Therefore, the goal of this DNP project was the development of OSCEs for each of these positions from current evidence-based literature. A panel of current anesthesia providers, USM NAP faculty, and anesthesia students at USM NAP were surveyed to evaluate the developed OSCEs. The survey data showed that the OSCEs were well received, represented evidence-based doctoral-level work, addressed potential complications of each position, and would improve learner confidence
Observations of Lateral Salinity Variability at a Deltaic-Bay Transition Zone, Mobile Bay, Alabama
Get PDFExamining Executive Functions and Cognitive Emotion Regulation as Pathways from Childhood Adversity to Learning Effectiveness and Subsequent Functional Impairment in College Students
No full textAdverse childhood experiences (ACEs) refer to childhood abuse, neglect, and household dysfunction that impact later behavioral and physical health, academic, and occupational outcomes (Felitti et al., 1998; Metzler et al., 2017). Prior, studies have more recently shown that ACEs predict deficits in executive functions (Lund et., 2022; Wilson, 2020) and emotional regulation (Badour & Feldner, 2013) and these variables have been found to impact the relation between ACEs and multiple domains of functioning (e.g., psychosocial, behavioral, physical health; Boles, 2021; Cameron et al., 2018; Rudenstine et al., 2019; Trossman et al., 2020). However, no known study has simultaneously examined executive functions and cognitive emotion regulation as mediators of the relation between ACEs and functional outcomes that are particularly relevant to emerging adults. Given these gaps in the literature, the primary aim of this study was to examine pathways through which ACEs are negatively associated with learning effectiveness and positively associated with functional impairment. A sample of 4153 college students across 7 universities completed online measures via Qualtrics. Results revealed that the relation between ACEs and learning effectiveness and subsequent functional impairment was mediated by executive functioning deficits and maladaptive cognitive emotion regulation. Without learning effectiveness in the model, associations were in the expected negative direction and executive functioning deficits and maladaptive cognitive emotion regulation partially mediated the association between ACEs and functional impairment. Thus, the results of this study highlight the importance of utilizing clinical interventions that target maladaptive cognitive emotion regulation and executive functioning deficits to help mitigate the impact of ACEs on learning effectiveness and functional impairment in college students
Ecologies of Invasion and Welsh Resistance in Late Medieval Arthuriana
No full textThis dissertation analyzes how Welsh and non-Welsh literary texts, during and following the Norman Invasion of Wales (1067–1266), attempt to construct a unified Welsh identity, despite Wales itself being largely ununified throughout the Middle Ages and having a significant amount of internal difference. Often, these attempts to define “Welshness” incorporated environmental factors, which I analyze through a postcolonial ecocritical framework to argue that both the Welsh and Anglo-Normans participate in similar projects that attempt to define the Welsh through their relationship to the Welsh environment. While the Anglo-Normans do this as a means of “othering” the Welsh against themselves, the Welsh try to solidify their identity in response to the Normans’ colonization as a means of resistance. When the Arthurian legend emigrates to the European continent, French romances show a shift in how Wales features in the romance. Rather than questions of Welsh identity being at the forefront of Arthurian considerations, French romances marginalize Wales and the Welsh but do not entirely eliminate the earlier considerations of twelfth-century Arthuriana.
I argue that the interactions between the Welsh and Anglo-Normans were more nuanced than is often acknowledged in prior scholarship. This nuance becomes clear when considering the environmental depictions of Wales in texts that participate in the collective project of Arthurian legend. I examine Middle Welsh texts such as the First Branch of the Mabinogi and poems from the Book of Taliesin and the Black Book of Carmarthen alongside Latin sources, like Geoffrey of Monmouth’s Vita Merlini, Old French sources, such as the Lancelot-Grail Cycle and Marie de France’s Lanval, as well as the Middle English adaptation thereof, Sir Launfal. Examining the connections between these texts demonstrates how Arthuriana developed predominantly during the twelfth through thirteenth centuries, from a corpus of works invested in environmental tropes about Wales to a corpus more invested in English conquest, because of the Norman Invasion of Wales
Localized Hermite Method of Approximate Particular Solutions
Get PDFA localized Hermite method of approximate particular solutions (LHMAPS) is presented in this dissertation. This method is designed to improve the accuracy of the localized method of approximate particular solutions (LMAPS) for solving partial differential equations. LMAPS is a strong-form method that defines local radial basis function approximations to the solution values at a group of collocation points before applying the differential operator to this approximation function. Based on the LMAPS\u27s local scheme, LHMAPS seeks Hermite-type local approximations based on both function values and derivatives. Numerical experiments validate the superior accuracy of the proposed method to the LMAPS by solving the 2D Poisson equation, Helmholtz equation, and convection-reaction-diffusion equation. Also, when the convection term is dominating in the convection-reaction-diffusion problem, we employ the up-winding technique to control the oscillatory nature of the numerical solution. Again, numerical results show that the proposed method has better accuracy than LMAPS and RBF-HFD
Development of Polymeric-based Materials for Enhanced Mass and Heat Transport
No full textPolymeric materials are widely used in separation membranes and thermal management applications, yet improving their mass and heat transport properties remains a notable challenge. This work explores the use of coatings derived from polydopamine to enhance the antifouling properties of oil-water separation membranes. Additionally, the versatile thiol-ene chemistry was employed to fabricate polymer composites with enhanced thermal conductivity and gas separation.
Chapter I provides a comprehensive overview of oil-water emulsions, focusing on their background and separation techniques. It covers various aspects such as the sources of oil-water emulsions, the classification of emulsion types, typical demulsification methods, and the range of technologies employed for separating oil-water emulsions.
Chapter II explores the investigation of surface modification using polydopamine to mitigate inherent oil fouling in poly(vinylidene fluoride) microfiltration membranes. This work aimed to address the unwanted membrane pore blockage by exploring methods to control the morphology of polydopamine deposition on membrane surfaces, with the ultimate objective of minimizing pore blockage and enhancing oil-water separation performance.
Chapter III discusses the thermal transport within polymer composites, focusing on the various classes of thermally conductive fillers and the different techniques for measuring thermal conductivity. Furthermore, the chapter reviews the diverse applications of thermally conductive polymer composites.
Chapter IV delves into the investigation of dopamine surface modification of boron nitride filler to facilitate the decoration of silver nanoparticles on the filler platelets’ surface, aiming to enhance the thermal conductivity of poly(lactic acid) composites by promoting better dispersion and interaction between the filler and the polymer matrix.
In Chapter V, thiol-ene ‘photo-click’ polymerization was described to fabricate thermally conductive polymer composites. This work aimed to evaluate and compare the influence of boron nitride on the thermal conductivity of rubbery versus glassy polymeric networks. Furthermore, the effects of solvent and filler particle size on thermal conductivity are investigated.
Chapter VI provides an overview of the thiol-ene ‘photo-click’ polymerization introduced in Chapter V, aimed at addressing the trade-off between gas selectivity and permeability observed in pure polymeric membranes, along with the challenges posed by the high operational and production costs of inorganic membranes. This chapter centers on the fabrication of zeolite/thiol-ene mixed matrix membranes with enhanced gas separation performance
Understanding The Variability Of Circulation And Water Quality At Experimental Oyster Leases In The Mississippi Sound Using A High-Resolution Nested Modeling Approach
Get PDFFour 50-acre experimental oyster leases; two near Saint Louis Bay (StLB) and two near Pascagoula Bay (PB) were recommended to provide science-based guidance for oyster reef restoration efforts in response to continued limited productivity of oysters in the Mississippi Sound (MSS). Two-way nested simulations using ROMS within COAWST modeling framework have been run with improved forcings to analyze circulation, salinity and temperature variability within and around the lease areas under the extreme freshwater inflow from Bonnet Carré Spillway (BCS) openings and local rivers in 2019. High-resolution atmospheric forcing data is crucial because diurnal sea-land breeze affects salinity variability by increasing the vertical mixing and affecting shelf water intrusion in the MSS. Oyster lease areas are affected differently under high and low freshwater inflow conditions depending on the mean circulation variability at StLB and PB regions in response to the combined effects of different forcings i.e., high freshwater inflow from BCS and local rivers, winds, shelf water intrusion on different timescales i.e., hourly, daily, bi-weekly, seasonal. Oyster leases near StLB show more criticality (vulnerability) under low salinity conditions than the leases near PB which shows criticality (vulnerability) in terms of low salinity conditions during spring and summer and high salinity conditions during fall. This study identified suitable and critical (vulnerable) locations for potential oyster reef productivity in the MSS considering the fair condition ranges of temperature and salinity for oyster spat age class. This eventually helps the policymakers and stakeholders to find suitable locations for oyster reefs under changing climate