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Mindfulness Meditation to Reduce Nurse Burnout: An EBP Implementation Project
Get PDFHospitals across the United States are suffering from poor staffing (American Nurses Foundation, 2021). A common thread throughout those facilities is that nurses are leaving their jobs due to self-reported burnout, contributing to the staffing shortage and low morale (Shah et al., 2021).
Mindfulness training plays a part in decreasing emotional exhaustion for staff nurses. A reduction of emotional exhaustion has been discovered after the implementation of mindfulness-based intervention programs, with continued improvement after completion of the program (Sarazine et al., 2021; Bianchini & Copeland, 2021). The benefit of this implementation would be a reduction of nurse burnout which ultimately affects nurse turnover. The cost of RN turnover ranges from 64,500 per RN (Gamble, 2022).
A change project was implemented with a cohort of 10 acute care travel nurses working in a variety of locations, who are experiencing symptoms of burnout and job dissatisfaction. The participants performed a self-guided mindfulness meditation or breathing exercise intervention prior to the beginning of each shift, for 10 weeks.
The nurses completed the Copenhagen Burnout Inventory prior to implementation and post-implementation. Pre-implementation survey results revealed a moderate incidence of burnout. The pre- and post-implementation survey results were compared and a reduction in burnout was noted by a decrease in the overall mean scores of the survey results. These findings indicate that this project implementation was successful and a reduction in the incidence of burnout was revealed.
Because there is a potential to decrease perceived stress levels, healthcare organizations must prioritize nurses’ access to mindfulness-based interventions (Bianchini & Copeland, 2021)
Synthetic Studies of Dragonamide E and Its Potential Treatment of Leishmaniasis
Get PDFLeishmaniasis is a parasitical infection categorized as one of about twenty Neglected Tropical Diseases. Spread by the female sand fly, it can become very severe if left untreated. Symptoms include skin lesions, which may cause scarring, and mucosal membrane infection, which may lead to facial deformity. The most severe form of leishmaniasis can infect organs such as the liver and spleen, possibly leading to death. The current treatments for leishmaniasis are becoming limited due to an increase in drug resistant parasites. Furthermore, the side effects of these treatments can be very problematic.
In the search for new treatments for tropical diseases such as leishmaniasis, researchers have been exploring marine plant compounds for their potential in drug development. In 2001, the first in a series of linear lipopeptides called the “dragonamides” was reported from marine cyanobacteria Lyngbya. The following years brought forth the isolation of additional members to the series, and in 2010, dragonamide E was discovered. This tetrapeptide has caught our interest due to its display of significant activity against Leishmania parasites in vitro. A total synthesis of dragonamide A was reported in 2005 by the Chen group. However, none of the other dragonamides have been reportedly synthesized to date. Smith conducted synthetic studies of dragonamide E, but encountered various obstacles, especially during amino acid coupling.
In this work, we present our progress toward a total synthesis of dragonamide E as well as a series of analogues that can be used to expand our understanding of the molecule’s activity. Herein we follow a retrosynthetic approach to visually break down dragonamide E into two fragments: the hydrophobic alkyne “tail” and the tetrapeptide “head.” We have successfully developed an efficient synthesis of the tail in excellent yield and high diastereomeric purity.
The latter part of this work will discuss our progress in peptide coupling of the amino acid head as well as the final addition of the tail via solid-phase peptide synthesis. The hindered coupling of N-methyl amino acids posed a significant challenge. We also report our synthesis of two non-methylated dragonamide analogues that might be useful as work continues in our lab
A MACHINE LEARNING APPROACH FOR THE EARLY DETECTION OF BRONCHOPULMONARY DYSPLASIA (BPD) IN PRETERM INFANTS USING INTER HYPOXEMIA INTERVALS
Get PDFPreterm birth is a significant global public health concern, affecting millions of babies yearly. Despite advancements in medical care that have improved the survival rates of preterm infants, preterm birth remains a leading cause of neonatal morbidity and mortality worldwide. It has both short-term and long-term health consequences that can profoundly impact the child\u27s growth and development, as well as their family and society.
One of the challenges preterm infants face is their underdeveloped immune system, which makes them more vulnerable to infections and other health problems. Their delicate condition requires specialized care, often provided in a Neonatal Intensive Care Unit (NICU). In NICUs, physiological signals such as heart rate and blood oxygen levels, also known as SpO2 levels, are monitored to ensure the well-being of these infants. However, there is currently no standardized technique for quantitatively evaluating the progress and development of preterm infants in the NICU.
Hypoxemia is a significant concern among the health complications associated with preterm birth. Hypoxemia refers to low oxygen levels in the blood and is a common issue in preterm infants. It is linked to a range of short-term and long-term health problems, including retinopathy of prematurity, neurodevelopmental disorders, and even mortality. Evaluating the severity of Hypoxemia and measuring the effectiveness of treatment require using indices related to its frequency, patterns of occurrence over time, and the total time spent in a hypoxic state.
Hypoxemia in preterm infants is associated with various complications, including bronchopulmonary dysplasia (BPD). BPD is a chronic lung disease that primarily affects preterm infants who require mechanical ventilation or oxygen therapy. It typically develops due to lung injury caused by mechanical ventilation and inflammation in the developing lung. Infants with BPD have trouble breathing and may require ongoing respiratory support, such as oxygen therapy or mechanical ventilation. BPD can also lead to long-term health complications, including impaired neurodevelopment, pulmonary hypertension, and an increased risk of respiratory infections. Currently, no established techniques are considered optimal for screening infants with evolving, established, or severe BPD. Developing quantifying measures that can predict BPD earlier than four weeks after birth would be highly beneficial for clinical settings.
However, developing a predictive model that customizes treatment plans based on an infant\u27s previous oxygenation behavior could assist clinicians in anticipating the infant\u27s condition and tailoring interventions accordingly. It is crucial to understand the temporal processes underlying hypoxemic events and analyze data on their frequency and distribution of inter-event intervals.
The first objective of this work is to analyze hypoxemic events in preterm infants and gain insights into the temporal dynamics underlying these events. This analysis aims to derive statistical models describing the occurrence and frequency of Hypoxemia in preterm infants. By studying the probability distribution of the inter-hypoxemia interval (IHI), and the duration between two successive hypoxemic events, valuable insights into the system dynamics can be obtained.
The second objective is to develop a signal-based model by incorporating IHI distribution features obtained from the analysis of data collected during the first week of life. This model aims to identify infants likely to be diagnosed with BPD. Early detection of BPD would enable timely interventions and improved clinical decision-making, potentially leading to better outcomes for preterm infants.
In conclusion, the stochastic properties of time intervals between adverse hypoxemia events were investigated in preterm infants. Theoretical distributions with observed data fit in and found high accuracy in characterizing these intervals. The analysis revealed that different distributions were suitable for capturing dynamics over short and long-time scales. Inter-hypoxemic interval (IHI) distributions were explored as potential indicators for predicting BPD. Remarkably, using only IHI parameters, the prediction model achieved an impressive 91% sensitivity for identifying BPD subjects. The findings suggest that IHI parameters can serve as early precursors for BPD prediction, providing clinicians with valuable insights during the first week of an infant\u27s life. Furthermore, the combination of IHI parameters with demographic factors like gestational age and birth weight yielded the best predictive model. These results contribute to our understanding of hypoxemia dynamics and offer valuable tools for managing the risks associated with BPD in preterm infants
Volksdrogen: The Third Reich Powered by Methamphetamine
Get PDFLeading up to and during the Second World War, the Nazified German Government wanted to perpetuate the belief that due to their exceptional strength spread through various forms of propaganda the “Aryan Race” was undefeatable. Unfortunately, this testament, and the propaganda that supported it, is still used by some to substantiate their claims that the Nazis devised the “master race”. The source of their strength has remained largely unresearched, so what was the factor that allowed the German home and war front to possess large amounts of energy to aid in their fight against the Allied forces? Initially, from whisperings at German pubs after the war was over, word began to spread outside of Germany that this unexplainable strength was, in fact, manufactured.
Volksdrogen: The Third Reich Powered by Methamphetamine analyzes the rise of German pharmaceuticals to how the German people during the interwar years and into World War II were able to gain boundless strength and energy to support and fight for their homeland. This paper examines how methamphetamine was accepted and integrated into German society due to its availability over-the-counter in pharmacies under the name Pervitin. Despite the anti-drug agenda pushed by the Nazis, Pervitin was widely accepted because initial studies showed it increased the productivity of the German people. As a result, it quickly became utilized by the Wehrmacht and Luftwaffe as a way to keep soldiers fighting. Examining this topic is important not only for understanding the deeper context of the war, but it is also crucial to preventing future generations from striving to achieve what the Nazis were fighting for
Early Mobilization for Adult Mechanically Ventilated Patients
Get PDFApproximately 13 million people worldwide receive treatment in intensive care units (ICUs) annually. Many patients admitted to the intensive care unit require mechanical ventilation for their survival and attempts to mobilize these critically ill patients is frequently restricted for their own safety. It has been suggested that this lack of mobility may have a significant negative impact on the recovery process and lengthen the time of the patient’s overall hospital stay and recovery. Additionally, survivors report significant physical impairments and deconditioning that present obstacles towards their recovery and well-being after prolonged ventilation
Virtual Human Resource Development: Definitions, Challenges, and Opportunities
No full textThe purpose of this article is to promote knowledge and understanding about the concept and utility of Virtual Human Resource Development (VHRD) for both research and practice in Human Resource Development (HRD). This article begins with a brief history of VHRD, defines VHRD, and then presents an appendix that summarizes key insights from 36 VHRD peer-reviewed publications located across five academic journals and 52 authors associated with this line of inquiry. The article then discusses challenges and opportunities associated with VHRD as a result of this summary which may be insightful for researchers and practitioners. It concludes by considering the implications of VHRD along with offering directions for future research in the VHRD space
Working Across Boundaries: School Leaders Redefining Communities of Practice Through Twitter
Get PDFAttrition rates among school leaders have risen in recent years, and scholars cite a lack of meaningful connections and responsive professional learning as leading reasons why they are leaving the field. School leaders are called to navigate unfamiliar and complex challenges, often working in isolation with limited opportunities for collaboration and professional growth. Social media forums, like Twitter, have potential to support a Community of Practice to facilitate learning around school leadership; however, there is a lack of scholarship exploring how school leaders use social media to support their needs. This mixed-methods study used sentiment and content analysis along with a phronetic iterative approach to explore how school leaders use Twitter to connect with others in the field. The umbrella categories of efficacy, agency, and resiliency emerged from the analysis, offering a glimpse into potential connections made through social media. The findings of this exploratory study suggest that principals are seeking connection, encouragement, and professional learning, yet further development in this area could help inform more formal practices to fill the gap in access to informal professional learning
Demonstrating the Benefits of Antihypertensive Nighttime Dosing and Indapamide Usage in Hypertension Management
Get PDFBackground: Uncontrolled hypertension, specifically nocturnal hypertension, increases the risk for significant clinical outcomes. Evidence on the use of nighttime antihypertensives is scant and conflicting. In addition, hydrochlorothiazide continues to be the primary thiazide used despite being the least potent. Objective: The primary purpose of this study was to evaluate instituting nighttime dosing to control hypertension and compare the short-term effectiveness of blood pressure control with indapamide versus hydrochlorothiazide. Methods: This was a retrospective, observational study. Participant inclusion criteria consisted of patients 18 years of age or older, a current diagnosis of hypertension, and hypertension that required medical therapy. The investigator documented whether a patient was taking at least one antihypertensive at night versus all morning medications, as well as the use of indapamide versus hydrochlorothiazide. The patient’s baseline and first follow-up blood pressure readings were documented. The primary outcome was to determine whether including nighttime dosing in antihypertensive regimens is more effective than all morning antihypertensive regimens. The secondary outcome was to determine whether indapamide was more effective than hydrochlorothiazide. Results: A total of 64 patients were included in the study. Twenty-eight patients were taking \u3e1 nighttime antihypertensives versus 32 patients on all morning medications. Patients on at least one nighttime medication demonstrated greater systolic blood pressure reduction. There was no difference in blood pressure reduction between indapamide and hydrochlorothiazide. Conclusion: The study findings support the use of nighttime dosing to improve blood pressure management. The results on the effectiveness of indapamide versus hydrochlorothiazide conflict with previous research
CLEAN ENERGY & SUSTAINABLE ENVIRONMENT BY CARBON DIOXIDE MITIGATION STRATEGIES
Get PDFDissolution trapping is one of the most dominant mechanisms for secure storage of CO2 injected in porous subsurface formations saturated with brine. This study uses a 2D visual Hele-Shaw cell to investigate and visualize the impact of CO2 injection locations, reservoir dipping angle, permeability heterogeneity, and brine with different initial ionic concentrations on the density-driven convection during CO2 dissolution (Chapter 2). Also, the role of complex heterogeneity, i.e., irregular permeability distribution in CO2 dissolution, is investigated using a novel experimental approach to create medium permeability heterogeneity in Hele-Shaw cells (Chapter 3). We observed that the presence of salts resulted in an earlier onset of convection and a larger convective finger wavelength than the case with no dissolved salts. Additionally, a higher lateral mixing between CO2 fingers is observed when dipping is involved. The CO2 dissolution, indicated by the area of the pH-depressed region, depends on the type and concentration of the ions present in the brine and is observed to be 0.38-0.77 times compared to when no salt is present. Although convective flow is slowed in the presence of salts, the diffusive flux is enhanced, as observed from both qualitative and quantitative results. The effect of discrete high- conductivity fractures within the flow barriers is also investigated, which showed an uneven vertical sweep and enhanced flow channeling. Complex subsurface transport phenomena such as preferential dissolution path, CO2 sweep efficiency, changes in finger morphology, and CO2 concentration distribution are visualized by creating heterogeneous media. Experimental results showed reservoir permeability heterogeneity causes significant channeling effects and poor sweep efficiency. A scaling relationship between average finger growth rate (Gr) and permeability (k) was obtained as [m.-1] = 266.8 [m2 ] + 1.20 × 10-6. Furthermore, the mass of CO2 dissolved is calculated using the spectrophotometric method to characterize the convective instability. The convective flux was analyzed by comparing experimental dissolution flux with theoretical diffusion flux, calculating a maximum Sherwood number of 6.8. The study\u27s findings improve the current understanding of the CO2 convection morphology, allowing better assessment of long-term CO2 storage
EVALUATION AND IMPROVEMENT OF PROCESSES AND METRICS IN A DUAL CREDIT PROGRAM
Get PDFThis dissertation used convergent mixed methods design in a program implementation evaluation of a dual credit program. A binary logistic regression was performed on dual credit enrollment persistence. A stakeholder survey was deployed to parents, administrators, instructors and counselors associated with the dual credit program. A full review of district documents related to dual credit was included as part of the qualitative component. The results of the regression indicated non-significance in the predictor variables for the dependent variable of dual credit persistence. The emergent themes from the survey included concerns about student readiness for dual credit coursework and a need for more course options. This dissertation also revealed a notable gap in the literature related to guidelines for dual credit program implementation for public schools as well as a lack of research examining cognitive and non-cognitive factors in the secondary environment which may impact student participation in dual credit programs. These results and findings highlight the lack of research-based guidance for secondary institutions in the data strategies, program implementation and monitoring for their dual credit programs. Research to investigate secondary-specific effects of dual credit participation is recommended. Further recommendations include development of data strategies and program implementation for dual credit programs for secondary schools