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Data supporting "Controls on Greenland moulin geometry and evolution from the Moulin Shape model"
No full textNearly all meltwater from glaciers and ice sheets is routed englacially through moulins. Therefore, the geometry and evolution of moulins has the potential to influence subglacial water pressure variations, ice motion, and the runoff hydrograph delivered to the ocean. We develop the Moulin Shape (MouSh) model, a time-evolving model of moulin geometry. MouSh models ice deformation around a moulin using both viscous and elastic rheologies and melting within the moulin through heat dissipation from turbulent water flow, both above and below the water line. We force MouSh with idealized and realistic surface melt inputs. Our results show that variations in surface melt change the geometry of a moulin by approximately 10% daily and over 100% seasonally. These size variations cause observable differences in moulin water storage capacity and moulin water levels compared to a static, cylindrical moulin. Our results suggest that moulins are significant storage reservoirs for meltwater, with storage capacity and water levels varying over multiple timescales. Representing moulin geometry within subglacial hydrologic models may therefore improve the representation of subglacial pressures, especially over seasonal periods or in regions where overburden pressures are high.NASA Cryosphere 80NSSC19K005
Development and Implementation of an Educational In-service for Nurse Practitioners and Physician Assistants working in an Emergency Department regarding the Utility of the YEARS Criteria in Pregnant Women Being Evaluated for Pulmonary Embolism
No full textUB SON, DNP Research ProjectProblem: Pulmonary embolism (PE), a leading cause of pregnancy related death in the United States, presents five to ten times more frequently in pregnant women than in non-pregnant women and occurs between 1 out of every 200 to 1.2 out of every 1000 deliveries. Current models for evaluating risk of PE rely on clinical scoring systems that are either not validated or overestimate risk for PE, potentially exposing both mother and fetus to harmful ionizing radiation. Provider education is needed regarding safe and effective evaluation criteria. Purpose and Aim: To create and implement an evidence-based educational in-service for nurse practitioners (NPs) and physician assistants (PAs) working in an Emergency Department (ED) to promote understanding and awareness regarding use of the YEARS Criteria to evaluate pregnant women presenting with PE symptoms to the ED. Methods: Evidence-based literature and current recommendations and guidelines were reviewed. An educational in-service for NPs and PAs was created based on findings resulting from the review and implemented via a videoconferencing session. Results: Use of YEARS Criteria for evaluating PE risk in pregnancy was found to decrease unnecessary computed tomography pulmonary angiogram (CTPA) studies and increase accurate diagnosis of PE. The main advantage of the YEARS algorithm is the absolute 14% decrease in the number of CTPA examinations. Implications: Utilizing the YEARS Criteria can decrease use of potentially harmful radiation for evaluating pregnant women presenting to the ED with suspected PE. ED clinicians should utilize the YEARS Criteria for evaluating and diagnosing PE in pregnant women
Perceived Barriers to Promoting Breastfeeding Efforts and Support among Nurse Practitioners and Registered Nurses Practicing in Rural Hospital in New York
No full textUB SON, DNP Research ProjectIneffective breastfeeding promotion and support for women choosing to breastfeed among healthcare providers (HCPs) has contributed to declining breastfeeding rates in the United States, especially in rural areas. The purpose of this Doctor of Nursing Practice (DNP) project was to explore perceived barriers to promoting breastfeeding efforts and support among registered nurses (RNs) and nurse practitioners (NPs) working in a rural hospital located in Oneida, New York. Project aims were to improve care and communication between registered nurses (RNs) and Nurse Practitioners (NPs) and the breastfeeding women they care for regarding the importance and benefits of breastfeeding and to promote breastfeeding efforts and support through the development of an evidence-based educational outline for RNs and NPs caring for women who are breastfeeding. A qualitative descriptive approach was utilized with individual semi-structured interviewing. Pender’s Health Promotion Model guided the development of the semi-structed interview questionnaire. Institutional Review Board approval was obtained. Braun and Clarke’s Thematic Analysis method was used to analyze data. The analysis of data generated one overarching theme, Not Enough Help…Everybody Should be Educated, and three key themes, Breastfeeding benefits for Mom and Baby, Breastfeeding Barriers, and Breastfeeding Resources. To help overcome breastfeeding barriers, all participants agreed that more breastfeeding education is needed for RNs, NPs, and providers, that more lactation consultants should be made readily available, and that better promotion and awareness of breastfeeding support resources is needed. Future research is needed exploring breastfeeding barriers among diverse populations of breastfeeding women to better support breastfeeding efforts and success
Diabetes Technology Policies: A Retrospective Descriptive Analysis of Policy Quality and Update Based on Current Best-Practices
No full textUB SON, DNP Research ProjectBackground and Significance There is often confusion surrounding diabetes technology in the perioperative area, leading to dissatisfaction, lapses in patient safety, and increased cost. Purpose, Aims and Objectives The purpose of this project was to develop criteria evaluating existing diabetes technology policies, determine their adequacy, then develop a policy guideline, based on current best practices, for dissemination to facilities with perioperative settings. Theoretical Framework The integrated Promoting Action on Research Implementation in Health Services (i-PARiHS) framework was applied. Methods and Design The project design was a retrospective, descriptive analysis of policy quality using a quantitative tool. Samples were diabetes technology policies from surgical facilities within the United States. Results 16 policies were reviewed. Majority were from academic medical centers (53%), created within the last ten years (56%), and updated within the last two years (82%). 76% had a diabetes specialist involved in its creation and those that did not had a lower average score. Only two policies fully met the criteria, while half of the policies somewhat met the criteria, indicating a fair policy. Conclusion Overall low scores indicate the need for policy guidance and improvement, even among top scorers. Policies from large, academic facilities, and those with the involvement of diabetes specialists yielded higher scores. Future Implications and Recommendations Diabetes technology is an evolving field with many opportunities for future research, specifically, the use of diabetes devices in the presence of diathermic surgical instruments, as well as automated insulin delivery systems in the perioperative area
The Impact of Provider Education on Palliative Care Referrals and Initiating of the End-of-life Discussion for Adult Oncology Patients
No full textUB SON, DNP Research ProjectBackground and Significance: Palliative care referral improves the quality of life and promotes patient's autonomy in end-of-life planning. The National Cancer Institute recommended initiating a palliative care consult at the time of diagnosis. References to palliative care were low because of the provider's lack of clinical knowledge and barriers
Purpose: This study aimed to assess the impact of palliative care education intervention on the level of knowledge of intermediate care providers and identify barriers to end-of-life discussions with patients. The overarching goal was to improve palliative care referrals and end-of-life discussion rates among cancer patients.
Theoretical Framework: Miller's information process theory was used as the theoretical framework to guide this study.
Methods and Design: The study was designed as a quasi-experimental study using pre/post-intervention questionnaires. The non-probability sampling approach was used to select samples for this study. A web-based education program on palliative care was delivered to the mid-level providers. The provider's palliative care knowledge was assessed by the pretest/posttest method. A paired t-test was used to analyze the scores in the pretest and posttest surveys.
Results: Post-educational intervention knowledge scores were statistically significant.
Conclusion: Primary oncologist-related barrier was the most significant barrier for palliative care referrals. The educational intervention was effective in improving the provider's knowledge.
Future Implications: Standard palliative care education for providers would bridge clinical practice and national guidelines
Model code supporting "Evidence for a more extensive Greenland Ice Sheet in southwestern Greenland during the Last Glacial Maximum"
No full textThis item contains the MATLAB code and outputs (Excel files) supporting the analysis described in the abstract. All contributions provided by Chris Sbarra, December 2020.The maximum extent and elevation of the Greenland Ice Sheet (GrIS) in southwestern Greenland during the Last Glacial Maximum (LGM, 26-19.5 ka) is poorly constrained. Yet the size of the GrIS during the LGM helps inform estimates of past ice sheet sensitivity to climate change and provides benchmarks for ice sheet modeling. Reconstructions of LGM ice extents vary between an inner-continental-shelf minimum, a mid-shelf position, and a maximum extent at the shelf break. We use three approaches to resolve LGM ice extent in the Sisimiut sector of southwestern Greenland. First, we explore the likelihood of minimum vs. maximum GrIS reconstructions using existing relative sea level data. We use an empirical relationship between marine limit elevation and distance to LGM terminus established from other Northern Hemisphere Pleistocene ice sheets as context for interpreting marine limit data in southwestern Greenland. Our analysis supports a maximum regional GrIS extent to the shelf break during the LGM. Second, we apply a simple 1D crustal rebound model to simulate relative sea level curves for contrasting ice sheet sizes and compare these simulated curves with existing relative sea level data. The only realistic ice sheet configuration resulting in relative sea level model-data fit suggests that the GrIS terminated at the shelf break during the LGM. Lastly, we constrain the LGM ice sheet thickness using cosmogenic 10Be, 26Al and 14C exposure dating from two summit areas, one at 381 m above sea level at the coast, and another at 798 m asl 32 km inland. Twenty-four cosmogenic radionuclide measurements, combined with results of our first two approaches, reveal that our targeted summits were likely ice-covered during the LGM and became deglaciated at ~11.6 ka. Inventories of in situ 14C in bedrock at one summit point to a small degree of inherited 14C and suggest that the GrIS advanced to its maximum late Pleistocene extent at 17.1±2.5 ka (significantly later than the global LGM). Our results point to a configuration where the southwestern part of the GrIS reached its maximum LGM extent at the continental shelf break
Database Archive Roman Bricks off the Wall
No full textSubmitted on 12.11.2020 with the full title "Roman Bricks off the wall. New data for understanding production centers and distribution of building materials in the ager Rusellanus"This is the dataset linked to the article submitted to the American Journal of Archaeology (AJA), currently under review.Marie Curie IEF 2012-2014 ALBTUSMED I
Examining the Perceptions of Anesthesia Providers Concerning Perioperative Critical Incidents and the Development of a Stress Management Protocol
No full textUB SON, DNP Research ProjectBackground and Significance: Critical incidents (CIs) are unexpected adverse patient events that can lead to significant stress for providers. Anesthesia providers are at high risk for experiencing these events. Despite growing evidence that critical incident stress management (CISM) protocols might reduce stress following these events, they are not routinely utilized.
Purpose, Aims and Objectives: The purpose of this DNP project was to examine how anesthesia providers working in a large Western New York teaching hospital perceive and experience CIs in the perioperative setting. A secondary goal was to assess their perceptions regarding CISM protocols, and to develop a site-specific CISM protocol for the anesthesia providers.
Theoretical Framework: The Transactional Model of Stress and Coping by Lazarus and Folkman served as the guiding framework.
Methods and Design: This was a descriptive, exploratory study involving a one-time survey of anesthesia providers at the study site. The survey assessed perceptions of CIs in three domains: potential stressors, impact of CIs, and desire for CISM guidelines. Frequency distributions, correlational and chi-square analyses were conducted.
Results: Fifteen providers participated in the study. Death, wrong-site surgery, and medication errors were the most stressful events. Anxiety, guilt, professional self-doubt and fear of litigation were common after CIs. Strong support for CISM implementation exists, with time constraints being the main barrier.
Conclusion: The data supported the need for and interest in CISM to reduce negative impact on providers.
Future Implications and Recommendations: Future studies should evaluate the efficacy of the protocol to reduce stress and improve coping
The Impact of a Hyperoxia Online Educational Training Forum for Anesthesia Providers Working in a Pediatric Hospital
No full textUB SON, DNP Research ProjectBackground & Significance: The phenomenon of hyperoxia can lead to cell damage and alteration of blood flow to vital organs. Despite the delivery of oxygen being far from harmless, evidence suggests it is liberally used.
Purpose: To determine if an online educational forum on hyperoxia and hyperoxygenation increases knowledge and awareness among anesthesia providers working in a pediatric hospital.
Aims & Objective(s): To increase knowledge, awareness, and understanding of hyperoxia and hyperoxygenation among anesthesia providers working in a pediatric hospital to promote quality and safe patient care through an online presentation.
Theoretical Framework: Lev Vygotsky’s Theory of Learning, which encompasses the zone of proximal development, more knowledgeable other, and scaffolding.
Methods & Design: Pre and post survey design comprised of the Professional Quality of Life Scale (PROQOL), multiple choice, scaled, and free response questions, with quantitative data analysis and the use of both quantitative and qualitative data for results dissemination.
Results: Valid participants = 9, participants for paired sample t-tests = 6. PROQOL mean for compassion satisfaction was 39.8 with a range of 32-50, burnout was 22.4 with a range of 17-32, and secondary trauma was 22.4 with a range of 14-31. Confidence means increase from 2.50 to
3.50 (p = 0.041). Mean increase from 1.727 to 2.166 of correct answers pre to post survey. Free response questions indicated an increased knowledge and awareness of practice.
Conclusion: This educational presentation was developed to spark interest and open communication about oxygenating patients properly, and so that this anesthesia team will leave this research endeavor with an enriched knowledge base after delivery of current literature and evidenced based practices that exist today surrounding hyperoxia. This project represents a transition to becoming a Doctoral Prepared Nurse and an Advanced Practice Clinician