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Beyond the Chart: Reflections on Transforming Data into Patient-Centered Care
No full textThe Data, Information, Knowledge, Wisdom (DIKW) Framework is a foundational model in nursing informatics that helps conceptualize how raw data is transformed into meaningful clinical decision-making. At its core, the framework describes four hierarchical levels: data (raw, unprocessed facts), information (organized and contextualized data), knowledge (synthesized information based on experience and evidence), and wisdom (the ability to apply knowledge in practice to achieve the best patient outcomes). In nursing, this framework is particularly valuable because it mirrors the cognitive processes nurses use to assess, interpret, and act on patient information in real-time clinical settings.
Developing critical thinking is a challenge for student nurses as they must learn to move beyond task-based thinking to recognizing patterns, making connections, and anticipating patient needs. Nurses work most closely with patients, continuously gathering and interpreting data from direct interactions. Nurses are at the bedside observing trends over time, integrating subjective cues, and responding dynamically to evolving patient needs. Novice nurses often struggle with information overload, unsure of which data points are most relevant or how to prioritize competing demands in a fast-paced clinical environment. By using the DIKW framework, students gain a structured way to organize and process clinical information, helping them make sense of complex patient cases. This approach bridges the gap between classroom knowledge and real-world application, guiding students toward independent, confident clinical reasoning that leads to better patient care and outcomes.
Using the DIKW framework to explain clinical decisions enhances student nurse clinical reasoning skills by helping them recognize how seemingly isolated data points contribute to a larger clinical picture. For example, a student may document a blood pressure reading of 88/50 mmHg (data). When combined with the patient’s dizziness and recent medication changes, the data become information that suggests hypotension. Drawing on knowledge of pharmacology and fluid balance, the student understands that the patient\u27s antihypertensive medication may need adjustment. Finally, wisdom is demonstrated when the student collaborates with the healthcare team to adjust the care plan, ensuring patient safety. By following this structured thinking process, students develop the ability to critically evaluate patient information rather than relying on memorization or intuition alone.
We hope these reflections on clinical judgement, written by experienced nurses in the masters of nursing program at UNLV, helps student nurses learn to integrate research findings, clinical guidelines, and team-based communication into their decision-making. This approach not only strengthens their ability to navigate complex patient cases but also builds confidence in their clinical judgment. By guiding students through this structured framework, nurse educators equip them with the tools to think like a nurse, ensuring they become competent, reflective, and effective practitioners
Power, Labor, and Hierarchies: Deconstructing Work in Speculative Fiction
No full textIn discussions of literary and speculative fiction, a persistent divide emerges regarding the modes and aims of each genre. Literary fiction generally aims to reflect the human condition in familiar, “realistic” terms, exploring characters, relationships, and narratives within existing social structures. In contrast, speculative fiction is characterized by what Darko Suvin identifies as the “the strange newness” of the novum: a radically new element or phenomenon that reshapes the fictional world. This paper argues that the novum in science fiction provides a unique framework for interrogating the relationships between labor, knowledge, and power, revealing how these constructs are contingent upon specific social and economic structures. By examining the strategic use of knowledge in Asimov’s Foundation, the racialized labor hierarchy aboard Rivers Solomon’s An Unkindness of Ghosts, and the hierarchy of knowledge in Sofia Samatar’s The Practice, the Horizon, and the Chain, this study demonstrates how speculative fiction deconstructs the assumed neutrality of labor and knowledge, exposing them instead as commodified, racialized, and deeply hierarchical forces. Through these fictional worlds, the novum allows us to confront the ways in which labor and knowledge are wielded as tools of control, raising critical questions about access, equity, and the very construction of “worthwhile” work in our own society
Demographic Correlates of Weight-Loss Strategies in US Adults: Cross-Sectional Analysis of NHANES Data 2017–2020
No full textObjective: To investigate the frequency of various weight loss strategies among adults in the United States and to explore which weight-loss strategies are associated with several demographic factors.
Methods: The study utilized 2017–2020 data from the National Health and Nutrition Examination Survey. Adult participants (N = 3,130) who had tried to lose weight during the past year were included. Pregnant women and individuals under age 20y were excluded. Weight-loss strategies were categorized into 6 groups: consuming more healthy options (e.g., more fruits); consuming less un-healthy options (e.g., junk food); quality of diet changes (e. g., changed eating habits); assisted weight-loss method (e.g., special diet); exercising; and un-healthy strategies (e.g., vomiting). Adjusted odds ratios (aORs) and 95%CIs were calculated using weighted logistic regression models.
Results: The most frequently employed strategies to achieve weight loss were exercising (60.6%), consuming less un-healthy options (60.4%), and drinking a lot of water (55.3%). Un-healthy strategies were less prevalent among older individuals (aOR:0.46 [95% CI:0.37–0.58]) and those with higher incomes (aOR:0.69 [95% CI:0.54–0.89]). Conversely, individuals with obesity class I (aOR:1.85 [95% CI:1.38–2.48]) and obesity class II/ III (aOR:1.69 [95% CI:1.27–2.25) showed an increased likelihood of adopting unhealthy strategies. Similarly, widowed individuals (aOR:1.31 [95% CI:1.03–1.66]) and those who have never been married (aOR:1.36 [95% CI:1.09–1.69]) exhibited a higher tendency for such behaviors compared to married individuals.
Conclusion: The likelihood of using various weight-loss methods differs based on demographic characteristics. Recognizing these tendencies can guide public health initiatives and customized strategies for weight control
Exploring the Use of Bimodal Transcranial Direct Current Stimulation to Enhance Movement in Individuals with Patellofemoral Pain—A Sham-Controlled Double Blinded Pilot Study
No full textIntroduction: In individuals with patellofemoral pain (PFP), addressing increased knee valgus during weight-bearing activities typically involves strengthening weak hip muscles. However, recent literature highlights the role of altered descending central control in abnormal movements associated with PFP. While transcranial direct current stimulation (tDCS) has demonstrated the capacity to enhance neuroplasticity, its application targeting the corticomotor function of gluteal muscles in PFP remains unexplored. This study aimed to investigate the effects of combining bimodal tDCS with exercise on frontal plane kinematics in individuals with PFP. The hypothesis was that bimodal tDCS, specifically targeting the corticomotor function of the gluteal muscles, would augment the effectiveness of exercise interventions in improving frontal plane kinematics compared to sham stimulation.
Methods: Ten participants with PFP participated in two sessions involving either bimodal tDCS or sham stimulation, concurrently with hip strengthening exercises. Weight-bearing tasks, including single leg squat, single leg landing, single leg hopping, forward step-down, and lateral step-down, were performed and recorded before and after each session. Pain visual analog scale (VAS) scores were also documented. A one-way ANOVA with repeated measures was employed to compare kinematics, while a Friedman test was used to compare VAS across the three conditions (pre-test, post-tDCS, and post-Sham).
Results: We observed no significant differences in trunk lean angle, hip and knee frontal plane projection angles, or dynamic valgus index among the three conditions during the five weight-bearing tasks. VAS scores did not differ across the three conditions.
Discussion and conclusion: A single session of tDCS did not demonstrate immediate efficacy in enhancing frontal plane kinematics or relieving pain in individuals with PFP. Considering observed positive outcomes in other neurological and orthopedic populations with multi-session tDCS applications, suggesting potential cumulative effects, further research is essential to explore the effects of multi-session tDCS on weight-bearing movement and underlying neurophysiology in individuals with PFP
Biopsychosocial Occupational Therapy Interventions for Complex Regional Pain Syndrome – A Pilot Manuscript
No full textOccupational therapists (OTs) have an essential role in the treatment of upper extremity Complex Regional Pain Syndrome (CRPS) in outpatient therapy settings. Occupational therapy (OT) guidelines and research focus treatment on the Budapest Criteria’s biological signs and symptoms. The International Association for the Study of Pain (IASP) now recognizes CRPS as a primary chronic pain condition and not an autonomic disorder, as it was thought to be in the past. This recognition, along with the psychological and social impacts of the condition, highlight the need for updated OT treatment interventions incorporating a biopsychosocial model. Combining evidence-based CRPS OT interventions for signs and symptoms with current research-based, psychosocial treatments for chronic pain management provides a more comprehensive treatment approach for people with CRPS. Additionally, this aligns with the OT profession’s commitment to the “whole-person” approach to treatment.
This culminating paper describes the background, need, research, justification, and journey for developing the capstone project. The capstone project itself is a pilot manuscript, with details in an outline format in the appendices, developed for OTs to guide their treatment of upper extremity CRPS in an outpatient setting. The manuscript is based on the most up-todate research available at the time of publishing for CRPS and chronic pain management. It provides pertinent goals, assessments, and an 8-week biopsychosocial treatment intervention plan to be utilized in conjunction with clinical reasoning skills
The Effects of Implementing an Early Childhood Education Health and Wellness Program in Underserved Elementary Schools in Las Vegas on Student Mentors and Elementary Staff: Anatomy Academy
No full textAcademy (AA) is a seven/eight-week program implemented by select University of Nevada, Las Vegas Doctorate of Physical Therapy (DPT) students to promote health and wellness at a Title I elementary school and help bridge the health education gap that underserved youth populations may be facing. We aimed to assess and improve the overall satisfaction of both the faculty members at the elementary school and the physical therapy students who participated in the program, while enhancing the health education of 5th grade students. Our aim was centered on stakeholders (elementary school administrators) and student mentors (DPT students) having the desire to continue implementing the AA program as a valuable health and wellness resource and to improve AA in the future. Lessons were centered around the musculoskeletal, cardiovascular, respiratory, gastrointestinal, and sensory nervous systems, as well as oral cavity and neuroanatomy. Each lesson had learning objectives for the children including introductory knowledge about each body system and different health care professions. UNLV DPT students focused on making the lessons engaging for elementary students by using active learning teaching methods (crafting art projects, exercising, recreational games, conducting science experiments, and hands-on participation). Stakeholders and student mentors were given a post-program survey to reflect on the different aspects of AA and areas of improvement. These were completed by 12 DPT students and 2 stakeholders (PE teacher and a teaching assistant). The survey results overall represented a positive response to AA. The qualitative and quantitative results allowed us to make suggestions for future UNLV DPT students to implement in future AA sessions to enhance the overall satisfaction
Remote Detection of Leaks in High Level Waste Storage Tanks
No full textThe purpose of this research was to characterize three devices potentially capable of remotely detecting signatures of a leak from high-level waste (HLW) storage tanks, specifically ones found at the Savannah River Site and the Hanford Site. The hazard HLW found within these tanks include 137Cs, a gamma-ray emitter, and 90Sr, an electron emitter leading to heat generation. These pose health risks to the personnel and maintenance problems and environmental safety issues if released to the environment. Additionally, pinpointing the location of a leak is a task that could lead to the mitigation of excess waste leaking from the tank.
There were three objectives of this work, each associated with its respective leak detection device. The first objective was to validate a Kromek CZT gamma spectrometer by measuring sealed 137Cs sources with various activity levels. The second objective was to use a FLIR Duo-R thermal camera to image heated metal objects of varying shapes to highlight how a hotspot stands out against a cooler background in thermal imaging. The third and final objective was using a Roga Instruments iSV1611 USB ultrasonic microphone to measure high frequency noises that would be associated with pressurized gas or a liquid leaking from a crack in a tank. Testing each device set a benchmark for accuracy that can be scaled to larger scale experiments and field work.
The experiments completed with these devices provided accurate data used to characterize them to be used in the field. The gamma spectrometer data was compared to known data of 137Cs emissions, and the microphone measured known frequency emissions with extreme accuracy. The thermal camera provided the data numerically, but visually provided great indication of the desired hotspots. The data acquired allowed for a conclusion to be made on the accuracy of these devices to be used to detect a leak in a HLW tank. Future work considered would be large scale experiments and field applications
Exploring Intention Mapping and Action in Pursuit of Emotional Storytelling for Musicians
No full textThis document presents a novel approach to music education by integrating acting pedagogies, specifically the concepts of Intention and Action, to enhance the expressive capabilities of musicians. Rooted in the methodologies of Konstantin Stanislavski, Sanford Meisner, and Michael Chekhov, this research seeks to bridge the gap between traditional music education, which often emphasizes technical execution, and the need for emotional expressivity and storytelling in musical performances.
The role of the musician as a \u27human instrument,\u27 capable of conveying complex human emotions and narratives through music is explored in this document. Drawing from acting techniques, the document proposes methods to help musicians internalize and express emotions more authentically, thus elevating their communicative power. The introduction of Intention Mapping or Actioning in musical performances is examined, where specific intentions are assigned to musical phrases, transforming technical execution into emotionally charged expression.
The document discusses the impact of these acting methodologies on teaching approaches and student experiences in music education. It suggests that this interdisciplinary approach can lead to more holistic development, emphasizing not just technical skills but also emotional intelligence, empathy, and narrative understanding.
Furthermore, it delves into the psychological theories underpinning these methods, including the James-Lange theory and cognitive appraisal theory, to understand how intentions stimulate emotions. The role of mirror neurons in the performer-audience interaction is also explored, highlighting the empathetic resonance that can be achieved through this approach.
In conclusion, the document argues that the integration of acting methodologies in music education can transform performance dynamics, leading to more emotionally resonant and communicatively effective musical experiences. This innovative approach has the potential to reshape teaching methodologies and expand career opportunities for musicians, making them more versatile and expressive artists. The document calls for further research into the cognitive and emotional processes underlying this interdisciplinary approach, paving the way for its broader application in the arts
Phosphorous Heteroatom Bond Formation Strategies and the Development of Green Synthetic Methods
No full textStrategies to forge phosphorous heteroatom bonds are in high demand as organophosphorus compounds have seen a variety of uses in medicinal chemistry, materials chemistry, and agricultural chemistry. Phosphorous monoacids are a challenging functional group to synthesize and current methods suffer from harsh conditions and limited substrate scope. Furthermore, fluorophosphine oxides have not yet been made in a sustainable way. An electrochemical synthetic is an attractive strategy as it would remove the need for conventional metal catalysts. However, a potential challenge to overcome is the low reactivity of fluoride. Synthetic methods to synthesize phosphorous monoacids and the electrochemical synthesis of fluorophosphine oxide are presented.
Thiophosphates are another functional group that interests organic chemists as they display important biological activity. The use and study of P(O)OEt2SH as a synthon for this functional group allow for unprecedented access to new synthetic methods to forge thiophosphates. The dual role of P(O)OEt2SH behaving as a Brønsted acid and thiolate nucleophile can be harnessed to synthesize thiophosphates under highly atom-economic, energy-neutral, catalyst-free, and additive-free conditions. This strategy has been used to develop green synthetic methodologies to access diaryl thiophosphate and phosphorous disulfides.
Another organosulfur functional group that has not been well studied is the hydrogen persulfide. Only three examples of hydrogen persulfides have been synthesized in the literature. Access to hydrogen persulfides is hampered by a difficult synthetic preparation method and their inherent instability. New hydrogen persulfides have been synthesized and applied in the hydrothiolation of alkenes. Mechanism studies such as control experiments and isotope labeling experiments have been performed to elucidate the mechanism of this new transformation. The hydrothiolation of alkenes using hydrogen persulfides is a green strategy to access thioethers. This transformation is solvent-free, atom-economical, and an energy-neutral method.
Lastly, a Friedel-Crafts type reaction of beta naphthol has been explored to access allylation and benzylation products. The beta naphthol motif is important and has been used in medicinal chemistry and as an imaging reagent. The challenge of regioselectivity and allylic alcohol activation has been studied. Different reactions, such as phosphorylation and intramolecular annulation, also demonstrated the synthetic utility. This strategy is a catalytic, regioselective, and atom economical method, which can serve as a general strategy to functionalize arenols