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Advanced Micro-/Nanostructured Wicks for Passive Phase-Change Cooling Systems
No full textHeat pipes and vapor chambers have been widely utilized for the thermal management of electronic devices due to their effective heat transport, passive cooling operation, and high reliability. In these devices, a wick structure transports a working fluid from the heat sink to the heat source via capillary action in the wick structure. This paper provides a broad overview of the latest studies on the development of Micro-/Nanostructured wicks for passive cooling systems. Micro/nanopillar-based wick structures provide a high capillary pressure, a large permeability, and larger areas for evaporation, resulting in a significantly higher heat removal capability and dryout heat flux. A special emphasis is placed on the various types and geometries of wick structures and their performance. Additionally, limitations and recommendations for future investigations are discussed
Direction and Associated Motion in Tibeto-Burman
Get PDFThis study analyzes systems of direction and associated motion in 23 languages of the Tibeto-Burman family. Both direction and associated motion can be encoded by a range of grammatical strategies, including affixes, clitics, parti- cles, serial-verb constructions, and auxiliary verbs. While some languages have only associated motion or direction, others have both, either via distinct sub- systems, syntactic ambiguity, or context-dependent interpretation. While direc- tional encodings can be interpreted as associated motion in some contexts, the reverse can also be true. Verbal semantics is key to the pragmatic interpretation of examples in context; some types of motion verbs are more compatible with directional interpretations and others with associated motion. In addition, certain types of motion verbs were found to be compatible with different temporal re- lationships that hold between the activity of the primary verb and the motional component. Finally, the grammatical role of the figure in such constructions de- pends on both the temporal relationship and the semantics of the verb
Implementation of A Mental Health Screening in a Gastroenterology Office
Get PDFThe growing prevalence of depression in gastrointestinal patients is the reason why outpatient offices, gastrointestinal offices included, need to screen for mental health problems in their appointments. Many outpatient settings don\u27t have a standard tool to screen for depression in patients, and therefore many patients are not being treated or diagnosed with depression in the process. The PHQ-9 has been shown to have strong validity and specificity in diagnosing depression in the outpatient setting
Media Use Management with Toddlers and Preschoolers: Introducing Screen Time Recommendations in Pediatric Primary Care
Get PDFAs the field of technology has advanced, screens have become easier than ever to access both for adults and their children in the form of smartphones, tablets, laptops, televisions, and more. This advancement has brought on unforeseen challenges for families as they grapple with understanding and implementing healthy boundaries between their children and technology. By their second year of life, 50% of children will have interacted with some form of media, and research is beginning to reflect that there is a measurable effect of screen time on toddler development. The need for intervention has continued to grow, as children are interacting with a screen for seven hours a day on average.
This project initiated the use of a screen time screening questionnaire and three-point education tool in a rural pediatrics office where no formal screening or education tool had been in place. Throughout the intervention period, forty families with children ranging from one- to five-years-old were screened for the purpose of further assessment and intervention. Screened families were offered relevant, evidence-based education to allow them to begin to form and implement healthy screen time boundaries within their home. At the completion of the project, the two office providers completed a questionnaire regarding the process and its perceived success or failure. The completed Likert scales were analyzed and revealed that over half of the families engaged in a higher than recommended amount of daily screen time along with other relevant conclusions. The office providers vocalized strong, positive opinions about the project.
The office has reported continued use of the questionnaire and three-point education tool for patients of all ages. This project could easily be replicated in other offices of varying sizes, locations, and demographics
Introduction of Strong for Surgery Pre-surgical Checklist for Elective Procedures
Get PDFNearly one-third of hospitalized patients experience preventable harm or adverse effects related to the care they received, often due to preventable surgical complications. Thorough preoperative assessment and management of risk factors can lessen this risk. The purpose of this quality improvement project was to increase knowledge and prepare staff for use of the preoperative tool Strong for Surgery (S4S) in a general surgery clinic in a rural hospital in southern Illinois. Support for each of the key components of the Strong for Surgery pre-surgical checklist was reviewed in the literature; these include nutrition, smoking cessation, glycemic control, medication management, safe and effective pain management, prehabilitation, and delirium. The process of staff education began with an in-person introduction to the Strong for Surgery pre-surgical checklist followed by an online computer-based learning module. The learning module encompassed the entirety of the S4S checklist, rationales for use, and methods for implementation. Learning outcomes were measured by comparing scores of identical pre-assessment and post-assessment tests containing multiple choice, true/false, and select all that apply questions. Post-assessment score results of 20 participants increased by 35% compared to pre-assessment. This project provided education on the S4S pre-surgical checklist as the initial step for planned future implementation into the standard of care. The immediate impact was an improvement in knowledge about the checklist and staff roles related to integrating S4S into care. The long-term implications of this project are the potential for improved patient outcomes, such as decreases in mortality, morbidity, reoperation, and length of stay. Education and preparation for the planned implementation of the S4S checklist will lead to a smooth implementation process.
Key Words: surgery, quality of care, recovery, Strong for Surgery, ERAS, presurgica
Development of a Heparin Dosing Guideline for Vascular Surgery
Get PDFUnfractionated heparin is administered to provide anticoagulation for the prevention of thrombosis and ischemia during vascular surgery. The intraoperative goals of heparin administration are the achievement of adequate anticoagulation and maintaining a steady-state plasma concentration throughout the procedure to prevent thrombotic events. Due to patient variation in heparin sensitivity, the standard within vascular surgery is to obtain the intraoperative activated clotting time (ACT) as a means of monitoring heparin activity and guiding dosing regimens. Measuring the intraoperative ACT allows for evaluation of the intrinsic pathway to assist the provider in achieving a steady-state heparinization with high-dose heparin administration.
To reduce adverse events associated with intraoperative heparin administration, a Level I trauma center in the Midwest implemented a reference for heparinization during non-cardiac vascular surgery. The reference served as a tool for on-call anesthesia providers who did not routinely deliver care for non-cardiac vascular surgeries. The tool provided guidelines for initial heparin dosing, activated clotting time goals, and intervals for ACT assessment. Following a two-month implementation period, providers were given one month to complete a post-implementation survey to collect their perceptions on the effectiveness of the intraoperative reference tool. The data obtained from the survey was utilized to determine reference tool applicability, provider satisfaction, and barriers to implementation. The overarching goal of the project was to obtain greater than 90% satisfaction among on-call providers surrounding reference tool use for non-cardiac vascular surgeries. Unanimously, the reference tool was categorized as both thorough in its content and an easy-to-use cognitive aid. Ninety four percent of providers felt confident in their ability to implement the tool
Pediatric Concussion Clinic: A Needs Assessment
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Pediatric Concussion Clinic: A Needs Assessment
Concussions are a mild traumatic brain injury by a biomechanical force to the head. Concussion rates among youth are as high as 33 million per year worldwide. Most children recover within 4 weeks post injury; however, 30% of patients have delayed recovery. Recent studies have shown that evaluation by a concussion specialist within 1 week of injury results in quicker recovery. The purpose and goal of this project was to determine if there was a need for establishing a pediatric concussion clinic at Southern Illinois University Medicine. Study participants included pediatric providers from an academic institution in central Illinois caring for pediatric concussion patients. A 10-question questionnaire was given to the participants through Survey Monkey to maintain anonymity. Subsequently, a voice over PowerPoint presentation was sent to participants, along with a request to complete the questionnaire again. Of the 14 providers employed at this institution, 12 participated in the questionnaire prior to the presentation; however, only 5 completed the questionnaire after the presentation. Initial scores ranged from 38-100%. Post-presentation scores ranged from 88-100%. Nine of the participants stated they were likely/very likely to refer concussion patients to a pediatric concussion clinic. Only 2 participants stated they were not likely to do so. This information lends itself to support the implementation of a pediatric concussion clinic at Southern Illinois University Medicine
Continuing Education Preferences Amongst CRNAs
Get PDFThe Illinois Association of Nurse Anesthetists (IANA) is a professional organization representing Certified Registered Nurse Anesthetists (CRNAs). To ensure compliance with high standards of care in the profession, CRNAs are required to obtain continuing education units (CEUs) for each 4-year certification period. The IANA offers conferences in both fall and spring, however, a loss in attendance and revenue at state meetings concerns the board members as to how state members are complying with the educational requirements to remain certified. It was imperative that the IANA needed to implement new educational opportunities that actively engaged CRNAs resulting in an increase in clinical competence, member attendance, and revenue. This project involved the development and use of a 15-question survey to identify format preferences for CE opportunities and barriers to earning CEUs. A total of 143 CRNAs completed the survey, reflecting a 7.6% participation rate statewide. The top three preferences for CEUs were: online modules and case studies (63.38%, n =90), in-person conferences within the state of Illinois (54.93%, n = 78), and online conferences (47.89%, n=68). The top three barriers encountered to earning CEUs were: being able to take time away from work (40.14%, n=57), family restraints (19.72%, n=28), and uninteresting topics offered (17.61%, n=25). The results of the assessment will guide an educational plan to meet the needs of state members, by providing the preferred CE opportunities. Providing the educational needs for state members in the long-term will increase revenue to promote the advocacy work of IANA
Survival of Fishes in a Stormwater Retention Pond at the Watershed Nature Center, Edwardsville, Illinois
Get PDFA study of the Upper Pond at the Edwardsville Watershed Nature Center (WNC) was conducted to discover the potential cause of fish kills in the small stormwater retention pond and to determine how the current populations of bluegill (Lepomis macrochirus), redear sunfish (Lepomis microlophus), common carp (Cyprinus carpio) and largemouth bass (Micropterus salmoides) can survive in the pond based on prevailing environmental conditions. Dissolved oxygen (DO) was measured from June 19 to December 5, 2019 at a site in the center of the open lake (4 m deep) and from a dock near the shore (1.1 m deep). Water temperature was measured intermittently at both sites from June 19 to November 4. In the open lake, oxygen levels reached a peak of 11.6 mg/L at the surface on July 2. Below 2.5 m DO remained less than 1.5 mg/L until Oct. 8 when it slowly began to rise reaching a high of 10.8 on Nov. 20. The dock station had similar oxygen levels. Temperature varied from a high of 31.2 °C on July 21 to a low of 6.5° C on November 3. The low DO in the pond results from a nearly continuous cover of duckweed (Lemna sps) which prevents interchange of oxygen with the atmosphere. It is likely that the low oxygen levels select for fish species that are physiologically and behaviorally capable of surviving hypoxia
Mindfulness and Meditation to Reduce Test and Evaluation Anxiety in Doctoral Nurse Anesthesia Students
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Mindfulness and Meditation to Reduce Test and Evaluation Anxiety in Doctoral Nurse Anesthesia Students
Background/Information
A significant number of university students report experiencing test anxiety. Extreme anxiety has been reported as a cause of withdrawal from university studies. Certified Registered Nurse Anesthetists are required to complete an intense curriculum with tests and evaluations prior to passing a national board certifying exam, which is anxiety provoking.
Purpose
The primary objective of this project was to provide mindfulness intervention information to be utilized by the DNP students and assess desires of having a mindfulness meditation practice to alleviate academic anxiety.
Methods
Following a lecture covering the effects of anxiety on academic performance, definitions of mindfulness meditation practices, and the usefulness of mindfulness meditation practices on alleviating academic anxiety, students were given a questionnaire to assess anxiety levels prior to evaluations, knowledge regarding the effects of anxiety on performance, and to assess desires of having a mindfulness or medication practice to alleviate academic anxiety
Results
Students who reported interest in mindfulness meditation and were likely to utilize the intervention to alleviate anxiety increased for all cohorts in attendance.
Limitations
Most students expressed having prior knowledge of mindfulness meditation; however, it is unclear what knowledge students had of the topic, its effects on anxiety, whether it was previously practiced, or if they knew someone who practiced meditation.
Conclusion/Implications for Practice
The research implication includes the potential for mindfulness and meditation practices to decrease test and evaluation anxiety through increased self-efficacy in DNP students