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Improving Identification of Complicated Alcohol Withdrawal Syndrome Using the Prediction of Alcohol Withdrawal Severity Scale
Get PDFProblem: Individuals who drink alcohol excessively are at great risk for alcohol withdrawal syndrome (AWS) when hospitalized. Symptoms and their severity differ for everyone, and research shows that the identification and treatment of AWS is challenging and often inadequate. Mild AWS is often overtreated, while moderate to severe AWS is often underdiagnosed and undertreated, placing individuals at risk for longer hospital stays, more time needed in critical care units, and a variety of unintended consequences.
Methods: This evidence-based practice project had a pre-post intervention design in which the Prediction of Alcohol Withdrawal Severity Scale (PAWSS) was implemented to promptly identify individuals at risk for moderate to severe (complicated) AWS. Data was collected via retrospective chart review before the PAWSS implementation, followed by a prospective chart review after implementation. Data included length of stay, time spent in critical care units, timeliness of withdrawal protocol initiation, severity of withdrawal, and benzodiazepine usage for AWS. Independent samples T-tests were conducted to analyze the difference between data for the two groups.
Results: A statistically significant difference was found between the following outcomes: time from arrival to CIWA-Ar protocol initiation, time from arrival to prophylactic Librium administration, total length of hospital stay, time spent in the ICU/IMU, total Ativan administration, and the highest recorded CIWA-Ar score. There was also a decrease noted between transfers of patients to a higher level of care by 7.3%.
Implications for Practice: Widespread utilization of the PAWSS tool in inpatient settings could aid in promptly and accurately identifying patients at risk of complicated AWS and improve treatment and patient outcomes
Social Work in Pediatric Primary Care
Get PDFSocial Work in Pediatric Primary Care
Abstract
Social determinants of health significantly impact a child\u27s health, and pediatric primary care providers are in the optimal position to help provide treatment and resources to children in need. Studies have shown that integrating social work and nurse care managers has improved many health outcomes for children. This study attempts to answer how the presence of a social work led team impacts pediatric primary care. This project includes children ages 0-18 years seen at a pediatric office with select chronic conditions. Epic was used to perform a medical record review to identify the number of emergency department visits and available medication refills. An independent sample t-test was performed on each set of data. The results did not yield statistically significant changes in emergency department visits, available as-needed medication refills or available daily medication refills. However, the available daily medication refills may offer clinical significance, and pediatric primary care providers should consider making regular contact with patients to evaluate medication compliance and needs. This study\u27s most significant limitation was the time data was collected. Future research should consider an extended data collection period, a longitudinal study following the patients before and after enrollment, and patient satisfaction with the program
The Impacts of Authentic Learning on Student Outcomes
Get PDFThis dissertation explores the evolving American education system, emphasizing the role of authentic learning in bridging the gap between schooling and employment, especially in the context of the modern post-pandemic student. Authentic learning, characterized by hands-on activities and real-world applications, is posited as a solution to the skilled labor shortage impacting the economy. This study delves into the history and current practices of authentic learning, examining various programs and strategies implemented in educational settings. Utilizing a phenomenological approach, qualitative data was collected through interviews with recent high school graduates to assess the impact of authentic learning on their post-secondary trajectories. The research focused on students from both rural and inner-city backgrounds to highlight the differences and similarities in their experiences. Findings from this study indicate that authentic learning significantly influences students\u27 decision-making and preparedness for life after graduation. Themes identified include the positive impact of internships, extracurricular activities, and real-world projects on career readiness and personal development. However, limitations such as sample size and demographic representation were noted. The implications of these findings suggest that integrating authentic learning experiences in education can enhance student outcomes, providing valuable insights for educators, policymakers, and stakeholders aiming to improve the effectiveness of the American education system
Recovering Ancient DNA Using the Polymerase Chain Reaction
No full textInvestigations into aDNA offer a window into the past that modern DNA and paleontological studies alone cannot provide and help address the evolution and connections between hominids, domestication timelines, the analysis of populations over time, and general diversity. Progress in aDNA research has been inherently technology-driven, with modern molecular biology methods, such as the inventions of Polymerase Chain Reaction (PCR) and Next Generation Sequencing (NGS), substantially increasing the analysis possibilities of aDNA. My research this semester has taken me along two parallel paths of investigation: literary research into aDNA and practical exposure to the laboratory techniques used in its analysis. My work in the lab exposed me to the utilization of PCR as a technique to amplify DNA regions that permits a doubling of the number of target molecules with each cycle. The PCR process is essential for studying aDNA samples since the DNA found on site is limited in quantity and quality. Under favorable conditions, DNA has survived for several millennia, though the length of time varies considerably between preservation environments. Its degradation and post-mortem chemical alterations make its quantification and amplification difficult. The major bottleneck in its research lies in DNA extraction from low-quality and quantity samples and contamination by exogenous current DNA. My practical lab experience was in the extraction process, PCR amplification of the pieces, and analysis with agarose gel electrophoresis using a plant-based system. I experienced firsthand the problems researchers encounter with PCR, such as insufficient amplification with a low amount of template, incomplete or incorrect amplification due to contaminants, and excessive smearing. Using parallel lines of evidence, such as aDNA studies and the fossil record, will aid us in new understandings concerning evolutionary history
White Allies in the American South
Get PDFFrom the era Chattel Slavery, which marks people as the personal property to their owners, to modern day police brutality, African Americans have fought for equality in American society. Great black leaders have emerged throughout this fight for equality, but there is another group of leaders that aren’t so popularly known. These leaders have put their time, resources, and lives on the line for this fight for freedom. These leaders are spies, allies, and secret friends to the African American fight for equality. Many of these leaders were influenced by one another to stand together in solidarity with African Americans. Although many of these leaders are unheard of, their stories speak for themselves. This paper unmasks those hidden leaders in history, specifically the era of Chattel Slavery in the American South and examines how religion, and personal observations influenced personal convictions against the institution of slavery
Determination of Antibody Affinity for the Alzheimer’s Amyloid-β Protein
Get PDFAlzheimer\u27s Disease (AD) is a common form of dementia that is characterized by inflammation, loss of brain mass, and loss of motor function and memory. One of the pathological hallmarks of AD is the accumulation of Amyloid-β (Aβ) in the brain as senile plaques. Aβ is formed from a large protein called Amyloid Precursor Protein (APP) when specific enzymes cut a segment of the protein into a shorter polypeptide chain, Aβ. Different aggregation species were used in this project, specifically monomers and protofibrils. Monomers are naturally occurring and nontoxic, while protofibrils are neurotoxic and neuroinflammatory. One way that Aβ can be studied is through the Indirect ELISA technique. This technique aims to determine how aggregation intermediates of Aβ interact with different antibodies. Antibodies recognize a specific sequence of the amino acid chain. Antibody (Ab) 5 and 2.1.3 were used in these experiments. Ab5 binds to the N-terminus of the polypeptide chain, while Ab2.1.3 binds to the C-terminus. The Indirect ELISA assay has aided in determining which part of the amino acid the antibody recognizes and binds to. Data obtained from Indirect ELISAs indicates that the N-terminus and C-terminus of the polypeptide is exposed on both protofibrils and monomers. However, Ab5 has a higher affinity for both protofibrils and monomers. These results give insight into the conformation of protofibrils and monomers
Gangsterism, the Urban Ruling Elite, and the Guomindang: Power Sharing During the Early Years of the Chinese Republic, 1927-1937
Get PDFChina’s Republican era, prior to the Japanese occupation and while under the authority of Chiang Kai-shek and the Guomindang (c. 1927-1937), has in many respects been underexplored by historians. The Shanghai Massacre, Chiang’s subsequent military campaigns against the Communists, the factious divisions within the Guomindang, and the ongoing Japanese campaign to annex parts of the Chinese mainland are often highlighted. In my presentation, rather than focusing on the various foes of the Guomindang, I plan to focus on the political alliances Chiang forged. In particular I will explore his ties to, and alliances with Organized Crime (specifically Du Yuesheng and other members of the so-called Green Gang) and the Urban Elite of Shanghai. The complex web of interested parties and political players that emerged in Shanghai during this decade serves as an interesting reflection (or alternatively, vestige) of the capitalist and colonial forces that had been shaping the city since the Opium wars. Chiang’s association with Shanghai and it’s contingent of organized crime bosses and bourgeois ruling elites (which became increasingly indistinguishable during this period) is illustrative of the Guomindang‘s fundamental modus operandi for governance and power sharing from 1927-37
Recognition Promotes Sodomy: Gay Lib Vs. The University of Missouri
Get PDFIn the spring of 1971 Larry Eggleston, president and founder of the Gay Lib student organization at the University of Missouri, submitted the proper documentation for formal recognition of his club. The dean, and subsequently the executives of the University of Missouri, denied the club’s petition. What followed was a contentious game of chess between the university and its gay student population, the outcome of which would span seven years and litigation that rose all the way to the supreme court. What motivated the University of Missouri’s decision to ban gay student organizations in the 1970s? The answers can be found In archival materials that reveal the true intentions and desires of those who had decision making power
The 1904 World’s Fair: Intended Impact of the U.S. Government Building Versus Visitor Experience
Get PDFThe 1904 Saint Louis World’s Fair, known as the Louisiana Purchase Exposition, has long been known for its significant impact on America and the world. This research explores the intended purpose of the 1904 World’s Fair’s United States Government Building and its exhibits of the War and Navy Departments. Furthermore, this analysis investigates the visitor experience of the Government Building’s characteristics and exhibits. During the Progressive Era, American society was undergoing a significant paradigm shift through countless evolutions in industry, technology, and culture, and this research contextualizes historical study of the time. Though the recent body of literature revolves around analyzing the impact of the anthropological exhibits at the fair, an inquiry into the Government Building and its impact on visitors reveals important aspects of the fair, American society, and the U.S. Government during this transformative period. By investigating official documents, newspaper articles, diaries, and photographs, this research reveals that those in charge of the construction of the building and its displays were used as a showcase of American superiority and military might. This conclusion is furthered to discover that visitors generally accepted the impositions of the building and its exhibits, thus strengthening fond American sentiment regarding superiority and dominance
The Effect of Caffeine on Bee Behavior: A Progressive Ratio Study
Get PDFThis presentation focuses on the effect of caffeine on bee behavior using behavioral pharmacology methodologies. Researchers trained bumblebees to drink out of artificial flowers, then administered sucrose nectar or caffeinated sucrose nectar during a schedule of progressive and fixed ratios. The finding suggests that caffeine did increase the number of rewards during the fixed ratio, but not in the progressive ratio. However, research is still ongoing as bees continue to be tested.