Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training

Achieving peripheral venous access in patients is one of the first steps in most treatment protocols. Delays or even failures to obtain peripheral venous access can delay lifesaving treatments, prolong hospital stays, and affect patient outcomes. Peripheral venous access can be difficult due to chronic disease processes, scarring of valves from frequent cannulation, limitation due to dialysis fistulas, or due to acute conditions such as hypovolemia and hypotension. Studies have found the use of ultrasound-guided techniques can achieve peripheral venous access quickly and prevent the need for more aggressive procedures (Skulec et al., 2020). However, there is a gap between evidence-based practice and clinical practice when the technique is not utilized in clinical practice due to a lack of knowledge and training. The DNP project intervention included the development, implementation, and assessment of a recorded training video. Pre- and post-intervention surveys were conducted to determine if the training video increased participant’s knowledge and confidence in the technique. Forty-one of the 46 employees (89%) participated in the project. The pre-and post-intervention scores were compared and indicated the intervention was successful in increasing participants\u27 knowledge and confidence in the technique. Of the participants, 2% were confident in their knowledge and confidence enough to adopt the technique in the pre-intervention survey. This increased to 51% in the post-intervention survey. This exceeded the goal of increasing the participant’s knowledge and confidence in the technique by 25%

Acquisition of S-Band Telemetry Data during Spacecraft Launch Phases

Whenever one sets out to write a paper dealing with space exploration, the temptation is strong to try to cover everything, from the philosophy of why we are in the space business, to the detailed component description of our own favorite spacecraft . It is therefore, worth while to define the limits of the topic of this paper. The object is to compare the problems encountered in the acquisition of S-band telemetry data from spacecraft during the launch phases, with those encountered in the deep space phases. The paper is also limited to a discussion of the Pioneer, Mariner and Surveyor missions. In the discussion of telemetry mission support, the point of primary concern is data quality, which is directly related to the system signalto- noise ratio (S/N). It is primarily from this point of view that this paper discusses support problems. There were some valid reasons for transferring some telemetry link frequencies from the 215 to 260 MHz band to the 2200 to 2300 MHz band . Of primary importance was the lower noise environment at S-band. Also of importance was the improvement in overall antenna system gain for a given size directional antenna on the ground and on the spacecraft . If you consider system antenna gain as the sum of the transmitting and receiving antenna gains, fixed parabolic sizes will give an increase in system gain proportional to the square of the cormnunication frequency. During launch, an omni-directional spacecraft antenna nrust be used since the spacecraft may not be stabilized and the aspect angles from the multiple ground stations vary widely. Any improvement in system antenna gain with increase in frequency due to the ground antenna alone , is cancelled by the increase in free space attenuation. Even though the transition to S-band improved system performance in the deep space mode, during the launch phases, it did nothing but complicate the acquisition problem with narrower beam widths . For example, the beamwidth of the 85\u27 antennas on the Range decrease from 4 degrees at 230 MHz to 0 . 4 degrees at 2300 .MHz

Reducing Uncertainty in Effects-Based Operations

Known as the fog of war, uncertainty has been prevalent in the conduct of military operations throughout human history. Intelligence collection efforts are tasked to reduce this uncertainty through the collection of information. Utilizing Shannon\u27s entropy as a measure of the expected information gain due to an intelligence collection effort, a methodology is developed to prioritize and allocate intelligence assets in an efficient manner. Incorporated in this methodology are target priority and the requirement to reassess dynamic targets. The application area for the methodology is Effects-Based Operations. A generalized state model is developed to conduct adversary system-of-systems analysis. This model forms the basis for the entropy calculations and the resultant integer program to maximize the information gain

A Survey of Dissociation, Identity Distress, and Rejection Sensitivity in Adult Adoptees

This study quantitatively measures dissociation, rejection sensitivity, and identity distress among adults who experienced adoption as a child and the relationship between these factors. This study also compares groups of adoptees recruited through Amazon Mechanical Turk (MTurk) and social media to assess whether these two recruitment methods achieve similar results. An online survey was conducted of adopted adults and non-adopted adults to serve as controls using both MTurk and social media. A total of 539 participants were recruited representing 151 non-adopted individuals recruited exclusively through Mturk, and 388 adoptees, 247 of whom were recruited through MTurk and 141 through social media. Significant differences were found between adopted and non-adopted groups on the measures of dissociation, rejection sensitivity, and identity. Both rejection sensitivity and dissociation were also found to be significant mediating factors between adoption status and measures of identity. Significant differences were also found between adoptee recruitment methods on measures of dissociation, identity distress and rejection sensitivity with large effect sizes for dissociation and identity distress and a small effect size for rejection sensitivity. Implications for consideration in a clinical setting are discussed as well as potential areas of future research

Application of enhancement strategies for the improvement of discriminating forensic DNA profiles from human bones

Although DNA profiling techniques are considered a powerful method for identification, problems arise when low quantity and/or quality DNA is tested. Analyzing samples with low template DNA using standard genotyping techniques like STR typing can yield no or an incomplete profile, making conclusive identification nearly impossible. One challenging forensic sample material is bone. For example, DNA within bone can be degraded due to harsh environmental conditions even when the structure of the bone appears to be relatively well preserved. Consequently, the amount of usable DNA in bones can be limited which complicates downstream applications for DNA profiling. This study investigated techniques that would improve obtaining a discriminating DNA profile from human bones. First, the performances of three commercial DNA extraction kits were evaluated for the recovery of genomic DNA from human bones. The PrepFiler® BTA Forensic DNA Extraction Kit recovered the highest DNA yield according to qPCR data and was used for additional bone extractions. Next, purified DNA from a total of 12 bone samples was subject to genotyping methods using capillary electrophoresis (CE) as well as massively parallel sequencing (MPS) to determine which strategy would produce the most discriminating DNA profile. The genotyping techniques evaluated were: CE-based STR analysis with the GlobalFiler® PCR Amplification Kit, whole genome amplification (WGA) with the REPLI-g® Mini Kit for improved CE-based STR detection, and MPS for STR/SNP analysis using the Ion PGM™ and MiSeq® FGx™ platforms. Random match probabilities were calculated to determine the discriminatory power of the resulting DNA profiles. Although the Ion PGM™ SNP profiles had the highest RMPs, the GlobalFiler® STR profiles produced similar discriminatory power. Considering the time and labor required for MPS, one could argue STR analysis using traditional CE may be better suited for DNA profiling of challenging bone samples. However, the MPS technologies provide additional information that CE-methods can’t, such as Y-haplogroup and biogeographical ancestry predictions from SNP analyses