Master of Science

thesisQuestionnaires were distributed to 198 registered nurses and 1979 licensed practical nurses in five hospitals to determine: 1) their attitude toward disabled persons through response to the Attitude Toward Disabled Persons Scale, developed by the Human Resources Foundation; 2) their performance level of the rehabilitative aspects of nursing care through response to the Performance of Rehabilitative Aspects of Nursing Care Scale, developed by the author; and 3) the correlation of attitude with performance. It was expected that attitude and performance would be correlated; a low, but significant correlation of .19 (p = .01) was found. It was also expected that registered nurses, by virtue of their higher level of educational preparation, would score higher on both instruments, but the results did not show this to be so. There was no significant difference in either attitude or performance between the two levels of nursing personnel. Mean score of the two scales revealed that nursing personnel exhibited somewhat lower levels of attitude and performance scores than would be considered, in the opinion of the author, to be indicative of an accepting attitude toward the disabled person and the performance of a high quality of nursing care in relation to the rehabilitative needs of patients. Although generalizations made from the results of this study should be drawn with caution, some inferences can be derived which have implications for the future provision of a high quality of nursing care

Surface Ozone Background in the United States: Canadian and Mexican Pollution Influences

We use a global chemical transport model (GEOS-Chem) with 1° × 1° horizontal resolution to quantify the effects of anthropogenic emissions from Canada, Mexico, and outside North America on daily maximum 8-hour average ozone concentrations in US surface air. Simulations for summer 2001 indicate mean North American and US background concentrations of 26 ± 8 ppb and 30 ± 8 ppb, as obtained by eliminating anthropogenic emissions in North America vs. in the US only. The US background never exceeds 60 ppb in the model. The Canadian and Mexican pollution enhancement averages 3 ± 4 ppb in the US in summer but can be occasionally much higher in downwind regions of the northeast and southwest, peaking at 33 ppb in upstate New York (on a day with 75 ppb total ozone) and 18 ppb in southern California (on a day with 68 ppb total ozone). The model is successful in reproducing the observed variability of ozone in these regions, including the occurrence and magnitude of high-ozone episodes influenced by transboundary pollution. We find that exceedances of the 75 ppb US air quality standard in eastern Michigan, western New York, New Jersey, and southern California are often associated with Canadian and Mexican pollution enhancements in excess of 10 ppb. Sensitivity simulations with 2020 emission projections suggest that Canadian pollution influence in the Northeast US will become comparable in magnitude to that from domestic power plants.Engineering and Applied Science

Cracking the Nut on LCME Standard 8.7: Innovations to Ensure Comparability Across Geographically Distributed Campuses

Problem: A large state university in the southeastern United States and state Area Health Education Centers (AHEC) collaborated to establish branch campuses to increase clinical capacity for medical student education. Prior to formally becoming branch campuses, two AHEC sites had established innovative curricular structures different than the central campus. These sites worked with the central campus as clinical training sites. Upon becoming formal campuses, their unique clinical experiences were maintained. A third campus established a curricular structure identical to the central campus. Little exists in the literature regarding strategies that ensure comparability yet allow campuses to remain unique and innovative. Intervention: We implemented a balanced matrix organizational structure, well-defined communication plan, and newly developed tool to track comparability. A balanced matrix organization model framed the campus relationships. Adopting this model led to identifying reporting structures, developing multidirectional communication strategies, and the Campus Comparability Tool. Context: The UNC School of Medicine central campus is in Chapel Hill. All 192 students complete basic science course work on central campus. For required clinical rotations, approximately 140 students are assigned to the central campus, which includes rotations in Raleigh or Greensboro. The remaining students are assigned to Asheville (25–30), Charlotte (25–30), or Wilmington (5–7). Chapel Hill and Wilmington follow identical rotation structures, 16 weeks each of (a) combined surgery and adult inpatient experiences; (b) combined obstetrics/gynecology, psychiatry, and inpatient pediatrics; and (c) longitudinal clinical experiences in adult and pediatric medicine. Asheville offers an 8-month longitudinal integrated outpatient experience with discreet inpatient experiences in surgery and adult care. Charlotte offers a 6-month longitudinal integrated experiences and 6 months of block inpatient experiences. Aside from Charlotte and Raleigh, the other sites are urban but surrounded by rural counties. Chapel Hill is 221 miles from Asheville, 141 from Charlotte, and 156 from Wilmington. Outcome: Using the balanced matrix organization, various reporting structures and lines of communication ensured the educational objectives for students were clear on all campuses. The communication strategies facilitated developing consistent evaluation metrics across sites to compare educational experiences. Lessons Learned: The complexities of different healthcare systems becoming regional campuses require deliberate planning and understanding the culture of those sites. Recognizing how size and location of the organization affects communication, the central campus took the lead centralizing functions when appropriate. Adopting uniform educational technology has played an essential role in evaluating the comparability of core educational content on campuses delivering content in very distinct ways

The Farthest Known Supernova: Support for an Accelerating Universe and a Glimpse of the Epoch of Deceleration

We present photometric observations of an apparent Type Ia supernova (SN Ia) at a redshift of ~1.7, the farthest SN observed to date. SN 1997ff, was discovered in a repeat observation by the HST of the HDF-), and serendipitously monitored with NICMOS on HST throughout the GTO campaign. The SN type can be determined from the host galaxy type:an evolved, red elliptical lacking enough recent star formation to provide a significant population of core-collapse SNe. The class- ification is further supported by diagnostics available from the observed colors and temporal behavior of the SN, both of which match a typical SN Ia. The photo- metric record of the SN includes a dozen flux measurements in the I, J, and H bands spanning 35 days in the observed frame. The redshift derived from the SN photometry, z=1.7+/-0.1, is in excellent agreement with the redshift estimate of z=1.65+/-0.15 derived from the U_300,B_450,V_606,I_814,J_110,J_125,H_160, H_165,K_s photometry of the galaxy. Optical and near-infrared spectra of the host provide a very tentative spectroscopic redshift of 1.755. Fits to observations of the SN provide constraints for the redshift-distance relation of SNe~Ia and a powerful test of the current accelerating Universe hypothesis. The apparent SN brightness is consistent with that expected in the decelerating phase of the preferred cosmological model, Omega_M~1/3, Omega_Lambda~2/3. It is inconsistent with grey dust or simple luminosity evolution, candidate astro- physical effects which could mimic past evidence for an accelerating Universe from SNe Ia at z~0.5.We consider several sources of possible systematic error including lensing, SN misclassification, selection bias, and calibration errors. Currently, none of these effects appears likely to challenge our conclusions.Comment: Accepted to the Astrophysical Journal 38 pages, 15 figures, Pretty version available at http://icarus.stsci.edu/~stefano/ariess.tar.g

Synthesis and Assessment Product

This report focuses on the Climate Projections Based on Emissions Scenarios. The influence of greenhouse gases and particle pollution on our present and future climate has been widely examined. While both long-lived (e.g., carbon dioxide) and short-lived (e.g., soot) gases and particles affect the climate, other projections of future climate, such as the IPCC reports focus largely on the long-lived gases. This U.S. Climate Change Science Program Synthesis and Assessment Product provides a different emphasis. The authors examine the effect of long-lived greenhouse gases on the global climate based on updated emissions scenarios produced by another CCSP Synthesis and Assessment Product (SAP 2.1a). In these scenarios, atmospheric concentrations of the long-lived greenhouse gases leveled off, or stabilized, at predetermined levels by the end of the twenty-first century (unlike in the IPCC scenarios). However, the projected future temperature changes fall within the same range as those projected for the latest IPCC report. The authors confirm the robust future warming signature and other associated changes in the climate

Childhood asthma and indoor allergens in Native Americans in New York

BACKGROUND: The objective of this study was to assess the correlation between childhood asthma and potential risk factors, especially exposure to indoor allergens, in a Native American population. METHODS: A case-control study of St. Regis Mohawk tribe children ages 2–14 years, 25 diagnosed with asthma and 25 controls was conducted. Exposure was assessed based on a personal interview and measurement of mite and cat allergens (Der p 1, Fel d 1) in indoor dust. RESULTS: A non-significant increased risk of childhood asthma was associated with self-reported family history of asthma, childhood environmental tobacco smoke exposure, and air pollution. There was a significant protective effect of breastfeeding against current asthma in children less than 14 years (5.2 fold lower risk). About 80% of dust mite and 15% of cat allergen samples were above the threshold values for sensitization of 2 and 1 μg/g, respectively. The association between current asthma and exposure to dust mite and cat allergens was positive but not statistically significant. CONCLUSION: This research identified several potential indoor and outdoor risk factors for asthma in Mohawks homes, of which avoidance may reduce or delay the development of asthma in susceptible individuals

The potential influences of ENSO on interhemispheric transport

Ph.D.Dana E. Hartle