Intravenous patient-controlled analgesia (IV PCA) for post-operative pain management: an education module for registered nurses

Background: Providing effective pain management post-operatively is essential to prevent complications after surgery, increase patient satisfaction and ultimately enhance optimal post-surgical outcomes. Intravenous patient-controlled analgesia (PCA) is a method of post-operative pain management which can achieve all of these outcomes and improve the overall quality of post-surgical care provided. Registered Nurses (RNs) at the Labrador West Health Centre (LWHC) in Labrador City, NL identified a lack of knowledge and experience with caring for patients receiving intravenous PCA. By providing a resource to enhance the knowledge of RNs regarding this method of post-surgical pain management, PCA will be a more feasible option for patients at the LWHC, where the current practice of intermittent intravenous or intramuscular injections of opioids remains in use. Purpose: The purpose of this practicum was to develop an educational resource for RNs focusing on the care of patients receiving PCA post-operatively. As a result of this educational resource, an increase in knowledge and confidence of RNs at the LWHC in using PCA is expected. Methods: An integrative literature review, consultations with key informants, and an environmental scan of other facilities within Newfoundland and Labrador were conducted. Results: Blended education has been found to be effective when educating RNs. This involves the use of self-directed and face-to-face learning. In keeping with this method of blended education, an educational module was created along with a face-to-face education session involving a discussion of case studies and the use of pre and post-tests. Conclusion: Prior to implementation, key informants from the LWHC will review the content of the education module. This module, combined with a face-to-face session, is expected to increase the knowledge and confidence of RNs along with improving the quality of post-operative care offered to patients. It is further anticipated that the implementation of this education module will lead to the consistent use of intravenous PCA as a method of post-operative pain management at the LWHC, thus enhancing optimal post-surgical outcomes

UML Activity Diagram Semantics and Automated GUI Prototyping

Extended Activity Semantics (XAS) is a notation which can be used with Unified Modeling Language (UML) activity diagrams to specify user interactions with a system and to automatically generate a prototype of the graphical user interface (GUI) that would be used in these interactions. XAS has been incorporated in a CASE tool, Guibot, which has been developed as a plug-in for Rational Rose, a leading UML tool. The notation and tool address a specific gap in UML – the inability to model user interaction

On the Performance of Trellis Coded Modulation in a Concatenated Reed-Bolomon System

Concatenated systems combining the error correcting power of trellis codes and Reed-Solomon (RS) codes have been used to achieve error rates between 10-10 and 10-20 on satelite communications links [l]. The need for spectral efficiency has motivated consideration of of non-binary signalling with Ungerboeck [2,3] codes or the Pragmatic standard recently proposed by Viterbi [4], in place of quaternary signalling with rate 1/2 coding. In this paper we investigates the use of 8-PSK trellis-coded modulation (TCM) in a concatenated system using a (255,233) RS code. The use of the 8-PSK codes doubles the spectral efficiency with a performance cost of approximately 2 dB

The evolution of stable silicon isotopes in a coastal carbonate aquifer on Rottnest Island, Western Australia

Dissolved silicon (dSi) is a key nutrient in the oceans, but data regarding Si isotopes in coastal aquifers are not widely available. Here we investigate the Si isotopic composition of 12 fresh and 16 saline groundwater samples from Rottnest Island, Western Australia, which forms part of the world's most extensive aeolianite deposit (the Tamala Limestone formation). In total, two bedrock samples were also collected from Rottnest Island for Si isotope analysis. The δ30Si values of groundwater samples ranged from −0.4 ‰ to +3.6 ‰ with an average +1.6 ‰, and the rock samples were −0.8 ‰ and −0.1 ‰. The increase in δ30Si values in fresh groundwater is attributed to the removal of the lighter Si isotopes into secondary minerals and potentially also adsorption onto Fe (oxy)hydroxides. The positive correlations between δ30Si values and dSi concentrations (ρ = 0.59; p = 0.02) and δ30Si values and Cl, but not dSi and Cl concentrations, are consistent with vertical mixing between the younger fresh groundwater and the deeper groundwater, which have undergone a greater degree of water–rock interactions. This has produced a spatial pattern in δ30Si across the aquifer due to the local hydrogeology, resulting in a correlation between δ30Si and tritium activities when considering all groundwater types (ρ = −0.68; p = 0.0002). In the deeper aquifer, the inverse correlation between dSi and Cl concentrations (ρ = −0.79; p = 0.04) for the more saline groundwater is attributed to groundwater mixing with local seawater that is depleted in dSi (< 3.6 µM). Our results from this well-constrained island aquifer system demonstrate that stable Si isotopes usefully reflect the degree of water–aquifer interactions, which is related to groundwater residence time and local hydrogeology. Our finding that lithogenic Si dissolution occurs in the freshwater lens and the freshwater–seawater transition zone on Rottnest Island appears to supports the recent inclusion of a marine–submarine groundwater discharge term in the global dSi mass balance. Geologically young carbonate aquifers, such as Rottnest Island, may be an important source of dSi in coastal regions with low riverine input and low oceanic dSi concentrations

Establishment and characterization of an iPSC line (UCLi023-A) derived from a Late-Onset Retinal Degeneration patient carrying a founder mutation in C1QTNF5

Late-Onset Retinal Degeneration (L-ORD) is a rare autosomal dominant macular disease, with most cases being caused by a founder mutation in C1QTNF5. Initial symptoms, which generally occur during or after the sixth decade, include abnormal dark adaptation and changes in peripheral vision. Over time, the build-up of sub-retinal pigment epithelium (RPE) deposits leads to macular atrophy and bilateral central vision loss1. Here, we describe the generation of a human induced pluripotent stem cell (iPSC) line from dermal fibroblasts of a 61-year-old L-ORD Caucasian male patient carrying the founder mutation (c.489C>G, p.Ser163Arg), using episomal reprogramming

Humanly space objects — Perception and connection with the observer

Expanding humanity into space is an inevitable step in our quest to explore our world. Yet space exploration is costly, and the awaiting environment challenges us with extreme cold, heat, vacuum and radiation, unlike anything encountered on Earth. Thus, the few pioneers who experience it needed to be well protected throughout their spaceflight. The resulting isolation heightens the senses and increases the desire to make humanly connections with any other perceived manifestation of life. Such connections may occur via sensory inputs, namely vision, touch, sound, smell, and taste. This then follows the process of sensing, interpreting, and recognizing familiar patterns, or learning from new experiences. The desire to connect could even transfer to observed objects, if their movements and characteristics trigger the appropriate desires from the observer. When ordered in a familiar way, for example visual stimuli from lights and movements of an object, it may create a perceived real bond with an observer, and evoke the feeling of surprise when the expected behavior changes to something no longer predictable or recognizable. These behavior patterns can be designed into an object and performed autonomously in front of an observer, in our case an astronaut. The experience may introduce multiple responses, including communication, connection, empathy, order, and disorder. While emotions are clearly evoked in the observer and may seem one sided, in effect the object itself provides a decoupled bond, connectivity and communication between the observer and the artist-designer of the object. In this paper we will discuss examples from the field of arts and other domains, including robotics, where human perception through object interaction was explored, and investigate the starting point for new innovative design concepts and future prototype designs, that extend these experiences beyond the boundaries of Earth, while taking advantage of remoteness and the zero gravity environment. Through a form of emotional connection and design, these concepts will focus on the connection and brief emotional bond between a humanly animate object in space and a co-located observer in spaceflight. We conclude that beyond providing creative expressions for humanly contacts, these experiences may also provide further insights into human perception in spaceflight, and could be tested on the International Space Station, and serve as a stepping-stone towards use on long-duration spaceflight to Mars

U.S. West Coast fishing communities and climate vulnerability in an ecosystem-based management context

As changes in climate and corresponding ocean shifts threaten U.S. fisheries with uncertain change, West Coast marine scientists and fishery management institutions have newly emphasized ecosystem-based analysis and management. The development of the West Coast-specific California Current Integrated Ecosystem Assessment (CCIEA) has accordingly allowed for economic analyses and the social science on human communities to be included in this holistic endeavor, generating enhanced collaborations between applied socioeconomic and biophysical scientists. These collaborations are beneficial, but challenges emerge within aspects of the integrated approach to ecosystem-based management including, for example, a natural science emphasis on frequent monitoring of ecosystem indicators. Alongside temporal limitations on available socioeconomic data and other data constraints that sometimes preclude frequent monitoring, distinct social science methodologies require new thinking on collaborations and socio-ecological ecosystem modeling efforts. One potentially productive avenue for collaboration involves the linkage of climate vulnerability evaluations for marine species with evaluations of both community socioeconomic vulnerability and community involvement in fishing. Northwest Fisheries Science Center (NWFSC) social scientists have developed indices of community socioeconomic vulnerability and general community-level engagement with and dependence on commercial and recreational fishing. These fishing indices are additionally modified to enable those involved in integrated ecosystem assessments to consider species and fishery-specific dependence indices by community, pairing these measures with climate vulnerability assessments for associated fish species. Such linkages allow for integrated metrics of climate-oriented exposure and vulnerability for a range of people, places and marine species, and the work presented here demonstrates the results and utility of this approach