Diversity Management: Seeking Validation

Diversity management is widely valued in higher education today, but closer examination often reveals a lack of action to support the level of diversity that institutions claim to embrace in many of their strategic documents. This paper includes an assessment of diversity management within South Carolina’s technical colleges and an examination of survey results.  It is a companion study to a prior study of diversity in North Carolina Independent Colleges and Universities (NCICU).  The purpose of that research was to review campus-wide documents and structure of schools in the NCICU to determine diversity transparency (Bledsoe/Oatsvall)

The Ouachita Singers in a Spring Concert

This is the program for The Ouachita Singers spring concert conducted by David O. De Armond and accompanied by Terri Lucas on piano and Beau Bledsoe on guitar. The concert was held on February 15, 1991

Views of emergency care providers about factors that extend on-scene time intervals

Abstract: Introduction: Rapid response, patient care and transportation remain recognised goals of the Emergency Medical Services (EMS). Spending more time on-scene may delay the initiation of definitive care interventions. This study focused on describing the perceptions of a sample of emergency care providers regarding the impact of environmental, clinical and systemic factors with respect to their on-scene time intervals. Method: The study was descriptive and prospective in nature making use of a self-designed questionnaire. Basic descriptive methods were used during the analysis of the participants’ responses to 16 close-ended questions. A further review of the limited narrative elicited by two open-ended questions allowed for the reporting of additional views and opinions. Results: Thirty-three (92%) participants agreed that extended time on-scene may negatively affect patient outcome. Twenty-three (64%) agreed that spending longer than 20 min on-scene may be considered excessive for medical emergencies and 28 (77%) felt the same for trauma cases. Respondents felt that many of the environmental, clinical and systemic factors mentioned in the questionnaire do have the potential to extend on-scene time intervals. The factors that were seen to have the greatest effect included waiting for fire, rescue and police services, patient acuity, the use of an air ambulance, patient extrication and multi-casualty incidents. Discussion: There are a number of environmental, clinical and systemic factors that emergency care providers indicate have the potential to extend on-scene time intervals. Acknowledging and attempting to address these factors is important for EMS as limiting the time spent on-scene is not only clinically desirable but may also lead to improved efficiency and availability of resources

Pilot evaluation of a novel unilateral onychectomy model and efficacy of an extended release buprenorphine product

Abstract Background Non-steroidal anti-inflammatory drugs (NSAIDs), transdermal fentanyl patches, and transmucosal buprenorphine are probably the most commonly used options for providing post-operative analgesia in the early at-home period. However, these require daily administration or are associated with abuse concerns. One of the significant unmet needs in veterinary surgery and pain management is for longer acting opioids for cats to effectively bridge the gap between the in-hospital and at-home recovery periods. A proof of concept study of an extended release formulation of buprenorphine HCL (ER-Bup) was conducted using objective kinetic measures and a unilateral onychectomy model. Using a blinded, randomized, two period crossover design, four cats were allocated to control (saline) or ER-Bup (0.6 mg/kg, subcutaneously [SC]) treatment groups. All animals underwent a unilateral forelimb onychectomy per period with a washout/recovery period in between. Observational pain scores and kinetic data (using a pressure sensitive walkway [PSW]) were collected prior to (baseline) and at intervals for 72 h following surgery. Symmetry indices were derived for kinetic variables (peak vertical force [PVF]; vertical impulse [VI]) of each forelimb for landing following a jump and for walking. A rescue analgesic protocol was in place. Effect of surgery and treatment were evaluated using a mixed model statistical approach. Results No cats required rescue analgesics based on subjective pain score. ER-Bup had a positive influence on subjective pain scores during the 72 h postsurgery (p = 0.0473). PVF and VI of the operated limb were significantly decreased for both landing (p < 0.0001 and p < 0.0001) and walking (p < 0.0001 and p < 0.0001 respectively) compared to control. ER-Bup resulted in significantly decreased asymmetry in limb use during landing (PVF, p < 0.0001; VI, p < 0.0001) and walking (PVF, p = 0.0002, VI, p < 0.0001). The novel use of data collected following a jump from an elevated platform appeared to provide all desired information and was easier to collect than walking data. Conclusion This study demonstrates that SC administration of ER-Bup may be an effective analgesic for a 72 h period postoperatively. Furthermore, landing onto a PSW from an elevated perch may be a useful and efficient way to assess analgesics in cats using a unilateral model of limb pain

Development and Testing of the Orion CEV Parachute Assembly System (CPAS)

The Crew Exploration Vehicle (CEV) is an element of the Constellation Program that includes launch vehicles, spacecraft, and ground systems needed to embark on a robust space exploration program. As an anchoring capability of the Constellation Program, the CEV shall be human-rated and will carry human crews and cargo from Earth into space and back again. Coupled with transfer stages, landing vehicles, and surface exploration systems, the CEV will serve as an essential component of the architecture that supports human voyages to the Moon and beyond. In addition, the CEV will be modified, as required, to support International Space Station (ISS) mission requirements for crewed and pressurized cargo configurations. Headed by Johnson Space Center (JSC), NASA selected Jacobs Engineering as the support contractor to manage the overall CEV Parachute Assembly System (CPAS) program development. Airborne Systems was chosen to develop the parachute system components. General Dynamics Ordnance and Tactical Systems (GD-OTS) was subcontracted to Airborne Systems to provide the mortar systems. Thus the CPAS development team of JSC, Jacobs, Airborne Systems and GD-OTS was formed. The CPAS team has completed the first phase, or Generation I, of the design, fabrication, and test plan. This paper presents an overview of the CPAS program including system requirements and the development of the second phase, known as the Engineering Development Unit (EDU) architecture. We also present top level results of the tests completed to date. A significant number of ground and flight tests have been completed since the last CPAS presentation at the 2007 AIAA ADS Conference

Impact of antibacterials on subsequent resistance and clinical outcomes in adult patients with viral pneumonia: An opportunity for stewardship

INTRODUCTION: Respiratory viruses are increasingly recognized as significant etiologies of pneumonia among hospitalized patients. Advanced technologies using multiplex molecular assays and polymerase-chain reaction increase the ability to identify viral pathogens and may ultimately impact antibacterial use. METHOD: This was a single-center retrospective cohort study to evaluate the impact of antibacterials in viral pneumonia on clinical outcomes and subsequent multidrug-resistant organism (MDRO) infections/colonization. Patients admitted from March 2013 to November 2014 with positive respiratory viral panels (RVP) and radiographic findings of pneumonia were included. Patients transferred from an outside hospital or not still hospitalized 72 hours after the RVP report date were excluded. Patients were categorized based on exposure to systemic antibacterials: less than 3 days representing short-course therapy and 3 to 10 days being long-course therapy. RESULTS: A total of 174 patients (long-course, n = 67; short-course, n = 28; mixed bacterial-viral infection, n = 79) were included with most being immunocompromised (56.3 %) with active malignancy the primary etiology (69.4 %). Rhinovirus/Enterovirus (23 %), Influenza (19 %), and Parainfluenza (15.5 %) were the viruses most commonly identified. A total of 13 different systemic antibacterials were used as empiric therapy in the 95 patients with pure viral infection for a total of 466 days-of-therapy. Vancomycin (50.7 %), cefepime (40.3 %), azithromycin (40.3 %), meropenem (23.9 %), and linezolid (20.9 %) were most frequently used. In-hospital mortality did not differ between patients with viral pneumonia in the short-course and long-course groups. Subsequent infection/colonization with a MDRO was more frequent in the long-course group compared to the short-course group (53.2 vs 21.1 %; P = 0.027). CONCLUSION: This study found that long-course antibacterial use in the setting of viral pneumonia had no impact on clinical outcomes but increased the incidence of subsequent MDRO infection/colonization

Epidemiology, co-infections, and outcomes of viral pneumonia in adults an observational cohort study

Advanced technologies using polymerase-chain reaction have allowed for increased recognition of viral respiratory infections including pneumonia. Co-infections have been described for several respiratory viruses, especially with influenza. Outcomes of viral pneumonia, including cases with co-infections, have not been well described. This was observational cohort study conducted to describe hospitalized patients with viral pneumonia including co-infections, clinical outcomes, and predictors of mortality. Patients admitted from March 2013 to November 2014 with a positive respiratory virus panel (RVP) and radiographic findings of pneumonia within 48 h of the index RVP were included. Co-respiratory infection (CRI) was defined as any organism identification from a respiratory specimen within 3 days of the index RVP. Predictors of in-hospital mortality on univariate analysis were evaluated in a multivariate model. Of 284 patients with viral pneumonia, a majority (51.8%) were immunocompromised. A total of 84 patients (29.6%) were found to have a CRI with 48 (57.6%) having a bacterial CRI. Viral CRI with HSV, CMV, or both occurred in 28 patients (33.3%). Fungal (16.7%) and other CRIs (7.1%) were less common. Many patients required mechanical ventilation (54%) and vasopressor support (36%). Overall in-hospital mortality was high (23.2%) and readmissions were common with several patients re-hospitalized within 30 (21.1%) and 90 days (36.7%) of discharge. Predictors of in-hospital mortality on multivariate regression included severity of illness factors, stem-cell transplant, and identification of multiple respiratory viruses. In conclusion, hospital mortality is high among adult patients with viral pneumonia and patients with multiple respiratory viruses identified may be at a higher risk

Disruption of Lateral Olivocochlear Neurons via a Dopaminergic Neurotoxin Depresses Sound-Evoked Auditory Nerve Activity

We applied the dopaminergic (DA) neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to the guinea pig cochlear perilymph. Immunolabeling of lateral olivocochlear (LOC) neurons using antibodies against synaptophysin was reduced after the MPTP treatment. In contrast, labeling of the medial olivocochlear innervation remained intact. As after brainstem lesions of the lateral superior olive (LSO), the site of origin of the LOC neurons, the main effect of disrupting LOC innervation of the cochlea via MPTP was a depression of the amplitude of the compound action potential (CAP). CAP amplitude depression was similar to that produced by LSO lesions. Latency of the N1 component of the CAP, and distortion product otoacoustic emission amplitude and adaptation were unchanged by the MPTP treatment. This technique for selectively lesioning descending LOC efferents provides a new opportunity for examining LOC modulation of afferent activity and behavioral measures of perception.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41386/1/10162_2004_Article_2429.pd

Modelos de predicción de mortalidad en cirugía cardiaca: diseño de un modelo, evaluación de modelos generales y análisis de mortalidad ajustada a riesgo

Las intervenciones de cirugía cardiaca tienen costes elevados, emplean recursos complejos, y se asocian a riesgos quirúrgicos medios comparativamente más elevados que la mayor parte de las demás disciplinas quirúrgicas. Es un área de especial interés para los estudios de evaluación de riesgo y de análisis de calidad. El parámetro más empleado como variable de medición es la mortalidad hospitalaria, por su relevancia clínica, facilidad de medir, y estandarización. La necesidad de establecer rangos de mortalidad aceptable ha originado iniciativas nacionales para medirlo. Ningún organismo emite datos de mortalidad por tipo de procedimiento ajustado a riesgo de los servicios cardioquirúrgicos adaptados a criterios acordados con las sociedades científicas. Las fuentes existentes son las memorias de resultados de las Consejerías, los registros de gastos y el Registro de Actividad de la SECTCV. Ninguna de estas fuentes contiene información paciente a paciente, ni información pronóstica de los pacientes. La fuente más útil a nivel clínico es el Registro de Intervenciones de la SECTCV. El análisis de la mortalidad debe tener en cuenta el riesgo de los pacientes. Los modelos de predicción de mortalidad estiman este riesgo..