Decision Making and Quality: The Flint Water Crisis

Flint is a poor city with 41% of residents below federal poverty line. In 2011 Flint declared a financial state of emergency. An Emergency Financial Manager (EFM) had control over most city governing matters. In 2014 Flint switched from pre-treated Detroit water (DSWD) to the Flint River in an effort to save money. Failure to ensure water quality led to the Flint Water Crisis

A Multiple Decision-Maker Approach to Resource Allocation Models for Prevention, Preparation, and Response to Major Disruptions

Dealing with disruptions require attention to prevention, preparation, and response. Cost individuals and organizations large amounts of both time and money. Susceptibility to, and damage from, disruptions can vary based on geographical location

Senior Recital: Chris Marks

Senior Recital: Chris Markshttps://digitalcommons.kennesaw.edu/musicprograms/2444/thumbnail.jp

Junior Recital: Bob Wright, jazz trumpet

This recital is presented in partial fulfillment of requirements for the degree Bachelor of Music in Performance. Mr. Wright studies trumpet with Douglas Lindsey.https://digitalcommons.kennesaw.edu/musicprograms/1253/thumbnail.jp

Jazz Combos and Jazz Guitar Ensemble

Kennesaw State University School of Music presents Jazz Combos and Jazz Guitar Ensemble.https://digitalcommons.kennesaw.edu/musicprograms/1399/thumbnail.jp

Endoscopic Endonasal Transclival Approach versus Dual Transorbital Port Technique for Clip Application to the Posterior Circulation: A Cadaveric Anatomical and Cerebral Circulation Simulation Study

Purpose  Simulation training offers a useful opportunity to appreciate vascular anatomy and develop the technical expertise required to clip intracranial aneurysms of the posterior circulation. Materials and Methods  In cadavers, a comparison was made between the endoscopic transclival approach (ETA) alone and a combined multiportal approach using the ETA and a transorbital precaruncular approach (TOPA) to evaluate degrees of freedom, angles of visualization, and ergonomics of aneurysm clip application to the posterior circulation depending on basilar apex position relative to the posterior clinoids. Results  ETA alone provided improved access to the posterior circulation when the basilar apex was high riding compared with the posterior clinoids. ETA + TOPA provided a significantly improved functional working area for instruments and visualization of the posterior circulation for a midlevel basilar apex. A single-shaft clip applier provided improved visualization and space for instruments. Proximal and distal vascular control and feasibility of aneurysmal clipping were demonstrated. Conclusions  TOPA is a medial orbital approach to the central skull base; a transorbital neuroendoscopic surgery approach. This anatomical simulation provides surgical teams an alternative to the ETA approach alone to address posterior circulation aneurysms, and a means to preoperatively prepare for intraoperative anatomical and surgical instrumentation challenges

Endoscopic Management of Cavernous Carotid Surgical Complications: Evaluation of a Simulated Perfusion Model

Objective—Endoscopic surgical treatment of pituitary tumors, lateral invading tumors, or aneurysms requires surgeons to operate adjacent to the cavernous sinus. During these endoscopic endonasal procedures, the carotid artery is vulnerable to surgical injury at its genu. The objective of this simulation model was to evaluate trainees regarding management of a potentially lifethreatening vascular injury. Methods—Cadaveric heads were prepared in accordance with the Oregon Health & Science University body donation program. An endoscopic endonasal approach was used, and a perfusion pump with a catheter was placed in the ipsilateral common carotid artery at its origin in the neck. Learners used a muscle graft to establish vascular control and were evaluated over 3 training sessions. Simulation assessment, blood loss during sessions, and performance metric data were collected for learners. Results—Vascular control was obtained at a mean arterial pressure of 65 mm Hg using a muscle graft correctly positioned at the arteriotomy site. Learners improved over the course of training, with senior residents (n = 4) performing better across all simulation categories (situation awareness, decision making, communications and teamwork, and leadership); the largest mean difference was in communication and teamwork. Additionally, learner performance concerning blood loss improved between sessions (t = 3.667, P \u3c 0.01). Conclusions—In this pilot endoscopic endonasal simulation study, we successfully demonstrate a vascular complication perfusion model. Learners were able to gain direct applicable expertise in endoscopic endonasal techniques, instrumentation use, and teamwork required to optimize the technique. Learners gained skills of vascular complication management that transcend this model