Why Can\u27t We Retain Principals and Teachers in Our Schools?

A capstone submitted in partial fulfillment of the requirements for the degree of Doctor of Education in the College of Education at Morehead State University by Crystal A. Fultz and Brandon E. Richards on March 17, 2017

241-AZ Farm Annulus Extent of Condition Baseline Inspection

This report provides the results of the comprehensive annulus visual inspection for tanks 241- AZ-101 and 241-AZ-102 performed in fiscal year 2013. The inspection established a baseline covering about 95 percent of the annulus floor for comparison with future inspections. Any changes in the condition are also included in this document

Exploring Race: The Collaborative Inquiry Experience of a Group of Black Social Work Faculty

Through a partnership presentation, presenters discussed the co-inquiry group process through which they explored their experiences as Black faculty who teach race based content in social work programs. They shared insights into what it means, what it takes, and what it costs to teach such content, and the benefits of the group process

Differences in Perceived Patient Mobility Barriers Among Nurses from Various Departments and Location Work-Sites

Background: Hospitalized patients suffer negative outcomes related to lack of mobilization activities such as falls with injury or infection. Mobility requires a multi-disciplinary team approach including Registered Nurses (RNs), Certified Nursing Assistants (NA-Cs), and Physical/Occupational Therapists (PT/OTs) to promote best patient outcomes. The Johns Hopkins Culture of Mobility toolkit provides evidence-based practices for integrating multi-disciplinary mobilization efforts for hospitalized patients. This toolkit had not been implemented on a busy orthopedic post-operative nursing unit in one large hospital. Purpose/aims: To test the impact of the culture of mobility toolkit on caregiver perceptions of mobility barriers and evaluate the implementation of the toolkit on a surgical acute care unit. Methods/Approach: This quality improvement project was implemented on an orthopedic post-surgery inpatient unit in a large medical center in the Pacific Northwest. A pre-survey was administered to RNs, NA-C\u27s and PT/OTs prior to the implementation of this project, and those findings guided the development of an educational intervention. The education was a poster on the Johns Hopkins Culture of Mobility toolkit with focus on using the toolkit\u27s mobility screening tool presented to RN\u27s, NAC\u27s and PT/OT\u27s. Caregivers were also informed to complete a form each shift on the following: the patient\u27s Highest Level of Mobility score, the patient\u27s mobility goal for the shift, whether the patient met the personal goal, and barriers/facilitators to the patient\u27s ability to meet personal goals. Staff were directed to complete tracking sheets each shift for each patient during a 6-week period. After the intervention, all staff were invited to complete the post-survey to re-assess perceived mobility barriers. Results: More than 90 caregivers completed the pre-intervention perceived mobility barriers survey, which suggested that staff felt that patient mobilization efforts were time-intensive and posed an injury risk for caregivers. After the education was provided, over 240 mobility tracking sheet were submitted by mainly RN\u27s working night shift, and 65% of caregivers reported that the patient\u27s self-reported mobility goal was met by the end of the shift. Barriers to achieving patient-created mobility goals included inadequate symptom management, reduced patient-specific motivation to move, and lack of adequate resources to safely mobilize patients. A total of 32 caregivers responded to the post-project mobility survey, revealing a significant decrease in overall perceived mobility barriers from preintervention levels. PT/OTs reported significantly less barriers compared to nursing staff at both time points. Conclusion: This project demonstrated that multi-disciplinary staff working on a busy orthopedic postsurgical floor can adopt evidence-based practice tools to promote mobility which may facilitate increased patient mobilization activities. Future projects may include greater adoption of the toolkit throughout the medical center. Implications for practice: Hospital-based mobility programs such as the Johns Hopkins Culture of Mobility toolkit can mitigate functional decline of adults following hospitalization. Inpatient mobility activities may be enhanced by engaging patients to set and attain mobility goals each shift, partnering with PT/OTs, identifying patient motivation to mobilize, and optimizing symptom management.https://digitalcommons.psjhealth.org/prov_rn_conf_all/1035/thumbnail.jp

Innate Immune Cell Recovery Is Positively Regulated by NLRP12 during Emergency Hematopoiesis

With enhanced concerns of terrorist attacks, dual exposure to radiation and thermal combined injury (RCI) has become a real threat with devastating immunosuppression. NLRP12, a member of the NOD-like receptor family, is expressed in myeloid and bone marrow cells and has been implicated as a checkpoint regulator of inflammatory cytokines as well as an inflammasome activator. We show that NLRP12 has a profound impact on hematopoietic recovery during RCI by serving as a checkpoint of TNF signaling and preventing hematopoietic apoptosis. Using a mouse model of RCI, increased NLRP12 expression was detected in target tissues. Nlrp12−/− mice exhibited significantly greater mortality, inability to fight bacterial infection, heightened levels of pro-inflammatory cytokines, overt granulocyte/monocyte progenitor cell apoptosis and failure to reconstitute peripheral myeloid populations. Anti-TNF antibody administration improved peripheral immune recovery. These data suggest that NLRP12 is essential for survival after RCI by regulating myelopoiesis and immune reconstitution

Reply to Ruan et al. (2017): Non-medical use of prescription opioids is associated with heroin initiation among US veterans.

We thank Ruan and colleagues for their letter and appreciate their comments regarding our recent study, which demonstrated an independent association between non-medical use of prescription opioids (NMUPO) and heroin initiation among US veterans

Non-medical use of prescription opioids is associated with heroin initiation among US veterans: a prospective cohort study

Aims: To estimate the influence of non-medical use of prescription opioids (NMUPO) on heroin initiation among US veterans receiving medical care. Design: Using a multivariable Cox regression model, we analyzed data from a prospective, multi-site, observational study of HIV-infected and an age/race/site-matched control group of HIV-uninfected veterans in care in the United States. Approximately annual behavioral assessments were conducted and contained self-reported measures of NMUPO and heroin use. Setting: Veterans Health Administration (VHA) infectious disease and primary care clinics in Atlanta, Baltimore, New York, Houston, Los Angeles, Pittsburgh and Washington, DC. Participants: A total of 3396 HIV-infected and uninfected patients enrolled into the Veterans Aging Cohort Study who reported no life-time NMUPO or heroin use, had no opioid use disorder diagnoses at baseline and who were followed between 2002 and 2012. Measurements: The primary outcome measure was self-reported incident heroin use and the primary exposure of interest was new-onset NMUPO. Our final model was adjusted for socio-demographics, pain interference, prior diagnoses of post-traumatic stress disorder and/or depression and self-reported other substance use. Findings: Using a multivariable Cox regression model, we found that non-medical use of prescription opioids NMUPO was associated positively and independently with heroin initiation [adjusted hazard ratio (AHR) = 5.43, 95% confidence interval (CI) = 4.01, 7.35]. Conclusions: New-onset non-medical use of prescription opioids (NMUPO) is a strong risk factor for heroin initiation among HIV-infected and uninfected veterans in the United States who reported no previous history of NMUPO or illicit opioid use

Aerosol characterization study using multi-spectrum remote sensing measurement techniques.

A unique aerosol flow chamber coupled with a bistatic LIDAR system was implemented to measure the optical scattering cross sections and depolarization ratio of common atmospheric particulates. Each of seven particle types (ammonium sulfate, ammonium nitrate, sodium chloride, potassium chloride, black carbon and Arizona road dust) was aged by three anthropogenically relevant mechanisms: 1. Sulfuric acid deposition, 2. Toluene ozonolysis reactions, and 3. m-Xylene ozonolysis reactions. The results of pure particle scattering properties were compared with their aged equivalents. Results show that as most particles age under industrial plume conditions, their scattering cross sections are similar to pure black carbon, which has significant impacts to our understanding of aerosol impacts on climate. In addition, evidence emerges that suggest chloride-containing aerosols are chemically altered during the organic aging process. Here we present the direct measured scattering cross section and depolarization ratios for pure and aged atmospheric particulates