6,752 research outputs found

    Alternatives to Spendthrift Trusts in Kentucky

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    Assessment of Student Learning in a Business Department with an Entrepreneurial Focus

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    This multi-faceted, action-research project utilized researched assessment practices and current practices acquired through case study research. The research question of this study was: How could a department in a small liberal arts college best measure and evaluate the student-learning outcomes to inform the business department with an entrepreneurial focus? The researcher answered this question by comparing assessment best practices to the home-institution department assessment plan and conducting case study analyses of assessment practices utilized by similar departments of other selected institutions. An action plan was developed and focused on home departmental collaboration and use of data

    Students with Special Needs and Career and Technical Education

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    The purpose of this paper is to review the importance of creating a practical pairing of CTE and students with special needs. The combination is not without problems. Proper training to fully implement inclusion for CTE instructors and career counseling may be necessary to make significant improvements for current programs. Regardless of the issues facing CTE and students with special needs, this paper concludes with the undeniable benefits for the students with special needs

    The Contribution of HIV to Mortality in Pregnant and Postpartum Women

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    Background: High levels of HIV and maternal mortality go hand in hand in many regions of sub-Saharan Africa. Therefore, understanding the interaction between pregnancy and HIV is important, not only for the clinical management of pregnant women, but also for the measurement of maternal mortality, the standard definition of which excludes infectious causes of death not aggravated by pregnancy. Methods: In this thesis the excess mortality attributable to HIV in pregnant and postpartum women is calculated by comparing the risk of mortality in HIV-infected pregnant and postpartum women to their uninfected counterparts using two different data sources: 1) studies identified through a systematic review and; 2) data from six demographic surveillance sites (DSS) in sub-Saharan Africa. Verbal autopsy (VA) data from the DSS are also used to explore the percentage of deaths classified as HIV/AIDS-related. Two additional systematic reviews are conducted to assess whether HIV increases the risk of obstetric complications, or pregnancy accelerates HIV disease progression. Results: HIV-infected women have eight times the risk of pregnancy-related mortality compared with HIV-uninfected women. Based on this estimate, we predict that roughly a quarter of deaths in pregnant or postpartum women are attributable to HIV in sub-Saharan Africa. A lower percentage of pregnancy-related deaths are attributed to HIV/AIDS using VA data. There is little evidence that HIV-infected women are at increased risk of direct obstetric complications, with the exception of sepsis, or that pregnancy increases the risk of HIV disease progression. Conclusion: HIV may cause up to 25% of deaths during pregnancy and in the postpartum period in areas of high HIV prevalence. Most of the evidence suggests that this excess pregnancy-related mortality attributable to HIV is largely coincidental to pregnancy. This implies that there is little reason to discourage healthy, HIV-infected women from becoming pregnant if they desire to do so

    The role for S-carboxymethylcysteine (carbocisteine) in the management of chronic obstructive pulmonary disease

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    Prescription of mucoactive drugs for chronic obstructive pulmonary disease (COPD) is increasing. This development in clinical practice arises, at least in part, from a growing understanding of the important role that exacerbation frequency, systemic inflammation and oxidative stress play in the pathogenesis of respiratory disease. S-carboxymethylcysteine (carbocisteine) is the most frequently prescribed mucoactive agent for long-term COPD use in the UK. In addition to its mucoregulatory activity, carbocisteine exhibits free-radical scavenging and anti-inflammatory properties. These characteristics have stimulated interest in the potential that this and other mucoactive drugs may offer for modification of the disease processes present in COPD. This article reviews the pharmacology, in vivo and in vitro properties, and clinical trial evidence for carbocisteine in the context of guidelines for its use and the current understanding of the pathogenic processes that underlie COPD

    Increasing vertical mixing to reduce Southern Ocean deep convection in NEMO3.4

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    Most CMIP5 (Coupled Model Intercomparison Project Phase 5) models unrealistically form Antarctic Bottom Water by open ocean deep convection in the Weddell and Ross seas. To identify the mechanisms triggering Southern Ocean deep convection in models, we perform sensitivity experiments on the ocean model NEMO3.4 forced by prescribed atmospheric fluxes. We vary the vertical velocity scale of the Langmuir turbulence, the fraction of turbulent kinetic energy transferred below the mixed layer, and the background diffusivity and run short simulations from 1980. All experiments exhibit deep convection in the Riiser-Larsen Sea in 1987; the origin is a positive sea ice anomaly in 1985, causing a shallow anomaly in mixed layer depth, hence anomalously warm surface waters and subsequent polynya opening. Modifying the vertical mixing impacts both the climatological state and the associated surface anomalies. The experiments with enhanced mixing exhibit colder surface waters and reduced deep convection. The experiments with decreased mixing give warmer surface waters, open larger polynyas causing more saline surface waters and have deep convection across the Weddell Sea until the simulations end. Extended experiments reveal an increase in the Drake Passage transport of 4 Sv each year deep convection occurs, leading to an unrealistically large transport at the end of the simulation. North Atlantic deep convection is not significantly affected by the changes in mixing parameters. As new climate model overflow parameterisations are developed to form Antarctic Bottom Water more realistically, we argue that models would benefit from stopping Southern Ocean deep convection, for example by increasing their vertical mixing

    Ultrasonic locating devices for central venous cannulation: meta-analysis

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    OBJECTIVES: To assess the evidence for the clinical effectiveness of ultrasound guided central venous cannulation. DATA SOURCES: 15 electronic bibliographic databases, covering biomedical, science, social science, health economics, and grey literature. DESIGN: Systematic review and meta-analysis of randomised controlled trials. POPULATIONS: Patients scheduled for central venous access. INTERVENTION REVIEWED: Guidance using real time two dimensional ultrasonography or Doppler needles and probes compared with the anatomical landmark method of cannulation. DATA EXTRACTION: Risk of failed catheter placement (primary outcome), risk of complications from placement, risk of failure on first attempt at placement, number of attempts to successful catheterisation, and time (seconds) to successful catheterisation. DATA SYNTHESIS: 18 trials (1646 participants) were identified. Compared with the landmark method, real time two dimensional ultrasound guidance for cannulating the internal jugular vein in adults was associated with a significantly lower failure rate both overall (relative risk 0.14, 95% confidence interval 0.06 to 0.33) and on the first attempt (0.59, 0.39 to 0.88). Limited evidence favoured two dimensional ultrasound guidance for subclavian vein and femoral vein procedures in adults (0.14, 0.04 to 0.57 and 0.29, 0.07 to 1.21, respectively). Three studies in infants confirmed a higher success rate with two dimensional ultrasonography for internal jugular procedures (0.15, 0.03 to 0.64). Doppler guided cannulation of the internal jugular vein in adults was more successful than the landmark method (0.39, 0.17 to 0.92), but the landmark method was more successful for subclavian vein procedures (1.48, 1.03 to 2.14). No significant difference was found between these techniques for cannulation of the internal jugular vein in infants. An indirect comparison of relative risks suggested that two dimensional ultrasonography would be more successful than Doppler guidance for subclavian vein procedures in adults (0.09, 0.02 to 0.38). CONCLUSIONS: Evidence supports the use of two dimensional ultrasonography for central venous cannulation
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