Leading Climate Action Planning: A Case Study of Local Community Practices

Given the increasing rate of anthropogenic climate change and the resulting climate impacts that communities around the world will be coping with over the next century, it is becoming increasingly important that communities, cities, and regions begin to develop climate action plans that will assist them in coping with climate impacts. As a result, it is becoming evident that understanding how to effectively develop a climate action plan (CAP) and engage a community in the climate action planning process is a question at the forefront for many municipalities. This research utilized case study to examine the process the City of Imperial Beach engaged in to draft its CAP in an effort to understand the strengths the city was able to leverage and challenges the city faced. A chronological time-series was developed to assist in understanding the critical events that must take place in order to develop a CAP. Findings revealed that the CAP process in Imperial Beach was a years’ long effort championed by city council members and pushed forward by city staff and community members. The central themes found in this case study were community engagement, collaboration, environmental justice, and political polarization. Finally, the findings of this case study were viewed through the lens of complexity leadership theory in order to draw conclusions about the leadership needs in the CAP process

An Exploration of Embodiment, Narrative Identity, and Healing in Dungeons and Dragons

An Exploration of Embodiment, Narrative Identity, and Healing in Dungeons and Dragons is composed of two sister articles: the first is titled Me, Myself, and My D&D Character: The Recursive Process of Embodiment and Narrative Identity in Dungeons and Dragons, and the second is titled Dungeons and Dragons as a Site of Healing: Towards Embodied Writing as Healing. Dungeons and Dragons, or D&D, is a fantasy role-playing game where a Dungeon Master, leader and rules referee, leads a group of players acting as fantasy characters, or avatars, through a story together where outcomes are determined by rolling dice. Since players role-play their designated characters alongside other players, I pose that D&D is a rich and recursive process where players embody their characters through experiences similar to and different from their own lives. This recursive process of embodiment and narrative identity, I pose, also has significant use in allowing players to heal through these embodied experiences. Using an ethnographic approach to autoethnography, I observe in the first article my own experiences playing D&D both as player and Dungeon Master to understand the recursive process between a player, their character, and the other players/characters in the game. In the second article, I take this understanding that D&D is a recursive embodied experience and explore my own healing journey playing my two most recent characters, Shasta and Edris. I found that a character’s embodied experience can interact and overlap with the player’s embodied experience, and that D&D provides opportunity for self-reflection through these experiences to heal and grow

The Evolving Professional Identity of the Clinical Research Nurse - A Qualitative Exploration

BACKGROUND: Clinical research nurses (CRN) make a significant contribution to healthcare research within the UK and internationally. However, lack of clarity about their role, and scope of practice renders their contribution within the profession and in the minds of the wider public invisible. This has implications in terms of promoting the role nurses play not only in terms of recruitment, retention, and care of research participants but also as research leaders of the future. AIM: To examine the perspectives of CRNs in the UK on their professional role identity, in order to inform the professional practice of Clinical Research Nursing. METHODS: Exploratory qualitative design using thematic analysis conducted within a realist paradigm. FINDINGS: Participants viewed the positive aspects of their identity 'as agents of change' who were fundamental to the clinical research process. Resourcefulness and the ability to guide members of the research team were valued as key to job satisfaction. Successful navigation through the complexity of advice, support, management and leadership tasks related to their role in caring for research patients were role affirming and generated a sense of pride. However, lack of recognition, clarity of the role and career development opportunities within an identified structure undermined the CRN identity and optimism about progression in the future. Participants reported feeling invisible to colleagues within the clinical community, isolated and excluded from wider nursing groups. IMPLICATIONS: The study describes UK CRN practice, highlighting the positive benefits and challenges associated with the role, including the need to support professional development to maximise their research contribution. Drawing on international comparators the study makes recommendations to establish well-defined educational, career and promotional pathways that include opportunities for research leadership

The Use of Hyperbaric Oxygen Therapy in Idiopathic Sensorineural Hearing Loss: A Case Study

Idiopathic sudden sensorineural hearing loss (ISSHL) is an otologic emergency that can provoke anxiety in the patient and can be clinically challenging for the practitioner. The natural history of the condition can be as varied as its possible etiologies. Adding to the clinical challenge is the current debate of treatment modalities available. In what follows, we provide a case detailing our treatment course, including the novel use of hyperbaric oxygen therapy (HBOT) as an emerging therapy for sensorineural hearing loss. Additionally, we provide a brief review of the current state of treatment options available in the armament for ISSHL. As no identifying information is contained in our discussion, we believe the privacy of the patient has been protected and, as such, feel our manuscript is exempt from prior Institutional Review Board (IRB) approval

Estimating Modeling Parameters for COVID-19 Spread on Campus

Understanding the true burden of community transmission of communicable diseases like COVID-19 is crucial for effective public health response. Clinical cases, while important, only represent a fraction of the actual disease prevalence within a population. In this thesis, we investigate methods to estimate parameters that link clinical cases to the true disease prevalence using a modified compartmental model known as SICR (Susceptible, Infected, Cases, Recovered). We employ Bayesian inference and ensemble Markov chain Monte Carlo (MCMC) simulations to analyze clinical case data provided by the University of Central Florida Health Center from 2020 to 2022. Our goal is to estimate modeling parameters that shed light on the spread of COVID-19 spread on campus, which could help understand the spread of other respiratory diseases in communities like colleges

Emotion and coping in the aftermath of medical error: A cross country exploration.

Objectives: Making a medical error can have serious implications for clinician wellbeing, affecting the quality and safety of patient care. Despite an advancing literature base, cross-country exploration of this experience is limited and a paucity of studies has examined the coping strategies used by clinicians. A greater understanding of clinicians¿ responses to making an error, the factors that may influence these, and the various coping strategies used are all essential for providing effective clinician support and ensuring optimal outcomes. The objectives were therefore to investigate a) the professional or personal disruption experienced after making an error, b) the emotional response and coping strategies used, c) the relationship between emotions and coping strategy selection, d) influential factors in clinicians¿ responses, and e) perceptions of organisational support. Methods: A cross-sectional, cross-country survey of 265 physicians and nurses was undertaken in two large teaching hospitals in the UK and USA. Results: Professional and personal disruption was reported as a result of making an error. Negative emotions were common, but positive feelings of determination, attentiveness and alertness were also identified. Emotional response and coping strategy selection did not differ due to location or perceived harm, but responses did appear to differ by professional group; nurses in both locations reported stronger negative feelings after an error. Respondents favoured problem-focused coping strategies and associations were identified between coping strategy selection and the presence of particular emotions. Organisational support services, particularly including peers, were recognised as helpful, but fears over confidentiality may prohibit some staff from accessing these. Conclusions: Clinicians in the UK and US experience professional and personal disruption after an error. A number of factors may influence clinician recovery; these factors should be considered in the provision of comprehensive support programmes so as to improve clinician recovery and ensure higher quality, safer patient care.British Psychological Society Travel Gran

Charge Saturation and Neutral Substitutions in Halomethanes and Their Group 14 Analogues

A computational analysis of the charge distribution in halomethanes and their heavy analogues (MH4-nXn: M= C, Si, Ge, Sn, Pb; X = F, Cl, Br, I) as a function of n uncovers a previously unidentified saturation limit for fluorides when M ≠ C. We examine the electron densities obtained at the CCSD, MP2(full), B3PW91, and HF levels of theory for 80 molecules for four different basis sets. A previously observed substituent independent charge at F in fluoromethanes is shown to be a move toward saturation that is restricted by the low polarizability of C. This limitation fades into irrelevance for the more polarizable M central atoms such that a genuine F saturation is realized in those cases. A conceptual model leads to a function of the form [qM(n) -- qM(n)] = a[χA\u27 -- χA] + b that links the electronegativities (χ) of incoming and leaving atoms (e.g., A\u27 = X and A = H for the halogenation of MH4-nXn) and the associated charge shift at M. We show that the phenomenon in which the charge at the central atom, qM, is itself independent of n (e.g., at carbon in CH4-nBrn) is best described as an “M-neutral substitution”—not saturation. Implications of the observed X saturation and M-neutral substitutions for larger organic and inorganic halogenated molecules and polymeric materials are identified

Plane and simple: planar tetracoordinate carbon centers in small moleculesw

A class of neutral 18-electron molecules with planar tetracoordinate carbon (ptC) centers is introduced. We show computationally that when n = 3 the neutral singlet molecule C(BeH)n(BH2)4-n and other isoelectronic (18-valence electron) molecules of main group elements collapse from locally tetrahedral arrangements at the C-center to (near) planar tetracoordinate structures. For C(BeH)3BH2 and C(CH3)(BH2)Li2, for example, the tetrahedral type conformation is not even a minimum on the potential energy surface at the B3PW91, MP2(full), or CCSD levels of theory. The Mg analogue C(MgH)3BH2 of the Be system also features a completely flat global minimum (with even higher energy planar minima in both cases as well). Other neutral compounds that may prefer planar geometries are apparent, and new openings for experimental investigations and theoretical analyses of planar tetracoordinate main group systems are identified. The planar conformation persists at one center in the C(BeH)3BH2 dimer, and may be identifiable in higher order clusters of ptC molecules as well

The Use of Hyperbaric Oxygen Therapy in Idiopathic Sensorineural Hearing Loss: A Case Study

Idiopathic sudden sensorineural hearing loss (ISSHL) is an otologic emergency that can provoke anxiety in the patient and can be clinically challenging for the practitioner. The natural history of the condition can be as varied as its possible etiologies. Adding to the clinical challenge is the current debate of treatment modalities available. In what follows, we provide a case detailing our treatment course, including the novel use of hyperbaric oxygen therapy (HBOT) as an emerging therapy for sensorineural hearing loss. Additionally, we provide a brief review of the current state of treatment options available in the armament for ISSHL. As no identifying information is contained in our discussion, we believe the privacy of the patient has been protected and, as such, feel our manuscript is exempt from prior Institutional Review Board (IRB) approval