Navigating Independent Double Checks for Safer Care: A Nursing Perspective

Abstract The purpose of this study was to explore registered nurses’ understanding and practice of “independent double-checks” prior to administration of high-alert medications. The study used a qualitative descriptive design for data collection and data analysis. It included thirteen participants from a hospital located in southern New Hampshire. Results of the study revealed a core theme of navigating independent double checks (IDC) for safer care. Two major themes stemming from the core theme were also uncovered. Navigating IDC through knowing and navigating IDC through nurse partnership both focused on the perception and practice on IDC prior to administration of high alert medications. IDC was accepted and promoted as best practice, but the definition and process is still unclear. Having a universal definition will assist in clarity of the process and in turn, promote ensuring safe administration of high alert medications to patients. Keywords: independent double check, safer care, knowing, nurse partnershi

Wintering strategies of an Arctic-nesting goose: costs of migration and over-wintering for Pacific black brant

Thesis (M.S.) University of Alaska Fairbanks, 2005Birds wintering in different climates may have different strategies for storing and using energy. We documented changes in body morphology and composition of Pacific Black Brant (Branta bernicla nigricans) wintering in Alaska and Baja California and modeled the energetic costs of wintering at each location. We compared costs associated with two different wintering strategies: 1) to remain in an unstable and harsh environment but close to breeding grounds, or 2) to migrate long distances to a mild environment, but distant from breeding grounds. Despite dramatic differences in the timing and magnitude of energetic costs between sites, Brant stored similar amounts of lipid and maintained similar body mass throughout winter. Brant operate under similar physiological bounds but changes in organ mass and nutrient storage took place within these bounds. This flexibility allowed Brant to employ two contrasting winter strategies. We suggest that there may be reproductive and energetic advantages associated with shortening migration distance and remaining in Alaska over winter. The number of Brant wintering in Alaska should continue to increase if constraints on food intake do not impede energy storage and survival is similar between sites

Self-efficacy and allocation of effort during reading among older and younger adults

Recent research in social cognition suggests one\u27s self-efficacy beliefs regarding one\u27s cognitive abilities can influence the effort expended on cognitive tasks (Bandura, 1989; 1997; Cavanaugh & Greene, 1990; Dunlosky & Hertzog, 1998), which may affect performance. This project was conducted to examine the relationship between age, self-efficacy beliefs, text difficulty, resource allocation to text comprehension processes, and memory for text. 82 younger adults and 74 older adults completed the Metamemory in Adulthood Questionnaire (MIA; Dixon, Hultsch & Hertzog, 1988), Reading Self-Efficacy Questionnaire (RSEQ), and Media Consumption Habits Questionnaire. Using the on-line word-by-word moving window method, participants read 24 two-sentence passages for immediate recall after reading either comparatively easier or more difficult texts. Younger adults reported higher Memory Self-Efficacy (MSE) and higher Reading Self-Efficacy Strength (RSE) than older adults; there were no age differences in RSE Level. Groups were split into high reading self-efficacy (HRSE) and low reading self-efficacy (LRSE) based on RSEQ scores. Analyses of reading times indicated that HRSE individuals allocated more time to processing target texts after reading difficult texts than LRSE individuals, suggesting that SE may influence effort and persistence following difficulty. HRSE individuals recalled more of the text than LRSE individuals overall. A marginal interaction of Self-Efficacy and Age was found; older adults with HRSE recalled more from the text than older adults with LRSE, whereas there were no differences in performance among younger adults. RSE was also more strongly related to recall performance among the old than among the young. HRSE individuals recalled more from target texts following difficult texts than those with LRSE. While HRSE individuals overpredicted recall performance, LRSE individuals were relatively accurate. Regression analyses indicate that working memory span, verbal ability, age, and reading self-efficacy make independent contributions to recall performance. The data also suggest that reading self-efficacy, as measured by the domain-specific RSEQ, may be a better predictor of memory for text than memory self-efficacy, as measured by the domain-general MIA. Collectively, the data support Bandura\u27s (1997) self-efficacy theory in that self-efficacy beliefs influence both effort to reading and performance. Limitations and avenues for future research are discussed

Young children\u27s use of causal connections during storytelling : The role of context and individual differences in attention.

Narrative causal understanding is related to a variety of school-related skills such as reading comprehension, and memory. Previous research shows a developmental trend in the ability to use and understand causal connections that begins at age 4 and continually improves up through ages 10 and 11. Researchers posit that this developmental trend in one aspect of narrative ability is explained by an increase in narrative knowledge; children learn more about what is required in narratives they get older. There is a dearth of research on other possible influences on narrative ability. In two experiments, the current study uses a storytelling procedure to investigate narrative ability and causal understanding in 58 preschool children based on a conceptual model of early causal understanding in discourse. In the first experiment it was hypothesized that both individual and age-related differences will be observed in the complexity of causal connections children produce and the distance over which children causally connect. Variations in stimulus complexity (i.e., complexity of the goals of each story) were expected to account for differences in the production of causal connections. In the second experiment it was hypothesized that individual differences in skills related to three attention networks can explain differences in causal understanding. The results show that 3-year-olds can use causal connections during storytelling and that patterns of age-related increases differ depending on the connection type and narrative context. The results also show that attention skills influence specific aspects of causal understanding. The results are consistent with previous storytelling research and research with children diagnosed with ADHD. The current study illustrates the importance of investigating a variety of contextual and child factors that may impact the development of children\u27s causal understanding. Implications for future research and the development early intervention programs are discussed

Icing Mitigation via High-pressure Membrane Dehumidification in an Aircraft Thermal Management

Icing, or the formation of ice from water via freezing or water vapor via desublimation, is a phenomenon that commonly occurs within air cycle-based refrigeration systems and requires thermal control that limits system performance. In aircraft applications icing frequently occurs in the heat exchangers and turbine(s) that are part of the air cycle machine, the refrigeration unit of the environmental control system. Traditionally, water vapor is removed from an air cycle machine via condensing in a heat exchanger and subsequent high-pressure water separation. This approach is not capable of removing all of the vapor present at low altitude conditions, corresponding to a high risk of icing. To mitigate icing under these conditions, a membrane dehumidifier is considered to separate the water vapor that remains after condensing and liquid water separation. Three distinct investigations are conducted as part of this work. The first is aimed at modeling approaches for desublimation frosting, or frost growth on sufficiently cold flat surfaces. This results in a novel, analytical, and non-restrictive solution well-suited for representing frost growth and densification in moist air heat exchangers. The second investigation concerns membrane dehumidification and module design. A custom component model is developed and verified under aircraft conditions, then the Pareto frontier of volumetrically efficient membrane modules is characterized via a multi-objective optimization study. The final investigation evaluates three two-wheel air cycle subsystem architectures with differing dehumidification approaches: (1) condenser-based, (2) membrane dehumidifier-based, and (3) combined. Steady-state simulations are run for each of these over a range of flow rates and altitudes. The results demonstrate that incorporating a membrane dehumidifier reduces the turbine inlet saturation temperature, which mitigates icing in the turbine and reduces the required bypass flow, thus increasing the cooling capacity

Scouting 21st Century Feminism: Exploring Girl Scouts as an Activist Volunteer

When I was growing up in the 1990\u27s, I quit Girl Scouts to join karate classes. At the time, I was bored. My critical eye fell back on Girl Scouts years later when my eldest sister started a Daisy troop for her daughter, my niece. She took on the role as her daughter turned ten, and I began to plan my senior capstone project. I began to wonder if the Girl Scouts had changed much from my brief experience in the 1990\u27s. The methods for this project are simple, but their weighted importance to my research shows the complex relationship between my method and my epistemological questions. In my internship I carried out the activist volunteer role, becoming active in leading the troop. I\u27d like to define my of valued experience and critical thinking as Gynocentric Method. In this way, I have not only been a troop leader, I have been a feminist activist who can draw analysis upon these experiences

Effects of the Strong Kids Curriculum as a Targeted Intervention for Students At-Risk for Developing Depressive Disorders

Children who show signs of depression are at greater risk of having depression as adults as well as developing comorbid conditions. A multi-tiered system of support (MTSS) approach is currently the best evidence-based method for addressing behavioral and mental health concerns in a school setting. At this time, few research-based interventions exist that adequately address internalizing behaviors such as those associated with depression. Strong Kids is an evidence-based social-emotional learning curriculum that can be used at both the universal and secondary levels of prevention. It is designed to address internalizing behaviors; however, it has only been tested as one chronological series of lessons. This makes immediate response to a student’s need – a hallmark of secondary prevention in MTSS – challenging because the Strong Kids program can take a minimum of 6 weeks for delivery. The current single-case design research evaluated the delivery of Strong Kids in an elementary school on a continuously rotating 4-week basis, such that students referred for the intervention began at the beginning of any given week and continued to receive the intervention until all lessons were received. Three hypotheses were tested: (a) Students at risk for developing depressive disorders would show reduced risk of depression following the Strong Kids intervention; (b) this intervention would be effective for students regardless of the lesson on which they begin the intervention; and, (c) any differential effects among students beginning the intervention during different weeks would be small and not reach the level of clinical significance. The obtained findings and implications for school practices are discussed

Seismic anisotropy beneath the southern Puna Plateau

The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file.Title from PDF of title page (University of Missouri--Columbia, viewed on December 30, 2009).Thesis advisor: Dr. Eric Sandvol.Includes bibliographical references.M.S. University of Missouri--Columbia 2009.Dissertations, Academic -- University of Missouri--Columbia -- Geological sciences.The central Andean plateau is a prime region to study mantle flow above an active plateau margin, where it has been suggested that a link exists between plateau uplift and removal of the lower crust and lithospheric mantle. This study analyzed shear-wave splitting measurements of the southern Puna plateau (25°S to 28°S) caused by anisotropic layers of the mantle in an effort to infer asthenospheric flow patterns. Using 30 teleseismic and 88 local splitting events for vertical constraint, results imply that trench-parallel subslab splitting occurs from retrograde slab motion and shifts to trench-perpendicular as the angle of slab subduction transitions to shallow. The behavior of slab flattening also seems to affect the mantle wedge as splitting above the slab shifts from trench-perpendicular in accordance with absolute plate motion to trench-parallel towards the trench. A toroidal rotation pattern of mantle wedge splitting is also observed around the Cerro Galan ignimbrite region, suggesting a flow obstruction. As a primary source of ignimbrite flare-ups, a delamination event is a likely cause of the detected pattern