MS

thesisTraditionally postpartum infant care classes have been structured to meet the educational needs of the adult mother. Due to the increasing number of pregnant adolescents, the educational needs of the adolescent mother must be assessed. With this information postpartum infant care classes can then be structured to effectively assist the adolescent to assume her role of mother. The goal of this descriptive study was to identify and compare infant care questions and concerns of adult and adolescent primiparous women. Data obtained through questionnaires were analyzed in terms of the number and importance of infant care questions and concerns of the subject. The comparing of demographic data revealed that more differences exist between the two groups than those solely based on age. The first hypothesis, adolescent primiparous women would choose a significantly different number of questions and concerns' concerning infant care than adult primiparous women was statistically supported. The adult mothers asked more questions than adolescent mothers, but the reason for the significant difference has not been uncovered. Hypothesis II, adolescent primiparous mothers would have significantly different needs and concerns than adult mothers were not statistically supported. The descriptive statistics did show that each group has specific questions and concerns they felt were more important. The results of this study indicated a need for further study. Recommendations were made in the deliverance of Nursing; care to adolescent mothers

The text of Targum Qoheleth

The aim of this thesis is to produce a lightly-corrected diplomatic edition of Targum Qoheleth (the Targum to Ecclesiastes), using MS Urbinati Ebr. 1, Biblioteca Apostolica Vaticana as the base text for the transcription, and incorporating readings from 52 other witnesses into the critical apparatus. The texts range in date from 1189 to the 17th century; both Western and Yemenite manuscripts have been used. The edition features physical descriptions of the textual witnesses; an explanation of the methodology used in constructing the apparatus, detailing which types of readings have been included or excluded in order to produce an apparatus which is of a manageable size rather than a “graveyard of errors”; a translation of the text; and stemmatological analysis. Criteria have been developed to establish which variant readings and shared errors allow the manuscripts to be grouped together into textual families. Only the consonantal text has been taken into consideration, as the pointing is of poor quality in many of the manuscripts; the presence or absence of matres lectionis may be simply a matter of scribal preference. It is hoped that through the examination of the relationships between the different witnesses, some light may be shed on the nature of the Late Jewish Literary Aramaic dialect, and the extent to which there is a division between the Western and Yemenite recensions for Targum Qoheleth. This edition would also allow for a more detailed study of Targum Qoheleth and its textual history than currently afforded by existing editions

Goals of international exchange : an exploratory study of why American host families participate in international exchange programs

This thesis presents the findings of a descriptive study of goals of international exchange and how they are perceived in terms of relevance by host family participants in homestay exchange programs. The literature of international exchange was examined to identify goals as established and defined by researchers in the field. Experienced exchange coordinators, host families and others were interviewed for their suggestions of additional goals not discussed in the literature. A survey questionnaire was developed and administered to 69 host family members from Tillamook County, Oregon. They were asked to evaluate the importance and achievement of 14 literature-based and 22 non-literature-based goals represented by 43 two-part questions

Structured representation for requirements and specifications

This document was generated in support of NASA contract NAS1-18586, Design and Validation of Digital Flight Control Systems suitable for Fly-By-Wire Applications, Task Assignment 2. Task 2 is associated with a formal representation of requirements and specifications. In particular, this document contains results associated with the development of a Wide-Spectrum Requirements Specification Language (WSRSL) that can be used to express system requirements and specifications in both stylized and formal forms. Included with this development are prototype tools to support the specification language. In addition a preliminary requirements specification methodology based on the WSRSL has been developed. Lastly, the methodology has been applied to an Advanced Subsonic Civil Transport Flight Control System

Temporary placement of a fully covered self-expanding metal stent to allow therapeutic ERCP

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Opioid Withdrawal Signs and Symptoms in the Pediatric Patient during Opioid Tapering

Opioids are used routinely in the pediatric intensive care population for analgesia, sedation, blunting of physiologic responses to stress, and safety. In children, physical dependence may occur in as little as two to three days of continuous opioid therapy. Once the child no longer needs the opioid, the medications are reduced over time. A review of the literature revealed that the majority of the published studies used either a neonatal opioid assessment tool or no assessment tool. A subsequent international survey of pediatric providers found a wide range of opioid tapering practices and sporadic use of opioid withdrawal instruments to guide practice. Since tapering routines vary among practitioners, it is not uncommon to see signs and symptoms of opioid withdrawal. A prospective, descriptive study was conducted to describe the frequency of opioid withdrawal signs and symptoms and to identify factors associated with these opioid withdrawal signs and symptoms. The sample of 25 was drawn from all patients, ages 2 weeks to 21 years admitted to the Children’s Hospital of Richmond Pediatric Intensive Care Unit (PICU) and who have received continuous infusion or scheduled opioids for at least 5 days. Data collected included: opioid withdrawal score (WAT-1), opioid taper rate (total dose of opioid per day in morphine equivalents per kilogram [MEK]), pretaper peak MEK, pretaper cumulative MEK, number of days of opioid exposure prior to taper, and age. Out of 26 enrolled participants, only 9 (45%) had opioid withdrawal on any given day. In addition, there was limited variability in WAT-1 scores. The most common symptoms notes were diarrhea, vomit, sweat, and fever. For optimal opioid withdrawal assessments, clinicians should use a validated instrument such as the WAT-1 to measure for signs and symptoms of opioid withdrawal. Further research is indicated to examine risk factors for opioid withdrawal in children

Supported accommodation evaluation framework (SAEF) guide

High hopes for the NDIS are that people with disability will be able to live as independently as they choose, with the housing of their choice, and with the paid support that suits their preferences and life goals. Research conducted by the Social Policy Research Centre for the NSW government about disability housing support that is like the NDIS found that most people did achieve some positive outcomes. Least change was evident in people’s interpersonal relationships and employment, and some people did not live in housing that met their needs.&nbsp

Ethical leadership--a search for self : a reflective essay

Robert DeBlois (2000) in an article in Phi Delta Kappan magazine stated that Maybe being a good leader is neither more or less complicated than knowing who you are and what your job is. Aristotle stated it even more simply as Know thyself\u27. What is good leadership? We have had in recent years a plethora of books and articles on leadership from Steven Covey, Anthony Robbins, John Maxwell, to Peter Senge, with ideas on learning to take a risk to \u27\u27find new cheese to using Christopher Robin as a leadership style. What is it that all of these experts have in common? What is at the core of leadership? After reading book after book on leadership and taking seven years of leadership classes, I came across, by accident, DeBlois\u27 article and there in bold print he states part of what I have been thinking about for the past eight years - knowing who you are..

Long-term effects of intermittent IL-2 in HIV infection: extended follow-up of the INSIGHT STALWART Study

BACKGROUND The Study of Aldesleukin with and without Antiretroviral Therapy (STALWART) was designed to evaluate whether intermittent IL-2 alone or with peri-cycle ART increased CD4+ cell counts (and so delayed initiation of ART) in HIV infected individuals having ≥ 300 CD4+ cells/mm(3) compared to untreated controls. When the results of two large clinical trials, ESPRIT and SILCAAT, showed no clinical benefit from IL-2 therapy, IL-2 administration was halted in STALWART. Because IL-2 recipients in STALWART experienced a greater number of opportunistic disease (OD) or death and adverse events (AEs), participants were asked to consent to an extended follow-up phase in order to assess persistence of IL-2 effects. METHODOLOGY Participants in this study were followed for clinical events and AEs every 4 months for 24 months. Unadjusted Cox proportional hazards models were used to summarize death, death or first OD event, and first grade 3 or 4 AE. PRINCIPAL FINDINGS A total of 267 persons were enrolled in STALWART (176 randomized to the IL-2 arms and 91 to the no therapy arm); 142 individuals in the IL-2 group and 80 controls agreed to enter the extended follow-up study. Initiation of continuous ART was delayed in the IL-2 groups, but once started, resulted in similar CD4+ cell and viral load responses compared to controls. The hazard ratios (95% CI) for IL-2 versus control during the extension phase for death or OD, grade 3 or 4 AE, and grade 4 AE were 1.45 (0.38, 5.45), 0.43 (0.24, 1.63) and 0.20 (0.04, 1.03), respectively. The hazard ratios for the AE outcomes were significantly lower during the extension than during the main study. CONCLUSIONS Adverse events associated with IL-2 cycling did not persist upon discontinuation of IL-2. The use of IL-2 did not impact the subsequent response to initiation of cART