Quality Improvement: An Update for Outpatient Oncology Education

This project is focused on quality improvement in patient satisfaction with regard to side effect management after oncology patient education. The global aim of this project is to improve oncology-specific patient education through the development of an evidenced-based educational binder to be given to patients in a hospital outpatient infusion center and used as an educational guide for nursing staff. Effective standardized patient education has been seen to improve: satisfaction, quality of life, adherence, self-management, outcomes, and reduce unnecessary emergency room visits (Dalby, 2013; Mann, 2011; Smith et al., 2013). A rise in patient confidence for nausea and vomiting self-care, and when it is appropriate to call for provider help, is expected. After unforeseen delays with project coordination, baseline patient survey data collection, and product branding, implementation of the education binder tool is expected to begin in May, 2016 with a PDSA cycle followed by every four-week SDSA cycles along with six-month post-implementation patient surveys given beginning October, 2016, in order to measure and confirm project expectations. Further justification for the project should appear in reduced ED visits for chemotherapy induced nausea, vomiting, and dehydration

Identification of presumed pathogenic KRT3 and KRT12 gene mutations associated with Meesmann corneal dystrophy.

PurposeTo report potentially pathogenic mutations in the keratin 3 (KRT3) and keratin 12 (KRT12) genes in two individuals with clinically diagnosed Meesmann corneal dystrophy (MECD).MethodsSlit-lamp examination was performed on the probands and available family members to identify characteristic features of MECD. After informed consent was obtained, saliva samples were obtained as a source of genomic DNA, and screening of KRT3 and KRT12 was performed. Potentially pathogenic variants were screened for in 200 control chromosomes. PolyPhen-2, SIFT, and PANTHER were used to predict the functional impact of identified variants. Short tandem repeat genotyping was performed to confirm paternity.ResultsSlit-lamp examination of the first proband demonstrated bilateral, diffusely distributed, clear epithelial microcysts, consistent with MECD. Screening of KRT3 revealed a heterozygous missense variant in exon 1, c.250C>T (p.(Arg84Trp)), which has a minor allele frequency of 0.0076 and was not identified in 200 control chromosomes. In silico analysis with PolyPhen-2 and PANTHER predicted the variant to be damaging to protein function; however, SIFT analysis predicted tolerance of the variant. The second proband demonstrated bilateral, diffusely distributed epithelial opacities that appeared gray-white on direct illumination and translucent on retroillumination. Neither parent demonstrated corneal opacities. Screening of KRT12 revealed a novel heterozygous insertion/deletion variant in exon 6, c.1288_1293delinsAGCCCT (p.(Arg430_Arg431delinsSerPro)). This variant was not present in either of the proband's parents or in 200 control chromosomes and was predicted to be damaging by PolyPhen-2, PANTHER, and SIFT. Haplotype analysis confirmed paternity of the second proband, indicating that the variant arose de novo.ConclusionsWe present a novel KRT12 mutation, representing the first de novo mutation and the first indel in KRT12 associated with MECD. In addition, we report a variant of uncertain significance in KRT3 in an individual with MECD. Although the potential pathogenicity of this variant is unknown, it is the first variant affecting the head domain of K3 to be reported in an individual with MECD and suggests that disease-causing variants associated with MECD may not be restricted to primary sequence alterations of either the helix-initiation or helix-termination motifs of K3 and K12

Flight test evaluation of a separate surface attitude command control system on a Beech 99 airplane

A joint NASA/university/industry program was conducted to flight evaluate a potentially low cost separate surface implementation of attitude command in a Beech 99 airplane. Saturation of the separate surfaces was the primary cause of many problems during development. Six experienced professional pilots who made simulated instrument flight evaluations experienced improvements in airplane handling qualities in the presence of turbulence and a reduction in pilot workload. For ride quality, quantitative data show that the attitude command control system results in all cases of airplane motion being removed from the uncomfortable ride region

Development of systems and techniques for landing an aircraft using onboard television

A flight program was conducted to develop a landing technique with which a pilot could consistently and safely land a remotely piloted research vehicle (RPRV) without outside visual reference except through television. Otherwise, instrumentation was standard. Such factors as the selection of video parameters, the pilot's understanding of the television presentation, the pilot's ground cockpit environment, and the operational procedures for landing were considered. About 30 landings were necessary for a pilot to become sufficiently familiar and competent with the test aircraft to make powered approaches and landings with outside visual references only through television. When steep approaches and landings were made by remote control, the pilot's workload was extremely high. The test aircraft was used as a simulator for the F-15 RPRV, and as such was considered to be essential to the success of landing the F-15 RPRV

Singular values of some modular functions

We study the properties of special values of the modular functions obtained from Weierstrass P-function at imaginary quadratic points.Comment: 19 pages,corrected typo

Zooming into a Tinkering Project: The Progression of Learning through Transitional Objects

The Maker Movement has been received by the field of K–12 education with great enthusiasm as a way of teaching STEM content to children. We call attention to and identify learning opportunities in children’s projects created in a playful, informal environment with easily available materials. In keeping with research in the field of maker education and learning sciences, we describe tinkering as a constructionist learning activity in which meaning making is captured through transitional objects (Bamberger, 1995). First, we examine one specific tinkering project and identify transitional objects within the project. Next, we discuss the process of meaning making as captured through the transitional objects and identify the significance of children’s emerging views of scientific concepts. Finally, we discuss implications for adopting the concept of transitional objects for capturing children’s meaning making and learning in the domains of K–12 science and engineering education

A discourse analysis of trainee teacher identity in online discussion forums

Teacher education involves an identity transformation for trainees from being a student to being a teacher. This discourse analysis examined the online discussion board communications of a cohort of trainee teachers to better understand the situated identities of the trainees and how they were presented online. Their discussion board posts were the primary method of communication during placement periods and, as such, provided insight into how the trainees situated their identities in terms of being a student or being a teacher. During the analysis, the community boundaries, language and culture were explored along with the tutor's power and role in the identity transformation process. This involved looking at the lexis used by the students, the use of pronouns to refer to themselves and others such as teachers and pupils, the types of messages allowed in the community and the effect of the tutor's messages on their communication. The research found that the trainees felt comfortable with teaching but did not feel like teachers during the course. Tutors and school teachers need to develop an awareness of the dual nature of trainees' identities and help promote the transition from student to teacher. In the beginning of the course, trainees should be familiarised with teacher vocabulary and practical concepts in addition to pedagogical theory. Towards the end of the course, trainee identity as teachers could be promoted through the use of authentic assessments that mirror real teacher tasks and requirements

Local political leadership and the modernisation of local government

Political leadership has been a key element of central government’s attempts to ‘modernise’ local government over the past decade, within a discourse that emphasised ‘strong’ and ‘visible’ leadership and the role of leaders and leadership in driving change within local authorities. In the context of such an approach, and also taking account of academic discourse, this article draws upon interviews with nearly thirty individuals in leadership positions in local authorities in England, Scotland and Wales to assess their experiences of leadership and their views of some aspects of the role and work of councils. It suggests that whilst there is broad convergence between the aspirations of government and the narratives that emerge from these leaders on some aspects of local political leadership, there are also differences, perhaps most notably over the relationship between changes to decision making structures and the loci of political power