Increasing the Number of Nurse Practitioner Preceptors by Increasing Preceptor Preparedness

Background: the healthcare provider shortage has resulted in increased enrollment in nurse practitioner programs. Traditionally, the clinical education of these students has occurred primarily in clinical settings with the guidance of a practicing nurse practitioner. There is currently a shortage of these preceptors. Research indicates part of the shortage may be attributed to hesitancy to precept due to feeling ill-prepared as a preceptor. It is proposed that a focus group will verify concepts found in the literature. In addition, creating a webinar to better prepare preceptors will result in an increase in prepared preceptors. Significance: The shortage of nurse practitioner preceptors not only impacts the student’s ability to obtain quality clinical education, it also affects the universities; enrollment will decrease as available preceptors decrease. This will further negatively impact the healthcare shortage. Methods: A focus group was held to confirm the concepts found in the literature. Further, concepts gleaned from the literature and the focus group will guide the development of a preparation webinar for preceptors. Results: the focus group did confirm the barriers found in the literature. Discussion: The shortage of preceptors for nurse practitioner students impacts completion of the nurse practitioner program. Creating a webinar using data from the focus group and the literature will better prepare nurse practitioners to precept, thereby, resulting in an increase in the number of available preceptors

An investigation of the use of a digital process monitoring and control system in an undergraduate chemical engineering laboratory

Call number: LD2668 .R4 CHE 1989 G54Master of ScienceChemical Engineerin

Payment for Ecosystem Services’ Effects on Coupled Human-Natural Systems at Fanjingshan National Nature Reserve, China

China has responded to some of its ecological challenges with an ambitious reforestation project called the Grain to Green Program (GTGP), which pays farmers to plant trees on steeply sloping cropland. This is one of many payment for ecosystem services (PES) programs throughout the world that acknowledge landholders as providers of environmental benefits and compensate them for managing land in a prescribed way. While GTGP and other PES programs have produced measurable land cover changes and contributed directly to many families’ incomes, policy analyses tend to neglect these programs’ more complex, indirect effects. PES intercedes in complex webs of human-environment interactions as people adopt new norms and face new challenges and opportunities for their livelihoods. This study aims to demonstrate how households’ motivation to enroll in PES goes beyond straightforward microeconomic calculations, its potentially permanent impacts on livelihood strategies and land use, and how unintended ecological effects may hamper or enhance land change goals. First, it will demonstrate how social norms, demographics, and other characteristics impact the decision to enroll, and how this knowledge may be used to improve financial and administrative efficiency. Second, it will explore how PES funnels farmers into different sectors of the off-farm labor market and how these transitions affect the permanence of PES-initiated land cover changes. Third, it will investigate how changes in land cover may contribute to a growing wild boar population and the burden of crop raiding, and how this burden may influence land use and cooperation with GTGP long-term. These findings will contribute to a more comprehensive understanding of how PES impacts people and their environment both directly and indirectly, and how people’s reactions to these changes impact the success of PES itself.Doctor of Philosoph

Chaotic Escape from an Open Vase-shaped Cavity. I. Numerical and Experimental Results

We present part I in a two-part study of an open chaotic cavity shaped as a vase. The vase possesses an unstable periodic orbit in its neck. Trajectories passing through this orbit escape without return. For our analysis, we consider a family of trajectories launched from a point on the vase boundary. We imagine a vertical array of detectors past the unstable periodic orbit and, for each escaping trajectory, record the propagation time and the vertical detector position. We find that the escape time exhibits a complicated recursive structure. This recursive structure is explored in part I of our study. We present an approximation to the Helmholtz equation for waves escaping the vase. By choosing a set of detector points, we interpolate trajectories connecting the source to the different detector points. We use these interpolated classical trajectories to construct the solution to the wave equation at a detector point. Finally, we construct a plot of the detector position versus the escape time and compare this graph to the results of an experiment using classical ultrasound waves. We find that generally the classical trajectories organize the escaping ultrasound waves

Numerical simulation of droplet dispersion within meso-porous membranes

Analysis of membrane processes in fluid processing, and their main influencing operating conditions are relevant in a variety of industrial applications. Increasing regulatory scrutiny and environmental considerations are forcing industries across all sectors, from food and pharma to oil and gas, to further understand and optimise the handling and formulation of liquid systems for efficient process design. In a generic setup for emulsification and liquid formulation the flow and dispersion behaviour of a liquid oil droplet on its way through a porous water filled membrane is analysed. A set of high-resolution numerical simulations of a single oil droplet dispersed in water through a porous membrane structure with varying contact angles is performed. In this work cluster analysis of volume-of-fluid simulation results to obtain statistical droplet size distributions is conducted and further analysed to highlight the effect of the contact angle as well as pressure drop on the dynamics of the system. It is observed that based on the membrane surface activity the droplet behaviour changes from filtration with coalescence when the membrane is lipophilic to emulsification with droplet break-up when the membrane is lipophobic. Furthermore, the pressure drop is identified as a key factor for the dynamics of the droplet process and the frame in which it occurs. These results highlight that the membrane wettability is a determining factor for the emulsification or filtration effectiveness of a membrane for various applications

Effects of Late-Summer Prescribed Fire on Botanical Composition, Soil Cover, and Forage Production in Caucasian Bluestem-Infested Rangeland in the Kansas Smoky Hills: Year 4 of 5

Objective: Our objective was to determine effects of late-summer prescribed fire on frequency of Caucasian bluestem (Bothriochloa bladhii) in the Kansas Smoky Hills as well as changes in soil cover, botanical composition, and forage production associated with fire treatment. Study Description: The study was in Ellsworth County, KS. Eighteen one-acre plots were randomly assigned to one of three treatments: no burn, one burn (August 14, 2019), and two burns (August 14, 2019, and August 11, 2021). Soil cover, botanical composition, forage production, and Caucasian bluestem frequency were measured annually beginning in 2019. The Bottom Line: These data suggest that regular application of late-summer prescribed fire may be an effective method to reduce Caucasian bluestem frequency while improving overall grass-species richness

Impact of Obesity on Pediatric Acute Recurrent and Chronic Pancreatitis

OBJECTIVE: The aim of this study was to assess the impact of obesity on pediatric acute recurrent pancreatitis or chronic pancreatitis (CP). METHODS: We determined body mass index (BMI) status at enrollment in INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) cohort using CDC criteria for pediatric-specific BMI percentiles. We used the Cochran-Armitage test to assess trends and the Jonckheere-Terpstra test to determine associations. RESULTS: Of 446 subjects (acute recurrent pancreatitis, n = 241; CP, n = 205), 22 were underweight, 258 normal weight, 75 overweight, and 91 were obese. The BMI groups were similar in sex, race, and age at presentation. Hypertriglyceridemia was more common in overweight or obese. Obese children were less likely to have CP and more likely to have acute inflammation on imaging. Compared with children with normal weight, obese or overweight children were older at first acute pancreatitis episode and diagnosed with CP at an older age. Obese or overweight children were less likely to undergo medical or endoscopic treatment, develop exocrine pancreatic insufficiency, and require total pancreatectomy with islet autotransplantation. Diabetes was similar among all groups. CONCLUSIONS: Obesity or overweight seems to delay the initial acute pancreatitis episode and diagnosis of CP compared with normal weight or underweight. The impact of obesity on pediatric CP progression and severity deserves further study

Chronic pancreatitis: Pediatric and adult cohorts show similarities in disease progress despite different risk factors

Objectives: To investigate the natural history of chronic pancreatitis (CP), patients in the North American Pancreatitis Study2 (NAPS2, adults) and INternational Study group of Pediatric Pancreatitis: In search for a cuRE (INSPPIRE, pediatric) were compared. Methods: Demographics, risk factors, disease duration, management and outcomes of 224 children and 1,063 adults were compared using appropriate statistical tests for categorical and continuous variables. Results: Alcohol was a risk in 53% of adults and 1% of children (p<0.0001); tobacco in 50% of adults and 7% of children (p<0.0001). Obstructive factors were more common in children (29% vs 19% in adults, p=0.001). Genetic risk factors were found more often in children. Exocrine pancreatic insufficiency was similar (children 26% vs adult 33%, p=0.107). Diabetes was more common in adults than children (36% vs 4% respectively, p<0.0001). Median emergency room visits, hospitalizations, and missed days of work/school were similar across the cohorts. As a secondary analysis, NAPS2 subjects with childhood onset (NAPS2-CO) were compared to INSPPIRE subjects. These two cohorts were more similar than the total INSPPIRE and NAPS2 cohorts, including for genetic risk factors. The only risk factor significantly more common in the NAPS2-CO cohort compared with the INSPPIRE cohort was alcohol (9% NAPS2-CO vs 1% INSPPIRE cohorts, p=0.011). Conclusions: Despite disparity in age of onset, children and adults with CP exhibit similarity in demographics, CP treatment, and pain. Differences between groups in radiographic findings and diabetes prevalence may be related to differences in risk factors associated with disease and length of time of CP