Evaluation of Critical Care Nurses Utilization of Pain Assessment Tools in Clinical Practice

Background: Unmanaged pain among critically ill patients is a primary stressor that leads to acute and long-term complications, increased mortality, and a decline in patient outcomes (Chookalayia et al., 2018; Gélinas, 2010). This project inquiry aims to evaluate TMC critical care nurses’ utilization of BPS and NVPS pain assessment tools used and the amount of analgesics used in clinical practice. Methods: A retrospective chart review on 16 ventilated patients requiring analgesic administration to (1) to evaluate nurses’ utilization of the BPS and NVPS pain assessment tools to guide analgesic administration and (2) determine if the pain assessment scores correlate with the current pain scale used and analgesics given for pain control, and utilization of RASS to guide sedation administration used in clinical practice. Results: Of the 16 patients evaluated approximately 25.8% of the time were critical care nurses compliant in documenting NVPS with analgesic titrations and 24.5% compliant in recording BPS with analgesic titrations. This data showed that critical care nurses used both pain scales successfully 30.5% of the time when titrating analgesia. Conclusion: The literature supports the use of NVPS or BPS as a pain assessment tool to guide titration of analgesics in the general population admitted to the ICU requiring mechanical ventilation (Bouajram et al., 2018; Rijkenberg et al., 2017). However, this DNP project showed low compliance with using validated tools NVPS or BPS, indicating that the current practice utilized at Tucson Medical Center (TMC) does not correspond to the current literature. Future studies could explore a nurse's perspective on ease of use and effectiveness of the NVPS or BPS for assessing pain to the general population admitted to the ICU requiring mechanical ventilation

Physical and moral forces: An analysis of World War II’s 1944-1945 Ardennes offensive using Clausewitzian Theory

This thesis employs Carl von Clausewitz’s theory on moral forces to conduct an analysis of World War II’s 1944-1945 Ardennes Offensive. The literature largely focuses on presenting the physical components of the offensive, neglecting the moral. This thesis aims to fill this gap by presenting an analysis of the utilisation and effects of both physical and moral forces in the Ardennes Offensive and determining the importance of each to the outcome. Analysing the planning and execution of the offensive through this theoretical perspective reveals that moral forces played a significant part in Allied success in the Ardennes. The analysis exposed the German reliance on physical superiority yet failure to adjust initial plans to the geographical conditions in the area, in part due to Adolf Hitler’s total control of the armed forces. Following the offensive’s commencement, Allied military leadership demonstrated intuitive thought, good judgment, and determination resulting in swift defense of the area. German Forces were unable to break through this defense despite their great physical advantage. The analysis suggests that Allied moral forces greatly contributed to this initial defense, utilising psychological strength until the physical forces were able to be brought up to equal strength. As a reinterpretation of the Ardennes Offensive, this thesis contributes to the historical studies on battles of World War II and demonstrates the importance of moral forces in warfar

Reading Research for Struggling and Reluctant Readers

Reading instruction is an important part of a child’s education. Reading is essential in their academic career. Students who read well are able to perform at high standards but students who struggle with reading can experience many difficulties, ranging from doing poorly in all subjects to behavior issues. Many researchers are reporting successful studies in closing the achievement gap in reading. Teachers need this information to best support students who need interventions when learning to read. This literature review looks at how best to instruct students who struggle to read

Protest Lyrics at Work: Labor Resistance Poetry of Depression-Era Autoworkers

This dissertation argues that scholarly inquiry into American poetry of the Great Depression is incomplete without a critical understanding of poems produced within the labor movement. Through archival research and methodologies drawn from American studies, gender studies, cultural studies, and labor history, this dissertation demonstrates that autoworkers from 1935-1941 developed a rich poetic discourse that championed their cause. Autoworker poets—including autoworker song lyricists—used humor and borrowed extensively from popular, religious, and “folk” cultures to craft their own poetic styles and trope sets. They wrote about a diverse range of topics from their hopes for the unionization movement, to scab conversions, to comic exaggerations of capitalist figures such as Henry Ford and GM’s William S. Knudsen. Their poems and songs also capture aspects of quotidian life on the shop floor, such as the difficulty of assembly line work, gripes about managers and fellow workers, and frustrations with union factionalization. Women autoworkers and union auxiliary members, similarly, fashioned a discourse that spoke to their own particular set of goals, separate from—yet related to—those of unionizing men. This dissertation, further, shows how parodies of songs and poems, so often written in the labor movement, were frequently written and rewritten time and time again. Tracing the histories of two parodies, in particular, this study demonstrates 1) how older versions can influence the subtext of newer versions and 2) how mapping geographical appearances of parodies can reveal both evolutions in class consciousness and intersections between aspects of society typically thought to be unrelated. More broadly, discovering the connections between autoworker-authored poems and songs and their wider artistic underpinnings helps us to more deeply understand the array of cultural touchstones that working-class Americans drew upon during a dynamic moment in history

Activity-promoting gaming systems in exercise and rehabilitation

Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation

Identifying Health-Related Informatics Education and Partnerships in ALA-Accredited Programs and iSchools

Health-related informatics (i.e. Bioinformatics, Clinical Informatics) has been underexplored within American Library Association (ALA)-accredited programs and iSchools regarding interdisciplinary relationship development in their educational offerings. The first part of this study explores ALA-accredited and iSchool programs’ websites to discover what partnerships exist within their health-related informatics degrees and courses. Of the ALA-accredited and/or North American iSchool programs, 69 offer health-related informatics education. Three hundred fifty-two total educational offerings exist, the most prevalent options are courses (45%) and Master's degrees (21%). The most common healthrelated informatics offerings are bioinformatics (126/352) and general health informatics (107/352). ALA/iSchools are collaborating in about 36% of these offerings (130/352), while most are solo offerings (213/352). The second part of this study is underway and explores the nature of partnerships in the offerings found above. We are surveying faculty to determine the disciplines involved in these collaborations and who initiated them. We also ask which factors influence them such as funding, staffing, and alignments with mission, values, or existing competencies. We hope to better define how these partnerships originate so that other institutions seeking involvement within health-related informatics education will have ideas of where and how to create strategic relationships

A new Approach for Accurate Detection of Chromosome Rearrangements That Affect Fertility in Cattle

Globally, cattle production has more than doubled since the 1960s, with widespread use of artificial insemination (AI) and an emphasis on a small pool of high genetic merit animals. Selecting AI bulls with optimal fertility is, therefore, vital, as impaired fertility reduces genetic gains and production, resulting in heavy financial and environmental losses. Chromosome translocations, particularly the 1;29 Robertsonian translocation, are a common cause of reduced fertility; however, reciprocal translocations are significantly underreported due to the difculties inherent in analysing cattle chromosomes. Based on our porcine work, we have developed an approach for the unambiguous detection of Robertsonian and reciprocal translocations, using a multiple-hybridization probe detection strategy. We applied this method on the chromosomes of 39 bulls, detecting heterozygous and homozygous 1;29 translocations and a 12;23 reciprocal translocation in a total of seven animals. Previously, karyotype analysis was the only method of diagnosing chromosomal rearrangements in cattle, and was time-consuming and error-prone. With calving rates of only 50–60%, it is vital to reduce further fertility loss in order to maximise productivity. The approach developed here identifies abnormalities that DNA sequencing will not, and has the potential to lead to long-term gains, delivering meat and milk products in a more cost-effective and environmentally-responsible manner to a growing population

Library or iSchool Involvement in Health-Related Informatics Education

Objective: An underexplored area in Library and Information Science (LIS) is the development of educational offerings and partnerships in Health-Related Informatics (HRI) (e.g., bioinformatics, clinical informatics, health informatics). The purpose of this study is to identify which disciplines are collaborating in HRI education and how partnerships developed. Methods: This study was conducted in two parts: a website review and survey. Seventy-seven North American ALA-accredited and iSchool member websites were searched between November 2019-March 2020 for HRI-related educational offerings and which academic units were involved. Two hundred sixteen individuals involved in LIS and/or HRI education were contacted for a 40-question survey that included: their roles and responsibilities regarding HRI education; the alignment of this education with strategic plans or competencies; and how HRI partnerships developed. The survey also asked those who were not currently partnering in HRI education which factors influenced their circumstances. Results: 352 HRI educational offerings existed within ALA-accredited or iSchool programs. A total of 38 (17.5%) responded to the survey. For almost two-thirds of these, there was no indication of partnership in that education (213/352, 60.5%). LIS or iSchool involvement in HRI is just under one-third of all offerings (111/352, 31%). “Health or healthcare” informatics (35) or “biomedical or bioinformatics” were the most common types of HRI offered from the website review and survey. Conclusions: Opportunities exist for LIS programs to form HRI educational partnerships that will provide richer educational offerings for LIS students and health sciences librarians