TUITION ASSISTANCE: EFFECT OF POLICY CHANGE ON USAGE IN THE MARINE CORPS

Tuition assistance (TA) is one of many voluntary education programs available to Marines to facilitate continuing their education and increase knowledge within the force. This program could thus support the Commandant of the Marine Corps’ call for preparing the force for the future by increasing knowledge management and retention. In March of 2019, the Marine Corps removed eligibility restrictions on TA to expand the opportunity of continued education to more Marines. This study determines what effect, if any, was achieved by the policy change with respect to utilization rate, type of individual TA user, and type of institutions chosen for high education. The analysis utilizes data from the Total Force Data Warehouse (TFDW), the Navy College Management Information System (NCMIS), and the Integrated Postsecondary Education Data System (IPEDS). As intended, the 2019 policy change increased TA usage. Specifically, the rank most impacted by the policy is E3, which showed a significant increase in TA usage; however, the policy also resulted in a decrease in overall course success and an increase in the use at for-profit institutions. This study recommends further investigation of this topic covering a longer time frame, with data capable of accounting for potential selection bias, and a comparison between different branches of service.Outstanding ThesisMajor, United States Marine CorpsApproved for public release. Distribution is unlimited

Improving Systems of Care to Manage Preoperative Anemia in Patients Who Elect to have Total Hip or Total Knee Replacement Surgery

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are surgical procedures performed for painful, dysfunctional joints most often caused by osteoarthritis. These procedures are increasing in demand for not just the elderly, but young adults as well. They are elective procedures associated with a three to five gram decrease in hemoglobin postoperatively, considered a major blood loss. International research results, verified by analysis of a 228 patient sample from the system in this study, demonstrate that patients who enter these procedures with anemia are more likely to require postoperative blood transfusions. With a decreasing supply due to a shrinking donor pool and added costs due to stringent testing, allogeneic blood used for transfusions demands that providers use stewardship with this precious resource. Autologously donated blood as an option is falling out of favor because it further reduces the preoperative hemoglobin, is costly, and unused units are wasted. Blood use for transfusions, whether autologously donated or allogeneic, is associated with many risks including but not limited to fluid volume overload, delayed wound healing, postoperative infections, and longer hospitalizations. Anemia is an abnormal finding and, in the setting of elective surgical procedures with major blood loss, should be corrected preoperatively to decrease the need for blood transfusions. This change project describes interventions to increase red blood cells preoperatively, weaving the interventions into an evidenced-based algorithm for consideration in practice by members of the healthcare team. The evidence-based algorithm and study findings will be shared with providers to invoke discussion on strategies for implementation and evaluation. Furthermore, this project serves as an example of research-guided changes, designed by a doctorally prepared nurse, capable of enhancing positive health care outcomes for both the patient and the healthcare system

Ball Screw Actuator Including a Compliant Ball Screw Stop

An actuator includes a ball nut, a ball screw, and a ball screw stop. The ball nut is adapted to receive an input torque and in response rotates and supplies a drive force. The ball screw extends through the ball nut and has a first end and a second end. The ball screw receives the drive force from the ball nut and in response selectively translates between a retract position and a extend position. The ball screw stop is mounted on the ball screw proximate the first end to translate therewith. The ball screw stop engages the ball nut when the ball screw is in the extend position, translates, with compliance, a predetermined distance toward the first end upon engaging the ball nut, and prevents further rotation of the ball screw upon translating the predetermined distance

Does the California market squid (Loligo opalescens) spawn naturally during the day or at night? A note on the successful use of ROVs to obtain basic fisheries biology data

The California market squid (Loligo opalescens Berry), also known as the opalescent inshore squid (FAO), plays a central role in the nearshore ecological communities of the west coast of the United States (Morejohn et al., 1978; Hixon, 1983) and it is also a prime focus of California fisheries, ranking first in dollar value and tons landed in recent years (Vojkovich, 1998). The life span of this species is only 7−10 months after hatching, as ascertained by aging statoliths (Butler et al., 1999; Jackson, 1994; Jackson and Domier, 2003) and mariculture trials (Yang, et al., 1986). Thus, annual recruitment is required to sustain the population. The spawning season ranges from April to November and spawning peaks from May to June. In some years there can be a smaller second peak in November. In Monterey Bay, the squids are fished directly on the egg beds, and the consequences of this practice for conservation and fisheries management are unknown but of some concern (Hanlon, 1998). Beginning in April 2000, we began a study of the in situ spawning behavior of L. opalescens in the southern Monterey Bay fishing area

Squid have nociceptors that display widespread long-term sensitization and spontaneous activity after bodily injury

© The Author(s), 2013. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Journal of Neuroscience 33 (2013): 10021-10026, doi:10.1523/JNEUROSCI.0646-13.2013.Bodily injury in mammals often produces persistent pain that is driven at least in part by long-lasting sensitization and spontaneous activity (SA) in peripheral branches of primary nociceptors near sites of injury. While nociceptors have been described in lower vertebrates and invertebrates, outside of mammals there is limited evidence for peripheral sensitization of primary afferent neurons, and there are no reports of persistent SA being induced in primary afferents by noxious stimulation. Cephalopod molluscs are the most neurally and behaviorally complex invertebrates, with brains rivaling those of some vertebrates in size and complexity. This has fostered the opinion that cephalopods may experience pain, leading some governments to include cephalopods under animal welfare laws. It is not known, however, if cephalopods possess nociceptors, or whether their somatic sensory neurons exhibit nociceptive sensitization. We demonstrate that squid possess nociceptors that selectively encode noxious mechanical but not heat stimuli, and that show long-lasting peripheral sensitization to mechanical stimuli after minor injury to the body. As in mammals, injury in squid can cause persistent SA in peripheral afferents. Unlike mammals, the afferent sensitization and SA are almost as prominent on the contralateral side of the body as they are near an injury. Thus, while squid exhibit peripheral alterations in afferent neurons similar to those that drive persistent pain in mammals, robust changes far from sites of injury in squid suggest that persistently enhanced afferent activity provides much less information about the location of an injury in cephalopods than it does in mammals.This work was supported by NSF Grants IOS-1146987 to E.T.W. and IOS-1145478 to R.T.H., and the Baxter Pharmaceuticals Fellowship and Bang Summer Research Fellowship from the Marine Biological Laboratory to R.J.C.2013-12-1

A qualitative exploration of the client experience of inter-professional practice in the delivery of ActivePlus: a combined smoking cessation and physical activity intervention

Abstract Background Research investigating interprofessional practice (IPP) frameworks has predominately focused on the service delivery of IPP or educating practitioners through interprofessional education. Minimal research has addressed client outcomes or the experience of clients with IPP in real world contexts. In this paper, we explore the experience of seven participants in the ActivePlus program, an IPP-based smoking cessation intervention combined with physical activity promotion. Methods Participants informed on their program experiences through post-program in-depth interviews. A thematic analysis drew out themes pertaining to participant experiences of the joint practice element of the IPP model of care. Results Analysis identified two major themes: the joint practice experience, and the client-centered approach of the IPP model of care. Participants reflected on the ways that having two health practitioners in joint sessions benefited their intervention experience, as well as providing some critical feedback. Participants also reported observing and valuing aspects of client-centered practice that strengthened the rapport within the practitioner-client team and aided their behaviour change progress. The client-centered practice was instrumental in overcoming initial teething issues with joint session delivery and alleviating pre-program participant concerns about being outnumbered by multiple practitioners. Conclusion Despite some early teething issues, participants reported a positive acceptance of the IPP and joint session delivery model, which added value to the overall ActivePlus program. Results from this research can provide practitioners with a client perspective on the key aspects they perceive as important in IPP joint session delivery. Further investigation into the client perception in similar interventions is recommended with larger samples and non-clinical groups

Strontium is required for statolith development and thus normal swimming behaviour of hatchling cephalopods

When cephalopod eggs were incubated in artificial sea water it was found that they sometimes resulted in hatchlings with defects of the statocyst suprastructure, leading to the severe behavioural defect of uncontrolled swimming. Experiments in defined media (seven basic salts mixed in deionized water) with seven species of cephalopods demonstrated clearly that there is 100% normal development of the aragonite statoliths when strontium levels were 8 mg l-1. Conversely, statoliths did not develop when strontium was absent. In cuttlefish, the growth of the cuttlebone was also affected adversely when strontium was absent. In mariculture production tanks, supplementing commercial artificial sea water with strontium to normal levels of 8 mg l-1 almost eliminated the occurrence of abnormal hatchlings. Circumstantial evidence indicates that there is a critical window in development during which strontium is required for normal development. The role of strontium in biomineralization during embryogenesis is unknown, but it appears to be important in the Mollusca

Emission Spectra from Internal Shocks in Gamma-Ray-Burst Sources

Unsteady activity of gamma-ray burst sources leads to internal shocks in their emergent relativistic wind. We study the emission spectra from such shocks, assuming that they produce a power-law distribution of relativistic electrons and posses strong magnetic fields. The synchrotron radiation emitted by the accelerated electrons is Compton up-scattered multiple times by the same electrons. A substantial component of the scattered photons acquires high energies and produces e+e- pairs. The pairs transfer back their kinetic energy to the radiation through Compton scattering. The generic spectral signature from pair creation and multiple Compton scattering is highly sensitive to the radius at which the shock dissipation takes place and to the Lorentz factor of the wind. The entire emission spectrum extends over a wide range of photon energies, from the optical regime up to TeV energies. For reasonable values of the wind parameters, the calculated spectrum is found to be in good agreement with the burst spectra observed by BATSE.Comment: 12 pages, latex, 2 figures, submitted to ApJ