Short Term Mission as the Undiscovered Country:

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Experiences of Veterans Transitioning to Postsecondary Education

An increasing number of U.S. military veterans are entering postsecondary education with problems attributed to deployed military service. The primary objective of this research was to describe the lived experiences of student veterans transitioning from active military service to postsecondary education. Phenomenological interviews were performed with 13 student veterans who had transitioned from military deployment to postsecondary education. An overall essential meaning of “emerging in college culture” was manifested from three themes, supported by rich textural and structural descriptions of student veterans’ experiences: (1) repurposing military experiences for life as a student veteran, (2) reconstructing civilian identity, and (3) navigating postsecondary context and interactions. These findings highlight implications that may facilitate occupational therapists’ efforts in supporting the needs of student veterans

Perceptions of Retinal Imaging Technology for Verifying the Identity of 4-H Ruminant Animals

The purpose of the study reported here was to determine the perceptions of 4-H members and volunteers regarding the retinal imaging process as an innovative method to verify the identity of 4-H animals. Participants were surveyed to determine the perceived strengths and weaknesses of the retinal imaging process and to determine whether participants consider retinal imaging to be beneficial to the Indiana 4-H program. Retinal imaging was perceived to be an accurate and efficient method of livestock identification by both 4-H members and adult volunteers. Volunteers determined that their ability to capture a retinal image requires skill and practice

Green Infrastructure

The transportation industry has increasingly recognized the vital role sustainability serves in promoting and protecting the transportation infrastructure of the nation. Many state Departments of Transportation have correspondingly increased efforts to incorporate concepts of sustainability into the planning, design, and construction phases of projects and congruently adopted sustainability measures into their internal standard policies and procedures. Sustainably constructed highways foster economic development, promote stewardship of the environment, and solicit citizen involvement for an integrated, comprehensive approach to project planning. As part of an effort to understand the extent to which sustainable design and construction principles are being used, this report selects and analyzes three case studies involving previously completed KYTC projects and assesses their commitment to sustainable concepts. Specifically, this report examines the extent to which KYTC utilized sustainable concepts for each case study as described in FHWA’s INVEST rating system. This research effort comprised three components. First, KTC researchers analyzed KYTC’s policies and manuals for project planning, design, and construction and determined the extent to which INVEST criteria and related principles were incorporated into their standard processes. Second, KTC analyzed the individual case studies themselves, to include project plans and other relevant documentation. Finally, KTC conducted interviews with each of the KYTC district offices responsible for managing those previously completed projects and obtained feedback on the INVEST criteria used for each particular project. Following this approach, KTC validated and finalized the assigned scoring ratings for each case study in accordance with the INVEST scoring guidance. In summary, this report describes the sustainable concepts and corresponding INVEST scores for each project, presents a summary of the main findings, and provides recommendations for the way ahead

Spectral Models for Early Time SN 2011fe Observations

We use observed UV through near IR spectra to examine whether SN 2011fe can be understood in the framework of Branch-normal SNe Ia and to examine its individual peculiarities. As a benchmark, we use a delayed-detonation model with a progenitor metallicity of Z_solar/20. We study the sensitivity of features to variations in progenitor metallicity, the outer density profile, and the distribution of radioactive nickel. The effect of metallicity variations in the progenitor have a relatively small effect on the synthetic spectra. We also find that the abundance stratification of SN 2011fe resembles closely that of a delayed detonation model with a transition density that has been fit to other Branch-normal Type Ia supernovae. At early times, the model photosphere is formed in material with velocities that are too high, indicating that the photosphere recedes too slowly or that SN 2011fe has a lower specific energy in the outer ~0.1 M_sun than does the model. We discuss several explanations for the discrepancies. Finally, we examine variations in both the spectral energy distribution and in the colors due to variations in the progenitor metallicity, which suggests that colors are only weak indicators for the progenitor metallicity, in the particular explosion model that we have studied. We do find that the flux in the U band is significantly higher at maximum light in the solar metallicity model than in the lower metallicity model and the lower metallicity model much better matches the observed spectrum.Comment: 9 pages, 14 figures, MNRAS, in press, fixed typ

Ultrasound-Guided Greater Auricular Nerve Block as Sole Anesthetic for Ear Surgery

A greater auricular nerve (GAN) block was used as the sole anesthetic for facial surgery in an 80-year-old male patient with multiple comorbidities which would have made general anesthesia challenging. The GAN provides sensation to the ear, mastoid process, parotid gland, and angle of the mandible. In addition to anesthesia for operating room surgery, the GAN block can be used for outpatient or emergency department procedures without the need for a separate anesthesia team. Although this nerve block has been performed using landmark-based techniques, the ultrasound-guided version offers several potential advantages. These advantages include increased reliability of the nerve block, as well as prevention of inadvertent vascular puncture or blockade of the phrenic nerve, brachial plexus, or deep cervical plexus. The increasing access to ultrasound technology for medical care providers outside the operating room makes this ultrasound guided block an increasingly viable alternative

Auditory feature perception and auditory hallucinatory experiences in schizophrenia spectrum disorder

Schizophrenia spectrum disorder (SZ) is associated with deficits in auditory perception as well as auditory verbal hallucinations (AVH). However, the relationship between auditory feature perception and auditory verbal hallucinations (AVH), one of the most commonly occurring symptoms in psychosis, has not been well characterized. This study evaluated perception of a broad range of auditory features in SZ and to determine whether current AVHs relate to auditory feature perception. Auditory perception, including frequency, intensity, duration, pulse-train and temporal order discrimination, as well as an embedded tone task, was assessed in both AVH (n = 20) and non-AVH (n = 24) SZ individuals and in healthy controls (n = 29) with the Test of Basic Auditory Capabilities (TBAC). The Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ) was used to assess the experience of auditory hallucinations in patients with SZ. Findings suggest that compared to controls, the SZ group had greater deficits on an array of auditory features, with non-AVH SZ individuals showing the most severe degree of abnormality. IQ and measures of cognitive processing were positively associated with performance on the TBAC for all SZ individuals, but not with the HPSVQ scores. These findings indicate that persons with SZ demonstrate impaired auditory perception for a broad range of features. It does not appear that impaired auditory perception is associated with recent auditory verbal hallucinations, but instead associated with the degree of intellectual impairment in SZ

Design of MARQUIS2: study protocol for a mentored implementation study of an evidence-based toolkit to improve patient safety through medication reconciliation.

BackgroundThe first Multi-center Medication Reconciliation Quality Improvement Study (MARQUIS1) demonstrated that implementation of a medication reconciliation best practices toolkit decreased total unintentional medication discrepancies in five hospitals. We sought to implement the MARQUIS toolkit in more diverse hospitals, incorporating lessons learned from MARQUIS1.MethodsMARQUIS2 is a pragmatic, mentored implementation QI study which collected clinical and implementation outcomes. Sites implemented a revised toolkit, which included interventions from these domains: 1) best possible medication history (BPMH)-taking; 2) discharge medication reconciliation and patient/caregiver counseling; 3) identifying and defining clinician roles and responsibilities; 4) risk stratification; 5) health information technology improvements; 6) improved access to medication sources; 7) identification and correction of real-time discrepancies; and, 8) stakeholder engagement. Eight hospitalists mentored the sites via one site visit and monthly phone calls over the 18-month intervention period. Each site's local QI team assessed opportunities to improve, implemented at least one of the 17 toolkit components, and accessed a variety of resources (e.g. implementation manual, webinars, and workshops). Outcomes to be assessed will include unintentional medication discrepancies per patient.DiscussionA mentored multi-center medication reconciliation QI initiative using a best practices toolkit was successfully implemented across 18 medical centers. The 18 participating sites varied in size, teaching status, location, and electronic health record (EHR) platform. We introduce barriers to implementation and lessons learned from MARQUIS1, such as the importance of utilizing dedicated, trained medication history takers, simple EHR solutions, clarifying roles and responsibilities, and the input of patients and families when improving medication reconciliation

Self-diffusion in dense granular shear flows

Diffusivity is a key quantity in describing velocity fluctuations in granular materials. These fluctuations are the basis of many thermodynamic and hydrodynamic models which aim to provide a statistical description of granular systems. We present experimental results on diffusivity in dense, granular shear in a 2D Couette geometry. We find that self-diffusivities are proportional to the local shear rate with diffusivities along the mean flow approximately twice as large as those in the perpendicular direction. The magnitude of the diffusivity is D \approx \dot\gamma a^2 where a is the particle radius. However, the gradient in shear rate, coupling to the mean flow, and drag at the moving boundary lead to particle displacements that can appear sub- or super-diffusive. In particular, diffusion appears superdiffusive along the mean flow direction due to Taylor dispersion effects and subdiffusive along the perpendicular direction due to the gradient in shear rate. The anisotropic force network leads to an additional anisotropy in the diffusivity that is a property of dense systems with no obvious analog in rapid flows. Specifically, the diffusivity is supressed along the direction of the strong force network. A simple random walk simulation reproduces the key features of the data, such as the apparent superdiffusive and subdiffusive behavior arising from the mean flow, confirming the underlying diffusive motion. The additional anisotropy is not observed in the simulation since the strong force network is not included. Examples of correlated motion, such as transient vortices, and Levy flights are also observed. Although correlated motion creates velocity fields qualitatively different from Brownian motion and can introduce non-diffusive effects, on average the system appears simply diffusive.Comment: 13 pages, 20 figures (accepted to Phys. Rev. E