Reducing Barriers to Timely Indwelling Urinary Catheter Removal

Problem Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs. Context The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area. Interventions Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit director. One-on-one conversations explaining the use of the posters were conducted with bedside nurses. Stickers with a cartoon IUC and the text “Why am I here?” were distributed as a light-hearted conversation starter to promote IUC discussion. Measures Interdisciplinary rounds were observed before and after the intervention to measure the proportion of rounds in which IUC indication or removal was discussed by members of the care team. The catheter utilization rate was compared between the pre- and post-intervention periods. Results The frequency of interdisciplinary rounds discussing IUC indication or removal increased from 23% to 30%. Catheter days per patient day decreased by 20% from a rate of 0.61 in April 2023 to 0.50 from April 1-21, 2024. Conclusions Early findings suggest that promoting interdisciplinary communication with visual reminders increases communication and decreases IUC utilization. More evaluation is needed to determine sustainability and impact over time. Keywords: NDRP, barriers, CAUTI, empowerment, interdisciplinary communicatio

Doctor of Philosophy

dissertationMany cellular membrane fission events are mediated by dynamin-related proteins (DRP), which self-assemble into spirals encircling the lipid tubes at their sites of action. DRPs are GTPases whose activities are dramatically stimulated upon assembly. Rapid GTP hydrolysis causes constriction of DRP spirals and leads to membrane fission. DRPmediated membrane fission is initiated by the recruitment of a certain DRP to the specific cellular membrane via adaptor proteins. The adaptors also co-assemble with DRPs to form active fission complexes. The molecular mechanism for this important recruitment step is poorly understood, as is the function of adaptor proteins during fission complex formation and membrane severing. In this thesis, we studied DRP membrane recruitment and adaptor functions using the yeast mitochondrial fission machinery including the DRP Dnm1, the adaptor Mdv1, and the membrane anchor Fis1. To initiate mitochondrial fission, Dnm1 is recruited to the mitochondria via a direct interaction with Mdv1, which binds Fis1 on the mitochondrial outer membrane. As described in Chapter 2, we identified a novel motif in the Dnml Insert B domain that is essential for the interaction of Dnml with Mdvl. Mutations in this conserved motif severely impaired Dnml-Mdvl interaction and mitochondrial fission. Suppressor mutations in the Mdvl P-propeller domain rescued defects caused by the Insert B mutations. The positions of these suppressor mutations define potential binding sites for Insert B on the Mdvl P-propeller. In Chapter 3, we demonstrated that Mdvl plays dual functions, as an adaptor and in scaffolding, during fission complex formation. Mdvl dimerizes via a 92A coiled-coil, which determines the optimal architecture of fission complexes. Together, these studies provide mechanistic insights regarding DRP membrane recruitment and the functions of adaptors in DRP-mediated membrane fission. Although the sequence of Insert B and the adaptors are varied among DRPs, we believe that they are functionally conserved and may have co-evolved to meet the requirements of specific fission events in different tissues and cell types

Quality versus Quantity: An Investigation into Electronic Word of Mouth’s Influence on Consumer Buying Intention

Online consumer reviews play an increasingly crucial role in shaping purchasing intention. With the wide-spread reviews available around the world on sites like TripAdvisor or Yelp, companies’ reputation and hence survival are potentially at risk. The purpose of this study is to investigate the impacts of electronic word-of-mouth (eWOM) on the individual’s attitudes towards the quantity and quality of online store reviews and consider how it impacts their behavior. We incorporate brand trust as a mediator in the relationship between eWOM and purchase intention. Using a vignette survey experiment centered on coffee shop reviews in Hanoi, Vietnam, we test our hypothesis with 223 respondents. Results showed that the number and quality of review does significantly affect purchase intention. Findings also show that brand trust has a mediating effect on the relationship between online reviews and buying intention. This study assists practitioners to develop user-oriented information review format in order to manage online consumer reviews properly and effectively

Electrochemical copper recovery from galvanic sludge

The feasibility of recovering copper from electronic industrial waste mud (galvanic sludge) using a combination of leaching and electrowinning has been examined. Leaching with sulfuric acid was found to be the most efficient and cost-effective way of extracting the copper from the sludge, and the optimum acid concentration and time were determined. The copper was then extracted by electrowinning in a batch recirculation electrochemical reactor (Porocell™) employing a three-dimensional carbon felt cathode. The influence of applied current, flow rate and the presence of other metal ion contaminates on the rate and current efficiency of copper electrowinning was investigated. An analysis of the experimental data showed that the current efficiency was lower than unity even though the limiting current for copper deposition was not exceeded. This low current efficiency was attributed to the occurrence of a side reaction, most likely the reduction of dissolved oxygen or oxygen-induced corrosion. The influence of this side reaction can be minimized by operating at relatively high currents and low flow rates

Total flow of N and P in Vietnam urban wastes

The amount of organic matters, N and P, is quite significant in urban wastes, especially in wastewater and solid wastes. It was found from this study that their production was about 302,241 ton of TN/day and 54,682 ton of TP/day. During the urbanization and industrialization, these numbers continue to increase. These nutrient matters can be used in agriculture as well as in other practices. Nevertheless, they will become pollutants when being discharged to surrounding environment (rivers, lakes, etc.) as they cause water eutrophication and increase risks for water supply