Hirschsprung’s disease

A 28-year-old, primagravida woman, gave birth to a boy at 40 gestational weeks. On delivery, the baby was found to have blood stained liquor. This was followed by non-bilious vomiting after feeds and a distended abdomen. He was transferred to NPICU at 36 hours of age due to persistent vomiting and failure to open his bowels. An initial diagnosis of septic shock necessitated the following management plan: nurse in an incubator, establish intravenous access and perform a septic screen. Nevertheless, at 50 hours of age, persistent bilious vomiting and abdominal distension persisted. An upper GI contrast study excluded a malrotation. Hirschsprung’s Disease was then suspected and confirmed on punch rectal biopsies. A surgical operation was carried out, which included a mapping laparotomy and a colostomy. Three days after the operation was performed, he developed wound dehiscence and required re-repair in theatre. The small and large intestine were cleaned and replaced in the abdomen and the stoma site secured. Swabs taken from the wound grew Enterococcus faecalis and Pseudomonas aueriginosa.peer-reviewe

Retention Issues in Nonprofit University Foundations

Turnover of major gift officers (MGOs) within university foundations has been a problem for foundations and their affiliated universities. Turnover of MGOs results in less fundraised dollars, fewer donor-fundraiser relationships, and higher incomings costs. Retention of MGOs is vital for foundations’ success and directly correlates to the overall prosperity of the respective university. The purpose of this descriptive, non-experimental study that utilized a cross-sectional survey design was to examine perceptions of currently employed MGOs, in the interest of determining what was important to them to remain employed at their nonprofit university foundation. Using a web-based survey, data showed MGOs need to feel appreciated and valued within their foundations. They were in pursuit of more responsibility over the fundraising strategies and their longevity in their position was dependent on their work culture. Data also found older MGOs are mostly intrinsically motivated, less motivated by compensation, and most likely to stay employed. The perceptions of work culture, perceived value, and workplace environment provided by the currently employed MGOs may provide a better understanding for employers to retain MGOs

Breast cancer patients diagnosed by National Breast Screening Programme

Breast cancer is the most common cancer in Malta. A National Breast Screening Programme (NBSP) was introduced in 2009 for women in the 50 to 60 year old age group. The first 112 patients diagnosed by the NBSP were compared to a matched control group of symptomatic patients randomly selected from the Breast Clinic, who had presented to the clinic with a breast lump. The files of all these patients were reviewed retrospectively. In the screening group there were 94 patients with invasive cancer and 18 patients with ductal carcinoma in situ (DCIS) while in the control group there were 114 patients with invasive cancer and 3 with DCIS. In the screening group, 81 (86.2%) patients with invasive cancer underwent wide local excision (WLE) and 13 (13.8%) underwent mastectomy. In the control group 88 (77.2%) patients with invasive cancer underwent WLE and 26 (22.8%) had a mastectomy. Out of all the patients in the screened group with DCIS, 12 (66.7%) underwent WLE and 6 (33.3%) underwent mastectomy. In the control group only 3 patients had DCIS and these were all treated by WLE. The average Nottingham Prognostic Index (NPI) of the screening population with invasive cancer is (3.28 (95% CI)) and is lower than the NPI of the control group is (3.74 (95% CI)). This study shows that in the screening group there is a higher percentage of patients with DCIS when compared to the control group. Furthermore, the screened group patients with DCIS were more likely to undergo mastectomy than those with invasive cancer.peer-reviewe

The Relationship Among Reflective Functioning, History of Childhood Trauma, and Symptoms of Depersonalization and Derealization in Patients with Panic Disorder

This exploratory study examined the relationship among reflective functioning (RF), history of childhood trauma, and symptoms of depersonalization and derealization in an attempt to provide a more nuanced clinical picture of panic disorder. All analyses were conducted using baseline data collected as part of the “Dynamic therapy vs. CBT for Panic Disorder” study at Weill Cornell Medical College and the University of Pennsylvania. The study participants were 201 patients with a primary DSM-IV diagnosis of panic disorder with or without agoraphobia who completed the parent study. While there was a significant relationship found between trauma and panic severity at one of the sites, t(95) = -2.44, p = .009, as well as between trauma and ratings of reflective functioning at the other, t(82) = 1.70, p = .047, there were no significant findings related to the study hypotheses supported by data across both sites. Notably, however, demographic characteristics such as race and age made significant contributions to the variability in scores of depersonalization/ derealization for both sites. In addition, the presence of this sample’s large incidence of childhood trauma (62% at site 1 and 64% at site 2) has potential implications for the way panic disorder should be conceptualized and treated

Counseling Skills Training an Extensive Review of Literature

Counseling Skills Training is a broad topic and although the proper training of counselors is considered to be consequential, relatively little systematic research of a profound nature has been carried out using graduate level trainees or professional level counselors. Research that has been conscientiously done has centered interviewing skills and suggestions for training rather than on the actual skills of conducting real psychotherapy. Given the state of inconclusive research to date, considerations for future research need to be addressed

Word Study Promotes the Application of Spelling Skills within Elementary Students’ Independent Writing

The research question addressed in this project was how does a balanced literacy program that includes word study promote application of spelling skills within elementary students’ independent writing? It documents the implementation of effective word study components within an elementary setting. The action research project included whole group lessons, followed by guided practice using interactive writing and writing conferences, and also individualized, hands-on, independent word work. These strategies were based off of the research of Fountas and Pinnell and the resource Word Matters (2001). Through the implementation of these components the author developed a deeper understanding of effective word study strategies that promote implementation during independent writing

Individual and Work-Related Variables Contributing to Hospital Nurses\u27 Participation or Non-Participation in Available Clinical Career Ladder Programs.

One solution to overcome the shortage of hospital nurses is to establish and implement clinical career ladder programs. The purpose of this study was to examine hospital clinical nurses\u27 perceptions of ladder programs as a job enrichment strategy and to determine individual and work-related variables contributing most to nurses\u27 participation or nonparticipation in available clinical ladder programs. A random sample of 600 clinical nurses employed full time in five regional medical center hospitals located in Louisiana and Mississippi were the study subjects. Respondents were 106 (88.3%) of the 120 ladder program participants and 385 (80.2%) of the 480 nonparticipant nurses. A three section instrument was used for data collection and analysis: perceptions of clinical ladder programs; the Job Diagnostic Survey (JDS); demographic information. Section one was researcher developed to measure nurses\u27 perceptions of three factor areas of clinical ladder programs. The JDS measured the motivational potential of the clinical nurses\u27 job according to selected core job dimensions. The demographic section identified clinical nurses\u27 individual and work-related characteristics. The Chi square and t-test statistical procedures revealed that subjects by ladder program participation status were more alike than different on the demographic characteristics of gender, ethnic group, educational level, nursing practice unit, patient care delivery method and years\u27 clinical experience. However, significant differences were reported between nurse groups by program participation status and the variables age, shift worked, hours worked per shift and years present clinical position. A comparison between nurse groups by participation status and perceptions of clinical ladder programs showed significant differences in the factor areas of intrinsic and extrinsic outcomes, need for a ladder program and criteria for program advancement. Also, a t-test showed significant differences in the two groups\u27 JDS means task identity, feedback from agents, growth need satisfaction and job security. Using discriminant analysis, a model was found that correctly classified 75.69% of hospital nurses by program participation status group. The results suggest implications for nursing practice and future research studies of hospital clinical nurses and clinical ladder programs for job enrichment. A replication of this study to test the model was also recommended