A Clinical Pathway Education Program for Pediatric Nurses

Clinical pathways have been studied to promote best practices in nursing and enhance patient satisfaction. For 10 years a pediatric orthopedic surgical team at a Midwest hospital has not had a clinical pathway to treat or standardize care for adolescents following posterior spinal fusion surgery. Pain scores and patients\u27 length of stay were collected using a retrospective chart review. This information was used to revise preoperative education materials and develop a visual poster. The purpose of this project was to identify and develop a way to educate the pediatric nursing staff on the use of the developed educational materials, poster, and clinical pathway prior to its implementation. David A. Kolb\u27s learning cycle and the experiential learning model was used as the theoretical foundation of this study. The quality improvement project for the nurses will be developed using a flipped classroom approach as the learning environment. Videos, scenarios, and small group activities will be created and used in an interactive learning environment. The study will use a pretest-posttest design of retrospective chart review data with the independent variable being the education provided to the nurses. Social implications related to this project are to provide information on the plan of care following surgery to the adolescent and caregiver. This project will promote positive social change for adolescents and caregivers who will be engaged in the postoperative care to increase their satisfaction and decrease their anxiety

Methane Seep Carbonates Host Distinct, Diverse, and Dynamic Microbial Assemblages

Marine methane seeps are globally distributed geologic features in which reduced fluids, including methane, are advected upward from the subsurface. As a result of alkalinity generation during sulfate-coupled methane oxidation, authigenic carbonates form slabs, nodules, and extensive pavements. These carbonates shape the landscape within methane seeps, persist long after methane flux is diminished, and in some cases are incorporated into the geologic record. In this study, microbial assemblages from 134 native and experimental samples across 5,500 km, representing a range of habitat substrates (carbonate nodules and slabs, sediment, bottom water, and wood) and seepage conditions (active and low activity), were analyzed to address two fundamental questions of seep microbial ecology: (i) whether carbonates host distinct microbial assemblages and (ii) how sensitive microbial assemblages are to habitat substrate type and temporal shifts in methane seepage flux. Through massively parallel 16S rRNA gene sequencing and statistical analysis, native carbonates are shown to be reservoirs of distinct and highly diverse seep microbial assemblages. Unique coupled transplantation and colonization experiments on the seafloor demonstrated that carbonate-associated microbial assemblages are resilient to seep quiescence and reactive to seep activation over 13 months. Various rates of response to simulated seep quiescence and activation are observed among similar phylogenies (e.g., Chloroflexi operational taxonomic units) and similar metabolisms (e.g., putative S oxidizers), demonstrating the wide range of microbial sensitivity to changes in seepage flux. These results imply that carbonates do not passively record a time-integrated history of seep microorganisms but rather host distinct, diverse, and dynamic microbial assemblages

Neurofibromin Deficient Myeloid Cells are Critical Mediators of Aneurysm Formation In Vivo

Background Neurofibromatosis Type 1 (NF1) is a genetic disorder resulting from mutations in the NF1 tumor suppressor gene. Neurofibromin, the protein product of NF1, functions as a negative regulator of Ras activity in circulating hematopoietic and vascular wall cells, which are critical for maintaining vessel wall homeostasis. NF1 patients have evidence of chronic inflammation resulting in development of premature cardiovascular disease, including arterial aneurysms, which may manifest as sudden death. However, the molecular pathogenesis of NF1 aneurysm formation is unknown. Method and Results Utilizing an angiotensin II-induced aneurysm model, we demonstrate that heterozygous inactivation of Nf1 (Nf1+/−) enhanced aneurysm formation with myeloid cell infiltration and increased oxidative stress in the vessel wall. Using lineage-restricted transgenic mice, we show loss of a single Nf1 allele in myeloid cells is sufficient to recapitulate the Nf1+/− aneurysm phenotype in vivo. Finally, oral administration of simvastatin or the antioxidant apocynin, reduced aneurysm formation in Nf1+/− mice. Conclusion These data provide genetic and pharmacologic evidence that Nf1+/− myeloid cells are the cellular triggers for aneurysm formation in a novel model of NF1 vasculopathy and provide a potential therapeutic target

Laying the groundwork at the AGS: Recent results from experiment E895

The E895 Collaboration at the Brookhaven AGS has performed a systematic investigation of Au+Au collisions at 2-8 AGeV, using a large-acceptance Time Projection Chamber. In addition to extensive measurements of particle flow, spectra, two-particle interferometry, and strangeness production, we have performed novel hybrid analyses, including azimuthally-sensitive pion HBT, extraction of the six-dimensional pion phasespace density, and a first measurement of the Lambda-proton correlation function.Comment: Presented at Quark Matter 2001, 8 pages, 5 figure

Model-independent source imaging using two-pion correlations in 2 to 8A GeV Au + Au collisions

We report a particle source imaging analysis based on two-pion correlations in high multiplicity Au + Au collisions at beam energies between 2 and 8A GeV. We apply the imaging technique introduced by Brown and Danielewicz, which allows a model-independent extraction of source functions with useful accuracy out to relative pion separations of about 20 fm. The extracted source functions have Gaussian shapes. Values of source functions at zero separation are almost constant across the energy range under study. Imaging results are found to be consistent with conventional source parameters obtained from a multidimensional HBT analysis.Comment: 4 pages, 3 figure

Comparison of Source Images for protons, π−\pi^-'s and Λ\Lambda's in 6 AGeV Au+Au collisions

Source images are extracted from two-particle correlations constructed from strange and non-strange hadrons produced in 6 AGeV Au + Au collisions. Very different source images result from pp vs p$\Lambda$ vs $\pi^-\pi^-$ correlations. These observations suggest important differences in the space-time emission histories for protons, pions and neutral strange baryons produced in the same events

Near-threshold production of the multi-strange Ξ−\Xi^- hyperon

The yield for the multi-strange $\Xi^{-}$ hyperon has been measured in 6 AGeV Au+Au collisions via reconstruction of its decay products $\pi^{-}$ and $\Lambda$, the latter also being reconstructed from its daughter tracks of $\pi^{-}$ and p. The measurement is rather close to the threshold for $\Xi^{-}$ production and therefore provides an important test of model predictions. The measured yield for $\Xi^{-}$ and $\Lambda$ are compared for several centralities. In central collisions the $\Xi^{-}$ yield is found to be in excellent agreement with statistical and transport model predictions, suggesting that multi-strange hadron production approaches chemical equilibrium in high baryon density nuclear matter.Comment: Submitted to PR