Advanced beaded and tubular structural panels

A program to develop lightweight beaded and tubular structural panels is described. Applications include external surfaces, where aerodynamically acceptable, and primary structure protected by heat shields. The design configurations were optimized and selected with a computer code which iterates geometric parameters to satisfy strength, stability, and weight constraints. Methods of fabricating these configurations are discussed. Nondestructive testing produced extensive combined compression, shear, and bending test data on local buckling specimens and large panels. The optimized design concepts offer 25 to 30% weight savings compared to conventional stiffened sheet construction

Nurse Preceptors\u27 Perceptions of Non-Traditional Education

Background: A preceptor is an experienced nurse who teaches and provides feedback to a new orientee on their professional practice for a designated time. The preceptor is the key educator for new nurses in their learning process. Continuing education for the nurse preceptor is necessary to foster the professional development of this complex role. Aims: The purpose of this study is to determine if nurse preceptors perceive non traditional education as effective as in person instruction for preceptor professional development. Methods: This descriptive study used a convenient sample. An educational journal was created covering a variety of topics that aide in the growth and development of the nurse preceptor. The education was sent electronically to nurse preceptors in a critical care setting. Preceptors were required to read the journal and complete a post test. Once completed, nurse preceptors were invited to participate in the study. A 25 item questionnaire, using a 5 point Likert scale, was sent via email. Nurse preceptors were given one month to voluntarily participate in the study. Responses to the survey were scored and averaged. Findings: There were a total of 14 participants. Not all items were answered by each participant. Eighty six percent were BSN prepared, 14% were MSN prepared. The majority of participants (71%, n= 10) have been preceptors for 2 or more years in their current practice setting. Some participants did not attend the previous in person preceptor education (4 out of 14). All participants completed the non traditional (journal) education. Nearly all participants (92%, n=12 out of 13) believed that the non traditional educational journal had high impact. When responding to educational preferences, 61.5% preferred to receive preceptor education in a non traditional format while 38% preferred to receive education in both non traditional and traditional formats. The study results provide a better understating of the educational preferences of the nurse preceptor. This information is vital for the development for future preceptor education programs. Tailoring education to the learners preferred methods can make education more impactful. Providing meaningful education to preceptors will improve their practice, further benefiting the experience of the newly hired/transferred nurses. The study may be applicable to other practice areas and/or organizations.https://scholarlycommons.henryford.com/nursresconf2021/1010/thumbnail.jp

Improving Early Detection of C. difficile Infections

Background: Patients with C. difficile will have liquid, loose, mucous like, or non formed stools. These infections can occur in both the inpatient and community settings and can range from diarrhea to life threatening illness. C. difficile positive stool samples collected within the first three calendar days of hospital admission is considered community acquired. Positive stool samples for C. difficile calendar day 4 or greater are considered hospital acquired. In 2019 and 2020, the P4 surgical intensive care unit (SICU) at Henry Ford Hospital (HFH) experienced high rates of hospital acquired C. difficile infections (CDI). Aim: The purpose of this project was to utilize an electronic health record (EHR) report to conduct early screening for patients to capture CDI during the community acquired timeframe rather than during the hospital acquired timeframe. Methods: Pre-post quasi-experimental retrospective study. Institutional Review Board approval was obtained. Incidence and rate of hospital acquired CDI were tracked from 2019-2022. All community-acquired CDI identified using the stool report were tracked from 2021-2022. Findings: Significant reductions occurred in unit incidence and rates of hospital acquired CDI (Table 2). During the study timeframe, 15 community acquired CDIs were successfully detected within the first 3 calendar days of hospital admission (7 in 2021, 8 in 2022). These infections were detected with the use of the stool report tool and CNS and/or IPC follow up. Without this tool, these CDIs may not have been identified during the community acquired infection timeline. Discussion: October 2021: A Loose Stool Best Practice Alert (BPA) was implemented. This electronic health record BPA alerts nursing staff of potential CDI during the community acquired window. The stool report remains a useful monitoring tool in the event that the Loose Stool BPA is bypassed. The CNS and IPC continue with daily screening of the stool report and follow up with nursing for all potential CDI patients. This quality improvement project is in the process of being expanded to additional units at the hospital. Implications: Delay in CDI detection can cause negative outcomes for patients and can result in inflated hospital acquired rates. Utilizing an electronic report in conjunction with clinical nurse specialist follow up, is an effective method for early screening for C. difficile.https://scholarlycommons.henryford.com/nursresconf2023/1000/thumbnail.jp

Using Interprofessional Collaboration to Reduce CLABSI Rates in an Intensive Care Setting

Background: Central line associated bloodstream infections (CLABSI) are preventable hospital-acquired infections associated with increased morbidity and mortality, and cost. CLABSIs are the most expensive healthcare associated infection (HAI) with a cost upwards of $90,000 per infection. This cost does not account for increased length of stay or future readmissions. The criteria used to define CLABSIs in an acute care setting is based on the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN) definitions. An infection window period (IWP) is used to review infection criteria to meet the surveillance definition. This is defined as a 7 day period, which includes the 3 calendar days before and after the first positive diagnostic test (Table 1). If no secondary sources are identifiable as a cause of the bloodstream infection (BSI) within the IWP, it will qualify as a CLABSI based on the NHSN definition. Healthcare organizations are encouraged to adhere to evidence based central line (CL) insertion and maintenance practices to reduce infection, which include: Adherence to hand hygiene practices Insertion bundles Maintenance bundles Removal of CL when they are no longer indicated Despite improved compliance with these infection prevention interventions, the surgical intensive care unit (SICU) at Henry Ford Hospital (HFH) continued to experience high CLABSI rates in 2019 and 2020. Aims: Using an interprofessional proactive approach, this project\u27s goal was to reduce the number of NHSN reportable CLABSIs by identifying at risk patients and clinically assessing for alternative infection sources. Methods: An interprofessional team formed to better understand the occurrence of CLABSI on the surgical intensive care unit (SICU). The team included: Unit Medical Director Infection Prevention Specialist Clinical Nurse Specialist Multiple opportunities were identified when reviewing root cause analysis data: Care team documentation Assessments for alternative infection. Verification of blood culture indication following HFH Blood Culture Stewardship Guidelines IRB approval and a waiver of informed consent were obtained. The interprofessional team (Figure 1): Completed daily chart audits on patients with central access Screened patients for blood culture collection and result status Verified blood culture indication using the HFH Blood Culture Stewardship Guidelines Established an IWP and reviewed medical record for infection source once blood cultures were collected Shared findings with interprofessional team via secure messaging Communicated potential gaps with the patient care teams, which included collaborative efforts regarding the treatment plan and proper documentation of clinical findings This proactive approach ensured supporting evidence was present to meet NHSN definitions for secondary BSI to avoid CLABSIs This quasi experimental retrospective study compared data from the pre intervention period (January 2019 to January 2021) to the intervention period (March 2021 to December 2022): CLABSI rate per 1,000 CL days Blood culture order rate per 1,000 CL days CL utilization ratio per 1,000 patient days Standardized infection ratio The t test was used to compare the continuous variables and was determined statistically significant if P \u3c 0.05. All analyses were performed using IBM SPSS Statistics (Version 29; Armonk, NY). Results: After implementation, the interprofessional team identified alternative sources of bloodstream infection in 37 patients (17 in 2021 and 20 in 2022) with qualifying central access and positive blood culture. When comparing pre and post intervention periods, significant reductions were made (see Table 2). This included an 82$1.6 million difference in healthcare costs. Discussion: This project demonstrates that an interpersonal team reviewing potential CLABSIs and identifying alternative sources of BSI can decrease CLABSI rates, improve patient management and lead to better outcomes. In addition to being a safe and effective approach, this intervention had the additional benefit of cost savings for the health system. Healthcare institutions should consider implementing this intervention to reduce unnecessary CLABSI rates, as well as cost.https://scholarlycommons.henryford.com/nursresconf2023/1001/thumbnail.jp

Perceptions of Nurses Who Are Second Victims in a Hospital Setting

https://scholarlycommons.henryford.com/nursresconf2021/1004/thumbnail.jp

Neutron Capture Cross Sections for the Weak s Process

In past decades a lot of progress has been made towards understanding the main s-process component that takes place in thermally pulsing Asymptotic Giant Branch (AGB) stars. During this process about half of the heavy elements, mainly between 90<=A<=209 are synthesized. Improvements were made in stellar modeling as well as in measuring relevant nuclear data for a better description of the main s process. The weak s process, which contributes to the production of lighter nuclei in the mass range 56<=A<=90 operates in massive stars (M>=8Msolar) and is much less understood. A better characterization of the weak s component would help disentangle the various contributions to element production in this region. For this purpose, a series of measurements of neutron-capture cross sections have been performed on medium-mass nuclei at the 3.7-MV Van de Graaff accelerator at FZK using the activation method. Also, neutron captures on abundant light elements with A<56 play an important role for s-process nucleosynthesis, since they act as neutron poisons and affect the stellar neutron balance. New results are presented for the (n,g) cross sections of 41K and 45Sc, and revisions are reported for a number of cross sections based on improved spectroscopic information

Playing with the future: social irrealism and the politics of aesthetics

In this paper we wish to explore the political possibilities of video games. Numerous scholars now take seriously the place of popular culture in the remaking of our geographies, but video games still lag behind. For us, this tendency reflects a general response to them as imaginary spaces that are separate from everyday life and 'real' politics. It is this disconnect between abstraction and lived experience that we complicate by defining play as an event of what Brian Massumi calls lived abstraction. We wish to short-circuit the barriers that prevent the aesthetic resonating with the political and argue that through their enactment, video games can animate fantastical futures that require the player to make, and reflect upon, profound ethical decisions that can be antagonistic to prevailing political imaginations. We refer to this as social irrealism to demonstrate that reality can be understood through the impossible and the imagined

UK Large-scale Wind Power Programme from 1970 to 1990: the Carmarthen Bay experiments and the Musgrove Vertical-Axis Turbines

This article describes the development of the Musgrove Vertical Axis Wind Turbine (VAWT) concept, the UK ‘Carmarthen Bay’ wind turbine test programme, and UK government’s wind power programme to 1990. One of the most significant developments in the story of British wind power occurred during the 1970s, 1980s, and 1990s, with the development of the Musgrove vertical axis wind turbine and its inclusion within the UK Government’s wind turbine test programme. Evolving from a supervisor’s idea for an undergraduate project at Reading University, the Musgrove VAWT was once seen as an able competitor to the horizontal axis wind systems that were also being encouraged at the time by both the UK government and the Central Electricity Generating Board, the then nationalised electricity utility for England and Wales. During the 1980s and 1990s the most developed Musgrove VAWT system, along with three other commercial turbine designs was tested at Carmarthen Bay, South Wales as part of a national wind power test programme. From these developmental tests, operational data was collected and lessons learnt, which were incorporated into subsequent wind power operations.http://dx.doi.org/10.1260/03095240677860621

Connecting

Connecting Helen Walker - Teaching/Seeing Jesus Jan Buley - The Realization S. Rebecca Leigh - Celebrating Ways of Learning Christopher M. Bache - The Opening Question Bette B. Bauer - Teaching as a Spiritual Practice Rachel Forrester - Appalachia Finally in the Spring Laurence Musgrove - Syllabu

Reconnaissance of the Bedrock Aquifers and Groundwater Chemistry of Crawford, Franklin, and Sebastian Counties, Arkansas

A ground water reconnaissance of Crawford, Franklin, and Sebastian counties was performed utilizing 122 wells having drillers\u27 logs from bedrock aquifers. North of the Arkansas River, essentially all bedrock wells produce from the Atoka Formation. There are many low producing aquifers within the Atoka with a range in yield of 0.1 to 55 gpm, but having a median yield of only 2 gpm. Well depths range from 18 to 248 feet with a median of 122 feet. More water is generally obtained from the shale/siltstone aquifers than the sandstones due to more bedding-plane partings and more closely spaced fractures. Greater yields are also found in valleys. South of the Arkansas River, three additional bedrock aquifers are utilized. The aquifers and median yield are as follows: (1)Savannah Sandstone (11.7 gpm), (2) Hartshorne Sandstone (10 gpm), and (3) McAlester Shale (5.2 gpm). Well depths range from 40 to 300 feet. Seventeen wells in the Atoka were sampled and analyzed. The median iron concentration was 0.15, but four wells had over the 0.3 ppm health limit. Sulfate values ranged from31 to 125 ppm with a median of 45 ppm. Chloride concentrations ranged from 16 to 58 ppm with a median of 33 ppm. These relatively high values commonly give the water a bitter and strigent taste with some H₃S odor. The source of these ions may be from pyrite weathering or to contamination from the many gas fields in the area