Transformational Education through Intercultural Service Learning Immersions

Theological educators are searching for capstone events and units that will maximise formation and enable ministerial students to find their ministerial identity and style. The contemporary context requires that cultural awareness and intercultural capacities be included in course outcomes. Avondale Seminary has found that intercultural service learning, where reflection is added as an integral facet of learning, provides the desired positive learning outcomes. We have trialled the use of intercultural service learning with selected ministerial students over the last three years to maximise the spiritual and professional formation of our ministerial students deepening their sense of calling and readiness for full-time ministry. Service learning in an overseas context stretched our ministerial students’ communication and relational skills, requiring them to solve multiple problems by adjusting their attitudes, approaches, and ministry skills. The curriculum design has been informed by Meizirow’s and Deardorff’s models and the writings of Tortorici and Gale, Zimmerman and Neyer, Moon, and Bamber and Hankin. Students’ responses, included in the article, reveal deep personal, relational, professional and spiritual growth. The creation of new instruments and processes to enrich the student experience overseas is also explored

The Physiological Response on Immersion in Cold Water and the Cooling Rates on Swimming in a Group of children Aged 10 – 11 years

Swimming is a popular sport in the United Kingdom (UK); however, cold water immersion often found in open waters in the UK is not without increased risk. Drowning is among the leading cause of accidental death in 1-14 year-olds in most countries. We examined whether children and adults exhibit similar cold shock responses; their rate of cooling while swimming; and subjective recognition of cooling. Nineteen children aged 10-11 years voluntarily undertook a 5 min static immersion in 15 °C (59 °F) water. Ten of them then completed a swim of up to 40 min. Resting heart rate, respiratory frequency and inspiratory volume increased in all participants on initial immersion. The mean (+SD) cooling rate while swimming was 2.5 °C hr1 (+3.1)). No significant correlation was found between cooling rate and thermal sensation or comfort, implying a lack of subjective awareness in children. On comparing data from unacclimatized adults in 12°C (53.6 °F) water, children showed a smaller ‘cold shock’ response (p \u3c .05), and no difference was found in cooling rates during swimming

Adaptation of the Cold Shock Response and Cooling Rates on Swimming Following Repeated Cold Water Immersions in a Group of Children Aged 10 – 12 years

Habituation of the cold shock response, and adaptation in deep body cooling with prolonged cold water immersion is well documented in adults. This study aimed to determine whether children exhibit similar responses. Eight children aged 10-11 years underwent a 5 min static immersion in 15°C (59°F) water, five then swam for up to 40 minutes, before and after a year of regular cold water swim training. Following acclimatization, no differences were found in heart rates or respiratory frequencies on initial immersion, despite a smaller relative VO2. Children reported feeling warmer (p \u3c .01) and more comfortable (p \u3c .05), implying acclimatization of subjective perception of cold. No difference was found in cooling rates while swimming. On comparison with data of adults swimming in 12°C (36°F) water, no difference was found in cooling rates, but the trend in both acclimatized groups to a slower rate of cooling was significant (p \u3c .026) when the data were pooled. These data may support a theory of insulative adaptation

Transgastric Pancreatic Necrosectomy: How I Do It

Necrotizing pancreatitis is a serious medical problem that often requires intervention to debride necrotic pancreatic and peripancreatic tissue. Recently, minimally invasive approaches have been applied to pancreatic necrosectomy. The purpose of this report is to review the history of transgastric pancreatic debridement, identify appropriate patient selection criteria, and highlight technical “pearls.” We present this subject matter in the context of our own clinical experience, with a primary focus on a “How I Do It” type of technical description

The energy penalty of post-combustion CO2 capture & storage and its implications for retrofitting the U.S. installed base

A review of the literature has found a factor of 4 spread in the estimated values of the energy penalty for post-combustion capture and storage of CO2 from pulverized-coal (PC) fired power plants. We elucidate the cause of that spread by deriving an analytic relationship for the energy penalty from thermodynamic principles and by identifying which variables are most difficult to constrain. We define the energy penalty for CCS to be the fraction of fuel that must be dedicated to CCS for a fixed quantity of work output. That penalty can manifest itself as either the additional fuel required to maintain a power plant's output or the loss of output for a constant fuel input. Of the 17 parameters that constitute the energy penalty, only the fraction of available waste heat that is recovered for use and the 2nd-law separation efficiency are poorly constrained. We provide an absolute lower bound for the energy penalty of ~11%, and we demonstrate to what degree increasing the fraction of available-waste-heat recovery can reduce the energy penalty from the higher values reported. It is further argued that an energy penalty of ~40% will be easily achieved while one of ~29% represents a decent target value. Furthermore, we analyze the distribution of PC plants in the U.S. and calculate a distribution for the additional fuel required to operate all these plants with CO2 capture and storage (CCS).Earth and Planetary SciencesEngineering and Applied Science

Post-Pancreatoduodenectomy Outcomes and Epidural Analgesia: A 5-Year Single Institution Experience

Introduction Optimal pain control post-pancreatoduodenectomy is a challenge. Epidural analgesia (EDA) is increasingly utilized despite inherent risks and unclear effects on outcomes. Methods All pancreatoduodenectomies (PD) performed from 1/2013-12/2017 were included. Clinical parameters were obtained from retrospective review of a prospective clinical database, the ACS NSQIP prospective institutional database and medical record review. Chi-Square/Fisher’s Exact and Independent-Samples t-Tests were used for univariable analyses; multivariable regression (MVR) was performed. Results 671 consecutive PD from a single institution were included (429 EDA, 242 non-EDA). On univariable analysis, EDA patients experienced significantly less wound disruption (0.2% vs. 2.1%), unplanned intubation (3.0% vs. 7.9%), pulmonary embolism (0.5% vs. 2.5%), mechanical-ventilation >48hrs (2.1% vs. 7.9%), septic shock (2.6% vs. 5.8%), and lower pain scores. On MVR accounting for baseline group differences (gender, hypertension, pre-operative transfusion, labs, approach, pancreatic duct size), EDA was associated with less superficial wound infections (OR 0.34; CI 0.14-0.83; P=0.017), unplanned intubations (OR 0.36; CI 0.14-0.88; P=0.024), mechanical ventilation >48 hrs (OR 0.22; CI 0.08-0.62; P=0.004), and septic shock (OR 0.39; CI 0.15-1.00; P=0.050). EDA improved pain scores post-PD days 1-3 (P<0.001). No differences were seen in cardiac or renal complications; pancreatic fistula (B+C) or delayed gastric emptying; 30/90-day mortality; length of stay, readmission, discharge destination, or unplanned reoperation. Conclusion Based on the largest single institution series published to date, our data support the use of EDA for optimization of pain control. More importantly, our data document that EDA significantly improved infectious and pulmonary complications

Exploring the Fate of Nitrogen Heterocycles in Complex Prebiotic Mixtures

A long standing question in the field of prebiotic chemistry is the origin of the genetic macromolecules DNA and RNA. DNA and RNA have very complex structures with repeating subunits of nucleotides, which are composed of nucleobases (nitrogen heterocycles) connected to sugar-phosphate. Due to the instability of some nucleobases (e.g. cytosine), difficulty of synthesis and instability of D-ribose, and the likely scarcity of polyphosphates necessary for the modern nucleotides, alternative nucleotides have been proposed for constructing the first genetic material. Thus, we have begun to investigate the chemistry of nitrogen heterocycles in plausible, complex prebiotic mixtures in an effort to identify robust reactions and potential alternative nucleotides. We have taken a complex prebiotic mixture produced by a spark discharge acting on a gas mixture of N2, CO2, CH4, and H2, and reacted it with four nitrogen heterocycles: uracil, 5-hydroxymethyluracil, guanine, and isoxanthopterin (2-amino-4,7-dihydroxypteridine). The products of the reaction between the spark mixture and each nitrogen heterocycle were characterized by liquid chromatography coupled to UV spectroscopy and Orbitrap mass spectrometry. We found that the reaction between the spark mixtUl'e and isoxanthopterin formed one major product, which was a cyanide adduct. 5-hydroxymethyluracil also reacted with the spark mixture to form a cyanide adduct, uracil-5-acetonitrile, which has been synthesized previously by reacting HCN with S-hydroxymethyluracil. Unlike isoxanthopterin, the chromatogram of the 5-hydroxymethyluracil reaction was much more complex with multiple products including spark-modified dimers. Additionally, we observed that HMU readily self-polymerizes in solution to a variety of oligomers consistent with those suggested by Cleaves. Guanine and uracil, the biological nucleobases, did not react with the spark mixture, even at high temperature (100 C). This suggests that there are alternative nucleobases which are more reactive under prebiotic conditions and may have been involved in producing precursor nucleotides