The Road Goes Ever On and On: A Path Through the Wilderness on R.S. 2477 Litigation in Alaska

Seeking to encourage people to settle the public domain, the federal government established the R.S. 2477 right of way, a grant to construct highways over land in the public domain. There are now thousands of miles of highway across the Western United States constructed pursuant to the authority in R.S. 2477, but most of these rights of way were never documented by any formal process. Alaska has made it a priority to document existing R.S. 2477 rights of way in an effort to manage and develop public lands. Identifying existing R.S. 2477 rights of way is essential for economic development, but the State’s aggressive litigation strategy threatens the rights of private property owners, the integrity of land allotments under the Alaska Native Claims Act, and federal conservation efforts in Alaska. After examining the history of R.S. 2477, Alaska’s litigation strategy, and how these rights of way conflict with interests of Native Corporations and federal wilderness and conservation efforts, this Note offers possibilities for resolving the conflict over R.S. 2477 rights of way in Alaska

The Road Goes Ever On and On: A Path Through the Wilderness on R.S. 2477 Litigation in Alaska

Seeking to encourage people to settle the public domain, the federal government established the R.S. 2477 right of way, a grant to construct highways over land in the public domain. There are now thousands of miles of highway across the Western United States constructed pursuant to the authority in R.S. 2477, but most of these rights of way were never documented by any formal process. Alaska has made it a priority to document existing R.S. 2477 rights of way in an effort to manage and develop public lands. Identifying existing R.S. 2477 rights of way is essential for economic development, but the State’s aggressive litigation strategy threatens the rights of private property owners, the integrity of land allotments under the Alaska Native Claims Act, and federal conservation efforts in Alaska. After examining the history of R.S. 2477, Alaska’s litigation strategy, and how these rights of way conflict with interests of Native Corporations and federal wilderness and conservation efforts, this Note offers possibilities for resolving the conflict over R.S. 2477 rights of way in Alaska

Childbirth Education

Includes bibliographical references.Although there are many types of prepared childbirth classes that teach the skills of birth utilizing many different techniques and philosophies, the goals of these classes are essentially the same--to have a happy, healthy, and safe childbirth experience. Although different methods may vary in philosophy or how they present the material, all childbirth education classes teach basic concepts of relaxation, breathing, and other coping skills that can help a woman work with labor contractions and gain a sense of mastery over the birth experience

'Leaves and Eats Shoots': Direct Terrestrial Feeding Can Supplement Invasive Red Swamp Crayfish in Times of Need

PMCID: PMC3411828This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

A Case Report of Acute Heart Failure Due to Infective Aortic Endocarditis Diagnosed by Point-of-care Ultrasound

Introduction: Infective endocarditis (IE) is a life-threatening condition with significant morbidity and mortality, and can require surgical repair.Case Report: A 36-year-old man presented to the emergency department for worsening dyspnea and chest pain. Point-of-care echocardiography demonstrated a mobile oscillating mass on the aortic valve with poor approximation of the valve leaflets, suggesting aortic valve insufficiency secondary to IE as the cause of acute heart failure. The patient underwent emergent aortic valve replacement within 24 hours.Discussion: While point-of-care echocardiography has been well documented in identifying tricuspid vegetations, aorticvalve involvement and subsequent heart failure is less well described. Earlier recognition of aortic valve vegetations and insufficiency can expedite surgical intervention, with decreased complication rates linked to earlier antimicrobial therapy.Conclusion: This case report highlights the ability of point-of-care ultrasound to identify aortic vegetations, allowing for the earlier diagnosis and therapy

Separation-distress as an affective mechanism of OCD

Includes abstract.Includes bibliographical references (p. 162-171).In this thesis, a series of four studies were carried out to address the question of whether separation distress (the associated feeling state of the basic emotion substrate PANIC; Panksepp, 1998) is a significant constituent of Obsessive-Compulsive Disorder (OCD). The aim was to characterize more accurately the affective nature of the disorder. Separation-distress and separation trauma were examined in samples of people with high scores on measures of obsessionality and low mood, and in patients with clinical OCD and depression; as well as in control groups. The Meta-Cognitions Questionnaire (Cartwright-Hatton & Wells, 1997) Padua Inventory (Sanavio, 1988), Major Depression Inventory (Olsen, Jensen, Noerholm, Martiny, & Bech, 2003) and Positive and Negative Affect Scales (Watson, Clark, & Tellegen, 1988) were used to position participants from low- to high-scoring on spectrums of obsessionality and low mood (Studies I and II) and of OCD and depression (Studies III and IV). Participants were then evaluated on measures of separation-distress, using the Separation Anxiety Symptom Inventory (Silove et al., 1993), the Structured Clinical Interview for Separation Anxiety Symptoms (Cyranowski et al., 2002), the Adult Separation Anxiety Checklist (Manicavasagar, Silove, Wagner, & Drobny, 2003) and the Affective Neuroscience Personality Scales (Davis, Panksepp, & Normansell, 2003). Descriptive and inferential statistics, including correlational analysis, independent and dependent t tests and mediation, confirmed that separation-distress is significantly and consistently higher in those who score higher on obsessionality and low mood, as well as in patients with OCD and depression. Heightened separation-distress is therefore strongly implicated in both OCD and depression. It was also found to be a critical variable in the well-recognized comorbidity of the two disorders. Chisquare contingency analysis was performed on the categorical data collected for early separation trauma experiences. The results showed that the development of OCD and/or depression in adulthood is highly contingent on the experience of separation trauma during critical early life periods. The main hypothesis, that separation-distress is a central affective mechanism of OCD, was confirmed

Measuring Primary Care Engagement in Emergency Department Patients in a Medically Underserved Area

The purpose of this study was to evaluate primary care engagement in an emergency department population of adults with diabetes and multiple chronic conditions (MCC) within the medically underserved Whitehaven community of Memphis, TN. Using a self-report survey, primary care characteristics of the population and the validity of the local hospital registrar\u27s assessment of primary care engagement were evaluated using descriptive statistics, independent sample t-tests, one-way ANOVA, and bivariate correlations. 83% of patients reported having a primary care provider. There was no effect of age, gender, or race on continuity of care or chronic illness care; however, insurance status did influence continuity of care. There was discordance between hospital registrar data and self-reports of primary care status. Facilitation of community programs that emphasize health coaching, combined with primary care, may help to improve coordination of care, reduce the high prevalence of people with diabetes and MCC, and improve quality of life

Connecting Healthcare – Leveraging Technology to Promote Value-Based Care in the Emergency Department

The emergency department is a fast-paced and complex environment that serves hundreds of thousands of people a day across the state of Georgia. The establishment of a culture of value-based care in the emergency department is attainable but often falls short when the staff cannot properly leverage the technology available to them. Framed by the Complex Adaptive Theory and The Input/Throughput/Output Model of ED Patient Flow, the purpose of this qualitative case study was to explore how emergency department leaders and staff could better leverage technology to develop and sustain a culture of value-based care. The 30 participants in this study were members of the executive suite, as well as members of the emergency department staff in Georgia. The data were collected through online surveys consisting of open-ended questions. Thematic analysis of the data yielded 5 key themes, including (1) training, (2) time, (3) access to information, (4) troubleshooting, and (5) vendor selection. A key recommendation from this study includes researching the effectiveness of post-implementation health information technology in the emergency department, as it relates to sustaining a culture of value-based care