Building Change Readiness Practices for Information Technology Support Staff

With the turbulent economic conditions of the healthcare market, organizational leaders are faced with significant factors driving unprecedented change. Healthcare organizations are challenged with reimbursement reductions, high costs, modification of government regulations, and demanding healthcare consumers. Survival for healthcare organizations in this volatile climate requires successful implementation of rapid change. Healthcare leaders recognize a correlation between competitive advantage and the implementation of advanced information technology. Unfortunately, despite the efforts of healthcare leaders, many change initiatives fail. This study explores the effects communication, leadership, and culture strategies have on individual change readiness as perceived by IT support staff in a not-for-profit healthcare system during the rapid implementation of an electronic medical record

Evaluation of accurate tidal volume as displayed on the Avea™ ventilator using predetermined neonatal ventilator settings

Published ThesisOptimal ventilator support of a critically ill patient admitted for intensive care, requires quality control governed by scientific method. In order to reduce morbidity and mortality related to ventilator induced lung injury in a vulnerable neonatal patient, measured tidal volume (Vt) verification is of critical importance. Various built-in self testing algorithms are generally included in the modern ventilator to ensure that the equipment is functioning properly before it is connected to the patient. However, no method of verifying the accuracy of the proximal hotwire flow sensor used in conjunction with the Avea™ ventilator, has been established to ensure that the flow sensor functions within its allowed 10% deviation of specification. Therefore, the aim of the study was to evaluate the Vt on various Avea™ ventilators in order to determine an average set of Vt, making use of a specific set of neonatal ventilator settings that could be used as a benchmark against which healthcare workers can verify the accuracy of the ventilators and proximal hotwire flow sensors used in their respective intensive care units

False Elevation of Volume Determined by Bladder Scanner Secondary to Bowel Obstruction

Bladder scanners allow for quick determination of bladder volumes (BV) with minimal training. BV measured by a machine is generally accurate; however, circumstances exist in which falsely elevated BVs are reported. This case details a patient with a significant small bowel obstruction (SBO) due to superior mesenteric artery syndrome causing a falsely elevated BV. We believe this is the first case report of a SBO causing an elevated BV by bladder scanner. Emergency physicians should be aware of the pitfalls of using bladder scanners, and use their point-of-care ultrasound skills when possible to expand their differential

Factors that Contribute to Resident Teaching Effectiveness

Background One of the key components of residency training is to become an educator. Resident physicians teach students, advanced practice providers, nurses, and even faculty on a daily basis. Objective The goal of this study was to identify the objective characteristics of residents, which correlate with perceived overall teaching effectiveness. Methods We conducted a one-year, retrospective study to identify factors that were associated with higher resident teaching evaluations. Senior emergency medicine (EM) teaching residents are evaluated by medical students following clinical teaching shifts. Eighteen factors pertaining to resident teaching effectiveness were chosen. Two items from the medical students' evaluations were analyzed against each factor: teaching effectiveness was measured on a five-point Likert scale and an overall teaching score (1-75). Results A total of 46 EM residents and 843 medical student evaluations were analyzed. The ACGME milestones for systems-based practice (p = 0.02) and accountability (p = 0.05) showed a statistically significant association with a rating of "five" on the Likert scale for teaching effectiveness. Three other ACGME milestones, systems-based practice (p = 0.01), task switching (p = 0.04), and team management (p = 0.03) also showed a statically significant association of receiving a score of 70 or greater on the overall teaching score. Conclusion Residents with higher performance associated with system management and accountability were perceived as highly effective teachers. USMLE and in-service exams were not predictive of higher teaching evaluations. Our data also suggest that effective teachers are working in both academic and community settings, providing a potential resource to academic departments and institutions

State Geologist\u27s Report on the Geology of Maine 1930-1932

State Geologist\u27s Report on the Geology of Maine 1930-1932 Joseph Conrad Twinem , State Geologist and Edward H. Perkins , Assistant Geologist Second Series - Augusta 1932 Sections: Bibliography, Economic Geology, General Geology, Paleontology, Structural Geologyhttps://digitalcommons.usm.maine.edu/me_collection/1023/thumbnail.jp

State Geologist\u27s Report on the Geology of Maine 1930-1932

State Geologist\u27s Report on the Geology of Maine 1930-1932 Joseph Conrad Twinem , State Geologist and Edward H. Perkins , Assistant Geologist Second Series - Augusta 1932 Sections: Bibliography, Economic Geology, General Geology, Paleontology, Structural Geologyhttps://digitalcommons.usm.maine.edu/me_collection/1023/thumbnail.jp

Anti-Cancer Drugs Effect on Quasi-palindrome Mutations in Escherichia coli

Cancer is one of the world\u27s largest health problems in today’s age. The Global Burden of Disease estimates that 10 million people died as a result of cancer per year (IHME). Although there are many treatments for different types of cancer, many of the drugs used are known to have severe side effects. These known consequences include hair loss, nausea, and, unfortunately, an increase in DNA mutation, which can trigger other classes of diseases. One class of mutations that have been studied and linked to a form of cancer is Quasi-palindrome template switch mutations. Quasi-palindromes are nearly perfect inverted repeats of nucleotides able to form DNA secondary structures. These Hairpins are an example of a secondary DNA structure made by DNA repeats and are known to block the DNA replication fork (VOINEAGU et al. 2008). Once DNA replication is blocked by these secondary DNA structures, the DNA replication fork needs to find a solution to continue the replication process. At some frequency, DNA polymerase (responsible for replicating the DNA) can use alternative DNA strands as templates to make more DNA. One alternative method is called “Template-switching”, and it results in a mutation that creates a perfect palindrome from a quasi-palindromic sequence. Previous work has linked anti-cancer drugs such as 5-azacytidine to an increase of QP mutations (Laranjo 2018). Therefore, I am interested in analyzing other anti-cancer drugs and their potential to cause QP mutations. Using an FDA approved drug library, with over 300 different drugs, we will select anti-cancer drugs to screen for QP mutators. We have constructed a QP reporter in E. coli that is specific for QP mutations (Laranjo 2017). To understand the effect of anti-cancer drugs during DNA replication is critical to give us an understanding of potential side effects for patients undergoing chemotherapy

Particle phenomenology on noncommutative spacetime

We introduce particle phenomenology on the noncommutative spacetime called the Groenewold-Moyal plane. The length scale of spcetime noncommutativity is constrained from the CPT violation measurements in $K^{0}-\bar{K}^{0}$ system and $g-2$ difference of $\mu^+ - \mu^-$. The $K^{0}-\bar{K}^{0}$ system provides an upper bound on the length scale of spacetime noncommutativity of the order of $10^{-32} \textrm{m}$, corresponding to a lower energy bound $E$ of the order of $E \gtrsim 10^{16}\textrm{GeV}$. The $g-2$ difference of $\mu^+ - \mu^-$ constrains the noncommutativity length scale to be of the order of $10^{-20} \textrm{m}$, corresponding to a lower energy bound $E$ of the order of $E \gtrsim 10^{3}\textrm{GeV}$. We also present the phenomenology of the electromagnetic interaction of electrons and nucleons at the tree level in the noncommutative spacetime. We show that the distributions of charge and magnetization of nucleons are affected by spacetime noncommutativity. The analytic properties of electromagnetic form factors are also changed and it may give rise to interesting experimental signals.Comment: 10 pages, 3 figures. Published versio

A Sustainable Clinical Simulation Framework For Pre-Specialisation Clinical Technology Training In South Africa

ThesisIntroduction: As part of the healthcare fraternity, clinical technology has been lacking in using clinical simulation as part of the training of clinical technology students. However, as healthcare professionals, clinical technology students often face similar problems as other healthcare students when dealing with real patients for the first time or entering the healthcare environment. Simulation has proved its worth to prepare and train various healthcare students in the necessary technical and non-technical skills in a safe and controlled environment. Therefore, the purpose of this study was to investigate the development of a sustainable clinical simulation framework for pre-specialisation clinical technology students in South Africa. Methods: An in-depth study based on the grounded theory approach was done using three known qualitative methods: a detailed literature review and data collected from focus group discussions and nominal group interviews. Due to the COVID-19 pandemic outbreak, both the focus groups discussions and nominal group interviews were conducted via an online meeting platform. Two focus groups discussions were conducted with work-integrated learning (WIL) supervisors responsible for the supervision and training of clinical technology students busy with WIL. Three online nominal group interviews were held with the personnel of tertiary institutions in South Africa responsible for offering the clinical technology qualification. The tertiary institutions included Central University of Technology (CUT), Durban University of Technology (DUT) and Tshwane University of Technology (TUT). Data and transcripts from the focus group discussions were analysed through a triple coding process, whereas nominal group interviews’ data were analysed via known qualitative techniques. Results: Two focus groups were conducted with various themes identified from the four focus group areas. The central theme from focus group area one was “The importance of clinical simulation”. Focus group area two, “The preparation of the pre-specialisation clinical technology students.”, identified five major themes. Focus group area 3 viewed the role simulation may play in the training and assessment of clinical technology students. One major theme surfaced from this focus group area, namely “The expectations of a clinical simulation programme”. Focus group area 4, “Important issues regarding practical and skills training”, resulted in four major themes. In addition to the two focus group discussions, three nominal groups meetings were conducted with fifteen themes identified regarding the role simulation may play in the training and assessment of pre-specialisation clinical technology students. Ten themes related to the important graduate attributes the nominal group participants ranked essential, clinical technology students should be trained in, were identified from the collected data. Conclusion: The researcher was able to construct a clinical simulation framework that could be implemented into the current pre-specialisation clinical technology students’ curriculum from the results. A clinical simulation framework and program will ensure that these students are adequately prepared on both a theoretical and practical level with the ability to apply the acquired knowledge in a real-life healthcare environment. The resultant effect will be a better prepared and knowledgeable student entering the WIL environment with confidence