Knowledge, Perceptions, and Attitudes of Certified Registered Nurse Anesthetists Regarding the use of Desflurane with a Laryngeal Mask Airway

Abstract The purpose of this capstone project is to evaluate the knowledge, perceptions, and attitudes of currently practicing, nationally board certified, registered nurse anesthetists regarding the use of desflurane with laryngeal mask airways. This research was conducted by developing a questionnaire and administering it to current nurse anesthetists. A literature review was completed to establish a theoretical framework, summarize and describe the current state of science, and determine the nature and design of this study. Although there are studies regarding desflurane use during the maintenance of general anesthesia using a laryngeal mask airway, there is no current perception-based research regarding the use of desflurane with a laryngeal mask airway. Gaining knowledge about the motives behind the nurse anesthetist’s practices will provide the information to reveal why desflurane is or is not used. These results will assist in promoting change and will encourage using the most up-to-date practice regimens. Attribution theory wasappliedto this study, as this theory explains how behaviors and practices are formed and altered by previous experiences. The survey revealed that a majority of nurse anesthetists had a positive perception of desflurane use with laryngeal mask airways based on their positive attitude, knowledge, and overall positive experience with the use of desflurane with laryngeal mask airways. It was also concluded that nurse anesthetists are using desflurane with laryngeal mask airways safely and effectively on a routine basis. The evidence provided by this survey may be beneficial in developing future research regarding experienced-based practice to establish evidence-based practice guidelines involving the use of desflurane with laryngeal mask airways in future anesthesia management care plans

Rhetorical Lessons in Advocacy and Shared Responsibility: Family Metaphors and Definitions of Crisis and Care in Unpaid Family Caregiving Advocacy Rhetoric

In this rhetorical analysis, I analyze pro-caregiving advocates, individuals and organizations who are attempting to energize policy change for unpaid family caregiving. I piece together an expansive text that includes online advocacy discourse, public policy statements, and hard copies of organizational promotional materials. Pro-caregiving advocates are attempting to expand shared responsibility for an issue that is traditionally assumed to be private--unpaid family caregiving. Throughout this dissertation, I argue that pro-caregiving advocates are standing in the way of their own goals by rhetorically constructing inherent barriers to policy change. Each analysis chapter analyzes a dominant frame that is commonplace in pro-caregiving advocacy rhetoric (i.e., family, crisis, and care) and reveals inherent barriers to shared responsibility. In addition to locating the inherent barriers, each analysis chapter offers suggestions for navigating the barriers using the practical tools of rhetoric. As such, this dissertation will have practical usefulness for other social advocates who are championing a cause assumed to be private

Welfare, Work, and Well-Being in Metro and Nonmetro Louisiana

This paper examines the extent to which persons in the Temporary Assistance to Needy Families (TANF) have been able to leave the TANF program. The analysis is based on the Louisiana Welfare Survey which is a panel study of 1,000 persons (500 in New Orleans and 500 in two labor market areas in northeastern Louisiana) who in 1998 and 1999 had been on welfare. The original respondents have been reinterviewed annually, with the fifth and final wave currently (May 2002) in the field. The findings reported in this paper are based on the first three waves of the panel survey, 1998- 2000. The findings show that by 2000 more than half of the respondents had left TANF, mostly because of employment. Well over one-half of all TANF leavers reported to be working in 2000. Although most respondents that had left TANF reported being better off economically, the work these persons could find consisted mostly of low-status low-pay jobs in service industries. As a result, TANF recipients as well as TANF leavers faced a good many economic hardships, such as not having enough to eat, having phone and utilities disconnected, and inability to obtain medical and dental services. The comparison of metro and nonrnetro areas showed that TANF recipients in nonmetro areas were less likely to leave the TANF program for work, had lower human capital, and tended to face more economic hardships than their metro counterparts. The picture that emerges from these findings shows that the economic situation of TANF leavers is fragile and tenuous, and that it is premature to consider the welfare reform legislation of 1996 a success

A Project to Study Urban Earthquake Risk Worldwide

In 1998, the Secretariat of the International Decade for Natural Disaster Reduction (IDNDR) and GeoHazards International (GHI) launched the understanding Urban Seismic Risk around the World (UUSRAW) project. The 18-month project established an internet network of 74 seismically active cities worldwide to compare their earthquake hazard and to share their experiences and resources in working to reduce the impact of future earthquakes. In each city, a local scientist or municipal officer gathered the information necessary to conduct the comparative assessment using the Earthquake Disaster Risk Index (Davidson, 1997), a composite index used to assesses risk based on several factors. The comparative assessment and other project results, including a compilation of city profiles that systematically describe the key elements of each participating city’s earthquake risk and its risk management practices, as well as a compilation of more than 60 risk management efforts from 27 cities, will be included in a formal report published by the United Nations. Although work continues in developing a technically sound, widely accepted assessment of the earthquake risk and risk management practices of cities worldwide, the UUSRAW project represents a significant first step in establishing a worldwide network of earthquake professionals and helping cities share experiences and learn from each other more effectively

Field evaluation of rK39 test and direct agglutination test for diagnosis of visceral leishmaniasis in a population with high prevalence of human immunodeficiency virus in Ethiopia

Accuracy of an rK39 rapid diagnostic test (DiaMed-IT-Leish ) for visceral leishmaniasis (VL) was compared with splenic aspiration and the direct agglutination test (DAT) in a population with a high prevalence of infection with human immunodeficiency virus (HIV) in Ethiopia. There were 699 patients clinically suspected of having VL (153 parasitologically confirmed, 482 DAT confirmed, and 130 DAT negative), and 97 DAT-negative controls. A total of 84% were tested for HIV and 34% were HIV positive. Sensitivity of the rK39 test in parasitologically confirmed VL patients was 84% (77% in HIV positive and 87% in HIV negative; P = 0.25). Sensitivity of the DAT was higher (94%; P = 0.01), 89% in HIV-positive patients and 95% in HIV-negative patients; P = 0.27). Specificity of the rK39 test was 99% in DAT-negative controls and 92% in DAT-negative patients clinically suspected of having VL. A diagnostic algorithm combining DAT and the rK39 test had a sensitivity of 98% in HIV-positive VL patients and 99% in HIV-negative VL patients. Despite the lower sensitivity in a population with a high prevalence of HIV, the DiaMed-IT-Leish rK39 test enables decentralization of diagnosis. Patients clinically suspected of having VL who show negative results on the rK39 antigen test should undergo follow-up DAT testing, especially if they are HIV positive

Orion Launch Abort System Performance During Exploration Flight Test 1

The Orion Launch Abort System Office is taking part in flight testing to enable certification that the system is capable of delivering the astronauts aboard the Orion Crew Module to a safe environment during both nominal and abort conditions. Orion is a NASA program, Exploration Flight Test 1 is managed and led by the Orion prime contractor, Lockheed Martin, and launched on a United Launch Alliance Delta IV Heavy rocket. Although the Launch Abort System Office has tested the critical systems to the Launch Abort System jettison event on the ground, the launch environment cannot be replicated completely on Earth. During Exploration Flight Test 1, the Launch Abort System was to verify the function of the jettison motor to separate the Launch Abort System from the crew module so it can continue on with the mission. Exploration Flight Test 1 was successfully flown on December 5, 2014 from Cape Canaveral Air Force Station's Space Launch Complex 37. This was the first flight test of the Launch Abort System preforming Orion nominal flight mission critical objectives. The abort motor and attitude control motors were inert for Exploration Flight Test 1, since the mission did not require abort capabilities. Exploration Flight Test 1 provides critical data that enable engineering to improve Orion's design and reduce risk for the astronauts it will protect as NASA continues to move forward on its human journey to Mars. The Exploration Flight Test 1 separation event occurred at six minutes and twenty seconds after liftoff. The separation of the Launch Abort System jettison occurs once Orion is safely through the most dynamic portion of the launch. This paper will present a brief overview of the objectives of the Launch Abort System during a nominal Orion flight. Secondly, the paper will present the performance of the Launch Abort System at it fulfilled those objectives. The lessons learned from Exploration Flight Test 1 and the other Flight Test Vehicles will certainly contribute to the vehicle architecture of a human-rated space launch vehicle

Limited effectiveness of high-dose liposomal amphotericin B (AmBisome) for treatment of visceral leishmaniasis in an Ethiopian population with high HIV prevalence.

Due to unacceptably high mortality with pentavalent antimonials, Médecins Sans Frontières in 2006 began using liposomal amphotericin B (AmBisome) for visceral leishmaniasis (VL) patients in Ethiopia who were severely ill or positive for human immunodeficiency virus (HIV)

Baseline Assessment to Evaluate Attitudes, Norms, Knowledge, and Behaviors around Violence Against Women and Girls and Evidence-based Practices for the Curricula of a Faith-based Youth Organization

Background: Violence against women and girls (VAWG) is a significant public health issue globally and in urban informal settlement communities, such as those in Nairobi, Kenya. A Nairobi faith-based organization, Ambassadors Football Kenya (AFK), recognizes this issue as one with significant, adverse impact in the communities where it serves and endeavors to implement activities to disrupt this cycle of violence, improving health outcomes of women. Methods: A literature review was conducted to identify an evidence-based, community-led intervention program with documented results in preventing VAWG and a model leveraging activities already performed by AFK. The SASA! Faith community mobilization intervention, a four-phased program, fits these criteria. AFK began implementation of SASA! Faith’s first phase, the START phase, during August 2019 by engaging a volunteer with previous experience working in the field of VAWG prevention. A baseline assessment was conducted using qualitative and quantitative exercises in the form of Assessment Dialogues and Rapid Assessment Surveys, respectively, to measure the starting point of community knowledge, attitudes, behaviors, and norms around VAWG. Results: The baseline assessment indicated that VAWG is, indeed, a significant issue in the communities served by AFK. Men and women who participated have varying views on the power imbalance between them but agree that VAWG is a problem that needs to be addressed to improve safety and health in their communities. Conclusion: AFK should continue to pursue implementation of SASA! Faith, engaging partners to aid in these activities and augment visibility in the community.Master of Public Healt

Subversive Voices in Contemporary Motherhood: The Rhetoric of Resistance in Independent Film Narratives

Indiana University-Purdue University Indianapolis (IUPUI)Interpretive textual analysis, informed by a feminist perspective, is applied to five independent films written and directed by female filmmakers in order to understand to what extent the rhetorical construction of motherhood as presented in the films deviates from or supports a patriarchal Western vision. This study provides a rich textual analysis of Amreeka (2009), Frozen River (2008), Waitress (2006), The Dead Girl (2006), and Lovely and Amazing (2001); five films that each considers the role of contemporary mothering as a central part of its plot. Each film has been distributed within ten years of the inception of this study, is considered an independent film, has received some degree of critical acclaim, and is written and directed by a female filmmaker. Using a feminist critical interpretive lens, this study investigates the public and private sphere identification of the mothers, the mother-child relationships, and the family systems that work to unveil a vision of motherhood in contemporary independent film and identify the extent to which this vision challenges or adheres to traditional representations. The readings of these films rely on theoretical insights of feminist film criticism and feminist theory. In addition, feminist rhetorical perspectives provide the framework to reveal the broader cultural implications of the representation of contemporary motherhood in public discourse. The analysis reveals a subversive reading of contemporary mothering characterized by the rejection of domesticity and other traditional mothering ideologies. Informed by resistance theory, the findings suggest the female filmmakers utilize the symbolic inversion tactic as a tool to resist their subordinate status. The subversive discourses give voice to female filmmakers attempting to negotiate power in a traditionally patriarchal forum by invoking a rhetoric of resistance. However, the rhetorical construction of the “indie” mother is characterized by maternal sacrifice and maternal autonomy which ultimately forces women to negotiate their mothering identity in relation to the hegemonic childrearing model of intensive mothering. The production of contradictory messages illustrates an attempt to adapt to existing conditions rather than transform the patriarchal system suggesting that independent film is a dynamic medium that both reflects hegemonic discourse while remaining open to ideological variance

Electroactive Light Metal Nanostructures for Corrosion Protection and Electrochemical Energy Storage

Stability in electrochemical systems is governed by interactions at the local scale where isolated inhomogeneities can define system performance. This concept plays a key role in failure of battery systems and corrosion of materials. For rechargeable batteries, replacement of graphite with metal anodes provides considerable promise for sizable gains in gravimetric and volumetric energy densities. However, out of equilibrium processes guide formation of anisotropic, dendritic growths which are capable of short circuiting the cell and causing catastrophic failure of the system. Magnesium-based batteries have garnered significant interest as an alternative to lithium-ion largely due to its designation as a ‘dendrite free’ system. This would allow for the use of metal anodes providing significant improvements in capacity compared to graphite but requires controlled and consistent plating and stripping of the active metal over hundreds of cycles. Here, we detail our investigations into the electrodeposition of magnesium in varying electric fields, electrolyte concentrations, and with the addition of growth-directing ligands, providing understanding of mechanisms of deposition across a wide range of deposit morphologies. Through combining in situ video microscopy studies of electrodeposition of Mg in symmetric cells with 3D tomographic characterization and mesoscale modeling we demonstrate some of the first definitive examples of dendritic growth on magnesium anodes and elucidate mechanisms of formation. In corroding systems, local inhomogeneities often serve as key sites in failure, often dominating electrochemical activity. For corrosion inhibition, our approach has involved modular design of nanocomposite coatings enabling multiple modes of corrosion protection. Here we outline our efforts in design of magnesium nanoparticle and exfoliated graphite-based nanocomposites for protection of high-strength aluminum alloys. Mechanisms of corrosion inhibition have been elucidated through extended submersion testing coupled with electrochemical impedance spectroscopy measurements