The Role and Function of a Hospital Chaplain in an Interdisciplinary Team

Healthcare workers provide quality of care to patients who enter the hospital. However, to provide the holistic care, patients need interdisciplinary teams who meet and collaborate on a plan of care. There are various skills sets required on an interdisciplinary team including chaplains. However, members of an interdisciplinary team do not necessarily understand how to utilize the chaplain’s multifaceted training for the best holistic care of the patient. The purpose of this study is to review the interdisciplinary team in the hospital context and address the understanding of the chaplain’s role and function. The study will utilize a qualitative research method within the hospital context using interdisciplinary teams as the sample population and a sample size of 12 healthcare workers. The setting will be within the context of the hospital using questionnaires, one-on-one interviews, and observations as data collection methods. This study should help educate healthcare workers on interdisciplinary teams regarding the role and function of the hospital chaplain within the hospital. It should also draw attention to how members of those on the interdisciplinary teams are trained not only together, but also in their initial medical training, whether it be nursing, caseworker, pharmacist, or physician. If there is an expectation and consideration for members on the interdisciplinary team to work together then part of their education should be on not only team development, but the different roles and functions of those they will come in contact with during their career in order to provide quality care for patients

Investments in Leadership and Management Succession Planning at a Department of Defense Organization in the Southeastern United States: A Review of Strategic Implications

With the impending aging workforce retirement tidal wave, targeted investments are needed in leadership and management skills for new leader growth. Some organizations currently invest in leadership and management skill development. However, the impacts of the investments remain unknown in the organizations. A Department of Defense Organization in the Southeast United States (DODSE) serves as a scientific knowledge generating organization that supports the Department of Defense. At the DODSE, investments in leadership and management skills training began in 2007 with little understanding of how an increased investment in leadership and management training would be utilized within the organization. To create the leadership development program at the DODSE, a group of middle managers established learning objectives personally desirable before assuming their first leadership role. The resulting leadership and management training produced numerous trained personnel between 2007 and 2010. This study investigates whether the DODSE leadership and management training investments align with DODSE\u27s strategic plan and DODSE\u27s utilization of the trained personnel in leadership and management positions

Transition probabilities in OH A 2 sigma + - X 2 pi i: Bands with v prime = 0 and 1, v double prime = 0 to 4

Experimental results for relative vibrational band transition probabilities for v prime = 0 and 1, and v double prime = 0 to 4 in the A-X electronic system of OH are presented. The measurements, part of a larger set involving v prime = 0 to 4 and v double prime = 0 to 6, were made using spectrally dispersed laser-induced fluorescence (LIF) in the burnt gases of a flame. These Einstein coefficients will be useful in dynamics experiments for quantitative LIF determinations of OH radical concentrations in high v double prime

Recent Investigations of Mission Period Activity on Sapelo Island, Georgia

Prior to their retreat to Florida in 1684, Muskogean-speaking Guale Indians inhabited much of what is now the Georgia coast. The arrival of Spanish missionaries in Florida and Georgia in the mid-1500s began what is known archaeologically as the mission period (1568-1684), a time of sustained interaction between the Spanish and the Guale people. Over time, population loss due to European-introduced diseases and conflict with English-backed Native American slave raiders resulted in a drastic reconfiguration of Guale society and the abandonment of the Guale\u27s ancestral homeland (Worth 2007). Sapelo Island (Figure 6.1) is the site of at least one Spanish mission, the Mission San Joseph de Sapala (Worth 2007:194). Ethnohistoric data indicate that this mission played a critical role in the story of Guale culture change, serving as an aggregation point for other Guale towns that were forced to relocate after attacks by slave raiders and pirates. Of particular interest is the period from ca. 1660 to 1684, when extensive demographic shuffling and relocation led to the mixing of many formerly separate Native American social entities and the emergence of the Yamassee, a newly formed but culturally distinct sociopolitical group made up of individuals from several collapsed chiefdoms (Saunders 2001; Worth 2004a, 2004b)

High Efficiency Carbon Dioxide Removal Devices for Minimally Invasive Partial Respiratory Assistance

Acute and chronic lung injuries remain significant clinical problems, and are the third leading cause of death in the United States. Carbon dioxide removal (CO2R) devices can effectively manage acute hypercapnia in patients during treatment of acute exacerbations of chronic obstructive pulmonary disease (aeCOPD) and acute respiratory distress syndrome (ARDS) when combined with protective ventilation strategies. Widespread adaptation of CO2R systems for this purpose or early intervention have been hindered partially due to invasive placement of large diameter intravascular devices or high circuit blood flows necessary for available extracorporeal CO2R (ECCO2R) devices. We are in development of mechanical and enzymatic approaches that facilitate high efficiency CO2 removal in artificial lung devices to minimize invasiveness of treatment with no or low blood flow outside the body. The impeller percutaneous respiratory assist catheter (IPRAC) uses an array of rotating impellers in an annular bundle to generate an “active mixing” effect that enabled the highest efficiency CO2R of any reported artificial lung device. We investigated additional impeller design parameters finding gas exchange could be significantly improved by reducing impeller axial spacing. Total gas exchange in the IPRAC was improved by 10% versus previous work. The impeller system was adapted for extracorporeal use in the ultra-low-flow ECCO2R device (ULFED) with the objective of matching blood flow rates common for renal hemodialysis (250 mL/min). Effective CO2R at ultra-low-flows enables adaptation of common renal hemodialysis connection strategies with potential for use with dialysis equipment or to be spliced directly in existing dialysis circuitry. CO2 removal up to 75 mL/min (30-37% metabolic CO2 production) at hemodialysis blood flows was demonstrated in the ULFED. The effects of bundle aspect ratio and impeller length on gas exchange were evaluated. Reducing bundle diameter was found to improve CO2 removal performance, while bundle and impeller length insignificantly affected performance. Subsequent in vitro hemolysis testing showed the ULFED to be comparable to a control circuit, indicating no hemolysis related issues are anticipated in vivo. Carbonic anhydrase (CA) enzyme fiber coatings were also evaluated for CO2R enhancement. CA fibers previously demonstrating 37% improved performance with specific applications at ultra-low blood flows. Mini-ULFED prototypes were fabricated but did not significantly outperform control fibers in gas exchange testing versus active mixing alone

Sublethal salinity stress contributes to habitat limitation in an endangered estuarine fish.

As global change alters multiple environmental conditions, predicting species' responses can be challenging without understanding how each environmental factor influences organismal performance. Approaches quantifying mechanistic relationships can greatly complement correlative field data, strengthening our abilities to forecast global change impacts. Substantial salinity increases are projected in the San Francisco Estuary, California, due to anthropogenic water diversion and climatic changes, where the critically endangered delta smelt (Hypomesus transpacificus) largely occurs in a low-salinity zone (LSZ), despite their ability to tolerate a much broader salinity range. In this study, we combined molecular and organismal measures to quantify the physiological mechanisms and sublethal responses involved in coping with salinity changes. Delta smelt utilize a suite of conserved molecular mechanisms to rapidly adjust their osmoregulatory physiology in response to salinity changes in estuarine environments. However, these responses can be energetically expensive, and delta smelt body condition was reduced at high salinities. Thus, acclimating to salinities outside the LSZ could impose energetic costs that constrain delta smelt's ability to exploit these habitats. By integrating data across biological levels, we provide key insight into the mechanistic relationships contributing to phenotypic plasticity and distribution limitations and advance the understanding of the molecular osmoregulatory responses in nonmodel estuarine fishes

The politics of trade unionism in Ghana: A case-study of the Railway Workers Union.

Trade unions in Ghana are, generally speaking, fairly recent in origin and politically ineffectual. The Railway Union is an important exception. This was the spontaneous creation during the 1920's of African skilled workers in the Sekondi workshops, who, together with the harbour workers of nearby Takoradi (conjointly the bulk and most active section of the Union's membership) have since maintained an exceptionally militant style of unionism. On several occasions, most notably the railway strikes of 1950, 1961, and 1971, these workers have demonstrated their importance as a major power centre within Ghanaian society, together with a notable readiness to engage in oppositional political activity against successive ruling regimes. The political strength of the railway workers derives in part from their strategic position in the national economy, but also from the high degree of corporate solidarity which enables them to exploit this position so effectively. Concentrated in large numbers in the Sekondi-Takoradi workshop and harbour installations, and free of serious ethnic divisions, the skilled railway workers form a close-knit cultural community. Within this community, the ethic of corporate solidarity is strengthened by shared attitudes toward the developing social structure and by the force of historical tradition. The railway workers' political orientation is not adequately conceived or explained in terms of their association with particular political parties. The most striking aspect of their historical behaviour has been its independent character, together with the ideological continuity which has informed their relationship with both colonial and post-colonial regimes. In some respects, this might be described as a form of class- consciousness. It differs from the classical Marxian model, however, in that the railway workers see themselves as representatives of the urban 'masses' rather than a clearly differentiated working-class, and, further, in that this mass constituency tends to be communally defined