Breast Fibroadenomas

Breast fibroadenomas are common benign (non-cancerous) breast tumors made up of glandular and stromal (connective tissue) found in women of all ages. Fibroadenomas take on a solid lump feeling like a marble in the breast. They often cause no pain to the patient and are unilateral. There are four types of breast fibroadenomas: complex fibroadenoma, juvenile fibroadenoma, giant fibroadenoma, and phyllodes tumor. Each type has their own distinct characteristics. Fibroadenomas tend to shrink after a woman goes through menopause. While there is no medical treatment or medicine to decrease the lumps, surgical excision may be necessary if the lumps are increasing in size, becoming painful, and if there is any uncertainty between breast fibroadenomas and other health conditions. It is important for women who have breast fibroadenomas to participate in yearly mammograms to confirm the fibroadenomas are not growing. A case report showed the findings of a 26-year-old female with a lump measuring 6 x 3 cm in her right breast. Her left breast was normal with no problems and the axillary lymph nodes were evident. An ultrasound verified the diagnosis of a non-cancerous breast fibroadenoma. An excisional biopsy was arranged to remove the fibroadenoma.https://digitalcommons.misericordia.edu/medimg_seniorposters/1006/thumbnail.jp

Desalination for Sustainable Water Production with an Emphasis on Low Pressure Distillation

Freshwater resources depletion is a growing concern. This freshwater scarcity motivates research into seawater desalination as a means for alleviating the stresses on water demands. The primary methods of desalination include filtration and distillation. This paper explores the potential energy savings of vacuum distillation for seawater desalination to reduce the amount of energy needed to achieve phase change. Depending on the vacuum boiler design, the vaporization mechanism may be boiling, evaporation, or cavitation. There is very little literature on cavitation that involves mass transfer, so cavitation is not developed here. This thesis focuses on standard models for boiling and evaporation at STP then explores the potential for these models to represent vacuum desalination. To model the transition to vacuum, the model parameters are changed for boiling. The resulting fresh water mass outputs are presented. The purpose is to determine if low pressure conditions are favorable to producing freshwater compared to STP. The final output of this thesis is a proposed algorithm for estimating fresh water mass transfer from a solar vacuum distillation process as a function of heat and electrical inputs

Cohesive Integration of E-Learning in Nursing Leadership Reality

There is a constant challenge to develop and implement courses in a manner that leads to direct translation of principles and skills to the workplace. As health care is an everchanging field, nursing faculty are faced with a constant state of flux that leads to research, review and re-creation of course materials. Most students in graduate nursing programs are nontraditional students. These students need to apply their newly learned skills in order to remain motivated and see the immediate value from course work. Problem-based learning is a way to meet the needs of nursing students. Creating unique opportunities through the combination of distance learning, virtual face to face interaction, and local practica experiences not only leads to student success, but profound student satisfaction. It is the value-added hybrid intervention that leads to the development of work-ready students and nurse leaders

Learn, Reflect, Practice, Discuss: A Professional Development Pilot for Clinical Nurse Educators

Abstract AIM: The aim of this project was to assess the effect of a professional development pilot on the self-efficacy among clinical nurse educators toward evaluation and assessment of students in the clinical setting. BACKGROUND: Nursing schools employ clinical nurse faculty with varied levels of experience and formal education in teaching. Positive student outcomes are dependent on the competency of their nursing faculty, yet best practices to train and support the professional growth of clinical faculty have not yet been identified. METHOD: A multi-modal professional development pilot including online-learning modules, self-reflection, practice-learning, and peer-mentoring components was designed and implemented with a small group of clinical nursing faculty (n=9). Participants were provided a survey on self-efficacy toward teaching prior to and following this professional development pilot. RESULTS: Mean scores in total self-efficacy toward teaching were somewhat increased following participation in this pilot (r = 0.246, Z = - 0.676, p = 0.499) with a pre-post survey percent change of 3.98 percent (n = 7). More notably the percent change in self-efficacy in the subscale of exam and evaluation increased by 10.98 percent (n = 7). CONCLUSION: Results suggest that this professional development pilot was successful in increasing self-efficacy toward evaluation and assessment of students in the clinical setting among clinical nurse educators

STUDY ON LITHIUM MONITORING AMONGST PATIENTS IN A COMMUNITY MENTAL HEALTH AND PRIMARY CARE SETTING IN RURAL ENGLAND

Background: Lithium is widely used as a mood stabilizer in managing Bipolar Disorder. It is also licensed as an augmenting agent for recurrent depression and treatment resistant depression. However, it has a narrow therapeutic index with potentially significant side effects and adverse drug interactions. Toxicity is one of the main concerns for prescribers and serum levels should be checked regularly. Also, due to the adverse effects on Kidneys and Thyroid, there are strict guidelines to monitor the kidney as well as thyroid functions periodically. Whilst the need to monitor blood biochemistry is well established, less well recognized is the need to monitor patients’ physical health by means of annual checks of Body Mass Index (BMI) and waist circumference. Aim: The purpose of this study was to investigate compliance against the NICE CG185 guidelines. Hereford is a rural town in England with a population of about 180000. Currently, the Herefordshire part of 2gether Mental Health NHS Foundation Trust does not have clearly agreed shared care protocols for Lithium monitoring. Lithium monitoring is done by GPs as part of QOF targets. As Psychiatrists recommend treatment with lithium, they have the responsibility to have an updated results and act on these appropriately. Therefore, an important aspect of this audit was to identify monitoring gaps that may result from the dual ownership of patient care. Results: We found that 80% of cases complied with NICE guidance as regards blood monitoring however, only 40% of cases were compliant as regards checks on the physical health parameters of BMI and weight. Conclusion: The blood biochemistry of patients on lithium is generally well monitored however, physical health assessment is rarely completed with the required annual frequency and, waist circumference is almost never measured; either on initiation of lithium therapy or, on an on-going basis. More needs to be done to promote awareness of the need to monitor the physical health of patients on lithium and, in particular, to ensure that these checks include measurement of waist circumference. We believe that to improve monitoring of patients on lithium, shared care protocols should be developed between mental health services and GP services

The Best Available Evidence: Assessing the Quality of Nursing Students’ Bibliographies

Librarians and academic staff suggest a relationship between the quality of references which students use in academic assignments and the marks received. This study tested that assertion by using a citation analysis methodology to assess the quality of bibliographies written by undergraduate nursing students at the University of York.Bibliographies from sixty essays across three modules were analysed, noting the types and quantities of references used and whether references were sourced independently or included in the module’s reading list. Each bibliography was given an overall quality rating: ‘Poor’, ‘Average’ or ‘Good’. This rating was compared with the mark the student was awarded for the essay.Results showed that, whilst students demonstrated the ability to locate items independently, the quality of those items was often poor. Generally, quality of selected sources and bibliographies improved as students progressed through the programme. There was an association between higher quality bibliographies and higher assignment marks.The study concludes that critical thinking skills are vital for nursing students to develop academically, as these skills will be tested within a clinical environment once students have completed their degree. A benefit for students is the conclusion that using higher quality sources results in higher marks

In a network of lines that intersect: The socio-economic development impact of marine resource management and conservation in Southeast Asia

Marine protected areas (MPAs) are rapidly spreading to meet global conservation targets, but new governance arrangements can have unintended impacts on socio-economic development that can undermine and counteract their intended outcomes. We use an exploratory mixed-method research design to understand these development impacts and their underlying mechanisms, guided by an innovative activity space framework that situates marine resource management and conservation in a network of relationships between communities, human services, and nature. Qualitative research – based on 22 interviews in Koh Sdach Archipelago, Cambodia – demonstrates how the local community experienced improving relationships with the state and a slowing deterioration of marine resources, but also social division, heightened livelihood anxiety, and potentially a false sense of economic security. We hypothesise on this basis that marine conservation could impede socio-economic development, for which we find support in our quantitative analysis across Cambodia, the Philippines, and Timor-Leste: MPAs materialised in better-off communities but were associated with slower and partly regressive socio-economic development, in particular decreasing wealth and increasing child mortality. These findings suggest that the rapid global expansion of MPA coverage in its current, environmental-conservation-focused form is problematic as it disregards local social realities. Livelihood adaptation support should complement the implementation of marine resource governance mechanisms to mitigate unintended negative consequences

Habitat specialization and the role of trait lability in structuring diverse willow (genus Salix) communities

Abstract. The co-occurrence of closely related species is challenging to explain because biotic filters are expected to limit the ecological similarity of species within communities. To investigate the mechanisms important in facilitating species' co-occurrence in diverse willow and poplar communities, we examined functional diversity and community phylogenetic structure along a hydrologic gradient. We focused on traits related to drought tolerance, leaf hydraulics, and recruitment, and examined species' phylogenetic relatedness and trait lability using a molecular phylogeny. Within habitats, species exhibited phenotypic clustering, and across the landscape, species distributions were correlated with their functional traits in a manner consistent with environmental filtering. With increasing water availability, communities changed from being phylogenetically even to being phylogenetically clustered. We suggest that this shift results from environmental filtering acting on conserved traits in wet habitats and labile traits in dry habitats. Taken together, these results suggest that environmental filtering is important to community assembly along the entire hydrologic gradient within this system. Although many of the traits important to habitat specialization in upland habitats are phylogenetically labile, species' habitat affinity is phylogenetically conserved overall, indicating that niche conservatism can occur as an emergent property despite trait lability. This study demonstrates the complementary nature of trait and community phylogenetic analyses and how these methods can be used to better understand the processes involved in community assembly along environmental gradients

Habitat specialization and the role of trait lability in structuring diverse willow (genus Salix) communities

Abstract. The co-occurrence of closely related species is challenging to explain because biotic filters are expected to limit the ecological similarity of species within communities. To investigate the mechanisms important in facilitating species' co-occurrence in diverse willow and poplar communities, we examined functional diversity and community phylogenetic structure along a hydrologic gradient. We focused on traits related to drought tolerance, leaf hydraulics, and recruitment, and examined species' phylogenetic relatedness and trait lability using a molecular phylogeny. Within habitats, species exhibited phenotypic clustering, and across the landscape, species distributions were correlated with their functional traits in a manner consistent with environmental filtering. With increasing water availability, communities changed from being phylogenetically even to being phylogenetically clustered. We suggest that this shift results from environmental filtering acting on conserved traits in wet habitats and labile traits in dry habitats. Taken together, these results suggest that environmental filtering is important to community assembly along the entire hydrologic gradient within this system. Although many of the traits important to habitat specialization in upland habitats are phylogenetically labile, species' habitat affinity is phylogenetically conserved overall, indicating that niche conservatism can occur as an emergent property despite trait lability. This study demonstrates the complementary nature of trait and community phylogenetic analyses and how these methods can be used to better understand the processes involved in community assembly along environmental gradients