Theories of Grammar, Thoughts of God

This essay is an exploration of the potential of modern scientific linguistic study to provide insight into the ways of God

A Comparison of Critical Thinking Ability and Clinical Judgement Skills in Associate and Baccalaureate Senior Nursing Students

The purpose of this descriptive, correlational study was to compare the critical thinking and clinical judgement skills of senior nursing students at two educational levels. A convenience sample of 34 students in the Midwest was obtained during the spring semester before graduation (n = 19 baccalaureate, n = 15 associate). The framework for the study was decision theory. Critical thinking ability was measured by the Watson Glaser Critical Thinking Appraisal. Clinical judgement was determined by the ability to recognize cues, provide nursing diagnosis, interventions and corresponding rationale after viewing five video vignettes produced by Performance Management Services. Demographic data was obtained to determine if there were any relationships with either critical thinking or clinical judgement ability. Findings of t-tests indicated that there was no difference in critical thinking ability or clinical judgement skills between baccalaureate and associate senior nursing students. Using Pearson\u27s r correlation coefficient, a positive correlation was found between critical thinking ability and clinical judgement. A positive correlation was also found between grade point average and critical thinking ability as well as clinical judgement. A larger sample as well as a longitudinal and qualitative study may provide more predictive and generalizable data

Metrical dependencies in tone assignment

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Linguistics and Philosophy, 1989.Includes bibliographical references (leaves 343-350).by Brian Mark Sietsema.Ph.D

Biomechanical Evaluation of fracture Fixation Constructs using a Variable-angle Locked Periprosthetic Femur Plate System

BackgroundIn the United States there are more than 230,000 total hip replacements annually, and periprosthetic femoral fractures occur in 0.1–4.5% of those patients. The majority of these fractures occur at the tip of the stem (Vancouver type B1). The purpose of this study was to compare the biomechanically stability and strength of three fixation constructs and identify the most desirable construct.MethodsFifteen medium adult synthetic femurs were implanted with a hip prosthesis and were osteotomized in an oblique plane at the level of the implant tip to simulate a Vancouver type B1 periprosthetic fracture. Fractures were fixed with a non-contact bridging periprosthetic proximal femur plate (Zimmer, Inc., Warsaw, IN). Three proximal fixation methods were used: Group 1, bicortical screws; Group 2, unicortical screws and one cerclage cable; and Group 3, three cerclage cables. Distally, all groups had bicortical screws. Biomechanical testing was performed using an axial-torsional testing machine in three different loading modalities (axial compression, lateral bending, and torsional/sagittal bending), next in axial cyclic loading to 10,000 cycles, again in the three loading modalities, and finally to failure in torsional/sagittal bending.ResultsGroup 1 had significantly greater load to failure and was significantly stiffer in torsional/sagittal bending than Groups 2 and 3. After cyclic loading, Group 2 had significantly greater axial stiffness than Groups 1 and 3. There was no difference between the three groups in lateral bending stiffness. The average energy absorbed during cyclic loading was significantly lower in Group 2 than in Groups 1 and 3.ConclusionsBicortical screw placement achieved the highest load to failure and the highest torsional/sagittal bending stiffness. Additional unicortical screws improved axial stiffness when using cable fixation. Lateral bending was not influenced by differences in proximal fixation.Clinical RelevanceTo treat periprosthetic fractures, bicortical screw placement should be attempted to maximize load to failure and torsional/sagittal bending stiffness

Linguistics

Contains table of contents for Section 4, an introduction and abstracts for three doctoral dissertations

Recombinant Human Bone Morphogenetic Protein-2 in Posterolateral Spinal Fusion: What's the Right Dose?

Study DesignSingle center retrospective cohort analysis.PurposeThe goal was to evaluate the influence of varying amount of recombinant human bone morphogenetic protein 2 (rhBMP-2) per level on fusion rates and complications in posterolateral spinal fusions.Overview of LiteraturerhBMP-2 has been utilized for lumbar posterolateral fusions for many years. Initial rhBMP-2 recommendations were 20 mg/level of fusion. Dose and concentration per level in current studies vary from 4.2 to 40 mg and 1.5 to 2.0 mg/mL, respectively. Variable fusion and complication rates have been reported.MethodsPatients (n=1,610) undergoing instrumented lumbar spinal fusion (2003–2009) with utilization of rhBMP-2 were retrospectively evaluated. Patient demographics, body mass index (BMI), comorbidities, number of levels, associated interbody fusion, and types of bone void filler were analyzed. Fusions rates and nonunions were subdivided into number of levels and amount of rhBMP-2 used per level.ResultsPatients (n=559) were evaluated with 58.5% females having an average age of 63 years, BMI of 31 kg/m2. Number of levels fused ranged from 1 to 8. rhBMP-2 averaged 7.3 mg/level (range, 1.5–24 mg/level) based upon length of collagen sponge in relation to length of fusion levels. Patients with non-union formation had lower rhBMP-2 dose per level (p=0.016). A significant difference in non-union rate was found between patients undergoing fusion with 6 mg/level (9.1% vs. 2.4%, χ2=0.012). No significant differences were noted between 6–11.9 mg/level and ≥12 mg/level. No threshold was found for seroma formation or bone overgrowth.ConclusionsPrevious recommendation of 20 mg/level of rhBMP-2 is more than what is required for predictable fusion rates of 98%. No dose related increase of infection, seroma formation, and bone overgrowth has been found. In order to provide variable dosing and cost reduction, industry generated rhBMP-2 kit size should be optimized

At identical isowork rates, ageing influences cardiorespiratory adaptations in COPD out-patients

SummaryPurposeTo determine the extent to which younger COPD patients improve their cardiorespiratory function during exercise in comparison with older COPD patients, as a result of exercise training.MethodsThirty-nine COPD patients underwent an exercise program. They were divided into two groups: a younger group (57.2±1.0 years, n=18 patients) and an older group (68.8±0.6 years, n=21 patients). Forced expiratory volume in 1s was lower than 55% of the predicted value for all patients.ResultsAfter training, V˙O2 symptom-limited significantly improved by 10.3% and 8.4% for the younger and older COPD patients, respectively (P<0.05). Peak power significantly improved by 25.2% and 17.8% in the younger and older groups, respectively (P<0.05) with a greater improvement for the younger group (P<0.05). At submaximal exercise, ventilation and heart rate significantly decreased after training in the younger COPD patients (P<0.05) with no significant modification in the older COPD patients.ConclusionsThe results suggest that all patients with COPD benefit from exercise rehabilitation at maximal exercise workload, however, according to their age, submaximal cardiorespiratory adaptations were greater in younger patients