The Birchwood Lakeside Cottages 1961

An advertising brochure for a resort on Lake Cobbosseecontee in Winthrop Maine.https://digitalmaine.com/books/1063/thumbnail.jp

Anesthesia Related Outcomes in Patients Receiving Regional Anesthesia for Shoulder Surgery in a CRNA-Only Practice In the Rural Setting

The purpose of this retrospective chart review was to characterize the complication rate and outcomes among a group of patients receiving regional anesthesia (RA) undergoing shoulder surgery in the rural setting utilizing a Certified Registered Nurse Anesthetist (CRNA) only model. Demographic information was obtained. Patients were primarily ASA 2 and 3 classifications and were outpatients with a mean age of 52.6 years. The most common preoperative diagnosis was rotator cuff tear. The recorded procedure was most often shoulder arthroscopy. RA was performed on 70 patients (92.1%) with 6 (7.9%) patients receiving no RA. General anesthesia (GA) was administered with RA to 68 (89.5%) patients with the remainder receiving sedation with RA. Pain scores as measured by visual analogue scale (VAS) reflected effective analgesia. The mean VAS score reported on arrival to PACU was 1.27, after one hour 1.69, and 0.38 upon discharge from PACU. Postoperative analgesics were required for 26 (34.2%) patients. The incidence of postoperative nausea or vomiting was 6.6% of patients reporting nausea and 2.6% patients experiencing emesis. The mean anesthesia time was 127.3 minutes with mean operating room time of 121.2 minutes. Mean time in PACU was 134.6 minutes. The descriptive data attained in the analysis demonstrate RA as a safe and effective supplement to GA administered by CRNAs in a rural setting. Future research is needed specific to CRNA-only practice models and rural settings and should include controlled randomized trials to evaluate outcomes in groups consisting of GA, GA+RA, RA + sedation and even RA alone in select populations

Brunner's Gland Hyperplasia: Treatment of Severe Diffuse Nodular Hyperplasia Mimicking a Malignancy on Pancreatic-Duodenal Area

Brunner's gland hyperplasia is a benign tumor of the duodenum and it is rarely associated with clinical symptoms. We report on a 64-yr-old man with Brunner's gland hyperplasia who had undergone a duodenocephalo-pancreatectomy. The reason is that he presented upper gastrointestinal obstructive symptoms and the esophagogastroduodenoscopic finding revealed the lesion to be an infiltrating type mass on the second portion of the duodenum with luminal narrowing. An abdominal computed tomography showed a 2.5 cm-sized mass in the duodenal second portion with a suspicious pancreatic invasion and 7 mm-sized lymph node around the duodenum. Duodenocephalopancreatectomy was successfully performed. Histological examination revealed a Brunner's gland hyperplasia. The final diagnosis was the coexistence of Brunner's gland hyperplasia and pancreatic heterotopia with a pancreatic head invasion. The literature on Brunner's gland hyperplasia is reviewed

The Presentation of Temperature Information in Television Broadcasts: What is Normal?

In a typical weather broadcast, observed daily temperature information such as maximum and minimum temperatures are shown and compared to the daily average or “normal”. Such information, however, does not accurately describe whether or not that particular day is fairly typical for that time of year or truly an unusual occurrence. Thus it is suggested that the presentation of temperature information can be augmented with elementary statistical information in order to give a more meaningful presentation of temperature information without the need to explain the basis of such statistical information. A study of the climatological maximum and minimum temperatures over a 30-year period for Columbia, Missouri is performed in order to provide the rationale for displaying a "typical" temperature range. This information was incorporated into television weather broadcasts at KOMU TV-8, which is the campus television station and local NBC affiliate

A Systematic Review of the Literature on Parenting of Young Children with Visual Impairments and the Adaptions for Video-Feedback Intervention to Promote Positive Parenting (VIPP)

Secure parent-child attachment may help children to overcome the challenges of growing up with a visual or visual-and-intellectual impairment. A large literature exists that provides a blueprint for interventions that promote parental sensitivity and secure attachment. The Video-feedback Intervention to promote Positive Parenting (VIPP) is based on that blueprint. While it has been adapted to several specific at risk populations, children with visual impairment may require additional adjustments. This study aimed to identify the themes that should be addressed in adapting VIPP and similar interventions. A Delphi-consultation was conducted with 13 professionals in the field of visual impairment to select the themes for relationship-focused intervention. These themes informed a systematic literature search. Interaction, intersubjectivity, joint attention, exploration, play and specific behavior were the themes mentioned in the Delphi-group. Paired with visual impairment or vision disorders, infants or young children (and their parents) the search yielded 74 articles, making the six themes for intervention adaptation more specific and concrete. The rich literature on six visual impairment specific themes was dominated by the themes interaction, intersubjectivity, and joint attention. These themes need to be addressed in adapting intervention programs developed for other populations, such as VIPP which currently focuses on higher order constructs of sensitivity and attachment

Bin Half Full: Construction Waste Recycling Solutions

According to the City of Portland’s Office of Sustainable Development (OSD), construction, remodeling, and demolition (CR&D) waste comprises 20 percent of the City’s waste stream. Additionally, per capita waste generation in this sector is increasing faster than in the residential or commercial sectors. However, the current amount of CR&D waste that is landfilled can be reduced: 90 percent of the waste from a typical project can be diverted from landfill disposal. Although OSD currently requires that 50 percent of CR&D waste from every project is recycled, the City estimates that contractors recycle slightly less than this. OSD’s Portland Recycles! Plan (PRP) mandates that CR&D waste that contractors recycle or salvage and reuse increase to 75 percent of the total weight of a project’s waste by 2015. This document synthesizes the findings of Project Team Bin Half Full (BHF) and provides recommendations to help general contractors meet OSD’s new mandate. Additional recommendations for haulers, facilities, policy makers and the recycling process are also provided. This project was conducted under the supervision of Sy Adler and Ethan Seltzer

The Birchwood Lakeside Cottages 1961

An advertising brochure for a resort on Lake Cobbosseecontee in Winthrop Maine.https://digitalmaine.com/books/1063/thumbnail.jp

Current Practices and Considerations regarding Long Cane Instruction with Preschool Children

Orientation and mobility (O&amp;M) specialists are instructing an increasing number of preschool-age children who are visually impaired. With the growth in O&amp;M services to these children comes questions regarding the provision of long cane instruction. This article reports the findings of a survey of 37 O&amp;M specialists who serve preschool-age children. It presents demographics of the children and the specialists involved in long cane instruction and identifies and evaluates the important factors that are related to the decision to begin this instruction. </jats:p