Tips for Teaching Knife Skills

This publication gives tips about teaching knife skills safely and effectively

Reading, A Major Factor in Determining Success in Nursing Education

For the last twenty-eight years the Reading Center and Clinic, at Western Michigan University, has been testing applicants for the Bronson School of Nursing. This school has room for only eighty-six entering freshmen each year; so it is vital that only the most capable applicants be selected

Evaluation of a Prelicensure Nursing Capstone Preceptorship

https://digitalcommons.psjhealth.org/summit_all/1053/thumbnail.jp

Late Holocene Stratigraphic History of the Gulf of Aqaba Coastal Plain, Jordan

Title from PDF of title page viewed November 9, 2020Thesis advisor: Tina M. NiemiVitaIncludes bibliographical references (pages 47-52)Thesis (M.S.)--Department of Earth and Environmental Sciences. University of Missouri--Kansas City, 2020Construction of the lower tidal lagoon at the Ayla Oasis Development in Aqaba, Jordan provided a unique opportunity to study the 3-D architecture of coastal plain sediment of the northern Gulf of Aqaba. Previous studies of sediment cores had identified a mid-Holocene transgression and a late Holocene regression. In this study, one cross-section of buried structures adjacent to the archaeological site of Tel el-Kheleifeh (8th-4th C. BCE) and two stratigraphic columns of 7 m-high outcrops that extended to a depth of 3.2 m below sea level were described and sampled for grain-size, SEM, and radiocarbon age analyses. The base of the section contains subtidal and beach sand and cobble gravel containing abundant shells and coral fragments. Three vertically stacked beachrock layers that developed in the intertidal zone indicate a rising sea level. The uppermost beachrock is found at an elevation of 1.3 m above present sea level and is constrained to be younger than 3.5 ka based on radiocarbon dating of shells. Raised reef, wave-cut notches, and other sea level indicators across the Gulf of Aqaba and northern Red Sea attest to a mid-Holocene highstand. A down-cutting event that eroded the beach sediment and is marked by an irregular unconformity and channels cut to depths below modern sea level. The channels are filled with a blue-gray gravel and sand with abundant rip-up clasts, terrestrial organic material, cross-bedding and convolute bedding which denote high flow velocities and rapid sedimentation. Radiocarbon dating of sediment above the channel constraint its age to before 3.1 ka. As rapid sea level change is not supported by regional evidence, the erosion and deposition of blue-gray channels are interpreted to represent inundation and drawdown of the sea by a tsunami. Similar erosion and deposition in low-lying areas has been documented in tsunamis in Sumatra, Chili, and the Kuril Islands.Introductions -- Regional environmental setting -- Methods -- Results -- Discussion -- Conclusion -- Appendix A. Sample metadata -- Appendix B. Weighed grain-size fractions -- Appendix C. Grain-size analyses using GRADISTAT software -- Appendix D. Radiocarbon calibration data -- Appendix E. XRD, SEM, EDS dat

Identification of a Hemolysis Threshold That Increases Plasma and Serum Zinc Concentration.

Background: Plasma or serum zinc concentration (PZC or SZC) is the primary measure of zinc status, but accurate sampling requires controlling for hemolysis to prevent leakage of zinc from erythrocytes. It is not established how much hemolysis can occur without changing PZC/SZC concentrations.Objective: This study determines a guideline for the level of hemolysis that can significantly elevate PZC/SZC.Methods: The effect of hemolysis on PZC/SZC was estimated by using standard hematologic variables and mineral content. The calculated hemolysis threshold was then compared with results from an in vitro study and a population survey. Hemolysis was assessed by hemoglobin and iron concentrations, direct spectrophotometry, and visual assessment of the plasma or serum. Zinc and iron concentrations were determined by inductively coupled plasma spectrometry.Results: A 5% increase in PZC/SZC was calculated to result from the lysis of 1.15% of the erythrocytes in whole blood, corresponding to ∼1 g hemoglobin/L added into the plasma or serum. Similarly, the addition of simulated hemolysate to control plasma in vitro caused a 5% increase in PZC when hemoglobin concentrations reached 1.18 ± 0.10 g/L. In addition, serum samples from a population nutritional survey were scored for hemolysis and analyzed for changes in SZC; samples with hemolysis in the range of 1-2.5 g hemoglobin/L showed an estimated increase in SZC of 6% compared with nonhemolyzed samples. Each approach indicated that a 5% increase in PZC/SZC occurs at ∼1 g hemoglobin/L in plasma or serum. This concentration of hemoglobin can be readily identified directly by chemical hemoglobin assays or indirectly by direct spectrophotometry or matching to a color scale.Conclusions: A threshold of 1 g hemoglobin/L is recommended for PZC/SZC measurements to avoid increases in zinc caused by hemolysis. The use of this threshold may improve zinc assessment for monitoring zinc status and nutritional interventions

The FEM Wiki Project: A Conversion of a Training Resource for Field Epidemiologists into a Collaborative Web 2.0 Portal

While an ever increasing popularity of online wiki platforms, user-tagging tools, blogs, and forums is the core characteristic of the Web 2.0 era, converting an existing high-quality training module into a collaborative online space for an active community of practice (CoP) while preserving its quality approval processes is a challenging task. This is the aim of the ECDC-funded Field Epidemiology Manual (FEM) wiki project, based on training resources organized in 17 chapters developed for the European EPIET epidemiology training programme. This paper describes the challenges, solutions, and development processes behind the FEM wiki portal – an online collaborative Web 2.0 platform taking advantage of the user-generated input while preserving the structure, editorial processes and style of the existing FEM manual. We describe the need for ECDC-recognised content and discuss the editorial roles developed in this European project but applicable to any other training resource converted into an online wiki platform

Exploring patterns of error in acute care using framework analysis

Background: Junior doctors are often the first responders to deteriorating patients in hospital. In the high-stakes and time-pressured context of acute care, the propensity for error is high. This study aimed to identify the main subject areas in which junior doctors' acute care errors occur, and cross-reference the errors with Reason's Generic Error Modelling System (GEMS). GEMS categorises errors according to the underlying cognitive processes, and thus provides insight into the causative factors. The overall aim of this study was to identify patterns in junior doctors' acute care errors in order to enhance understanding and guide the development of educational strategies. Methods: This observational study utilised simulated acute care scenarios involving junior doctors dealing with a range of emergencies. Scenarios and the subsequent debriefs were video-recorded. Framework analysis was used to categorise the errors according to eight inductively-developed key subject areas. Subsequently, a multi-dimensional analysis was performed which cross-referenced the key subject areas with an earlier categorisation of the same errors using GEMS. The numbers of errors in each category were used to identify patterns of error. Results: Eight key subject areas were identified; hospital systems, prioritisation, treatment, ethical principles, procedural skills, communication, situation awareness and infection control. There was a predominance of rule-based mistakes in relation to the key subject areas of hospital systems, prioritisation, treatment and ethical principles. In contrast, procedural skills, communication and situation awareness were more closely associated with skill-based slips and lapses. Knowledge-based mistakes were less frequent but occurred in relation to hospital systems and procedural skills. Conclusions: In order to improve the management of acutely unwell patients by junior doctors, medical educators must understand the causes of common errors. Adequate knowledge alone does not ensure prompt and appropriate management and referral. The teaching of acute care skills may be enhanced by encouraging medical educators to consider the range of potential error types, and their relationships to particular tasks and subjects. Rule-based mistakes may be amenable to simulation-based training, whereas skill-based slips and lapses may be reduced using strategies designed to raise awareness of the interplay between emotion, cognition and behaviour.</p

Sex differences in response to Marek’s Disease: mapping quantitative trait loci regions (QTLRs) to the Z chromosome

Marek’s Disease (MD) has a significant impact on both the global poultry economy and animal welfare. The disease pathology can include neurological damage and tumour formation. Sexual dimorphism in immunity and known higher susceptibility of females to MD makes the chicken Z chromosome (GGZ) a particularly attractive target to study the chicken MD response. Previously, we used a Hy-Line F6 population from a full-sib advanced intercross line to map MD QTL regions (QTLRs) on all chicken autosomes. Here, we mapped MD QTLRs on GGZ in the previously utilized F6 population with individual genotypes and phenotypes, and in eight elite commercial egg production lines with daughter-tested sires and selective DNA pooling (SDP). Four MD QTLRs were found from each analysis. Some of these QTLRs overlap regions from previous reports. All QTLRs were tested by individuals from the same eight lines used in the SDP and genotyped with markers located within and around the QTLRs. All QTLRs were confirmed. The results exemplify the complexity of MD resistance in chickens and the complex distribution of p-values and Linkage Disequilibrium (LD) pattern and their effect on localization of the causative elements. Considering the fragments and interdigitated LD blocks while using LD to aid localization of causative elements, one must look beyond the non-significant markers, for possible distant markers and blocks in high LD with the significant block. The QTLRs found here may explain at least part of the gender differences in MD tolerance, and provide targets for mitigating the effects of MD

Exploring patterns of error in acute care using framework analysis

Background: Junior doctors are often the first responders to deteriorating patients in hospital. In the high-stakes and time-pressured context of acute care, the propensity for error is high. This study aimed to identify the main subject areas in which junior doctors' acute care errors occur, and cross-reference the errors with Reason's Generic Error Modelling System (GEMS). GEMS categorises errors according to the underlying cognitive processes, and thus provides insight into the causative factors. The overall aim of this study was to identify patterns in junior doctors' acute care errors in order to enhance understanding and guide the development of educational strategies. Methods: This observational study utilised simulated acute care scenarios involving junior doctors dealing with a range of emergencies. Scenarios and the subsequent debriefs were video-recorded. Framework analysis was used to categorise the errors according to eight inductively-developed key subject areas. Subsequently, a multi-dimensional analysis was performed which cross-referenced the key subject areas with an earlier categorisation of the same errors using GEMS. The numbers of errors in each category were used to identify patterns of error. Results: Eight key subject areas were identified; hospital systems, prioritisation, treatment, ethical principles, procedural skills, communication, situation awareness and infection control. There was a predominance of rule-based mistakes in relation to the key subject areas of hospital systems, prioritisation, treatment and ethical principles. In contrast, procedural skills, communication and situation awareness were more closely associated with skill-based slips and lapses. Knowledge-based mistakes were less frequent but occurred in relation to hospital systems and procedural skills. Conclusions: In order to improve the management of acutely unwell patients by junior doctors, medical educators must understand the causes of common errors. Adequate knowledge alone does not ensure prompt and appropriate management and referral. The teaching of acute care skills may be enhanced by encouraging medical educators to consider the range of potential error types, and their relationships to particular tasks and subjects. Rule-based mistakes may be amenable to simulation-based training, whereas skill-based slips and lapses may be reduced using strategies designed to raise awareness of the interplay between emotion, cognition and behaviour.</p