Development of a Delirium Educational Program for Hospital Medicine Providers

Hospital medicine providers were surveyed to evaluate baseline delirium attitudes and behaviors. An educational program was then shared, and a follow up survey was given to determine if their delirium attitudes and practices were impacted by the educational intervention. Follow up survey results indicated that providers perceived more of a change in their attitudes than practices, and overall found the education to be useful and felt more confident in treating delirium as a result

Gukundana

Twenty years after the 1994 Rwandan Genocide, Violet Walters makes her way to the tiny village of Murumba to fulfill her dream of becoming a philanthropist. In addition to the shock of a new culture, Violet must now contend with Bret Calloway, a hardened philanthropist whose ten years at Murumba have made him less than happy about the arrival of Violet and her optimistic new perspective. Amid the mounting tension of their relationship, war looms in the background. What ensues is a testament to the transformational nature of a culture and its people. Gukundana seeks to illuminate injustices related to civil strife and genocide from an outsider\u27s perspective. The character of Violet acts as a stable lens from which western viewers can engage with cultural hardships very different from their own. Within this, the connection between the warring ideologies of Bret and Violet against the background of the mounting violence around them serves as another window into greater emotional engagement with themes of violence and war. Ultimately, this screenplay\u27s mission is to bridge cultural barriers in order to endear viewers to the unity, resiliency, and power of the Rwandan people, thus sparking change within a viewing audience\u27s surrounding community

The role of channel fens in permafrost degradation induced changes in peatland discharge at Scotty Creek, NT

Permafrost degradation in the peat-rich southern fringe of the discontinuous permafrost zone is producing substantial changes to land cover with concomitant expansion of permafrost-free wetlands (bogs and fens) and shrinkage of forest supported by permafrost peat plateaus. Predicting discharge from headwater basins in this region depends on understanding and numerically representing the interactions between storage and discharge within and between the major land cover types, and how these interactions are changing. To better understand the implications of land cover change on wetland discharge, the hydrological behaviour of a channel fen in the headwaters of Scotty Creek, Northwest Territories, Canada, dominated by peat plateau-bog complexes, was modelled using the Cold Regions Hydrological Modelling platform for the period of 2009 to 2015. The model performance was evaluated against measured snow depth, snow water equivalent (SWE), evapotranspiration (ET), and water level. The model adequately simulated snowpack dynamics, with root mean square errors (rmse) not greater than 11.8 cm for hourly snow depth at a point and 37 mm for annual maximum SWE from snow survey transects. The model generally captured seasonal ET flux and water level fluctuation, with rmse less than 0.089 mm/hr and 50 mm, respectively. After model performance evaluation, a sensitivity analysis was conducted to assess the consequences of permafrost loss on discharge from the sub-basin by incrementally reducing the ratio of peat plateau to wetland area in the modelled sub-basin. Reductions in permafrost extent decreased total annual discharge from the channel fen by 2.5% on average for every 10% permafrost loss, due to increased surface storage capacity, reduced runoff efficiency and increased landscape ET. Runoff ratios for the fen hydrological response unit dropped from 0.54 to 0.48 after the simulated 50% permafrost area loss, with a substantial reduction from 0.47 to 0.31 during the snowmelt season. The reduction in peat plateau area also resulted in decreased intra-annual variability in discharge, with higher low-flows and small increases in subsurface discharge, and decreased peak discharge with large reductions in surface runoff. The current trend of increasing discharge observed in the Scotty Creek basin may not be permanent, as this model shows that a completely connected sub-basin results in decreasing channel fen discharge with further land cover change

On nonparametric maximum likelihood for a class of stochastic inverse problems

We establish the consistency of a nonparametric maximum likelihood estimator for a class of stochastic inverse problems. We proceed by embedding the framework into the general settings of early results of Pfanzagl related to mixtures

You Are What You Eat: Malnutrition and its Determinants in Ecuador:

Thesis advisor: John MichalczykWhy do we eat the foods that we do? This question is one that is not often considered by individuals as they go about their daily lives, but can have large implications on public health – for, there is a strong, physiological connection between food consumption and one’s health and wellbeing. Accordingly, when reflecting upon the health of a nation it is often important to consider its nutritional status. Ultimately, many determinants can contribute to how and why an individual eats certain foods, as can be seen in Ecuador. In this Latin American country, for instance, historical, socioeconomic, cultural, behavioral, socioeconomic, and environmental factors (among others) can be seen to influence the different diets – and by extension, the nutritional statuses – of different ethnic, regional, and geographic populations. Though common across Ecuador, discrepancies among these groups are particularly noticeable in the highland region, the Sierra. Overall, this paper examines the different forms of malnutrition, their implications on one’s health, and their prevalence across Ecuador. Additionally, it considers how the Ecuadorian diet was shaped, and how different subcuisines lend themselves to varying forms of malnutrition. Specifically, this paper focuses on the Sierra, given that levels of malnutrition are noticeably higher in this region, and that this highland area is home to large rural and indigenous communities who are most significantly impacted by the region’s nutritional conditions.Thesis (BS) — Boston College, 2017.Submitted to: Boston College. College of Arts and Sciences.Discipline: Arts and Sciences Honors Program.Discipline:

Missionary Kids and Trauma

AbstractMissionary Kids and Trauma by Lindsay E. Stone MA, Walden University, 2019MA, Southwestern Baptist Theological Seminary, 2010 BS, Charleston Southern University, 2006 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Human and Social Services Walden University February 2021 Abstract Missionary kids (MKs) around the world are more exposed to trauma than non-MKs. MKs often struggle with grief, loss, and stressors of cross-cultural living. Childhood trauma leads to short-and long-term effects of trauma, often into adulthood. The purpose of this basic qualitative study was to explore adult, Christian MKs’ perceptions of external trauma on the mission field. Contemporary trauma theory was used to frame this study. Semistructured interviews were conducted with 8 adult MK participants. These interviews were recorded, transcribed, and hand coded for analysis using Lui’s 5 steps of data analysis: (a) initial reading of the text data, (b) identification of specific text segments related to the objectives, (c) labelling the segments of the text to create categories, (d) reducing overlap and redundancy among the categories, and (e) creating a model incorporating most important categories. The thematic analysis results indicated that MKs experienced difficulty with: (a) mental health; (b) civil unrest; (c) physical harm; (d) separation from loved ones and uprooting, “goodbyes;” (e) lack of support; (f) difficulty with cultural identity, belonging, and language barriers; and (g) experience with epidemics and natural disasters. This study promotes positive social change by providing a better understanding of MKs and their perceptions of their experiences on the field in regard to trauma. MKs may benefit from the results of this study through receiving better support services created specifically for MKs who have experienced trauma

Preventing respiratory viral transmission in long-term care: Knowledge, attitudes, and practices of healthcare personnel

OBJECTIVETo examine knowledge and attitudes about influenza vaccination and infection prevention practices among healthcare personnel (HCP) in a long-term-care (LTC) setting.DESIGNKnowledge, attitudes, and practices (KAP) survey.SETTINGAn LTC facility in St Louis, Missouri.PARTICIPANTSAll HCP working at the LTC facility were eligible to participate, regardless of department or position. Of 170 full- and part-time HCP working at the facility, 73 completed the survey, a 42.9% response rate.RESULTSMost HCP agreed that respiratory viral infections were serious and that hand hygiene and face mask use were protective. However, only 46% could describe the correct transmission-based precautions for an influenza patient. Correctly answering infection prevention knowledge questions did not vary by years of experience but did vary for HCP with more direct patient contact versus less patient contact. Furthermore, 42% of respondents reported working while sick, and 56% reported that their coworkers did. In addition, 54% reported that facility policies made staying home while ill difficult. Some respondents expressed concerns about the safety (22%) and effectiveness (27%) of the influenza vaccine, and 28% of respondents stated that they would not get the influenza vaccine if it was not required.CONCLUSIONSThis survey of staff in an LTC facility identified several areas for policy improvement, particularly sick leave, as well as potential targets for interventions to improve infection prevention knowledge and to address HCP concerns about influenza vaccination to improve HCP vaccination rates in LTCs.Infect Control Hosp Epidemiol 2017;38:1449–1456</jats:sec

Setting up an arthroplasty care practitioner-led virtual clinic for follow-up of orthopaedic patients

AbstractThis article provides an overview of the set up for an arthroplasty care practitioner (ACP)-led virtual orthopaedic clinic (VOC). Suitable patients attend a local hospital for an X-ray and complete a questionnaire, but do not physically attend a clinic. This has been running successfully in a university teaching hospital and has led to cost savings, a reduction in outpatient waiting times and high levels of patient satisfaction. Similar clinics have the potential to become normal practice across the NHS. This article outlines the steps necessary to implement a successful VOC. The lessons learnt during this exercise may be useful for other ACPs when setting up a VOC

Learning and Doing Together: Student Outcomes from an Interdisciplinary, Community-Based Research Course on Homelessness in a Local Community

Colleges and universities continue to work toward innovative high-impact learning experiences to promote informed citizenship. Pedagogical research highlights the value of both interdisciplinary teaching and community-based participatory research (CBPR) in undergraduate civic development. Yet, research is limited in examining undergraduate student learning outcomes employing both pedagogical approaches. Utilizing mixed methods (i.e. surveys, concept maps, and focus groups) this study investigates the student learning outcomes of an interdisciplinary course (political science and criminal justice, community psychology, and social work) consisting of a CBPR project to inform local policy surrounding homelessness. Findings highlight student growth in the domains of: 1) interdisciplinary collaboration (applying an interdisciplinary lens and resolving diverse perspectives), 2) transference of course knowledge to real-world application, 3) critical consciousness building (specifically, critical reflection), 4) civic development, and 5) increased self-awareness. Finally, this paper highlights implications regarding course development, lessons learned, and future assessment