Sea Interdictions: Are Aliens Apprehended On The High Seas Entitled To Protections Afforded By The Immigration And Nationality Act

As more and more foreign nationals attempt entry into the United States by sea, legal scholars and lay persons have become interested in issues related to alien rights

Oxygenation in The Anesthetized Morbidly Obese Patients Population

Obesity in America is a known public health epidemic. Not only are more Americans considered obese, many are now classified as morbidly obese based on extreme excesses of Body Mass Index (BMI). As the incidence of obesity continues to climb, the need for enhanced knowledge in caring for this patient population exists. Obesity negatively affects nearly every physiological process and patients with obesity present unique challenges for the healthcare provider including the Certified Registered Nurse Anesthetist (CRNA). Of particular concern to CRNAs arc the changes th, 1. occur to the pulmonmy sys cm. Ventilation and oxygenation of H1ese patients during anesthesia is often extremely challenging, yet is paramount to preventing pcrioperative atelectasis and other respiratory complications The purpose of this independent project is to thoroughly review the literature and to determine from an evidence-based perspective, the best method or methods for ventilating, oxygenating and reducing respiratory complications for the morbidly obese patients undergoing anesthesia. The findings from this project will be presented to the first year anesthesia students and to fellow CRNAs at a state educational meeting. It is anticipated that enhanced knowledge of the CRNA and student registered nurse anesthetist (SRNA) regarding ventilation and oxygenation of the morbidly obese patient will positively impact patient care and ideally reduce perioperative respiratory complicatio

Risk Factors for Ventilator-Associated Pneumonia in the Adult Trauma Patient: A Retrospective Case-Control Study From a Level I Trauma Center

Introduction: Ventilator-Associated Pneumonia (VAP) continues to be a common complication among the adult trauma population. Little advancements have been made to decrease the incidence, suggesting further research is needed to establish modifiable risk factors. The purpose of this study was to test for an associated link between prehospital intubation and the development of VAP in the adult trauma patient. Methodology: A retrospective, case-control study design was utilized. The sample included 494 adult trauma patients who required endotracheal intubation and mechanical ventilation for a minimum of 24 hours. All patients presented as a priority one or two trauma to the Charleston Area Medical Center (CAMC) between January 1, 2005 and May 1, 2012. The sample was divided into two groups: VAP group (n = 247) and No-VAP group (n = 247). Patient demographics (age, gender, body mass index), Injury Severity Score (ISS), Glasgow Coma Score (GCS), location of first intubation, length of time on ventilator, Intensive Care Unit (ICU) and hospital Length Of Stay (LOS) were gathered. The hypothesis was tested using logistic regression. Additional regression analysis and correlation studies assessed for additional risk factors for the development of VAP. Linear regressions analyzed for factors associated with an increased ICU LOS and hospital LOS. Results: Trauma patients who were first intubated in the prehospital setting were 1.6 times more likely to develop VAP than those intubated by anesthesia upon arrival to or during their stay at the trauma center. Of those intubated by anesthesia, ICU and floor intubations were 3.2 times more likely to develop VAP compared to others intubated within the trauma center. Patients experiencing first intubation by anesthesia personnel upon arrival to Emergency Department (ED) were 2.5 times less likely to develop VAP than those intubated either in the prehospital setting or by anesthesia personnel in the operating room or after admission to the medical unit or ICU. Increased ventilator time and ICU LOS were found to have a statistically significant correlation to VAP. The presence of VAP, lower systolic blood pressure in ED, higher ISS, increased length of time on the ventilator, and intubation in the ICU or medical floor were significantly associated with the ICU length of stay. Higher ISS, presence of VAP, time on the ventilator, and ICU length of stay were associated with length of hospital stay. Discussion: Prehospital intubation was associated with a significantly increased risk of developing VAP and those trauma patients who were first intubated in the prehospital setting were 1.6 times more likely to develop VAP than those who were intubated by anesthesia personnel after arrival to the trauma center. Additionally, patients who required emergent intubation after admission to the ICU or medical floor were 3.2 times more likely to develop VAP than any other patient who experienced the first intubation by anesthesia within the trauma center. Situational Airway management providers must be aware of this increased risk and practice techniques to minimize the risk of aspiration or tracheal contamination during intubation. Additionally, this study represented an area where there were not standardized Rapid Sequence Induction (RSI) protocols in place in the prehospital setting therefore standardization of prehospital RSI protocols should be initiated with follow-up prospective studies testing these benefits. Conclusion: The high correlation between prehospital intubation and ventilator-associated pneumonia demonstrated in this study suggests that prehospital care may influence subsequent development of VAP

Benefits of Therapeutic Recreation for Young Adults with Special Needs

There are many benefits of therapeutic recreations; however, due to the lack of knowledge about the organizations and services available, many young adults with special needs are not able to fully participate within the community. The purpose of this project is to discover those benefits specifically for people who have special needs. Through a vast literature review and several interviews among local therapeutic recreation organizations, the findings indicate that therapeutic recreation provide many benefits that contribute to a person\u27s physical, social, and all around quality of life and well-being

Classroom Management

This project focused its research on how various teachers implement classroom management into their classrooms. The definition of classroom management used for this project is from The Glossary of Education Reform, which says classroom management refers to the “wide variety of skills and techniques that teachers and schools use to keep students organized, orderly, focused, attentive, on task, and academically productive during a class” (Great Schools Partnership, 2014, p. 1). The purpose of this project was to determine how various teachers incorporate classroom management into their classrooms. Two schools were used during this project where two principals were interviewed and three teachers’ classroom management styles were observed and then inquired about with follow-up interviews. One result of this research was the discovery of new methods of classroom management to use in my future classroom. I was able to see how various middle level teachers were successful with their classroom management techniques and why that is. Then I researched what theories supported the use of their techniques from scholarly literature including Building Classroom Discipline (Charles, 2014), Training Our Future Teachers: Classroom Management (Greenberg, Putnam, and Walsh, 2014) and Classroom Management: Research for Beginning Teachers (Borden, 2013). In summary, I conducted a multiple case study that was descriptive and exploratory. I asked the how and why questions of classroom management and learned the theories behind classroom management from scholarly literature

National Association of Manufacturers v. Department of Defense

In an attempt to provide consistency to the interpretation and application of the statutory phrase “waters of the United States,” as used in the Clean Water Act, the EPA and Army Corps of Engineers together passed the WOTUS Rule. Unfortunately, the Rule has created more confusion than clarity, resulting in a number of lawsuits challenging substantive portions of the Rule’s language. National Association of Manufacturers v. Department of Defense did not address those substantive challenges, but instead determined whether those claims challenging the Rule must be filed in federal district courts or federal courts of appeals. In its decision, the United States Supreme Court refused to apply the Government’s extratextual interpretations of the WOTUS Rule and other applicable regulations, and instead limited its analysis to the plain language of those provisions. The Court concluded that petitions for review regarding the Rule should be filed in federal district courts

Lewis v. Clarke

One manner in which Indian tribes exercise their inherent sovereignty is by asserting sovereign immunity. In Lewis v. Clarke, the Court decided that the sovereign immunity extended to instrumentalities of tribes did not further extend to tribal employees acting within the scope of their employment. The Court acknowledged the concerns of the lower court, namely, the possibility of setting a precedent allowing future plaintiffs to sidestep a tribe’s sovereign immunity by suing a tribal employee in his individual capacity. However, the Supreme Court ultimately felt that the immunity of tribal employees should not exceed the immunity extended to state and federal employees sued in their individual capacity

Functions of the Rat\u27s Temporal Association Cortex in Higher Perceptual Functions

The role of the rodent temporal cortex in relational perception was investigated. Eighteen Long Evans rats were separated into three surgical groups (sham, partial striate, and Te2/3) and trained on a preoperative and postoperative discrimination task. The rats were then presented a series of relational judgement trials consisting of both between category judgments and within category judgments. It was hypothesized that the rats with Te2/3 lesions would perform as well as controls on the preoperative and postoperative discrimination task, but show a considerable behavioral dysfunction on the tests of visual relational perception. The results showed no differences across groups in the percentage of correct responses made in the visual relational perception task. These findings suggest that visual relational judgement does not appear to be a function of the Te2/3 area in the temporal cortex

National Association of Manufacturers v. Department of Defense

In an attempt to provide consistency to the interpretation and application of the statutory phrase “waters of the United States,” as used in the Clean Water Act, the EPA and Army Corps of Engineers together passed the WOTUS Rule. Unfortunately, the Rule has created more confusion than clarity, resulting in a number of lawsuits challenging substantive portions of the Rule’s language. National Association of Manufacturers v. Department of Defense did not address those substantive challenges, but instead determined whether those claims challenging the Rule must be filed in federal district courts or federal courts of appeals. In its decision, the United States Supreme Court refused to apply the Government’s extratextual interpretations of the WOTUS Rule and other applicable regulations, and instead limited its analysis to the plain language of those provisions. The Court concluded that petitions for review regarding the Rule should be filed in federal district courts