Implementation of a Critical Incident Stress Management Program for Nurse Anesthetists.

BACKGROUND: Healthcare is a stressful profession where in addition to routine stressors, there are critical incident (CI) events which are occurrences capable of overwhelming an individual’s normal coping mechanisms. The purpose of this quality improvement project was to improve the process by which certified registered nurse anesthetists (CRNAs) exposed to critical incident events are provided post-critical incident support thus mitigating the potential for CI stress METHODS: We created a CI stress management pilot program for nurse anesthetists employed by an academic hospital located in the Southeastern United States. The program was based upon concepts introduced by Medically Induced Trauma Support Services and the Scott Three-Tiered Interventional Model of Second Victim Support. The program goal was to offer 100% of CRNAs exposed to a CI event supportive measures prior to assuming care for a patient other than the patient involved in the CI event. The program was piloted for five months as data was collected regarding the number and type of critical incident occurrences as well as the percentage of individuals offered said support post-critical incident. The National Institute for Healthcare Improvement’s Plan-Do-Study-Act methodology was utilized throughout the pilot period to evaluate for any changes needed to the program as issues arose. RESULTS: Over the five month period, three CI events occurred. Two of the three individuals involved in the events received support as prescribed. Failure of the third individual to receive timely support was due to facility and staff limitations. Nevertheless, the initial receptivity to the program was positive. Future improvement of the program’s processes are intended to yield support offered to 100% of individuals involved in a critical incident in a more timely manner

Using Chimeric Proteins to Determine Basis of FBF-2 Localization

FBF-1 and FBF-2 are proteins within the PUF protein family that are required for stem cell maintenance in Caenorhabditis elegans. FBF-1 and FBF-2 exhibit mRNA binding activity and are involved in localization, activation and repression of their target mRNA’s. The two are similar in sequence with the exception of four Variable Regions (VR’s). FBF-2 localizes to P granules in germ cells of the C. elegans while FBF-1 does not. We propose that the different localization patterns exhibited between the FBF-1 and 2 are due to these VR’s. Analysis of which VR or combination of VR’s is responsible for this difference in localization was undertaken through chimeric protein assembly and insertion into the C. elegans genome. Assembly of DNA encoding chimeric proteins with various VR’s and a tagging Fluorescent Protein (GFP) present was achieved through fusion Polymerase Chain Reaction (PCR) and BP/LR clonase plasmid assembly. Introduction of chimeric DNA constructs is in progress, and done through Crispr-CAS-9 genome editing. Expression of the modified proteins and assessment of localization patterns will be carried out using GFP visualization. The poster will discuss our observations and preliminary conclusions

Electrophysiological indices of target and distractor processing in visual search

Attentional selection of a target presented among distractors can be indexed with an event-related potential (ERP) component known as the N2pc. Theoretical interpretation of the N2pc has suggested that it reflects a fundamental mechanism of attention that shelters the cortical representation of targets by suppressing neural activity stemming from distractors. Results from fields other than human electrophysiology, however, suggest that attention does not act solely through distractor suppression; rather, it modulates the processing of both target and distractors. We conducted four ERP experiments designed to investigate whether the N2pc reflects multiple attentional mechanisms. Our goal was to reconcile ostensibly conflicting outcomes obtained in electrophysiological studies of attention with those obtained using other methodologies. Participants viewed visual search arrays containing one target and one distractor. In Experiments 1 through 3, the distractor was isoluminant with the background, and therefore, did not elicit early lateralized ERP activity. This work revealed a novel contralateral ERP component that appears to reflect direct suppression of the cortical representation of the distractor. We accordingly name this component the distractor positivity (

Full-scale wind-tunnel investigation of a VTOL aircraft with a jet-ejector system for lift augmentation

Full scale wind tunnel investigation of VTOL AIRCRAFT with jet ejector system for lift augmentatio

ASSESSMENT OF THE VALUE OF POSITIVE PRESSURE BREATHING APPARATUS IN INDUCING COUGH1 1Received August, 1978.

In the last decade, numerous papers have discussed what has been called the indiscriminate use of intermittent positive pressure breathing therapy (IPPB) for the treatment of obstructive airways disease (Curtis et al., 1968; Loke and Anthonisen, 1974; Cheney et al., 1976; Baker, 1974; Murray, 1974; Barach and Segal, 1975; Sheldon and Gold, 1976; Dolovich et al., 1977). These papers have all failed to show any advantage of positive pressure breathing therapy, either in the acute or chronic stages of obstructive airways disease. IPPB apparatus is expensive, requires careful maintenance and cleaning and may lead to patient dependence. However, physiotherapists in this hospital gained the impression that patients who were receiving nebulisation with positive pressure appeared to cough more frequently, and to produce greater volumes of sputum, suggesting that IPPB apparatus may be a useful adjunct of physiotherapy. Therefore a study was designed to compare the effectiveness of nebulisation therapy, with and without positive pressure, on the production of cough and sputum volume in patients with chronic obstructive airways disease

Survey of lift-fan aerodynamic technology

Representatives of NASA Ames Research Center asked that a summary of technology appropriate for lift-fan powered short takeoff/vertical landing (STOVL) aircraft be prepared so that new programs could more easily benefit from past research efforts. This paper represents one of six prepared for that purpose. The authors have conducted or supervised the conduct of research on lift-fan powered STOVL designs and some of their important components for decades. This paper will first address aerodynamic modeling requirements for experimental programs to assure realistic, trustworthy results. It will next summarize the results or efforts to develop satisfactory specialized STOVL components such as inlets and flow deflectors. It will also discuss problems with operation near the ground, aerodynamics while under lift-fan power, and aerodynamic prediction techniques. Finally, results of studies to reduce lift-fan noise will be presented. The paper will emphasize results from large scale experiments, where available, for reasons that will be brought out in the discussion. Some work with lift-engine powered STOVL aircraft is also applicable to lift-fan technology and will be presented herein. Small-scale data will be used where necessary to fill gaps

The Academic Elite in SixSocial Science Disciplines: Linkages Among Top-Ranked Graduate Departments

In 1981 the National Academy of Sciences initiated an evaluation by faculty of the quality of doctoral programs in the social sciences. Changing Times listed the top tell percent of all graduate programs in the social sciences based upon a combination 01two variables from the National Academy study which tile magazine believed constituted the best measures of program quality. Given the subjective nature of the evaluation process which produced these ratings, and the mass media's infatuation with these rankings, this paper examines tire top-rated graduate programs in six social science disciplines based upon criteria established in the Changing Times article. It was found that depanments in each discipline were substantially linked to each other by hiring each other's graduates, and bence, enhancing each other's reputations

Bright White-Light Emitting Manganese and Copper Co-Doped ZnSe Quantum Dots

Cataloged from PDF version of article.Doubly doped quantum dots with highly efficient (17 %) white-light emission (WLE) have been directly synthesized using a one-pot hot-injection technique (see picture). The generation of WLE was due to the judicious manipulation of the synthesis strategy for the co-doping of the host material-ZnSe quantum dots-with Mn and Cu. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim