Technological Leapfrogging as a Source of Competitive Advantage

This paper examines technological leapfrogging industries characterized by long term investments in perennial crops. Threshold farm size and economic valuation are used to evaluate adoption of harvester innovations. Less than 1 percent of Polish farmers are able to adopt overhead harvesters and sunk costs limit the ability of rapid adjustments in U.S. technology.Research and Development/Tech Change/Emerging Technologies,

Predictors of Situation Awareness in Graduate Student Registered Nurse Anesthetists

ABSTRACT PREDICTORS OF SITUATION AWARENESS IN GRADUATE STUDENT REGISTERED NURSE ANESTHETISTS Suzanne M. Wright, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2009 Major Director: J. James Cotter, Ph.D. Situation awareness (SA) is defined as one’s perception of the elements of the environment, the comprehension of their meaning, and the projection of their status in the near future. Stated more simply, SA is knowing what is going on around you. The concept of SA is well known in the field of aviation which is characterized by complexity and dynamism. The discipline of anesthesia shares these same characteristics, yet the study of SA in this setting is in its infancy. Human error has been implicated in nearly 80% of all preventable medical errors. It is well documented that lack of SA frequently contributes to human error. Although the discipline of anesthesia has led the medical field in patient safety through rigorous study of human error and adverse events in the operating room, crises in anesthesia still exist. Nurse anesthetists should possess the ability to acquire and maintain SA at all times during clinical situations in the operating room, yet there are no studies examining SA in this population. Guided by Endsley’s theory of situation awareness, the purpose of this study was to provide nurse anesthesia educators with a best evidence predictor model of SA in GSRNAs for curricular implementation. The study objectives are to determine: a) the extent to which memory, cognition, and automaticity are related to situation awareness, b) the extent to which any relationship amongst memory, cognition, and automaticity mediates their relationship with situation awareness, and c) the extent to which Endsley’s theory of situation awareness is supported in the GSRNA population. After IRB approval, 71 GSRNAs were randomly selected from each of three universities chosen for this study. A non-experimental, correlational design was used to measure the relationship between memory, cognition, and automaticity and SA. Situation awareness was measured by the WOMBAT-CS, a computer-based assessment tool for evaluating SA in complex-system operators such as pilots, air traffic controllers, and anesthetists. A stepwise multiple regression was performed between the GSRNA attributes and SA scores. Beta-weights were used to identify the magnitude each relationship. Findings from this study revealed that cognition best predicts SA in the population of Graduate Student Registered Nurse Anesthetists, with the addition of memory and automaticity contributing no additional predictive value to the model. The results of this study have the potential to make a positive impact on the education and training of GSRNAs. Additionally, this study may provide foundational support for further research directed at assessing the effectiveness of high-fidelity simulated operating room environments in promoting SA in GSRNAs

Treatment for unicameral bone cysts in long bones: an evidence based review

The purpose of this paper is to perform an evidence based review for treatment of unicameral bone cysts. A search of MEDLINE (1966 to 2009) was conducted and the studies were classified according to levels of evidence. This review includes only comparative Level I-III studies. The systematic review identified 16 studies. There is one level I study, one level II study and the remaining 14 studies are level III. Seven of the sixteen studies had statistically different results: three studies indicated that steroid injection was superior to bone marrow injection or curettage and bone grafting; one study indicated that cannulated screws were superior to steroid injections; one study indicated resection and myoplasty was superior to steroid injection; one study indicated a combination of steroid, demineralized bone matrix and bone marrow aspirate, and curettage and bone grafting were superior to steroid injection; and one study indicated that curettage and bone grafting was superior to non-operative immobilization. Based on one Level I study, including a limited number of individuals, steroid injection seems to be superior to bone marrow injection. As steroid injections have already demonstrated superiority over bone marrow injections in a randomized clinical trial, the next step would be a prospective trial comparing steroid injections with other treatments

The Pathology of Methanogenic Archaea in Human Gastrointestinal Tract Disease

Methane-producing archaea have recently been associated with disorders of the gastrointestinal tract and dysbiosis of the resident microbiota. Some of these conditions include inflammatory bowel disease (Crohn’s disease (CD) and ulcerative colitis (UC)), chronic constipation, small intestinal bacterial overgrowth, gastrointestinal cancer, anorexia, and obesity. The causal relationship and the putative mechanism by which archaea may be associated with human disease are poorly understood, as are the strategies to alter methanogen populations in humans. It is estimated that 30–62% of humans produce methane detectable in exhaled breath and in the gastrointestinal tract. However, it is not yet known what portion of the human population have detectable methanogenic archaea. Hydrogen and methane are often measured in the breath as clinical indicators of intolerance to lactose and other carbohydrates. Breath gas analysis is also employed to diagnose suspected small intestinal bacterial overgrowth and irritable bowel syndrome, although standards are lacking. The diagnostic value for breath gas measurement in human disease is evolving; therefore, standardized breath gas measurements combined with ever-improving molecular methodologies could provide novel strategies to prevent, diagnose, or manage numerous colonic disorders. In cases where methanogens are potentially pathogenic, more data are required to develop therapeutic antimicrobials or other mitigation strategies

General Education Diploma Students\u27 Familial Attachment Experiences Influencing Premature High School Departure

Lowered academic achievement and premature departure from high school continue to plague the educational system, creating the need for greater insight into experiences affecting students\u27 classroom performance. Much is known about academic achievement; however, less research has focused on the role of familial attachment on premature departure from high school. Guided by attachment theory, the purpose of this interpretative phenomenological study was to gain insight into General Education Diploma (GED) students\u27 familial attachment experiences influencing premature departure from high school. The research questions focused on GED students\u27 primary caregiver and educational experiences. Participants (n = 14) consisted of current or previous GED students 18-30 years of age. Data were gathered from semistructured interviews and a Life Map used to capture expression of feelings through symbols. Interview transcriptions were hand-coded by bracketing words and phrases for composite textual descriptions. Data interpretations were bolstered by committee member checking and participants\u27 review of extracted data. Findings revealed a close connection between the types of attachment formed with primary caregivers and early departure from high school, but participants were more strongly influenced by external influences such as relationship conflicts, health crises, domestic violence, abuse, loss, and paternal abandonment. This study offers insight to educators, counselors, and those within the criminal justice system on these students\u27 emotional and mental needs

Opioid Fast Facts for Parents

This fact sheet explains what opioids are and how they are used--or misused, which can lead to opioid use disorder (OUD). The information provided can help parents understand what questions to ask if a doctor prescribes opioids, and ways parents can safeguard their child against opioid misuse. It also includes ideas for managing an emergency, namely, using naloxone to address overdose

Scaling Community Health Coalitions: The Well Connected Communities Pilot Initiative

We outline the process and development of the Well Connected Communities health initiative as undertaken in three Utah communities. This transformative community-focused alternative to addressing public health issues through Extension situates local communities as the origin for health decision making. The initiative recognizes the need for varied community statuses (i.e., planner, implementer, and innovator) based on varying levels of readiness and diversity of populations. We concluded that the Utah Well Connected Communities initiative aligns well with the 2014 Extension Committee on Organization and Policy National Framework for Health and Wellness. Replication requirements and implications for other Extension programs are presented