Letter from Charles DeGarmo

Letter concerning a plan for the summer session at Cornell University

Comparing the Effectiveness of the Video Laryngoscope with the Direct Laryngoscope in the Emergency Department: A Meta-Analysis of the Published Literature

Purpose: Rapid intubation is essential for the critically ill patient in the emergency department in order to ensure adequate oxygenation. Regardless of presenting illness or injury, the first pass success rate (FPSR) can impact patient morbidity and mortality. The study aim was to evaluate the FPSR of direct laryngoscopy (DL) compared with video laryngoscopy (VL) in adult patients intubated in the emergency department. Methods: Ovid Medline, Cochrane Library database, Embase, and Google Scholar were searched for peer-reviewed articles of studies of human subjects reporting a comparison of FPSR between VL and DL in adult patients who were orotracheally intubated in the emergency department. A meta-analysis was conducted using odds ratio (OR) as the summary effect measure for FPSR. A pooled effect size with the 95% Confidence Interval (CI) was calculated using a random effect model with inverse weighted method. Results: 8,428 intubations (5,840 DL and 2,588 VL) from nine studies (five observational and four randomized controlled trials) were included in the sample. The pooled OR for FPSR across all studies was 1.89 [95% CI = 1.17, 3.07; p \u3c 0.01], favoring VL when compared with DL. The results were limited by potential bias (selection and performance) and high levels of heterogeneity [I2 = 88%; 95% CI: 79%, 93%; Q = 64.61; p \u3c 0.01]. Conclusions: Threats to validity made it difficult to conclude with certainty that one device is better than the other for achieving a successful intubation on the first attempt in the emergency department

IMPROVING INTERNSHIP PROGRAM AND INTERN RETENTION AT NAVAL SURFACE WARFARE CENTER PORT HUENEME DIVISION CONTRACTING OFFICE

Entry-level employees (ELEs) play a vital role in the Naval Surface Warfare Center Port Hueneme Division (NSWC PHD) Contracting Office, as they enable the office to complete contract requirements for current and future missions. More specifically, ELEs are responsible for procurement planning, preparing documents, conducting negotiations, and ensuring compliance with regulations and policies. NSWC PHD spends between $100,000 and$250,000 annually to recruit, onboard, and train each ELE with the expectation that ELEs will transition into full-time employees after graduation. With one to three ELEs hired annually, the total annual cost of recruiting, onboarding, and training ELEs ranges from $300,000 to$750,000. Despite recent improvement in the retention rate of ELEs, only 58.3% of ELEs over the past five years chose to maintain full-time employment with NSWC PHD upon completion of their internships, meaning over 40% of funds spent on the internships fail to produce the desired results. This shortfall translates into reduced numbers of staff devoted to managing contracts. In turn, this shortfall causes delays in contract completion, overworks existing employees, and lowers office morale. This study will gather data on ELEs’ perceptions of the program and how these perceptions inform their decisions whether to seek full-time employment with NSWC PHD. The intention is to provide information and insight to managers charged with overseeing the internship experience.Civilian, Department of the NavyCivilian, Department of the NavyApproved for public release. Distribution is unlimited

Finite element analysis of stress distribution and the effects of geometry in a laser-generated single-stage ceramic tile grout seal using ANSYS

Optimisation of the geometry (curvature of the vitrified enamel layer) of a laser-generated single-stage ceramic tile grout seal has carried out with a finite element (FE) model. The overall load bearing capacities and load-displacement plots of three selected geometries were determined experimentally by the indentation technique. Simultaneously, a FE model was developed utilising the commercial ANSYS package to simulate the indentation. Although the load-displacement plots generated by the FE model consistently displayed stiffer identities than the experimentally obtained results, there was reasonably close agreement between the two sets of results. Stress distribution profiles of the three FE models at failure loads were analysed and correlated so as to draw an implication on the prediction of a catastrophic failure through an analysis of FE-generated stress distribution profiles. It was observed that although increased curvatures of the vitrified enamel layer do enhance the overall load-bearing capacity of the single-stage ceramic tile grout seal and bring about a lower nominal stress, there is a higher build up in stress concentration at the apex that would inevitably reduce the load-bearing capacity of the enamel glaze. Consequently, the optimum geometry of the vitrified enamel layer was determined to be flat

Understanding the Comparisons of Routine Activities and Contagious Distributions of Victimization: Forming a Mixed Model of Confluence and Transmission

Recently the borders between two theoretical traditions have become blurred. While “Routine Activities Theories” have come to dominate the theoretical landscape of criminology, “Contagion Theories” have either been subsumed under the former or entirely forgotten. In the following, the theoretical lines of Routine Activities and Contagion are reviewed and evaluated. Discovered is the issue that both theories are very similar yet also very different; essentially distinguished from one another by what each omits from the other. It is henceforth argued that the two disparate traditions might benefit from coalescence, whereby they are combined into a single theoretical construct and, further, explicate causal model. A new typology of contagion is provided, allowing for a larger model that incorporates both Routine Activities and Contagion while illustrating the coming-to-gather of individuals [confluence] and the spread of behavior beyond an original point of contact between actors [transmission]

Delivering manufacturing technology and workshop appreciation to engineering undergraduates using the flipped classroom approach

Delivery of manufacturing technology and practical workshop-based work, on undergraduate engineering courses that engage the learners, is challenging. The paper presents an experimental method of workshop delivery using the flipped learning approach, a pedagogical model in which the typical lecture and homework elements of a course are reversed. Video lectures are viewed by students prior to class. In-class time can be devoted to exercises, projects, or discussions as in this case. Learners were asked to observe three audiovisual clips in preparation for class. The objective was to determine whether the flipped classroom approach can enhance the learning experience, through better engagement with the students, compared to conventional classroom-based learning. The level of student participation and level of success have been established by means of feedback questionnaires from more than 100 participants and peer observation. The results are encouraging and demonstrate that this approach is favoured by the students

A Recovery Capital and Stress-Buffering Model for Post-deployed Military Parents

We tested a recovery capital model for military families employing the After Deployment, Adaptive Parenting Tools (ADAPT) randomized control trial, a longitudinal preventive intervention study of 336 post-deployed military parents. Recovery resources included measures of social capital (parenting support, observed partner support behaviors), personal capital (parenting efficacy, education), and community capital (the ADAPT behavioral parent-training intervention). We hypothesized higher levels of recovery capital would buffer the negative impact of military stress on growth in post-traumatic stress disorder (PTSD) symptoms for deployed and civilian parents. Outcome data were evaluated with three waves across 2-years. Hypotheses were tested with latent growth models in a structural equation modeling framework. Military stress was assessed by reports of exposure to combat and battle aftermath. Recovery capital was measured by reported support for parenting and direct observation of behavioral interactions during problem-solving discussions of deployment-related stressors. Fathers had higher levels of military-related stress and PTSD symptoms over time compared to mothers. Growth curve models showed that fathers were characterized by individual differences in 2-year average levels of PTSD symptoms while mothers were characterized by individual differences in initial status and linear growth trajectories. Results supported a recovery capital model. Higher levels of parenting efficacy and parenting support were associated with lower PTSD symptoms, representing common pathways for both mothers and fathers. Similarly, parenting support operated as a moderating buffer for both parents. That is, effects of military trauma exposure on psychological distress were lower for mothers and fathers with higher levels of parenting support relative to parents with lower levels. Regions of significance indicated that half a standard deviation above the mean of support was beneficial for mothers, while one and half standard deviations were needed to impact the effects of trauma on fathers’ PTSD. For mothers assigned to the ADAPT parent training intervention – but not fathers – the intervention was associated with linear reductions in PTSD symptoms over 2 years. The recovery capital model explained 36% of the variance in father outcomes and 46% for mothers. The intervention obtained a medium effect size in reducing mothers’ symptoms (d = 0.41). Implications for prevention and treatment within a recovery capital model are discussed

High power diode laser modification of the wettability characteristics of an Al2O3/SiO2 based oxide compound for improved enamelling

High power diode laser (HPDL) surface melting of a thin layer of an amalgamated Al2O3/SiO2 oxide compound (AOC) resulted in significant changes in the wettability characteristics of the material. This behaviour was identified as being primarily due to: (i) the polar component of the AOC surface energy increasing after laser melting from 2.0 to 16.2 mJm-2, (ii) the surface roughness of the AOC decreasing from an Ra value of 25.9 to 6.3 μm after laser melting and (iii) the relative surface oxygen content of the AOC increasing by 36% after laser melting. HPDL melting was consequently identified as affecting a decrease in the enamel contact angle from 1180 prior to laser melting to 330 after laser melting; thus allowing the vitreous enamel to wet the AOC surface. The effective melt depth for such modifications was measured as being from 50 to 125 μm. The morphological, microstructural and wetting characteristics of the AOC were determined using optical microscopy, scanning electron microscopy, energy disperse X-ray analysis, X-ray diffraction techniques and wetting experiments by the sessile drop technique. The work has shown that laser radiation can be used to alter the wetting characteristics of the AOC only when surface melting occurs

2006 Apsa Teaching and Learning Conference Track Summaries

The 3rd Annual APSA Conference on Teaching and Learning in Political Science hosted over 300 participants in lively discussions of trends, techniques, and models in teaching in political science. Held in downtown Washington, D.C. on February 18-20, the Conference was organized as a workshop-based forum to develop models of teaching and learning as well as to discuss broad themes affecting political science education today. Joining the discussion, APSA President Ira Katznelson (Columbia University) and keynote speaker Thomas E. Cronin (Colorado College) shared their thoughts on teaching and learning in the discipline