Units in local history for Newburyport, Massachusetts

Thesis (Ed.M.)--Boston Universit

Predictors of NICU Nurse Activism: Response to Ethical Dilemmas

Thesis advisor: Pamela J. GraceNurses working in newborn intensive care units (NICU) report experiencing ethical dilemmas related to treatment decisions for infants in their care. The opportunity for nurses to contribute to the formulation of treatment plans for these infants is increasing, but often nurses are required to implement treatment plans with which they may not agree. This causes conflict for the nurse and has been shown to have implications for the nurse and, ultimately, nursing and healthcare practice. Not taking action to resolve the perceived dilemma is especially problematic on several counts (Raines, 1996). Nurse Activism, the outcome variable, is defined as the range of likely actions nurses may take to resolve ethical dilemmas in practice (Penticuff & Walden, 1987). This cross-sectional study investigated the range of likely actions that nurses would take in response to a hypothetical ethical dilemma. The web-based survey was completed by 224 NICU nurses from seven Massachusetts hospitals. Subjects responded to the Nurses Ethical Involvement Survey (Penticuff & Walden, 1987) and demographic questions. Hierarchical multiple regression analysis found that NICU nurses with greater concern for the ethical aspects of clinical practice (p = .001) and an increased perception of their ability to influence ethical decision-making (p = .018) were more likely to exhibit nurse activism to resolve an ethical dilemma and these findings explained just 8.5 percent of the variance. Future research is necessary to determine other factors contributing to, and inhibiting the actions of, nurses to resolve ethical dilemmas encountered in the NICU.Thesis (PhD) — Boston College, 2010.Submitted to: Boston College. Connell School of Nursing.Discipline: Nursing

Isolation and Characterization of a Lipid and Plastoquinone Deficient Cytochrome b?-f Complex

Biochemistr

Examining the Correlation Between Coliform Bacteria and Human Wastewater in Home Well Water

Nearly 15% of the U.S. population relies on home wells for drinking water, and approximately 34% of U.S. wells test positive for coliform bacteria. However, the presence of coliform bacteria alone does not confirm the presence of fecal matter, leaving the well users uncertain of their health risk and which mitigation measures to take. Therefore, understanding the correlation between human waste and the presence of coliform bacteria is vital to public health. A significant correlation would inform well owners and public health practitioners that mitigation must include addressing home septic system(s) (the well owner’s system as well as neighbors’ upgradient systems). The goal of this project is to analyze rural residential well water on the Crow Reservation to determine the degree of correlation between coliform presence, E coli presence and markers of human wastewater. The three primary analytes we are looking for are caffeine, cotinine and urobilin. All three chemicals are biomarkers of human waste. The methodology we are using to identify and quantify analytes within our water samples is solid phase extraction to concentrate the unknowns for further analysis using Gas Chromatography Mass Spectrometry. Subsequent analysis with colleagues will determine whether there are any significant correlations between the biomarkers of human waste and (1) the presence of coliform bacteria, (2) the presence of E. coli bacteria and/or (3) the absence of either coliform or E. coli. I will present my results to team members at a monthly meeting of the Crow Environmental Health Steering Committee, whereupon my colleagues on the Crow Reservation will use the data collected to inform and work with home well owners to properly mitigate home well contamination. After the completion of this project my colleagues and I plan on presenting this project at an additional conference and publishing in a peer review journal

Eradication of hepatitis C infection: the importance of targeting people who inject drugs

Hepatitis C virus (HCV) affects ~170 million people worldwide and causes significant morbidity and mortality.1 In high-income countries, people who inject drugs (PWID) are at greatest risk of HCV infection.2 Until recently HCV eradication seemed unlikely, but recent advances in HCV treatment and improved understanding of the effectiveness of harm-reduction intervention effectiveness give reason for optimism. Current HCV treatments can cure ~75% of patients and new drugs will further improve effectiveness (over 90% cure) and improve tolerability.3 If HCV treatment can be delivered effectively to those at highest risk of onward transmission, significant reductions in future HCV cases are possible. The feasibility of disease eradication must be assessed on both scientific criteria (e.g., epidemiological susceptibility, effective and practical intervention available, and demonstrated feasibility of elimination) and political criteria (e.g., burden of disease, cost of intervention).4 With effective, curative treatment now available, HCV meets these criteria

Implementation of a Quit Smoking Programme in Community Adult Mental Health Services–A Qualitative Study

Little is known about the experiences of people with severe mental health difficulties in smoking cessation interventions. This study aimed to review the implementation of a smoking cessation programme across 16 community mental health day services. The aim was to establish the experience from both service user and facilitator perspectives and refine implementation for future groups. In-depth interviews were conducted with 20 service users and four focus groups held with 17 facilitators. Thematic analysis was used to analyse the data for emergent themes in relation to key enablers and barriers to implementation. Data from service users and facilitators revealed that implementation was enabled by an open and engaged recruitment approach; the resourcefulness of facilitators; programme materials and group-based format; combining the cessation programme with other and broader health initiatives; and participants\u27 motivations, including health and money. Barriers included the structure of the service; the lack of a joined-up approach across the health services; literacy issues and the serial/logical process assumed by the programme. Barriers perceived as more specific to those with mental health difficulties included the use of smoking as a coping mechanism, lack of alternative activities/structure and lack of consistent determination. The tobacco free policy, implemented shortly before the programme, interestingly emerged as both a barrier and an enabler. In conclusion, although this group-based cessation programme in community mental health settings was well-received overall, a number of key barriers persist. A joined-up approach which addresses the culture of smoking in mental health settings, inconsistencies in smoking policies, and provides consistent cessation support, is needed. Care needs to be taken with the timing as overall it may not be helpful to introduce a new smoking cessation programme at the same time as a tobacco free policy

Heat: An Inquiry-based Physics Laboratory for Life Sciences Students

We have developed an inquiry-based first-year undergraduate experiment to investigate heat transfer. Students consider the real-world problem of how the temperature inside a building is influenced by various factors. Students develop their understanding of heat transfer through scaffolding experiments, and then construct a simple model house, and monitor its internal temperature when exposed to ambient conditions over a 24-hour period. In a following session, based on their acquired knowledge, teams design and test a model building according to their own chosen goal (constant-temperature house, greenhouse, etc.). As an extension, students also examine the insulating characteristics of animals. Class observation, analysis of student responses and survey data show that the activity successfully engages students, better motivating them to understand the physics involved. They have to deal with problems that arise during the experiments and discuss solutions with their group members. They encounter other interesting questions as they try to achieve their goal, and learn more science in the process. The aspects of this activity that work particularly well are the realism of the scenario, a degree of student ownership of experiments, and controlled variation in what students do through the design choices possible