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Association Between Latent Toxoplasma Gondii Infection And Alzheimer's Disease, Cynthia Elizabeth Wyman

Theses and Dissertations

Introduction: Many studies have found an association between Toxoplasma gondii seropositivity and behavioral and cognitive changes in animal models and in humans. In addition, early findings have suggested an association between T. gondii seropositivity and Alzheimer's disease (AD). We sought to determine whether there is an association between T. gondii seropositivity and AD as well as cognitive functioning (including memory, working memory, processing speed, language functioning, executive functioning) in a large, well-characterized sample of subjects with AD and matched controls without dementia. Method: Using ELISA assays, we determined anti-T. gondii IgG antibody titers in 114 control subjects and in …

"To You I Give Myself, For I Am Yours": Editorial Giving And Taking In Shakespeare's As You Like It, Jennifer Jean Thorup

Theses and Dissertations

In As You Like It 5.4.107-08 we receive Rosalind returning as herself—a woman—no longer in the guise of Ganymede, the "boy" page. Her first lines upon returning are repetitive: "To you I give myself, for I am yours [To Duke Senior] / To you I give myself, for I am yours [To Orlando]." However, comparing Folio versions of these lines produces a provocative variant. In the third and fourth folios, these lines are no longer a repetitious patriarchal pledging, but a tender dialogic exchange—much like vows—between Rosalind and Orlando. While none of our modern Shakespeare editions make a note of …

Tribopairs In Wellbore Drilling: A Study Of Pcd Tilting Pad Bearings In An Electric Submersible Pump, Cameron B. Ellis

Theses and Dissertations

A polycrystalline diamond was tested as a bearing material for a tilting pad thrust bearing to be used in an electric submersible pump, which elevates process fluids from the bottom of well bores. The goal of this study was to compare the PCD to a current best of technology, which is stainless steel with an engineering polymer.This study found that PCD can handle larger loads than current technology but is limited in size due to diamond sintering and manufacturing constraints. The maximum size is Ø75mm.

An Investigation Of Elementary Teachers<'> Self-Efficacy For And Beliefs About The Importance Of Engineering Education, Khristen Lee Massic

Theses and Dissertations

In order for the United States to regain its global standing in science and engineering, educational and governmental organizations have started to re-emphasize science, technology, engineering, and math content in k-12 classrooms.While some preliminary research has been conducted on student and teacher perceptions related to engineering, there has been little research conducted related to teachers beliefs about the importance of engineering content in their classrooms and relatively few studies have investigated elementary teachers teaching engineering self-efficacy. Current studies have investigated the impact of professional development on teachers teaching engineering self-efficacy but these studies were conducted with limited sample sizes, for …

Foxes At The Henhouse: Occupational Licensing Boards Up Close, Rebecca Haw Allensworth

Vanderbilt Law School Faculty Publications

The dark side of occupational licensing-its tendency to raise prices to consumers with dubious effects on service quality, its enormous payout to licensees, and its ability to shut many willing workers out of the workforce-has begun to receive significant attention. But little has been said about the legal institutions that create and administer this web of professional entry and practice rules. State-level licensing boards regulate nearly one-third of American workers, yet, until now, there has been no systematic attempt to understand who serves on these boards and how they operate. This Article undertakes an ambitious and comprehensive study of all …

International Law In The Post-Human Rights Era, Ingrid (Wuerth) Brunk

Vanderbilt Law School Faculty Publications

International law is in a period of transition. After World War II, but especially since the 1980s, human rights expanded to almost every corner of international law. In doing so, they changed core features of international law itself, including the definition of sovereignty and the sources of international legal rules. But what might be termed the golden-age of international human rights law is over, at least for now. Whether measured in terms of the increasing number of authoritarian governments, the decline in international human rights enforcement architecture such as the Responsibility to Protect and the Alien Tort Statute, the growing …

The Production Function Of The Regulatory State, J.B. Ruhl, Jonathan R. Nash, James Salzman

Vanderbilt Law School Faculty Publications

How much will our budget be cut be this year? This question has loomed ominously over regulatory agencies for over three decades. After the 2016 presidential election, it now stands front and center in federal policy, with the Trump administration pledging over $50 billion in cuts. Yet very little is known about the fundamental relationship between regulatory agencies budgets and the social welfare outcomes they are charged to produce. Indeed, the question is scarcely studied in scholarship from law, economics, or political science. This article lays the groundwork for a new field of theoretical and empirical research, using what we …

Transforming (Perceived) Rigidity In Environmental Law Through Adaptive Governance, J.B. A. Ruhl, Hannah Gosnell, Brian C. Chaffin, Craig A. Arnold, Et Al.

Vanderbilt Law School Faculty Publications

The Endangered Species Act (ESA) is often portrayed as a major source of instability and crisis in river basins of the U. S. West, where the needs of listed fish species frequently clash with agriculture dependent on federal irrigation projects subject to ESA Section 7 prohibitions on federal agency actions likely to jeopardize listed species or adversely modify critical habitat. Scholarship on Section 7 characterizes the process as unwaveringly rigid, the legal hammer forcing federal agencies to consider endangered species needs when proposing operations and management plans for federally funded irrigation. In this paper, we identify barriers to an integrated …

Patients’ Willingness To Participate In Rapid Hiv Testing: A Pilot Study In Three New York City Dental Hygiene Clinics, Susan H. Davide, Anthony J. Santella, Winnie Furnari, Petal Leuwaisee, Marilyn Cortell, Bhuma Krishnamachari

Publications and Research

Purpose: One in eight people living with an HIV infection in the United States is unaware of their status. Rapid HIV testing (RHT) is an easily used and accepted screening tool that has been introduced in a limited number of clinical settings. The purpose of this study was to investigate patient acceptability, certainty of their decision, and willingness to pay for screening if RHT was offered in university-based dental hygiene clinics.

Methods: A cross-sectional survey was administered to 426 patients at three dental hygiene clinics in New York City over a period of four months. The survey questionnaire was based …

Linking Centralized And Decentralized Nursing Education, Sarah Nagy, Shellie Scribner

General Submissions: Presentations (Oral and Poster)

A large multi-hospital system adopted an innovative strategy to unite the system NPD practitioners in the centralized education department and decentralized unit based NPD practitioners. The goals of this approach were to: develop a standardized approach and process to professional development and training across the system; create and promulgate effective training and development to advance the mission and strategy of the organization; and to share knowledge and best practices across the organization.

Several strategies were developed. First, was the development of the Clinical Education Team Lead (CETL) role. This position serves as liaison between the centralized system education department and …

Preceptor Utilization Of Learning Style Assessment: Perception Vs Reality, Linda Rus, Khristina Grimm

General Submissions: Presentations (Oral and Poster)

Learning style assessment instruments are often used in organizations to identify learner's preference and facilitate the exchange of information during the orientation process. Literature validates orientees learn more quickly and easily when they are able to use their learning preference. All new employees at the study hospital complete the Learning Style Self-Assessment instrument during New Hire Orientation. Orientees and nurse preceptors are instructed to utilize assessment results during orientation. Orientees at the study hospital complete an evaluation of their orientation experience. Results of this evaluation confirmed utilization of the orientee's preferred learning style. However, anecdotal feedback from nurse preceptors contradicted …

Utilizing Shared Governance Model To Develop A State Of Nursing Report, Elizabeth Rolston

General Submissions: Presentations (Oral and Poster)

Nursing Professional Development Specialists are often called upon to collect evidence about direct care staff achievements and the condition of the patient care units in which they practice in preparation for Magnet®. An innovative strategy to meet this challenge is the development of an annual State of Nursing report. Through a Shared Governance Model, the Nursing Professional Development Specialist and the direct care nurses create a living document of past, present and future unit based activities. These activities include but are not limited to: certifications, continuing education, Evidenced Based Practice initiatives, Quality Improvement projects and Best Practice strategies. The State …

Using Avatars In A Phased Approach Behavioral Health Education Series, Samantha Marotta

General Submissions: Presentations (Oral and Poster)

Patients seeking care at health care facilities not only need their medical health care needs addressed, but "the majority of patients receiving services through their health care provider also suffer from psychological and psychosocial problems" (Wodarski, 2014, p. 302). According to Ramos et al. (2013), in the younger population between the ages of 12 and 15 years old, 13% of patients met "diagnostic criteria for a mental health disorder within the previous year" (p. 712).

Currently, staff education does not specifically address behavioral health or give employees the knowledge and tools for use in behavioral health crises. In an ideal …

Preceptor Workshop: "I Wish I'D Known That", Vanessa Gant Clark

General Submissions: Presentations (Oral and Poster)

The nurse preceptor class was formulated to introduce the preceptor to the many facets to precepting. Precepting not only entails validation of technical skills but a realm of other vital components to include critical methods of time management for preceptee, identifying learning styles and how to teach based on the learning style of the preceptee, social interaction and the ward/unit routine and layout just to name a few.

The preceptor may have the knowledge but lack the skills necessary to effectively preceptor a new employee. Precepting requires that the preceptor is well educated on how to teach the adult. This …

Npd Practitioner Role In An Interprofessional Safe Patient Handling Culture, Sarah Lesniak, Colleen Neary, Erin Sugarman

General Submissions: Presentations (Oral and Poster)

Musculoskeletal injuries related to patient movement and handling are among the leading causes of injuries for healthcare professionals. In January 2016, state legislation was enacted requiring hospital compliance with a comprehensive Safe Patient Handling (SPH) program. The role of the NPD Practitioner was utilized to coordinate an interdisciplinary, organization-wide SPH initiative at a large academic medical center. The NPD Practitioner and a clinical bedside nurse were appointed to co-chair the comprehensive committee with collaboration from the Medical Center's Environmental Health and Safety Specialist. An extensive committee was formed including 45 key stakeholders from various interprofessional and ancillary departments.

Objectives of …

Who Wants To Be A Nurse? — Gaming Methods For Teaching Nursing Students, Vanessa Gant Clark

General Submissions: Presentations (Oral and Poster)

Gaming is an innovative tool for teaching nursing students that is both fun and competitive. Gaming promotes learning activities that encourages critical thinking, active participation, and retention of information for longer periods of time. Gaming is a teaching methodology with preset rules that are familiar to the nursing student. This teaching method helps to promote interactive learning that helps the nursing student with putting classroom theory into practice. Research has shown that gaming increases the student's enjoyment of learning. In addition to promoting active participation, gaming facilitates opportunities for students to work together, increase communication and think "outside the box. …

Rapid Cycle Deliberate Practice Facilitation In A Nurse Residency Program, Maureen Washock, Julie Sobolewski

General Submissions: Presentations (Oral and Poster)

Nurse residency programs may have inherent gaps in what their learners take away from their simulations that can be addressed with an alteration in simulation facilitation technique. A fundamental lack of knowledge and experience may sabotage the traditional simulation-debrief structure when working with novice nurses. The concept of rapid cycle deliberate practice (RCDP) as described by Elizabeth Hunt et al in 2014 will be discussed as well as how its incorporation in a nurse residency program could improve both confidence and skills of a novice learner as compared to traditional facilitation techniques alone. RCDP allows participants to leave a simulation …

Using An Electronic Needs Assessment To Develop Unit-Based Education Plans, Ronald Cottman, Eileen Gabbard

General Submissions: Presentations (Oral and Poster)

Problem: In previous years, formal Educational Needs Assessments were conducted by individual Unit-based Educators utilizing various formats of paper based surveys asking "What kind of topics would you like education on?" These surveys tended to result in long lists of topics offering limited insight into the educational priorities of team members and little correlation to Quality Improvement Directives. In addition, few paper surveys were completed and returned.

Approach/Method: Following formation of a Medical Center based Clinical Education Team in 2014, a process to formalize and standardize the annual Educational Needs Assessment into a single consolidated assessment was developed. Fifteen assessment …

Transforming Npd Practice By Increasing Certification Rates, Nicki M. Shonka, Susan Clarke, Lisa Baske

General Submissions: Presentations (Oral and Poster)

Ongoing professional development is essential to maintain the knowledge, skills and attitudes needed for current nursing professional development (NPD) practice. Specialty certification delineates the Professional Development Specialist role in the latest edition of the NPD Scope and Standards of Practice, 3rd ed. A team was inspired after attending the Association for Nurses in Professional Development 2016 conference to transform all NPD practitioners into specialists. This presentation will focus on one team's efforts to increase NPD certification rates at a pediatric academic organization.

This team employed a leap to NPD certification campaign. One of the engaging interventions to increase certification rates …

It's Big, And It's Not Easy: Implementing A Transition To Practice Program, William Parrish, Valerie Stalsbroten

General Submissions: Presentations (Oral and Poster)

Implementation of an evidence-based (EB) transition to practice (TTP) program has been shown to improve retention of new graduate nurses in the hospital setting (Spector et al, 2015). A twelve-month EB TTP curriculum was developed through a collaborative effort by nursing professional development (NPD) practitioners across a large multi- hospital system. Curriculum elements, based on the eleven EB best practice elements for TTP programs (Hansen, 2015), include preceptor training, clinical orientation, simulation, professional development opportunities, and completion of an EB practice project. Clinical orientation and simulation content was developed to build upon the knowledge and skills acquired as a student …

Nursing Accuracy Improves With Embedded Clinical Decision Support Tools, Andrea Lee-Riggins

General Submissions: Presentations (Oral and Poster)

Providing anticoagulation therapy safely is a Joint Commission National Patient Safety Goal that can impact the safety of patients when performed incorrectly. The Nursing Professional Development Generalist and Informatics Nurse surmised that by incorporating clinical decision support (CDS) tools into nursing workflows during EMR training, nursing accuracy for PTT monitoring and timing, and Heparin nomogram calculations may improve; which would lead to improved nurses' responsiveness in preventing harm to patients caused by: complex nomograms, insufficient PTT monitoring, and inconsistent EMR workflow knowledge. The ADPIE (Assessment, Diagnosis, Planning, Implementation, and Evaluation) process is the strategy that was utilized. After observing current …

Integrating An Ed Nurse Residency Orientation Model With Npd Principles, Christine Foote-Lucero, Amanda Miller

General Submissions: Presentations (Oral and Poster)

New Graduate Nurses face unique challenges when beginning their career in a specialty care environment such as the ED. ED nursing is a specialized area of practice that "requires expertise in triage and prioritization, resuscitation, intervention and stabilization, discharge training, crisis intervention, and emergency preparedness (Gurney, Bush, Walsh, & Wilson, 2015, p. 1). According to ENA, ED nurses must care for diverse patients of all ages that are suffering from complex and multi-system illnesses, complaints, and injuries (Gurney, Bush, Walsh, & Wilson, 2015). The literature supports a comprehensive approach to ED orientation to assure that nursing staff are competent to …

Outcome And Impact Evaluation Of A Peripheral Iv Removal Competency For Uap, Cynthia Kautzmann

General Submissions: Presentations (Oral and Poster)

Professional Practice Gap: Nursing Professional Development (NPD) practitioners create educational programs based on facility needs and measure outcomes of learners, yet effects on the system are measured less frequently due to the time and resources required. An NPD practitioner developed a program based on an observed practice gap then measured learning outcomes and impact. The purpose of this project was to evaluate the outcomes of a peripheral intravenous catheter (PIV)-removal training program for Unlicensed Assistive Personnel (UAP) and its impact on nursing practice. Current State: NPD practitioners identified UAPs were removing (PIVs) without standardized competency demonstration and without standardized documentation. …

Development And Program Evaluation Of Npd Practitioner Peer Review Process, Ryan Basiliere, Laura Wilkinson

General Submissions: Presentations (Oral and Poster)

Our hospital performed a cultural assessment of nursing practice using Nelson and Burns (2005) framework of high performance programming model. This framework consisted of four levels of development based on characteristics of behaviors or habits within a microsystem. The levels include reactive, responsive, proactive and high performing. The assessment revealed that 47% of the nursing care environment is responsive. The responsive level behaviors include a reluctance to speak up regarding safety concerns and a lack of self-awareness of developmental needs. A robust action plan was developed. This action plan included the implementation of nursing peer review. The NPD practitioners began …

Creating Orientation Competencies: From Academic To Community, Jean Carraher, Jason Concannon

General Submissions: Presentations (Oral and Poster)

Realignment of multiple hospitals within a larger system resulted in two community hospitals with a shared clinical practice/education team. Re-development of nursing orientation was undertaken through examination of existing tools, processes, and documentation throughout the system in addition to deeper dives into existing practices at both sites. Improved nursing orientation processes and documentation was needed at both community sites. Existing orientation competencies were highly variable (from task checklists to detailed "textbook" like documents for review). Review of the electronic competency documents from the academic hospital within the system showed the existing medical-surgical competencies to be more detailed than needed for …

Flipped2: Removing The €˜Ouchie’ From Pain Management Education, Sandi Coufal

General Submissions: Presentations (Oral and Poster)

Proper pediatric pain management is important, especially when caring for patients too young to verbalize their quality or quantity of pain. A detailed, constructive education process is needed to make sure that new pediatric nurses, both residents and fellows, understand the premise behind pediatric pain management. Our previous pediatric pain management class was instructor-led and the nurses were not retaining the information to accurately care for these patients. This course was developed to educate these nurses to care for patients receiving pain medications through different modalities; specifically patient controlled analgesia and epidural infusions. Our nursing professional development practitioners chose to …

If You Build It, They Will Use It. Creating Task Trainers For Simulation, Leslie Harder

General Submissions: Presentations (Oral and Poster)

Background: There was an identified gap in recognizing the risk of harm from PIV infiltrations and extravasations and, to uncircumcised males pre, during, and post catheterization. This indicated a need for training, education, and competency assessment. Extensive product searching to assist with these two simulations/return demonstrations revealed no pediatric task trainers available for purchase.

Purpose: To provide education, training, and simulation for two nursing skills. The first skill was identifying, assessing, and measuring peripheral IV infiltrations and extravasations. The second was catheterization care/insertion for uncircumcised males.

Methods: Development of two task trainers: 1. arms for nurses to assess and measure …

Improved Interprofessional Continuing Education Process Implementation, Tamara Eis, Stephanie Von Bacho

General Submissions: Presentations (Oral and Poster)

At a large academic medical center, continuing nursing education demands have escalated exponentially due to robust specialty certification, career ladder, and Magnet re-designation requirements. Also contributing to the increase are the NPD Practitioner's efforts to align educational needs with the organization's strategic plan and the growth of Interprofessional Continuing Education.

IPCE is essential to promoting healthcare team collaboration and positive patient care outcomes. However, the NPD Practitioner, serving as the Lead Nurse Planner of an accredited with distinction ANCC Provider Unit, exposed barriers with process differences and duplication of documentation requirements for CME and CNE.

The NPD Practitioner collaborated with …

Increasing The Reach Of The Npd Practitioner: Using A Specialized Team, Lesley Worsley-Hynd

General Submissions: Presentations (Oral and Poster)

Within most work environments, the NPD Practitioner feels they are unable to provide enough continuing education to existing staff. This is especially true in Emergency, ICU, Pediatric, and Trauma settings, where decisions must be rapid and often based on limited research. Since the NPD Practitioner is limited in the time they have to dedicate to the classroom, the best option is to create a specialized team to provide education. The Specialized Team consists of bedside staff who are interested in optimal patient care, positive outcomes, and evidence based practice. The NPD Practitioner and a member of leadership should help provide …

It's Fat Tuesday! Get The Skinny On Lean And The Npd Scope And Standards, Greta Price

General Submissions: Presentations (Oral and Poster)

One NPD department director was faced with a choice: become irrelevant and extinct or radically change the work being produced within the department. Upon direction from a chief nursing officer to the current department, the director began by conducting an intensive, three-month learning needs assessment and consulting a lean coach. The department held a two-day offsite strategic planning. The resultant vision and strategic objectives shaped the next year of work. The department developed specific metrics based off of the strategic objectives and the NPD scope and standards of practice. These metrics were tracked at a department huddle. Education requests (ERs) …