Digital Commons Network^™

General Anesthesia Clinical Practice Guidelines For Patients With Posttraumatic Stress Disorder, Bradley Closson

Doctor of Nursing Practice Scholarly Projects

General anesthesia is an induced state of unconsciousness administered by anesthesia providers to obtain patient amnesia, analgesia, and akinesia. Adult patients with posttraumatic stress disorder (PTSD) are at risk for general anesthesia-related complications throughout the perioperative setting. Emergence delirium is a clinically significant postoperative complication that patients with PTSD have an increased risk of developing. Postoperative complications of emergence delirium include patient or medical staff injury, surgical site damage, prolonged postanesthesia care unit (PACU) stay, and increased medical care costs. Evidence demonstrates that implementing preventive interventions decreases the incidence of emergence delirium. There are no standardized, evidence-based general anesthesia guidelines …

Preprocedural Ultrasound For Labor Neuraxial Anesthesia: Evidence-Based Practice Recommendations, Nicholas Anderson

Doctor of Nursing Practice Scholarly Projects

Central neuraxial blockade (CNB) is the most widely used method of anesthesia provided to laboring patients and includes epidural, spinal, combined spinal-epidural, and caudal techniques. Studies have shown that using preprocedural ultrasound is a safe and effective tool to facilitate the placement of neuraxial needles, especially in patients with predicted difficulty. With the prevalence of obesity increasing, laboring patients with predicted difficulty of neuraxial needle placement is increasing as well. In addition, the traditional method of palpation and visualization of anatomical landmarks to place neuraxial needles can produce inaccurate results due to inconsistencies between patients. Use of preprocedural ultrasound to …

Civil Service Merit And Employment At Will Personnel Systems: The Role Of Transformational Change Leadership In Public Sector Recruitment, Hiring, Promotion, Retention, And Succession Planning, Angela Lauria-Gunnink

Dissertations

Purpose: This nonexperimental, descriptive, and comparative study aimed to identify and describe the differences between Public Sector HR Association (PSHRA) professionals who worked in a state or local government civil service merit or employment at will (EAW) personnel system.

Methodology: This nonexperimental, descriptive, and comparative study identified and described the responses of 214 state and local government PSHRA professionals throughout the United States, focusing on their respective personnel systems. The researcher collected data and tabulated descriptive statistics and z scores to compare and statistically determine the differences between the two public sector personnel systems.

Findings: The 214 PSHRA professionals who …

Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), Joel Jackson

Doctor of Nursing Practice Scholarly Projects

When a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this …

Guidelines For The Optimal Assessment Of Airway To Predict Difficult Intubation, Morgan Kleinfelder

Doctor of Nursing Practice Scholarly Projects

Managing the airway is the cornerstone of anesthesia care. However, difficult airway or intubation is not clearly defined. A major complication with a difficult airway is a cannot intubate, cannot ventilate (CICV) situation, which is reported to be as high as 10%. In addition, according to the American Society of Anesthesiologists (ASA) Closed Claim Study, "Adverse respiratory events are the most common type of injury, with difficult intubation [DI] and ventilation contributing to most of the cases. Twenty-eight percent of all anesthesia deaths are related to a CICV situation. As anesthesia evolves, basic airway assessments were developed and include mallampati …

Development Of A Rotem-Guided Transfusion Algorithm In Cardiothoracic Surgery Patients, Kourtney Jane Snyder

Doctor of Nursing Practice Scholarly Projects

Abstract

Cardiothoracic surgical patients are at an increased risk for bleeding complications for various reasons, including induction of hypothermia, initiation of the coagulation cascade, degradation of the coagulation factors, mechanical destruction of platelets, and a systemic inflammatory response due to cardiopulmonary bypass (CPB). The American Society of Anesthesiologists recommends rotational thromboelastometry (ROTEM)-guided transfusion algorithms for perioperative blood management; however, there remains a heavy reliance on conventional coagulation laboratory values. Utilization of the following PICOT question will guide this project: In cardiothoracic surgical patients, how does the use of ROTEM versus traditional coagulation laboratory tests (PT, INR, aPTT, ACT, platelet count, …

A Curriculum Development For Writing A Personal Narrative In A French Immersion 5th Grade Class., Aliou Sall

Masters Theses/Capstone Projects

The purpose of this curriculum development project was to address the need of more writing in elementary French immersion school in grade five French class through the fusion on the writing workshop and the ECRI model (Reasoned and Coherent Writing in Immersion). The writing workshop is proven to work in schools teaching students writing in L1 and the Ecri model was developed by teachers who are experienced in teaching in an immersion setting to help students write in L2. A new framework was developed based on those two frameworks above to support fifth graders in a French immersion school to …

Development Of Evidence-Based Clinical Practice Guidelines For The Prevention Of Peripheral Neurological Injury During Robotic-Assisted Prostatectomies For Patients In The Steep Trendelenburg Position, Tyler Wolpert

Doctor of Nursing Practice Scholarly Projects

Robotic-assisted surgery (RAS) is becoming more prevalent in modern surgical practice and is currently being utilized in a range of surgical specialties from colorectal and gynecological procedures to bariatrics and orthopedics. Every surgical procedure has potential risk to patients, however robotic-assisted laparoscopic prostatectomies (RALP) in the steep Trendelenburg (ST) position poses unique risk for peripheral nerve injury (PNI). Despite attempts to reduce the incidence rate of PNI during RALP, injuries are still occurring to patients causing patient harm and anesthesia provider litigation. The implementation of a CRNA based safety checklist may reduce the incidence rate of PNI and provider litigation …

Mining Optical Narrow-Band Imaging Data To Study Agn Feedback And Galaxy Evolution, Dakota Michael Davis

Honors Capstone Projects and Theses

No abstract provided.

Education Of The Effects Of Obesity Medications And A Stepwise Approach To Mitigate Prevalence And Encourage Lifestyle Medicine For Primary Care Physicians, Kiely M. Curran

Department of Nutrition Student Projects

My Capstone project is an Educational Manual that emphasizes a healthcare team approach to the treatment and management of obesity. The Educational Manual consists of a standardized protocol in management of obesity in patients and a document with summarized references for primary care providers; and a simplified document for patient education. There is a growing interest in the usage of obesity medications. The purpose of my Capstone project is to provide a simplified manual for the primary care provider to reference to make knowledgeable and patient-centered decisions in the prescription of obesity medications and decisions in weight-management. My methodology included …

Just “Getting By” – Understanding Resource Deficits And Barriers To Medical Interpretation From The Perspectives Of Spanish-Speaking Patients And Emergency Department Nurses, Magdalena Scribner Briggs

Undergraduate Honors Theses

Introduction: Professional medical interpretation has been found to improve communication quality and health outcomes for patients with LEP. There are over 16 million LEP Spanish-speakers in the United States, yet the literature indicates that professional interpretation is lacking and underutilized in many clinical settings. Study Aims: Based on gaps in the literature pertaining to the perspectives of nurses and the cultural factors that influence patient experience, this study aims to qualitatively analyze the matter from the perspectives of both nurses and Spanish-speaking patients. The purpose of this study is to identify barriers to the utilization of professional interpreters, especially by …

Sequence Learning In A 6-Ohda Mouse Model Of Parkinson’S Disease, Ani Gribbin

Neuroscience Honors Projects

Parkinson’s disease (PD), a neurodegenerative disorder originating in the dopaminergic cells of the basal ganglia, is characterized by severe motor impairments such as tremors, bradykinesia, and postural instability. However, non-motor symptoms impacting sensory systems and cognition are consistently pointed to as more greatly affecting quality of life for PD patients. Cognitive impairments in PD can include changes in reward processing, depression, apathy, and increases in risk-taking behavior. Additionally, learning and memory deficits are seen in PD, specifically in motor sequence learning. Often, the neural correlates of sequence learning impairments are traced to the substantia nigra. However, there is some evidence …

Decreasing Re-Intubation Rates In Mechanically Ventilated Adult Patients: A Scoping Review, Anne J. Shearin Bsn, Rn, Wesley Gray Bsn, Rn, Philip Habegger Msn, Aprn, Fnp-C, Evan Gregory Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Donna Lynch-Smith Dnp, Aprn, Acnp-Bc, Ne-Bc, Cnl

Doctor of Nursing Practice Projects

Decreasing Re-Intubation Rates in Mechanically Ventilated Adult Patients: A Scoping Review

Purpose/Background

Critically ill patients often require mechanical ventilation to support respiratory function. Prolonging mechanical ventilation can increase adverse outcomes. Weaning patients from the ventilator as soon as clinically appropriate can decrease adverse outcomes. The decision to wean mechanical ventilation lacks a standardized approach. This scoping review will evaluate the literature about the effectiveness of a standardized weaning protocol in decreasing the number of reintubations within 72 hours of extubation.

Methods

We conducted a literature search on PubMed, CINAHL, Scopus, and Medline between November 2020 and November 2023 using key …

My Patient Or Law Enforcement, Who Gets First Say?, Hollis T. Redden

Arkansas Law Notes

Law enforcement is often left struggling with determining how to appropriately respond to nurses who refuse their request to collect a suspect’s blood when that patient is suspected of intoxicated driving and the officer has a valid search warrant. These scenarios trigger compliance issues including a patient’s right to privacy and consent, “particularly when a medical entity’s compliance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) provisions directly conflicts with law enforcement needs and goals.” Once a suspect becomes a patient, whose interest prevails? Is it healthcare providers’ interest in abiding by the rights, health, and safety …

The Heavy Mark Of Ptsd The Justice System Leaves On The People Going Through It., Ezavier Miller, Angel Emetuche, Sakina Ahmed

ENGL 1102 Showcase

This is a paper about how the justice system in it's many forms can cause PTSD. Not only to the criminals that go through it but also the children, victims. With many process having extensive repercussion causing PSTD to take hold of the many people that seek the justice system for help or judgement.

Theft And Entertainment, Francesco Maiolo, Bryce Mccaskill, Libbie Brown

ENGL 1102 Showcase

An anthology that looks at the interaction between theft and entertainment. Why and how entertainment is stolen, the prevention of theft by entertainment companies, and the depiction of theft in media.

The Hidden Scams In Business & Finance, Jake Patten, Carter Harrell, Claude Auguste, Sheldon Jerome Downing Ii

ENGL 1102 Showcase

For our research papers, we chose to look into different kinds of scams lurking in the business world, and how they can affect businesses and society as a whole. There are hundreds of different scams at any given time, but we decided to focus on lesser-known scams that the majority of people don't even think about. These scams include rigged casinos, charity fraud, business email compromise, and embezzlement within smaller businesses.

We chose this topic in an attempt to bring more attention to the criminal side of the business world that people otherwise see as harmless. Especially with the recent …

The Fundamentals Of Claymation Films, John Hardy

ENGL 1102 Showcase

This anthology covers three different aspects of a clay-animated film. It covers the unique financial situation that clay-animated films encounter, the different psychological responses that are related to clay-animation, and the specific character creation and voice acting done for the films.

How Different Forms Of Art And Entertainment Can Affect Our Mental Well-Being, Tucker Johnson

ENGL 1102 Showcase

The following paper is a complete anthology of our collective ideas. We wrote this paper from the prompt of entertainment and health. With this given prompt we divulged separate but similar ideas. Then with these ideas formulated our anthology which is the exploration of the impact of various artistic expressions and entertainment on our psychological health. This anthology shows the intersection between art, entertainment, and our mental health. We delve into how different art and entertainment mediums can influence our mental wellbeing. This exploration has been a great culmination of research and analysis. We used extensive research to shed light …

A Tilted Broad Plume Underneath The Greenland Cratonic Keels, Dan Wang, Stephen S. Gao, Yangyang Liao, Kelly H. Liu

Geosciences and Geological and Petroleum Engineering Faculty Research & Creative Works

To advance our comprehension of the complex geological history and mantle dynamics in the north atlantic region, we employ all available broadband seismic data recorded in greenland to reveal an abnormal mantle transition zone (mtz) structure. Central and eastern greenland exhibits depressed 410 and 660 km discontinuities (d410 and d660, respectively) bordering the mtz, indicative of a substantial thermal anomaly associated with an underlying plume, surpassing the 1,800°c threshold for post-garnet phase transitions at the d660. Variations in mtz thickness across greenland stem from differing temperature anomalies at the d410 and d660, possibly linked to a tilted plume within the …

Rotational Spectrum, Structure, And Quadrupole Coupling Of Cyclopropylchloromethyldifluorosilane, Alexander R. Davies, Abanob G. Hanna, Alma Lutas, Gamil A. Guirgis, Garry S. Grubbs

Chemistry Faculty Research & Creative Works

Cyclopropylchloromethyldifluorosilane, C-C3H5SiF2CH2Cl, Has Been Synthesized, and its Rotational Spectrum Has Been Recorded by Chirped-Pulse Fourier Transform Microwave Spectroscopy. the Spectral Analysis of Several Isotopologues Indicates the Presence of Two Distinct Conformations in the Free-Jet Expansion, Which Are Interconvertible through a Rotation of the Chloromethyl Group. a Partial Substitution Structure is Presented for the Lower Energy Conformation and is Compared to the Equilibrium Structure Obtained from Quantum Chemical Calculations. Additionally, the Presence of the Chlorine Nucleus Leads to the Rotational Transitions Splitting into Multiple Hyperfine Components and Χaa, a Measure of the Electric Field Gradient Along the a Axis, is Unusually …

Improving Student Engagement Despite Lowering Attention Spans In The Classroom, Kaycee Lee

Senior Honors Theses

Attention spans have been decreasing throughout society for many years, partially due to the constant increase of technological advances. The average human attention span of eight seconds is particularly concerning to teachers and others in the classroom. It does not seem that the average attention span is ever going to increase, so teachers must implement intentional methods and strategies within their classroom to keep their students’ attention. Physical activities, technology and hands-on supports, small group instruction, shorter lessons, making intentional mistakes, flexible seating, and differentiated instruction are all strategies supported by research to improve student engagement within the classroom. Every …

Sex-Related Differences In Reaction Time During Normobaric Hypoxic Hypoxia In Physically Active University Students, Danielle Passburg

Senior Honors Theses

Limited research has been completed on the sex-related differences in reaction time during hypoxic hypoxia. This is concerning due to the importance of reaction time during hypoxic hypoxia in aviation (particularly within the realm of military aviation). The purpose of this study was to examine the sex-related differences in reaction time during hypoxic hypoxia in university students. The study used a normobaric oxygen device to simulate hypoxic states and Delphi computer software to test reaction time. Subjects were physically active university students (10 females, 10 males). The results of the study showed no significant differences between sexes in reaction times …

The Impact Of Testimonies On Partner Development Strategies: Mission Work In Europe, Kimberly Witte

Senior Honors Theses

This study seeks to answer how first-world missionaries can utilize research findings on the effectiveness of testimonials and apply that knowledge to partner development strategies. Research trends demonstrate that most missionaries are being sent to countries with the largest practicing Christian populations, such as those in Africa or South America, and are more likely to receive financial partnerships. Europe has a high rate of non-practicing Christians and is a cultural intersection due to the refugee crisis, leading to a need for mission work. This research will culminate in the creation of a prayer guide, highlighting testimonies of individuals impacted by …

Planting Of Stimulated Corn Seeds At Different Dates In Spring Seasons, M. M. Khudhair, J. H. Hamza, H. Z. Rihan

School of Biological and Marine Sciences

This study was aimed to investigate the appropriate planting date and tolerance to adverse growing conditions in the spring season through seeds stimulation technology. A field experiment was carried out in the spring seasons of 2022 and 2023 according to a randomized complete block design in a split-plot arrangement with four replications. The main factor is planting dates (February 15^th, March 1^st and 15^th, and April 1^st and 15^th). The secondary factor is seeds stimulation (potassium nitrate 6 mg L ^-1 + licorice extract 6 g L ^-1, as well as …

Role Of Neurocellular Endoplasmic Reticulum Stress Response In Alzheimer’S Disease And Related Dementias Risk, Miriam Aceves, Jose C. Granados, Ana C. Leandro, Juan M. Peralta, David C. Glahn, Sarah Williams-Blangero, Joanne E. Curran, John Blangero, Satish Kumar

School of Medicine Publications

Currently, more than 55 million people around the world suffer from dementia, and Alzheimer’s Disease and Related Dementias (ADRD) accounts for nearly 60–70% of all those cases. The spread of Alzheimer’s Disease (AD) pathology and progressive neurodegeneration in the hippocampus and cerebral cortex is strongly correlated with cognitive decline in AD patients; however, the molecular underpinning of ADRD’s causality is still unclear. Studies of postmortem AD brains and animal models of AD suggest that elevated endoplasmic reticulum (ER) stress may have a role in ADRD pathology through altered neurocellular homeostasis in brain regions associated with learning and memory. To study …

Be Aware Of The Unexpected : Interrupted Inferior Vena Cava With Azygos Continuation, Tit Kei Ng, Tommy King-Him Ma, Chi-Chun Au, Janice Woon-Yan Wong, Jenny Nga-Lai Chow, Andrew Vincent Li, Adrian Yin-Cheung Luk, Candy Ming-Yan Cheuk, Jaclyn Chi-Lin Chan, Li-Wah Tam

Journal of the Hong Kong College of Cardiology

Interrupted inferior vena cava with Azygos continuation is a rare anomaly. Nevertheless, being a high-volume operator of endovascular procedures, a cardiologist should have knowledge about this anomaly. We reported a case of incidental finding of this anomaly during an intended Leadless pacemaker (Micra) implantation. Embryological development, anatomy and procedural implication of this condition were discussed. In particular, management options when confronted by this anomaly during Micra implantation were explored.

The Ugliness Movement: Riot Grrrl's Use Of Ugliness As Feminist Subversion, Maylee Rollins

The Purdue Historian

In the 1990s, Riot Grrrl took the punk and feminist worlds by storm. It emphasized community and represented third-wave feminism in radical form. One particular example that represents the Riot Grrrl ideology well is ugliness. Throughout the movement, artists like Courtney Love and Kathleen Hanna used their musical platform to show the world their view of femininity. This involved body writing and reclaiming words used to degrade women, as well as dressing up in controversial outfits dubbed as “kinderwhore.” The aims of these women in using ugliness in their music were to subvert sexism in the punk scene and bring …

Where To Test A Nuclear Bomb, Tyler Kliegl

The Purdue Historian

The United States detonated three underground nuclear bombs on a far-off Alaskan island called Amchitka in the 1960s and 70s. The goal is to understand what the motive of the United States in selecting Amchitka over the endless potential sites to test at were. What makes a place worthy in being tested on, or unworthy in being left alone. How does the United States deal with resistance from locals and other organizations, fighting to prevent their tests.

The American West And Nozick’S Theory Of Entitlements, Kaitlyn E. Price

The Purdue Historian

Customary law emphasizing the protection of private property rights rather than the authoritative assertion of the law characterized expansion into the American West from 1848-1895. The subsequent legal systems developed in a minarchistic manner that aligned with Robert Nozick’s “theory of entitlements,” leading to the adoption of a “night-watchman state.” This theory asserts that a society built upon customary law that focuses on the protection of individual rights will undoubtedly develop a protective body to safeguard these rights in pursuit of the third principle, the “rectification of justice.” Thus, the chaotic and often disorganized way the West’s extralegal and formal …