Sandhills Community College

None.

The transition from student to professional nurse is an important milestone in the development of newly graduated nurses. Mindfulness-based stress reduction (MBSR) has been shown to reduce symptoms of stress in those engaged in regular practice (Bazarko, Cate, Azocar, & Kreitzer, 2013; Kabat-Zinn, 1990). The quality improvement project used a one-group pre-test/posttest design to measure newly graduated registered nurses' awareness of mindfulness and perceived stress. Mindfulness awareness improved from pre-intervention (M = 3.66, SD = .81) to post-innovation (M = 4.03, SD = .69) although this was not statistically significant, (t[67] = 1.93, p = .057). There was a statistically significant decrease in perceived stress from pre-innovation (M = 19.47, SD = 7.16) to post-innovation (M = 15.71, SD = 6.90), (t[66] = 2.16, p = .034). Qualitative themes of increased patient safety, communication, and teamwork were identified. MBSR has the potential to increase mindfulness and decrease perceived stress in newly graduated registered nurses, encouraging improved patient safety, communication, and teamwork.

BACKGROUND Cyberincivility is a pervasive issue that demands upfront thinking and can negatively impact one’s personal, professional, social, and educational well-being. Although massive open online courses (MOOCs) environments could be vulnerable to undesirable acts of incivility among students, no study has explored the phenomena of cyberincivility in this learning environment, particularly in a health-related course in which mostly current or eventual health professions students enroll. OBJECTIVE This study aimed to analyze the characteristics of text entries posted by students enrolled in a medicine and health care MOOC. The objectives were to (1) examine the prevalence of posts deemed disrespectful, insensitive or disruptive, and inconducive to learning; (2) describe the patterns and types of uncivil posts; and (3) highlight aspects that could be useful for MOOC designers and educators to build a culture of cybercivility in the MOOC environment. METHODS We obtained data from postings in the discussion forums from the MOOC Medical Neuroscience created by a large private university in the southeast region of the United States. After cleaning the dataset, 8705 posts were analyzed, which contained (1) 667 questions that received no responses; (2) 756 questions that received at least one answer; (3) 6921 responses that applied to 756 posts; and (4) 361 responses where the initiating post was unknown. An iterative process of coding, discussion, and revision was conducted to develop a series of a priori codes. Data management and analysis were performed with NVivo 12. RESULTS Overall, 19 a priori codes were retained from 25 initially developed, and 3 themes emerged from the data—Annoyance, Disruption, and Aggression. Of 8705 posts included in the analysis, 7333 (84.24%) were considered as the absence of uncivil posts and 1043 (11.98%) as the presence of uncivil posts, while 329 (3.78%) were uncodable. Of 1043 uncivil posts analyzed, 466 were coded to >1 a priori codes, which resulted in 1509 instances. Of those 1509 instances, 826 (54.74%) fell into “annoyance”, 648 (42.94%) into “disruption”, and 35 (2.32%) into “aggression”. Of 466 posts that related to >1 a priori codes, 380 were attributed to 2 or 3 themes. Of those 380 posts, 352 (92.6%) overlapped both “annoyance” and “disruption,” 13 (3.4%) overlapped both “disruption” and “aggression,” and 9 (2.4%) overlapped “annoyance” and “aggression,” while 6 (1.6%) intersected all 3 themes. CONCLUSIONS This study reports on the phenomena of cyberincivility in health-related MOOCs toward the education of future health care professionals. Despite the general view that discussion forums are a staple of the MOOC delivery system, students cite discussion forums as a source of frustration for their potential to contain uncivil posts. Therefore, MOOC developers and instructors should consider ways to maintain a civil discourse within discussion forums.

High %n‐6 HUFA in plasma and tissues is associated with a heightened inflammatory response.PURPOSETo test if a diet that lowers the %n‐6 would be associated with less strength loss after fatiguing load carriage exercise and shorter time to recover muscle strength and performance.METHODSVolunteers were randomly assigned to either a control diet (CON; n=23; 22.5 g n‐6 and 0.2 g n‐3 HUFA/2,000 kcal) plus placebo smoothie (‐S), an experimental diet (EXP; n=25; 8.0 g n‐6 and 0.9 g n‐3 HUFA/2,000 kcal) and ‐S, or EXP plus n‐3 fortified smoothie (EXP+S; n=23; 1.9 g n‐3 HUFA) for 10 weeks. Volunteers performed a single leg step test (up to 3 sets & 6 min each leg) while wearing a 20 kg vest. Maximal isometric and isokinetic torque at 60°/sec, and total work during 20 reps at 180°/sec were measured before, 5 min after the step test, and 24, 48 and 72 h of recovery.RESULTSThe step test produced a 20% (95%CI 16‐25), 19% (12‐25), and 19% (15‐27) reduction in isometric torque for EXP+S, EXP‐S, and CON, respectively, with no group x time interaction during recovery (p=0.89). A similar magnitude and pattern was observed for isokinetic torque and total work.CONCLUSIONA 10‐wk dietary manipulation that substantially lowered %n‐6 and increased %n‐3 HUFA was not associated with less fatigue or faster recovery after load carriage exercise. The views expressed in this abstract are those of the authors and do not reflect the official policy of the Dept. Army, Dept. Defense, or the U.S. Government.

Purpose: CH is a 6 y/o WF who presented because of “constipation all my life” and periumbilical abdominal pain. Previous treatment with Miralax® relieved the constipation but had no effect on the abdominal pain. It was discontinued because of concern for long term side effects. PMH: constipation. PE: normal. CBC, CMP, TSH, TTG IgA, total IgA, B12 and magnesium were normal. 25 hydroxy vitamin D was 23.3 ng/ml (nl 32-100). Colon transit study revealed 7/24 markers in the rectum, 5 days after ingestion of a SITZMARKS® capsule. Anorectal manometry revealed dyssynergic defecation with a 60 mm Hg increase in anal sphincter tone when bearing down to have a bowel movement. Lactulose breath test for small intestine bacterial overgrowth revealed baseline hydrogen=2 ppm, that increased to 78 ppm at 2 hours, and peaked at 106 ppm at 2 hrs 40 min; with an average of 46 ppm H2 throughout the 3 hour test. Treatment included amoxicillin 250 mg tid for one week, a generic probiotic and the specific carbohydrate diet developed by Elaine Gottschall and outlined in her book, “Breaking the Vicious Cycle.” The diet eliminates sugar, except for honey - because bacteria can't grow in honey; and starches. After two weeks on the diet, she had only one episode of abdominal pain and was having a hard stool every other day. After two months on the diet CH was having a bowel movement 5 days out of 7 and her abdominal pain had resolved completely. After nine months on the diet, she continued to be free of abdominal pain and was having a soft stool daily. Vitamin D level was 46 ng/ml on vitamin D 2,000 units daily. Repeat lactulose breath hydrogen test revealed baseline of 3 ppm H2, 34 ppm H2 at 2 hours, peak H2 at 56 ppm after 3 hours. The average breath H2 was 24.1 ppm H2 throughout the test. Periumbilical abdominal pain and constipation was present in association with moderately severe vitamin D deficiency and an abnormal lactulose breath hydrogen test. Sustained relief of these symptoms and significant reduction in breath hydrogen occurred with dietary treatment with restriction of sugar, except for honey; and starches.

To compare the McMaster and centrifugal flotation techniques and larval culture for recovery of cyathostomin (small strongyle) eggs from the feces of horses. Fecal samples from 101 horses. In experiment I, homogenized fresh feces from a single horse were randomly subsampled by use of each technique for 10 replicates. In experiment II, samples from 43 horses that had no anthelmintic treatment were analyzed by use of McMaster, centrifugal flotation, and larval culture techniques. In experiment III, 57 horses were treated with an anthelmintic by owners, and fecal samples were analyzed as for experiment II. In experiment I, use of the McMaster technique recovered 72% of the eggs obtained by use of centrifugal flotation from paired subsamples. In experiment II, use of the McMaster technique recovered 81% of the eggs obtained by use of centrifugal flotation. Only cyathostomins resulted from individual larval cultures. In experiment III, 24 samples had negative results for all 3 tests, 18 samples had positive results only with larval cultures, and 15 samples had positive results of centrifugal flotation (only 5 of which had positive results via the McMaster technique). Centrifugal flotation consistently was superior to the McMaster technique, especially at low fecal egg numbers. The combination of centrifugal flotation and larval culture may provide the best accuracy for evaluation of anthelmintic efficacy.

Abstract The current procedures for calculating pressure-temperature (P/T) limits for normal reactor startup and shutdown are defined by deterministic fracture mechanics methodology in the ASME Code, Appendix G (in both Section XI and Section III). The recent pressurized thermal shock (PTS) re-evaluation effort used a very thorough probabilistic fracture mechanics (PFM) evaluation to develop a technical basis to increase the PTS screening criteria. The feasibility of applying this same PFM methodology to evaluate normal startup and shutdown operation for both pressurized water reactor (PWR) and boiling water reactor (BWR) pressure vessels is described in this paper. The approach taken in this study was to define a new risk-informed margin term to be applied to the stress intensity factor for membrane tension (KIm) in Appendix G. The margin on KIm was determined by finding the value that results in a vessel failure frequency equal to 10−6 failures/reactor-year when the reactor operates up to the pressure-temperature limits calculated using the risk-informed margin. This simple approach was selected because it results in a minimum change to the current ASME Code procedure, is easy to apply when revising plant operating P/T limits, and allows for an increase in the allowable P/T limits by as much as would be provided by any alternate procedure. The results from this initial study indicate the margin on KIm in Appendix G can be reduced from 2 to 1.5 for PWR vessels for shutdown and potentially reduced from 2 to as low as 1 for startup. The results indicate the margin on KIm in Appendix G can be reduced from 2 to approximately 1 for BWR vessels for shutdown and potentially startup. Additional analyses for PWR and BWR vessels will be needed to develop a comprehensive risk-informed basis for any revisions to the ASME Code, Appendix G.

The International Atomic Energy Agency (IAEA) has sponsored a series of Coordinated Research Programs (CRPs) that have been focused on integrity of reactor pressure vessel (RPV) materials. The emphasis in the last few years has been on the development of a large fracture mechanics database of three-point bend fracture toughness tests on precracked Charpy specimens and larger 1T (25.4 mm thickness) compact tension specimens, using the Master Curve approach that has been standardized in ASTM Test Method for the Determination of Reference Temperature, To, for Ferritic Steels in the Transition Range (E 1921). More than 20 international laboratories have conducted a significant amount of fracture toughness testing to allow evaluation of the Master Curve results obtained following ASTM E 1921. The current CRP also has the objective to develop international guidelines for producing adequate Master Curve data and applying the data to RPV integrity analyses. This paper will first describe a preliminary review of the data that have been produced with emphasis on the A533B-1 correlation monitor heat JRQ, which has served as a key material for the CRP. The main emphasis of the paper will be on the development of international guidelines for applying the Master Curve data that can be obtained from irradiated sample material for the most limiting RPV material.

The rotating stool for angular momentum described in this article uses a hub removed from the rear axle of a salvaged Geo automobile. The bearings of this hub are sealed and will not require any additional preparation. This rotating stool weighs 18 pounds, is 18 inches high, and will conform to an uneven floor. The seat and stand can easily be removed from the base for storage and transportation.