Student Perception of Clicker Usage in Nursing Education

Nurse educators must explore innovative ways to engage students and stimulate learning. Student response system (SRS) technology is one tool educators can use to increase participation, provide immediate feedback, and encourage critical thinking. This study evaluated perceptions of first-year nursing students using SRS technology. The findings support the use of SRS technology as a positive pedagogical approach to incorporate in teaching associate degree nursing students

Hypertrophic obstructive cardiomyopathy: alcohol septal ablation

Alcohol septal ablation (ASA) was introduced in 1994 as an alternative to septal myectomy for patients with hypertrophic obstructive cardiomyopathy and symptoms refractory to medical therapy. This procedure alleviates symptoms by producing a targeted, limited infarction of the upper interventricular septum, resulting in an increase in left ventricular outflow tract (LVOT) diameter, a decrease in LVOT gradient, and regression of the component of LV hypertrophy that is due to pressure overload. Clinical success, with improvement in symptoms and reduction in gradient, is achieved in the great majority of patients with either resting or provocable LVOT obstruction. The principal morbidity of the procedure is complete heart block, resulting in some patients in the requirement for a permanent pacemaker. The introduction of myocardial contrast echocardiography as a component of the ASA procedure has contributed to the induction of smaller myocardial infarctions with lower dosages of alcohol and, in turn, fewer complications. Non-randomized comparisons of septal ablation and septal myectomy have shown similar mortality rates and post-procedure New York Heart Association class for the two procedure

The reactions to the 1988 Yellowstone wildfires highlight the differences in American and Canadian politics

In 1988, Yellowstone National Park in the Northwest United States experienced the largest wildfires in its more than 100-year history. Shannon K. Orr and Nichole Fifer take a close look at the reactions of policy-makers in the U.S. and Canada to the fires, writing that while Parks Canada adopted a policy of ‘let-burn’, U.S. authorities have taken a far more interventionist line. They argue that these reactions are the products of the two country’s differing political systems. In Canada decision-making is highly centralized, and largely rests with Parks Canada, while in the U.S., the separation of powers often means that public policies are open to multiple avenues of influence, and power often rests with political appointees and federal politicians

Stable Electromyographic Sequence Prediction During Movement Transitions using Temporal Convolutional Networks

Transient muscle movements influence the temporal structure of myoelectric signal patterns, often leading to unstable prediction behavior from movement-pattern classification methods. We show that temporal convolutional network sequential models leverage the myoelectric signal's history to discover contextual temporal features that aid in correctly predicting movement intentions, especially during interclass transitions. We demonstrate myoelectric classification using temporal convolutional networks to effect 3 simultaneous hand and wrist degrees-of-freedom in an experiment involving nine human-subjects. Temporal convolutional networks yield significant $(p<0.001)$ performance improvements over other state-of-the-art methods in terms of both classification accuracy and stability.Comment: 4 pages, 5 figures, accepted for Neural Engineering (NER) 2019 Conferenc

History and present state of the Slano Blato landslide

The Slano Blato landslide is more than 1290 m long, 60 to 200 m wide and 3 to 11 m deep with a volume of about 700 000 m(3). It is located in the Eocene flysch region of western Slovenia with a limestone overthrust in the direct vicinity, above the landslide. The landslide moves mainly as a viscous earth flow with occurrences of rapid mud flows. In dry periods or in freezing conditions it behaves as a group of several slow to moderate landslides. The landslide follows the course of the Grajscek stream and is presently only 220 m away from Lokavec village. The landslide was first mentioned about 200 years ago. In 1887 it flowed as a liquid flow and reached and destroyed the main road in the valley 2 km away. The Austro-Hungarian monarchy sent one engineer to the site and 17 years later the slide was remediated with a series of torrential check dams. The monarchy prohibited any construction works in the influence, area of the landslide. During the 20th century the region changed from Austrian, Italian, Yugoslav, and finally to Slovenian government in 1991. The relevant Austrian measures and decisions were forgotten during the course of the years, and building permits were issued after the World War II to local people who populated the part of the landslide influence area. Simultaneously, regular maintenance of the excellent past engineering works was neglected. In November 2000 a large landslide of mud and debris was triggered again and it still presents a danger to the relatively new residential houses today. At present, the village is protected against mudflows by a small rockfill dam and by the regulation of the stream bed. In rainy periods removal of mud is necessary to maintain safe conditions for the village. The paper discusses the geological, hydrogeological, hydrological and geotechnical conditions for the occurrence of the Slano Blato landslide. The primary reasons for the Slano blato landslide are the geological and hydrogeological conditions just beneath the overthrust of a Triassic limestone plateau over the Eocene flysch of Vipava valley. The direct reason for triggering the earth flow in 2000 was the intensive precipitation. During the course of years the precipitation threshold for earth flow movements has diminished. The landslide has to be remediated for two main reasons (1) the village below the landslide is endangered, and (2) the landslide is still advancing retrogressively and laterally. The foreseen permanent remediation measures that are currently under construction are briefly presented

Exploring behavioral responses of motorists to risk-based charging mechanisms

This paper reports the behavioral response of motorists in Australia to a variable-rate charging scheme designed to encourage safer driving practices and reduce exposure to crash risk, specifically kilometers driven, nighttime driving, and speeding. The study involved a 5-week before period of Global Positioning System monitoring to establish how motorists drove normally, followed by a 5-week after period of Global Positioning System monitoring in which charges were levied and changes assessed. Incentives were paid to motorists for the difference in the charges between the two 5-week periods. Vehicle kilometers traveled (VKT) was reduced by 10%, although the sample was evenly split into motorists with increasing VKT and those with decreasing VKT. The proportion of distance speeding fell by 4.7%; this finding, when coupled with decreases in VKT, implied a net reduction of more than 40% in kilometers spent speeding. Three-fourths of the participants reduced their speeding. Exit interviews with a cross section of participants highlighted the practical difficulties of reducing kilometers but (more encouragingly) reinforced the potential to reduce speedin

Personal qualities of effective sport psychologists: a sports physician perspective

Abstract Previous literature within applied sport psychology offers little detailed discussion regarding the personal qualities of sport psychology practitioners and the impact of these qualities on practice. This paper presents an exploration of the views of sport physicians regarding the personal characteristics and qualities of applied sport psychologists deemed necessary for effective practice. Five UK-based physicians and one Head of Medical Services, working in a range of elite and professional sports, were interviewed about their experience and perceptions of working with sport psychologists. The interview transcripts were content analysed and trustworthiness criteria applied. Four key themes emerged from the data, labelled ‘Personal qualities’, ‘Relationship Building’, ‘Professionalism in Practice’, and ‘Similarities between Psychologist and Physician’. The findings within each theme offered interesting insights into the impact of personal qualities on effective sport psychology practice. This study extends the existing literature on sport psychologists’ characteristics and effectiveness and offers new insights into their personal qualities and how these interact with the practice environment. The findings supported the growing emphasis within the field on the importance of the person behind the practitioner. Suggestions are offered with reference to the need to consider how literature from counselling psychology and medical training could assist the development of practice and education and training in sport psychology

Entropy Information of Cardiorespiratory Dynamics in Neonates during Sleep

Abstract: Sleep is a central activity in human adults and characterizes most of the newborn infant life. During sleep, autonomic control acts to modulate heart rate variability (HRV) and respiration. Mechanisms underlying cardiorespiratory interactions in different sleep states have been studied but are not yet fully understood. Signal processing approaches have focused on cardiorespiratory analysis to elucidate this co-regulation. This manuscript proposes to analyze heart rate (HR), respiratory variability and their interrelationship in newborn infants to characterize cardiorespiratory interactions in different sleep states (active vs. quiet). We are searching for indices that could detect regulation alteration or malfunction, potentially leading to infant distress. We have analyzed inter-beat (RR) interval series and respiration in a population of 151 newborns, and followed up with 33 at 1 month of age. RR interval series were obtained by recognizing peaks of the QRS complex in the electrocardiogram (ECG), corresponding to the ventricles depolarization. Univariate time domain, frequency domain and entropy measures were applied. In addition, Transfer Entropy was considered as a bivariate approach able to quantify the bidirectional information flow from one signal (respiration) to another (RR series). Results confirm the validity of the proposed approach. Overall, HRV is higher in active sleep, while high frequency (HF) power characterizes more quiet sleep. Entropy analysis provides higher indices for SampEn and Quadratic Sample entropy (QSE) in quiet sleep. Transfer Entropy values were higher in quiet sleep and point to a major influence of respiration on the RR series. At 1 month of age, time domain parameters show an increase in HR and a decrease in variability. No entropy differences were found across ages. The parameters employed in this study help to quantify the potential for infants to adapt their cardiorespiratory responses as they mature. Thus, they could be useful as early markers of risk for infant cardiorespiratory vulnerabilities

A randomised trial of early palliative care for maternal stress in infants prenatally diagnosed with single-ventricle heart disease

AbstractChildren with single-ventricle disease experience high mortality and complex care. In other life-limiting childhood illnesses, paediatric palliative care may mitigate maternal stress. We hypothesised that early palliative care in the single-ventricle population may have the same benefit for mothers. In this pilot randomised trial of early palliative care, mothers of infants with prenatal single-ventricle diagnoses completed surveys measuring depression, anxiety, coping, and quality of life at a prenatal visit and neonatal discharge. Infants were randomised to receive early palliative care – structured evaluation, psychosocial/spiritual, and communication support before surgery – or standard care. Among 56 eligible mothers, 40 enrolled and completed baseline surveys; 38 neonates were randomised, 18 early palliative care and 20 standard care; and 34 postnatal surveys were completed. Baseline Beck Depression Inventory-II and State-Trait Anxiety Index scores exceeded normal pregnant sample scores (mean 13.76±8.46 versus 7.0±5.0 and 46.34±12.59 versus 29.8±6.35, respectively; p=0.0001); there were no significant differences between study groups. The early palliative care group had a decrease in prenatal to postnatal State-Trait Anxiety Index scores (−7.6 versus 0.3 in standard care, p=0.02), higher postnatal Brief Cope Inventory positive reframing scores (p=0.03), and a positive change in PedsQL Family Impact Module communication and family relationships scores (effect size 0.46 and 0.41, respectively). In conclusion, these data show that mothers of infants with single-ventricle disease experience significant depression and anxiety prenatally. Early palliative care resulted in decreased maternal anxiety, improved maternal positive reframing, and improved communication and family relationships.</jats:p