The Handoff Culture: Can we change how an ICU to floor transfer works?

Handoffs between providers have increased following the implementation of the 2011 Accreditation Council for Graduate Medical Education (ACGME) work hour restrictions. Properly structured and timed handoffs are essential to patient safety.1 Despite this, studies have shown that errors in code status, medication allergies, and important updates to the problem list are common, all of which can lead to adverse outcomes to patients.2 At Thomas Jefferson University Hospital (TJUH) the 2016 Safety Culture Survey revealed that across all specialties, 37% of residents felt that things “fall through the cracks” when transferring patients from one unit to another. Our interdepartmental Housestaff Quality and Safety Leadership Council (HQSLC) sought to evaluate and modify the TJUH ICU to floor handoff process. Through engaging our diverse membership, we realized that the ICU to floor handoff process at TJUH lacks standardization. The following areas demonstrated a high degree of variation, and were seen as targets for improvement: ● Timing of handoff: Some departments give the handoff at the time of transfer order, and others at bed assignment. ● Incorporation of best practices: Both verbal and written handoffs should be performed with time for follow up questions by the receiving team ● Closed loop communication: Both sending and receiving teams should clearly communicate the plan of care, and the receiving team should clearly indicate when they have taken over primary responsibility. Poster presented at: House Staff Quality and Safety Leadership Council conference at Thomas Jefferson University.https://jdc.jefferson.edu/patientsafetyposters/1073/thumbnail.jp

The Many Shades of Anne Boleyn

Anne Boleyn, the second wife of King Henry VIII and the mother to Elizabeth I, is a famous historical figure who has been the focus of many fictional dramas. Mysteries surrounding Anne’s looks and her involvement in historical events has created interest that allow historical fiction writers to produce different version of Anne Boleyn on film and in the theater. Multiple of these fictional representation of Anne Boleyn processes feminist ideals that are a result of the feminist wave happening at the time. Though a feminist lens, one can see how the portrayal of Anne Boleyn has varied. This project analyzes the way in which second, third, and fourth-wave feminism have shaped the way Anne Boleyn has been portrayed on television, in film, and on stage

What are we being told about how to teach games? a three-dimensional analysis of comparative research into different instructional studies in Physical Education and School Sports

Determining what pedagogical approach could be most effective in delivering the desired learning outcomes in teaching games has been one of the more relevant concerns for physical education teachers, coaches and researches in the last few decades. Nevertheless, until recently, the research carried out in this field has been little profuse, has met with several difficulties and has been made from different perspectives, which has complicated its analysis altogether. The present study follows three main objectives: a) to analyse the nature of the interventions used in the comparative investigation directed to teaching sports, b) to determine the effects of the levels of treatment and, c) to outline some didactic consequences. Twenty comparative studies were selected for a systematic review

Effluent Treatment and Recovery of Polyether Using Nanoporous Technology

This semester Evonik Industries, a specialty chemical producer located in Hopewell, Virginia, approached VCU’s Chemical Engineering department with a project that would reduce their costs and increase process sustainability. The project is to determine a way to separate their liquid organic product from their waste stream in order to recycle the lost product. Liquid-Liquid extraction is a procedure used across most of the chemical industry. Proven separation techniques already exist for the standard liquid-liquid separation; however, when one liquid is miscible in the other the difficulty of separation is greatly increased. In order to do a liquid-liquid separation of an organic liquid in water at a large scale at an advantageous cost, a new technique must be implemented. This project would be well suited for students with the knowledge gained over three years in Chemical Engineering. Implementing a method using a hydrophilic nano-porous membrane to separate organic material from water using a pressure gradient will require experimental analysis of the compounds initially. Our team will perform testing on several organic molecules in order to determine the polymer’s hydrodynamic radius. This allows the team to determine the appropriate material and porosity needed for our proposed porous material. The addition of a cosurfactant is also recommended in order to create micelles, which would increase the size of the product being collected. These procedures will be carried out on a bench scale and later scaled up to determine the solution’s feasibility in Evonik’s Hopewell facility. Currently, flash distillation is the primary technique of liquid-liquid separation of miscible liquids, but in a large process this would become very costly and energy consuming. The solution to this project can become very cost effective and would not require much, if any, energy input to work. The proposed solution to this problem could be used worldwide in order to further purify products, increase product yield, as well as to drive down costs production costs from recycling.https://scholarscompass.vcu.edu/capstone/1014/thumbnail.jp

Building an Economical and Sustainable Lunar Infrastructure to Enable Lunar Science and Space Commerce

A new concept study was initiated to examine the framework needed to gradually develop an economical and sustainable lunar infrastructure using a public private partnerships approach. This approach would establish partnership agreements between NASA and industry teams to develop cis-lunar and surface capabilities for mutual benefit while sharing cost and risk in the development phase and then allowing for transfer of operation of these infrastructure services back to its industry owners in the execution phase. These infrastructure services may include but are not limited to the following: lunar cargo transportation, power stations, energy storage devices, communication relay satellites, local communication towers, and surface mobility operations

Defining the crime of aggression : cutting the Gordian knot ?

"Mémoire présenté à la Faculté des Études supérieures en vue de l'obtention du grade de LL.M. en Maîtrise en droit Option recherche"Le crime d'agression se veut etre un des quatre crimes internationaux sous la juridiction de la CPI. Lorsque les delegues a la Conference de Rome n'eurent point atteint de consensus sur une definition du crime, celui-ci resta, depuis, indefini en droit. En consequence, la CPI n'aura juridiction pour entendre des causes portant sur le crime d'agression qu'une fois la definition sera adoptee par l'Assemblee des Etats Parties au plus tot en 2009. Ce memoire traite trois problematiques liees au crime d'agression : la question de la responsabilite penale individuelle, le role du Conseil de securite de l'ONU, et les parametres du crime en tant que tel. La responsabilite penale individuelle est analysee, inter alia, du point de vue du principe des sources du droit international. Quant al'eventuelle implication du Conseil de securite dans le champ de competence de la CPI sur le crime d'agression, l'auteure soutient tel que suit: Si le Conseil de securite se voit accorde un pouvoir plus large que celui dont il est presentement dote en vertu des articles 13(b) et 16 du Statut de Rome, chaque membre permanent aura un veto sur toute situation d'agression qui serait autrement portee devant la Cour. Ceci aura pour consequence de politiser la CPI en ce qui a trait au crime et rendra hypothethique toute definition eventuelle. Si la definition est bien con9ue et redigee, on fait valoir, qu'il n' est point necessaire de limiter davantage la competence de la CPI. Les parametres de la definition du crime proposes par l'auteure sont etablis selon les conclusions d'une analyse des notions composantes de l'agression. L'essentiel du concept se veut un recours illegal et non-necessaire qui constitue une rupture ala paix. Amoins qu'il ne soit exerce en « legitime defence» ou en vertu d'un mandat du Chapitre VII, Ie recours ala force constitue prima facie une agression et s'il est suffisamment grave, il s'agira d'un crime d'agression. Ce memoire termine avec un projet de definition du crime d'agression en vue d'avancer Ie discours vers un consensus sur ces problematiques majeures. Non seulement est-il possible d'arriver aun consensus sur la definition, croit l'auteure, mais nous sommes plus que jamais al'aube d'y parvenir.The crime of aggression is one of the four international crimes under the jurisdiction of the ICC. When delegates at the Rome Conference were unable to agree on the content of a definition, the crime was left undefined. As a result, the ICC can only begin prosecuting individuals for the crime of aggression once a definition is adopted by the Assembly of States Parties in 2009, at the earliest. This thesis examines three issues associated with the crime of aggression: the question of individual criminal responsibility, the role of the UN Security Council and the general scope of the definition of the crime of aggression itself Individual criminal liability is reviewed, inter alia, from the perspective of international sources doctrine. Regarding the role of the Security Council in relation to the crime of aggression, the author concludes: if the Security Council is vested with more powers than it already has under Articles 13(b) and 16 of the Rome Statute, each permanent member will have a veto over any situation of aggression that might otherwise be brought before the Court. This would result in a complete politicization of the ICC and render moot any future definition of the crime of aggression. If a definition for the crime of aggression is properly conceived and constructed, it is argued, there is no need to further limit the Court's exercise of jurisdiction. The author proposes general parameters for the scope ofthe definition based on conclusions reached in the analysis of the conceptual components of aggression. At its essence, the act of aggression is the unnecessary, unlawful use of force which constitutes a breach ofthe peace. Unless employed in "self-defence" or under a Chapter VII mandate, the use offorce constitutes prima facie an act of aggression, and if it is sufficiently grave, a crime ofaggression. This thesis concludes with a working definition ofthe crime of aggression to promote dialogue and ultimately a consensus on these core issues. Not only is a definition is within reach, the author believes, we are closer to it than we ever have been before