Practice Patterns Contributing to Positive Patient Outcomes by Nurse Practitioners

Purpose: The purpose of this study was to identify NP practice patterns most important for positive patient outcomes. Data Sources: A convenience sample (n = 93) of Nurse Practitioners attending the 2005 California Association for Nurse Practitioners Conference (N = 535) completed the survey. Conclusions: The most important practice patterns identified were associated with patient-centered care. When analyzed with years in practice, patient-centered practice patterns continued to be the most important. This study suggests that patient-centered practice patterns are most important to positive patient outcomes for NPs. Implications for practice: Identifying the practice patterns that are most important to positive patient outcomes creates a distinct picture of the quality of care that is unique to nursing. As the role of NP continues to expand and be defined, these practice patterns will provide evidence of the unique quality of care given by the NP profession

Interpretive Freedom: A Necessary Component of Article III Judging

As judges have debated the best method of constitutional and statutory interpretation, scholars have begun calling for increased constraints on the methodological freedoms of Article III judges. This Note rejects such proposals on constitutional grounds. Drawing upon the jurisprudence and scholarship on inherent powers, I argue that interpretive choice is an inherent judicial power. The drafting and ratification history of Article III demonstrates that the Framers expected federal judges to interpret the law. To accomplish this task, however, judges must have some methodological approach to help them prioritize interpretive evidence. Thus, imposition of a binding interpretive methodology upon federal judges would pose two constitutional problems. First, it would infringe the essential judicial function of interpretive deliberation. Second, it would prevent the judiciary as a whole from engaging in its most powerful constitutional check on the excesses of the political branches. Because interpretive freedom is necessary to the fulfillment of the Article III judicial function, that freedom must be considered an inherent power vested in all federal judges

Performance evaluation of electrochemical concentration cell ozonesondes

Laboratory calibrations of more than a hundred electrochemical concentration cell (ECC) ozonesondes were determined relative to UV-photometry. The average intercept and slope, 0 plus or minus 5 nb and 0.96 plus or minus 0.06, respectively, indicate reasonable agreement with UV photometry, but with considerable variation from one ECC ozonesonde to another. The time required to reach 85% of the final reaction to a step-change in ozone concentration was found to average 51 seconds. Application of the individual calibrations to 20 sets of 1976 flight data reduced the average of the differences between ozonesonde and Dobson spectrophotometric measurements of total ozone from 3.9 to 1.3%. A similar treatment of a set of 10 1977 flight records improved the average ECC-Dobson agreement from -8.5 to -1.4%. Although systematic differences were reduced, no significant effect on the random variations was evident

Performance tests on the Kohmyr ECC ozone sonde

The reliability and accuracy of the Kohmyr ECC ozone sonde are determined. Emphasis is placed on establishing and testing for leak-free connections and stable pump flow rates as well as properly adjusting the pumping pressure. Calibration of the Kohmyr ECC ozone sondes and Dasibi monitors is described. Raw ordinate data and ozone connection data are presented in tabular form. The results of a linear regression treatment of the sonde-indicated ozone concentration vs. Dasibi readings for each switch position are included along with averages of the regression parameters over the six sequencing switch positions. It is suggested that sondes and Dasibi monitors be individually calibrated before flight

Transport of sulfur dioxide from the Asian Pacific Rim to the North Pacific troposphere

The NASA Pacific Exploratory Mission over the Western Pacific Ocean (PEM-West B) field experiment provided an opportunity to study sulfur dioxide (SO2) in the troposphere over the western Pacific Ocean from the tropics to 60°N during February–March 1993. The large suite of chemical and physical measurements yielded a complex matrix in which to understand the distribution of sulfur dioxide over the western Pacific region. In contrast to the late summer period of Pacific Exploratory Mission-West A (PEM-West A) (1991) over this same area, SO2showed little increase with altitude, and concentrations were much lower in the free troposphere than during the PEM-West B period. Volcanic impacts on the upper troposphere were again found as a result of deep convection in the tropics. Extensive emission of SO2 from the Pacific Rim land masses were primarily observed in the lower well-mixed part of the boundary layer but also in the upper part of the boundary layer. Analyses of the SO2 data with aerosol sulfate, beryllium-7, and lead-210 indicated that SO2 contributed to half or more of the observed total oxidized sulfur (SO2 plus aerosol sulfate) in free tropospheric air. The combined data set suggests that SO2 above 8.5 km is transported from the surface but with aerosol sulfate being removed more effectively than SO2. Cloud processing and rain appeared to be responsible for lower SO2 levels between 3 and 8.5 km than above or below this region

A mass-balance/photochemical assessment of DMS sea-to-air flux as inferred from NASA GTE PEM-West a and B observations

This study reports dimethyl sulfide (DMS) sea-to-air fluxes derived from a mass-balance/photochemical-modeling approach. The region investigated was the western North Pacific covering the latitude range of 0°-30°N. Two NASA airborne databases were used in this study: PEM-West A in September-October 1991 and PEM-West B in February-March 1994. A total of 35 boundary layer (BL) sampling runs were recorded between the two programs. However, after filtering these data for pollution impacts and DMS lifetime considerations, this total was reduced to 13. Input for each analysis consisted of atmospheric DMS measurements, the equivalent mixing depth (EMD) for DMS, and model estimated values for OH and NO3. The evaluation of the EMD took into account both DMS within the BL as well as that transported into the overlying atmospheric buffer layer (BuL). DMS fluxes ranged from 0.6 to 3.0 μmol m-2d-1 for PEM-West A (10 sample runs) and 1.4 to 1.9 μmol m-2d-1 for PEM-West B (3 sample runs). Sensitivity analyses showed that the photochemically evaluated DMS flux was most influenced by the DMS vertical profile and the diel profile for OH. A propagation of error analysis revealed that the uncertainty associated with individual flux determinations ranged from a factor of 1.3 to 1.5. Also assessed were potential systematic errors. The first of these relates to our noninclusion of large-scale mean vertical motion as it might appear in the form of atmospheric subsidence or as a convergence. Our estimates here would place this error in the range of O to 30%. By far the largest systematic error is that associated with stochastic events (e.g., those involving major changes in cloud coverage). In the latter case, sensitivity tests suggested that the error could be as high as a factor of 2. With improvements in such areas as BL sampling time, direct observations of OH, improved DMS vertical profiling, direct assessment of vertical velocity in the field, and preflight (24 hours) detailed meteorological data, it appears that the uncertainty in this approach could be reduced to ±25%. Copyright 1999 by the American Geophysical Union

Family Structure and Income During Childhood and Subsequent Prosocial Behavior in Young Adulthood

Models of young adults’ prosocial behavior—charitable giving and volunteering—are estimated as functions of family structure and income during the stages of childhood. Estimating a model of any subsequent outcome (prosocial or otherwise) as a function of stage-specific family structure and income imposes a set of restrictions on the underlying dynamic model of the child development process. Such restrictions have been implicitly and unknowingly imposed by the family structure specifications used in past research, and in some cases the past restrictions may not be sensible a priori. We consider several specifications used in past research, propose several new specifications with a priori sensible restrictions, and use Bayesian model comparison methods to choose among them. The models are estimated using data from the Panel Study of Income Dynamics and its new module the Center on Philanthropy Panel Study. The results indicate that the development of charitable giving and volunteering behavior is associated with family instability and low income in adolescence

Potential impact of iodine on tropospheric levels of ozone and other critical oxidants

A new analysis of tropospheric iodine chemistry suggests that under certain conditions this chemistry could have a significant impact on the rate of destruction of tropospheric ozone. In addition, it suggests that modest shifts could result in the critical radical ratio HO2/OH. This analysis is based on the first ever observations of CH3I in the middle and upper free troposphere as recorded during the NASA Pacific Exploratory Mission in the western Pacific. Improved evaluations of several critical gas kinetic and photochemical rate coefficients have also been used. Three iodine source scenarios were explored in arriving at the above conclusions. These include: (1) the assumption that the release of CH3I from the marine environment was the only iodine source with boundary layer levels reflecting a low-productivity source region, (2) same as scenario 1 but with an additional marine iodine source in the form of higher molecular weight iodocarbons, and (3) source scenario 2 but with the release of all iodocarbons occurring in a region of high biological productivity. Based on one-dimensional model simulations, these three source scenarios resulted in estimated Ix (Ix =I + IO + HI + HOI + 2I2O2 +INOx) yields for the upper troposphere of 0.5, 1.5, and 7 parts per trillion by volume (pptv), respectively. Of these, only at the 1.5 and 7 pptv level were meaningful enhancements in O3 destruction estimated. Total column O3 destruction for these cases averaged 6 and 30%, respectively. At present we believe the 1.5 pptv Ix source scenario to be more typical of the tropical marine environment; however, for specific regions of the Pacific (i.e., marine upwelling regions) and for specific seasons of the year, much higher levels might be experienced. Even so, significant uncertainties still remain in the proposed iodine chemistry. In particular, much uncertainty remains in the magnitude of the marine iodine source. In addition, several rate coefficients for gas phase processes need further investigating, as does the efficiency for removal of iodine due to aerosol scavenging processes. Copyright 1996 by the American Geophysical Union

Edge Intersection Graphs of L-Shaped Paths in Grids

In this paper we continue the study of the edge intersection graphs of one (or zero) bend paths on a rectangular grid. That is, the edge intersection graphs where each vertex is represented by one of the following shapes: $\llcorner$,$\ulcorner$, $\urcorner$, $\lrcorner$, and we consider zero bend paths (i.e., | and $-$) to be degenerate $\llcorner$s. These graphs, called $B_1$-EPG graphs, were first introduced by Golumbic et al (2009). We consider the natural subclasses of $B_1$-EPG formed by the subsets of the four single bend shapes (i.e., {$\llcorner$}, {$\llcorner$,$\ulcorner$}, {$\llcorner$,$\urcorner$}, and {$\llcorner$,$\ulcorner$,$\urcorner$}) and we denote the classes by [$\llcorner$], [$\llcorner$,$\ulcorner$], [$\llcorner$,$\urcorner$], and [$\llcorner$,$\ulcorner$,$\urcorner$] respectively. Note: all other subsets are isomorphic to these up to 90 degree rotation. We show that testing for membership in each of these classes is NP-complete and observe the expected strict inclusions and incomparability (i.e., [$\llcorner$] $\subsetneq$ [$\llcorner$,$\ulcorner$], [$\llcorner$,$\urcorner$] $\subsetneq$ [$\llcorner$,$\ulcorner$,$\urcorner$] $\subsetneq$ $B_1$-EPG; also, [$\llcorner$,$\ulcorner$] is incomparable with [$\llcorner$,$\urcorner$]). Additionally, we give characterizations and polytime recognition algorithms for special subclasses of Split $\cap$ [$\llcorner$].Comment: 14 pages, to appear in DAM special issue for LAGOS'1