Downtown Providence Farmers Market Design

This market essentially combines a marketplace with an existing or new industrial building. The hybrid created results in space that has daily retail sales and hours, as well as other goods available at other times. The industrial aspect typically acts as the anchor, as the market’s activities help attract a different group of consumers at other business times. An example of this would be a seafood supply warehouse that also provides dining and entertainment as a nightlife destination

Inter-rater reliability of post-arrest cerebral performance category (CPC) scores.

PURPOSE: Cerebral Performance Category (CPC) scores are often an outcome measure for post-arrest neurologic function, collected worldwide to compare performance, evaluate therapies, and formulate recommendations. At most institutions, no formal training is offered in their determination, potentially leading to misclassification. MATERIALS AND METHODS: We identified 171 patients at 2 hospitals between 5/10/2005 and 8/31/2012 with two CPC scores at hospital discharge recorded independently - in an in-house quality improvement database and as part of a national registry. Scores were abstracted retrospectively from the same electronic medical record by two separate non-clinical researchers. These scores were compared to assess inter-rater reliability and stratified based on whether the score was concordant or discordant among reviewers to determine factors related to discordance. RESULTS: Thirty-nine CPC scores (22.8%) were discordant (kappa: 0.66), indicating substantial agreement. When dichotomized into favorable neurologic outcome (CPC 1-2)/ unfavorable neurologic outcome (CPC 3-5), 20 (11.7%) scores were discordant (kappa: 0.70), also indicating substantial agreement. Patients discharged home (as opposed to nursing/other care facility) and patients with suspected cardiac etiology of arrest were statistically more likely to have concordant scores. For the quality improvement database, patients with discordant scores had a statistically higher median CPC score than those with concordant scores. The registry had statistically lower median CPC score (CPC 1) than the quality improvement database (CPC 2); p\u3c0.01 for statistical significance. CONCLUSIONS: CPC scores have substantial inter-rater reliability, which is reduced in patients who have worse outcomes, have a non-cardiac etiology of arrest, and are discharged to a location other than home

Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest : The PRINCESS Randomized Clinical Trial

© 2019 American Medical Association. All rights reserved.Importance: Therapeutic hypothermia may increase survival with good neurologic outcome after cardiac arrest. Trans-nasal evaporative cooling is a method used to induce cooling, primarily of the brain, during cardiopulmonary resuscitation (ie, intra-arrest). Objective: To determine whether prehospital trans-nasal evaporative intra-arrest cooling improves survival with good neurologic outcome compared with cooling initiated after hospital arrival. Design, Setting, and Participants: The PRINCESS trial was an investigator-initiated, randomized, clinical, international multicenter study with blinded assessment of the outcome, performed by emergency medical services in 7 European countries from July 2010 to January 2018, with final follow-up on April 29, 2018. In total, 677 patients with bystander-witnessed out-of-hospital cardiac arrest were enrolled. Interventions: Patients were randomly assigned to receive trans-nasal evaporative intra-arrest cooling (n = 343) or standard care (n = 334). Patients admitted to the hospital in both groups received systemic therapeutic hypothermia at 32°C to 34°C for 24 hours. Main Outcomes and Measures: The primary outcome was survival with good neurologic outcome, defined as Cerebral Performance Category (CPC) 1-2, at 90 days. Secondary outcomes were survival at 90 days and time to reach core body temperature less than 34°C. Results: Among the 677 randomized patients (median age, 65 years; 172 [25%] women), 671 completed the trial. Median time to core temperature less than 34°C was 105 minutes in the intervention group vs 182 minutes in the control group (P < .001). The number of patients with CPC 1-2 at 90 days was 56 of 337 (16.6%) in the intervention cooling group vs 45 of 334 (13.5%) in the control group (difference, 3.1% [95% CI, -2.3% to 8.5%]; relative risk [RR], 1.23 [95% CI, 0.86-1.72]; P = .25). In the intervention group, 60 of 337 patients (17.8%) were alive at 90 days vs 52 of 334 (15.6%) in the control group (difference, 2.2% [95% CI, -3.4% to 7.9%]; RR, 1.14 [95% CI, 0.81-1.57]; P = .44). Minor nosebleed was the most common device-related adverse event, reported in 45 of 337 patients (13%) in the intervention group. The adverse event rate within 7 days was similar between groups. Conclusions and Relevance: Among patients with out-of-hospital cardiac arrest, trans-nasal evaporative intra-arrest cooling compared with usual care did not result in a statistically significant improvement in survival with good neurologic outcome at 90 days. Trial Registration: ClinicalTrials.gov Identifier: NCT01400373.Peer reviewedFinal Accepted Versio

Wartime China’s Resistance against Japanese Aggression: Changing Interpretations and Perspectives

In 1931, Japan invaded Manchuria and established the puppet state of Manchukuo in northeast China. Hoping to avoid an all-out war with Japan, China pursued a policy of appeasement and did not resist the occupation of China. Nonetheless, in 1937 the Japanese launched a massive attack against Beijing and the eastern coastal cities of China and continued its assault until World War II ended in August 1945. This period, known as the Chinese People’s War of Resistance against Japanese Aggression, has seen many shifts in its historical narrative. After Japan surrendered, a full-fledged civil war broke out between the Communist Party of China (CPC) and the Nationalist/Kuomintang (KMT). The 1949 victory of the CPC and subsequent Mao Zedong era (1949-1976) limited the Chinese memory of the war of against Japanese aggression. However, following the death of Mao, China began a “new remembering” of this war. Our research examines the changing interpretations and perspectives of wartime China in the Mao and post-Mao eras. In addition to academic literature on the subject, our paper draws upon our first-hand exploration of Chinese government-sponsored wartime museums and sites from our research trip to China in June, 2010. Our paper also evaluates the challenges that the Chinese government has encountered as it works to advance a comprehensive history that details the contributions of both the Nationalists and the Communists in the War against Japanese Aggression

Walley School Community Arts Center Feasibility Study

The Walley School community arts center initiative began in the fall of 2011 as a joint project between the Town of Bristol and Roger Williams University’s School of Architecture. Shortly thereafter, the Gabelli School of Business was asked to development a business case for the project. Four students in the course “Management 439: Business Planning” took on the Walley School as their team project for the semester. The business case study was developed in conjunction with the Town of Bristol, the initiative’s steering committee, Roger Williams University’s Community Partnerships Center, the School of Architecture and the School of Construction Management. After a year of student work and public workshops, the conclusion has been made that it would be programmatically, architecturally and financially feasible to reopen the Walley School as a community arts and education facility for the Town of Bristol

International Cooperation on Trade and Labor Issues

The relationship between the labor market and international trade is a broad and complex subject that has been the focus of significant attention in recent years. Discussion and analysis in this area has covered a number of discrete issues, including the effect of shifting trade patterns on employment levels and earnings in domestic markets, the impact of wage levels and labor legislation on the location of production facilities, and the positive and negative aspects of the cross-border movement of workers, among others. The continuing importance of labor issues within the larger trade debate is highlighted by the inclusion of measures relating to labor standards and/or the cross-border movement of workers in recent bilateral and multilateral trade agreements such as the North American Free Trade Agreement (NAFTA), the General Agreement on Trade in Services (GATS), and the U.S.–Oman Free Trade Agreement. This paper aims to provide background for future work on trade-related labor issues by describing how labor issues such as internationally recognized labor standards and the cross-border movement of workers have been addressed by international organizations, as well as in U.S. trade legislation and recent trade agreements

Pre-empting protectionism in services - the WTO and outsourcing

Cross-border trade in services is growing rapidly, with both industrial and developing countries among the most dynamic exporters. Despite the substantial global benefits from such trade, the adjustment pressures created in importing countries could provoke a protectionist backlash-some signs of which are already visible in procurement and regulatory restrictions. The current negotiations under the Doha Development Agenda offer an opportunity to lock in current openness and preempt protectionism. This paper describes how a bold initiative under the General Agreement on Trade in Services can help secure openness.Decentralization,Enterprise Development&Reform,Payment Systems&Infrastructure,ICT Policy and Strategies,Banks&Banking Reform,ICT Policy and Strategies,Banks&Banking Reform,Governance Indicators,Health Economics&Finance,Knowledge Economy

The Constitution of North Korea: Its Changes and Implications

Though a departure from mainstream socialist States, a glimpse of North Korea\u27s Constitution can still provide observers with an understanding of how North Korea has undergone and responded to social changes and vicissitudes. Hence, this Essay sets out to do a number of things. First, this study succinctly examines the nature and status of law in North Korea. Second, it reviews the country\u27s constitutional history in sequence, and then, provides a more in depth look into the characteristics of the current Constitution. Conclusions are then drawn from this examination. The goal of this Essay is not to describe the principles or contents of North Korean Constitutions per se, but rather to look at how North Korea has responded to change from a constitutional perspective. However, our discussion will be mostly limited to the texts of the constitutions since there is no case known to outsiders that would afford us an understanding of its real operation in daily life. At the same time, constitutional processes including the North Korean amendment process does not deserve our attention either, as all constitutional processes in North Korea are, by design, endorsed without opposition and manipulated by the country\u27s top leadership --an undisputable reality of the totalitarianism housed within the country\u27s borders