Quality of Care Provided to HIV-Infected Clients by Nurse Practitioners at a Specialized Nursing Center

This study evaluates the quality of care provided by nurse practitioners HIVinfected clients in a specialized nursing center in Georgia. Quality of care is evaluated using Donabedians\u27 Structure-Process-Outcome domains as presented in the Unifying Model of Quality Health Care. Structure is evaluated as the nurse practitioners in this clinic providing health care. The interpersonal aspect ofthe process of quality health care is measured by the researcher developed Outpatient Client Satisfaction Survey. The technical aspect ofthe process ofquality health care is measured by the researcher developed Provider Adherence Measurement Tool which measures adherence to current clinical practice guidelines. Reliability and validity information is provided on both tools. The outcome ofthe health care provided is measured by the rate ofpneumocystis carinii pneumonia (PCP). A literature review is included which describes related studies. The data analysis includes a description ofthe demographics ofthe clients in this clinic, and compares the data to national statistics. The adherence ofthe nurse practitioners care to the current clinical practice guidelines is analyzed against the client characteristics of age, CD4 cell count, education completed, gender, race, income, risk factor and insurance coverage. A favorable statistically significant difference is found: as the clients CD4 cell count decreases, the providers\u27 adherence increases. The outcome of care is determined by active cases of PCP, of which there are none in this sample. Client satisfaction is measured against the client characteristics of age, CD4 cell count, education completed, gender, income, wait time, race, risk factor, and insurance coverage. A statistically significant difference is found in the satisfaction of the nonwhite clients. The study is summarized with the conclusion that the nurse practitioners in this clinic are providing quality health care to these HTV-infected clients. The limitations ofthe study are described as well as recommendations for future research. A reference list and the actual data collection tools are also included

Institutional Factors influencing E-Business Adoption

Studies of e-business adoption have generally been restricted to understanding organizational factors. Institutional factors provide an alternate explanation of the diffusion of e-business across organizations. We test the influence of coercive, normative, and mimetic pressures on first-time adoption of B2B and B2C innovations by organizations. We further propose that an organization’s response to institutional pressures may be affected by its distinctive organizational identity. Specifically, we hypothesize that those organizations that value innovation and customer service will be more likely to adopt e-business over time. We test the likelihood that the intensity of institutional pressures will vary over different time periods. Data are gathered from secondary sources and we use event-history techniques to test our model. We contribute to the IS literature by integrating institutional and organizational identity concepts to understand the adoption and diffusion of Type III innovations

Relationship of surface changes to metal leaching from tungsten composite shot exposed to three different soil types

Physical changes that occur on the surface of fired shots due to firing and impact with soil may increase the dissolution of muniton metals. Increased metal dissolution could potentially increase metal transport and leaching, affecting metal concentrations in surface and groundwater. This research describes the relationship between the surface changes on fired tungsten–nickel–iron (94% W:2% Ni:4% Fe) composite shots and metals leaching from those shots. Tungsten composite shot was fired into, and aged in, three soil types (Silty Sand, Sandy Clay, and Silt) in mesoscale rainfall lysimeters to simulate live-fire conditions and subsequent interactions between the metals of the composite and soil. Leachate, runoff, and soil samples were collected from the lysimeters and analyzed for metal content. The shots were analyzed using scanning electron microscopy (SEM) to evaluate surface changes. SEM results indicated that a soil’s particle size distribution initially affected the amount of metal that was sheared from the surface of the fired W-composite shots. Shearing was greatest in soils with larger soil particles (sand and gravel); shearing was least in soils composed of small soil particles (fines). Increased metallic shearing from the shot’s surface was associated with increasedWdissolution, compared to controls, following a simulated 1 year soil aging

A newly-described host-symbiont interaction: first record of Dinocheirus panzeri (Pseudoscorpiones: Chernetidae) associated with Cyanistes caeruleus (Paridae) nests

We report the discovery of a female Dinocheirus panzeri (Chernetidae) (C.L. Koch 1837) in a Cyanistes caeruleus (Linnaeus 1758) nest built in a wooden nestbox at Nagshead Nature Reserve, Gloucestershire, UK. The nest was collected within 24 hours post-fledging under English Nature licence 20060590 as part of a larger project and double sealed to prevent cross-contamination

Diploma Privilege and the Constitution

The COVID-19 pandemic and resulting shutdowns are affecting every aspect of society. The legal profession and the justice system have been profoundly disrupted at precisely the time when there is an unprecedented need for legal services to deal with a host of legal issues generated by the pandemic, including disaster relief, health law, insurance, labor law, criminal justice, domestic violence, and civil rights. The need for lawyers to address these issues is great but the prospect of licensing new lawyers is challenging due to the serious health consequences of administering the bar examination during the pandemic. State Supreme Courts are actively considering alternative paths to licensure. One such alternative is the diploma privilege, a path to licensure currently used only in Wisconsin. Wisconsin\u27s privilege, limited to graduates of its two in-state schools, has triggered constitutional challenges never fully resolved by the lower courts. As states consider emergency diploma privileges to address the pandemic, they will face these unresolved constitutional issues. This Article explores those constitutional challenges and concludes that a diploma privilege limited to graduates of in-state schools raises serious Dormant Commerce Clause questions that will require the state to tie the privilege to the particular competencies in-state students develop and avenues they have to demonstrate those competencies to the state\u27s practicing bar over three years. Meeting that standard will be particularly difficult if a state adopts an in-state privilege on an emergency basis. States should consider other options, including privileges that do not prefer in-state schools. The analysis is important both for states considering emergency measures and for those that might restructure their licensing after the pandemic

The Bar Exam and the COVID-19 Pandemic: The Need for Immediate Action

The novel coronavirus COVID-19 has profoundly disrupted life in the United States. Among other challenges, jurisdictions are unlikely to be able to administer the July 2020 bar exam in the usual manner. It is essential, however, to continue licensing new lawyers. Those lawyers are necessary to meet current needs in the legal system. Equally important, the demand for legal services will skyrocket during and after this pandemic. We cannot close doors to the profession at a time when client demand will reach an all-time high.In this brief policy paper, we outline six licensing options for jurisdictions to consider for the Class of 2020. Circumstances will vary from jurisdiction to jurisdiction, but we hope that these options will help courts and regulators make this complex decision. These are unprecedented times: We must work together to ensure we do not leave the talented members of Class of 2020 on the sidelines when we need every qualified professional on the field to keep our justice system moving

Telerounding: A Scoping Review and Implications for Future Healthcare Practice

Telerounding is slated to become an important avenue for future healthcare practice. As utilization of telerounding is increasing, a review of the literature is necessary to distill themes and identify critical considerations for the implementation of telerounding. We provide evidence of the utility of telerounding and considerations to support its implementation in future healthcare practice based on a scoping review. Method: We collected articles from nine scientific databases from the earliest dated available articles to August 2020. We identified whether each article centered on telerounding policies, regulations, or practice. We also organized information from each article and sorted themes into four categories: sample characteristics, technology utilized, study constructs, and research outcomes. Results: We identified 21 articles related to telerounding that fit our criteria. All articles emphasized telerounding practice. Most articles reported data collected from surgical wards, had adult samples, and utilized robotic telerounding systems. Most articles reported null effects or positive effects on their measured variables. Discussion: Providers and patients can benefit from the effective implementation of telerounding. Telerounding can support patient care by reducing travel expenses and opportunities for infection. Evidence suggests that telerounding can reduce patient length of stay. Patients and providers are willing to utilize telerounding, but patient willingness is influenced by age and education. Telerounding does not appear to negatively impact satisfaction or patient care. Organizations seeking to implement telerounding systems must consider education for their providers, logistics associated with hardware and software, scheduling, and characteristics of the organizational context that can support telerounding. Considerations provided in this article can mitigate difficulties associated with the implementation of telerounding

“The Original Journals of ‘Kitty’ Wilmot”: manufacturing women’s travel writing in the salon of Helen Maria Williams

This article discusses the implications of a previously unknown Romantic-period manuscript by Anglo-Irish traveler Katherine Wilmot (1773–1824). A later version of Wilmot’s epistolary travelogue of 1801–03 has been valued as an artifact of British experience abroad during the Peace of Amiens for its descriptions of Napoleonic Paris. Yet the newly discovered draft reveals a deeper assimilation within and sympathy towards the radical political and literary networks Wilmot documented, as well as a budding relationship with author and salonnière Helen Maria Williams that is occluded from the later narrative. This article examines the complex choices surrounding authorship for British women abroad in the period by considering a refused invitation that Wilmot submit writing to The English Press, the publishing venture of Williams and her companion John Hurford Stone. The article details Wilmot’s evolving writing in terms of Williams’s influence, outlining how British women travel writers reshaped their experiences to meet the expectations of readers at home while also considering the impact of sedition, gendered agency, and political affinity on the production and reception of their writing