A Smartphone Intervention to Reduce Hospital Readmission Rates in Adult Patients Who Have Heart Failure

Heart failure (HF) is the leading cause of 30-day hospital readmission, with up to 23.5% of Medicare beneficiaries requiring subsequent admission within 30 days post hospital discharge (CMS, 2020a). Mobile-health applications (MHA), such as smartphone applications, have emerged as cost-effective methods to safely manage chronic disease in the outpatient setting (Inglis et al., 2015). The purpose of this evidence-based practice (EBP) project was to evaluate the impact of a MHA on HF-related 30-day readmission rates. The Iowa Model Revised guided the implementation of the project in a rural, for-profit hospital in Northwest Indiana. An extensive literature search was conducted, and a MHA project plan was implemented. Adult inpatients (N = 18) who were admitted with a diagnosis of HF exacerbation were identified through a comprehensive chart review process. A prospective between group comparison design allowed for assessment of thirty-day and 8-week readmission rates for each group. Readmission rate data were analyzed using a one-way multivariate analysis of variance (MANOVA). No significant difference in readmission rates were appreciated between groups (Llambda(2,4) = .804, p \u3e 0.05). To further evaluate if any association existed between the use of the MHA and readmission rates, epidemiologic measures of association were evaluated (OR = 0.156, 95% CI 0.013 - 1.828, p \u3e 0.05, ARR = 0.33; NNT = 3). No statistically significant results were identified. Despite non-significant results of the primary outcomes, clinical significance can be appreciated. Statistically significant differences were noted in pre- (M = 3.81, sd = .654) and postintervention (M = 2.57, sd = .672) selfcare behavior scale scores (t = 4.06, p = 0.005). Findings from this project may be used to further evaluate the use, long-term benefits, and financial implications of MHA interventions on HF-related readmissions

Leveraging a Teacher Mentorship Program in a Complex System

The support a beginning teacher receives varies from school to school, and from district to district. When beginning teachers are not supported, their learning as teachers is not maximized. New teacher induction is the strategy most school districts employ to support new-hires. Current scholarship suggests the terms induction and mentor program are often used interchangeably, but actually have very different definitions. Mentors programs are one component of a comprehensive induction program; where as, an induction program is a series of events or activities in the beginning years of a teacher’s career. Effectively leveraging the mentorship program in a complex system meant creating the time and space for instructional conversations between new-hires, mentors and principals. How to create that space and time required examining and understanding the experiences of all stakeholders involved in the mentorship program and the district as a whole. This design research study implemented the Integrative Learning Design (ILD) framework proposed by Bannan-Ritland (2003) provided both the structure and flexibility to explore complex systems in naturalistic settings. The ILD is comprised of four stages: (a) Informed Exploration, (b) Enactment, (c) Evaluation: Local Impact, (d) Evaluation: Broader Impact. The informed exploration of this study included a review of the program history and a survey of the literature. Data collected for this study include archival data, 659 surveys of new-hire and mentor experiences, 232 classroom observations, and 6 focus interviews with principals. Findings from this design study indicated that creating the space for new-hires and mentors to learn and grow in a complex system means adapting to changes, dealing with conflict, and constantly asking ourselves as scholarly practitioners, “Why we are doing this?” and “Why we are doing this, this way?” as we work to impact policy and practice. Adaptations and iterations of the program will continue to as the mentorship program in this study evolves. Adviser: Edmund T. Haman

Lessons from wolves: stakeholder perspectives and experiences with northern rocky wolf reintroduction

The gray wolf, Canis lupus, inhabited all parts of the North American continent for at least 300,000 years prior to European colonization (Wilson, et al. 2000). Lopez (1978) estimated the species population to have been around several hundred thousand in just the western United States and Mexico. In the short time span of 150 years, Euro-Americans fiercely eradicated this predator to the brink of extinction for preying on domesticated livestock during American colonization. By the mid 1900\u27s the gray wolf was absent from this land with the exception of rumored howls in the northernmost states. Then, in 1995, only sixty years after the completion of one of the most aggressive species eradications in U.S. history, the U.S. Federal government reintroduced Canis lupus into Idaho, Montana and Wyoming, despite extreme protests from these Rocky Mountain States. My research seeks information pertaining to the human element that essential to co-existing with wolves. I hypothesize that human-human conflicts about wolves are more prevalent than actual conflicts between humans and wolves, such as attacks or property damage. This hypothesis was examined while conducting fieldwork in Central Idaho. I utilized formal, informal, and unstructured interviews, as well as participant observation, with ranchers, conservationists, and the Nez Perce. The research sample consisted of seven individuals, three ranchers, three conservationists, and one Nez Perce man. My findings indicate that human-wolf conflicts do exist, but that conflicts more often are between different groups of people regarding control over management of valued natural resources. Additionally, I found that people vary in terms of where they derive their authority on such issues, such as number of generations spent on the land versus formal education

Perekayasaan Mixer Settler Untuk Ekstraksi Siklus II Pada Recovery Uranium Dalam Larutan Asam Fosfat

Mixer settler atau pesawat pengaduk pengenap secara teknis dirancang untuk proses ekstraksi dan pemisahan uranium dari larutan asam fosfat. Hasil perhitungan perekayasaan menunjukkan bahwa pesawat pengaduk pengenap terdiri dari dua bagian, yaitu bagian untuk proses ekstraksi terjadi dalam tangki berpengaduk dan proses pemisahan terjadi dalam tangki pengenap. Tangki berpengaduk bertipe kotak dengan 4 penghalang dengan ukuran lebar 0,8 m, panjang 0,8 m, tinggi cairan 1 m, tinggi tangki 1,05 m dan jenis pengaduk disk 6 blade, daya pengaduk 4 Hp dan tangki pengenap bertipe persegi panjang dengan ukuran lebar 0,8 m, panjang 5 m, tinggi cairan 1 m dan tinggi tangki 1,05 m. Pengambilan uranium dengan efisiensi sampai 91 % diperlukan 3 tingkat ekstraksi, menggunakan pelarut Organik (O) DEHPA-TOPO dalam Kerosene. Perbandingan fase cair dan fase organik (A/O) yang digunakan adalah 2:1. Proses ekstraksi dilakukan dengan arus berlawanan arah dengan pelarut Organik (O) masuk tahap 1 dan cair (A) yang kaya uranium masuk tahap 3. Proses pengenapan berlangsung dengan laju pengenapan 0,000694 m/s, nilai faktor dispersi Ψ= 0,3638 fraksi ringan sebagai fase terdispersi dan nilai bilangan Reynolds (NRE ) = 3.438. Nilai bilangan Reynolds di bawah 5.000, menunjukkan bahwa kualitas pemisahan berjalan dengan baik. Mixer settler is technically designed for extraction and separation process of uranium from phosphoric acid solution. Design calculation results shows that: the mixer settler consists of two parts: part of extraction process in the mixer tank and part of separation process in settler tank. The mixer tank type of box with 4 baffles, the size of mixer tank, 0.8 m width, 0.8 m length, 1 m high of liquid, 1.05 m high of mixer tank, stirrer type of disk 6 blade, and power of mixing 4 hp and the settler tank type of rectangular with size of settler tank, 0.8 m width 5 m length, 1 m high of liquid, 1.05 m high of settler tank. For uranium recovery efficiency up to 91%, extraction process is done in 3 stage counter current flow using a solvent Organic (O) DEHPA-TOPO in Kerosene at a phase of ratio A/O of 2:1. The aqueous enter through stage 3 and the organic solvent enter through stage 1. The process of settling occurred with the value of settling velocity is 0.000694 m/s, dispersion factor Ψ = 0.3638 and the light fraction as the dispersed phase and value of Reynolds number (NRE) = 3,438. Because of the Reynolds number is lower than 5,000, it indicates that the quality of the separation is very good

Perekayasaan Tangki Pengendap Untuk Memisahkan (Nh4)4uo2(co3)3 Dari Cairan Nh4f

A DESIGN OF SETTLING TANK FOR SEPARATION OF (NH4)4UO2(CO3)3 FROM NH4F LIQUID. A Settling tank is designed for AUC (Ammonium Uranyl Carbonate) separation process from liquid containing of NH4F. From the design calculation results is concluded that the settling tank type is continuous clarifier of vertical cylindris with size of diameter 0.40 m, height of fluid 3.18 m, height of tank 3.5 m. Because the diameter of tank 0.40 m is lower than critical diameter (0.427 m) for slurry of AUC , the design of tank is safe geometrically. The settling velocity is 0.0008824 m/s, above the rate of linear overflow that is 0.0004665 m/s, theoretically there is no solid particles are carried away by the stream overflow and separation process goes well. PEREKAYASAAN TANGKI PENGENDAP UNTUK MEMISAHKAN (NH4)4UO2(CO3)3 DARI CAIRAN NH4F. Tangki pengendap dirancang untuk proses pemisahan slurry AUK dari cairan yang mengandung NH4F. Dari hasil perhitungan perekayasaan disimpulkan bahwa tangki pengendap dengan tipe continuous clarifier berbentuk tabung selinder vertikal dengan diameter 0.40 m, tinggi fluida total dalam tangki 3.18 m dan tinggi tangki 3.5 m. Karena diameter tangki 0.40 m dan dibawah diameter kritis (0.427 m) untuk slurry AUK, maka desain tangki cukup aman secara geometri. Dengan laju pengendapan 0.0008824 m/s diatas laju linier overflow yaitu 0.0004665 m/s, maka secara teoritis tidak ada partikel padatan yang terbawa oleh aliran overflow dan proses pemisahan berjalan dengan baik

Educate, Empower, Employ

Since the start of the Syrian Civil War in 2011, Lebanon is estimated to have taken in more than two million Syrian refugees. Due to policy and security obstacles, many of these refugees are considered by the Lebanese government to be living in Lebanon illegally, which restricts, among other aspects, their ability to continue employment or education. Based on field research conducted in-country through interviews, surveys, and focus groups, the authors have identified areas where innovative and inclusive higher education opportunities can be provided for Syrian refugees in Lebanon to allow them to move forward with their lives in self-sufficiency and dignity. The research aimed to answer the following questions: Where are the intersections of the interests and expectations of Syrian refugees in Lebanon with higher education and employment opportunities? How do individual characteristics such as gender, age, time in exile, and class affect refugees’ perceptions of their higher education needs and ambitions? What are the current barriers to accessing higher education, and what is the necessary support needed to overcome the barriers? Where are the opportunities for universities to fill the gaps in programming or resources

Characterizing Phantom Arteries with Multi-Channel Laser Ultrasonics and Photo-Acoustics

Multi-channel photo-acoustic and laser ultrasonic waves are used to sense the characteristics of proxies for healthy and diseased vessels. The acquisition system is non-contacting and non-invasive with a pulsed laser source and a laser vibrometer detector. As the wave signatures of our targets are typically low in amplitude, we exploit multi-channel acquisition and processing techniques. These are commonly used in seismology to improve the signal-to-noise ratio of data. We identify vessel proxies with a diameter on the order of 1 mm, at a depth of 18 mm. Variations in scattered and photo-acoustic signatures are related to differences in vessel wall properties and content. The methods described have the potential to improve imaging and better inform interventions for atherosclerotic vessels, such as the carotid artery

Housing Cost Burden and Maternal Stress among Very Low Income Mothers

As the affordable housing shortage proliferates, more American households struggle with high housing cost burdens. Grounded in Belsky’s (1984) parenting stress framework, we use a weighted low-income sample from the Fragile Families and Child Wellbeing Study of mothers who rent their homes (N=388) to investigate a relationship between housing cost burden, or paying a substantial portion of income toward housing, and higher rates of reported maternal stress. Findings of the linear regression indicate that younger mothers and those paying 30% or more of their income each month toward rent have higher reported maternal stress scores. These findings are discussed with attention to practice and policy implications