Association of Self-Care Confidence and Hospital Readmission Following Student Nurse Led Congestive Heart Failure Transitional Care Project

Abstract Over 5 million Americans have been diagnosed with heart failure, and that number is growing. This disease is burdensome to the patient as it lessens their quality of life and to the healthcare system due to costliness and frequent readmissions. This study aims to evaluate if a student nurse led transitional care program can increase patient self-care confidence, in turn reducing 30 day hospital readmission rates. Twenty patients completed the Self Care of Heart Failure Index before and after a 14-week transitional care program. These reported data were compared using a paired samples t-test. There was not a statistically significant difference in pre- and post- self-care maintenance with a mean difference of 3.51 (95% CI, -5.89 to 12.91), t (17) = .788, p= .44, nor was there a statistically significant difference in self-care confidence with a mean difference of 8.34 (95% CI, -1.71 to 18.39), t (17) = 1.751, p= 0.98. Only 5 participants were included in measuring self-care management, with a mean difference of 18 (95% CI, -58.85 to 22), t (5) = -1.223, p= .29. The implementation of a transitional care program did not increase reported self-care maintenance, management, or confidence. Transitional care is complex and is most effective when provided at home with trained professionals for an extended amount of time. Despite the absence of a large increase in self-care, 30-day hospital readmissions occurred among the study group at a rate of 4.7%, compared to the 25% rate commonly found in the literature. Transitional care models have the capacity to improve patient care and health outcomes

Photolytic ozonation for protection and rehabilitation of ground-water resources; a mechanistic study

The cleanup of ground-water resources which have been contaminated by anthropogenic organic compounds is difficult and expensive. Furthermore, most treatment methods merely transfer the contaminant to another phase, such as an adsorbant or the atmosphere. A treatment process which produces harmless by-products, could be set up on-site, and does not require the transport of hazardous materials is very desirable for such cleanup operations. Photolyticozonation, the combination of ozone treatment and ultraviolet irradiation, is an oxidative water treatment process which is capable of convert ing virtually any organic pollutant completely to carbon dioxide and water. Thus, it is potentially a very "clean" solution to many contamination problems. There has, however, been disagreement in the scientific literature concerning the effectiveness of the process, due largely to a lack of understanding of the chemistry which is involved. In this project, photolytic ozonation was studied at the laboratory scale, to better understand and, if possible, model the complex chemical reaction mechanism, so that the process can be more easily optimized from an economic stand point. It was shown that hydroxyl radical, the active species responsible for the destruction of organic pollutants, is not generated directly by ozone photolysisas has generally been speculated, but is produced by secondary reactions. A model has been developed which explains the behavior of the process under a variety of conditions and is useful for the prediction of process performance. The model includes parameters, the values of which may be inferred from the chemical structure of the organic pollutant. The reaction system is seen to be "versatile" in that it has alternate pathways by which pollutant destruction may proceed, depending on conditions in the water being treated.U.S. Department of the InteriorU.S. Geological Surve

The Effects of Child Restraint System Use and Motor Vehicle Collision Severity on Injury Patterns and Severity in Children 8 Years Old and Younger.

Motor vehicle collisions (MVCs) are a leading cause of injury and death for children under the age of 14 years in North America. Children, eight years old or younger, are required to use a child restraint system (CRS) when travelling in a vehicle in Canada. In the present study, the hypothesis that head injury severity of children in this age group, seated in rear rows of vehicles in MVCs, will be influenced by the types of restraint systems used was not supported by the data; however, other secondary aspects of collision data were explored. There were injury patterns that involved the head, thorax, and lower extremities. Head injury severity decreased when the number of rear row occupants increased. Winter cases were associated with more severe head injuries. Future studies of the relation between CRS types and designs, and trauma will be enhanced by larger sample sizes and more consistent data collection methods

Country and city life in the plays of Tirso de Molina

Thesis (M.A.)--University of Kansas, Romance Language and Literature, 1931

High-sensitivity receiver for CO2 laser communications

Wideband heterodyne receiver provides detection and demodulation of incident frequency modulated laser signal; search and acquisition circuitry to align two stations; tracking circuitry to maintain spatial alignment; and laser frequency monitor to frequency lock the transmit and local oscillator lasers

Developments in electromagnetic tomography instrumentation.

A new EMT sensor and instrumentation is described which combines the best features of previous systems and has a modular structure to allow for future system expansion and development

The Cost of Stability in Coalitional Games

A key question in cooperative game theory is that of coalitional stability, usually captured by the notion of the \emph{core}--the set of outcomes such that no subgroup of players has an incentive to deviate. However, some coalitional games have empty cores, and any outcome in such a game is unstable. In this paper, we investigate the possibility of stabilizing a coalitional game by using external payments. We consider a scenario where an external party, which is interested in having the players work together, offers a supplemental payment to the grand coalition (or, more generally, a particular coalition structure). This payment is conditional on players not deviating from their coalition(s). The sum of this payment plus the actual gains of the coalition(s) may then be divided among the agents so as to promote stability. We define the \emph{cost of stability (CoS)} as the minimal external payment that stabilizes the game. We provide general bounds on the cost of stability in several classes of games, and explore its algorithmic properties. To develop a better intuition for the concepts we introduce, we provide a detailed algorithmic study of the cost of stability in weighted voting games, a simple but expressive class of games which can model decision-making in political bodies, and cooperation in multiagent settings. Finally, we extend our model and results to games with coalition structures.Comment: 20 pages; will be presented at SAGT'0

Liveness-Based Garbage Collection for Lazy Languages

We consider the problem of reducing the memory required to run lazy first-order functional programs. Our approach is to analyze programs for liveness of heap-allocated data. The result of the analysis is used to preserve only live data---a subset of reachable data---during garbage collection. The result is an increase in the garbage reclaimed and a reduction in the peak memory requirement of programs. While this technique has already been shown to yield benefits for eager first-order languages, the lack of a statically determinable execution order and the presence of closures pose new challenges for lazy languages. These require changes both in the liveness analysis itself and in the design of the garbage collector. To show the effectiveness of our method, we implemented a copying collector that uses the results of the liveness analysis to preserve live objects, both evaluated (i.e., in WHNF) and closures. Our experiments confirm that for programs running with a liveness-based garbage collector, there is a significant decrease in peak memory requirements. In addition, a sizable reduction in the number of collections ensures that in spite of using a more complex garbage collector, the execution times of programs running with liveness and reachability-based collectors remain comparable

Stream Fusion, to Completeness

Stream processing is mainstream (again): Widely-used stream libraries are now available for virtually all modern OO and functional languages, from Java to C# to Scala to OCaml to Haskell. Yet expressivity and performance are still lacking. For instance, the popular, well-optimized Java 8 streams do not support the zip operator and are still an order of magnitude slower than hand-written loops. We present the first approach that represents the full generality of stream processing and eliminates overheads, via the use of staging. It is based on an unusually rich semantic model of stream interaction. We support any combination of zipping, nesting (or flat-mapping), sub-ranging, filtering, mapping-of finite or infinite streams. Our model captures idiosyncrasies that a programmer uses in optimizing stream pipelines, such as rate differences and the choice of a "for" vs. "while" loops. Our approach delivers hand-written-like code, but automatically. It explicitly avoids the reliance on black-box optimizers and sufficiently-smart compilers, offering highest, guaranteed and portable performance. Our approach relies on high-level concepts that are then readily mapped into an implementation. Accordingly, we have two distinct implementations: an OCaml stream library, staged via MetaOCaml, and a Scala library for the JVM, staged via LMS. In both cases, we derive libraries richer and simultaneously many tens of times faster than past work. We greatly exceed in performance the standard stream libraries available in Java, Scala and OCaml, including the well-optimized Java 8 streams