Public perceptions of quick-care clinic and hospital emergency department capabilities: A pre-illness and injury analysis

This dissertation examines the public and medical professionals\u27 perceptions of the capabilities of quick-care clinic and hospital emergency departments. A probability-based survey was administered to three hundred and sixty-six adults in the Las Vegas metropolitan area detailing twenty-one medical conditions ranging in severity from an ingrown toenail to a child not breathing. For each scenario the respondent was asked to select either a hospital emergency department or a quick-care clinic as the appropriate facility for the proper treatment of each medical condition. Their responses were then compared to a medical benchmark which was established by a sample of one hundred and fifteen health care professionals currently working in hospital emergency departments and quick-care clinics. By holding constant respondent\u27s economic status, insurance, HMO rules, the location of the facilities, and the confusion and inevitable intangibles associated with medical decisions, this study can focus on the actual medical condition as the determining factor in the public\u27s perception of which medical condition should be treated where; The principal findings of this study show that the general public does seem capable of correctly differentiating between the medical capabilities of hospital emergency departments and quick-care clinics for a wide range of emergency and non-emergency health conditions. From a public health point of view, while there are some significant differences in facility perception from within the general public sample, I believe those discrepancies can be overcome by a combination of public service messages, community education, and a more audience-specific marketing campaign designed to attract older and minority patients to quick-care clinics for non-emergency conditions. Some significant differences in perception are also noted from within the medical staff population. Gender, age and job title differences were not strong predictors of facility selection. The location of where the medical respondent works, however, is the most reliable predictor of facility selection. Those differences and their implication for evaluating previous and future work are addressed

Crime and its relationship to the University Medical Center

This study explores the relationship between crime and violence and the University Medical Center of Southern Nevada. An investigation was conducted to determine how crime and violence affects the medical center from an economic, security, staff and organizational response perspective; Nursing staff and security officer interviews, supplemented with security department incident reports, suggest a perception problem exists. Nurses interviewed believe a major cost of crime and violence at the medical center is the perceived threat to their personal safety by gang members and patients under the influence of drugs or alcohol. Security officer interviews and data from incident reports suggest the major cost of crime and violence at the hospital center has to do with minor property offenses and not threats or assaults against staff. Additionally, nursing attitudes and compassion levels seem to be negatively affected from treating large numbers of patients whom they feel are deserving of their injuries

Entitled to Cheat: An Examination of Incoming Freshmen at a Small Regional University

On their first day of college, 363 incoming freshmen were surveyed at a small regional public university in the Southeastern United States to determine how their senses of entitlement and superiority influence their tolerance of cheating behavior. Descriptive statistics reveal these incoming freshmen are entering college with disturbingly high academic entitlement scores; plus, they also appear quite tolerant of cheating behavior. Initial bivariate analysis shows a positive association between the students’ sense of entitlement and their tolerance of cheating; while a negative association between a self-assessed superiority measure and the students’ cheating tolerance is found. In a series of multiple regression models, when accounting for a wide array of control variables, the students’ sense of entitlement remained positively associated with cheating tolerance, while the superiority measure lost its predictive power. Results from this study not only support the entitlement–cheating relationship, but indicate that many students are starting their college careers with some very troubling beliefs

Gambling Alone? A Study of Solitary and Social Gambling in America

In his acclaimed 2000 book Bowling Alone, Robert Putnam documents a disturbing social trend of the broadest kind. Putnam cites a wide variety of data that indicate that over the past fifty years, Americans have become increasingly socially disengaged. In developing this theme, Putnam specifically cites the increase in casino gambling (and especially machine gambling) as evidence in support of his argument. Building on the empirical and theoretical work of Putnam, this exploratory article examines the subphenomenon of gambling alone by exploring sample survey data on solitary and social gambling behavior among adults who reside in Las Vegas, Nevada. Specifically, to further understand these phenomena, a number of demographic, attitudinal, and behavioral variables are examined for their explanatory power in predicting solitary vs. social gambling behavior

Generic Quantum Ratchet Accelerator with Full Classical Chaos

A simple model of quantum ratchet transport that can generate unbounded linear acceleration of the quantum ratchet current is proposed, with the underlying classical dynamics fully chaotic. The results demonstrate that generic acceleration of quantum ratchet transport can occur with any type of classical phase space structure. The quantum ratchet transport with full classical chaos is also shown to be very robust to noise due to the large linear acceleration afforded by the quantum dynamics. One possible experiment allowing observation of these predictions is suggested.Comment: 4 pages, 4 figure

When is Quantum Decoherence Dynamics Classical?

A direct classical analog of quantum decoherence is introduced. Similarities and differences between decoherence dynamics examined quantum mechanically and classically are exposed via a second-order perturbative treatment and via a strong decoherence theory, showing a strong dependence on the nature of the system-environment coupling. For example, for the traditionally assumed linear coupling, the classical and quantum results are shown to be in exact agreement.Comment: 5 pages, no figures, to appear in Physical Review Letter

Using Caenorhabditis elegans as a model organism for evaluating extracellular signal-regulated kinase docking domain inhibitors

We have recently identified several novel ATP-independent inhibitors that target the extracellular signal-regulated kinase-2 (ERK2) protein and inhibit substrate phosphorylation. To further characterize these compounds, we describe the use of C. elegans as a model organism. C. elegans is recognized as a versatile and cost effective model for use in drug development. These studies take advantage of the well characterized process of vulva development and egg laying, which requires MPK-1, the homolog to human ERK2. It is shown that treatment of C. elegans eggs or larvae prior to vulva formation with a previously identified lead compound (76) caused up to 50% reduction in the number of eggs produced from the adult worm. In contrast, compound 76 had no effect on egg laying in young adult or adult worms with fully formed vulva. The reduction in egg laying by the test compound was not due to effects on C. elegans life span, general toxicity, or non-specific stress. However, compound 76 did show selective inhibition of phosphorylation of LIN-1, a MPK-1 substrate essential for vulva precursor cell formation. Moreover, compound 76 inhibited cell fusion necessary for vulva maturation and reduced the multivulva phenotype in LET-60 (Ras) mutant worms that have constitutive activation of MPK-1. These findings support the use of C. elegans as a model organism to evaluate the selectivity and specificity of novel ERK targeted compounds

Chaos and Correspondence in Classical and Quantum Hamiltonian Ratchets: A Heisenberg Approach

Previous work [Gong and Brumer, Phys. Rev. Lett., 97, 240602 (2006)] motivates this study as to how asymmetry-driven quantum ratchet effects can persist despite a corresponding fully chaotic classical phase space. A simple perspective of ratchet dynamics, based on the Heisenberg picture, is introduced. We show that ratchet effects are in principle of common origin in classical and quantum mechanics, though full chaos suppresses these effects in the former but not necessarily the latter. The relationship between ratchet effects and coherent dynamical control is noted.Comment: 21 pages, 7 figures, to appear in Phys. Rev.

Coherent Control and Entanglement in the Attosecond Electron Recollision Dissociation of D2+

We examine the attosecond electron recollision dissociation of D2+ recently demonstrated experimentally [H. Niikura et al., Nature (London) 421, 826 (2003)] from a coherent control perspective. In this process, a strong laser field incident on D2 ionizes an electron, accelerates the electron in the laser field to eV energies, and then drives the electron to recollide with the parent ion, causing D2+ dissociation. A number of results are demonstrated. First, a full dimensional Strong Field Approximation (SFA) model is constructed and shown to be in agreement with the original experiment. This is then used to rigorously demonstrate that the experiment is an example of coherent pump-dump control. Second, extensions to bichromatic coherent control are proposed by considering dissociative recollision of molecules prepared in a coherent superposition of vibrational states. Third, by comparing the results to similar scenarios involving field-free attosecond scattering of independently prepared D2+ and electron wave packets, recollision dissociation is shown to provide an example of wave-packet coherent control of reactive scattering. Fourth, this analysis makes clear that it is the temporal correlations between the continuum electron and D2+ wave packet, and not entanglement, that are crucial for the sub-femtosecond probing resolution demonstrated in the experiment. This result clarifies some misconceptions regarding the importance of entanglement in the recollision probing of D2+. Finally, signatures of entanglement between the recollision electron and the atomic fragments, detectable via coincidence measurements, are identified