Developments in the Law of Evidence

The purpose of this Article is to alert Indiana practitioners to significant 1991 developments in the law of evidence. The Article first discusses Indiana developments. It then briefly highlights Seventh Circuit and United States Supreme Court decisions of note

Developments in the Law of Evidence

The purpose of this Article is to alert Indiana practitioners to significant 1991 developments in the law of evidence. The Article first discusses Indiana developments. It then briefly highlights Seventh Circuit and United States Supreme Court decisions of note

Enhancing Depression Care Outcomes in Primary Care Patients through Secure E-mail Structured Follow-Up Monitoring by Mental Health Nurse Practitioner

Improving Antidepressant Medication Follow-Up Management Sophia Lawrence, MSN, RN, PMHNP-BC Doctor of Nursing Practice Student Faculty Chair: Kathy James, DNSc, APRN, FAAN Clinical Mentor: Henry Kane, MD, Psychiatrist Purpose: The purpose of this evidence-based practice project is to integrate a structured follow-up management protocol for patients prescribed antidepressant in primary care and improve HEDIS antidepressant medication management scores. Background: Depression is a highly prevalent condition affecting 14 million adults in the United States annually. Antidepressant is an effective treatment. However adherence to antidepressant medication remains a significant problem and treatments have failed to improve in primary care. Methods and evaluation: Using the Plan-Do-Study-Act method of quality improvement, the standardized was implemented and integrated into practice. Using the project facility’s past HEDIS Antidepressant medication management data as a baseline, data collection points include pre and post intervention to determine project impact on the HEDIS scores. Outcomes: Data collected demonstrated a 10% increase in HEDIS antidepressant scores for the continuation phase and a 4% increase for the acute phase of treatment. Conclusions: Organized follow-up care management for patients prescribed antidepressants in primary care that employed the use of a structured protocol delivered by secure e-mail has the potential to improve adherence to treatment, make a profound impact on HEDIS measurements, and patient outcome

Consumption Behavior of Economics Education Students Faculty of Economics, State University of Manado

This study aims to determine the influence of financial literacy and social environmental factors on consumption behaviour of Economics Faculty of Economics students of Manado State University. The design of this study using the quantitative approach with survey method, with the number of samples is 67 students as respondents through proportionate stratified random sampling. The research instrument used questionnaire with a Likert scale which then tested the validity and reliability. Data analysis techniques include 1) Descriptive analysis; 2) Classical assumption test, and 3) Multiple linear regression analysis. The results showed: 1). There is a significant influence on financial literacy and student consumption behaviour, with the influence of financial literacy on student consumption behaviour of 54.4%; 2). There is a significant influence on social environment factor with student consumption behaviour, with the influence of social environment factor to student consumption behaviour equal to 37.5%; and 3). There is the influence of variable of financial literacy and social environment factor to student consumption behaviour variable with a contribution equal to 78.6%. Conclusion, partially or simultaneously financial literacy and social environmental factors have a significant effect on the consumption behaviour of students of Economics Education Faculty of Economics, State University of Manado

Feasibility Evaluation of Wastewater Treatment Plant System: A Case Study of Domestic Wastewater System in Sleman Regency, Yogyakarta, Indonesia

Domestic Wastewater Treatment Plant (DWWTP) type 1 and DWWTP type 2 were being evaluated. DWWTP type 1 is located in Sembir area while DWWTP type 2 is located in Tambakrejo area which are both in Sleman Regency, Special Region of Yogyakarta (Daerah Istimewa Yogyakarta or DIY), Indonesia. The emphasis of this research is to choose the manhole material which has the least leakage to the soil, influent discharge performance and wastewater treatment quality effluent. The method used to measure the discharge was by averaging daily discharge for twelve hours, while the E. Coli bacteria under the manhole was also being analyzed. Pollution Index method was also used to evaluate the pollution levels of the wastewater treatment effluent. Results of the study indicated that DWWTP type 1 performance was not optimal because the number of users was greater than that of the design. The impacts were excessive capacity, improper detention time and several parameters of the effluent did not meet the Indonesian legal regulation, including Chemical Oxygen Demand (COD), with efficiency of 34.43%. Wastewater treatment quality effluent parameters which met the Indonesian legal regulation were pH, TSS, TDS, Oil and Grease and Chlorine for DWWTP type 1. Pollution Index (PI) of DWWTP type 1 was 7.02 and PI of DWWTP type 2 was 6.96 which were relatively categorized as moderately polluted. DWWTP type 2 performance was optimal with mean discharge lower than the design discharge. Parameters of the effluent which met the Indonesian legal regulation were pH, TSS, TDS, Oil and Grease, Detergent and COD for DWWTP type 2. The COD of DWWTP type 2 met the Indonesian legal regulation with high efficiency of 73.24%. The E. Coli bacteria was not found in soils under the ring type precast concrete manholes. Hence ring type precast concrete base manhole is recommended

MODELAMIENTO PARA LA MEDICIÓN DE LA CONSTANTE “K” DE DIFERENTES RESORTES

En el presente artículo se muestra la adquisición de datos de una celda de carga tipo viga en voladizo. Para medir la constante k de los resortes, la señal de salida dada en mili voltios, es amplificada con el circuito integrado AD620. La tarjeta Arduino Uno se conecta con Labview donde se muestra una interfaz amigable indicando como dato de ingreso la elongación que tiene el resorte y como dato de salida el peso ejercido sobre la celda de carga permitiendo con cálculos matemáticos obtener el valor de la constante K

Galaxy Nurseries: Crowdsourced analysis of slitless spectroscopic data

We present the results of Galaxy Nurseries project, which was designed to enable crowdsourced analysis of slitless spectroscopic data by volunteer citizen scientists using the Zooniverse online interface. The dataset was obtained by the WFC3 Infrared Spectroscopic Parallel (WISP) Survey collaboration and comprises NIR grism (G102 and G141) and direct imaging. Volunteers were instructed to evaluate indicated spectral features and decide whether it was a genuine emission line or more likely an artifact. Galaxy Nurseries was completed in only 40 days, gathering 414,360 classifications from 3003 volunteers for 27,333 putative emission lines. The results of Galaxy Nurseries demonstrate the feasibility of identifying genuine emission lines in slitless spectra by citizen scientists. Volunteer responses for each subject were aggregated to compute $f_{\mathrm{Real}}$, the fraction of volunteers who classified the corresponding emission line as "Real". To evaluate the accuracy of volunteer classifications, their aggregated responses were compared with independent assessments provided by members of the WISP Survey Science Team (WSST). Overall, there is a broad agreement between the WSST and volunteers' classifications, although we recognize that robust scientific analyses typically require samples with higher purity and completeness than raw volunteer classifications provide. Nonetheless, choosing optimal threshold values for $f_{\mathrm{Real}}$ allows a large fraction of spurious lines to be vetoed, substantially reducing the timescale for subsequent professional analysis of the remaining potential lines.Comment: Accepted for publication in Research Notes of the AA

Reducing the within-patient variability of breathing for radiotherapy delivery in conscious, unsedated cancer patients using a mechanical ventilator

OBJECTIVE: Variability in the breathing pattern of patients with cancer during radiotherapy requires mitigation, including enlargement of the planned treatment field, treatment gating and breathing guidance interventions. Here, we provide the first demonstration of how easy it is to mechanically ventilate patients with breast cancer while fully conscious and without sedation, and we quantify the resulting reduction in the variability of breathing. METHODS: 15 patients were trained for mechanical ventilation. Breathing was measured and the left breast anteroposterior displacement was measured using an Osiris surface-image mapping system (Qados Ltd, Sandhurst, UK). RESULTS: Mechanical ventilation significantly reduced the within-breath variability of breathing frequency by 85% (p < 0.0001) and that of inflation volume by 29% (p < 0.006) when compared with their spontaneous breathing pattern. During mechanical ventilation, the mean amplitude of the left breast marker displacement was 5 ± 1 mm, the mean variability in its peak inflation position was 0.5 ± 0.1 mm and that in its trough inflation position was 0.4 ± 0.0 mm. Their mean drifts were not significantly different from 0 mm min(−1) (peak drift was −0.1 ± 0.2 mm min(−1) and trough drift was −0.3 ± 0.2 mm min(−1)). Patients had a normal resting mean systolic blood pressure (131 ± 5 mmHg) and mean heart rate [75 ± 2 beats per minute (bpm)] before mechanical ventilation. During mechanical ventilation, the mean blood pressure did not change significantly, mean heart rate fell by 2 bpm (p < 0.05) with pre-oxygenation and rose by only 4 bpm (p < 0.05) during pre-oxygenation with hypocapnia. No patients reported discomfort and all 15 patients were always willing to return to the laboratory on multiple occasions to continue the study. CONCLUSION: This simple technique for regularizing breathing may have important applications in radiotherapy. ADVANCES IN KNOWLEDGE: Variations in the breathing pattern introduce major problems in imaging and radiotherapy planning and delivery and are currently addressed to only a limited extent by asking patients to breathe to auditory or visual guidelines. We provide the first demonstration that a completely different technique, of using a mechanical ventilator to take over the patients' breathing for them, is easy for patients who are conscious and unsedated and reduces the within-patient variability of breathing. This technique has potential advantages in radiotherapy over currently used breathing guidance interventions because it does not require any active participation from or feedback to the patient and is therefore worthy of further clinical evaluation