Successful Strategies for Financial Sustainability in Nursing Homes

From 2014 to 2015, deficiency fines cost Pennsylvania nursing homes more than $2.5 million. Costs associated with adhering to increased health care regulations can reduce profit and affect the financial sustainability of the nursing home industry. Some nursing home administrators (NHAs) lack successful strategies to improve state and federal regulation compliance and promote financial sustainability. Drucker\u27s management by objectives theory was the conceptual framework for this study. The purpose of this qualitative multiple case study was to explore successful strategies NHAs use to improve state and federal regulation compliance to mitigate deficiencies and derivative fines to promote financial sustainability of nursing homes. NHAs who manage 5-star rated nursing homes within a 100-mile radius of Pittsburgh, Pennsylvania use effective management strategies to mitigate deficiencies and derivative fines to earn a 5-star rating which, helps promote financial sustainability. Data were collected from semistructured face-to-face and telephone interviews with 4 NHAs and from Medicare\u27s Nursing Home Compare website. The data on the website provided information on the 3 domains of health inspections, staffing, and quality measures, that made up the overall star rating of nursing homes. Data were analyzed using Yin\u27s 5-phase cycle. The findings revealed 3 major themes: develop knowledgeable staff, enhance communication with staff and residents, and promote innovation for continuous quality improvement. The implications for positive social change could include increased quality of patients\u27 health care, creation of employment opportunities to promote prosperity in communities, and financial sustainability in the United States nursing home industry

A survey of new technology for cockpit application to 1990's transport aircraft simulators

Two problems were investigated: inter-equipment data transfer, both on board the aircraft and between air and ground; and crew equipment communication via the cockpit displays and controls. Inter-equipment data transfer is discussed in terms of data bus and data link requirements. Crew equipment communication is discussed regarding the availability of CRT display systems for use in research simulators to represent flat panel displays of the future, and of software controllable touch panels

Adaptation of Boethian Structure and Theme in \u3ci\u3eTroilus and Criseyde\u3c/i\u3e

That Chaucer\u27s Troilus and Criseyde is steeped in Boethian influence is unquestionable. The manner in which Chaucer employs this influence is less clear. John P. McCall suggests a structural similarity. Martin Camargo supports the notion of character parallels, and, in his book Chaucer and the Consolation of Philosophy of Boethius, Bernard L. Jefferson particularly emphasizes Chaucer\u27s use of Boethian quotations. Several other scholars point to thematic similarities in the works, such as Chaucer\u27s and Boethius\u27 discussions of Lady Fortuna. Clearly much study has been given to the role of Boethian influence on Chaucer\u27s Troilus. Unfortunately, most of these examinations focus on one particular element of influence separate from the others. I assert there is an interconnectedness of Boethian elements in Troilus and Criseyde which demonstrates a closer relationship between the two texts than the narrower studies indicate

Magnetic reconnection in space plasmas

This is the final report of a three-year, Laboratory-Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). Magnetic reconnection produces fundamental changes in the magnetic field topology of plasmas and leads ultimately to substantial plasma heating and acceleration. The transfer of stored magnetic field energy to the plasma occurs primarily at thin conversion layers that extend outward from the reconnection site. We performed a comparative study of the structure and nature of these conversion layers as observed during reconnection at Earth`s magnetopause and in the geomagnetic tail. Our research utilized plasma and magnetic field data from the Earth-orbiting ISEE satellites during crossings of the conversion layers at the magnetopause and in the geomagnetic tail, as well as data obtained during a long-duration balloon flight in Antarctica and simultaneously from satellites in geosynchronous orbit. We have found that the reconnection layer at the magnetopause usually does not contain a slow mode shock, contrary to earlier theoretical expectations. Through a coordinated analysis of data obtained from balloon altitudes and at geosynchronous orbit, we obtained evidence that reconnection can occur simultaneously in both hemispheres at the magnetopause above the polar caps. The final year of our study was oriented primarily towards the question of determining the magnetic topology of disturbances in the solar wind associated with coronal mass ejections (CMEs) and understanding how that topology is affected by magnetic reconnection occurring near the Sun

“Retornem para os seus países” parlamentares de cor: Trump, racismo e a repercussão na mídia negra dos EUA

Este artigo analisa, sob a perspectiva da interseccionalidade, a repercussão das mensagens racistas  do presidente  Donald Trump  na mídia negra estadunidense, no episódio envolvendo as quatro parlamentares de cor estreantes no Congresso Nacional pelo Partido Democrata. Nos posts publicados no Twitter, observa-se como gênero, raça, geração, nacionalidade e posicionamento político foram acionados por Trump para  discriminar  e  “mandar”   as parlamentares voltarem aos seus respectivos países de origem. Baseado na análise de conteúdo de cinco mídias negras, verifica-se que a cobertura  destacou os tweets e a trajetória racista de Trump. Pouca intersecção foi realizada para mostrar os cruzamentos entre as categorias utilizadas por ele para agredir as parlamentares. 

Transient reconnection in the cusp during strongly negative IMF B y

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94721/1/jgra16996.pd

Nonadiabatic Heating in Magnetic Reconnection

Plasma transport process as a fundamental problem in magnetospheric physics is often associated with strong nonadiabatic heating. At the magnetopause, observations show an increase of specific entropy (i.e., S = p/ργ) by 2 orders of magnitude from the magnetosheath into the magnetosphere. In the near‐Earth magnetotail, particle injection requires strongly entropy depleted plasma bubbles, and their evolution can be strongly modified in the presence of nonadiabatic heating. In this study, one of the critical plasma transport mechanisms, magnetic reconnection, is investigated as a nonadiabatic process in the framework of MHD. It is important to examine whether magnetic reconnection can provide sufficient nonadiabatic heating to explain the observed plasma properties and to identify plasma conditions that allow such strong nonadiabatic heating. We demonstrate that the entropy can indeed strongly increase associated with magnetic reconnection provided that the plasma beta (i.e., the ratio of thermal to magnetic energy density) is low in the inflow region of reconnection

Instances of Escapism and the Messages within “Cinderella” Folklore

This paper explores elements of escapism and the messages behind traditional Cinderella folklore using Charles Perrault’s French “The Little Glass Slipper”, Kashmir’s “The Wicked Stepmother”, and “The Poor Turkey Girl” from Pueblo-Zuni mythology. Despite both differences and distances, connections between these tales can be made through their identities as escapist fantasies alongside their Cinderella-esque storylines. The implications behind the tales—upwards-mobility, surviving abuse, and remembering promises—point towards the intended messages that their original authors attempted to convey to their audiences. These messages are linked to the specific time period and cultural contexts that each tale belongs to, but still prove to be no less relevant today as they were generations before. Ultimately, the idea that misfortune is temporary and escape can be achieved from any and all situations can be gleaned from these three tales, connecting humanity and fantasy across miles