Implementation of a Proactive Rapid Response Team Nurse Rounding Protocol to Address Afferent Limb Failure in a Mature Rapid Response System

Background: Rapid response system afferent limb failure (ALF) is associated with increased hospital mortality rates, unplanned transfer to the ICU, and increased hospital length of stay. Factors contributing to ALF are complex, including individual, team, organizational, and systemic barriers. The aims of this study were to evaluate the impact of implementation of a proactive rapid response team nurse (RRT RN) rounding protocol on the frequency of ALF preceding adverse events, patient disposition following RRT activation, and discharge disposition of patients experiencing adverse events during their hospital stay at a 281 bed community hospital. Methods: This was a two part quantitative, descriptive study using retrospective review of patient medical records who experienced adverse events on inpatient medical-surgical units to evaluate the frequency of ALF preceding adverse events, unplanned transfer to the ICU, and hospital mortality following intervention implementation. Results: Following implementation of the RRT RN rounding protocol there was a decrease in frequency of ALF preceding adverse events (35.1% to 20.8%, p \u3c .001), frequency of patients transferred to the ICU following RRT activation (25.9% to10.7%, p = .009), frequency of patients discharged to a skilled nursing following hospitalization (22.6% to 12.6%, p = .015). There was no significant change in frequency of patients experiencing in hospital mortality (17.6% vs 22.3%, p = 207), rates of adverse events (11.5 vs 14.0, p = .615), or unplanned transfers to the ICU (3.05 vs 8.05, p = .077) per 1000 inpatient medical surgical inpatient day. Conclusion: Proactive rounding by a RRT RN is associated with improved rate of ALF preceding adverse events and decreased transfer to the ICU following RRT activation

New2U Impact Report: Fostering Sustainability and Student Engagement at UMass

This report presents a cost-benefit analysis of the New2U reuse and waste reduction program at the University of Massachusetts Amherst (UMass). Rooted in the university\u27s strategic goals, New2U addresses the environmental impact of landfill waste generated during student move-outs. The program, initiated in 2014, has diverted 80,000 pounds of waste, saving 127 metric tons of carbon dioxide equivalent (CO2e) by redistributing items through a tag sale during move-in

A Macroeconomic Investigation of the Labor Market Matching Efficiency

The first section of this research explores how traditional measures of unemployment can mask important changes in the labor market across the business cycle. We therefore use broader definitions of unemployment to estimate time-varying job-matching efficiency rates that are consistent with vacancies and hiring activity data for the U.S. Our efficiency rates are then modeled along with employment data to study their dynamic, non-linear relationship. We find that including part-time workers for economic reasons as well as marginally attached workers helps explain the changes in employment patterns observed after the global financial crisis, emphasizing the importance of accounting for underemployment, particularly in the last decade. The second section of this research conducts a preliminary analysis of a new coincident and leading composite index following the structural changes inflicted on the economy after the great recession. Since the recession, many critical aspects of the economy have changed; from interest rates near the zero lower bound, record low levels of unemployment, falling labor force participation, and stagnant inflation and wages. This paper takes a novel approach by including the match efficiency parameter as a leading indicator to incorporate a broader view of the labor market. We find that including the match efficiency with other more established indicators improves the composite index

An examination of the influence of gender in juvenile offending, patterns of crime, sentencing and public opinion. an exploratory study of public opinion on the sentencing of male and female juvenile offenders and an examination of the respondents gender

The aim of this literature review was to examine public perception of juvenile crimes, laws and sentencing practices to address whether the public were content with current punishments. It also observed the methodological issues with public opinion survey research to see whether these may influence the belief that the laws and sentencing practices were inconsistent with how the public wanted juveniles to be punished. The review also examined whether the gender of the juvenile offender influenced the types of crimes committed and the types of punishments sanctioned by the courts. Additionally, it observed whether the demographics of the respondent, victim or offender influenced how the public perceived the effectiveness of sentencing and seriousness of the crime, with close attention to gender. It concluded suggesting that future research needs to examine if the public are as punitive as research suggests and if the public perceive different punishments for males and females as research in this area was limited. Recently researchers have reported that the gender of juvenile offenders influenced the outcomes of the punishments sanctioned by the courts. However, paucity in the research exists that examines how the public perceive appropriate punishments for male and female juvenile offenders. Due to the public\u27s influence on social policy, the current study examined if the public perceived that there was a need for different sentencing practice for male and female juvenile offenders. Further, the study aimed to examine whether there was a difference between male and female participants\u27 perception of crime as previous research has been inconsistent on this topic. Sixty one participants, 27 males and 33 females, were recruited to read one of two versions of a crime-based vignette and complete a survey. Participants were asked to rate how serious they viewed the offence and how severe a required punishment should be. A qualitative measure was also included to supplement the quantitative data. Results indicated that the participants in the study were not influenced by the gender of the perpetrator in how serious they viewed the offence or the severity of the required punishment. The qualitative component which was examined for themes and converted to percentages supported non gender specific sentencing practices. Further, the responses provided by male and female participant did not significantly differ on the Likert scales; however the qualitative component suggested some discrepancies. These results were discussed in relation to previous research and implications were also presented

The Analysis of Labor Market Efficiency: A Comparative Analysis of Maine and the United States

The purpose of this research is to analyze the change in the labor market efficiency from before to after the great recession and its effect on economic output following the recession. Concerns have been raised about the adjustment of the labor market compared to the recovery of other economic indicators. Influenced by the methods of Blanchard and Diamond (1989) and Dixon et al. (2014), the Beveridge curve and matching function are used to estimate and observe changing labor market dynamics through the relationship between unemployment and job vacancies. This thesis finds that labor markets for both Maine and the United States are less efficient after the recovery period than they were prior to the recession. There is also evidence indicating that in 2015 and 2016 Maine has a more efficient labor market than the United States. Possible reasons for the lower labor market efficiencies are the lower labor force participation, automation, and the distribution of vacancies across industries. Future research will consist of measuring the influence of labor market efficiency as well as applying the Beveridge curve and matching function across all states

Efficient quantum circuits for diagonal unitaries without ancillas

The accurate evaluation of diagonal unitary operators is often the most resource-intensive element of quantum algorithms such as real-space quantum simulation and Grover search. Efficient circuits have been demonstrated in some cases but generally require ancilla registers, which can dominate the qubit resources. In this paper, we point out a correspondence between Walsh functions and basis for diagonal operators that gives a simple way to construct efficient circuits for diagonal unitaries without ancillas. This correspondence reduces the problem of constructing the minimal-depth circuit within a given error tolerance, for an arbitrary diagonal unitary eif(ˆx) in the |xi basis, to that of finding the minimal-length Walsh-series approximation to the function f(x). We apply this approach to the quantum simulation of the classical Eckart barrier problem of quantum chemistry, demonstrating that high-fidelity quantum simulations can be achieved with few qubits and low depth.Chemistry and Chemical BiologyPhysic

Is the perception of time pressure a barrier to healthy eating and physical activity among women?

Objectives To describe the proportion of women reporting time is a barrier to healthy eating and physical activity, the characteristics of these women and the perceived causes of time pressure, and to examine associations between perceptions of time as a barrier and consumption of fruit, vegetables and fast food, and physical activity.Design A cross-sectional survey of food intake, physical activity and perceived causes of time pressure.Setting A randomly selected community sample.Subjects A sample of 1580 women self-reported their food intake and their perceptions of the causes of time pressure in relation to healthy eating. An additional 1521 women self-reported their leisure-time physical activity and their perceptions of the causes of time pressure in relation to physical activity.Results Time pressure was reported as a barrier to healthy eating by 41 % of the women and as a barrier to physical activity by 73 %. Those who reported time pressure as a barrier to healthy eating were significantly less likely to meet fruit, vegetable and physical activity recommendations, and more likely to eat fast food more frequently.Conclusions Women reporting time pressure as a barrier to healthy eating and physical activity are less likely to meet recommendations than are women who do not see time pressure as a barrier. Further research is required to understand the perception of time pressure issues among women and devise strategies to improve women’s food and physical activity behaviours

Role of accounting practices in the disempowerment of the Coahuiltecan Indians

This paper argues that a complex of accounting measures : account books, inventories of accumulated wealth, and detailed instructions for production performance : were used to inculcate Western values into the native population located at five Franciscan missions along the San Antonio River in New Spain (present-day Texas) from 1718 to 1794. Bolstered by the need to alleviate communications problems caused by extreme isolation, the missionaries constructed detailed mission documents that described the acquisition of scarce resources, reported the aggregation of material and spiritual mission wealth, and controlled daily production performance of the native population. In short, the resulting mission economic system, which held the Indians to certain notions of accountability, primarily by restricting their choices, nourished the Western view of income distribution based on effort. We propose that these procedures ultimately caused the Coahuiltecans to abandon their native beliefs, and gradually, to be absorbed into Spanish society. The 150 Coahuiltecan tribes ceased to exist as a distinct culture by the early 19th century. The exploitation and ultimate subjugation of the Coahuiltecan Indians parallels strikingly subsequent developments in Canada, Australia, and the Scottish Highlands

State of Welfare Families on Reservations: Progress, Setbacks, and Issues for Reauthorization (Working Paper 3)

State of Welfare Families on Reservations: Progress, Setbacks, and Issues for Reauthorization (Working Paper 3