A Comparative Analysis of Two Low-Acuity Flow Processes in the Emergency Department

Emergency Departments have begun implementing new patient flow processes aimed at improving ED throughput and limiting ED crowding. The purpose of this study was to evaluate the effectiveness of two flow processes. This was a retrospective quasi-experimental study designed to evaluate the impact of a Rapid Medical Assessment process versus Fast Track process on improving ED throughput. Data analysis included descriptive statistics and two-factor analyses of covariance (ANCOVA). ANCOVA statistics were calculated using arrival to first provider contact time and arrival to departure time as the dependent variables and RMA process versus FT process as well as ESI levels as the independent variables. There was a significant difference in the mean arrival to first provider contact times for all patients during all hours, F (1, 5744) = 9.5, p = .002. There was also a significant difference in the mean arrival to first provider contact time for low-acuity patients during all hours, F (1, 3131) = 14.6, p = \u3c .001 There was a significant difference in the mean arrival to departure times for all patients during all hours, F (1, 6079) = 5.8, p = .016. There was no significant difference in the mean arrival to departure times for low-acuity patients during all hours, F (1, 3306) = 0.774, p = .379, or for all patients during FT hours, F (1, 2647) = 1.1, p = .295. The results of the study support the belief that rapid evaluation and disposition of low-acuity patients improve ED efficiency and reduce ED crowding

A Thirty Year Collaboration in Uniquely Black and Catholic Mission

The Institute for Black Catholic Studies arose out of a passion for authentically Black and truly Catholic theology and ministry in 1980. It continues to inspire its students, its faculty, and all those who are touched by its unique approach and identity. Kathleen Dorsey Bellow and C. Vanessa White reflect on the history and mission of the IBCS

Computer programs for a reactive turbulent boundary layer - Hydrogen version

IBM 7094 Fortran II program for calculating turbulent boundary layer properties, with hydrogen chemistr

Full, Conscious and Active Participation: Sunday Eucharist, Black Life and Theological Considerations

The renewal of Catholic worship implemented through Vatican Council II instruction was designed to encourage the people of God towards “full, conscious and active participation” in liturgical celebrations. Their holistic engagement in liturgy is considered the best and most effective formation for the Christian life. This work presents Black Catholic theological reflections that connect “full, conscious and active participation” in Sunday Eucharist with the faithful’s weekday commitment to community-building that affirms Black life

Securing the Legacy of Black Catholics through Archival Donations: Dom Cyprian Davis, O.S.B. (1930-2015), A Case in Point

Cyprian Davis, O.S.B., was a lifelong scholar of church history and a prolific archivist. This article recaps his development as a Catholic historian whose struggle with black consciousness and commitment to serve God’s people placed him in a unique position to chronicle the growth of the U.S. Black Catholic church. In late 2014, he made a plan with colleagues to finally organize and dispose of the substantial collection of documents, files, photos, correspondence, and articles related to the history of Black Catholics in the United States that he had accumulated during the course of his career and ministry. Fr. Davis’ death, just a few months later, required a drastic change of those plans. His colleagues were left with the task of researching institutional archives, making key decisions, discerning and advocating with his religious community for the disposition of the invaluable paper trail of Fr. Cyprian’s life work according to his unwritten plans. As a result of this experience, the author advises Black Catholic scholars to evaluate the historical significance of their personal and professional papers for future researchers, put in writing their intentions to make an archival donation and share their written plans with others

The Black Community and the Call for Vatican Council II (1962-1965)

Even as the Church celebrates the 50th anniversary of Vatican Council II (1962-65), the people of God have not unfolded much of its meaning for Catholic pastoral practice and teaching. In the excitement of Council developments, many updates were implemented in the life of the church without proper catechesis, leaving many of the faithful – proponents and opponents of the Council - wholly uninformed about the continuity of Council reforms with Catholic tradition. The dialogue between the Church and contemporary society formally endorsed in Vatican II is ongoing. A review of the world’s situation in the 1950s and 60s provides perspective on the social unrest and cultural change that inspired Pope John XIII, with prompting from the Holy Ghost, to convene an ecumenical council. This essay will ground the Second Vatican Council in the context of the mid-twentieth century, with a particular focus on Black America and Black Catholic liturgical reform, to grasp a sense of its ongoing relevance for the faithful of today

Design Of First-Row Transition Metal Bis(alkoxide) Complexes And Their Reactivity Toward Nitrene And Carbene Transfer

The novel alkoxide ligand [OCtBu2Ph], or [OR], was synthesized in a single step as a lithium salt. It was then reacted with a series of first-row transition metal(II) halides, with widely varying results. Upon reaction with chromium, manganese, iron, or cobalt(II) chloride, dimeric complexes of the form M2(OR)4Li2Cl2 were formed, which displayed rare seesaw geometry at the metal. This unusual geometry was confirmed by various spectroscopic and computational studies. Computational studies also indicate that the steric bulk of the ligand, as well as the inclusion of lithium atoms in the molecules, are what lead to the seesaw geometry. Reaction of [OR] with nickel(II) halides generates monomeric species of the form Ni(OR)2XLi(THF)2 (X = Cl, Br), which display distorted trigonal planar geometry at three-coordinate nickel. Dimerization likely does not occur for nickel due to its smaller size. DFT studies support preference for nickel to form the monomer. Reaction of [OR] with copper(II) halides leads to reduction of the copper center by one electron, generating the tetramer Cu4(OR)4. Reduction of copper(II) by an alkoxide is a novel transformation. Spectroscopic studies to probe the mechanism suggest that Cu(OR)2XLi(THF)2 may be an intermediate prior to reduction. Observation by NMR of the ketone Ph(C=O)tBu and ROH suggest that alkoxide reduces the copper to give an alkoxide radical, which then decomposes via β-scission. To form the desired bis(alkoxide) system, the halide-containing alkoxide complexes were reacted with thallium(I) hexafluorophosphate. For manganese, iron, and copper, complexes of the form M(OR)2(THF)2 were isolated. The bis(alkoxide) complexes display distorted tetrahedral geometry at the metal, with large RO−M−OR angles. Cyclic voltammetry of these species show that the iron bis(alkoxide) is the most easily reduced of the three. Attempts to form the chromium bis(alkoxide) in a similar fashion led to the reduction of thallium(I) to thallium metal. Formation of the nickel bis(alkoxide) complex was also unsuccessful. Reaction of the iron bis(alkoxide) complex with adamantyl azide led to reductive coupling of the azide moieties to give the bridging hexazene complex (RO)2Fe(μ-η2:η2-AdN6Ad)Fe(OR)2. This complex was confirmed to be stable to explosive decomposition. Computational studies suggest a dimerization mechanism, whereby azide initially coordinates to iron(II), and upon dimerization the iron centers reduce the azides before N−N bond formation occurs. Stoichiometric reaction of the iron bis(alkoxide) complex with mesityl azide leads to nitrene formation followed by nitrene coupling to give the azoarene MesNNMes. Crystallization from a stoichiometric reaction afforded the azoarene and the iron tris(alkoxide) Fe(OR)3. Catalytic azoarene formation with catalyst loading as low as 1 mol% cleanly generates azoarene at room temperature within a day or two for mesityl azide and 2,6-diethylphenyl azide. Asymmetric azoarene can also be formed by reacting mesityl azide and 2,6-diethylpheynyl azides together with the iron bis(alkoxide). This process is highly selective: azoarene is the only product formed, even if the reaction is performed in the presence of cyclohexadiene or isocyanide. Other azides (i.e. those not possessing groups in positions ortho to the azide on the ring) do not form azoarene upon reaction with the iron bis(alkoxide): instead they form bis(imido) complexes of the form (RO)Fe(THF)(μ-NAr)2Fe(THF)(OR) (Ar = 4-(trifluoro)methyl, 3,5-dimethylphenyl, or phenyl). These are stable molecules that do not react with additional equivalents of aryl azide. A tentative mechanism is proposed, whereby the iron(III) imido radical Fe(OR)2(NAr) comproportionates with another equivalent of iron bis(alkoxide) to give the observed iron(III) tris(alkoxide), and the iron(III) bridging imido dimer. Nitrene coupling to give azoarene can occur from either the iron(III) imido radical complex, or from the bis(imido) dimer. For bulkier aryl azides, the bis(imido) dimer is disfavored to form due to sterics. This likely leads to preferential azoarene formation. Reaction of the iron bis(alkoxide) with diphenyldiazomethane generates the azine Ph2CNNCPh2, suggesting that a reactive iron carbene complex is formed before reacting with another equivalent of the diazoalkane. A similar reaction with the cobalt bis(alkoxide) leads to isolation of the stable carbene complex, Co(OR)2(CPh2). This molecule is the first example of an isolated, structurally characterized high-valent cobalt carbene complex. EPR and DFT studies confirm the electronics of the complex: it is likely that the cobalt oxidation state lies on a continuum between cobalt(III) and cobalt(IV) but that it displays significant alkylidene character. However, the high-valent cobalt carbene complex is surprisingly unreactive. Combination with both styrene and methyl acrylate at elevated temperatures failed to lead to any significant reactivity of the complex. This is likely due to the steric protection offered by both the bulky alkoxide ligands and the bulky carbene