Predictors of Physical Therapy Non-Treatment Among Patients Scheduled for Treatment Two Times a Day in the Acute Hospital

Background and Purpose: Consistent participation in physical therapy treatment is the key to the success of any physical therapy treatment program. Scheduled therapy sessions that do not result in treatment (non-treatment) may cause longer hospital stays and/or poor outcomes. A better understanding of the factors affecting non-treatment could allow proper adjustments to prevent non-treatment by hospital administration, improve patient-therapist interaction, and may result in improved care, greater patient satisfaction, and lower healthcare costs. The purpose of this study was to investigate characteristics of patients that affect physical therapy non-treatment events for patients scheduled for therapy twice a day (BID) in an inpatient hospital setting. Subjects: The subjects for this study were all patients scheduled to receive physical therapy BID during their hospital stay. Data was collected from a 450 bed hospital located in a metropolitan area of the Southwest United States. Data from 367 patients who were scheduled for physical therapy treatment BID were collected retrospectively from the medical record during the study period. There were 168 males and 199 females. A total of 810 scheduled BID treatment sessions were analyzed. Methods: The dependent variable was a dichotomous Yes or No to indicate if treatment occurred or did not occur giving 4 possible outcomes on a day of BID scheduled therapy: yes/yes, yes/no, no/yes, and no/no. Demographic patient information such as age, gender, diagnosis, and scheduled treatment day was also given to the research team for analysis. Patient diagnoses were grouped into 1 of 13 categories: Cardiovascular, Pulmonary, Neurological, Gastrointestinal, Musculoskeletal, Cancer, Integumentary, Genitourinary/Renal, Infections Disease, Obstetrics and Gynecology (OBGYN), Neonatal intensive care unit (NICU), Endocrine, or Other/Unknown. Ages of patients ranged from newborn children seen in the NICU to 97 years of age. Scheduled treatment day included the 7 days of the week. Descriptive and interferential statistics were performed. Chi-square analyses were performed to assess which patient characteristics including treatment day, gender, and diagnosis were associated with a change in BID treatment occurrences. One-way ANOVA and post-hoc paired t-tests were utilized to compare patient age in the 4 outcome groups. Results: Gender, diagnosis, day of the week, and age all influence non-treatment occurrence in the acute care setting for patients scheduled for BID therapy (p=\u3c0.003). Among females, 84% of scheduled sessions resulted in a yes/yes combination while only 64% yes/yes occurred for males (p=\u3c0.000). No/no events are at their highest proportions on Sunday 27.8% (p=\u3c0.000) and Saturday 23.5% (p=\u3c0.002). Tuesday and Thursday had the lowest occurrence of non-treatment at 4.2% of scheduled visits (p=\u3c0.001). Musculoskeletal diagnosis has the highest yes/yes outcome (p=\u3c0.000). The average age of patients that had a no/no outcome is 55.42 years old, and the average age that had a yes/yes outcome is 63.89 years old (p=\u3c0.002). Discussion: Gender, age, diagnosis and day of the week of treatment all appear to play a role in non-treatment in the acute hospital setting. Specifically, females have a lower occurrence of no/no treatment. Patients with musculoskeletal diagnosis has the highest occurrence of yes/yes treatment. Saturday and Sunday have the highest no/no treatment occurrence and Tuesday and Thursday have the lowest occurrence of non-treatment. It may be possible for hospitals to minimize the incidence of non-treatment, allowing patients to receive the physical therapy they need. In the future, other hospitals may use this information to reduce their BID non-treatment rates. Further studies should investigate a more inclusive population of patients in both BID scheduled treatment and those scheduled for one physical therapy treatment in order to explore trends that can potentially lead to missed treatment

Analysis of effects of surface roughness and local surface imperfections on measured pressure

When tests using pressure to characterize the performance or effects of an explosive are conducted in laboratory or other small scale, highly controlled settings, it is expected that any gages will be ideally mounted and there will not be any surface imperfections or roughness near the gage location. However, when explosive tests are scaled up, the test beds typically do not have perfect surfaces. Instead there may be rough surfaces with various types of geometry or situations where it is extremely difficult to get the gage flush mounted with a flat surface. In a time where tests with multiple replications are increasingly limited, it is critical to understand the experimental error present in a test. This document discusses pressure and optical data gathered from shock tube tests for flat and rough surfaces spanning two geometries and three amplitudes as well as three different imperfect mounting configurations. For each test, pressure data was recorded from gages mounted in the roughness plates and on a wing mount to provide information on how the measured pressure varied due to the location of the gage. In addition to the pressure data, Schlieren video was recorded for each shot on the same timebase as the pressure gages. Both geometry and amplitude of the roughness affected the shock structure and corresponding pressure waveform. The combination of pressure data and Schlieren video allowed particular waveform characteristics to be attributed to specific shock structures. With the roughness plates in place, the measured pressure varied from 12 to 85% higher than the baseline, while the impulse varied from 6% lower to 49% higher. The gage mounted on the wing at 7-inches above the floor of the shock tube remained unaffected during the test series, with only a 4% variance in peak pressures and impulses --Abstract, page iii

Retailing nursery products in four counties of Tennessee

Specifically the objectives of this study are: (1) to describe the present marketing practices and facilities used in merchandising nursery products at the retail level; and (2) to point out possible practices which may alleviate some marketing problems, as well as improve marketing efficiency

Impact effects of explosively formed projectiles on normal and high strength concrete

The ability to quickly estimate the damage that a projectile will do to a structure is highly desired for structures that will be required to resist threats of this nature. There are several formulas for concrete penetration due to projectile impact that are based on empirical data. However, there is a lack of publicly available data for projectile impacts with striking velocities that exceed 1 km/s and have weights greater than a few grams. This research is intended to expand the available data on explosively formed projectile impacts and determine which, if any, of the existing equations can be used or slightly modified to predict penetration depths. In order to determine un-deformed measurements for the explosively formed projectiles, five projectiles were recovered using a soft recovery system. Then, multiple shots were performed using blocks of normal and high strength concrete. The projectiles remained consistent throughout all of the shots --Abstract, page iii

NASA's Space Launch System and Deep-Space Opportunities for SmallSats

Designed to provide the significant capability required for human deep-space exploration, NASA's Space Launch System (SLS) also provides a unique opportunity for lower-cost deepspace science in the form of small-satellite secondary payloads. This opportunity will be leveraged beginning with the rocket's first flight; a launch of the SLS's Block 1 configuration, capable of delivering >26 metric tons (t) to Trans-Lunar Injection (TLI), which will see the Orion crew vehicle travel around the Moon and return to Earth. On that flight, SLS will also deploy 13 6U CubeSat-class payloads to multiple destinations including deep space. These secondary payloads will include not only NASA research, but also spacecraft from international partners, industry and academia. The payloads represent a variety of disciplines including, but not limited to, studies of the Moon, Earth, Sun, and asteroids, along with technology demonstrations that could pave the way for even more ambitious smallsat missions in the future. As the SLS Program is making significant progress toward that first launch, preparations are already under way for future missions, which will see the booster evolve to its more-capable Block 1 B configuration, able to deliver 40 metric tons to TLI. That configuration will have the capability to carry large payloads co-manifested with the Orion spacecraft, or to utilize an 8.4- meter (m) fairing to carry payloads several times larger than are currently possible. SLS will evolve to its full Block 2 configuration, with a TLI capability of >45 metric tons. Both the Block lB and Block 2 versions of SLS will be able to carry larger secondary payloads than the Block 1 configuration, creating even more opportunities for affordable scientific exploration of deep space. This lecture will provide a status of the SLS development and outline the progress being made toward flying smallsats on the first flight of SLS, and discuss future opportunities for smallsats on subsequent flights

Statistically generated weighted curve fit of residual functions for modal analysis of structures

A statistically generated weighting function for a second-order polynomial curve fit of residual functions has been developed. The residual flexibility test method, from which a residual function is generated, is a procedure for modal testing large structures in an external constraint-free environment to measure the effects of higher order modes and interface stiffness. This test method is applicable to structures with distinct degree-of-freedom interfaces to other system components. A theoretical residual function in the displacement/force domain has the characteristics of a relatively flat line in the lower frequencies and a slight upward curvature in the higher frequency range. In the test residual function, the above-mentioned characteristics can be seen in the data, but due to the present limitations in the modal parameter evaluation (natural frequencies and mode shapes) of test data, the residual function has regions of ragged data. A second order polynomial curve fit is required to obtain the residual flexibility term. A weighting function of the data is generated by examining the variances between neighboring data points. From a weighted second-order polynomial curve fit, an accurate residual flexibility value can be obtained. The residual flexibility value and free-free modes from testing are used to improve a mathematical model of the structure. The residual flexibility modal test method is applied to a straight beam with a trunnion appendage and a space shuttle payload pallet simulator

Large-Cell Renormalization-Group Approach to Long-Range Hopping on Energetically Disordered Lattices

We describe an approach for computing the conductivity associated with long-range hopping on energetically disordered lattices. Using a numerically exact supercell procedure we compute the distribution ρL(γ) of block conductances γL associated with conducting cubes of edge length L that are randomly chosen from the disordered system of interest. This distribution of block conductances is then used in a self-consistent numerical calculation to obtain the renormalized bulk conductivity. The approach displays a surprisingly fast approach to the infinite-system limit, allowing finite-size effects to be minimized. In this paper we use this approach to study transport in a series of binary lattices containing a random distribution of two enegetically inequivalent ions. Specific examples considered include variations of the nearest-neighbor site percolation problem, long-range hopping on more general binary lattices, and the trapping-to-percolation transition that occurs in such systems

Long-Range Random Walks on Energetically Disordered Lattices

Although the master equation describing long-range random walks on an energetically disordered lattice is governed by a nonsymmetric transition matrix W, it may be mapped through a similarity transform onto an imaginary-time Schrödinger equation governed by a Hermitian (Hamiltonian) operator H0 having a nondegenerate ground state. Under this mapping the diffusion constant D can be expressed in terms of the exact ground state energy of operators that are infinitesimally perturbed from H0

Energy-Projected Effective-Medium Theory of Long-Range Hopping on Energetically Disordered Lattices

We introduce energy-projected equations of motion to treat the diffusive transport of charge carriers that undergo long-range (i.e., greater than nearest-neighbor) hopping among the sites of an energetically disordered lattice. This approach leads naturally to an energy-projected effective-medium theory for treating such systems. Exact expressions for the diffusion constant associated with the energy-projected effective medium theory are obtained. Using the formalism in conjunction with what is normally a rather poor approximation, i.e., the virtual-crystal approximation, we are able to obtain the exact diffusion constant for the long-range symmetric-random-well problem. Effective-medium calculations and numerical simulations are presented for nearest-neighbor and long-range hopping on a disordered binary lattice