Effect of Remote Fetal Monitoring in an Inpatient Obstetrical Unit: A retrospective review

Electronic Fetal Monitoring (EFM) has been used as a tool for inpatient obstetrical care in the United States since the 1980\u27s. The litigious nature of our society has caused much emphasis to be placed upon EFM use and interpretation; however, little evolution has occurred in monitoring techniques. The review of relevant literature found a significant gap in knowledge in regards to research of the current monitoring practice. Therefore, this study was aimed to look at the effect of remote monitoring, like the practice currently used in telemetry, on inpatient obstetrical care. The study used a retrospective review to look at three components including: reaction time of nurses, overall quality of tracing, and the Apgar score of the neonates. Study participants were selected at random from two groups, one prior to implementation of a remote monitoring protocol and one after implementation. All three components improved from the control group to the experimental group, yet only nurse reaction time was found to be statistically significant; therefore, additional research on this subject matter may be warranted. If valid, the impact of these findings is significant because they suggest the potential benefit of a new standard in care. Therefore, more research on the use of remote monitoring techniques is needed along with more data to determine the overall effectiveness in improving obstetrical care

Creating a Request for Proposal for Software for a Non-Profit Organization

When an organization’s need for technology changes, users expect solutions to provide sophisticated and complex functionality regardless of the size of the organization’s budget or available resources. In exploring candidates for filling software needs for non- profit organizations, one of the best tools is the request for proposal (RFP). This case describes a situation where a small non-profit organization has outgrown its current website and needs to identify the best software provider to help them manage membership, events, and payment processing. The case reinforces requirements gathering techniques and allows students to practice creating an RFP. These activities are followed by an exercise in creating a weighted decision matrix to help make the best decision for the organization

Evaluating Methods for Quantifying Evapotranspiration in Arkansas Rice

The goal of this study was to evaluate different methods for quantifying evapotranspiration (ET) in commercial rice fields using different irrigation regimes. The rice fields were located in south central Arkansas. The different irrigation regimes were alternate wetting and drying (AWD) and continuous flooding (CF). Alternate wetting and drying and conventional flooding estimates of ET were 602 mm and 570 mm, respectively, based on field observations using eddy covariance. Models used to estimate ET estimated values between 498 and 653 mm for the 2015 growing season. The Penman Monteith actual evapotranspiration model (PM AET) performed best when compared to the eddy covariance field observations from both irrigation regimes using an iteration of the Jarvis model for conductance, which was scaled using field observations of leaf area index (LAI). The Breathing Earth Systems Simulator (BESS), a global product based on remote sensing data, also served as an acceptable method to estimate ET, though its estimated ET of 498 mm indicates a low bias. AWD showed no significant reductions in ET when compared to CF throughout the growing season, including during periods where the AWD field was confirmed to have a water table depth below zero. This pattern was also consistent in observing the PM AET model over the same periods of time. The lack of disturbance in changed ET rates while the water table was fluctuating implies that while the water table was below zero, the rice plants within the AWD field did not experience significant drought stress. Because the AWD plants were able to retain a normal amount of stomatal activity and production, there were also no significant differences in yield (9.42 ± 0.82 t ha-1 in CF, 9.83 ± 1.02 t ha-1 in AWD). These results indicate that AWD did not induce drought stress within the plants while still being able to take advantage of seasonal rain fall to offset pumping costs

The Respiratory Distress Observation Scale (RDOS), Pain, and Agitation

The Respiratory Distress Observation Scale (RDOS) is relatively new and has not been extensively evaluated. The purpose of this study was to, a) explore the incidence and severity of respiratory distress in the cognitively impaired adult patient on mechanical ventilation, b) examine the relationships between respiratory distress, pain, and agitation in that same population and, c) compare the differences in RDOS scoring results at a 1 minute versus 3 minute observation period. This study had Institutional Review Board approval and took place in a large metropolitan medical intensive care unit. Our subjects consisted of 148 cognitively impaired adults on mechanical ventilation. Our team found that 26% of our subjects experienced respiratory distress for over 5 hours aggregate per day. Patients on mechanical ventilation experience dyspnea even if cognitively impaired. The RDOS slightly correlated with pain as measured by the Critical-Care Pain Observation Tool (CPOT) score (rs = .15, p = .02). However, restlessness as measured by the Richmond Agitation and Sedation Scale (RASS) as compared to the RDOS score showed differentiation (rs = -.02, p = .76). Finally, our findings indicate that 1 minute of observation was as good as 3 minutes in terms of obtaining a score on the RDOS. This result has practical implications for use, research, and study with this scale since direct care staff is more likely to utilize a scale that takes less time. Our findings recommend further testing of the RDOS in the critical care population. Due to the limited amount of research on respiratory distress in the cognitively impaired patient prior to this research, this manuscript contributes to the body of knowledge on the clinical state of cognitively impaired adults on mechanical ventilation

The Effect of Home Health Interventions on Hospital Readmission Rates in Patients with Congestive Heart Failure

Heart failure is a common diagnosis that affects millions of people worldwide. Unfortunately, heart failure is associated with a high risk of 30-day hospital readmission rates. Home health nurses have the potential to bridge the gap between discharge and hospital readmission by providing up-to-date patient education on a one-to-one basis. Research indicates home health nurses lack knowledge of the disease process, nurse management of the disease, and treatment. This project focused on an educational session about the pathophysiology of heart failure, fluid/weight monitoring, diet, medications, and exercise with a pre- and post-tests evaluating home health nurses understanding of heart failure. This intervention provided educational opportunities to improve the patient’s understanding of their heart failure diagnosis, self-management of the disease process, and provide guidelines for notifying the nurse of a change in their condition with the use of a heart failure zone tool. This project revealed that in this small setting that home health nurses play a pivotal role in reducing 30-day readmission rates by increasing their heart failure knowledge and providing personal education sessions for heart failure patients

To See the Negro Saved: The Religious Pragmatism of Booker T. Washington

It might seem strange to group the words of Thomas Jefferson and Booker T. Washington together in the same context. Nearly a century separated the two men and they came from vastly different social and racial backgrounds. In fact, the greatest contrast between these two historical figures can be drawn from the fact that Booker T. Washington was born a slave and Thomas Jefferson owned slaves, even fathering children by one of them. For all the differences that these men had from one another, however, their views on religion were strikingly similar. Indeed, Booker T. Washington had much in common with the civil religion of nearly all the Founding Fathers. George Washington, John Adams, Thomas Jefferson, and Benjamin Franklin all understood that religion played a crucial role in the social and moral health of 50 a people and that some conception of God acted as a legitimizing force for political leaders (Bellah 225-245). As one of the most prominent black leaders during the late nineteenth and early twentieth centuries, Booker T. Washington was very much an heir to the religious legacy of the Founding Fathers, sharing with them what sociologist Max Weber famously called “the Protestant ethic,” a set of cultural values that blended Christian piety and capitalist productivity. Washington’s religion was intensely pragmatic and he stressed practical aspects of the Christian faith. Although he did not literally edit the Christian scriptures with scissors as did Thomas Jefferson, Booker T. Washington selectively amplified aspects of the faith that best suited his particular social philosophy. With his emphasis on the benefits of industrial education for working class African Americans, most notably associated with his founding of the Tuskegee Institute in Alabama, Washington preached a religion that envisioned a God powerful enough to save black souls and black society

Skeletal Analysis: Investigating Senescence in Ancient Nubia

The understanding of older adult life experiences is deficient when compared to younger adults and children in the archaeological record. Research has been devoted toward aging techniques and studies of osteoarthritis, but there are few discussions describing senescence, the cumulative process of aging, in the past. Most research includes the oldest cohort (45 years and above) within the broad category of adults, but it is useful to look at this demographic separately. Skeletal remains were analyzed from the site of Tombos (ancient Nubia) dated to the New Kingdom and the Napatan Periods (~1400‒650 BC). The focus of the analysis was on the pathological conditions and how this cohort’s life experiences contribute to what is known about senescence today. It was hypothesized that individuals who reached extreme old age (45+) would exhibit low signs of pathological and nutritional stress due to their abilities to escape chronic disease and disability. Results show there was a mix of disease survivors and disease escapers from the sample. Most individuals were in their 70s (39.1%), but age distributions were relatively equal among the 40s, 50s, 60s, and 80s. Many individuals were robust and displayed low frequencies of nutritional or infectious lesions (less than 14%). All individuals had some form of arthritis, but there was a wide range in severity. Two case studies are presented to detail disease survivors

A Comparison Of Functionality Between Mobile Apps And Browser-Based Applications

The popularity of mobile apps is increasing at a rapid rate. The attraction for many users is the availability of software functionality on their mobile phone or tablet. One of the trade-offs with using a mobile app is the reduced functionality of the mobile app when compared with the functionality of a browser-based application. This study quantifies the level of functionality in both types of applications and compares five broad categories of mobile apps with their comparable browser-based applications to determine the amount of functionality that the user gives up when opting for the mobile app version of the software