Hospital Admission from the Emergency Department for Patients Diagnosed with Heart Failure

Approximately 25% of those hospitalized with congestive heart failure are readmitted within 30 days after discharge. Because researchers and policy makers consider hospital readmission within 30 days for patients with heart failure to be a quality of care issue, the Centers for Medicare and Medicaid Services has imposed financial penalties of up to 3% of a hospital\u27s Medicare revenue for 1 year for excessive readmissions, potentially impacting the financial sustainability of some organizations. The purpose of the study was to address the research gap regarding the outcome quality measure of hospital admissions from the emergency department (ED) and 2 each process and structure variables. The Donabedian conceptual framework was used to assess quality of care through the triad of structure, process, and outcome. The quantitative study comprised analysis of cross-sectional archival data from the 2015 National Hospital Ambulatory Care Survey using cross-tabulations with chi-square followed by multiple logistic regression analysis. Findings showed that process quality measures of being seen in the ED within 72 hours and total laboratory tests obtained in the ED were predictive of lower likelihood of admission. The structure quality measure of insurance was not predictive; however, being seen by provider type consulting physician was predictive of higher likelihood of admission, whereas being seen by a nurse practitioner was predictive of lower likelihood of hospital admission. The implications of this study for social change are helping hospitals maintain financial stability through avoidance of financial penalties for heart failure readmission, supporting access to care for patients by avoiding hospital closures

Using Cornell notes to teach rational expressions

The purpose of the project was to determine whether or not students who learn how to take structured notes using the Cornell Notes format will develop a deeper conceptual understanding and an increased comprehension of concepts involving rational expressions as evidenced on their performance on a multiple choice and free response test

The Benefits of an Innovative Literacy Assessment Field Experience

In many fields of study, an internship or experiential practice is an essential part of learning the discipline. In education, those experiences are often clinical field placements in methods courses or student teaching. The combination of field work while learning the content has many benefits, which we sought to determine. This research study explores the benefits of an embedded field experience in a university literacy assessment course for preparing pre- and in-service teachers as they implement effective literacy assessments and instruction. Based on Kolb’s Experiential Learning Theory (1984), pre- and in-service teachers interacted with elementary students over a ten week span to administer an informal literacy assessment, analyze the data, and apply instructional strategies to support the literacy strengths and needs of the students. This mixed-methods research was conducted using the triangulation of four data points – an online survey and three course assignments – and findings are conclusive with previous research

Parental Characteristics and Parent-Child Relationship Quality in Families with Disabled Children

Parenting can be very challenging, especially when raising a disabled child. Children with disabilities require more supports and are more likely to be abused. The parent-child relationship is an important factor in ensuring child welfare. Little research has focused on identifying the impact of parenting characteristics on raising a child with a disability. The purpose of this study was to examine whether parenting style, parenting competence, and parenting stress were predictors of parent-child relationship quality in parents of children with disabilities ages 3 to 12 years. This study was quantitative and used multiple linear regression to identify predictor variables of the quality of the parent-child relationship. A convenience sample of 244 parents identified through a Qualtrics participant pool completed online surveys. Minuchin\u27s structural family theory was used to guide this research and identify how challenges, such as raising a child with a disability, can cause distress when families are unable to adapt and parents are unable to maintain authority. Parenting factors were assessed using the Parenting Stress Index-4 Competence subscale, the Parenting Stress Index-4 SF, and the Parenting Styles and Dimensions Questionnaire. The quality of the parent-child relationship was assessed using the Parent-Child Relationship Inventory. The results of this study indicated that all parenting factors examined were significant predictors of the parent-child relationship quality. Age of the child was not a predictor. These findings have positive social change implications and can be used to increase practitioner knowledge of the impact of these parenting characteristics on parent-child relationship quality. Modification of treatment models could improve parenting behaviors, reduce parental stress and incidents of child abuse, and assess for the most conducive parenting styles for raising a disabled child

Molecular phylogenetics of deep-sea amphipods (Eurythenes) reveal a new undescribed species at the Porcupine Abyssal Plain, North East Atlantic Ocean

The genus Eurythenes S. I. Smith in Scudder, 1882, has been the focus of integrated molecular and morphological taxonomy studies in recent years, resulting in the number of species in the genus increasing from three to eight. Samples of Eurythenes spp. collected using free-fall baited traps from the Porcupine Abyssal Plain (PAP), North East Atlantic Ocean, at 4850 m were examined in this study to investigate the identity of the species found using molecular barcoding methods. Mitochondrial COI analysis confirms the presence of E. maldoror at PAP and data from the nuclear 28S rDNA gene provides independent confirmation of this observation. A new, undescribed species that is clearly divergent from all other known species and molecular lineages was identified, which can be distinguished morphologically from known species. A specimen within the E. magellanicus lineage was also found at the site. We discuss the presence of these three Eurythenes species at the Porcupine Abyssal Plain

Characterization of potential health promoting lipids in the co-products of de-flossed milkweed

The floss and oil of the common milkweed (Asclepias syriaca L.) seeds are currently used to produce comforters/pillows and skin care products, respectively. As an outcome of these products, copious quantities co-products (pressed seed meal and pod biomass) are disposed of each year despite the presence of potential health benefiting lipids. The objective of this project was to determine the feasibility of developing the lipid fraction from of these co-products for the fast growing dietary human health market. Although certain types of lipids were affected by the extraction solvent used (hexane and diethyl ether) as were overall amounts, analysis of the each extract showed novel lipid profiles with several potential health benefiting agents present at levels comparable to or exceeding those present in other typically consumed dietary oils or food systems (vitamin E, carotenoids, sterols and unsaturated free fatty acids, particularly the both omega 7-fatty acids)

Myocilin polymorphisms and high myopia in subjects of European origin

Purpose: Three previous studies have tested for an association between high myopia and polymorphisms in the open angle glaucoma gene, myocilin (MYOC), all in subjects of Chinese ethnicity. In two of the studies, a significant association was found while in the third, there was no association. We sought to investigate the association between high myopia and polymorphisms in MYOC in subjects of European ethnicity. Methods: Subjects were recruited from two sites, Cardiff University in the UK and Duke University in the United States. The Cardiff University cohort was comprised of 164 families with high myopia (604 subjects) plus 112 unrelated, highly myopic cases and 114 emmetropic controls. The Duke University cohort was comprised of 87 families with high myopia (362 subjects) plus 59 unrelated, highly myopic cases. Subject DNA was genotyped with a panel of MYOC single nucleotide polymorphisms (SNPs) including those found previously associated with high myopia. The Cardiff cohort was also genotyped for two flanking microsatellite markers analyzed in prior studies. Association between high myopia and MYOC polymorphisms was assessed using the Unphased program. Results: Since there was no evidence of heterogeneity in genotype frequencies between families and singleton samples or between cohorts, both subject groups (families and unrelated subjects) from both recruitment sites were analyzed jointly for those SNPs genotyped in common. Two variants showed significant association before correction for multiple testing. These two variants were rs16864720 (p=0.043) and NGA17 (p=0.026). However, there was no significant association after Bonferroni correction. The estimated relative risk (RR) conferred by each of the MYOC variants was low (RR<1.5). Conclusions: Our results suggest that MYOC polymorphisms have a very low, or possibly negligible, influence on high myopia susceptibility in subjects of European ethnicity

Revisiting the Applicability of Adult Early Post-Operative Nausea and Vomiting Risk Factors for the Paediatric Patient: A Prospective Study Using Cotinine Levels in Children Undergoing Adenotonsillectomies

Background and Aims: Post-operative vomiting (POV) in children remains a significant clinical problem. This prospective study aims to investigate the applicability of well-established adult early post-operative nausea and vomiting (PONV) risk factors on paediatric POV after adenotonsillectomies under regulated anaesthetic conditions. Methods: After Institutional Review Board approval, 213 children aged 3–10-year-old were enrolled. The participants had pre-operative questionnaires completed, followed protocolised anaesthetic plans and had saliva analysed for cotinine. The primary outcomes were POV as correlated with age, gender, family or personal history of PONV, motion sickness history, opioid use, surgical time, anaesthetic time and environmental tobacco smoke (ETS) exposure, as assessed by cotinine levels and questionnaire reports. Data on analgesics, antiemetics and POV incidence before post-anaesthesia care unit discharge were collected. Statistical analysis was done through multiple logistic regression. Results: A total of 200 patients finalised the study. Early POV occurred in 32%. Family history of PONV (odds ratio [OR] = 5.3, P \u3c 0.01) and motion sickness history (OR = 4.4, P = 0.02) were highly significant risk factors. Age reached borderline statistical significance (OR = 1.4, P = 0.05). None of the other factors reached statistical significance. Conclusion: Early POV occurs frequently in paediatric patients undergoing adenotonsillectomies. In this paediatric-aged group, the incidence of POV was affected by the family history of PONV, and history of motion sickness. Age, female gender, opioid use, surgical and anaesthetic times did not affect the incidence of POV. ETS exposure, as assessed by cotinine levels and questionnaire reports, had no protective effect on early paediatric POV