A Quality Improvement Project to Increase Intimate Partner Violence Screening on College Campuses

Background: Sexual assault on college campuses can be a life-changing event and goes unreported 80% of the time. Women are not screened for intimate partner violence (IPV) regularly when seen in university student health settings. Student health settings on college campuses can fill this gap by routine screening for intimate partner violence. Purpose: This quality improvement project aimed to increase intimate partner violence screening rates with the implementation of an evidence-based intimate partner violence screening tool and healthcare provider training. Project method: A retrospective chart view was conducted before and after implementing the Humiliation, Rape, Anger, and Kick (HARK) evidenced-based IPV tool at a university student health center in Georgia. Healthcare providers working in student health completed the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) pre and post IPV educational session. Findings: Intimate partner violence screening rates pre-implementation of the HARK screening tool was 2.6% (N=303). Intimate partner violence screening rates post-implementation of the HARK screening tool was 95.7% (N=185). Results for the knowledge subscale of the PREMIS tool (Mdn = 27.50), z = -1.342, p \u3e.005. Conclusion: These findings support the use of an evidence-based IPV screening tool to increase rates of screening. Additional measures may be needed to enhance provider knowledge regarding IPV

A Quality Improvement Project to Increase Intimate Partner Violence Screening on College Campuses

Abstract A Quality Improvement Project to Increase Intimate Partner Violence Screening on College Campuses Background: Sexual assault or rape on college campuses can be a life-changing event and goes unreported 80% of the time. Women are not screened for intimate partner violence (IPV) regularly when being seen in university student health settings, even though females ages 18 to 24 have the highest rape and sexual assault rates compared to females in all other age groups. Students that are victims of IPV may not report because of fear, embarrassment, or being unsure who to or where to report. Student health settings on college campuses can fill this gap by routine screening for intimate partner violence. Purpose: The purpose of this quality improvement project was to increase intimate partner violence screening rates with the implementation of an evidence-based intimate partner violence screening tool along with healthcare provider training. Project method: The project implemented an evidenced based Intimate Partner Violence Screening tool, Humiliation, Anger, Rape and Kick (HARK) along with educational session on IPV on college campuses for health care providers at Student Health. A retrospective chart review was conducted over a 4-week period pre and post implantation of the HARK tool. The knowledge subscale of the Physician Readiness to Mange Intimate Partner Violence Survey (PREMIS) was utilized pre and post educational session. Finding: Intimate partner violence screening rates pre-implementation of the HARK screening tool was 2.6% (N=303). Intimate partner violence screening rates post-implementation of the HARK screening tool was 95.7% (N=185). Results for the knowledge subscale of the PREMIS tool (Mdn = 27.50), z = -1.342, p \u3e.005. Conclusion: These findings support the use of an evidence-based IPV screening tool to increase rates of screening. Additional measures may be needed to enhance provider knowledge regarding IPV

Homeland Security and Wireless Telecommunications: The Continuing Evolution of Regulation

Since the grant of the first Commercial Mobile Radio Service ( CMRS ) license over twenty years ago, the wireless industry has grown from a service of convenience to one that is indispensable. What once was a device used for sporadic phone calls now is viewed by many Americans as a source of invaluable communication and security. As the wireless industry matured, government officials turned to the mobile phone as a way to make the United States safer. E-9 11, the Communications Assistance for Law Enforcement Act ( CALEA ), Wireless Priority Service ( WPS ), and Outage Reporting all were initiated on the wireless platform in the name of safety. The FCC implementation proceedings for each of these initiatives have differed markedly. In an advanced technology area such as wireless, government goals may best be achieved by relying on industry experts, because the technology is so sophisticated and constantly developing that the legislative and regulatory process at times cannot keep pace. This Article reviews wireless public safety and Homeland Security initiatives in three phases and explores the evolution of Homeland Security regulation of the wireless industry

Homeland Security and Wireless Telecommunications: The Continuing Evolution of Regulation

Since the grant of the first Commercial Mobile Radio Service ( CMRS ) license over twenty years ago, the wireless industry has grown from a service of convenience to one that is indispensable. What once was a device used for sporadic phone calls now is viewed by many Americans as a source of invaluable communication and security. As the wireless industry matured, government officials turned to the mobile phone as a way to make the United States safer. E-9 11, the Communications Assistance for Law Enforcement Act ( CALEA ), Wireless Priority Service ( WPS ), and Outage Reporting all were initiated on the wireless platform in the name of safety. The FCC implementation proceedings for each of these initiatives have differed markedly. In an advanced technology area such as wireless, government goals may best be achieved by relying on industry experts, because the technology is so sophisticated and constantly developing that the legislative and regulatory process at times cannot keep pace. This Article reviews wireless public safety and Homeland Security initiatives in three phases and explores the evolution of Homeland Security regulation of the wireless industry

Untersuchung von Perlmutt als Vorbild für die Entwicklung von geklebten Keramik-Polymer-Schichtverbundwerkstoffen

Ceramic materials have through their brittle-elastic fracture behaviour today often disadvantages in terms of technical applicability. Inspired by nacre it is attempted to address this fundamental disadvantage and to push the development of ceramic-polymer layer composites. The objective is to provide a novel material with improved fracture toughness compared to previously known ceramic composite materials. Due to the task, this paper is divided into the part of an extensive characterization of nacre and into the section of the development of a ceramic-polymer layer composite. Nacre shows a regular structure of individual aragonite platelets, which are covered by an organic matrix. The different mechanical studies of the natural model show that the enormous increase in fracture toughness compared to the values of the individual components and the large ductility are affected by the intermediate polymer layers. By varying the temperature and humidity conditions of the organic matrix this result is further confirmed. The production of ceramic-polymer layer composites is done by gluing individual thin ceramic sheets with high performance characteristics. The properties of the used polymers plus the material and shape of the ceramic sheets are varied thereby. Tolerant fracture behaviour can be achieved with this new material by a suitable stiffness ratio between polymer and ceramic. The fracture mechanical investigations indicate a significant increase in fracture toughness compared to the single ceramic components. The material develops with increasing crack length even an increase of the crack resistance. With the combination of high hardness and strength of the engineering ceramic and the large elasticity of the adhesives it is possible to develop a ceramic-polymer layer composite, which exhibits improved fracture toughness and is therefore highly resistant to mechanical stress

Degrees of Clarity and Obscurity in Chinese Images

This essay examines the relationship between clearly visible and deliberately concealed visual symbols. Sharing a linguistic basis, the range of visual code may be thought of as comet shaped, with freely broadcast messages clustering at the head, and increasingly obscure puns and allusions steaming along, with the most difficult to comprehend sprinkled at the tail end, or even invisible. In situations where political consequences were serious, ambiguity was purposeful and intentional. The contrast of reading clear and obscure imagery is considered via thirteen categories: audience, purpose, visuality, mood, temporality, seasonality, consequences, display, sources and origins, orality, decorum, quantity, and stability.Cet article a pour objet l’examen des relations entre des symboles visuels clairement visibles et délibérément cryptés. Reposant sur une base linguistique commune, l’éventail de ces codes visuels pourrait être comparé à une forme de comète, comportant en tête un amoncellement de messages émis sans contrainte, dans la partie médiane des jeux de mots et des allusions de plus en plus obscurs, les plus difficiles à saisir se trouvant dispersés dans la queue de la comète, voire tout à fait invisibles. Dans un contexte où les conséquences politiques pouvaient être sérieuses, une telle ambiguïté était tout à fait intentionnelle. Les contrastes entre les images lisibles et obscures sont examinés selon treize catégories : les destinataires, l’intention, la visibilité, le mode, la temporalité, la saison, les conséquences, le type d’exposition, les sources et les origines, l’oralité, le décorum, la quantité et la stabilité

The Renin-Angiotensin-Aldosterone system in patients with depression compared to controls – a sleep endocrine study

BACKGROUND: Hypercortisolism as a sign of hypothamamus-pituitary-adrenocortical (HPA) axis overactivity and sleep EEG changes are frequently observed in depression. Closely related to the HPA axis is the renin-angiotensin-aldosterone system (RAAS) as 1. adrenocorticotropic hormone (ACTH) is a common stimulus for cortisol and aldosterone, 2. cortisol release is suppressed by mineralocorticoid receptor (MR) agonists 3. angiotensin II (ATII) releases CRH and vasopressin from the hypothalamus. Furthermore renin and aldosterone secretion are synchronized to the rapid eyed movement (REM)-nonREM cycle. METHODS: Here we focus on the difference of sleep related activity of the RAAS between depressed patients and healthy controls. We studied the nocturnal plasma concentration of ACTH, cortisol, renin and aldosterone, and sleep EEG in 7 medication free patients with depression (1 male, 6 females, age: (mean +/-SD) 53.3 ± 14.4 yr.) and 7 age matched controls (2 males, 5 females, age: 54.7 ± 19.5 yr.). After one night of accommodation a polysomnography was performed between 23.00 h and 7.00 h. During examination nights blood samples were taken every 20 min between 23.00 h and 7.00 h. Area under the curve (AUC) for the hormones separated for the halves of the night (23.00 h to 3.00 h and 3.00 h to 7.00 h) were used for statistical analysis, with analysis of co variance being performed with age as a covariate. RESULTS: No differences in ACTH and renin concentrations were found. For cortisol, a trend to an increase was found in the first half of the night in patients compared to controls (p < 0.06). Aldosterone was largely increased in the first (p < 0.05) and second (p < 0.01) half of the night. Cross correlations between hormone concentrations revealed that in contrast to earlier findings, which included only male subjects, in our primarily female sample, renin and aldosterone secretion were not coupled and no difference between patients and controls could be found, suggesting a gender difference in RAAS regulation. No difference in conventional sleep EEG parameters were found in our sample. CONCLUSION: Hyperaldosteronism could be a sensitive marker for depression. Further our findings point to an altered renal mineralocorticoid sensitivity in patients with depression