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Contributing Factors to Hospital Readmissions
Get PDFAims and objectives. To investigate the elderly patient’s perspective about the reasons for discharge to home being unsuccessful, resulting in rehospitalization. Background. Elderly patients have a high rate of readmission to the hospital within 30 days of discharge. Starting in October of 2013, hospitals having a high rate of readmission of patients with heart failure (HF), myocardial infarction (MI), and pneumonia (PNA) will face financial penalties. Evidence indicated that by utilizing risk prediction tools and incorporating transition interventions the risk of a hospital readmission may be reduced. Design. A qualitative, descriptive design was used. Methods. In 2013, a student investigator interviewed elderly patients over the age of 65 who were readmitted to the hospital with the diagnosis of HF, MI, PNA or chronic obstructive pulmonary disease (COPD) within 30 days of discharge. A total of six (N=6) patients and/or surrogates participated in the interviews. Data were collected using semistructured interviews and subjected to thematic content analysis. Results. Three major themes emerged: discharge readiness, communication, and education. Implications for the advanced practice registered nurse (APRN). Practicing in an APRN role provides the opportunity for the nurse to facilitate the appropriate transitional care of elderly patients placing them at less risk for hospital readmission within 30 days
Eye on Ethics: Revisiting the Limits of Client Confidentiality
No full textDecember 14, 2012: Newscasts shouted information impossible to absorb, that a lone shooter had murdered 20 children and six adults at Sandy Hook Elementary School in Newtown, CT. Almost immediately, people began speculating about shooter Adam Lanza’s motives and psychiatric challenges. Social workers were pressed into action, both as crisis intervention specialists and commentators, about what might have led Lanza to kill. Were there warning signs that foreshadowed his heinous assault? Was he receiving mental health services
Querying the Library: Digitization and Its Impact Conference: Opening Remarks and Greeting
No full textOpening remarks by Rhode Island College President, Nancy Carriuolo followed by a greeting by Hedi BenAicha, Director of the James P. Adams Library as featured during the Querying the Library: Digitization and Its Impact conference hosted by the James P. Adams Library at Rhode Island College on May 31, 2013
Possibilities in engaging partnerships: What happens when we work together?
Get PDFhttps://digitalcommons.ric.edu/innovation_lab/1005/thumbnail.jp
The Buried Seed: Generational Narcissism in D.H. Lawrence\u27s The Rainbow
Get PDFD.H. Lawrence’s novel The Rainbow follows three generations of the Brangwen family as they experience problems of identity while trying to navigate a changing world. The identity issues in the novel can be understood as symptomatic of what clinical psychologists term Narcissistic Personality Disorder. Each generation embodies narcissistic traits that prevent them from living happy, full lives. The thesis focuses on the generational aspect of the novel and how the repeated narcissistic issues found in each generation build on and reflect one another, culminating in the character of Ursula. With this character Lawrence portrays the struggles necessary to transcend the narcissistic state
Investigating the Leaf Cuticle of the Moss Physcomitrella Patens
Get PDFTo minimize water loss, the aerial parts of vascular land plants are covered with a hydrophobic layer called a cuticle. The cuticle typically consists of two major components: cutin and waxes. In contrast to vascular plants, research reports indicate that some primitive nonvascular plants, such as mosses, lack a cuticle. This study attempts to reconcile contradictory literature reports about the presence of a waxy cuticle on the leaves of the moss Physcomitrella patens.
Histochemical staining was utilized to investigate the presence of a cuticle on Physcomitrella leaves. Experiments employing dyes that stain hydrophobic substances were generally consistent with the presence of a cuticle. Hydrophilic dyes were also used to infer the presence of a cuticle through an absence of staining. Histochemical results were supported by observations made using freeze fracture electron microscopy. Leaves consistently fractured through an extracellular layer having a rippled texture, which resembling cuticles known to occur in vascular plants. Attempts to isolate a cuticle from Physcomitrella leaves by partial digestion with chromic acid or treatment with polysaccharide-degrading enzymes were also successful.
The existence of a cuticle on the leaves of Physcomitrella is further supported by genetic observations. The P. patens genome contains several genes that are homologous genes known to participate in cuticle synthesis in vascular plants. One of these, the homolog of the Solanum lycopersicum CD1 gene (SlCD1), may participate in cutin biosynthesis and was selected for further characterization. Using homologous recombination, knockouts of Physcomitrella samples deficient in the homolog CD1 were generated (PpCD1KO). Unfortunately, knockouts showed no changes in phenotype and may indicate the presence of a cuticle, supported by other genes with similar catalytic functions
Woonsocket Village & Marquette Building
No full textWoonsocket under went a revitalization process in the 1970s, specifically in an area known as the Social Flatlands. This photograph shows Woonsocket Village, a housing development that replaced neighborhoods that had formerly been multiple family mill homes. On the horizon is the Marquette Building. Completed in 1975, it is a 10 story steel and glass tower that came to symbolize the rebirth of Woonsocket.https://digitalcommons.ric.edu/smolski_images/1949/thumbnail.jp
Implementation of a Nurse-Driven Mobility Protocol in Critical Care
Get PDFProlonged immobilization plays an important role in negative outcomes of critically ill patients. Immobility is widely documented in the literature as a cause of increased mortality and complications. Despite the growing evidence in support of early mobility, many ICUs are unable to effectively integrate early/progressive mobility into their daily practice. Literature supports early mobilization and physical therapy as a safe and effective intervention that can have a significant impact on functional outcomes. A progressive mobility tool may help to force a daily structured assessment of current mobility status, which supports the critical thinking process by the nurse and team to ensure effective and safe evaluation of the mobility level. The purpose of this project was to increase critical care nurses’ understanding of the concept and benefits of early mobility during an educational program in which a nurse-driven progressive mobility protocol was introduced. Nurses were asked to voluntarily take a pre- and post- test surrounding the implementation of the protocol. Descriptive statistics were used to analyze study variables and differences between pre and post scores. Nurses’ knowledge regarding mobility of critical care patients increased and 83.3% of nurses responding felt they provided earlier mobility
Gender-Twisting and Bros Talking
Get PDFIn American Schools, students are rarely offered educational experiences about gender and sexuality. Programs that do address sexuality are rarely based on moral beliefs and democratic values of tolerance and inclusivity. Sexuality education is predominantly taught by health teachers, rather than human sexuality educators, and their focus is on facts, statistics, and controversial issues such as the prevention of teenage pregnancy and sexually transmitted infections, including HIV/AIDS. This limited perspective on sexuality neglects the important role of gender identity and sexual orientation (Donovan, 1989; Haffner & De Mauro, 1991; Nelson Trudell, 1993)
Using teacher-researcher-participant-observer qualitative methodology, I examined the discourse of thirteen and fourteen-year-old youth in relation to the construction of meaning of gender in a comprehensive sexuality education program using a progressive curriculum named Our Whole Lives, Grades 7-9 utilized in congregations throughout the United States. The setting was the eighth grade class of a progressive church Sunday school in a middle-size city in the U.S. Northeast
Differential Effects of Cognitive Load on University Wind Students’ practice
Get PDFThe purpose of this study was to investigate the effects of cognitive load during practice on university wind students’ learning. Cognitive load was manipulated through instrument family (woodwind or brass) and the amount of repetition used in practice (highly repetitive or random). University woodwind and valved-brass students (N = 46) completed two practice sessions and two retention testing sessions. Participants practiced three seven-pitch tasks in either a blocked, repetitive order or in a random order. Performance trials were scored for accuracy, speed and evenness. At 24-hour retention, woodwind players who had practiced in a random order were able to play significantly faster, F(4,80) = 4.448, p = .003, h2 = .15, and more evenly, F(4,80) = 4.464, p = .003, h2 = .16, than woodwind players who had practiced in a blocked order. However, for brass players, blocked practice supported better accuracy, F(4,64) = 3.508, p = .012, h2 = .15, and speed, F(4,64) = 4.489, p = .003, h2 = .18, than random practice. A secondary research question examined participants’ judgment of learning. At the end of the second practice session, participants predicted the tempo they expected to be able to play the tasks at during the 24-hour retention session. A significant correlation between predicted and performed tempo was found for brass players using blocked practice (r = .360, p = .04)