92 research outputs found
Reducing Violence in Las Vegas Communities through Police-Researcher Partnerships
No full textStacey Clouse, a first-year student in UNLV\u27s Criminology and Criminal Justice Doctoral program (bottom right), is evaluating and helping to direct the Las Vegas Metropolitan Police Department’s PIVOT program. PIVOT, which stands for Place-based Investigations of Violent Offender Territories, seeks to identify and disrupt criminal infrastructures in persistently violent locations. Ms. Clouse is currently working in the Department’s Northeast Area Command with Captain Nicole Splinter and her team of investigators to dismantle criminal networks of people and places that victimize our Las Vegas communities. She provides academic guidance and documents PIVOT investigative strategies to assess the team’s implementation and effectiveness.https://oasis.library.unlv.edu/image_of_research/1036/thumbnail.jp
Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients : post-hoc analysis of LAS VEGAS study
Get PDFFunding Information: LAS VEGAS was partly sponsored by the European Society of Anaesthesiology and the Amsterdam University Medical Centers, location ‘AMC’. It was also funded by a grant from the AAGBI via the NIAA in the UK. MFVM was supported by grant NIH-NHLBI UG3-HL140177. Funders provided support for logistic and study development. Funding Information: LAS VEGAS [8] was an international multicentre observational prospective study (registered at www. clini-caltrials.gov (study identifier NCT01601223)), endorsed and supported by the European Society of Anaesthesiology and the Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands. Details about the LAS VEGAS study collaborators, participating centres and hospital characteristics of participating centres are reported in ESM Tables S2a, b and S3.Peer reviewe
Evidence for Virgin Anasazi presence in the Las Vegas Valley and adjacent areas
No full textOlivine-tempered ceramics are a characteristic artifact of Virgin Anasazi culture. The ceramics are found in the Las Vegas area, more than 70 km west of permanent Anasazi settlements in the Moapa Valley. Little is known regarding Anasazi utilization of this area, since most investigators have focused on the permanent settlements. I examined 25 ceramic assemblages from the Las Vegas vicinity, calculated the frequencies of olivine-tempered sherds in each, and noted the geographical distribution of the wares. The evidence does not support down-the-line exchange, but shows concentrations of olivine-tempered wares in the north Las Vegas Valley, Paradise Valley, and further west in the Spring Mountains and Pahrump Valley. The number of sherds recovered does not indicate long-term habitation by people who consistently utilized pottery. The low frequency (6.5-percent) of decorated olivine-tempered wares provides support for the hypothesis that exchange of utilitarian wares brought olivine-tempered ceramics into the area
Team Policing Revisited: A Quasi-Experimental Evaluation in Las Vegas, Nevada
No full textIn 1967, the President\u27s Commission on Law Enforcement and Administration of Justice recommended team policing, which involves the decentralization of patrol officers and investigators to the same, defined geographical area, as a way to more effectively organize police officers and improve crime control. Despite initial enthusiasm from police officers and administrators, team policing quickly faded from use during the 1970s because its design was incompatible with the centralized model of policing prevalent at that time. However, the implementation of community-oriented policing, which promotes various organizational changes and the use of problem-focused strategies, has changed police departments in recent years and in many ways that complement the use of team policing, thus allowing it a better chance to succeed. In March 2012, the Las Vegas Metropolitan Police Department implemented its own version of team policing, which incorporates community-oriented, problem-oriented, and hot spots policing strategies in an effort to reduce crime and disorder in a local neighborhood. This study evaluates the impact of team policing in that neighborhood, discusses the limitations of the research design and data, and provides suggestions for future research on team policing
The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients : a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study
Get PDFFunding Information: G. Mazzinari: No interest declared; A. Serpa Neto: No interest declared; S.N.T. Hemmes: No interest declared; G. Hedenstierna: No interest declared; S. Jaber: No interest declared; M. Hiesmayr: No interest declared; M.W. Hollmann: Executive Section Editor Pharmacology with Anesthesia & Analgesia, Section Editor Anesthesiology with Journal of Clinical Medicine, and CSL Behring, no conflict of interest with the current work; G.H. Mills: No interest declared; M.F. Vidal Melo: is funded by NIH/NHLBI grant UH3-HL140177; R.M. Pearse: No interest declared; C. Putensen: No interest declared; W. Schmid: No interest declared; P. Severgnini: No interest declared; H.Wrigge: No interest declared; O. Diaz–Cambronero: had received a Merck Sharp & Dohme investigator–initiated grant (protocol code #53607). Sponsors and funders have no roles in study design, analysis of data or reporting. Also received speakers fees for lecture and medical advice from Merck Sharp & Dohme, no conflict of interest with the current work; L.Ball: No interest declared; M. Gama de Abreu: Ambu, GE Healthcare, ZOLL consulting fees, no conflict of interest with the current work; P.Pelosi: No interest declared; M.J.Schultz: No interest declared. Funding Information: The ethical committee of the Academic Medical Center, Amsterdam, the Netherlands, approved the LAS VEGAS study protocol (W12_190#12.17.0227). Each participating centre obtained approval from their institutional review board if needed, and patients were included after obtaining written informed consent when dictated by national or regional legislation. The LAS VEGAS study was partially funded and endorsed by the European Society of Anaesthesiology and registered at clinicaltrials.gov (study identifier NCT01601223, first posted date: 17/05/2012).Peer reviewe
Risk factors for PPCs in laparoscopic non---robotic vs. laparoscopic robotic abdominal surgery (LapRas): rationale and protocol for a patient---level analysis of LAS VEGAS and AVATaR
No full textIntroduction: Postoperative pulmonary complications (PPCs) vary amongst different surgical techniques. We aim to compare the incidence of PPCs after laparoscopic non-robotic versus laparoscopic robotic abdominal surgery. Methods and analysis: LapRas (Risk Factors for PPCs in Laparoscopic Non-robotic vs Laparoscopic robotic abdominal surgery) incorporates harmonized data from 2 observational studies on abdominal surgery patients and PPCs: 'Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS), and 'Assessment of Ventilation during general AnesThesia for Robotic surgery' (AVATaR). The primary endpoint is the occurrence of one or more PPCs in the first five postoperative days. Secondary endpoints include the occurrence of each individual PPC, hospital length of stay and in-hospital mortality. Logistic regression models will be used to identify risk factors for PPCs in laparoscopic non-robotic versus laparoscopic robotic abdominal surgery. We will investigate whether differences in the occurrence of PPCs between the two groups are driven by differences in duration of anesthesia and/or the intensity of mechanical ventilation. Ethics and dissemination: This analysis will address a clinically relevant research question comparing laparoscopic and robotic assisted surgery. No additional ethical committee approval is required for this metanalysis. Data will be shared with the scientific community by abstracts and original articles submitted to peer-reviewed journals. Registration: The registration of this post-hoc analysis is pending; individual studies that were merged into the used database were registered at clinicaltrials.gov: LAS VEGAS with identifier NCT01601223, AVATaR with identifier NCT02989415
Association of preoperative smoking with the occurrence of postoperative pulmonary complications: A post hoc analysis of an observational study in 29 countries
No full textIntroduction: While smoking has been consistently identified as a significant contributor to postoperative complications, the existing literature on its association with postoperative pulmonary complications remains conflicting.
Aim: We examined the association of preoperative smoking with the occurrence of postoperative pulmonary complications (PPCs).
Methods: Post hoc analysis of an observational study in 146 hospitals across 29 countries. We included patients at increased risk of PPCs, according to the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score (≥ 26 points). The primary endpoint was the occurrence of one or more predefined PPCs in the first five postoperative days, including unplanned postoperative need for supplementary oxygen, respiratory failure, unplanned need for invasive ventilation, ARDS, pneumonia and pneumothorax. Secondary endpoints included length of hospital stay and in-hospital mortality. We performed propensity score matching to correct for factors with a known association with postoperative outcomes.
Results: Out of 2632 patients, 531 (20.2 %) patients were smokers and 2102 (79.8 %) non-smokers. At five days after surgery, 101 (19.0 %) smokers versus 404 (19.2) non-smokers had developed one or more PPCs (P = 0.95). Respiratory failure was more common in smokers (5.1 %) than non-smokers (3.0 %) (P = 0.02), while rates of other PPCs like need for supplementary oxygen, invasive ventilation, ARDS, pneumonia, or pneumothorax did not differ between the groups. Length of hospital stay and mortality was not different between groups. Propensity score matching did not change the findings.
Conclusion: The occurrence of PPCs in smokers is not different from non-smokers.
Funding: This analysis was performed without additional funding. LAS VEGAS was partially funded and endorsed by the European Society of Anaesthesiology through their Clinical Trial Network and the Amsterdam University Medical Centers, Amsterdam, The Netherlands
A Review of the limnology of and water quality standards for Lake Mead
No full text1. The waters of Las Vegas Bay, a heavily utilized recreational resource, receive discharges from a variety of municipal and industrial waste sources. The U.S. Environmental Protection Agency has determined, on the basis of numerous studies, that the present water quality violates state and federal standards and constitutes a public nuisance. Consultants have advised the Sewage and Wastewater Advisory Committee that rapid abatement of the alleged pollution conditions can be achieved by an advanced wastewater treatment (AWT) plant.
2. The major problems in Las Vegas Bay are an objectionable water color, excessive turbidity, noxious odors, and oxygen depletion in certain portions of the water column. Previous studies indicate that these problems are due to the effect of Las Vegas Wash on the Bay, and that the problems decrease as distance increases from the Las Vegas Wash inflow. The Wash provides a source of nutrients for high levels of algal production, which, in turn, are responsible directly for the pollution perceived by the public. Conditions in Boulder Basin, as opposed to those in Las Vegas Bay, have not reached an objectionable eutrophic level.
3. Most of the previous studies point to industrial and municipal wastewater discharges as the ultimate source of nutrients entering the Bay. One advisor argues that the nutrients arise from soil eroded into the Bay.
4. Adherents of the first position suggest that removal of nutrients from wastewater will abate the problems in Las Vegas Bay. Adherents of the second position suggest that control of soil erosion is the only step that can mitigate these pollution problems.
5. The following deficiencies in these previous studies prevent the formulation of a dependable strategy for decreasing the excessive algal production in Las Vegas Bay to acceptable levels: (i.) There has been no detailed attempt to ascertain the fate of Las Vegas Wash inflow. The fact that the bulk of this inflow may leave the Bay in a well-defined current does not imply that partial mixing of the current with the Bay is not affecting algal production. The presence of enteric bacteria in the Bay suggests that partial mixing, in fact, is occurring. (ii.) A systematic series of algal bioessays has not been undertaken to ascertain directly which nutrients limit algal production. (iii.) Inputs of phosphorus other than via the Wash discharge have been neglected, particularly internal loading from the sediments to the water column. (iv.) The effect of changing water level on dilution of nutrients in Las Vegas Bay has been neglected, despite the fact that the water volume in the Bay has increased about 75% between 1967 and 1976. (v.) The standard of 0.5 mg 1-1 phosphorus established by the EPA for Las Vegas Wash water does not rest on adequate evidence that these levels are necessary or sufficient to abate the problems in Las Vegas Bay, but rather upon the predicted performance of AWT. (vi.) The studies have not been designed to predict changes in Las Vegas Bay following various alternative treatment strategies.
6. Ecological Research Associates initiated a field study of Las Vegas Bay and Boulder Basin (20-23 September 1976) to resolve certain discrepancies in previous studies and to provide supplemental information consistent with the short duration of the study.
7. Specific conductivity, temperature, pH, and oxygen profiles agreed with those collected by previous investigators. High conductivity values reflecting the presence of a well-defined current representing the Las Vegas Wash inflow were observed in Las Vegas Bay. However, this current was not detected at the mouth of the Bay in Boulder Basin. These results do not support the notion that the Wash inflow does not mix in the Bay, but the detailed investigation necessary to decide this issue could not be performed during the short time period of the study.
8. Virtually all dissolved phosphorus occurs in inorganic form and in very low concentrations, indicating that biologically-available phosphorus is cycling extremely rapidly and that the amount of analytically detectable soluble phosphorus may not be particularly relevant for determining the potential algal production.
9. Algal productivity measurements in September were lower than those of previous investigators by more than 90% in some cases. The discrepancy may represent differences in methodology or real decreases in algal production. Many hypotheses may be invoked to explain the results if the latter is the case, but insufficient evidence exists to distinguish between them. The results emphasize that important questions concerning the source and fate of inflowing nutrients remain to be answered, because previous studies cannot account unequivocally for this decrease in productivity. Severely eutrophic conditions were not observed in Las Vegas Bay during the course of this study.
10. Algal bioassays demonstrated that inner Las Vegas Bay algae are responsive to nitrogen because of the heavy phosphorus loading. Virgin Basin algae (and hence, presumably, Boulder Basin samples) are stimulated by addition of wastewater, nitrogen or phosphorus. Recalculated N:P ratios, based on previous studies, suggest that all Las Vegas Bay and Boulder Basin stations, except for the inner Bay, are most limited by phosphorus. The implication is that the middle and outer Bay and the Basin are sensitive to further loading of phosphorus. The uncertainty of decisions based upon nitrogen to phosphorus ratios is emphasized in this report.
11. Sediment analyses indicate that phosphorus is removed from the water by sedimentation. Proper standards for phosphorus concentrations in inflowing waters cannot be established without taking into account the role of phosphorus sedimentation in Las Vegas Bay.
12. The application of Vollenweider\u27s relationship to Las Vegas Bay suggests that, even if EPA standards of 0.5 mg 1-1 phosphorus were met in Las Vegas Wash, the reduction in loading obtainable from present day AWT technology is not sufficient to produce the desired conditions in Las Vegas Bay. In any case, the Vollenweider relationship does not constitute an adequate basis on which to decide an abatement strategy for Lake Mead.
13. AWT treatment of Las Vegas Wash wastewater cannot guarantee the eradication of problems in Las Vegas Bay, both because the exact initial source of the nutrients is not established fully (i.e., wastewater or erosion) and because the effect of reducing phosphorus concentrations to 0.5 mg 1-1 in the Wash cannot be predicted at present. The predictive relationship used by other consultants to justify AWT has not been applied correctly. The correct application of this relationship to the condition in Las Vegas Bay demonstrates, on the contrary, that AWT technology will not be sufficient. The enormous expense and deleterious side effects of AWT technology are not justified on the basis of existing data.
14. Numerous alternatives to AWT exist. Upgraded secondary wastewater treatment combined with biological stripping of both nitrogen and phosphorus in an expanded Las Vegas Wash marsh is the alternative that deserves special consideration. Control of soil erosion and partial discharge of treated wastes directly to Boulder Basin also should be considered in this scheme.
15. Any further study should be addressed to the following specific points: (i.) The extent to which Las Vegas Wash inflow mixes with Las Vegas Bay water must be determined more precisely. (ii.) The stimulating effect of eroded soil washed into the Bay on algal productivity must be determined. (iii.) The level of algal growth that can be supported by water equivalent to that produced by various treatment strategies must be determined. A predictive model is recommended. (iv.) The magnitude of the potential internal phosphorus loading from the sediment upon the eventual reduction of external loading should be investigated. (v.) Downstream effects of alternative abatement strategies must be predicted
The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study
No full textBackground: It is uncertain whether the association of the intraoperative driving pressure (ΔP) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time-weighted average ΔP (ΔPTW) with PPCs. We also tested the association of ΔPTW with intraoperative adverse events.
Methods: Posthoc retrospective propensity score-weighted cohort analysis of patients undergoing open or closed abdominal surgery in the 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events.
Results: The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. ΔP was lower in open abdominal surgery patients, but ΔPTW was not different between groups. The association of ΔPTW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P < 0.001 versus 1.05 [95%CI 1.05 to 1.05], P < 0.001; risk difference 0.05 [95%CI 0.04 to 0.06], P < 0.001). The association of ΔPTW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12- to 1.14], P < 0.001 versus 1.07 [95%CI 1.05 to 1.10], P < 0.001; risk difference 0.05 [95%CI 0.030.07], P < 0.001).
Conclusions: ΔP is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery.
Trial registration: LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223 )
Evaluating the Impact of Team Policing in Las Vegas, Nevada
No full textTeam policing involves the continuous geographical assignment of both patrol officers and investigators to the same, defined area, which allows them to become familiar with area residents and knowledgeable about community concerns and thus, enables them to develop individualized strategies to resolve the neighborhood problems that can lead to crime and disorder. This study evaluates the impact of a team policing intervention in Las Vegas, Nevada that combines an emphasis on community outreach with problem-focused policing strategies to determine the effectiveness of team policing as a crime control strategy. The results indicate that the team policing did not result in crime displacement though calls for service did increase in the target area during the intervention period. This result, however, may be an indicator of improved police-community relations rather than increasing crime rates
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