bluuebunny/crossref_metadata_2025 huggingface dataset:
A JUSTIFICAÇÃO CONSTITUCIONAL DA EXECUÇÃO PROVISÓRIA DA PENA PRIVATIVA DE LIBERDADE NA PENDÊNCIA DOS RECURSOS EXTRAORDINÁRIO E ESPECIAL RECEBIDOS SEM EFEITO SUSPENSIVO
Authors: Kurkowski Rafael Schwez
Published: February 2018

O presente artigo demonstra que a execução provisória da pena privativa de liberdade na pendência de recurso extraordinário e/ou especial recebido sem efeito suspensivo tem justificação na Constituição Federal, cuja interpretação sistemática deve primar pela sua unidade. A execução provisória, que respeita os direitos fundamentais relacionados ao status libertatis do réu e aqueles alusivos ao processo judicial, resulta da harmonização obtida pela proporcionalidade, vista como proibição de insuficiência, entre a presunção de inocência do réu, cuja culpabilidade não mais comporta discussão, e a segurança pública, a qual deve ser buscada pelo Estado, incluindo o Poder Judiciário. A revisão bibliográfica e a análise da jurisprudência do Supremo Tribunal Federal revelam que a execução provisória da pena é plenamente compatível com a Constituição Federal, especialmente com o princípio da presunção de inocência.

Palavras-chave: Pena. Execução Provisória. Interpretação constitucional. Proporcionalidade.
A PRODUÇÃO CIENTÍFICA SOBRE A APLICAÇÃO DA HIPÓTESE DE PORTER ENTRE OS ANOS DE 2000 A 2015
Authors: Fujihara Hillary Lapas , Silva Elizandra Da , Bertolini Geysler Rogis Flor
Published: February 2018

A presente pesquisa objetiva analisar a aplicação da Hipótese de Porter e sua relevância na inovação empresarial em decorrência das legislações ambientais evidenciados nos artigos disponíveis na Base Ebsco entre os anos de 2000 a 2015. A pesquisa caracteriza-se como levantamento bibliográfico exploratório, por proporcionar aos pesquisadores maior contato com o assunto pesquisado. Para tanto foi desenvolvido uma pesquisa na Ebsco de agosto a novembro de 2015 e posteriormente foram analisados 82 artigos de diferentes Instituições de Ensino e países. Verificou-se que apesar de ser muito criticada a hipótese consegue atingir seu objetivo nos mais diversos setores, entretanto a maioria das pesquisas concentra-se no setor industrial.
A FORMAÇÃO DO ESTADO NA CONTEMPORANEIDADE A PARTIR DA REVOLUÇÃO RUSSA – UM SÉCULO DETERMINANTE DOS NOVOS RUMOS DA SOCIEDADE E DO DIREITO
Authors: Knoerr Viviane Sellos , Knoerr Fernando Gustavo
Published: February 2018

Ao revisitar a história da Rússia no que tange o movimento revolucionário, o presente artigo objetiva traçar um paralelo com a formação de um Estado em contínua transformação e/ou revolução oriunda de convicções ideológicas, políticas e econômicas. Com breve retrospecto histórico, o artigo visita a formação do Estado (patrimonialista ou burocrático) também à luz de Max Weber. Trata-se, na sequência, da transição do Estado liberal ao Social com pressupostos de liberdades, direitos e garantias que superam a soberania a fim de outorgar-lhe o dever legal de prestar serviços públicos. Por conseguinte, essa transformação repercute no direito e passa a ser protagonista na construção de um novo modelo de Estado. Para o desenvolvimento deste artigo, a historiografia retratada se vale da metodologia bibliográfica, a qual contribui para a compreensão da formação do Estado e direito contemporâneos.
Film Education in Poland – Historical Outline and Current State of Research
Authors: Ciszewska Ewa
Published: February 2018

The text explores traditions of film education, understood as education through film, in Polish film studies. Although film education has been a de facto part of informal education, we can trace many initiatives aimed at making it an element of formal schooling. Hence the attempt to incorporate film education into school curriculums at various levels of education, undertaken mainly by academic film experts (B. W. Lewicki, E. Nurczyńska-Fidelska). School film education has been fraught with numerous technological obstacles, as well as a lack of available materials to use as a foundation for educational practice. It has also been a challenge to develop appropriate competences of teaching staff. Film education has not found its place as a subject within formal education until today. The current fragmentation of entities responsible for it, and the lack of a coherent strategy means that film education becomes the domain of commercial and non-commercial programmes implemented in cinemas for the purposes of school education.
Film Education-Related Supplemental Education and In-Service Training of Teachers in Poland (2010–2015)
Authors: Równy Anna
Published: February 2018

This article collects information on the functioning of the system of teacher training and development in the field of film education in Poland, and proposes how the process of self-education in this area may progress. The author focuses on the most popular forms, reaching broad audiences. The starting point in the text is a discussion about the place of film education in the Polish education system, and an analysis of syllabuses. The author also attempts to analyse the direction of activities related to the development of film education methodology in Poland, reviewing the activities of individual academic centres. In the latter part of the text, she describes the content and organisational concepts of cyclical and nationwide projects. A separate paragraph is devoted to online resources for the improvement, and consequent self-education of teachers in the area of film education. The article’s conclusion contains suggestions for systemic actions which would make it possible to raise the profile of this field of education, or even help make film education a school subject.
Methods of Film Education for Children and Teenagers – Selected Issues
Authors: Gołębiowska Dorota , Kołodziejczak Anna , Dowgiel Maciej , Kanownik Ewa
Published: February 2018

The article describes teaching techniques used in film education in schools (at every level) and outside schools. All techniques described in the article are placed within the context of Polish didactics and delineate the evolution of dominant approaches to film education and regulations determining the work of teachers and film educators. The article discusses various factors that need to be taken into consideration when selecting the most appropriate teaching techniques and describes the main film didactic methods with a special focus on participation stimulating techniques. Finally, the article provides a brief overview of various teaching techniques utilised in extracurricular film education, with reference to existing procedural demands. The article is based on theoretical knowledge as well as the authors’ practical experience.
Educational Potential of Animated Films in Poland
Authors: Żebrowski Mateusz
Published: February 2018

The paper describes events which are focused on Polish animation, with special regards to their educational values. The thesis refers to the importance of the Polish Film Institute, higher education, film workshops and film festivals for Polish animations. The most important part of the paper describes animation film festivals. Film festivals are portrayed as the most extensive educational platform, because of which the whole paper centres on an understanding of the issue through festival studies. The author evokes theories of the field configuring events by Bernard Leca, Charles-Clemens Rüling and Dominique Puthod. In the paper the Polish animation film scene is described as heterogeneous, however, filmmakers who make animations are evolving a coherent vision of it. Helpful in this process is the Polish Animation Producers Association. In the final part of the paper the author focuses on O!PLA. The Festival of Polish Animation. This event can be interpreted as a something more than a field-configuring event, and described as a communicator of the convergence of expertise (term of Grzegorz D. Stunża and associates).
Film Canon – Film History – Film Education: Remarks on the Polish Film Museum’s Anniversary Poll
Authors: Klejsa Konrad , Jajko Krzysztof
Published: February 2018

In 2015, the Film Museum in Lodz, Department of History and Theory of Film at the University of Lodz and the Polish Filmmakers Association worked together on a project “12 films for 120 years of cinema”. Filmmakers and people professionally involved in film culture were asked to compile their 12 best films ever and their 12 best Polish films. The organisers received 279 responses which mentioned 1,348 films in total. After analysing the results, the lists of best movies were published as well as variant lists according to the respondents’ profession and age. The first part of the paper raises questions regarding aesthetic axiology (as far as culture-based text hierarchies are concerned) and social communication (which concerns the question of a canon: who establishes it and for what purpose?). In the second part of the article, the authors discuss the results of the poll, highlighting shortcomings of the project when compared to similar polls in the past.
BIOENERGY ASPECTS OF PSORIASIS
Authors: Kuts L. V.
Published: February 2018

The subject of the study is the establishment of the role of bioenergetic (purinergic) in the pathogenesis of psoriasis disorders. For this purpose were examined 120 patients with psoriasis vulgaris  in progressive stage by ELISA (enzyme-linked immunosorbent assay) levels of cyclic nucleotide The imbalance of cAMP / cGMP levels were revealed may indicate not only functions violation of the second cellular mediators, but also signs of bioenergetics dysfunction with the development of changes neurotrophic functional  in psoriasis skin.Keywords: psoriasis, cyclic nucleotides, bioenergetics neurotrophic dysfunctions in the skin.Доктор медицинских наук, доцент, Куц Л. В. Биоэнергетические аспекты псориаза / Медицинский институт Сумского государственного университета, Украина, СумыПредмет исследования – установление роли биоэнергетических (пуринергических) нарушений в патогенезе псориаза. С этой целью клинически и при помощи иммуноферментного анализа уровней циклических нуклеотидов в крови обследовано 120 больных в прогрессирующей стадии вульгарного псориаза. Выявленный дисбаланс уровней цАМФ/цГМФ может свидетельствовать не только о нарушении функций вторых клеточных посредников, но и о признаках биоэнергетической дисфункции с развитием нейротрофических функциональных изменений в коже при псориазе.Ключевые слова: псориаз, циклические нуклеотиды, биоэнергетические нейротрофические дисфункции в коже.
FIGURATIVE LANGUAGE OF METAPHORS IN THE HOLY QURAN
Authors: Mutammam Mutammam , Zubaidah Aisyah
Published: February 2018

As a system of communication, language has literal and figurative meanings. In the case of literal language, words are used to express meaning as defined, while in the case of figurative language, words are used to provide room for interpretation. A profound contemplation done by some linguists shows that Holy Qur’an uses two kinds of meanings, they are haqiqi (literal language) and majazi (figurative languages). In this case, metaphors or figurative language is used as a persuasive device to strengthen Muslims’ faith in God and convince disbelievers to believe in God.
Cross-Cultural Patterns of Disability in non-Western Societies
Authors: Weiss Sara
Published: February 2018

With significant exceptions disabled persons and their disabilities have rarely been considered a topic of study by anthropologists. In fact, references to the disabled are difficult to locate in anthropological literature. Specific disabilities, such as deafness, have been researched by Kuschel: (1973); Shuman (1980); and Groce (1983). Nevertheless, anthropologists have not focused on the disabled as a separate entity in society. Goffman's (1963) work on stigma and· the disabled remains an exception; important as the study is, it deals with only one aspect of disability. Until the disabled and their relationship with society is studied holistically by anthropologists and other social scientists, there will be a gap in the study of man and his culture.
Archaeological Site Reports and Classroom Archaeology: Some Questions and Suggestions for Teachers
Authors: Leveillee Alan
Published: February 2018

The purpose of this thesis is twofold. It is an attempt to introduce the reader, through example, to ongoing archaeological research being conducted in southern New England. Secondly, it is meant to serve as a tool for teachers who wish to introduce students to archaeological concepts and exercise. The main body of the thesis consists of chapters which provide a historical context for current archaeological research and chapters which discuss the actual investigations of a prehistoric site area in Norwood, Massachusetts. Chapter IX, the concluding section, is a guide for the generalization and application of the archaeological data into the classroom setting. Chapter IX outlines the key elements of previous chapters and suggests questions, materials and activities which can be employed to provide classroom archaeological experiences.
Waking Life
Authors: Irving Dionne
Published: February 2018

Collection of short fiction dealing with themes of isolation and self-discovery. Contents include: Waking Life, Rice and Peas, Weaving, and Collage.
Ethnographic Field Research Methods
Authors: Grullon Edicta
Published: February 2018

Presents ethnographic research methods along with characteristics (evidential and non-evidential "identities") of an anthropologist that may affect his/her access to information and the quality of data collected. Offers several examples from experiences of field researchers. Considers Muslim North Africa as a region demanding attention to its specific cultural realities. Explores ethics and the role of the ethnographer.
Silent Subversions
Authors: Dubois Derek
Published: February 2018

Explores the concept of spectatorship in relation to gender in the earliest period of film history in the United States known as the silent era. Argues that a new mode of spectatorship emerges for women during the 1920s, which employs to advantage the extra-diegetic components of spectacle in theater design, new customized genres for female filmgoers, fandom, and exotic male film stars, such as Rudolph Valentino. Focuses primarily on feminist film theory and on cultural studies as methodological models.
Race, Class, and Herman Melville
Authors: De Santis Joan
Published: February 2018

Analyzes two of the short stories in Herman Melville's The Piazza Tales, "Bartleby the Scrivener: a Story of Wall Street" and "Benito Cereno" and argues that these stories are highly critical of the bourgeois class structure of American society that inform Wall Street, as well as the slave trade, in mid-Nineteenth-Century America. Posits that in these works Melville addresses the questions of hierarchical power in the workplace and the effects of racism and slavery in the colonization of America.
A Dream of Love
Authors: Middleton Kevin
Published: February 2018

Eleven landscape photos and an artist's statement comprise this work, through which the artist documents his search "for life within a single space ravaged by time and reclaimed by nature." (from Artist's Statement) The graduate exhibition of these photographs took place from April 27 through May 1, 2009 in the Bannister Gallery at Rhode Island College.
Superheros as Social Practice
Authors: Reilly Sara
Published: February 2018

In this thesis, I investigate two representative examples of the superhero as teaching machine of nationalism and consumerism, Superman and Iron Man. In the Superman chapter, I trace the corporate use of superheroes through Superman’s history of appropriation by corporations to sell both abstract ideals and material products. I also consider the rise of the role of media technology and media corporations, beginning with the radio show in 1941 and ending with the first “serious” superhero film in 1978, to show how the viewing audience internalizes messages of nationalism and consumerism. In the Iron Man chapter, I focus on the superhero industry’s shift to focusing on a post-9/11 American hero, discussing the changes to the nationalistic messages resulting from the Iron Man franchise that created a market desire for expensive, innovative technology. I end with a brief look at the future of the superhero film industry and what consequences it may have for the individual.
A Phenomenological Exploration of How Public School Administrators Balance Teacher Evaluation and Support of Teacher Growth
Authors: Slattery Mary
Published: February 2018

Educational reform efforts over the past several decades have focused on different ways to address student achievement. Since the quality of the teacher that students have is one of the biggest in-school factors that impact student achievement, schools have focused on identifying, measuring, and improving teacher quality. Some of those reform efforts have focused their attention on teacher evaluation as a way of increasing student achievement. There has been much research on the components quality evaluation tools. There is also research on ways to impact and change teacher practice. Unfortunately most evaluation tools do not impact teaching practice. Rhode Island administrators are current facing the challenge of implementing a high stakes evaluation system while also finding ways to help support growth and development of their teachers. This phenomenological study used open-ended interviews to understand how six administrators in Rhode Island negotiate that complexity. Administrators interviewed emphasized the importance of developing a trusting positive climate and utilizing this climate, along with various components of the evaluation system, to provide teachers with the kinds of support that will impact teacher growth and practice in the classroom. Administrators also expressed their frustration at some of the elements of the evaluation system and limitations they have found in their ability to impact teacher change. Findings from this study have implications for those revising or creating educator evaluation systems, as well as for administrators who must use high stakes evaluation systems while simultaneously attempting to impact teacher growth, development and change in practice.
Nurses' Knowledge of Hypoglycemia and Treatment in the Adult Hospitalized Patiend with Diabetes: A Quality Improvement Project
Authors: O'Neale Brittney
Published: February 2018

There are currently more than 29 million people in the United States with diabetes. With increasing numbers of diabetic patients across the nation, it is imperative that health care professionals receive the knowledge and skills required to manage them in the acute care setting. Hypoglycemia is the most common side effect of diabetes treatment (Borzi et al., 2016) and is defined by the American Diabetes Association (ADA) as a condition that occurs when one's blood glucose is lower than normal, usually less than 70 mg/dl. Nurses’ knowledge of hypoglycemia and their adherence to hospital protocols are essential to achieving positive patient outcomes. Research demonstrates that nurses in the acute care setting are not receiving consistent formal training on the care of adult diabetic patients and sometimes fail treat the patient according to evidence based hospital protocols. The purpose of this quality improvement project was to increase nurses’ knowledge of hypoglycemia and treatment in the adult hospitalized patient with diabetes. The project design was a pre-test, educational program and post-test on two medical-surgical units in a small community hospital in Rhode Island. Seventeen nurses completed the pre-test component (N=17, 22%) and eighteen nurses (N=18, 23%) attended the educational program and completed the post-test. Pre-test scores ranged from 11 to 94 out of a possible 100, with a mean score of 59.8%. Post-test scores ranged from 27 to 100, with a mean score of 76.5%. The average of post-test scores increased by about 16.7%. These findings suggest that providing hypoglycemia education can be successful in increasing nurses’ knowledge of hypoglycemia treatment and management in the adult hospitalized patient with diabetes.
The Impact of Preoperative Warming of Ambulatory Surgery Patients on the Prevention of Postoperative Hyposthermia
Authors: Croft Mary
Published: February 2018

Postoperative hypothermia is a continuing problem in surgical patients. Preoperative warming has been shown to benefit patients undergoing major surgical procedures but studies are lacking in patients in the ambulatory setting.

Objective: The purpose of this study was to explore the effect of warming ambulatory surgical patients preoperatively prior to anesthesia induction and surgery on maintenance of core body temperature, prevention of hypothermia in PACU, and patient comfort.

Method: A convenience sample of96 adult patients undergoing ambulatory surgery was provided standard care (cotton bath blankets) (n=4 7) or pre-warming (Bair Paws®Flex warming gown) (n =49). All patients received forced air warming intraoperatively.

Results: The mean pre-warming time was 58.6 minutes. The intervention group mean temperatures were significantly improved (intervention mean 97.304 pre vs. 98.044 post; p = 0.002 vs. control mean 97.54 pre vs. 97.87 post; p = 0.063) upon discharge from the preoperative holding area and prior to transport to the OR surgical suite. There was a 0.13 degree F increase in mean core temperature to PACU in the pre-warmed group as compared to control (intervention means 97.66 vs. control mean 97.53; 95% CI). The control group had a mean temperature decrease of 0.01 F from preop temperature to PACU while the intervention groups' mean temperatures increased by 0.19° F. Seven patients in the control group arrived to PACU complaining of cold and one shivering, compared to one patient in the intervention group.

Conclusions: Preoperative warming utilizing the Bair Paws® flex warming gowns increased patients' core temperatures on arrival to PACU and lessened the number of patients arriving to PACU complaining of cold.
Program Development to Educate Nurses Regarding Pressure Ulcer Detection and Documentation
Authors: D Margaret
Published: February 2018

Pressure ulcers continue to be a major health care problem in terms of pain, quality of life, and loss of function for patients entering the acute care system. The ability of nursing professionals to identify, treat, and clearly document pressure ulcers present on admission (PO A) is a safety indicator distinguishing good_ hospitals from Centers of Excellence. Competence of the nurses at the point of entry is critical to perform an accurate skin assessment. Timely identification, objective measurement, treatment, and documentation of pressure ulcers require that nurses have adequate knowledge of this complex, multi-factorial condition. The purpose of this project was to increase Emergency Department nurses' knowledge about pressure ulcer risks, staging, and wound description for documentation purposes. Benner's (1986) research, based on the Dreyfus and Dreyfus Model of Skill Acquisition, was used as a framework to explore the impact of an educational program on nurses• knowledge levels to advance clinical practice and awareness of practice standards. Findings, recommendations, and implications for nursing practice are presented and discussed.
Curriculum Development and Pilot Program of Preconception Planning for Latinas
Authors: Gutierrez Esperanza
Published: February 2018

Preconception planning is gaining popularity and is a promising method of improving pregnancy outcomes. The need to incorporate this kind of education in various settings is also identified in the literature. According to the March of Dimes, between 2004-2006 Hispanics had one of the highest preterm birth rate of 12.1% in the U.S. and 13.6o/o in RI (March of Dimes, 2009). In addition, during the same years RI statistics on low birth weight infants among Hispanics were 8.3% and 6.9% in the U.S. Healthy People 2010 suggested that this rate should be no more than 5% of live births. A preconception planning program connected with Latina women who were involved in a home based education program at a local community agency. This program used interactive learning, role play, and self-management skills aimed to empower participants by educating them about their health and future pregnancies. The selected educational topics included nutrition, exercise, stress reduction, lead, mercury, influenza and HPV vaccines, smoking and alcohol. Information about health and social services in the community were also provided. Most of the program participants demonstrated improvement in the post-test scores. The challenges faced by this program included lack of consistency in attendance and participants' difficulties answering open-ended questions. More emphasis on education for the minority population is recommended to improve maternal and child health outcomes. In addition, increasing cultural competency and diversity among the nursing profession is critical to improving outcomes.
Faith Community Nursing Program Development Project
Authors: Galloway Sharon
Published: February 2018

Faith community nursing is a model of nursing care that focuses on health promotion and disease prevention and the intentional care of the spirit within the context of a faith community's values, beliefs, and practices. The purpose of this program development project was to develop and identify an implementation plan for a faith community nursing program at the Church of The Apostles in Coventry, Rhode Island. A needs assessment was completed in order to determine the health status and risk factors of the congregants, identify diversity in needs within the congregation and to identify perceived needs and perceived barriers in meeting those needs. The needs assessment was an essential first step in assisting the church and the faith-based nurse. The approach used to complete the needs assessment included a demographic and health questionnaire and focus group. The nursing theoretical framework used to guide this project was a grand nursing theory based on human needs, The Neuman Systems Model. This model uses a systems approach to describe holistic health that is focused on a client's or client system's optimal well-being. The PRECEDE-PROCEED logic model was chosen as the framework to guide the construction of this long-term plan to develop a faith community nursing program. The proposed faith community nursing program will represent a Congregational model and an independent, stand-alone faith community nursing program. The health promotion program will be phased-in based on the needs of the congregation identified from the needs assessment.
A Policy Analysis of the Nursing Shortage in Selected Sub-Saharan African Countries
Authors: Twining Julia
Published: February 2018

This paper will begin with a comprehensive literature review of the nursing shortage in the sub-Saharan African region. The global nursing crisis is explored with a focus on the economics of nursing, challenges presented by the nursing shortage, interventions to increase nursing capacity, and partnerships that have been implemented to achieve this goal. The nursing shortage in selected sub-Saharan African countries is analyzed from a policy perspective using Fawcett and Russell’s Conceptual Model of Nursing and Health Policy (2005). Then, McLaughlin and McLaughlin's Policy Analysis Process (2008) is used to identify, analyze, evaluate, and make recommendations to create health policy. The primary thrust is to advocate for sustainable interventions that will assist in alleviating the nursing shortage in selected sub-Saharan African countries.
The Impact of Neonatal ICU Single Family Rooms on Select Developmental Outcomes
Authors: D Lynda
Published: February 2018

The purpose of this study was to determine if there is a weight gain benefit and earlier achievement to full feedings in the single family room NICU design compared to the multi-bed NICU design.
A retrospective chart review of infants less than 1000 grams born during a three month time frame in both the multi-bed unit and single family unit was conducted. The study compared average daily weight gain and achievement to full feedings in the multi-bed unit and single family room unit. Findings concluded there was a slight difference in the average daily weight gain and achievement to full feedings occurred several days earlier in the single family room unit.
In the single family unit the advanced practice nurses are able to promote a family-centered environment by encouraging rooming in, Kangaroo care, and breastfeeding, all of which were nearly impossible for the parents to accomplish in the multi-bed unit due to lack of space and pr1vacy.
Certified Nursing Assistants' Knowledge, Confidence, and Effectiveness in Providing End-of-Life Care
Authors: Falcone Carol
Published: February 2018

The objective of this research was to explore the knowledge, confidence and effectiveness level of certified nursing assistants (CNAs) working with persons at end-of-life (EOL). This study was a descriptive, one-dimensional study that was conducted at a long term care (LTC) facility in Rhode Island. Participants answered demographic and confidence questionnaires and completed a short exam. The participants regularly provided care for persons at EOL, but received no additional training in that specialty. The 20 participants were fro,m diverse backgrounds and cultures. The study was conducted over two months and results indicated perceived confidence and effectiveness levels higher than knowledge scores. Over fifty percent of the participants received a score of less than 70% on the knowledge exam. There were multiple findings that implied a need for further research. The number of individuals receiving EOL care in nursing homes has escalated over the past decade. To provide quality care to the terminally ill, including general comfort, pain relief, spiritual, and emotional support, it must be provided by qualified nursing assistants. It is the premise of the researcher that nursing assistants who provide the majority of care to patients at EOL require specialized training to meet both nursing assistant and patient needs. The findings from this study support this premise and have implications for research and practice in end-of-life care.
The Perceived Impact of Diabetes Support Groups
Authors: Garofalo Rebecca
Published: February 2018

A dearth o f research exists describing the perceived impact o f diabetes support groups from the perspective o f support group participants. This study examined the subjective experience of being a participant in a diabetes support group upon a person's physical and emotional well being. Participants were recruited from a diabetes support group and interviewed individually through a series of open ended interview questions. The participants reported various physical and emotional challenges related to their diabetes. The support group was a source of information, hope, shared experience and group problem solving as individuals strived to maintain lifestyle behaviors required to manage their diabetes. This support group was a positive source of support for these participants. More studies, with larger sample sizes, examining support group interventions or strategies would be beneficial in order to gain an understanding of which aspects of a support group promote positive client outcomes. Advanced practice nurses play a pivotal role in designing further studies that examine the impact of support groups. This will enhance our understanding of a support group's role in sustaining and promoting positive health behaviors and well being. In order to continue this form of support in the community, health policy needs to address the funding of this resource to sustain it as a tertiary intervention in the future.
Attributes of Effective Nurse Care Managers in Patient-Centered Medical Home
Authors: Corner Susan
Published: February 2018

The burden of chronic disease on our medical system and on society is substantial and adds to the difficulty of managing ever-increasing amounts of patient information as care becomes more complex. It has placed the quality of health care in the United States (US) under scrutiny because of medical errors, lack of coordination, patient frustration and poor outcomes. In response to the many challenges, the Patient-Centered Medical Home (PCMH) model of care was developed and is designed to increase the value of our health care and to improve the experience for the patient. The role of the Nurse Care Manager (NCM) in PCMH to help patients with chronic disease is relatively new, but results in the literature are promising.

In this evaluation study, the literature on effective NCM interventions and attributes is reviewed and summarized. In addition, a small sample of NCMs was interviewed to determine the specific attributes and interventions used by NCMs in PCMH. NCMs are effective in assisting patients in managing chronic disease, engaging and activating the patient, transition of care management, and using electronic medical records (EMR) to track patient outcomes. Collaboration with other clinicians, evidence-based and advanced protocol interventions, advanced education and training, and understanding the social and environmental context of the patient were all found to improve patient care. The findings from the literature as well as the interviews explore the components of effective nurse care management and the challenges for the NCM as the role evolves.
Nurses' Attitudes towards Drug-Seekers in the Emergency Room
Authors: Gernt Megan
Published: February 2018

Emergency department patients often present with a chief complaint of pain. There is a unique population of patients who present with this chief complaint in an effort to obtain narcotics for non-medical use. This population is often referred to as drug-seekers and there is little information available to define what exactly nurses mean when they use this term. This study utilized a descriptive survey design to gain a better understanding of nurses’ use of the term drug-seeker. Respondents agreed on a variety of behaviors that lead them to identify patients as drug-seeking and expressed a frustration with this population of patients. Many respondents identified a lack of clear policies and education around this population as a challenge. By understanding how nurses use the term drug-seeking, and developing an understanding what some of their concerns are regarding this population, the opportunity presents itself for the development of educational programs in order to train health care providers to best care for this challenging population. Additionally, the opportunity exists for policy development and implementation around this population in order to provide safe, comprehensive, and satisfactory care.
Online Learning Modules and Nursing Students' Knowledge of Tuberculosis
Authors: Kunkel Monica
Published: February 2018

Tuberculosis is identified as a major global health issue. Recommendations for increased training for health professionals from both the Institute of Medicine and the National Institutes of Health have been outlined. Nursing curriculum tools developed by the National Tuberculosis Consortium and presented through online learning modules were utilized in an experimental study of baccalaureate nursing students. Knowles’ Theory of Adult Learning provided the theoretical framework for the study. The test scores on a thirty question multiple-choice exam of students who participated in the intervention are compared to those of students who only participated in the regular course content. Although the mean raw score on the exam was higher for the experimental than the control group, the small number of participants that completed the study prevented the results from being analyzed to determine if there was a statistically significant difference between the two groups. Limitations of the study included the small sample size, inexperience of the investigator in designing and conducting an experimental study, the amount of extra time involved for students in the intervention group, and the lack of ability to correlate demographic information to individual results. Implications for nurses prepared to practice at the master’s level include the need for further research to explore effective teaching methods for baccalaureate nursing students; involvement in policy development related to tuberculosis knowledge and screening, especially of health care workers; and a recommendation for a continued commitment to encourage nurse research on educating future nurses on complex heath care topics such as tuberculosis.
Evaluating the Effectiveness of Concurrent Review
Authors: McGillivray Celia
Published: February 2018

Concurrent review may be seen as a relatively new quality improvement strategy or an improvement over an existing quality improvement strategy, but research is scant. This strategy incorporates several key elements of performance feedback, which may be broadly defined as sharing non-judgmental information to professionals regarding discrepancies between their actual performance and standards of care. The distinction between concurrent review and performance feedback is the timing of information provided. Concurrent review incorporates the provision ofmedical information regarding a provider's performance during the patient's hospitalization, so that the plan ofcare is altered. This study evaluated concurrent review by examining the impact on stroke measures and whether physician and nurse practice patterns in managing stroke patients were altered.
Intra-Femoral Sheath Time: Does it Increase a Patient's Risk for Developing a Hematoma?
Authors: Planchon Colleen
Published: February 2018

Despite advancements in technology and medication therapy, coronary artery disease continues
to remain the number one cause of death. Treatment for coronary artery disease requires life
style modifications, medication therapy, percutaneous coronary interventions, and sometimes
coronary artery bypass surgery. Though percutaneous coronary interventions are considered safe
and are commonly occurring procedures, there are still risks for complications. One of the most
frequently occurring complications is hematoma of the femoral artery site. The purpose of this
study was to determine if there was an increased incidence of hematomas in individuals
undergoing percutaneous coronary intervention with associated sheath times of less than five
hours (Group A) as compared to sheath time of greater than five hours (Group B). The study used a retrospective, two group design and was conducted at a tertiary care center that performs
over 1500 PCI’s annually. Inclusion criteria included adults over the age of 18 who were
hemodynamically stable, had no known bleeding disorders, and were punctured once at the
femoral artery to perform the percutaneous intervention. Two hundred fifty medical records
were reviewed utilizing a data collection tool designed by the researcher. Total sample size was
55, 21 in Group A and 34 in Group B. Six hematomas were documented as occurring, but were
not reportable based on the ACC definition. Hematomas were documented in the medical record
using the terms “small”, “medium,” and “large” versus an objective measurement. No
hematomas were identified using the ACC definition, which was the measurement standard for
this research hospital. Sheath times in Group A averaged 4.02 hours, and group B 7.42 hours.
There was a higher incidence of descriptive hematoma that did not meet the criteria of this study
in Group B. Results call for recommendations of on-going documentation of post procedure
hematomas using a standardized, reliable, and valid measuring tool. APRN’s can be
instrumental in implementing change in patient care , hospital policy and on the national level by
assuring that hematomas are accurately and consistently documented. Further research is
indicated related to sheath times and potential associated negative outcomes.
Educating Nursing Students on Emergency Preparedness: A Pilot Program
Authors: Burnock Sandra
Published: February 2018

The purpose of this project was to determine if a disaster preparedness educational intervention for nursing students’ could engage students in personal preparedness and enhance their willingness to respond during a public health emergency. The United States (U.S.) is among the top five countries in the world that experience frequent natural disasters (Guha-Sapir et al., 2012). With over 3.1 million nurses in the U.S. (AACN, 2011) and their importance to healthcare, the nursing profession plays a crucial role in the ability of the nation to prepare for and respond to disasters. Currently, however, nurses in the U.S. lack the knowledge, skills and attitudes needed to effectively respond to disasters, thereby placing the public at risk. A pilot program was developed that introduced the topic of disaster preparedness to senior level nursing students through a one-hour course. The pilot program utilized a pre- and post-survey method to evaluate the effect of the education on nursing students. A convenience sample of 18 students participated in the class, course evaluation and pre-survey, and 14 students responded to the post- survey request. Data were collected and analyzed on the course evaluation, measuring how well the course objectives were met and the appropriateness of the teaching strategies. Pre- and post- survey results were compared to determine the effectiveness of the pilot program. The results indicated that the course encouraged nursing students to engage in preparedness, and to be willing to respond. No increased in pre-registration with a professional emergency preparedness organization was noted. Implications from this pilot program include the need for further studies regarding best methods for educating nursing students. Also, advance practice registered nurses need to lead the nursing profession in emergency preparedness to increase the resilience of the United States during disasters.
Managing Hospitalized Adults with Alcohol Dependence
Authors: Darling Lisa
Published: February 2018

Alcohol withdrawal is a common clinical condition with a variety of presentations, complications and morbidities. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), an estimated 17 million Americans, or one in every 12 adults, have an alcohol use disorder (AUD). An unanticipated hospital admission can precipitate alcohol withdrawal syndrome that can develop six hours after the cessation of alcohol. Early assessment of potential alcohol dependence, as well as symptoms of withdrawal and utilizing the CIWA tool, is important in identifying and managing this at risk population and reducing the potential incidence of complications. The purpose of this project was to develop and implement an educational program for nurses targeted at management of hospitalized adults with alcohol withdrawal through assessment skills and utilizing the CIWA protocol. The goal was to increase the nurses’ knowledge of assessing, monitoring and treating this patient population. A needs assessment was conducted and an online education program was developed based on a review of the literature and clinical experience. The project included a pre and post survey surrounding the education module, followed by a program evaluation. Results indicated higher scores on the post-survey suggesting an increase in nurses’ knowledge, awareness and skills related to managing AWS in hospitalized adults utilizing an online education program. The APRN is in the position to improve nursing practice through evidence-based best practice, an important element in improving patient outcomes and safety.
A Policy Analysis of the Provisions of the Patient Protection and Affordable Care Act Related to Access to Primary Care for Older Adults
Authors: Fontaine Tonya
Published: February 2018

This paper begins with a comprehensive literature review of health care around the globe, health care in America, and the Patient Protection and Affordable Care Act (ACA). A problem has emerged from the ACA, in which it is unclear if the health care workforce is prepared to take care of all insured Americans, which now includes a large population of newly insured under the ACA. Primary care and the elderly population are a focus, as primary care is most affected by the ACA, and the aging population is growing and will continue to grow. The ACA policy is analyzed using Russell and Fawcett’s The Conceptual Model of Nursing and Health Policy Revisited (2005) and McLaughlin & McLaughlin’s Policy Analysis Process (2007). Policy recommendations are suggested based on evidence-based research.
An Evaluation of the Palliative Care Provided on a Medical Intensive Care Unit
Authors: Musso Peter
Published: February 2018

More patients die in intensive care units (ICUs) than in any other hospital setting. For survivors, ICU treatment is often accompanied by a significant burden of symptoms for both the patient and for the family and may result in long-term cognitive and physical impairments and an unacceptable quality of life. Over the last decade, the idea that palliative care should be provided along with intensive care regardless of prognosis has evolved from a novel formulation to a clinical practice guideline. The purpose of this research was to determine whether the patients on a Medical Intensive Care Unit (MICU) were being offered appropriate palliative care. A retrospective chart review of 250 charts was performed at a 653-bed acute care, teaching facility located in southern New England with a sample of 50 patients. The Care and Communication Bundle was used to measure if primary palliative care needs were met; the Palliative Care Service Consult Tool developed by the palliative care team at the study institution was used to measure if tertiary palliative care need s were met. Results indicated approximately 85% compliance with primary palliative care overall, compliance with the individual items ranged from 40% - 100%. Tertiary palliative care compliance was 7% overall, with only two out of 29 patients actually receiving a consult. Recommendations for practice change include integrating the tool into the electronic medical record as part of the admission assessment. Interdisciplinary staff education on the process and use of the measures is indicated. State and national policies related to palliative care would facilitate the implementation of palliative care programs aimed at providing care for all people in need of these services and ensure equitable access to end-of-life care. Advanced practice nurses have a key role in advocating for policy changes within their institutions, as well as, at the state and national levels that could help patients meet their goals of care, especially at the end of their lives.