Impact of Nursing Interventions on Positive Confusion Assessment Method (CAM) Scores

Delirium occurs in patients of all ages, especially in the older adult population. Symptoms vary from patient to patient, and delirium is often misdiagnosed. Patients with delirium have a higher cost of care and a longer length of stay in the hospital. Delirium is a stressful event for both the nurse and the patient, resulting in poor patient outcomes. The Confusion Assessment Method (CAM) tool is used to diagnose delirium in confused patients; a positive CAM score indicates delirium. Nursing interventions are used to treat delirium. Interventions used range from non-pharmacologic measures to use of pharmacological measures and restraints. This project will be a quality improvement project for patients with positive CAM scores. The most common nursing interventions used will be identified for possible bundling purposes

Using cluster analysis to evaluate the academic performance of demographic homogeneous subsets

No Child Left Behind (NCLB) requires states to develop, under very specific conditions, a valid and reliable system of measurement that meets certain requirements while neglecting others. One such provision is a system of assessments that holds all schools to the same academic criteria, regardless of circumstance, while at the same time acknowledging an achievement gap exists between certain subpopulations of students. Nevada has developed such a program, which effectively fulfills the requirements of NCLB, and like NCLB, neglects to recognize the unique challenges for those schools housing larger than average populations of lower-performing students; Historically, when discussing the achievement gap much attention has been placed on social difficulties of certain subpopulations, which may or may not contribute. It is not the intention of this study to examine social issues associated with racial subgroups or special populations of students. Regardless of the contributing factors, it will suffice to hypothesize a difference in subgroup performance exists. It is simply the intention of this study to examine the performance of schools within homogeneous clusters developed through subgroup membership. It is the belief of this researcher that a school\u27s dominant student population will have a significant influence on academic performance, which if not considered could result in grave consequences with respect to NCLB. Using cluster analysis, schools were classified based upon dominant student populations and determinations made concerning statistically significant differences in mean reading and mean math CRT scale scores for those schools contained within homogenous clusters; It was found that although NCLB requires schools to report the academic performance of students belonging to subgroup\u27s American Indian, Asian, Hispanic, African American, White, IEP, LEP, and FRL, the only subgroups that provide valid and measureable results were Asian, African American, I Hispanic, White, and IEP. Further, schools did demonstrate significant differences in mean reading and mean math scale scores with select schools performing significantly above expectations, certain schools performing significantly below expectations, and many demonstrating no significant difference relative to similar populations located in homogeneous clusters

Impacts of an invasive shrub, Buddleja davidii (butterfly bush), on plant succession on New Zealand floodplains

Plant successional trajectories are driven in part by the interactions among the biotic and abiotic components of a plant community such that introduction of an invasive species may impact the recruitment of native species. Buddleja davidii Franchet (Family Buddlejaceae) is an ornamental shrub, native to China, able to rapidly colonize and dominate disturbed areas around the world. This study details the impact B. davidii has on several New Zealand floodplain communities and the recruitment, growth and survival of a native species, Griselinia littoralis, in natural settings and under controlled conditions in plots and treatments representative of a multi-stage (i.e., open, young, vigorous and mature) developmental chronosequence (i.e., time since disturbance by flooding). Although B. davidii was abundant on the floodplains studied from the open to vigorous stages, it was rarely present as a mature plant. Soil phosphorus and nitrogen concentrations increased along a developmental gradient which suggested that B. davidii augmented soil nutrients over time. Growth of G. littoralis transplants under a B. davidii canopy remained unchanged from the time they were initially planted in the open and young stages yet nearly doubled in height in the vigorous stage suggests that B. davidii may enhance the growth of G. littoralis transplants. The growth of the G. littoralis transplants under the B. davidii canopy may have been facilitated by increased soil moisture and nutrients. G. littoralis seedlings established naturally beneath the B. davidii canopy, yet did not establish in the open or young stages. It appeared that B. davidii did not inhibit G. littoralis establishment. B. davidii was not able to survive under the relative darkness of a simulated vigorous developmental stage. Growth of G. littoralis cuttings was suppressed by B. davidii in the open and young developmental stages yet G. littoralis mortality was not negatively impacted by B. davidii. Although B. davidii initially dominated the floodplain plant community, its influence may be temporary because it cannot tolerate the closed canopy community of the later stages of succession on New Zealand floodplains. Native species, able to tolerate a broader range of conditions dominated the later stages of succession

Early Letters From R. K. Call

Richard Keith Call and Edward Brett Randolph were both born in Virginia, only a few months apart. Since they were distantly related, they may have known each other before their participation in the Indian wars in the southeast and Florida. By 1819, they had made exceptional reputations for loyalty and bravery, Randolph at Fort Erie and Chippaway, both in the Indian campaigns

Garden varieties: how attractive are recommended garden plants to butterflies?

One way the public can engage in insect conservation is through wildlife gardening, including the growing of insect-friendly flowers as sources of nectar. However, plant varieties differ in the types of insects they attract. To determine which garden plants attracted which butterflies, we counted butterflies nectaring on 11 varieties of summer-flowering garden plants in a rural garden in East Sussex, UK. These plants were all from a list of 100 varieties considered attractive to British butterflies, and included the five varieties specifically listed by the UK charity Butterfly Conservation as best for summer nectar. A total of 2659 flower visits from 14 butterfly and one moth species were observed. We performed a principal components analysis which showed contrasting patterns between the species attracted to Origanum vulgare and Buddleia davidii. The “butterfly bush” Buddleia attracted many nymphalines, such as the peacock, Inachis io, but very few satyrines such as the gatekeeper, Pyronia tithonus, which mostly visited Origanum. Eupatorium cannibinum had the highest Simpson’s Diversity score of 0.75, while Buddleia and Origanum were lower, scoring 0.66 and 0.50 respectively. No one plant was good at attracting all observed butterfly species, as each attracted only a subset of the butterfly community. We conclude that to create a butterfly-friendly garden, a variety of plant species are required as nectar sources for butterflies. Furthermore, garden plant recommendations can probably benefit from being more precise as to the species of butterfly they attract

Examining Employees\u27 Perceptions of Energy Conservation Behaviors in Office Settings

The estimates for potential energy and greenhouse gas (GHG) savings in office buildings are significant. Reports show that energy wasting behavior in office buildings such as computers being left on at night and on weekends result in billions of dollars lost annually and GHG\u27s being emitted needlessly. The estimated potential for energy savings ranges from 20 to 50 percent. Despite the potential for significant energy savings, a review of the literature revealed that there are relatively few studies of energy conservation interventions in office buildings. Most of the research on energy conservation has been done in households. There is agreement in the field of energy conservation that providing behavioral interventions based on evidence and theory could be instrumental in tapping the potential energy savings and GHG reductions in office buildings. The purpose of this quantitative study was to examine employee attitudes and perceptions of energy conservation as well as the prevalence of energy conservation behaviors among faculty and staff at a Midwestern University. This study demonstrates the use of two theoretical constructs, Ajzen\u27s Theory of Planned Behavior and Vroom\u27s Expectancy Theory, to examine employee attitudes and perceptions of energy conservation in an office setting in order to recommend HRD interventions designed to reduce energy use and associated GHG emissions. The study revealed a high degree of awareness of issues related to energy consumption as well as positive attitudes toward the environment in general and toward energy conservation specifically. In addition, there is a high degree of endorsement of the University\u27s energy conservation goals. The study demonstrated that energy conservation attitude and endorsement of the University\u27s goal are significantly correlated with energy behavior. The data on energy conservation behaviors revealed opportunities for improvement in specific areas such as turning off computers and monitors at the end of the day. The study also found that faculty and staff differ in three areas: energy issue awareness, perceived behavioral control, and outcome expectancy

Mars Reconnaissance Orbiter Interplanetary Cruise Navigation

Carrying six science instruments and three engineering payloads, the Mars Reconnaissance Orbiter (MRO) is the first mission in a low Mars orbit to characterize the surface, subsurface, and atmospheric properties with unprecedented detail. After a seven-month interplanetary cruise, MRO arrived at Mars executing a 1.0 km/s Mars Orbit Insertion (MOI) maneuver. MRO achieved a 430 km periapsis altitude with the final orbit solution indicating that only 10 km was attributable to navigation prediction error. With the last interplanetary maneuver performed four months before MOI, this was a significant accomplishment. This paper describes the navigation analyses and results during the 210-day interplanetary cruise. As of August 2007 MRO has returned more than 18 Terabits of scientific data in support of the objectives set by the Mars Exploration Program (MEP). The robust and exceptional interplanetary navigation performance paved the way for a successful MRO mission