Pressure ulcers and nutritional deficits in elderly long-term care patients: Effects of a comprehensive nutritional program on pressure ulcer healing, length of hospital stay and charges to patients

The elderly are at the highest risk of developing pressure ulcers that result in prolonged hospitalization, high health care costs, increased mortality, and decreased quality of life. The burden of pressure ulcers will intensify because of a rapidly increasing elderly population in the United States (US). Poor nutrition is a major predictor of pressure ulcer formation. The purpose of this study was to examine the effects of a comprehensive, interdisciplinary nutritional protocol on: (1) pressure ulcer wound healing (2) length of hospital stays, and (3) charges for pressure ulcer management. Using a pre-intervention/post intervention quasi-experimental design the study sample was composed of 100 patients 60 years or older, admitted with or acquiring a pressure ulcer. A pre-intervention group (n= 50) received routine pressure ulcer care (standard diet, dressing changes, and equipment). A post-intervention group received routine care plus an interdisciplinary nutrition intervention (physical therapy, speech therapy, occupational therapy, added protein and calories to the diet). Research questions were analyzed using descriptive statistics, frequencies, Chi-Square Tests, and T-tests. Findings indicated that the comprehensive, interdisciplinary nutritional protocol had a significant effect on the rate of wound healing in Week3 and Week4, total hospital length of stay (pre-intervention M= 43.2 days, SD=31.70 versus M=31.77, SID-12.02 post-intervention), and pressure ulcer length of stay (pre-intervention 25.28 days, SD5.60 versus 18.40 days, SD 5.27 post-intervention). Although there was no significant difference in total charges for the pre-intervention group ($727,245.00) compared to the post-intervention group ($702,065.00), charges for speech (m=$5885.12, SD=$332.55), pre albumin (m=$808.52,SD= $332.55), and albumin($278 .88, SD=55.00) were higher in the pre-intervention group and charges for PT ($5721.26, SD$3655.24) and OT($2544 .64, SD=1712.863) were higher in the post-intervention group. Study findings indicate that this comprehensive nutritional intervention was effective in improving pressure ulcer wound healing, decreasing both hospital length of stay for treatment of pressure ulcer and total hospital length of stay while showing no significant additional charges for treatment of pressure ulcers.

Quantum transition state theory and solving a first order master equation for complex reactions numerically

The field of chemical kinetics is an exciting and active field. The prevailing theories make a number of simplifying assumptions that do not always hold in actual cases. Another current problem concerns a development of efficient numerical algorithms for solving the master equations that arise in the description of complex reactions. The objective of the present work is to furnish a completely general and exact theory of reaction rates, in a form reminiscent of transition state theory, valid for all fluid phases and also to develop a computer program that can solve complex reactions by finding the concentrations of all participating substances as a function of time. To do so, the full quantum scattering theory is used for deriving the exact rate law, and then the resulting cumulative reaction probability is put into several equivalent forms that take into account all relativistic effects if applicable, including one that is strongly reminiscent of transition state theory, but includes corrections from scattering theory. Then two programs, one for solving complex reactions, the other for solving first order linear kinetic master equations to solve them, have been developed and tested for simple applications.

China's Relations with Brazil and Argentina and Implications for U.S. Security Concerns [Student's Paper Series]

This study on China’s relations with Brazil and Argentina, as well as its implications for U.S. concerns examines two main questions: Why China’s increasing influence on Brazil and Argentina may be considered a cause for U.S. security concerns? And if this is the case, how do China’s strategic alliances with the two countries has impacted U.S. leadership? In an effort to look at China’s influence from multidimensional angles and beyond China’s visible economic influence in these two countries, this paper argues that China’s interest in the Latin American region, with a focus on brazil and Argentina, responds to a more crafted, pragmatic and tailored vision with long-term strategic and political goals. The results of this study reveal that China – avoiding intra-regional competition through a strategic diversification of sectors – has been able to secure critical resources for its population as well as promote enduring alliances in the region that could represent a plausible cause of concern for U.S. interests. In this regard, China’s avoidance of a direct challenge to traditional partners’ influence has responded to the gaps left by a gradual, but steady lack of U.S. involvement.

Online Graduate Degree: Hospitality Executive Perceptions

Distance education is an option that allows managers to continue with work while completing a program of study The authors report on the establishment of a distance education graduate program and describes how participants learned of the program, what their motivations for participating were, how it impacted their jobs and personal lives, and what their initial reactions to the first courses were.

Leadership Styles, Behaviors, and Outcomes of Athletic Training Education Program Directors

Context: With the increase in athletic training education programs, the demand for a highly qualified faculty member to serve as program director (PD) and fill the multiple roles and responsibilities of the position has increased. A successful PD must possess leadership skills crucial for the evolving academic environment. Research suggests that educational leaders must provide both transactional and transformational leadership if athletic trainers are to secure a legitimate place as healthcare providers. Objective: To describe the leadership styles and behaviors of athletic training education PDs and to describe the associations between leadership style, behavior, outcome, and experience. Design: We will utilize a survey design to identify the leadership styles, behaviors, outcomes, and experiences of athletic training education PDs. Setting: On-line questionnaire. Participants: The population of this study will be limited to the academic PDs of the 360 accredited entry-level athletic training education programs in the United States. Intervention: The investigation will utilize the Multifactor Leadership Questionnaire (MLQ). The MLQ is a validated tool composed of 45 items that identify and measure key leadership and effectiveness behaviors shown to be strongly linked with both individual and organizational success. In addition to the leader, it is recommended that all persons working above, below, and directly at the same organizational level as the leader rate the leader. Raters evaluate how frequently, or to what degree, they have observed the leader engage in 32 specific behaviors. Main Outcome Measure(s): Statistical analysis will be utilized to describe the associations between leadership styles, behaviors, outcomes, and experiences.

Hospitality Graduate Students’ Program Choice Decisions: Implications for Faculty and Administrators

Despite rapid growth in the quality and volume of hospitality graduate research and education in recent years, little information is available in the extant body of literature about the program choices of hospitality management graduate students, information that is crucial for program administrators and faculty in their attempts to attract the most promising students to their programs. This paper reports on a study among graduate students in U.S, hospitality management programs designed to understand why they chose to pursue their degrees at their programs of choice. Given the large numbers of international students presently enrolled, the study additionally looked into why international hospitality management students chose to leave their home countries and why they decided to pursue a graduate degree in the U.S. Based on the findings, implications for hospitality administrators and faculty in the U.S. and abroad are discussed and directions for future research are presented.

The relationship between higher education curricular variables and human flight performance in a preliminary flying training program

The ability of the United States Air Force (USAF) to sustain a high level of operational ability and readiness is dependent on the proficiency and expertise of its pilots. Recruitment, education, training, and retention of its pilot force are crucial factors in the USAF's attainment of its operational mission: defense of this nation and its allies. Failure of a student pilot during a training program does not only represent a loss of costly training expenditures to the American public, but often consists of loss of human life, aircraft, and property. This research focused on the Air Force Reserve Officer Training Corps' (AFROTC) selection method for student pilots for the light aircraft training (LATR) program. The LATR program is an intense 16 day flight training program that precedes the Air Force's undergraduate pilot training (UPT) program. The study subjects were 265 AFROTC cadets in the LATR program. A variety of independent variables from each subject's higher education curricular background as well as results of preselection tests, participation in varsity athletics, prior flying experience and gender were evaluated against subsequent performance in LATR. Performance was measured by a quantitative performance score developed by this researcher based on 28 graded training factors as well as overall pass or fail of the LATR program. Study results showed participation in university varsity athletics was very significantly and positively related to performance in the LATR program, followed by prior flying experience and to a very slight degree portions of the Air Force Officers Qualifying Test. Not significantly related to success in the LATR program were independent variables such as grade point average, scholastic aptitude test scores, academic major, gender and the AFROTC selection and ranking system.

Pressure ulcers and nutritional deficits in elderly long-term care patients : effects of a comprehensive nutritional program on pressure ulcer healing, length of hospital stay and charges to patients

The elderly are at the highest risk of developing pressure ulcers that result in prolonged hospitalization, high health care costs, increased mortality, and decreased quality of life. The burden of pressure ulcers will intensify because of a rapidly increasing elderly population in the United States (US). Poor nutrition is a major predictor of pressure ulcer formation. The purpose of this study was to examine the effects of a comprehensive, interdisciplinary nutritional protocol on: 1) pressure ulcer wound healing 2) length of hospital stays, and 3) charges for pressure ulcer management. Using a pre-intervention/post intervention quasi-experimental design the study sample was composed of 100 patients 60 years or older, admitted with or acquiring a pressure ulcer. A pre-intervention group (n= 50) received routine pressure ulcer care (standard diet, dressing changes, and equipment). A post-intervention group received routine care plus an interdisciplinary nutrition intervention (physical therapy, speech therapy, occupational therapy, added protein and calories to the diet). Research questions were analyzed using descriptive statistics, frequencies, Chi-Square Tests, and T-tests. Findings indicated that the comprehensive, interdisciplinary nutritional protocol had a significant effect on the rate of wound healing in Week3 and Week4, total hospital length of stay (pre-intervention M= 43.2 days, SD=31.70 versus M=31.77, SD=12.02 post-intervention), and pressure ulcer length of stay (pre-intervention 25.28 days, SD5.60 versus 18.40 days, SD 5.27 post-intervention). Although there was no significant difference in total charges for the pre-intervention group ($727,245.00) compared to the post-intervention group ($702,065.00), charges for speech (m=$5885.12, SD=$332.55), pre albumin (m=$808.52,SD= $332.55), and albumin($278 .88, SD=55.00) were higher in the pre-intervention group and charges for PT ($5721.26, SD$3655.24) and OT($2544 .64, SD=1712.863) were higher in the post-intervention group. Study findings indicate that this comprehensive nutritional intervention was effective in improving pressure ulcer wound healing, decreasing both hospital length of stay for treatment of pressure ulcer and total hospital length of stay while showing no significant additional charges for treatment of pressure ulcers.