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Background: Reliable and valid instruments are needed to assess patient safety competencies, specifically nursing students' ability to appropriately respond to simulated rescue events. Methods: This was an instrument development study conducted with 152 senior nursing students in 2 phases. Results: Student groups performed poorly during the simulation scenario, with mean scores on the Heart Failure Simulation Competency Evaluation Tool ranging from 46% to 56%. Interrater reliability increased to .839 after item revision during Phase 2 of the study. Discussion: This simulation competency assessment package is ready to be tested with more diverse student groups and novice nurses in the practice setting. © 2012 International Nursing Association for Clinical Simulation and Learning.

Nurse practitioners are playing an increasingly visible role in home care. The Institute of Medicine in collaboration with the Robert Wood Johnson Foundation recommends wider use of Advanced Practice Registered Nurses and there has been growing interest in using the role in home care.1 However, the physician remains the provider who must sign home health agency paperwork and orders. The "Home Health Care Planning Improvement Act" would allow nurse practitioners to certify Medicare-sponsored treatment plans.2 This article will discuss the status of the nurse practitioner role in home care, the impact of reimbursement on home care services, how the passage of the new act would change current practice, and a vision for the future role of the nurse practitioner in home health care. © 2012 SAGE Publications.

PURPOSE: To examine the worklife experiences of physicians, to further the exploration of the worklife experiences of nurses with disabilities, and to discover how the two healthcare professions compare with each other with regard to these experiences., METHODS: This study employed the research tradition of interpretive naturalistic inquiry and used constant comparative analysis to collect and analyze the data., FINDINGS: Despite the cultural and educational differences between physicians and RNs, their experiences as healthcare professionals with self-identified permanent physical and/or sensory disabilities were very similar. The research team identified five core themes., CONCLUSIONS: Healthcare professionals, including staff and administrators, need to make an effort to retain employees as turnover and predicted shortages are likely to jeopardize the current healthcare system., CLINICAL RELEVANCE: Modifications can be made within both professions to support people with disabilities and to enable them to contribute to their professions using their abilities to think critically, solve problems, and care for patients safely. Copyright © 2012 Association of Rehabilitation Nurses.

PURPOSE: The authors sought to generate insights and hypotheses about the professional experiences of registered nurses and physicians with self-identified disabilities to inform local and national policy conversations on supporting a diverse health care workforce., METHOD: In 2009-2010, the authors conducted in-depth interviews in person and over the telephone with a sample of licensed registered nurses and physicians across the country who self-identified as having a permanent disability. They coded the interview transcripts to identify key themes across the participants' responses., RESULTS: The authors interviewed 10 registered nurses and 10 physicians. Five novel and consistent themes emerged from the data analysis: (1) Living and working with a physical/sensory disability narrows the career choices and trajectories of nurses and physicians, (2) nurses and physicians struggle with decisions regarding whether to disclose and discuss their disabilities at work, (3) nurses and physicians rarely seek legally guaranteed workplace accommodations, instead viewing patient safety as a personal responsibility, (4) interpersonal interactions often reflect the institutional climate and set the tone for how welcome nurses and physicians feel at work, and (5) reactions to workplace disability-related challenges run an emotional spectrum from anger and grief to resilience and optimism., CONCLUSIONS: The responses revealed several missed opportunities for supporting health care professionals with disabilities in the workplace. These findings should inform the continuing debate regarding what defines "reasonable accommodation" and how to create a workplace that is welcoming for nurses and physicians with disabilities.

A qualitative study was done to explore the perceptions of volunteering among retired registered nurses (RNs) in Kansas. Participants were volunteers in formal nursing roles or were using their nursing knowledge and experience in non-nursing roles, such as church work. Regardless of the type of volunteer position, retired RNs reported that they use what they have learned as nurses when they volunteer. Volunteering benefits include enhanced self-worth, intellectual stimulation, reduced social isolation, and opportunities to help others. Increased paperwork, new technology, difficulty finding nursing-specific volunteer opportunities, resistance from health care organizations, and a lack of respect for what these nurses know are challenges and barriers to volunteering. Retired RNs have accumulated years of clinical nursing experience and can be helpful to employed nurses. Health care organizations should launch targeted efforts to recruit and utilize retired RN volunteers. Health care professionals who care for older adults should recommend volunteering as a healthful endeavor. (Geriatr Nurs 2011;32:96-105)

A survey design was used to explore the perceptions and characteristics of registered nurses (RNs) with sensory disabilities and their risk for leaving their jobs. An earlier study found that nurses with disabilities are leaving nursing and that employers do not appear to support these nurses. Work instability and the mismatch between a nurse's perceptions of his or her ability and the demands of their work increase risk for job retention problems. This study's convenience sample of U.S. RNs had hearing, vision, or communication disabilities. Participants completed a demographic form, three U.S. Census questions, and the Nurse-Work Instability Survey. Hospital nurses were three times more likely to be at risk for retention problems. Nurses with hearing disabilities were frustrated at work. Hearing difficulties increased with years spent working as a nurse. Many nurses with sensory disabilities have left nursing. Early intervention may prevent work instability and increase retention, and rehabilitation nurses are ideally positioned to lead early intervention programs.

The Reconceptualized Uncertainty in Illness Theory (RUIT) was used to investigate antecedents to, appraisals of, and ways of coping with stressful caregiving. Four focus groups with caregivers (8 males and 16 females) of relatives with dementia were conducted; 15 cared for their parents and the remainder cared for their spouses. They were recruited from an adult care center and other community settings in a metropolitan area in New England. The discussions were audiotaped and transcribed verbatim. Two researchers independently coded the transcripts. Thematic analysis was structured according to the RUIT. The study is unique in its application to caregivers as opposed to patients and to all of the elements of the RUIT. Caregivers experience uncertainty in similar ways to patients with life-altering illness. Symptom severity--lack of personal boundaries, repetitive and aggressive behaviors, and the need for constant care--was the most frequent source of stress. The appraisals were mostly negative and included feelings of resentment, a lack of support from family members, financial strains, and loss of freedom. Self-improvement and self-care were important aspects of coping. Spirituality and humor were other coping skills that respondents used. Not all respondents said they were coping and some also reported that support from health care providers was not always helpful. Nurses can help improve coping by explaining the factors that contribute to caregiver strain and uncertainty, and by assisting caregivers to anticipate the effects of the caregiving role.

To ensure the function of wireless sensor networks (WSNs), nodes that fail to forward packets must be localized efficiently and then fixed or replaced promptly. The state-of-the-art work frames lossy node localization in WSNs as an optimal sequential testing problem guided by end-to-end data. It combines both the active and passive measurements to minimize the testing cost and the number of iterations. However, this hybrid approach has many limitations. Inspired by the success of coverage-based software debugging, and the similarity between software debugging and lossy node localization, we propose a coverage-based lossy node detection for WSNs. Supported by established statistic theories, this approach greatly boosts the performance. Experiments on randomly generated networks and deployed networks show that the proposed algorithm can significantly reduce testing cost and number of iterations, which are the two optimization goals of previous work. We expect to use this approach for other diagnostic problems in WSNs. © 2001-2012 IEEE.

Triangulations of 3-dimensional polyhedron are partitions of the polyhedron with tetrahedra in a face-to-face fashion without introducing new vertices. Schönhardt (Math. Ann. 89:309–312, 1927), Bagemihl (Amer. Math. Mon. 55:411–413, 1948), Kuperberg (Personal communication 2011) and others constructed special polyhedra in such a way that clever one line geometric reasons imply nontriangulability. Rambau (Comb. Comput. Geom. 52:501–516, 2005) proved that twisted prisms over n-gons are nontriangulable. Our approach for proving polyhedra are nontriangulable is to show that partitions with tetrahedra, which we call tilings, do not exist even if the face-to-face-restriction is relaxed. First we construct a polyhedron which is tileable but is not triangulable. Then we revisit Rambau type twisted prisms. In fact we consider a slightly different class of polyhedra, and prove that these new twisted prisms are nontileable, thus are nontriangulable. We also show that one can twist the regular dodecahedron so that it becomes nontileable, which is abstracted to a new family of nontileable polyhedra, called nonconvex twisted pentaprisms. © 2015, The Managing Editors.

We study transformations of finite modules over Noetherian local rings that attach to a module M a graded module H(x)(M) defined via partial systems of parameters x of M. Despite the generality of the process, which are called j-transforms, in numerous cases they have interesting cohomological properties. We focus on deriving the Hilbert functions of j-transforms and studying the significance of the vanishing of some of its coefficients. Copyright © 2016 Cambridge Philosophical Society.

Motor vehicle accidents (MVA) are often difficult to distinguish from non-accidental injury (NAI). This retrospective case–control study compared animals with known MVA trauma against those with known NAI. Medical records of 426 dogs and cats treated after MVA and 50 after NAI were evaluated. Injuries significantly associated with MVA were pelvic fractures, pneumothorax, pulmonary contusion, abrasions, and degloving wounds. Injuries associated with NAI were fractures of the skull, teeth, vertebrae, and ribs, scleral hemorrhage, damage to claws, and evidence of older fractures. Odds ratios are reported for these injuries. MVA rib fractures were found to occur in clusters on one side of the body, with cranial ribs more likely to fracture, while NAI rib fractures were found to occur bilaterally with no cranial–caudal pattern. Establishing evidence-based patterns of injury may help clinicians differentiate causes of trauma and may aid in the documentation and prosecution of animal abuse. © 2016 American Academy of Forensic Sciences

We extend and unify most known results about guarding orthogonal polygons by introducing the same-sign diagonal graphs of a convex quadrangulation and applying results about vertex covers for graphs. Our approach also yields new theorems and often guarantees two disjoint vertex guard sets of relatively small cardinality. For instance, an orthogonal polygon on n vertices has two disjoint vertex guard sets of cardinality at most (Formula presented.). We give new proofs of Aggarwal’s one-hole theorem and the orthogonal fortress theorem. We prove that an orthogonal polygon with n vertices and any number of holes can be protected by at most (Formula presented.) vertex guards, improving the best known bound of (Formula presented.). Also, an orthogonal polygon with n vertices and h holes can be protected by (Formula presented.) guarded guards, which is best possible when (Formula presented.). Moreover, for orthogonal fortresses with n vertices, (Formula presented.) guarded guards are always sufficient and sometimes necessary. © 2016, Springer Science+Business Media New York (outside the USA).

Let P be an orthogonal polygon with n vertices, and let V⁎ and E⁎ be specified sets of vertices and edges of P. We prove that P has a guard set of cardinality at most ⌊(n+3|V⁎|+2|E⁎|)/4⌋ that includes each vertex in V⁎ and at least one point of each edge in E⁎. Our bound is sharp and reduces to the orthogonal art gallery theorem of Kahn, Klawe and Kleitman when V⁎ and E⁎ are empty. © 2016 Elsevier B.V.

Software components, which are vulnerable to being exploited, need to be identified and patched. Employing any prevention techniques designed for the purpose of detecting vulnerable software components in early stages can reduce the expenses associated with the software testing process significantly and thus help building a more reliable and robust software system. Although previous studies have demonstrated the effectiveness of adapting prediction techniques in vulnerability detection, the feasibility of those techniques is limited mainly because of insufficient training data sets. This paper proposes a prediction technique targeting at early identification of potentially vulnerable software components. In the proposed scheme, the potentially vulnerable components are viewed as mislabeled data that may contain true but not yet observed vulnerabilities. The proposed hybrid technique combines the supports vector machine algorithm and ensemble learning strategy to better identify potential vulnerable components. The proposed vulnerability detection scheme is evaluated using some Java Android applications. The results demonstrated that the proposed hybrid technique could identify potentially vulnerable classes with high precision and relatively acceptable accuracy and recall.

The set of the first Hilbert coefficients of parameter ideals relative to a module—its Chern coefficients—over a local Noetherian ring codes for considerable information about its structure–noteworthy properties such as that of Cohen-Macaulayness, Buchsbaumness, and of having finitely generated local cohomology. The authors have previously studied the ring case. By developing a robust setting to treat these coefficients for unmixed rings and modules, the case of modules is analyzed in a more transparent manner. Another series of integers arise from partial Euler characteristics and are shown to carry similar properties of the module. The technology of homological degree theory is also introduced in order to derive bounds for these two sets of numbers. © 2014, Institute of Mathematics, Vietnam Academy of Science and Technology (VAST) and Springer Science+Business Media Singapore.

Our purpose is to study the cohomological properties of the Rees algebras of a class of ideals generated by quadrics. For all such ideals I⊂. R=. K[. x, y, z] we give the precise value of depth. R[. It] and decide whether the corresponding rational maps are birational. In the case of dimension d≥. 3, when K=R, we give structure theorems for all ideals of codimension d minimally generated by (d+12)-1 quadrics. For arbitrary fields K, we prove a polarized version. © 2014 Elsevier Inc.