Digital Commons Network^™

The Factors Affecting The Profitability Of Banks: The Case Of Latvia, Kristina Bojāre, Inna Romānova

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No abstract provided.

Suspension Of Payments, Guichet.Lu

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No abstract provided.

Danish Marketing Practices Act, Danish Parliament

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No abstract provided.

State Capture: The Case Of The Republic Of Moldova, Transparency International Moldova, Adept, Legal Resources Center From Moldova, Institute For Development And Social Initiatives

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No abstract provided.

Annual Report 2016, Société Fédérale De Participations Et D’Investissement (Sfpi)

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No abstract provided.

Annual Report 2016, Bank Of Italy

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No abstract provided.

Annual Report 2016 (Belfius), Belfius Bank

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No abstract provided.

Annual Report 2016, Dexia Group N.V./S.A.

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No abstract provided.

Uv-Induced Somatic Mutations Elicit A Functional T Cell Response In The Yummer1.7 Mouse Melanoma Model, Jake Xiao Wang

Yale Medicine Thesis Digital Library

Human melanomas exhibit relatively high somatic mutation burden compared to other malignancies. These somatic mutations may produce neoantigens that are recognized by the immune system, leading to an anti-tumor response. By irradiating a parental mouse melanoma cell line carrying three driver mutations with UVB and expanding a single cell-derived clone, we generated a mutagenized model that exhibits high somatic mutation burden. When inoculated at low cell numbers in immunocompetent C57BL/6J mice, YUMMER1.7 (YUMM Exposed to Radiation) regresses after a brief period of growth. This regression phenotype is dependent on T cells as YUMMER1.7 tumors grow significantly faster in immunodeficient Rag1-/- …

Frequently Asked Questions About Covered Bonds, Morrison And Foerster Llp

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No abstract provided.

Sareb Activity Report First Half 2017, Sareb

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First half report including Executive Summary, What is SAREB?, Corporate Governance, Business Model, Main Figures, Business Performance, and Repayment of Senior Debt.

Sareb Fact Sheet, Sareb

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No abstract provided.

Of A Healthy Constitution: Socialized Medicine Between The Triumphs Of Social Security And Medicare, Sarah D. Kim

Harvey M. Applebaum ’59 Award

No abstract provided.

Kissinger’S Strategy In The Iraqi Kurdish Rebellion Of 1972-75: False Start Or Foundation Of American-Kurdish Partnership?, Jonathan C. Esty

Harvey M. Applebaum ’59 Award

No abstract provided.

Understanding The Positive Correlates Of Veteran Suicide: A Review And Call For Research, Kevin R. Driscoll

Yale School of Nursing Digital Theses

Aristotle’s saying “the whole is greater than the sum of its parts” is as true today as it was in the mid 300 B.C., especially when it comes to making federal healthcare policy decisions. The Veterans Administration is facing an epidemic amongst its veteran population and is looking for novel ways to ensure “no solider is left behind” despite a complex data structure that makes it hard to extrapolate rates of suicide.

An epidemiologic approach grounded in the understanding of patterns as well as identifying the risk factors for suicide is at the epicenter for a population health approach. Positive …

Prediction Of Adverse Outcomes After Rt-Pa Treatment In Ischemic Stroke Patients, David Asuzu

Yale Medicine Thesis Digital Library

IV thrombolysis (rt-PA) for ischemic stroke treatment carries a substantial risk for symptomatic intracerebral hemorrhage (sICH) and adverse outcome. Our purpose was to develop a computationally simple and accurate clinical predictor of adverse outcome after rt-PA therapy.

Our derivation dataset consisted of 210 ischemic stroke patients receiving IV rt-PA from January 2009 until July 2013 at Yale New Haven Hospital. Our validation dataset included 303 patients who received IV rt-PA during the NINDS rt-PA trial. Predictive ability and goodness of fit were quantified by odds ratios (OR) and areas under the receiver operating characteristic curve (AUROC). Patient outcomes included sICH, …

Racial Disparities In Renal Cell Carcinoma: A Single Payer Healthcare Experience, Abiodun Mafolasire

Yale Medicine Thesis Digital Library

Introduction: Significant racial disparities in survival for renal cell carcinoma (RCC) exist between whites and blacks. Differences in access to care and comorbidities are possible contributors. To investigate if racial disparities persist when controlling for access to care, we analyzed data from a single payer healthcare system.

Methods: As part of a case-control study within the Kaiser Permanente Northern California system, pathologic and clinical records were obtained for RCC cases (2,152 white, 293 black) diagnosed from 1998 to 2008. Patient demographics, comorbidities, tumor characteristics, and treatment status were compared between whites and blacks. Overall survival and disease specific survival (DSS) …

Small Estimated Placental Volume Predicts Low Birthweight, Kimberly Marie Murdaugh

Yale Medicine Thesis Digital Library

The objective of the study was to validate Estimated Placental Volume (EPV) in a

population of patients at Yale-New Haven Hospital (YNHH) across a range of gestational

ages, and to evaluate the association between small EPV and low birthweight (BW). From

2009 to 2011, 366 patients at YNHH received ultrasound scans between 11+0 to 38+6

weeks gestational age (GA) to measure placental dimensions from 2009 to 2011. EPVs were

calculated using a previously validated convex-concave shell equation. An EPV vs GA best

fit curve was generated. The relationship between EPV and BW was analyzed. Subgroup

analyses were performed to evaluate …

The Application Of Small Molecule Inhibitors Of Ngr1 And Lpa1 Towards The Goal Of Neuroregeneration In The Central Nervous System, Hiam Naiditch

Yale Medicine Thesis Digital Library

Disorders affecting the CNS are significantly disabling and often carry a poor prognosis of functional recovery. Pharmacotherapies that promote functional improvement via neuroregeneration have proven to be an elusive goal. Factors intrinsic to the neuronal microenvironment, particularly myelin-associated proteins such as Nogo-A, MAG, and OMgp, have been shown to be important in inhibiting such regeneration through neuronal NgR1. Additionally, LPA signaling through LPA1 has also shown to be important in inhibiting neuroregeneration through mechanisms that are currently being researched.

It has been previously shown that application of a NgR1 decoy receptor (AA-NgR(310)ecto-Fc) increases sprouting below the site of the lesion …

Longitudinal Assessment Of Blood Brain Barrier Disruption In Primary Hiv Infection And Effect Of Cart Therapy, Elham Rahimy

Yale Medicine Thesis Digital Library

Abnormal blood brain barrier (BBB) permeability has been implicated in the neuropathogenesis of chronic HIV infection. As neurocognitive impairment can persist despite effective combination antiretroviral therapy (cART), it is possible that irreversible central nervous system (CNS) processes are initiated in early infection, before cART is typically initiated. We analyzed the natural history of BBB permeability in primary HIV infection (PHI), and the effects of cART initiated during this period. CSF:Serum albumin quotient (QAlb), a marker of BBB permeability, was measured in longitudinal observational studies of PHI. We analyzed trajectories of QAlb pre- and post-cART using mixed-effects models, and associations between …

Prioritizing Primary Prevention Strategies For Cardiovascular Disease At The Clinic Population Level, Giulio Cesare Rottaro Castejon

Yale Medicine Thesis Digital Library

Cardiovascular Disease remains the number one cause of mortality in the United States with atherosclerotic cardiovascular disease (ASCVD) being a major component. Lifestyle interventions remain the first line treatment for the prevention of ASCVD, and clinic- based interventions effectively improve rates of healthy lifestyle choices. However, these programs require additional resources and there is currently no guidance for clinic directors to understand what lifestyle intervention(s) have the highest value for their unique population. We propose a novel application of the 10-year ASCVD risk calculator to a clinic patient cohort, thereby acting as a tool for providers and administrators to develop …

Identifying Barriers To Implementing Guidelines For Monitoring Metabolic Syndrome In Patients Prescribed Second-Generation Antipsychotics In Incarcerated Populations, Carol-Ann Margaret Cenac

Yale School of Nursing Digital Theses

Individuals with serious mental illness (SMI) have increased rates of cardiovascular disease (CVD) and mortality. Also, the evidence indicates that second-generation antipsychotics (SGAs, a conventional treatment) increase the risk of metabolic syndrome (MetS) often leading to weight gain, cardiovascular disease (CVD) and type 2 diabetes (DM 2). U. S. correctional institutions, faced with increased rates of mental illness in its population, are confronted with the need to assure adequate monitoring for its patients treated with SGAs. This paper reviews guidelines for monitoring incarcerated patients to ensure early intervention that can improve clinical outcomes. Characteristics of the incarcerated population and institution-related …

Exploratory Descriptive Review Of Certified Nurse-Midwifery Outcomes Related To Scope Of Practice Legislation, Rebecca Huffer Burpo

Yale School of Nursing Digital Theses

.Abstract

Limited access to care and rising perinatal mortality rates have pivoted attention once again to practice barriers. Despite numerous studies reporting that CNM care is equal quality to physician care for the scope of practice provided, legislated restrictions remain in 25 states. The goal of this project was to determine if legislated restrictions affect the outcomes of care provided by midwives. Following a literature search, a retrospective descriptive review of “before and after” perinatal outcomes following midwifery care in three states was conducted. Three years of data from the period when the state had some form of supervisory regulation …

Improving Provider Compliance With Adult Inflammatory Bowel Disease Patient Care Guidelines In The Ambulatory Setting Through The Use Of Electronic Health Records, Nana Bernasko

Yale School of Nursing Digital Theses

Electronic Health Record (EHR) systems have the ability to improve the quality of patient care, patient safety and provide benefits to providers and clinic practices. These systems can transform quality measurement and quality improvement methods, facilitate workflow, and track patients over time to ensure that they receive guideline-recommended, and evidence-based, care. Simply having an EHR system, however, may not be enough to improve the quality and safety of healthcare, especially if the system is not designed to include features specific to the treatment population. In terms of the complex care necessary to treat adult patients with inflammatory bowel disease (IBD), …

Identifying Barriers To Implementing Guidelines For Monitoring Metabolic Syndrome In Patients Prescribed Second-Generation Antipsychotics In Incarcerated Populations, Carol-Ann Margaret Cenac

Yale School of Nursing Digital Theses

Individuals with serious mental illness (SMI) have increased rates of cardiovascular disease (CVD) and mortality. Also, the evidence indicates that second-generation antipsychotics (SGAs, a conventional treatment) increase the risk of metabolic syndrome (MetS) often leading to weight gain, cardiovascular disease (CVD) and type 2 diabetes (DM 2). U. S. correctional institutions, faced with increased rates of mental illness in its population, are confronted with the need to assure adequate monitoring for its patients treated with SGAs. This paper reviews guidelines for monitoring incarcerated patients to ensure early intervention that can improve clinical outcomes. Characteristics of the incarcerated population and institution-related …

Increasing Access To Evidence-Based Pediatric Palliative Care Through Continuing Education Of Nurses, Taryn J. Hamre

Yale School of Nursing Digital Theses

BACKGROUND

Each year approximately 42,000 children die and 400,000 children cope with chronic or life threatening illnesses in the U.S. Improved access to evidence based pediatric palliative care is essential to ease suffering, manage distressing symptoms and to improve quality of life.

METHODS

A literature review was conducted. A panel of national pediatric palliative care experts validated and rated educational subcategories identified in the review in accordance to relevance and importance.

RESULTS

The panel of experts rated 25 of 53 sub categories with a 0.78 percent agreement in both relevance and importance. Nine of those twenty-five sub categories had 100% …

Team-Based Care To Support Physiologic Birth: A Review Of Literature, Annemarie Heath

Yale School of Nursing Digital Theses

Abstract

Introduction: Physiologic birth practices support the normal processes of childbirth, are associated with improved outcomes, and can prevent unnecessary intervention. Defensive maternity practice contributes to the overuse of medical interventions and decrease in physiologic birth practices. Team-based maternity care has been studied as a method to improve safety through improved communication and teamwork skills. The purpose of this literature review was to explore whether team-based care can be used as a strategy to promote physiologic birth through decreasing defensive maternity practices.

Methods: The search engines OVID, CINAHL, Pub Med, Google Scholar and the Cochrane Library were used to identify …

Developing Dual Diagnosis Care Curriculum For Nurses In Acute Psychiatric Inpatient Settings, Kofi Ahumkah Bonnie

Yale School of Nursing Digital Theses

Patients with co-existing substance use and mental disorder (dual diagnosis) have complex and challenging care needs especially in acute psychiatric inpatient settings. Acute psychiatric care plays a vital role in mental health service delivery and there is evidence that nurses working in these settings often have unmet learning needs regarding dual diagnosis care, posing a challenge to nursing practice. The purpose of this project was to develop an educational module which will equip nurses with the skills and knowledge required to deliver evidence-based dual diagnosis care in acute psychiatric settings. A survey of 74 acute psychiatric nurses was initially completed …

The Ebola Experience: Media Lessons For Nurse Leaders, Elizabeth Leary

Yale School of Nursing Digital Theses

Background: In October, 2014 the nursing profession gained unprecedented media attention when two nurses became infected with the Ebola virus, and another nurse who cared for Ebola patients defied two gubernatorial quarantine orders. Nurses have traditionally received little media attention, and the nursing profession was largely unprepared for the intense media scrutiny which occurred during the Ebola crisis.

Purpose: For decades nursing scholars have called for a new media image for the nursing profession, yet most of the nursing literature has focused on the profession’s poor media image rather than effective media communication techniques. The purpose of this paper is …

Adapting An Evidence-Based Pediatric Acute Asthma Exacerbation Severity Assessment Tool For Pediatric Primary Care, Anne Tipay Magpuri

Yale School of Nursing Digital Theses

Abstract

Introduction: The purpose of this project was to examine criteria derived from evidence-based pediatric acute asthma exacerbation assessment tools, asthma scores, and the acute asthma prediction rule validated and utilized in the emergency department and to adapt these criteria for pediatric primary care.

Method: Three stages of the project included: (1) identification of criteria in a literature review, (2) validation of the criteria by an expert panel, and (3) adaptation of the criteria in the design of an assessment tool.

Results: The criteria were validated and adapted in the design of “The Pediatric Acute Asthma Exacerbation Severity Assessment and …