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2024

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Shame Clogs The Arteries Of Love: How To Love In The Face Of Shame And Conditions Of Oppression, Theodore J.M. Siasat Jan 2024

Shame Clogs The Arteries Of Love: How To Love In The Face Of Shame And Conditions Of Oppression, Theodore J.M. Siasat

CMC Senior Theses

Love and shame, on its face, are at odds with one another. Love tends to foster connection while shame makes one want to hide and isolate oneself. This thesis aims to resolve this tension, particularly in cases of mistaken shame, where the ashamed agent need not feel ashamed, such as in cases of internalized racism, sexism, etc. To do so, this thesis begins by exploring similar cases of love driving people away, looking at (1) love under conditions of oppression and (2) love as seen in Vida Yao’s “Grace and Alienation,” where she is also concerned with ashamed beloveds. …


U.S. Bankruptcy Courts Balance The Statutory Protections Of Stakeholders With The Needs Of Discovery In Foreign Bankruptcy Proceedings, Conor Carman Jan 2024

U.S. Bankruptcy Courts Balance The Statutory Protections Of Stakeholders With The Needs Of Discovery In Foreign Bankruptcy Proceedings, Conor Carman

Bankruptcy Research Library

(Excerpt)

Chapter 15 of title 11 of the United States Code (the "Bankruptcy Code") establishes methods for managing insolvency cases that encompass debtors, assets, claimants, and other parties across multiple nations. Section 1521(a)(4) allows courts to grant discovery relief. To determine whether to grant discovery relief, courts balance the right to discovery relief with stakeholder interests. As part of a U.S. courts’ analysis, it considers principles of comity to support a foreign bankruptcy proceeding.

This memorandum discusses the statutory availability for discovery relief under chapter 15, limitations on discovery imposed by courts to protect stakeholder interests, comity, and how courts …


Service Of A Subpoena Through Alternative Means: Social Media, Tayler Eynon Jan 2024

Service Of A Subpoena Through Alternative Means: Social Media, Tayler Eynon

Bankruptcy Research Library

(Excerpt)

Service of a subpoena via a means besides personal service, i.e., "alternative service," has been "routinely authorized" under Rule 45 of the Federal Rules. The functional purpose of requiring delivery is to "ensure receipt," which then allows the enforcement of a subpoena to be consistent with due process. With the development of new means of communication, however, an emerging issue has become whether service of a subpoena via social media may provide similar "evidence of actual receipt." Many courts have read Rule 45 broadly to allow for service of a subpoena through social media if certain fundamental requirements are …


Amended Proofs Of Claims That Present A New Request For Relief Could Be Disallowed, Lianna Meehan Jan 2024

Amended Proofs Of Claims That Present A New Request For Relief Could Be Disallowed, Lianna Meehan

Bankruptcy Research Library

(Excerpt)

When a creditor seeks to amend a proof of claim after the bar date has passed with an amount different to that provided in the original proof of claim, courts engage in an equitable analysis of multiple factors to determine whether to grant or deny the motion to amend. Under certain circumstances, Bankruptcy Rule 9006(b)(1) gives creditors an opportunity to file a proof of claim after the bar date has passed.

...

This memorandum examines whether a creditor can amend a timely-filed proof of claim after the bar date has passed with an amount that is unrelated to the …


How Sexual Health Knowledge Can Affect The Reproductive Behaviors Of Ethnic Minority Women, Bansari Modi Jan 2024

How Sexual Health Knowledge Can Affect The Reproductive Behaviors Of Ethnic Minority Women, Bansari Modi

Honors Undergraduate Theses

Background: Health knowledge plays a large role in health outcomes, especially those of racial and ethnic minorities. There is a lack of literature discussing the relation between sexual health knowledge obtained during adolescence and the reproductive behaviors of minority women later in life.

Purpose: To examine the association between sexual health knowledge during adolescence and subsequent contraception use among racial and ethnic minority women in adulthood.

Methods: Data from Waves I, III, and IV of the National Longitudinal Study if Adolescent to Adult Health (Add Health) was used to explore the relation between adolescent health knowledge and subsequent contraception use …


Decolonizing Yoga: Historical Perspectives And Contemporary Practices, Archana Ram Jan 2024

Decolonizing Yoga: Historical Perspectives And Contemporary Practices, Archana Ram

Honors Undergraduate Theses

Over the last few decades, yoga has become a multi-billion-dollar industry in the West. This industry is typically represented by glossy photographs of thin white women in physical postures. Given its religious origins in South Asia, this mass marketing of yoga has raised important questions about Western commodification and cultural appropriation. As a result, counter-movements have emerged to “Take Back Yoga” and “Honor the Cultural Roots of Yoga.” This thesis analyzes a range of critical-constructive responses to the commodification and colonization of yoga. It focuses on two case studies: Susanna Barkataki, an American yoga teacher of Indian descent, and Kallie …


Economic Policy Uncertainty And Its Impact On Unemployment Rates Among U.S. Ethnic Groups, Melody Shirley Nimoh Jan 2024

Economic Policy Uncertainty And Its Impact On Unemployment Rates Among U.S. Ethnic Groups, Melody Shirley Nimoh

Doctoral Dissertations (DBA)

The study aims to investigate the transmission of Economic Policy Uncertainty (EPU) shocks on unemployment rates across different ethnic groups in the United States. The research employs econometric analysis such as regression modeling to determine the relationship between EPU and unemployment rates among African American, Hispanic or Latino American, and White American communities. The study estimates coefficient estimates for the lagged change in EPU and its impact on respective unemployment rates for each ethnic group. This shows that there are statistically significant positive relationships between EPU shocks and unemployment rates across all ethnic groups. An increase in EPU leads to …


Synapsis: South Georgia Campus (2024), Philadelphia College Of Osteopathic Medicine Jan 2024

Synapsis: South Georgia Campus (2024), Philadelphia College Of Osteopathic Medicine

DO Yearbooks (1925-2019)

The 2024 South Georgia Campus Synapsis includes Student National Medical Association 2023-2024, White Coat, DO Class of 2024, DO Class of 2025, DO Class of 2026, DO Class of 2027, Master's of Biomedical Sciences Class of 2024 and 2025, Faculty and Staff, Student Ambassadors, Student Government Association, Student Osteopathic Medical Organization, Student Organizations Council, Student Ambassadors-Pathway Coordinators, Infectious Disease Society, Latino Medical Student Association (LMSA), Research Club, American Medical Women's Association (AMWA), Emergency Medical Club, Nutrition in Medicine, Pediatric Club, PsyCOM, Sports Medicine and Orthopedics Club, Wilderness Medicine Club, Wholistic Wellness Committee, Diversity Equity & Inclusion Council, Sisters in Medicine, …


Actionpoint: An App To Combat Cyberbullying By Strengthening Parent-Teen Relationships, Maddie Juarez, Natali Barragan, Deborah Hall, George K. Thiruvathukal, Yasin Silva Jan 2024

Actionpoint: An App To Combat Cyberbullying By Strengthening Parent-Teen Relationships, Maddie Juarez, Natali Barragan, Deborah Hall, George K. Thiruvathukal, Yasin Silva

Computer Science: Faculty Publications and Other Works

Overview: Urgent need for intervention tools to mitigate increase in cyberbullying • ActionPoint is based on parent-teen relationship research • App includes interactive modules to improve family communication and online behavior to combat cyberbullying effects • To be presented in the IEEE World Forum on Public Safety Technology 2024.


Understanding The Trafficking Of Children For The Purposes Of Labor In The United States, Amy Farrell, Meredith Dank, Katherine Kaufka Walts, Callie Hansson, Andrea Hughes, Chlece Neal Jan 2024

Understanding The Trafficking Of Children For The Purposes Of Labor In The United States, Amy Farrell, Meredith Dank, Katherine Kaufka Walts, Callie Hansson, Andrea Hughes, Chlece Neal

Center for the Human Rights of Children

No abstract provided.


Synthesis Of Cationic Liposome Nanoparticles Using A Thin Film Dispersed Hydration And Extrusion Method, Alessandro Cazzolla, Julie Rose Mae Mondala, Janith Wanigasekara, Joanna Carroll, Noah Daly, Brijesh Tiwari, Alan Casey, James F. Curtin Jan 2024

Synthesis Of Cationic Liposome Nanoparticles Using A Thin Film Dispersed Hydration And Extrusion Method, Alessandro Cazzolla, Julie Rose Mae Mondala, Janith Wanigasekara, Joanna Carroll, Noah Daly, Brijesh Tiwari, Alan Casey, James F. Curtin

Articles

Liposome nanoparticles can carry a wide range of therapeutic molecules including small molecules and nucleic acid-based therapeutics. Potential benefits include translocation across physiological barriers, reduced systemic toxicity, and enhanced pharmacokinetic parameters such as absorption, distribution, selective release and optimal elimination kinetics. Liposome nanoparticles can be generated with a wide range of natural and synthetic lipid-based molecules that confer desirable properties depending on the desired therapeutic application Nel et al (2023), Large (2021), Elkhoury (2020). This protocol article seeks to detail the procedures involved in the production of cationic liposomes using thin-film dispersed hydration method with an estimated uniform size of …


Synergistic Cytotoxicity Effect Of Ultrasound And Plasma Microbubble In Glioblastoma 3d Tumor Sphere Model, Janith Wanigasekara, Patrick J. Cullen, Brijesh Tiwari, James F. Curtin Jan 2024

Synergistic Cytotoxicity Effect Of Ultrasound And Plasma Microbubble In Glioblastoma 3d Tumor Sphere Model, Janith Wanigasekara, Patrick J. Cullen, Brijesh Tiwari, James F. Curtin

Articles

The combined application of ultrasound (US) and plasma microbubble (PMB) is a promising technology against glioblastoma (GBM). Here, we determined the effects of US and PMB (alone and combined) on U-251 MG GBM and A431 epidermoid carcinoma spheroids under different conditions. The synergistic treatment of US- and PMB-induced tumor sphere cell death in a time-, dose-, treatment frequency-, and reactive oxygen species dependent manner, while multiple treatments augmented this effect. Synergistic treatments significantly reduced three-dimensional GBM spheroid regrowth and cell proliferation while inducing cytotoxicity, spheroid shrinkage, and damage to the tumor microenvironment. PMB-induced cytotoxicity throughout the tumor sphere, likely via …


Loot Boxes May Exploit Gamers, But Their Sale Does Not Constitute Unlawful Gambling, John J. Chung Jan 2024

Loot Boxes May Exploit Gamers, But Their Sale Does Not Constitute Unlawful Gambling, John J. Chung

Law Faculty Scholarship

No abstract provided.


From Andy Warhol To Barbie: Copyright’S Fair Use Doctrine After Andy Warhol Foundation V. Goldsmith, Niki Kuckes Jan 2024

From Andy Warhol To Barbie: Copyright’S Fair Use Doctrine After Andy Warhol Foundation V. Goldsmith, Niki Kuckes

Law Faculty Scholarship

No abstract provided.


Leveraging Artificial Intelligence To Improve Data Configuration & Accuracy In Modern Flight Management Systems, Sreeram Chittayil Jan 2024

Leveraging Artificial Intelligence To Improve Data Configuration & Accuracy In Modern Flight Management Systems, Sreeram Chittayil

International Journal of Aviation, Aeronautics, and Aerospace

AI (Artificial intelligence) can automate the process of generating optimized flight routes using real-time data, such as AIRAC (Aeronautical Information Regulation and Control), significantly reducing the time needed for flight management tasks. While AIRAC data typically takes up to 28 days to refresh, AI could condense this process to just minutes, enhancing operational efficiency and ensuring pilots have timely and accurate flight information. The research includes practical experiments, prototype code, and visual case studies to demonstrate AI's role in optimizing FMS functions while addressing issues related to data input errors and human intervention. Key findings from trials show the algorithm's …


Performance Prism: A Comprehensive Framework For Performance Measurement In Aircraft Maintenance, Mohammed Timjerdine, Saoudi Taibi, Younes Moubachir Jan 2024

Performance Prism: A Comprehensive Framework For Performance Measurement In Aircraft Maintenance, Mohammed Timjerdine, Saoudi Taibi, Younes Moubachir

International Journal of Aviation, Aeronautics, and Aerospace

Aircraft maintenance is governed by rigorous safety requirements and high operational complexity, demanding robust performance measurement frameworks to ensure optimal maintenance practices. This paper investigates existing performance measurement methodologies within the sector, highlighting their limitations and the need for a more structured evaluation system. Through this critical analysis of current literature, the paper proposes the Performance Prism (PP) framework as a novel and potentially robust solution for assessing and enhancing aircraft maintenance performance. Because the PP framework integrates multiple dimensions of evaluation, it provides a holistic assessment of aircraft maintenance performance, thereby enhancing reliability, efficiency, and overall effectiveness. Using examples …


Prioritization Of Voluntary Silence Criteria In Military Aviation For The Sustainability Or Safety Superiority, Vildan Durmaz, Cüneyt Ceyran, Ebru Yazgan Jan 2024

Prioritization Of Voluntary Silence Criteria In Military Aviation For The Sustainability Or Safety Superiority, Vildan Durmaz, Cüneyt Ceyran, Ebru Yazgan

International Journal of Aviation, Aeronautics, and Aerospace

Since aviation is one of the sectors involving high levels of risk in today’s world, the presence of a safe working environment is crucial for both flight operations and aircraft maintenance services. Thus, it is vital for aviation workers to be aware of unsafe situations as well as dangers and potential risks in order to create a safe environment and establish an organizational safety culture. One of the fundamental components of such awareness is information, and voluntary reporting of this information as well as unsafe situations by aviation employees is one of the most important ways for managers to access …


Fatigue Reporting In Hellenic Skies: Attitudes, Barriers And Insights From Military, Commercial And General Aviation Pilots, Panagiotis Kioulepoglou, Katerina M. David, Vassilios Nikolaidis, Ilias Makris Jan 2024

Fatigue Reporting In Hellenic Skies: Attitudes, Barriers And Insights From Military, Commercial And General Aviation Pilots, Panagiotis Kioulepoglou, Katerina M. David, Vassilios Nikolaidis, Ilias Makris

International Journal of Aviation, Aeronautics, and Aerospace

Fatigue has long been a concern in aviation, especially today, with the ever-increasing traffic volume, pilot shortage, and operations that often disrupt the body’s natural biological rhythms. Despite the implementation of sophisticated fatigue reporting schemes, aviation organizations still face challenges, as many studies indicate that pilots often encounter barriers to effectively report their fatigue. As relevant research in Greece was scarce, the main objective of this study was to explore Greek pilots' attitudes towards fatigue reporting, identify the most significant barriers, and recommend mitigation measures based on the participants' perspectives. To that end, 18 semi-structured interviews were conducted and analyzed …


Just Culture In Aviation: A Metaphorical Study On Aircraft Maintenance Students, Ramazan Çoban, Cengiz Mesut Bükeç Jan 2024

Just Culture In Aviation: A Metaphorical Study On Aircraft Maintenance Students, Ramazan Çoban, Cengiz Mesut Bükeç

International Journal of Aviation, Aeronautics, and Aerospace

Just Culture, a sub-dimension of safety culture, has been a prominent and debated topic in aviation safety in recent years. Just culture signifies a work environment where employees are motivated to provide essential safety-related information, but a clear distinction must be made between acceptable and unacceptable behaviours. The aim of this study is to examine the fundamental characteristics of just culture in the aviation sector. The phenomenology method, one of the qualitative research designs, has been adopted in the study. Purposeful sampling was used in the selection of participants, with the sample consisting of 78 students studying in the aircraft …


Success Of Achieving Student Learning Objectives: Compressed Vs. Traditional Courses, Irene Miller, Timm Bliss Jan 2024

Success Of Achieving Student Learning Objectives: Compressed Vs. Traditional Courses, Irene Miller, Timm Bliss

International Journal of Aviation, Aeronautics, and Aerospace

Institutions of higher learning are offering varying course modalities to accommodate the changing needs of students. Notably, institutions of higher learning are offering an increasing number of compressed courses to meet student demand and remain competitive in higher education. The increase in the number of compressed classes presents the challenge of ensuring that similar academic rigor and breadth of knowledge are maintained in comparison to the traditional 16-week semester. The purpose of this research study was to determine if students enrolled in off-campus classes with compressed schedules are receiving a similar quality of instruction and achieving the equivalent student learning …


The Impact Of Corporate Social Responsibility On Airline Reputation And Passenger Satisfaction And Loyalty, Tamilla Curtis, Scott Ambrose, Wilfred S. Manuela Jr. Jan 2024

The Impact Of Corporate Social Responsibility On Airline Reputation And Passenger Satisfaction And Loyalty, Tamilla Curtis, Scott Ambrose, Wilfred S. Manuela Jr.

International Journal of Aviation, Aeronautics, and Aerospace

Aviation is a driving force of economic and social progress but has negative externalities such as carbon emissions and noise. This paper investigates passenger perceptions of airline corporate social responsibility and its impact on airline reputation and passenger satisfaction. Over 1,300 passenger responses were analyzed using the partial least squares model. The results indicate that the perception of corporate social responsibility influences airline reputation, customer satisfaction, and ultimately, customer loyalty. The findings suggest that focusing on corporate social responsibility initiatives leads to enhanced likeability among airline passengers above and beyond offering quality service. Moreover, likeability is the key aspect of …


Justifying The Cost Of Implementing Contactless Travel In Non-Primary Airports: A European Perspective, Sumeet Hassan Anwar Mr., Humna Asad Miss Jan 2024

Justifying The Cost Of Implementing Contactless Travel In Non-Primary Airports: A European Perspective, Sumeet Hassan Anwar Mr., Humna Asad Miss

International Journal of Aviation, Aeronautics, and Aerospace

In the wake of the COVID-19 pandemic, the aviation industry faces an unprecedented push towards digital transformation. This paper delves into the economic, operational, and safety imperatives of implementing contactless travel solutions in Europe's non-primary airports. By juxtaposing the substantial upfront costs against the long-term operational savings and improved passenger experience, the study presents a compelling financial justification for such investments. Drawing on case studies and current trends, the research demonstrates that, despite initial expenditures, the adoption of contactless technology is a prudent strategy that aligns with evolving consumer preferences and the heightened need for efficiency and safety. The paper …


Passenger Preferences For Ultra Long Haul Flights Vs. Connecting Flights: A Comparative Study Between Asia And Europe, Sumeet Hassan Anwar Mr., Humna Asad Miss Jan 2024

Passenger Preferences For Ultra Long Haul Flights Vs. Connecting Flights: A Comparative Study Between Asia And Europe, Sumeet Hassan Anwar Mr., Humna Asad Miss

International Journal of Aviation, Aeronautics, and Aerospace

This study looks at passenger preferences in air travel, specifically ultra-long-haul and connecting flights, utilizing a comparative lens between Asia and Europe. It investigates how economic conditions, cultural differences, and regional infrastructure affect flight choices. According to the findings, Asian travelers prefer connecting flights that use hub-and-spoke networks because they are more affordable, whereas European tourists choose direct flights for time efficiency. Furthermore, the interaction between purchasing power and travel intent has a major impact on flight preferences, with business travelers favoring full-service carriers and leisure travelers preferring low-cost options. Cultural factors also influence these decisions, altering airline loyalty, service …


The Value Addition Of National Civil Aviation Policy Implementation To Airport Development In Nigeria: A Qualitative Assessment, Salisu Ojonemi Paul Phd, Prof. Chikelue Ofuebe Phd Jan 2024

The Value Addition Of National Civil Aviation Policy Implementation To Airport Development In Nigeria: A Qualitative Assessment, Salisu Ojonemi Paul Phd, Prof. Chikelue Ofuebe Phd

International Journal of Aviation, Aeronautics, and Aerospace

Through “Top Down theory of Implementation,” the study assessed the extent to which the implementation of NCAP 2013 has enhanced infrastructural transformation of airports in Nigeria. The paper discussed how the sector witnessed an accelerated infrastructural development, which situated the industry. With case study design and qualitative approach method, we found that the implementation of the policy was not discontinued. That facilitated ICAO certification of airports in Nigeria. The paper recommended the creation of Civil Airports Infrastructural Maintenance Standing Committee whose membership should be drawn from all the critical stakeholders in the industry with the responsibility of periodic turnaround maintenance.


A Scale Development Study For Evaluating The Competency Perception Of Air Traffic Controllers, Arif Tuncal, Ertan Çinar Jan 2024

A Scale Development Study For Evaluating The Competency Perception Of Air Traffic Controllers, Arif Tuncal, Ertan Çinar

International Journal of Aviation, Aeronautics, and Aerospace

Ensuring the competencies that influence the performance of air traffic controllers is a key priority for the aviation sector in terms of flight safety. Notwithstanding the efforts of international organizations, the absence of a statistically valid and reliable scale in the academic literature for the measurement of air traffic controllers’ competency perceptions signifies a notable gap. The aim of the study was to develop a scale for measuring air traffic controller competency. The study sample comprised 482 air traffic controllers. Following semi-structured interviews and document analysis, an item pool was established, ensuring content validity through expert input, with a CVR …


Sofa-Surfing: The Cartographies Of Young People Utilising Host-Dependent Shelter., Kieran Green Jan 2024

Sofa-Surfing: The Cartographies Of Young People Utilising Host-Dependent Shelter., Kieran Green

School of Geography, Earth and Environmental Sciences Theses

In 2016, 35% of UK young people (16-25 years) reported having sofa-surfed in the past. Past research highlights that spaces where people sofa-surfing stay are often tenuous, short-lived and worsen over time, reducing mental health, educational attainment, and the ability to find work (McLoughlin, 2013; Albanese et al., 2018). However, a study has not elucidated how young people’s preferences, identities, experiences, and access to support create highly varied sofa-surfing geographies and outcomes. This study examined young people's different geographical experiences and outcomes of sofa-surfing. Specifically, I outline key sofa-surfing experiences centred on uses of space, mobility, and identity (cartographies) and …


Success Factors Facilitating Care During Escalation (The Suffice Study), Jody Ede Jan 2024

Success Factors Facilitating Care During Escalation (The Suffice Study), Jody Ede

School of Nursing and Midwifery Theses

BACKGROUND: In the United Kingdom, there continues to be preventable National Health Service (NHS) patient deaths. Contributory factors include inadequate recognition of deterioration, poor monitoring, or delayed escalation to a higher level of care. Strategies to improve care escalation, such as vital sign scoring systems and specialist teams who manage deterioration events, have shown variable impact on patient mortality. The need for greater care improvements has consistently been identified in NHS care reviews as well as patient stories. Furthermore, current research informing escalation improvements predominantly comes from examining failure to rescue events, neglecting what can be learned from rescue or …


An Exploration Of Preconception Care For People With Health Conditions Using Realist Methodology: What Works, For Whom, And In What Circumstances?, Heather Hopper Jan 2024

An Exploration Of Preconception Care For People With Health Conditions Using Realist Methodology: What Works, For Whom, And In What Circumstances?, Heather Hopper

School of Nursing and Midwifery Theses

Background: People living with pre-existing physical or mental health conditions are over-represented in audits and confidential enquiries regarding maternal morbidity and mortality and thus often advised to stabilise or optimise their health prior to becoming pregnant. Preconception care may include medication or behaviour change, which can be effective but not always accessed by those who need it, and there is a lack of evidence demonstrating how this can be achieved. The aim of this study was therefore to explore what form of preconception care for people living with health conditions works, for whom, how do these approaches work, and in …


Navigating A Complex Transition: From Qualifying As A Nurse To Becoming A Confident Practitioner., Rachel Pascoe Jan 2024

Navigating A Complex Transition: From Qualifying As A Nurse To Becoming A Confident Practitioner., Rachel Pascoe

School of Nursing and Midwifery Theses

This thesis explores the complexities of transition to professional practice of newly qualified nurses following an undergraduate professional preparation programme. Transition to professional practice from student to qualified nurse and then to confident practitioner has been explored since the late 1960s and is recognised as a complex and multi-faceted issue for the newly qualified nurses. They can feel unprepared for clinical practice and for the organisational demands who require competent and confident personnel to join the workforce. Adopting a social constructionist approach, this study utilises a combination of diaries and interviews to gain a deeper understanding of the experiences and …


Development And Validation Of A Patient-Reported Experience Measure For Older Adults Attending The Emergency Department: The Prem-Ed 65 Study, Blair Graham Jan 2024

Development And Validation Of A Patient-Reported Experience Measure For Older Adults Attending The Emergency Department: The Prem-Ed 65 Study, Blair Graham

School of Nursing and Midwifery Theses

Emergency Department (ED) care traditionally focuses on resolving single-organ pathology, emphasising rapid patient flow. As such, ED care may fall short of addressing the holistic needs of older adults, where atypical and complex presentations exacerbated by frailty, comorbidity, polypharmacy, and sensory deficits are much more prevalent than in the general population. Older adults are particularly vulnerable to the effects of ED crowding and prolonged length of ED stay and suffer increased in-hospital mortality as a result.Patient experience is a central determinant of quality of care and is positively associated with improved outcomes for acute conditions, including pneumonia, asthma, and acute …