Software Support during a Control Room Upgrade

DOE Office of Scientific and Technical Information (OSTI.GOV)

Michele Joyce; Michael Spata; Thomas Oren

2005-09-21

In 2004, after 14 years of accelerator operations and commissioning, Jefferson Lab renovated its main control room. Changes in technology and lessons learned during those 14 years drove the control room redesign in a new direction, one that optimizes workflow and makes critical information and controls available to everyone in the control room. Fundamental changes in a variety of software applications were required to facilitate the new operating paradigm. A critical component of the new control room design is a large-format video wall that is used to make a variety of operating information available to everyone in the room. Analogmore » devices such as oscilloscopes and function generators are now displayed on the video wall through two crosspoint switchers: one for analog signals and another for video signals. A new software GUI replaces manual configuration of the oscilloscopes and function generators and helps automate setup. Monitoring screens, customized for the video wall, now make important operating information visible to everyone, not just a single operator. New alarm handler software gives any operator, on any workstation, access to all alarm handler functionality, and multiple users can now contribute to a single electronic logbook entry. To further support the shift to distributed access and control, many applications have been redesigned to run on servers instead of on individual workstations.« less

Recommendations to Improve Employee Thermal Comfort When Working in 40°F Refrigerated Cold Rooms.

PubMed

Ceballos, Diana; Mead, Kenneth; Ramsey, Jessica

2015-01-01

Cold rooms are commonly used for food storage and preparation, and are usually kept around 40°F following food safety guidelines. Some food preparation employees may spend 8 or more hours inside cold rooms. These employees may not be aware of the risks associated with mildly cold temperatures, dampness, and limited ventilation. We performed an evaluation of cold rooms at an airline catering facility because of concerns with exposure to cold temperatures. We spoke with and observed employees in two cold rooms, reviewed daily temperature logs, evaluated employee's physical activity, work/rest schedule, and protective clothing. We measured temperature, percent relative humidity, and air velocities at different work stations inside the cold rooms. We concluded that thermal comfort concerns perceived by cold room employees may have been the result of air drafts at their workstations, insufficient use of personal protective equipment due to dexterity concerns, work practices, and lack of knowledge about good health and safety practices in cold rooms. These moderately cold work conditions with low air velocities are not well covered in current occupational health and safety guidelines, and wind chill calculations do not apply. We provide practical recommendations to improve thermal comfort of cold room employees. Engineering control recommendations include the redesigning of air deflectors and installing of suspended baffles. Administrative controls include the changing out of wet clothing, providing hand warmers outside of cold rooms, and educating employees on cold stress. We also recommended providing more options on personal protective equipment. However, there is a need for guidelines and educational materials tailored to employees in moderately cold environments to improve thermal comfort and minimize health and safety problems.

Recommendations to Improve Employee Thermal Comfort When Working in 40°F Refrigerated Cold Rooms

PubMed Central

Ceballos, Diana; Mead, Kenneth; Ramsey, Jessica

2015-01-01

Cold rooms are commonly used for food storage and preparation, and are usually kept around 40°F following food safety guidelines. Some food preparation employees may spend 8 or more hours inside cold rooms. These employees may not be aware of the risks associated with mildly cold temperatures, dampness, and limited ventilation. We performed an evaluation of cold rooms at an airline catering facility because of concerns with exposure to cold temperatures. We spoke with and observed employees in two cold rooms, reviewed daily temperature logs, evaluated employee’s physical activity, work/rest schedule, and protective clothing. We measured temperature, percent relative humidity, and air velocities at different work stations inside the cold rooms. We concluded that thermal comfort concerns perceived by cold room employees may have been the result of air drafts at their workstations, insufficient use of personal protective equipment due to dexterity concerns, work practices, and lack of knowledge about good health and safety practices in cold rooms. These moderately cold work conditions with low air velocities are not well covered in current occupational health and safety guidelines, and wind chill calculations do not apply. We provide practical recommendations to improve thermal comfort of cold room employees. Engineering control recommendations include the redesigning of air deflectors and installing of suspended baffles. Administrative controls include the changing out of wet clothing, providing hand warmers outside of cold rooms, and educating employees on cold stress. We also recommended providing more options on personal protective equipment. However, there is a need for guidelines and educational materials tailored to employees in moderately cold environments to improve thermal comfort and minimize health and safety problems. PMID:25961447

TeamSTEPPS Improves Operating Room Efficiency and Patient Safety.

PubMed

Weld, Lancaster R; Stringer, Matthew T; Ebertowski, James S; Baumgartner, Timothy S; Kasprenski, Matthew C; Kelley, Jeremy C; Cho, Doug S; Tieva, Erwin A; Novak, Thomas E

2016-09-01

The objective was to evaluate the effect of TeamSTEPPS on operating room efficiency and patient safety. TeamSTEPPS consisted of briefings attended by all health care personnel assigned to the specific operating room to discuss issues unique to each case scheduled for that day. The operative times, on-time start rates, and turnover times of all cases performed by the urology service during the initial year with TeamSTEPPS were compared to the prior year. Patient safety issues identified during postoperative briefings were analyzed. The mean case time was 12.7 minutes less with TeamSTEPPS (P < .001). The on-time first-start rate improved by 21% with TeamSTEPPS (P < .001). The mean room turnover time did not change. Patient safety issues declined from an initial rate of 16% to 6% at midyear and remained stable (P < 0.001). TeamSTEPPS was associated with improved operating room efficiency and diminished patient safety issues in the operating room. © The Author(s) 2015.

Report: EPA’s Radiation and Indoor Environments National Laboratory Should Improve Its Computer Room Security Controls

EPA Pesticide Factsheets

Report #12-P-0847, September 21, 2012.Our review of the security posture and in-place environmental controls of EPA’s Radiation and Indoor Environments National Laboratory computer room disclosed an array of security and environmental control deficiencies.

CONTROL ROOM WITH SPRINKLER SYSTEM CONTROLS, INCLUDING MANUAL CONTROL BOXES ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

CONTROL ROOM WITH SPRINKLER SYSTEM CONTROLS, INCLUDING MANUAL CONTROL BOXES FOR THE VENTILATION SYSTEM AND A PLC SWITCH FOR AUTOMATIC CO (CARBON MONOXIDE) SYSTEM. THE AIR TESTING SYSTEM IS FREE STANDING AND THE FANS ARE COMPUTER-OPERATED. - Alaskan Way Viaduct and Battery Street Tunnel, Seattle, King County, WA

75 FR 67450 - Pipeline Safety: Control Room Management Implementation Workshop

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-02

... PHMSA-2010-0294] Pipeline Safety: Control Room Management Implementation Workshop AGENCY: Pipeline and...) on the implementation of pipeline control room management. The workshop is intended to foster an understanding of the Control Room Management Rule issued by PHMSA on December 3, 2009, and is open to the public...

A Business Case for Nuclear Plant Control Room Modernization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas, Ken; Lawrie, Sean; Niedermuller, Josef M.

This paper presents a generic business case for implementation of technology that supports Control Room Modernization (CRM). The analysis presented in two forms; 1) a standalone technology upgrade, and 2) a technology upgrade that is built upon and incremental to a prior business case created for Mobile Work Packages (MWP). The business case contends that advanced communication and networking and analytical technologies will allow NPP to conduct control room operations with improved focus by reducing human factors and redundant manpower, and therefore operate with fewer errors. While some labor savings can be harvested in terms of overtime, the majority ofmore » savings are demonstrated as reduced time to take the plant off line and bring back on line in support of outages. The benefits are quantified to a rough order of magnitude that provides directional guidance to NPPs that are interested in developing a similar business case. This business case focuses on modernization of the operator control room and does not consider a complete overhaul and modernization of a plants instrument and control systems. While operators may be considering such an investment at their plants, the sizable capital investment required is not likely supported by a cost/benefit analysis alone. More likely, it is driven by obsolescence and reliability issues, and requires consideration of mechanical condition of plant systems, capital depreciation, financing, relicensing and overall viability of the plant asset over a 20-year horizon in a competitive market. Prior studies [REF] have indicated that such a modernization of plant I&C systems, alone or as part of a larger modernization effort, can yield very significant reductions in O&M costs. However, the depth of research and analysis required to develop a meaningful business case for a plant modernization effort is well beyond the scope of this study. While CRM as considered in this study can be easily integrated as part of grander plant

Engine Research Building’s Central Control Room

NASA Image and Video Library

1948-07-21

Operators in the Engine Research Building’s Central Control Room at the National Advisory Committee for Aeronautics (NACA) Lewis Flight Propulsion Laboratory. The massive 4.25-acre Engine Research Building contains dozens of test cells, test stands, and altitude chambers. A powerful collection of compressors and exhausters located in the central portion of the basement provided process air and exhaust for these test areas. This system is connected to similar process air systems in the laboratory’s other large test facilities. The Central Control Room coordinates this activity and communicates with the local utilities. This photograph was taken just after a major upgrade to the control room in 1948. The panels on the wall contain rudimentary floor plans of the different Engine Research Building sections with indicator lights and instrumentation for each test cell. The process air equipment included 12 exhausters, four compressors, a refrigeration system, cooling water, and an exhaust system. The operators in the control room kept in contact with engineers running the process air system and those conducting the tests in the test cells. The operators also coordinated with the local power companies to make sure enough electricity was available to operate the powerful compressors and exhausters.

75 FR 69912 - Pipeline Safety: Control Room Management/Human Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-16

... 192 and 195 [Docket ID PHMSA-2007-27954] RIN 2137-AE64 Pipeline Safety: Control Room Management/Human... rulemaking; Extension of comment period. SUMMARY: On September 17, 2010, PHMSA published a Control Room... Control Room Management/Human Factors rule at 49 CFR 192.631 and 195.446. The NPRM proposes to expedite...

Future of operating rooms.

PubMed

Reijnen, Michel M P J; Zeebregts, Clark J; Meijerink, Wilhelmus J H J

2005-01-01

Operating-room design has not changed significantly since the modern era of surgery began. Minimal invasive, endoscopic, procedures, and evolution of technology will affect operating-room design in the near future. Poor ergonomics has always been one of the major drawbacks of endoscopic surgery. Use of retractable arms and monitors will improve ergonomics of the operating team. Developments in telecommunication will allow surgeons to communicate with colleagues and experts during the procedure in virtually any location around the world, which increases teaching possibilities and procedural safety. Introduction and further development of intraoperative imaging, including real-time, three-dimensional (3-D) reconstructions of patient, and computer-aided surgery offer surgeons the opportunity to train the planned surgical procedure. Moreover, they will improve control and supervision of the procedure in learning situations. The last decade's robotics have made their introduction into the operating rooms. They improve control over the operating-room environment and will facilitate the performance of more complex procedures. However, high costs and lack of force feedback remain its major drawbacks. Improvements of robotic techniques and its implementation into the operating rooms will further guide their design into highly specialized operating units.

The application of a "6S Lean" initiative to improve workflow for emergency eye examination rooms.

PubMed

Nazarali, Samir; Rayat, Jaspreet; Salmonson, Hilary; Moss, Theodora; Mathura, Pamela; Damji, Karim F

2017-10-01

Ophthalmology residents on call at the Royal Alexandra Hospital identified workplace disorganization and lack of standardization in emergency eye examination rooms as an impediment to efficient patient treatment. The aim of the study was to use the "6S Lean" model to improve workflow in eye examination rooms at the Royal Alexandra Hospital. With the assistance of quality improvement consultants, the "6S Lean" model was applied to the current operation of the emergency eye clinic examination rooms. This model, considering 8 waste categories, was then used to recommend and implement changes to the examination rooms and to workplace protocols to enhance efficiency and safety. Eye examination rooms were improved with regards to setup, organization of supplies, inventory control, and maintenance. All targets were achieved, and the 5S audit checklist score increased by 33 points from 44 to 77. Implementation of the 6S methodology is a simple approach that removes inefficiencies from the workplace. The ophthalmology clinic removed waste from all 8 waste categories, increased audit results, mitigated patient and resident safety risks, and ultimately redirected resident time back to patient care delivery. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

IET control building (TAN620). control room. facing north. control consoles ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

IET control building (TAN-620). control room. facing north. control consoles have been removed. Openings in floor were communication and control conduits. Periscope controls at center left (see also HAER No. ID-33-E-20). INEEL negative no. HD-21-3-1 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Operating room efficiency improvement after implementation of a postoperative team assessment.

PubMed

Porta, Christopher R; Foster, Andrew; Causey, Marlin W; Cordier, Patricia; Ozbirn, Roger; Bolt, Stephen; Allison, Dennis; Rush, Robert

2013-03-01

Operating room time is highly resource intensive, and delays can be a source of lost revenue and surgeon frustration. Methods to decrease these delays are important not only for patient care, but to maximize operating room resource utilization. The purpose of this study was to determine the root cause of operating room delays in a standardized manner to help improve overall operating room efficiency. We performed a single-center prospective observational study analyzing operating room utilization and efficiency after implementing an executive-driven standardized postoperative team debriefing system from January 2010 to December 2010. A total of 11,342 procedures were performed over the 1-y study period (elective 86%, urgent 11%, and emergent 3%), with 1.3 million min of operating room time, 865,864 min of surgeon operative time (62.5%), and 162,958 min of anesthesia time (11.8%). Overall, the average operating room delay was 18 min and varied greatly based on the surgical specialty. The longest delays were due to need for radiology (40 min); other significant delays were due to supply issues (22.7 min), surgeon issues (18 min), nursing issues (14 min), and room turnover (14 min). Over the 1-y period, there was a decrease in mean delay duration, averaging a decrease in delay of 0.147 min/mo with an overall 9% decrease in the mean delay times. With regard to overall operating room utilization, there was a 39% decrease in overall un-utilized available OR time that was due to delays, improving efficiency by 2334 min (212 min/mo). During this study interval no sentinel events occurred in the operating room. A standardized postoperative debrief tracking system is highly beneficial in identifying and reducing overall operative delays and improving operating room utilization. Published by Elsevier Inc.

A field demonstration of energy conservation using occupancy sensor lighting control in equipment rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dagle, J.E.

1992-09-01

The Pacific Northwest Laboratory identified energy savings potential of automatic equipment-room lighting controls, which was demonstrated by the field experiment described in this report. Occupancy sensor applications have gained popularity in recent years due to improved technology that enhances reliability and reduces cost. Automatic lighting control using occupancy sensors has been accepted as an energy-conservation measure because it reduces wasted lighting. This study focused on lighting control for equipment rooms, which have inherent conditions ideal for automatic lighting control, i.e., an area which is seldom occupied, multiple users of the area who would not know if others are in themore » room when they leave, and high lighting energy intensity in the area. Two rooms were selected for this study: a small equipment room in the basement of the 337 Building, and a large equipment area in the upper level of the 329 Building. The rooms were selected to demonstrate the various degrees of complexity which may be encountered in equipment rooms throughout the Hanford Site. The 337 Building equipment-room test case demonstrated a 97% reduction in lighting energy consumption, with an annual energy savings of $184. Including lamp-replacement savings, a total savings of $306 per year is offset by an initial installation cost of $1,100. The installation demonstrates a positive net present value of $2,858 when the lamp-replacement costs are included in a life-cycle analysis. This also corresponds to a 4.0-year payback period. The 329 Building equipment-room installation resulted in a 92% reduction in lighting energy consumption. This corresponds to annual energy savings of $1,372, and a total annual savings of $2,104 per year including lamp-replacement savings. The life-cycle cost analysis shows a net present value of $15,855, with a 5.8-year payback period.« less

STS-109 Flight Control Room Photo

NASA Image and Video Library

2002-03-05

JSC2002-00575 (5 March 2002) --- The members of the STS-109 Orbit 3 Team pose for a group portrait in the shuttle flight control room (WFCR) in Houston’s Mission Control Center (MCC). Flight director Jeff Hanley is visible in the center foreground.

STS-109 Flight Control Room Photo

NASA Image and Video Library

2002-03-05

JSC2002-00576 (5 March 2002) --- The members of the STS-109 Orbit 3 Team pose for a group portrait in the shuttle flight control room (WFCR) in Houston’s Mission Control Center (MCC). Flight director Jeff Hanley is visible in the center foreground.

29. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

29. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, LOOKING SOUTH (LOCATION Q) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

28. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

28. MAIN CONTROL ROOM, PANELS WEST OF MAIN CONTROL AREA, LOOKING NORTH (LOCATION Q) - Shippingport Atomic Power Station, On Ohio River, 25 miles Northwest of Pittsburgh, Shippingport, Beaver County, PA

Information Foraging in Nuclear Power Plant Control Rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

R.L. Boring

2011-09-01

nformation foraging theory articulates the role of the human as an 'informavore' that seeks information and follows optimal foraging strategies (i.e., the 'information scent') to find meaningful information. This paper briefly reviews the findings from information foraging theory outside the nuclear domain and then discusses the types of information foraging strategies operators employ for normal and off-normal operations in the control room. For example, operators may employ a predatory 'wolf' strategy of hunting for information in the face of a plant upset. However, during routine operations, the operators may employ a trapping 'spider' strategy of waiting for relevant indicators tomore » appear. This delineation corresponds to information pull and push strategies, respectively. No studies have been conducted to determine explicitly the characteristics of a control room interface that is optimized for both push and pull information foraging strategies, nor has there been empirical work to validate operator performance when transitioning between push and pull strategies. This paper explores examples of control room operators as wolves vs. spiders and con- cludes by proposing a set of research questions to investigate information foraging in control room settings.« less

A Research Framework for Demonstrating Benefits of Advanced Control Room Technologies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le Blanc, Katya; Boring, Ronald; Joe, Jeffrey

Control Room modernization is an important part of life extension for the existing light water reactor fleet. None of the 99 currently operating commercial nuclear power plants in the U.S. has completed a full-scale control room modernization to date. A full-scale modernization might, for example, entail replacement of all analog panels with digital workstations. Such modernizations have been undertaken successfully in upgrades in Europe and Asia, but the U.S. has yet to undertake a control room upgrade of this magnitude. Instead, nuclear power plant main control rooms for the existing commercial reactor fleet remain significantly analog, with only limited digitalmore » modernizations. Previous research under the U.S. Department of Energy’s Light Water Reactor Sustainability Program has helped establish a systematic process for control room upgrades that support the transition to a hybrid control. While the guidance developed to date helps streamline the process of modernization and reduce costs and uncertainty associated with introducing digital control technologies into an existing control room, these upgrades do not achieve the full potential of newer technologies that might otherwise enhance plant and operator performance. The aim of the control room benefits research presented here is to identify previously overlooked benefits of modernization, identify candidate technologies that may facilitate such benefits, and demonstrate these technologies through human factors research. This report serves as an outline for planned research on the benefits of greater modernization in the main control rooms of nuclear power plants.« less

17. CONTROL ROOM, NORTH SIDE, WITH BRIDGE SWING CONTROLS ON ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. CONTROL ROOM, NORTH SIDE, WITH BRIDGE SWING CONTROLS ON LEFT, SIGNAL CONTROLS ON RIGHT, WHISTLE PULL TOP. RADIO TELEPHONE IN CENTER BACK (Fred Small) - Burlington Northern Railroad Bridge, Spanning Willamette River at River Mile 6.9, Portland, Multnomah County, OR

Light Water Reactor Sustainability Program A Reference Plan for Control Room Modernization: Planning and Analysis Phase

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jacques Hugo; Ronald Boring; Lew Hanes

2013-09-01

The U.S. Department of Energy’s Light Water Reactor Sustainability (LWRS) program is collaborating with a U.S. nuclear utility to bring about a systematic fleet-wide control room modernization. To facilitate this upgrade, a new distributed control system (DCS) is being introduced into the control rooms of these plants. The DCS will upgrade the legacy plant process computer and emergency response facility information system. In addition, the DCS will replace an existing analog turbine control system with a display-based system. With technology upgrades comes the opportunity to improve the overall human-system interaction between the operators and the control room. To optimize operatormore » performance, the LWRS Control Room Modernization research team followed a human-centered approach published by the U.S. Nuclear Regulatory Commission. NUREG-0711, Rev. 3, Human Factors Engineering Program Review Model (O’Hara et al., 2012), prescribes four phases for human factors engineering. This report provides examples of the first phase, Planning and Analysis. The three elements of Planning and Analysis in NUREG-0711 that are most crucial to initiating control room upgrades are: • Operating Experience Review: Identifies opportunities for improvement in the existing system and provides lessons learned from implemented systems. • Function Analysis and Allocation: Identifies which functions at the plant may be optimally handled by the DCS vs. the operators. • Task Analysis: Identifies how tasks might be optimized for the operators. Each of these elements is covered in a separate chapter. Examples are drawn from workshops with reactor operators that were conducted at the LWRS Human System Simulation Laboratory HSSL and at the respective plants. The findings in this report represent generalized accounts of more detailed proprietary reports produced for the utility for each plant. The goal of this LWRS report is to disseminate the technique and provide examples

Report: EPA’s Office of Environmental Information Should Improve Ariel Rios and Potomac Yard Computer Room Security Controls

EPA Pesticide Factsheets

Report #12-P-0879, September 26, 2012. The security posture and in-place environmental control review of the computer rooms in the Ariel Rios and Potomac Yard buildings revealed numerous security and environmental control deficiencies.

SIG -- The Role of Human-Computer Interaction in Next-Generation Control Rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ronald L. Boring; Jacques Hugo; Christian Richard

2005-04-01

The purpose of this CHI Special Interest Group (SIG) is to facilitate the convergence between human-computer interaction (HCI) and control room design. HCI researchers and practitioners actively need to infuse state-of-the-art interface technology into control rooms to meet usability, safety, and regulatory requirements. This SIG outlines potential HCI contributions to instrumentation and control (I&C) and automation in control rooms as well as to general control room design.

13. CONTROL ROOM OF GENE PUMPING STATION. CONTROL CUBICLES ARRAYED ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. CONTROL ROOM OF GENE PUMPING STATION. CONTROL CUBICLES ARRAYED BEHIND MANAGER'S ART DECO-STYLE CONTROL DESK, WITH CONTROL CUBICLE 1 AT FAR RIGHT AND CONTROL CUBICLE 9 AT FAR LEFT. - Gene Pump Plant, South of Gene Wash Reservoir, 2 miles west of Whitsett Pump Plant, Parker Dam, San Bernardino County, CA

49 CFR 195.446 - Control room management.

Code of Federal Regulations, 2010 CFR

2010-10-01

... written control room management procedures that implement the requirements of this section. The procedures... define the roles and responsibilities of a controller during normal, abnormal, and emergency operating... operator must define each of the following: (1) A controller's authority and responsibility to make...

Improving operating room efficiency via an interprofessional approach.

PubMed

Bender, Jeffrey S; Nicolescu, Teodora O; Hollingsworth, Susan B; Murer, Krystal; Wallace, Kristina R; Ertl, William J

2015-03-01

Third-party payer reimbursements will likely continue to decrease. Therefore, it is imperative for operating rooms (ORs), often a hospital's largest revenue source, to improve efficiency. We report the outcome after 3 years of a lean, Six Sigma program to improve OR utilization. In January 2011, our hospital system instituted a facility-wide approach to address the problem of OR efficiency. Interprofessional teams were formed to examine all aspects of OR use. An OR Governance Committee consisting of Department Chairs, nursing and senior administration oversaw the project. Outpatients' readiness on time for surgery increased from 59% to 95%, while first case on-time starts improved from 32% to 73%. Block utilization went from 68% to 74% and actual room utilization improved from 56% to 68%. The number of cases increased by 9%. Overtime went from 7% of total to 4%, so personnel costs decreased 14% despite 26% more employees. There was a reduction in annual voluntary OR staff turnover from 28% to 11%. Revenues increased more than 10% annually. A concerted effort to optimize OR performance resulted in marked improvements in access, overall case efficiency, staff satisfaction, and financial performance. Copyright © 2015 Elsevier Inc. All rights reserved.

MTR CONTROL ROOM WITH CONTROL CONSOLE AND STATUS READOUTS ALONG ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

MTR CONTROL ROOM WITH CONTROL CONSOLE AND STATUS READOUTS ALONG WALL. WORKERS MAKE ELECTRICAL AND OTHER CONNECTIONS. INL NEGATIVE NO. 4289. Unknown Photographer, 2/26/1952 - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

Interdisciplinary simulation-based training to improve delivery room communication.

PubMed

Dadiz, Rita; Weinschreider, Joanne; Schriefer, Jan; Arnold, Christine; Greves, Cole D; Crosby, Erin C; Wang, Hongyue; Pressman, Eva K; Guillet, Ronnie

2013-10-01

Poor communication among obstetric and pediatric professionals is associated with adverse perinatal events leading to severe disability and neonatal mortality. This study evaluated the effectiveness of an interdisciplinary simulation-based training (SBT) program to improve delivery room communication between obstetric and pediatric teams. Obstetric and pediatric teams participated in an SBT annually during 3 academic years, 2008-2011 (Y1-Y3), in a prospective, observational study. Eligible participants (n = 228) included attendings, fellows, house staff, midlevel providers, and nurses involved in delivery room care. Simulations were videotaped and evaluated using a validated 20-item checklist of best communication practices. Checklist scores were compared across years with the Kruskal-Wallis test. Providers were also surveyed annually regarding communication during actual deliveries using a standardized questionnaire. Ratings were analyzed using two-way analysis of covariance. At least 60% of eligible providers participated in 1 or more SBT sessions and completed surveys annually. Checklist scores on communication during SBT improved from Y1 (median, 6; interquartile range, 4) to Y3 (median, 11; interquartile range, 6) (P < 0.001). Survey results showed the perception of improvement over time in interteam communication during actual deliveries by obstetric (P < 0.005) and pediatric (P < 0.0001) providers. The obstetric team also perceived improved provider communication with the family (P < 0.05). Communication during SBT as well as the perception of communication during actual deliveries improved across the study period. The potential of a checklist to standardize delivery room communication and improve patient outcomes merits further investigation.

FRAMEWORK AND APPLICATION FOR MODELING CONTROL ROOM CREW PERFORMANCE AT NUCLEAR POWER PLANTS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ronald L Boring; David I Gertman; Tuan Q Tran

2008-09-01

This paper summarizes an emerging project regarding the utilization of high-fidelity MIDAS simulations for visualizing and modeling control room crew performance at nuclear power plants. The key envisioned uses for MIDAS-based control room simulations are: (i) the estimation of human error associated with advanced control room equipment and configurations, (ii) the investigative determination of contributory cognitive factors for risk significant scenarios involving control room operating crews, and (iii) the certification of reduced staffing levels in advanced control rooms. It is proposed that MIDAS serves as a key component for the effective modeling of cognition, elements of situation awareness, and riskmore » associated with human performance in next generation control rooms.« less

Light room therapy effective in mild forms of seasonal affective disorder--a randomised controlled study.

PubMed

Rastad, C; Ulfberg, J; Lindberg, P

2008-06-01

The most common way to provide bright light therapy to Swedish patients with Seasonal Affective Disorder (SAD), is treatment in a light therapy room. Since few studies have evaluated treatment provided in this setting and few have evaluated the effect of bright light in sub-clinical SAD (S-SAD), such a study including a one-month follow-up was designed. Fifty adults recruited from a previous prevalence study and clinically assessed as having SAD or S-SAD, were randomised to treatment in a light room or to a three-week waiting-list control group. The Hamilton Depression Rating Scale-Seasonal Affective Disorders Self-rating 29-items Version (SIGH-SAD/SR) was used to measure depressive mood at baseline, directly following treatment and at the one-month follow-up. ANCOVA with adjustment for baseline depression score, showed a significant main effect for the light room therapy group (p<0.001). Fifty-four percent (n=13/24) improved > or = 50% while no such improvement was seen in the control condition (n=0/24). After merging the two groups, repeated measures ANOVA confirmed the experimental analysis (p<0.001). At the one-month follow-up, 83.0% (n=39/47) had improved > or = 50% and 63.8% (n=30/47) had normal depression scores, i.e. < or = 8. Light room therapy was effective in reducing depressive symptoms in subjects with winter depressive mood. Results were maintained over a period of one month.

Main Control Room, view to the east. The door to ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Main Control Room, view to the east. The door to the motor room is to the right, and the main control cabinets are to the left - Wellton-Mohawk Irrigation System, Pumping Plant No. 1, Bounded by Gila River & Union Pacific Railroad, Wellton, Yuma County, AZ

10. Interior view of control room in Components Test Laboratory ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Interior view of control room in Components Test Laboratory (T-27), looking east. The control room is located in the center of the building and abuts the Test Cell 8, 9, and 10 and equipment room wings. Photograph shows upgraded instrumentation, piping, and technological modifications installed in 1997-99 to accommodate component testing requirements for the Atlas V missile. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

Guidelines on ergonomic aspects of control rooms

NASA Technical Reports Server (NTRS)

Mitchell, C. M.; Bocast, A. K.; Stewart, L. J.

1983-01-01

The anthropometry, workstation design, and environmental design of control rooms are outlined. The automated interface and VDTs and displays and various modes of communication between the system and the human operator using VDTs are discussed. The man in the loop is examined, the single controller single task framework and multiple controller multiple tasks issues are considered.

Role of Adult Asthma Education in Improving Asthma Control and Reducing Emergency Room Utilization and Hospital Admissions in an Inner City Hospital

PubMed Central

Mishra, Rashmi; Venkatram, Sindhaghatta; George, Teresa; Luo, Kristina; Diaz-Fuentes, Gilda

2017-01-01

Objective. Asthma education programs have been shown to decrease healthcare utilization and improve disease control and management. The purpose of our study was to evaluate the impact of an outpatient adult asthma education program in an inner city hospital caring for patients with low socioeconomic and educational status. Methods. An asthma education program was implemented in September 2014. Patients who received education from September 2014 to July 2015 were evaluated. Outcomes were compared for the same group of patients before and after education. Primary outcomes were emergency room (ER) visits and hospital admissions. Secondary outcomes were change in Asthma Control Test (ACT) score and number of pulmonary clinic visits. Results. Asthma education significantly decreased number of patients requiring ER visits and hospital admissions (p = 0.0005 and p = 0.0015, resp.). Asthma control as per ACT score ≥ 20 improved with education (p = 0.0001) with an increase in clinic visits (p = 0.0185). Conclusions. Our study suggests that implementation of a structured asthma education program in an inner city community hospital has a positive impact on reduction of ER visits and hospital admissions with improvement in asthma control. Institutional Review Board Clinical Study registration number is 01081507. PMID:28546781

Main control room, showing original sixpane windows and doors to ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Main control room, showing original six-pane windows and doors to pump motor room at left. The main control cabinets and switchgear, visible on right, were replaced in 2003. View to the south - Wellton-Mohawk Irrigation System, Pumping Plant No. 2, Bounded by Interstate 8 to south, Wellton, Yuma County, AZ

Successful strategies for improving operating room efficiency at academic institutions.

PubMed

Overdyk, F J; Harvey, S C; Fishman, R L; Shippey, F

1998-04-01

In this prospective study, we evaluated the etiology of operating room (OR) delays in an academic institution, examined the impact of multidisciplinary strategies to improve OR efficiency, and established OR timing benchmarks for use in future OR efficiency studies. OR times and delay etiologies were collected for 94 cases during the initial phase of the study. Timing data and delay etiologies were analyzed, and 2 wk of multidisciplinary OR efficiency awareness education was conducted for the nursing, surgical, and anesthesia staff. After the education period, timing data were collected from 1787 cases, and monthly reports listing individual case delays and timing data were sent to the Chiefs of Service. For the first case of the day, patient in room, anesthesia ready, surgical preparation start, and procedure start time were significantly earlier (P < 0.01) in the posteducation period compared with the preeducation period, and the procedure start time for the first case of the day occurred, on average, 22 min earlier than all other procedures. For all cases combined, turnover time decreased, on average, by 16 min. Unavailability of surgeons, anesthesiologists, and residents decreased significantly (P < 0.05) as causes of OR delays. Anesthesia induction times were consistently longer for the vascular and cardiothoracic services, whereas surgical preparation time was increased for the neurosurgical and orthopedic services (P < 0.05). Identification of the etiology of OR inefficiency, combined with multidisciplinary awareness training and personal accountability, can improve OR efficiency. The time savings realized are probably most cost-effective when combined with more flexible OR staffing and improved OR scheduling. We achieved significant improvements in operating room efficiency by analyzing operating room data on causes of delays, devising strategies for minimizing the most common delays, and subsequently measuring delay data. Personal accountability

Study About Ceiling Design for Main Control Room of NPP with HFE

NASA Astrophysics Data System (ADS)

Gu, Pengfei; Ni, Ying; Chen, Weihua; Chen, Bo; Zhang, Jianbo; Liang, Huihui

Recently since human factor engineering (HFE) has been used in control room design of nuclear power plant (NPP), the human-machine interface (HMI) has been gradual to develop harmoniously, especially the use of the digital technology. Comparing with the analog technology which was used to human-machine interface in the past, human-machine interaction has been more enhanced. HFE and the main control room (MCR) design engineering of NPP is a combination of multidisciplinary cross, mainly related to electrical and instrument control, reactor, machinery, systems engineering and management disciplines. However, MCR is not only equipped with HMI provided by the equipments, but also more important for the operator to provide a work environment, such as the main control room ceiling. The ceiling design of main control room related to HFE which influences the performance of staff should also be considered in the design of the environment and aesthetic factors, especially the introduction of professional design experience and evaluation method. Based on Ling Ao phase II and Hong Yanhe project implementation experience, the study analyzes lighting effect, space partition, vision load about the ceiling of main control room of NPP. Combining with the requirements of standards, the advantages and disadvantages of the main control room ceiling design has been discussed, and considering the requirements of lightweight, noise reduction, fire prevention, moisture protection, the ceiling design solution of the main control room also has been discussed.

141. Detail of east control panel in control room, looking ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

141. Detail of east control panel in control room, looking east. This panel contains electrical switches that were used to control valves at circular forebay. It also contains voltage regulators, synchroscope adjust field breaker, ammeters, wattmeters, temperature indicator of generator windings, and butterfly valve and governor controls. Photo by Jet Lowe, HAER, 1989. - Puget Sound Power & Light Company, White River Hydroelectric Project, 600 North River Avenue, Dieringer, Pierce County, WA

Central Control Room in the Engine Research Building

NASA Image and Video Library

1968-11-21

Operators in the Engine Research Building’s Central Control Room at the National Aeronautics and Space Administration (NASA) Lewis Research Center. The massive 4.25-acre Engine Research Building contains dozens of test cells, test stands, and altitude chambers. A powerful a collection of compressors and exhausters located in the central portion of the basement provides process air and exhaust for these test areas. This system is connected to similar process air systems in the laboratory’s other large test facilities. The Central Control Room coordinates this activity and communicates with the local utilities. The panels on the wall contain schematics with indicator lights and instrumentation for the atmospheric exhaust, altitude exhaust, refrigerated air, and process air systems. The process air equipment included twelve exhausters, four compressors, refrigeration system, cooling water, and an exhaust system. The operators in the control room kept in contact with engineers running the process air system and those conducting the tests in the test cells. The operators also coordinated with the local power companies to make sure enough electricity was available to operate the powerful compressors and exhausters.

Control Room Training for the Hyper-X Project Utilizing Aircraft Simulation

NASA Technical Reports Server (NTRS)

Lux-Baumann, Jesica; Dees, Ray; Fratello, David

2006-01-01

The NASA Dryden Flight Research Center flew two Hyper-X research vehicles and achieved hypersonic speeds over the Pacific Ocean in March and November 2004. To train the flight and mission control room crew, the NASA Dryden simulation capability was utilized to generate telemetry and radar data, which was used in nominal and emergency mission scenarios. During these control room training sessions personnel were able to evaluate and refine data displays, flight cards, mission parameter allowable limits, and emergency procedure checklists. Practice in the mission control room ensured that all primary and backup Hyper-X staff were familiar with the nominal mission and knew how to respond to anomalous conditions quickly and successfully. This report describes the technology in the simulation environment and the Mission Control Center, the need for and benefit of control room training, and the rationale and results of specific scenarios unique to the Hyper-X research missions.

Control Room Training for the Hyper-X Program Utilizing Aircraft Simulation

NASA Technical Reports Server (NTRS)

Lux-Baumann, Jessica R.; Dees, Ray A.; Fratello, David J.

2006-01-01

The NASA Dryden Flight Research Center flew two Hyper-X Research Vehicles and achieved hypersonic speeds over the Pacific Ocean in March and November 2004. To train the flight and mission control room crew, the NASA Dryden simulation capability was utilized to generate telemetry and radar data, which was used in nominal and emergency mission scenarios. During these control room training sessions, personnel were able to evaluate and refine data displays, flight cards, mission parameter allowable limits, and emergency procedure checklists. Practice in the mission control room ensured that all primary and backup Hyper-X staff were familiar with the nominal mission and knew how to respond to anomalous conditions quickly and successfully. This paper describes the technology in the simulation environment and the mission control center, the need for and benefit of control room training, and the rationale and results of specific scenarios unique to the Hyper-X research missions.

LOFT. Interior, control room in control building (TAN630). Camera facing ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

LOFT. Interior, control room in control building (TAN-630). Camera facing north. Sign says "This control console is partially active. Do not operate any switch handle without authorization." Date: May 2004. INEEL negative no. HD-39-14-3 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

11. Historic view of Building 100 control room, showing personnel ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Historic view of Building 100 control room, showing personnel operating rocket engine test controls and observer watching activity from observation room. May 27, 1957. On file at NASA Plumbrook Research Center, Sandusky, Ohio. NASA photo number C-45020. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Documentation of new mission control center White Flight Control Room (FLCR)

NASA Image and Video Library

1995-06-06

Documentation of the new mission control center White Flight Control Room (FLCR). Excellent overall view of White FLCR with personnel manning console workstations (11221). Fisheye lens perspective from Flight Director station with Brian Austin (11222). Environmental (EECOM) workstation and personnel (11223).

140. Detail of north control panel in control room, looking ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

140. Detail of north control panel in control room, looking north. This panel monitors a variety of activities: gages indicate the level of Lake Tapps and level of the circular forebay; wattmeters indicate output of exciters. Photo by Jet Lowe, HAER, 1989. - Puget Sound Power & Light Company, White River Hydroelectric Project, 600 North River Avenue, Dieringer, Pierce County, WA

83. DETAIL OF HONEYWELL AIRCONDITIONING CONTROLS IN SLC3E CONTROL ROOM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

83. DETAIL OF HONEYWELL AIR-CONDITIONING CONTROLS IN SLC-3E CONTROL ROOM - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

5. "UNDERGROUND CONTROL ROOM AT TEST STAND 1A, DIRECTORATE OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. "UNDERGROUND CONTROL ROOM AT TEST STAND 1-A, DIRECTORATE OF MISSILE CAPTIVE TEST, EDWARDS AFB, 15 JAN 58, 3097.58." Two men working in the control room. Photo no. "3097 58; G-AFFTC 15 JAN 58, T.S. 1-A Control". - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Control Center, Test Area 1-115, near Altair & Saturn Boulevards, Boron, Kern County, CA

Control Room at the NACA’s Rocket Engine Test Facility

NASA Image and Video Library

1957-05-21

Test engineers monitor an engine firing from the control room of the Rocket Engine Test Facility at the National Advisory Committee for Aeronautics (NACA) Lewis Flight Propulsion Laboratory. The Rocket Engine Test Facility, built in the early 1950s, had a rocket stand designed to evaluate high-energy propellants and rocket engine designs. The facility was used to study numerous different types of rocket engines including the Pratt and Whitney RL-10 engine for the Centaur rocket and Rocketdyne’s F-1 and J-2 engines for the Saturn rockets. The Rocket Engine Test Facility was built in a ravine at the far end of the laboratory because of its use of the dangerous propellants such as liquid hydrogen and liquid fluorine. The control room was located in a building 1,600 feet north of the test stand to protect the engineers running the tests. The main control and instrument consoles were centrally located in the control room and surrounded by boards controlling and monitoring the major valves, pumps, motors, and actuators. A camera system at the test stand allowed the operators to view the tests, but the researchers were reliant on data recording equipment, sensors, and other devices to provide test data. The facility’s control room was upgraded several times over the years. Programmable logic controllers replaced the electro-mechanical control devices. The new controllers were programed to operate the valves and actuators controlling the fuel, oxidant, and ignition sequence according to a predetermined time schedule.

11. CENTRAL ATLAS CONTROL CONSOLE IN SLC3W CONTROL ROOM. COMMUNICATIONS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. CENTRAL ATLAS CONTROL CONSOLE IN SLC-3W CONTROL ROOM. COMMUNICATIONS HEADSETS IN FOREGROUND. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

3. OBLIQUE VIEW OF THE PRESENT CONTROL ROOM (ORIGINALLY THE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. OBLIQUE VIEW OF THE PRESENT CONTROL ROOM (ORIGINALLY THE TRANSFORMER ROOM). - Washington Water Power Company Post Falls Power Plant, Middle Channel Powerhouse & Dam, West of intersection of Spokane & Fourth Streets, Post Falls, Kootenai County, ID

Maximum performance synergy: A new approach to recording studio control room design

NASA Astrophysics Data System (ADS)

Szymanski, Jeff D.

2003-10-01

Popular recording studio control room designs include LEDE(tm), RFZ(tm), and nonenvironment rooms. The common goal of all of these is to create an accurate acoustical environment that does not distort or otherwise color audio reproduction. Also common to these designs is the frequent need to have multiple ancillary recording rooms, often adjacent to the main control room, where group members perform. This approach, where group members are physically separated from one another, can lead to lack of ensemble in the finished recordings. New twists on old acoustical treatment techniques have been implemented at a studio in Nashville, Tennessee, which minimize the need for multiple ancillary recording rooms, thus creating an environment where talent, producer and recording professionals can all occupy the same space for maximum performance synergy. Semi-separated performance areas are designed around a central, critical listening area. The techniques and equipment required to achieve this separation are reviewed, as are advantages and disadvantages to this new control room design approach.

5. INTERIOR VIEW, SHOWING A CONTROL ROOM INSIDE THE RADIOGRAPHY ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. INTERIOR VIEW, SHOWING A CONTROL ROOM INSIDE THE RADIOGRAPHY ROOM; PASS-THROUGH FOR EXPOSED FILM ON RIGHT - Fort McCoy, Building No. T-1031, North side of South Tenth Avenue, Block 10, Sparta, Monroe County, WI

Individualized deliberate practice on a virtual reality simulator improves technical performance of surgical novices in the operating room: a randomized controlled trial.

PubMed

Palter, Vanessa N; Grantcharov, Teodor P

2014-03-01

The purpose of this study was to investigate whether individualized deliberate practice on a virtual reality (VR) simulator results in improved technical performance in the operating room. Training on VR simulators has been shown to improve technical performance in the operating room (OR). Currently described VR curricula consist of trainees practicing the same tasks until expert proficiency is reached. It has yet to be investigated whether the individualized deliberate practice, where curricula tasks vary depending on prior levels of technical proficiency, would translate into the OR. This single-blinded prospective trial randomized 16 novice surgical residents to a deliberate practice (DP) group and a conventional residency training group. Both groups performed a laparoscopic cholecystectomy in the OR that was video-recorded. Technical performance of DP group residents in the OR was assessed using 3 validated assessment tools. A score of less than 60% on any component of the assessment tool resulted in the trainee practicing a specific task on the VR simulator. The DP group practiced on the simulator as per their individualized schedule. Both groups then performed another laparoscopic cholecystectomy. A blinded expert assessed the OR recordings using a validated global rating scale. Although both groups had similar technical abilities preintervention [DP: median score, 13.5 (9.3-15.0); control: median score, 14.5 (9.3-17.8); P = 0.45], the DP residents had a superior technical performance postintervention [DP: median score, 17.0 (15.3-18.5); control: median score, 12.5 (7.5-14.0); P = 0.03]. Of 8 DP residents, 6 practiced 5 basic VR tasks (median 1 trial to pass), and 7 of 8 practiced 2 advanced tasks (median 4 trials to pass). A curriculum of deliberate individualized practice on a VR simulator improves technical performance in the OR. This has implications to greatly improve the feasibility of implementing simulation-based curricula in residency training

Ordered iron aluminide alloys having an improved room-temperature ductility and method thereof

DOEpatents

Sikka, Vinod K.

1992-01-01

A process is disclosed for improving the room temperature ductility and strength of iron aluminide intermetallic alloys. The process involves thermomechanically working an iron aluminide alloy by means which produce an elongated grain structure. The worked alloy is then heated at a temperature in the range of about 650.degree. C. to about 800.degree. C. to produce a B2-type crystal structure. The alloy is rapidly cooled in a moisture free atmosphere to retain the B2-type crystal structure at room temperature, thus providing an alloy having improved room temperature ductility and strength.

Closed-Loop Acoustic Control of Reverberant Room for Satellite Environmental Testing

NASA Astrophysics Data System (ADS)

Janssens, Karl; Bianciardi, Fabio; Sabbatini, Danilo; Debille, Jan; Carrella, Alex

2012-07-01

The full satellite acoustic test is an important milestone in a satellite launch survivability verification campaign. This test is required to verify the satellite’s mechanical design against the high-level acoustic loads induced by the launch vehicle during the atmospheric flight. During the test, the satellite is subjected to a broadband diffuse acoustic field, reproducing the pressure levels observed during launch. The excitation is in most cases provided by a combination of horns for the low frequencies and noise generators for the higher frequencies. Acoustic control tests are commonly performed in reverberant rooms, controlling the sound pressure levels in third octave bands over the specified target spectrum. This paper discusses an automatic feedback control system for acoustic control of large reverberation rooms for satellite environmental testing. The acoustic control system consists of parallel third octave PI (Proportional Integral) feedback controllers that take the reverberation characteristics of the room into consideration. The drive output of the control system is shaped at every control step based on the comparison of the average third octave noise spectrum, measured from a number of microphones in the test room, with the target spectrum. Cross-over filters split the output drive into band- limited signals to feed each of the horns. The control system is realized in several steps. In the first phase, a dynamic process model is developed, including the non-linear characteristics of the horns and the reverberant properties of the room. The model is identified from dynamic experiments using system identification techniques. In the next phase, an adequate control strategy is designed which is capable of reaching the target spectrum in the required time period without overshoots. This control strategy is obtained from model-in-the-loop (MIL) simulations, evaluating the performance of various potential strategies. Finally, the proposed strategy is

VIEW OF PDP CONTROL ROOM PANELS, LEVEL 0’, LOOKING WEST. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW OF PDP CONTROL ROOM PANELS, LEVEL 0’, LOOKING WEST. THESE PANELS WERE WHERE THE A-MOTOR TAPES WOULD HAVE BEEN VISIBLE IN THE CONTROL ROOM. MORE RECENT MONITOR IN UPPER CENTER FOR “LTR FLUX MONITORS” - Physics Assembly Laboratory, Area A/M, Savannah River Site, Aiken, Aiken County, SC

Improvement of a Chemical Storage Room Ventilation System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yousif, Emad; Al-Dahhan, Wedad; Abed, Rashed Nema

Scientists at universities across Iraq are actively working to report actual incidents and accidents occurring in their laboratories, as well as structural improvements made to improve safety and security, to raise awareness and encourage openness, leading to widespread adoption of robust Chemical Safety and Security (CSS) practices. This manuscript is the third in a series of five case studies describing laboratory incidents, accidents, and laboratory improvements. We summarize an improvement to the chemical storage room ventilation system at Al-Nahrain University to create and maintain a safe working atmosphere in an area where chemicals are stored and handled, using US andmore » European design practices, standards, and regulations.« less

IET. Control room in control building (TAN620). Terminal panels for ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

IET. Control room in control building (TAN-620). Terminal panels for instrumentation wiring. Note alarm horn and emergency light at right edge of view. Cable reel comes from Collier, Pawtucket, RI. Date: February 1955. INEEL negative no. 55-362 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Western Aeronautical Test Range (WATR) mission control Blue room

NASA Image and Video Library

1994-12-05

Mission control Blue Room, seen here, in building 4800 at NASA's Dryden Flight Research Center, is part of the Western Aeronautical Test Range (WATR). All aspects of a research mission are monitored from one of two of these control rooms at Dryden. The WATR consists of a highly automated complex of computer controlled tracking, telemetry, and communications systems and control room complexes that are capable of supporting any type of mission ranging from system and component testing, to sub-scale and full-scale flight tests of new aircraft and reentry systems. Designated areas are assigned for spin/dive tests, corridors are provided for low, medium, and high-altitude supersonic flight, and special STOL/VSTOL facilities are available at Ames Moffett and Crows Landing. Special use airspace, available at Edwards, covers approximately twelve thousand square miles of mostly desert area. The southern boundary lies to the south of Rogers Dry Lake, the western boundary lies midway between Mojave and Bakersfield, the northern boundary passes just south of Bishop, and the eastern boundary follows about 25 miles west of the Nevada border except in the northern areas where it crosses into Nevada.

Western Aeronautical Test Range (WATR) mission control Gold room

NASA Technical Reports Server (NTRS)

1990-01-01

Mission control Gold room is seen here, located at the Dryden Flight Research Center of the Western Aeronautical Test Range (WATR). All aspects of a research mission are monitored from one of two of these control rooms at Dryden. The WATR consists of a highly automated complex of computer controlled tracking, telemetry, and communications systems and control room complexes that are capable of supporting any type of mission ranging from system and component testing, to sub-scale and full-scale flight tests of new aircraft and reentry systems. Designated areas are assigned for spin/dive tests, corridors are provided for low, medium, and high-altitude supersonic flight, and special STOL/VSTOL facilities are available at Ames Moffett and Crows Landing. Special use airspace, available at Edwards, covers approximately twelve thousand square miles of mostly desert area. The southern boundary lies to the south of Rogers Dry Lake, the western boundary lies midway between Mojave and Bakersfield, the northern boundary passes just south of Bishop, and the eastern boundary follows about 25 miles west of the Nevada border except in the northern areas where it crosses into Nevada.

Governing time in operating rooms.

PubMed

Riley, Robin; Manias, Elizabeth

2006-05-01

This paper examines how time is controlled and governed in operating rooms through interpersonal communication between nurses and doctors. Time is a valuable commodity in organizations with improvements often directed towards maximizing efficiencies. As a consequence, time can be a source of tension and interpersonal conflict as individuals compete for control of its use. The data in this paper emanate from an ethnographic study that explored a range of communication practices in operating room nursing. Participants comprised 11 operating room nurses. Data were collected over two years in three different institutional settings and involved participant observation, interviews and the keeping of a personal diary. A deconstructive analysis of the data was undertaken. Results are discussed in terms of the practices, in which clinicians are engaged in, to govern and control their use of time. The four practices presented in this paper include; questioning judgment and timing, controlling speed, estimating surgeons' use of time and coping with different perceptions of time. Time and speed were hotly contested by nurses. They used their personal knowledge of individual surgeon's habits of time to govern and control practice. Nurses thought about surgeons in terms of time and developed commonly accepted understandings about the length of surgical procedures. They used this knowledge to manage the scheduling of operations in the departments and to control the workflow in individual operating rooms. Knowledge of individual surgeons was a source of power for operating room nurses. Nurses have more power in the operating room than might be imagined but they exercise this power in subtle ways. If operating rooms are to work effectively, the operating room team must understand each others' work better.

PBF Control Building (PER619). Interior detail of control room's severe ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

PBF Control Building (PER-619). Interior detail of control room's severe fuel damage instrument panel. Indicators provided real-time information about test underway in PBF reactor. Note audio speaker. Date: May 2004. INEEL negative no, HD-41-7-4 - Idaho National Engineering Laboratory, SPERT-I & Power Burst Facility Area, Scoville, Butte County, ID

2. CONTROL ROOM INTERIOR, CONSOLE AND MONITORS. Looking west. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. CONTROL ROOM INTERIOR, CONSOLE AND MONITORS. Looking west. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Control Center, Test Area 1-115, near Altair & Saturn Boulevards, Boron, Kern County, CA

First-of-A-Kind Control Room Modernization Project Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas, Kenneth David

This project plan describes a comprehensive approach to the design of an end-state concept for a modernized control room for Palo Verde. It describes the collaboration arrangement between the DOE LWRS Program Control Room Modernization Project and the APS Palo Verde Nuclear Generating Station. It further describes the role of other collaborators, including the Institute for Energy Technology (IFE) and the Electric Power Research Institute (EPRI). It combines advanced tools, methodologies, and facilities to enable a science-based approach to the validation of applicable engineering and human factors principles for nuclear plant control rooms. It addresses the required project results andmore » documentation to demonstrate compliance with regulatory requirements. It describes the project tasks that will be conducted in the project, and the deliverable reports that will be developed through these tasks. This project plan will be updated as new tasks are added and as project milestones are completed. It will serve as an ongoing description on the project both for project participants and for industry stakeholders.« less

White Paper for Virtual Control Room

NASA Technical Reports Server (NTRS)

Little, William; Tully-Hanson, Benjamin

2015-01-01

The Virtual Control Room (VCR) Proof of Concept (PoC) project is the result of an award given by the Fourth Annual NASA T&I Labs Challenge Project Call. This paper will outline the work done over the award period to build and enhance the capabilities of the Augmented/Virtual Reality (AVR) Lab at NASA's Kennedy Space Center (KSC) to create the VCR.

Wide angle view of the Flight control room of Mission control center

NASA Image and Video Library

1984-10-06

Wide angle view of the flight control room (FCR) of the Mission Control Center (MCC). Some of the STS 41-G crew can be seen on a large screen at the front of the MCC along with a map tracking the progress of the orbiter.

Closing emergency operating rooms improves efficiency.

PubMed

Wullink, Gerhard; Van Houdenhoven, Mark; Hans, Erwin W; van Oostrum, Jeroen M; van der Lans, Marieke; Kazemier, Geert

2007-12-01

Long waiting times for emergency operations increase a patient's risk of postoperative complications and morbidity. Reserving Operating Room (OR) capacity is a common technique to maximize the responsiveness of an OR in case of arrival of an emergency patient. This study determines the best way to reserve OR time for emergency surgery. In this study two approaches of reserving capacity were compared: (1) concentrating all reserved OR capacity in dedicated emergency ORs, and (2) evenly reserving capacity in all elective ORs. By using a discrete event simulation model the real situation was modelled. Main outcome measures were: (1) waiting time, (2) staff overtime, and (3) OR utilisation were evaluated for the two approaches. Results indicated that the policy of reserving capacity for emergency surgery in all elective ORs led to an improvement in waiting times for emergency surgery from 74 (+/-4.4) minutes to 8 (+/-0.5) min. Working in overtime was reduced by 20%, and overall OR utilisation can increase by around 3%. Emergency patients are operated upon more efficiently on elective Operating Rooms instead of a dedicated Emergency OR. The results of this study led to closing of the Emergency OR in the Erasmus MC (Rotterdam, The Netherlands).

Improving the safety of room air pneumoperitoneum for diagnostic laparoscopy.

PubMed

Ikechebelu, J I; Okeke, C A F

2008-06-01

Laparoscopic examination is a useful investigation in the evaluation of infertile women. To perform this test, pneumoperitoneum is required to distend the abdomen, improve visibility and displace the intestines out of the pelvis. Several gases have been used to achieve this purpose including Nitrous Oxide (N2O), Carbondioxide (CO2), Helium, Xenon andAir. This was a prospective study in a private fertility centre in Nnewi, Nigeria aimed at reducing the morbidities inherent in the use Room Air pneumoperitoneum for diagnostic laparoscopy. This was sequel to an earlier study, which revealed that women who had Room Air pneumoperitoneum had a higher port wound infection rate, abdominal discomfort (feeling of retained gas in the abdomen) and shoulder pain with resultant delayed return to normal activity than women who had Co2 pneumoperitoneum. This study demonstrated that the use of soda lime to purify the Room Air and a low pressure suction pump to evacuate the air after the procedure significantly reduced the wound infection rate and virtually eliminated the abdominal discomfort and shoulder pain associated with Room Air pneumoperitoneum. This was followed by early return to normal activity. Therefore, use of Room Air for pneumoperitoneum is safe and affordable. It is recommended for low resource settings.

10. Credit BG. Interior of control and observation room at ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Credit BG. Interior of control and observation room at Control and Recording Center Building 4221/E-22. - Jet Propulsion Laboratory Edwards Facility, Control & Recording Center, Edwards Air Force Base, Boron, Kern County, CA

Digital Full-Scope Simulation of a Conventional Nuclear Power Plant Control Room, Phase 2: Installation of a Reconfigurable Simulator to Support Nuclear Plant Sustainability

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ronald L. Boring; Vivek Agarwal; Kirk Fitzgerald

2013-03-01

The U.S. Department of Energy’s Light Water Reactor Sustainability program has developed a control room simulator in support of control room modernization at nuclear power plants in the U.S. This report highlights the recent completion of this reconfigurable, full-scale, full-scope control room simulator buildout at the Idaho National Laboratory. The simulator is fully reconfigurable, meaning it supports multiple plant models developed by different simulator vendors. The simulator is full-scale, using glasstop virtual panels to display the analog control boards found at current plants. The present installation features 15 glasstop panels, uniquely achieving a complete control room representation. The simulator ismore » also full-scope, meaning it uses the same plant models used for training simulators at actual plants. Unlike in the plant training simulators, the deployment on glasstop panels allows a high degree of customization of the panels, allowing the simulator to be used for research on the design of new digital control systems for control room modernization. This report includes separate sections discussing the glasstop panels, their layout to mimic control rooms at actual plants, technical details on creating a multi-plant and multi-vendor reconfigurable simulator, and current efforts to support control room modernization at U.S. utilities. The glasstop simulator provides an ideal testbed for prototyping and validating new control room concepts. Equally importantly, it is helping create a standardized and vetted human factors engineering process that can be used across the nuclear industry to ensure control room upgrades maintain and even improve current reliability and safety.« less

Baseline Study Methodology for Future Phases of Research on Nuclear Power Plant Control Room Technologies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le Blanc, Katya Lee; Bower, Gordon Ross; Hill, Rachael Ann

In order to provide a basis for industry adoption of advanced technologies, the Control Room Upgrades Benefits Research Project will investigate the benefits of including advanced technologies as part of control room modernization This report describes the background, methodology, and research plan for the first in a series of full-scale studies to test the effects of advanced technology in NPP control rooms. This study will test the effect of Advanced Overview Displays in the partner Utility’s control room simulator

Baseline Evaluations to Support Control Room Modernization at Nuclear Power Plants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boring, Ronald L.; Joe, Jeffrey C.

2015-02-01

For any major control room modernization activity at a commercial nuclear power plant (NPP) in the U.S., a utility should carefully follow the four phases prescribed by the U.S. Nuclear Regulatory Commission in NUREG-0711, Human Factors Engineering Program Review Model. These four phases include Planning and Analysis, Design, Verification and Validation, and Implementation and Operation. While NUREG-0711 is a useful guideline, it is written primarily from the perspective of regulatory review, and it therefore does not provide a nuanced account of many of the steps the utility might undertake as part of control room modernization. The guideline is largely summative—intendedmore » to catalog final products—rather than formative—intended to guide the overall modernization process. In this paper, we highlight two crucial formative sub-elements of the Planning and Analysis phase specific to control room modernization that are not covered in NUREG-0711. These two sub-elements are the usability and ergonomics baseline evaluations. A baseline evaluation entails evaluating the system as-built and currently in use. The usability baseline evaluation provides key insights into operator performance using the control system currently in place. The ergonomics baseline evaluation identifies possible deficiencies in the physical configuration of the control system. Both baseline evaluations feed into the design of the replacement system and subsequent summative benchmarking activities that help ensure that control room modernization represents a successful evolution of the control system.« less

Improving Operating Room Efficiency: First Case On-Time Start Project.

PubMed

Phieffer, Laura; Hefner, Jennifer L; Rahmanian, Armin; Swartz, Jason; Ellison, Christopher E; Harter, Ronald; Lumbley, Joshua; Moffatt-Bruce, Susan D

Operating rooms (ORs) are costly to run, and multiple factors influence efficiency. The first case on-time start (FCOS) of an OR is viewed as a harbinger of efficiency for the daily schedule. Across 26 ORs of a large, academic medical center, only 49% of cases started on time in October 2011. The Perioperative Services Department engaged an interdisciplinary Operating Room Committee to apply Six Sigma tools to this problem. The steps of this project included (1) problem mapping, (2) process improvements to preoperative readiness, (3) informatics support improvements, and (4) continuous measurement and feedback. By June 2013, there was a peak of 92% first case on-time starts across service lines, decreasing to 78% through 2014, still significantly above the preintervention level of 49% (p = .000). Delay minutes also significantly decreased through the study period (p = .000). Across 2013, the most common delay owners were the patient, the surgeon, the facility, and the anesthesia department. Continuous and sustained improvement of first case on-time starts is attributed to tracking the FCOS metric, establishing embedded process improvement resources and creating transparency of data. This article highlights success factors and barriers to program success and sustainability.

Design and implementation of new control room system in Damavand tokamak

NASA Astrophysics Data System (ADS)

Rasouli, H.; Zamanian, H.; Gheidi, M.; Kheiri-Fard, M.; Kouhi, A.

2017-07-01

The aim of this paper is design and implementation of an up-to-date control room. The previous control room had a lot of constraints and it was not apposite to the sophisticated diagnostic systems as well as to the modern control and multivariable systems. Although it provided the best output for the considered experiments and implementing offline algorithms among all similar plants, it needed to be developed to provide more capability for complex algorithm mechanisms and this work introduces our efforts in this area. Accordingly, four leading systems were designed and implemented, including real-time control system, online Data Acquisition System (DAS), offline DAS, monitoring and data transmission system. In the control system, three real-time control modules were established based on Digital Signal Processor (DSP). Thanks to them, implementation of the classic and linear and nonlinear intelligent controllers was possible to control the plasma position and its elongation. Also, online DAS was constructed in two modules. Using them, voltages and currents of charge for the capacitor banks and pressure of different parts in vacuum vessel were measured and monitored. Likewise, by real-time processing of the online data, the safety protocol of plant performance was accomplished. In addition, the offline DAS was organized in 13 modules based on Field Programmable Gate Array (FPGA). This system can be used for gathering all diagnostic, control, and performance data in 156 channels. Data transmission system and storing mechanism in the server was provided by data transmitting network and MDSplus standard protocol. Moreover, monitoring software was designed so that it could display the required plots for physical analyses. Taking everything into account, this new platform can improve the quality and quantity of research activities in plasma physics for Damavand tokamak.

Priority coding for control room alarms

DOEpatents

Scarola, Kenneth; Jamison, David S.; Manazir, Richard M.; Rescorl, Robert L.; Harmon, Daryl L.

1994-01-01

Indicating the priority of a spatially fixed, activated alarm tile on an alarm tile array by a shape coding at the tile, and preferably using the same shape coding wherever the same alarm condition is indicated elsewhere in the control room. The status of an alarm tile can change automatically or by operator acknowledgement, but tones and/or flashing cues continue to provide status information to the operator.

ETR CONTROL BUILDING, TRA647, INTERIOR. CONTROL ROOM, CONTEXTUAL VIEW. INSTRUMENT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

ETR CONTROL BUILDING, TRA-647, INTERIOR. CONTROL ROOM, CONTEXTUAL VIEW. INSTRUMENT PANELS AT REAR OF OPERATOR'S CONSOLE GAVE OPERATOR STATUS OF REACTOR PERFORMANCE, COOLANT-WATER CHARACTERISTICS AND OTHER INDICATORS. WINDOWS AT RIGHT LOOKED INTO ETR BUILDING FIRST FLOOR. CAMERA FACING EAST. INL NEGATIVE NO. HD42-6. Mike Crane, Photographer, 3/2004 - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

TRITIUM LABORATORY, TRA666, INTERIOR. MAIN FLOOR. CONTROL ROOM ENCLOSURE AT ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

TRITIUM LABORATORY, TRA-666, INTERIOR. MAIN FLOOR. CONTROL ROOM ENCLOSURE AT CENTER OF VIEW. SIGN ABOVE DOOR SAYS "HYDRAULIC TEST FACILITY CONTROL ROOM." SIGN IN WINDOW SAYS "EATING AREA." "EVACUATION AND EMERGENCY INFORMATION" IS POSTED ON CABINET AT LEFT OF VIEW. INL NEGATIVE NO. HD30-2-3. Mike Crane, Photographer, 6/2001 - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

Infection control in the operating room: is it more than a clean dish?

PubMed

Loftus, Randy W

2016-04-01

Healthcare-associated infections (HCAIs) are driven by a complex interplay between host defenses, pathogen traits, and pathogen transmission. A better understanding of each of these factors is required to extend infection control beyond antibiotic therapy to improvements in basic preventive measures that can achieve sustained HCAI reductions. The purpose of this article is to review recent advancements in our understanding of these issues for the operating room environment. The importance and implications of intraoperative bacterial transmission have been solidified, and hyper transmissible, virulent, and antibiotic resistant bacterial strains have been characterized. As a result, a best practice for improved intraoperative infection control has been delineated. Little advancement has been made in our understanding of the efficacy of higher inspired oxygen concentrations, improved postoperative glucose control, perioperative normothermia, and prophylactic antibiotic selection, timing, and dose for HCAI prevention. Recent work has led to the development of evidence-based hand hygiene, environmental cleaning, patient decolonization, and intravascular catheter design and handling improvement strategies. Evidence suggests that a best practice for postoperative infection control is a multimodal program that utilizes these interventions to target patient, provider, and environmental reservoirs in parallel. The development of novel diagnostic tools for targeted attenuation of hyper virulent, transmissible and resistant strains/strain characteristics is indicated to improve patient decolonization efforts.

11. Credit BG. Interior of control and observation room at ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Credit BG. Interior of control and observation room at Control and Recording Center, showing detail of switchboard and closed circuit television monitors. - Jet Propulsion Laboratory Edwards Facility, Control & Recording Center, Edwards Air Force Base, Boron, Kern County, CA

5. INTERIOR VIEW OF UPPER LEVEL ROOM OF THE CONTROL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. INTERIOR VIEW OF UPPER LEVEL ROOM OF THE CONTROL HOUSE LOCATED ON THE SOUTH END OF BIG TUJUNGA DAM SHOWING THE CONTROL PANEL. - Big Tujunga Dam, Control House, 809 West Big Tujunga Road, Sunland, Los Angeles County, CA

Turning the Waiting Room into a Classroom: Weekly Classes Using a Vegan or a Portion-Controlled Eating Plan Improve Diabetes Control in a Randomized Translational Study.

PubMed

Barnard, Neal D; Levin, Susan M; Gloede, Lise; Flores, Rosendo

2018-06-01

In research settings, plant-based (vegan) eating plans improve diabetes management, typically reducing weight, glycemia, and low-density lipoprotein (LDL) cholesterol concentrations to a greater extent than has been shown with portion-controlled eating plans. The study aimed to test whether similar benefits could be found using weekly nutrition classes in a typical endocrinology practice, hypothesizing that a vegan eating plan would improve glycemic control, weight, lipid concentrations, blood pressure, and renal function and would do so more effectively than a portion-controlled eating plan. In a 20-week trial, participants were randomly assigned to a low-fat vegan or portion-controlled eating plan. Individuals with type 2 diabetes treated in a single endocrinology practice in Washington, DC, participated (45 starters, 40 completers). Participants attended weekly after-hours classes in the office waiting room. The vegan plan excluded animal products and added oils and favored low-glycemic index foods. The portion-controlled plan included energy intake limits for weight loss (typically a deficit of 500 calories/day) and provided guidance on portion sizes. Body weight, hemoglobin A1c (HbA1c), plasma lipids, urinary albumin, and blood pressure were measured. For normally distributed data, t tests were used; for skewed outcomes, rank-based approaches were implemented (Wilcoxon signed-rank test for within-group changes, Wilcoxon two-sample test for between-group comparisons, and exact Hodges-Lehmann estimation to estimate effect sizes). Although participants were in generally good metabolic control at baseline, body weight, HbA1c, and LDL cholesterol improved significantly within each group, with no significant differences between the two eating plans (weight: -6.3 kg vegan, -4.4 kg portion-controlled, between-group P=0.10; HbA1c, -0.40 percentage point in both groups, P=0.68; LDL cholesterol -11.9 mg/dL vegan, -12.7 mg/dL portion-controlled, P=0.89). Mean urinary

37. ENGINE ROOM, FROM PORT SIDE OF CONTROL CONSOLE, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

37. ENGINE ROOM, FROM PORT SIDE OF CONTROL CONSOLE, LOOKING TOWARDS STERN, PORT ENGINE AT RIGHT, STARBOARD ENGINE AT LEFT, BOTH ARE DIESEL ENGINES, IN BACKGROUND IS STAIRS UP TO CREWS' BERTHING, BEYONE THE STAIRS IS THE DOOR TO AFT ENGINE ROOM & MACHINE SHOP. - U.S. Coast Guard Cutter WHITE HEATH, USGS Integrated Support Command Boston, 427 Commercial Street, Boston, Suffolk County, MA

49. Environmental equipment room, cbr filter at left, ventilation control ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

49. Environmental equipment room, cbr filter at left, ventilation control panel in center, brine chiller controls at right, looking southeast - Ellsworth Air Force Base, Delta Flight, Launch Control Facility, County Road CS23A, North of Exit 127, Interior, Jackson County, SD

First installation of a dual-room IVR-CT system in the emergency room.

PubMed

Wada, Daiki; Nakamori, Yasushi; Kanayama, Shuji; Maruyama, Shuhei; Kawada, Masahiro; Iwamura, Hiromu; Hayakawa, Koichi; Saito, Fukuki; Kuwagata, Yasuyuki

2018-03-05

Computed tomography (CT) embedded in the emergency room has gained importance in the early diagnostic phase of trauma care. In 2011, we implemented a new trauma workflow concept with a sliding CT scanner system with interventional radiology features (IVR-CT) that allows CT examination and emergency therapeutic intervention without relocating the patient, which we call the Hybrid emergency room (Hybrid ER). In the Hybrid ER, all life-saving procedures, CT examination, damage control surgery, and transcatheter arterial embolisation can be performed on the same table. Although the trauma workflow realized in the Hybrid ER may improve mortality in severe trauma, the Hybrid ER can potentially affect the efficacy of other in/outpatient diagnostic workflow because one room is occupied by one severely injured patient undergoing both emergency trauma care and CT scanning for long periods. In July 2017, we implemented a new trauma workflow concept with a dual-room sliding CT scanner system with interventional radiology features (dual-room IVR-CT) to increase patient throughput. When we perform emergency surgery or interventional radiology for a severely injured or ill patient in the Hybrid ER, the sliding CT scanner moves to the adjacent CT suite, and we can perform CT scanning of another in/outpatient. We believe that dual-room IVR-CT can contribute to the improvement of both the survival of severely injured or ill patients and patient throughput.

Improving operating room coordination: communication pattern assessment.

PubMed

Moss, Jacqueline; Xiao, Yan

2004-02-01

To capture communication patterns in operating room (OR) management to characterize the information needs of OR coordination. Technological applications can be used to change system processes to improve communication and information access, thereby decreasing errors and adverse events. The successful design of such applications relies on an understanding of communication patterns among healthcare professionals. Charge nurse communication was observed and documented at four OR suites at three tertiary hospitals. The data collection tool allowed rapid coding of communication patterns in terms of duration, mode, target person, and the purpose of each communication episode. Most (69.24%) of the 2074 communication episodes observed occurred face to face. Coordinating equipment was the most frequently occurring purpose of communication (38.7%) in all suites. The frequency of other purposes in decreasing order were coordinating patient preparedness (25.7%), staffing (18.8%), room assignment (10.7%), and scheduling and rescheduling surgery (6.2%). The results of this study suggest that automating aspects of preparing patients for surgery and surgical equipment management has the potential to reduce information exchange, decreasing interruptions to clinicians and diminishing the possibility of adverse events in the clinical setting.

Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost.

PubMed

McCray, Sally; Maunder, Kirsty; Krikowa, Renee; MacKenzie-Shalders, Kristen

2018-02-01

Room service is a foodservice model that has been increasingly implemented across health care facilities in an effort to improve patient satisfaction and reduce food waste. In 2013, Mater Private Hospital Brisbane, Australia, was the first hospital in Australia to implement room service, with the aim of improving patient nutrition care and reducing costs. The aim of this study was to comprehensively evaluate the nutritional intake, plate waste, patient satisfaction, and patient meal costs of room service compared to a traditional foodservice model. A retrospective analysis of quality-assurance data audits was undertaken to assess patient nutritional intake between a facility utilizing a traditional foodservice model and a facility utilizing room service and in a pre-post study design to assess plate waste, patient satisfaction, and patient meal costs before and after the room service implementation. Audit data were collected for eligible adult inpatients in Mater Private Hospital Brisbane and Mater Hospital Brisbane, Australia, between July 2012 and May 2015. The primary outcome measures were nutritional intake, plate waste, patient satisfaction, and patient meal costs. Independent samples t-tests and χ 2 analyses were conducted between pre and post data for continuous data and categorical data, respectively. Pearson χ 2 analysis of count data for sex and reasons for plate waste for data with counts more than five was used to determine asymptotic (two-sided) significance and n-1 χ 2 used for the plate waste analysis. Significance was assessed at P<0.05. This study reported an increased nutritional intake, improved patient satisfaction, and reduced plate waste and patient meal costs with room service compared to a traditional foodservice model. Comparison of nutritional intake between a traditional foodservice model (n=85) and room service (n=63) showed statistically significant increases with room service in both energy (1,306 kcal/day vs 1,588 kcal/day; P=0

Measuring Human Performance in Simulated Nuclear Power Plant Control Rooms Using Eye Tracking

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kovesdi, Casey Robert; Rice, Brandon Charles; Bower, Gordon Ross

Control room modernization will be an important part of life extension for the existing light water reactor fleet. As part of modernization efforts, personnel will need to gain a full understanding of how control room technologies affect performance of human operators. Recent advances in technology enables the use of eye tracking technology to continuously measure an operator’s eye movement, which correlates with a variety of human performance constructs such as situation awareness and workload. This report describes eye tracking metrics in the context of how they will be used in nuclear power plant control room simulator studies.

11. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF MECHANICAL ROOM. VIEW ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF MECHANICAL ROOM. VIEW TO SOUTHEAST. - Minuteman III ICBM Launch Control Facility November-1, 1.5 miles North of New Raymer & State Highway 14, New Raymer, Weld County, CO

12. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF GENERATOR ROOM. VIEW ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF GENERATOR ROOM. VIEW TO EAST. - Minuteman III ICBM Launch Control Facility November-1, 1.5 miles North of New Raymer & State Highway 14, New Raymer, Weld County, CO

21. Interior view of citric acid air pollution control room ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

21. Interior view of citric acid air pollution control room (also known as scrubber room) in Components Test Laboratory (T-27), looking southeast. Photograph shows upgraded instrumentation, piping, tanks, and technological modifications installed in 1997-99 to accommodate component testing requirements for the Atlas V missile. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

Improving operating room turnover time: a systems based approach.

PubMed

Bhatt, Ankeet S; Carlson, Grant W; Deckers, Peter J

2014-12-01

Operating room (OR) turnover time (TT) has a broad and significant impact on hospital administrators, providers, staff and patients. Our objective was to identify current problems in TT management and implement a consistent, reproducible process to reduce average TT and process variability. Initial observations of TT were made to document the existing process at a 511 bed, 24 OR, academic medical center. Three control groups, including one consisting of Orthopedic and Vascular Surgery, were used to limit potential confounders such as case acuity/duration and equipment needs. A redesigned process based on observed issues, focusing on a horizontally structured, systems-based approach has three major interventions: developing consistent criteria for OR readiness, utilizing parallel processing for patient and room readiness, and enhancing perioperative communication. Process redesign was implemented in Orthopedics and Vascular Surgery. Comparisons of mean and standard deviation of TT were made using an independent 2-tailed t-test. Using all surgical specialties as controls (n = 237), mean TT (hh:mm:ss) was reduced by 0:20:48 min (95 % CI, 0:10:46-0:30:50), from 0:44:23 to 0:23:25, a 46.9 % reduction. Standard deviation of TT was reduced by 0:10:32 min, from 0:16:24 to 0:05:52 and frequency of TT≥30 min was reduced from 72.5to 11.7 %. P < 0.001 for each. Using Vascular and Orthopedic surgical specialties as controls (n = 13), mean TT was reduced by 0:15:16 min (95 % CI, 0:07:18-0:23:14), from 0:38:51 to 0:23:35, a 39.4 % reduction. Standard deviation of TT reduced by 0:08:47, from 0:14:39 to 0:05:52 and frequency of TT≥30 min reduced from 69.2 to 11.7 %. P < 0.001 for each. Reductions in mean TT present major efficiency, quality improvement, and cost-reduction opportunities. An OR redesign process focusing on parallel processing and enhanced communication resulted in greater than 35 % reduction in TT. A systems-based focus should drive OR TT design.

Controlling allergens in animal rooms by using curtains.

PubMed

Krohn, Thomas C; Itter, Gabi; Fosse, Richard; Hansen, Axel K

2006-05-01

The reduction and control of allergens in the animal facility is important for staff working with laboratory animals. This study was designed to evaluate the efficiency of perforated Makrolon curtains in front of racks as a method to reduce the amount of allergen in the animal room. The experimental situation we studied provides some information regarding allergen disposition in animal rooms but is clearly artificial and does not reflect a typical, 'real-world' environment in terms of preventing exposure of workers to allergens. Plastic curtains with holes were placed in front of racks, and a corridor between the racks and a curtain was present. The room was ventilated with air, which was blown into the room through the middle of the corridor, flowing downstream and passing through the holes in the curtain. This set-up resulted in air flow from the corridor through the curtain. Air samples were collected from sites in the corridor and behind the curtain. The samples were analyzed for the allergen Mus m1, and the amount of allergen was calculated. The results show air flow from the aisle through the holes in the curtains and through the racks behind the curtains, and this flow keeps allergen behind the curtains and prevents its spread from the cages into the aisle. The present study shows that the use of curtains in front of the cage racks is an efficient way to prevent spread of allergens from rodent cages to the entire animal room.

The role of 'no-touch' automated room disinfection systems in infection prevention and control.

PubMed

Otter, J A; Yezli, S; Perl, T M; Barbut, F; French, G L

2013-01-01

Surface contamination in hospitals is involved in the transmission of pathogens in a proportion of healthcare-associated infections. Admission to a room previously occupied by a patient colonized or infected with certain nosocomial pathogens increases the risk of acquisition by subsequent occupants; thus, there is a need to improve terminal disinfection of these patient rooms. Conventional disinfection methods may be limited by reliance on the operator to ensure appropriate selection, formulation, distribution and contact time of the agent. These problems can be reduced by the use of 'no-touch' automated room disinfection (NTD) systems. To summarize published data related to NTD systems. Pubmed searches for relevant articles. A number of NTD systems have emerged, which remove or reduce reliance on the operator to ensure distribution, contact time and process repeatability, and aim to improve the level of disinfection and thus mitigate the increased risk from the prior room occupant. Available NTD systems include hydrogen peroxide (H(2)O(2)) vapour systems, aerosolized hydrogen peroxide (aHP) and ultraviolet radiation. These systems have important differences in their active agent, delivery mechanism, efficacy, process time and ease of use. Typically, there is a trade-off between time and effectiveness among NTD systems. The choice of NTD system should be influenced by the intended application, the evidence base for effectiveness, practicalities of implementation and cost constraints. NTD systems are gaining acceptance as a useful tool for infection prevention and control. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

14. GENE PUMPING STATION CONTROL ROOM AS SEEN FROM MAIN ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. GENE PUMPING STATION CONTROL ROOM AS SEEN FROM MAIN STATION MANAGER'S CONTROL DESK. ELECTRICAL CONTROL INDICATORS AND CONTROLS FOR REGULATING ELECTRICITY INTO PLANT AS WELL AS SYNCHRONIZING STARTUP OF PUMPS. - Gene Pump Plant, South of Gene Wash Reservoir, 2 miles west of Whitsett Pump Plant, Parker Dam, San Bernardino County, CA

11. CONTROL ROOM INTERIOR, SHOWING SEVERAL PERISCOPES. Looking north along ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. CONTROL ROOM INTERIOR, SHOWING SEVERAL PERISCOPES. Looking north along west wall. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Instrumentation & Control Building, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

Method of installing a control room console in a nuclear power plant

DOEpatents

Scarola, Kenneth; Jamison, David S.; Manazir, Richard M.; Rescorl, Robert L.; Harmon, Daryl L.

1994-01-01

An advanced control room complex for a nuclear power plant, including a discrete indicator and alarm system (72) which is nuclear qualified for rapid response to changes in plant parameters and a component control system (64) which together provide a discrete monitoring and control capability at a panel (14-22, 26, 28) in the control room (10). A separate data processing system (70), which need not be nuclear qualified, provides integrated and overview information to the control room and to each panel, through CRTs (84) and a large, overhead integrated process status overview board (24). The discrete indicator and alarm system (72) and the data processing system (70) receive inputs from common plant sensors and validate the sensor outputs to arrive at a representative value of the parameter for use by the operator during both normal and accident conditions, thereby avoiding the need for him to assimilate data from each sensor individually. The integrated process status board (24) is at the apex of an information hierarchy that extends through four levels and provides access at each panel to the full display hierarchy. The control room panels are preferably of a modular construction, permitting the definition of inputs and outputs, the man machine interface, and the plant specific algorithms, to proceed in parallel with the fabrication of the panels, the installation of the equipment and the generic testing thereof.

Migration of Older to New Digital Control Systems in Nuclear Power Plant Main Control Rooms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kovesdi, Casey Robert; Joe, Jeffrey Clark

The United States (U.S.) Department of Energy (DOE) Office of Nuclear Energy (NE) has the primary mission to advance nuclear power by resolving socio-technical issues through research and development (R&D). One DOE-NE activity supporting this mission is the Light Water Reactor Sustainability (LWRS) program. LWRS has the overall objective to sustain the operation of existing commercial nuclear power plants (NPPs) through conducting R&D across multiple “pathways,” or R&D focus areas. The Advanced Instrumentation, Information, and Control (II&C) Systems Technologies pathway conducts targeted R&D to address aging and reliability concerns with the legacy instrumentation and control (I&C) and related information systemsmore » in operating U.S. NPPs. This work involves (1) ensuring that legacy analog II&C systems are not life-limiting issues for the LWR fleet, and (2) implementing digital II&C technology in a manner that enables broad innovation and business improvement in the NPP operating model. Under the LWRS Advanced II&C pathway, Human Factors experts at Idaho National Laboratory (INL) have been conducting R&D in support of NPP main control room (MCR) modernization activities. Work in prior years has focused on migrating analog I&C systems to new digital I&C systems (). In fiscal year 2016 (FY16), one new focus area for this research is migrating older digital I&C systems to new and advanced digital I&C systems. This report summarizes a plan for conducting a digital-to-digital migration of a legacy digital I&C system to a new digital I&C system in support of control room modernization activities.« less

7. CONTROL AND EQUIPMENT ROOM INTERIOR. Looking to southwest corner ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. CONTROL AND EQUIPMENT ROOM INTERIOR. Looking to southwest corner and entrance to cable tunnel. - Edwards Air Force Base, South Base Sled Track, Firing Control Blockhouse, South of Sled Track at east end, Lancaster, Los Angeles County, CA

Innovative Patient Room Lighting System with Integrated Spectrally Adaptive Control

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maniccia, Dorene A.; Rizzo, Patricia; Kim, James

In December of 2013, the U.S. Department of Energy’s SSL R&D Program released a Funding Opportunity Announcement (FOA), that for the first time, contained opportunities for comprehensive application-specific system development. The FOA included opportunities for two applications, one of which was a Patient Room. Philips Lighting Research North America, submitted a proposal for the Patient Room application, and was selected for the complete project award. The award amount was for $497,127, with a Philips Research co-funding commitment 165,709 dollars. The total project value was 662,836 dollars. This project sought to redefine lighting for the patient room application. The goal wasmore » to deliver an innovative LED patient suite (patient room and bathroom) lighting system solution that was 40% more energy-efficient than traditional fluorescent incumbent technologies, and would meet all the visual and non-visual needs of patients, caregivers and visitors, and improve the patient experience. State-of-the-art multichannel LED platforms and control technologies that would provide spectral tuning and become part of an intelligent, connected lighting system drove the solution. The project was scoped into four main task areas that included a) System Concept Creation, b) Identification of the Luminaire Portfolio, c) Development of the Connected Lighting Infrastructure, and d) System Performance Validation. Each of the four main tasks were completed and validated extensively over the course the 2 ½ year project. The system concept was created by first developing a lighting design that demonstrated best practices for patient room lighting – illuminance and uniformity for task performance, reduced glare, and convenient controls, in addition to giving patients control over the lighting in their environment. A framework was defined to deliver circadian support via software behaviors. Through that process luminaires were identified from the Philips portfolio that were

[Controlling systems for operating room managers].

PubMed

Schüpfer, G; Bauer, M; Scherzinger, B; Schleppers, A

2005-08-01

Management means developing, shaping and controlling of complex, productive and social systems. Therefore, operating room managers also need to develop basic skills in financial and managerial accounting as a basis for operative and strategic controlling which is an essential part of their work. A good measurement system should include financial and strategic concepts for market position, innovation performance, productivity, attractiveness, liquidity/cash flow and profitability. Since hospitals need to implement a strategy to reach their business objectives, the performance measurement system has to be individually adapted to the strategy of the hospital. In this respect the navigation system developed by Gälweiler is compared to the "balanced score card" system of Kaplan and Norton.

6. UNDERGROUND FIRING CONTROL ROOM, INTERIOR. Looking southeast to escape ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. UNDERGROUND FIRING CONTROL ROOM, INTERIOR. Looking southeast to escape tunnel. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Firing Control Building, Test Area 1-100, northeast end of Test Area 1-100 Road, Boron, Kern County, CA

DHM simulation in virtual environments: a case-study on control room design.

PubMed

Zamberlan, M; Santos, V; Streit, P; Oliveira, J; Cury, R; Negri, T; Pastura, F; Guimarães, C; Cid, G

2012-01-01

This paper will present the workflow developed for the application of serious games in the design of complex cooperative work settings. The project was based on ergonomic studies and development of a control room among participative design process. Our main concerns were the 3D human virtual representation acquired from 3D scanning, human interaction, workspace layout and equipment designed considering ergonomics standards. Using Unity3D platform to design the virtual environment, the virtual human model can be controlled by users on dynamic scenario in order to evaluate the new work settings and simulate work activities. The results obtained showed that this virtual technology can drastically change the design process by improving the level of interaction between final users and, managers and human factors team.

Improving operating room schedules.

PubMed

Li, Fei; Gupta, Diwakar; Potthoff, Sandra

2016-09-01

Operating rooms (ORs) in US hospitals are costly to staff, generate about 70 % of a hospital's revenues, and operate at a staffed-capacity utilization of 60-70 %. Many hospitals allocate blocks of OR time to individual or groups of surgeons as guaranteed allocation, who book surgeries one at a time in their blocks. The booking procedure frequently results in unused time between surgeries. Realizing that this presents an opportunity to improve OR utilization, hospitals manually reschedule surgery start times one or two days before each day of surgical operations. The purpose of rescheduling is to decrease OR staffing costs, which are determined by the number of concurrently staffed ORs. We formulate the rescheduling problem as a variant of the bin-packing problem with interrelated items, which are the surgeries performed by the same surgeon. We develop a lower bound (LB) construction algorithm and prove that the LB is at least (2/3) of the optimal staffing cost. A key feature of our approach is that we allow hospitals to have two shift lengths. Our analytical results form the basis of a branch-and-bound algorithm, which we test on data obtained from three hospitals. Experiments show that rescheduling saves significant staffing costs.

Operating room management and operating room productivity: the case of Germany.

PubMed

Berry, Maresi; Berry-Stölzle, Thomas; Schleppers, Alexander

2008-09-01

We examine operating room productivity on the example of hospitals in Germany with independent anesthesiology departments. Linked to anesthesiology group literature, we use the ln(Total Surgical Time/Total Anesthesiologists Salary) as a proxy for operating room productivity. We test the association between operating room productivity and different structural, organizational and management characteristics based on survey data from 87 hospitals. Our empirical analysis links improved operating room productivity to greater operating room capacity, appropriate scheduling behavior and management methods to realign interests. From this analysis, the enforcing jurisdiction and avoiding advance over-scheduling appear to be the implementable tools for improving operating room productivity.

20. VIEW OF WASTE TREATMENT CONTROL ROOM IN BUILDING 374. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. VIEW OF WASTE TREATMENT CONTROL ROOM IN BUILDING 374. THE BUILDING 371/374 COMPLEX WAS DESIGNED TO EMPHASIZE AUTOMATICALLY CONTROLLED, REMOTELY OPERATED PROCESSES. (1/80) - Rocky Flats Plant, Plutonium Recovery Facility, Northwest portion of Rocky Flats Plant, Golden, Jefferson County, CO

Mounting evidence favoring single-family room neonatal intensive care.

PubMed

Stevens, D; Thompson, P; Helseth, C; Pottala, J

2015-01-01

Controversy regarding the optimal design for neonatal intensive care has existed for more than 20 years. Recent evidence confirms that in comparison with the traditional open-bay design, the single-room facility provides for improved control of excessive noise and light, improved staff and parental satisfaction with care and equal, or possibly reduced, cost of care. Single-room care was not associated with any increase in adverse outcomes. To optimize long term developmental outcomes, single-room care must be augmented with appropriate developmental therapy and programs to actively support parental involvement.

Operating room integration and telehealth.

PubMed

Bucholz, Richard D; Laycock, Keith A; McDurmont, Leslie

2011-01-01

The increasing use of advanced automated and computer-controlled systems and devices in surgical procedures has resulted in problems arising from the crowding of the operating room with equipment and the incompatible control and communication standards associated with each system. This lack of compatibility between systems and centralized control means that the surgeon is frequently required to interact with multiple computer interfaces in order to obtain updates and exert control over the various devices at his disposal. To reduce this complexity and provide the surgeon with more complete and precise control of the operating room systems, a unified interface and communication network has been developed. In addition to improving efficiency, this network also allows the surgeon to grant remote access to consultants and observers at other institutions, enabling experts to participate in the procedure without having to travel to the site.

Proteus DSA control room in Mojave, CA

NASA Image and Video Library

2003-04-03

Proteus DSA control room in Mojave, CA (L to R) Jean-Pierre Soucy; Amphitech International Software engineer Craig Bomben; NASA Dryden Test Pilot Pete Siebold; (with headset, at computer controls) Scaled Composites pilot Bob Roehm; New Mexico State University (NMSU) UAV Technical Analysis Application Center (TAAC) Chuck Coleman; Scaled Composites Pilot Kari Sortland; NMSU TAAC Russell Wolfe; Modern Technology Solutions, Inc. Scaled Composites' unique tandem-wing Proteus was the testbed for a series of UAV collision-avoidance flight demonstrations. An Amphitech 35GHz radar unit installed below Proteus' nose was the primary sensor for the Detect, See and Avoid tests.

An environmental disinfection odyssey: evaluation of sequential interventions to improve disinfection of Clostridium difficile isolation rooms.

PubMed

Sitzlar, Brett; Deshpande, Abhishek; Fertelli, Dennis; Kundrapu, Sirisha; Sethi, Ajay K; Donskey, Curtis J

2013-05-01

OBJECTIVE. Effective disinfection of hospital rooms after discharge of patients with Clostridium difficile infection (CDI) is necessary to prevent transmission. We evaluated the impact of sequential cleaning and disinfection interventions by culturing high-touch surfaces in CDI rooms after cleaning. DESIGN. Prospective intervention. SETTING. A Veterans Affairs hospital. INTERVENTIONS. During a 21-month period, 3 sequential tiered interventions were implemented: (1) fluorescent markers to provide monitoring and feedback on thoroughness of cleaning facility-wide, (2) addition of an automated ultraviolet radiation device for adjunctive disinfection of CDI rooms, and (3) enhanced standard disinfection of CDI rooms, including a dedicated daily disinfection team and implementation of a process requiring supervisory assessment and clearance of terminally cleaned CDI rooms. To determine the impact of the interventions, cultures were obtained from CDI rooms after cleaning and disinfection. RESULTS. The fluorescent marker intervention improved the thoroughness of cleaning of high-touch surfaces (from 47% to 81% marker removal; P < .0001). Relative to the baseline period, the prevalence of positive cultures from CDI rooms was reduced by 14% (P=.024), 48% (P <.001), and 89% (P=.006) with interventions 1, 2, and 3, respectively. During the baseline period, 67% of CDI rooms had positive cultures after disinfection, whereas during interventions periods 1, 2, and 3 the percentages of CDI rooms with positive cultures after disinfection were reduced to 57%, 35%, and 7%, respectively. CONCLUSIONS. An intervention that included formation of a dedicated daily disinfection team and implementation of a standardized process for clearing CDI rooms achieved consistent CDI room disinfection. Culturing of CDI rooms provides a valuable tool to drive improvements in environmental disinfection.

3. Credit BG. The interior of the control room appears ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. Credit BG. The interior of the control room appears in this view, looking north (0°). The control console in the room center permitted remote control of various propellant grinders and mixers in surrounding buildings. Television monitors (absent from their mounts in this view) permitted direct viewing of operating machinery. From foreground to background: Panel (1) contains OGAR warning light switches for Curing Buildings E-39, E-40, E-41 and E-86; (O=off, G=green safe, A=amber caution, R=red danger) Panel (2) E-85 Oxidizer Dryer Building console: OGAR switch Panel (3) E-84 Oxidizer Grinder Building console: controls for vibrator, feed, and hammer; Panel (4) E-36 Oxidizer Grinder Building console: controls for vibrator, feed, hammer, attritor, and SWECO ("SWECO" undefined) Panels (5) & (6) blank Panel (7) E-38 Mixer & Casting Building console: vacuum pump, blender, heating and cooling controls Panel (8) E-37 Mixer & Casting Building console: motor controls for 1 pint, 1 gallon, 5 gallon and 30 gallon mixers; vacuum pump, deluge (fire suppression), pot up/down, vibrator, feed, and SWECO. - Jet Propulsion Laboratory Edwards Facility, Weigh & Control Building, Edwards Air Force Base, Boron, Kern County, CA

Benefits of Advanced Control Room Technologies: Phase One Upgrades to the HSSL, Research Plan, and Performance Measures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le Blanc, Katya; Joe, Jeffrey; Rice, Brandon

Control Room modernization is an important part of life extension for the existing light water reactor fleet. None of the 99 currently operating commercial nuclear power plants in the U.S. has completed a full-scale control room modernization to date. A full-scale modernization might, for example, entail replacement of all analog panels with digital workstations. Such modernizations have been undertaken successfully in upgrades in Europe and Asia, but the U.S. has yet to undertake a control room upgrade of this magnitude. Instead, nuclear power plant main control rooms for the existing commercial reactor fleet remain significantly analog, with only limited digitalmore » modernizations. Previous research under the U.S. Department of Energy’s Light Water Reactor Sustainability Program has helped establish a systematic process for control room upgrades that support the transition to a hybrid control room. While the guidance developed to date helps streamline the process of modernization and reduce costs and uncertainty associated with introducing digital control technologies into an existing control room, these upgrades do not achieve the full potential of newer technologies that might otherwise enhance plant and operator performance. The aim of the control room benefits research is to identify previously overlooked benefits of modernization, identify candidate technologies that may facilitate such benefits, and demonstrate these technologies through human factors research. This report describes the initial upgrades to the HSSL and outlines the methodology for a pilot test of the HSSL configuration.« less

17. DETAIL INTERIOR VIEW OF CONTROL ROOM ON LEVEL +77 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. DETAIL INTERIOR VIEW OF CONTROL ROOM ON LEVEL +77 OF POWERHOUSE #1; NOTEBOOKS IN FOREGROUND ARE ON TOP OF THE NEW SWITCH GEAR CONTROL CONSOLE; THE ORIGINAL OPERATOR DESK IS IN CENTER; THE ORIGINAL BENCH BOARD CONTROLS ARE IN BACKGROUND. - Bonneville Project, Powerhouse No.1, Spanning Bradford Slough, from Bradford Island, Bonneville, Multnomah County, OR

Mission Operations Control Room (MOCR) activities during STS-6 mission

NASA Image and Video Library

1983-04-05

Astronauts Roy D. Bridges (left) and RIchard O. Covey serve as spacecraft communicators (CAPCOM) for STS-6. They are seated at the CAPCOM console in the mission operations control room (MOCR) of JSC's mission control center (30119); Flight Director Jay H. Greene communicates with a nearby flight controller in the MOCR just after launch of the Challenger (30120).

8. INTERIOR, CONTROL AND INSTRUMENTATION ROOM. Looking southwest toward entrance ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. INTERIOR, CONTROL AND INSTRUMENTATION ROOM. Looking southwest toward entrance and inner blast door. - Edwards Air Force Base, South Base Sled Track, Firing & Control Blockhouse for 10,000-foot Track, South of Sled Track at midpoint of 20,000-foot track, Lancaster, Los Angeles County, CA

The 'Room within a Room' Concept for Monitored Warhead Dismantlement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanner, Jennifer E.; Benz, Jacob M.; White, Helen

2014-12-01

Over the past 10 years, US and UK experts have engaged in a technical collaboration with the aim of improving scientific and technological abilities in support of potential future nuclear arms control and non-proliferation agreements. In 2011 a monitored dismantlement exercise provided an opportunity to develop and test potential monitoring technologies and approaches. The exercise followed a simulated nuclear object through a dismantlement process and looked to explore, with a level of realism, issues surrounding device and material monitoring, chain of custody, authentication and certification of equipment, data management and managed access. This paper focuses on the development and deploymentmore » of the ‘room-within-a-room’ system, which was designed to maintain chain of custody during disassembly operations. A key challenge for any verification regime operating within a nuclear weapon complex is to provide the monitoring party with the opportunity to gather sufficient evidence, whilst protecting sensitive or proliferative information held by the host. The requirement to address both monitoring and host party concerns led to a dual function design which: • Created a controlled boundary around the disassembly process area which could provide evidence of unauthorised diversion activities. • Shielded sensitive disassembly operations from monitoring party observation. The deployed room-within-a-room was an integrated system which combined a number of chain of custody technologies (i.e. cameras, tamper indicating panels and enclosures, seals, unique identifiers and radiation portals) and supporting deployment procedures. This paper discusses the bounding aims and constraints identified by the monitoring and host parties with respect to the disassembly phase, the design of the room-within-a-room system, lessons learned during deployment, conclusions and potential areas of future work. Overall it was agreed that the room-within-a-room approach was

27. Pump Room interiorDrainage pump motor control center with main ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

27. Pump Room interior-Drainage pump motor control center with main valve control panel at right. - Hunters Point Naval Shipyard, Drydock No. 4, East terminus of Palou Avenue, San Francisco, San Francisco County, CA

Clifford Charlesworth seated at his console in Mission Control Room

NASA Image and Video Library

1968-12-21

S68-55742 (21 Dec. 1968) --- Clifford E. Charlesworth, Apollo 8 "Green Team" flight director, is seated at his console in the Mission Operations Control Room in the Mission Control Center, Building 30, during the launch of the Apollo 8 (Spacecraft 103/Saturn 503) manned lunar orbit space mission.

8. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF DINING/RECREATION ROOM. VIEW ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. LAUNCH CONTROL SUPPORT BUILDING. INTERIOR OF DINING/RECREATION ROOM. VIEW TO EAST. - Minuteman III ICBM Launch Control Facility November-1, 1.5 miles North of New Raymer & State Highway 14, New Raymer, Weld County, CO

Impact of imaging room environment: staff job stress and satisfaction, patient satisfaction, and willingness to recommend.

PubMed

Quan, Xiaobo; Joseph, Anjali; Ensign, Janet C

2012-01-01

The built environment significantly affects the healthcare experiences of patients and staff. Healthcare administrators and building designers face the opportunity and challenge of improving healthcare experience and satisfaction through better environmental design. The purpose of the study was to evaluate how a novel environmental intervention for imaging rooms, which integrated multiple elements of healing environments including positive distractions and personal control over environment, affects the perceptions and satisfactions of its primary users-patients and staff. Anonymous questionnaire surveys were conducted to compare patient and staff perceptions of the physical environment, satisfaction, and stress in two types of imaging rooms: imaging rooms with the intervention installed (intervention rooms) and traditionally designed rooms without the intervention (comparison rooms). Imaging technologists and patients perceived the intervention rooms to be significantly more pleasant-looking. Patients in the intervention rooms reported significantly higher levels of environmental control and were significantly more willing to recommend the intervention rooms to others. The environmental intervention was effective in improving certain aspects of the imaging environment: pleasantness and environmental control. Further improvement of the imaging environment is needed to address problematic areas such as noise.

12. Historic view of Building 100 control room, showing television ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. Historic view of Building 100 control room, showing television monitoring of tests and personnel operating rocket engine test controls. May 27, 1957. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-45021. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Action Research to Improve Methods of Delivery and Feedback in an Access Grid Room Environment

ERIC Educational Resources Information Center

McArthur, Lynne C.; Klass, Lara; Eberhard, Andrew; Stacey, Andrew

2011-01-01

This article describes a qualitative study which was undertaken to improve the delivery methods and feedback opportunity in honours mathematics lectures which are delivered through Access Grid Rooms. Access Grid Rooms are facilities that provide two-way video and audio interactivity across multiple sites, with the inclusion of smart boards. The…

Altitude Wind Tunnel Control Room at the Aircraft Engine Research Laboratory

NASA Image and Video Library

1944-07-21

Operators in the control room for the Altitude Wind Tunnel at the National Advisory Committee for Aeronautics (NACA) Aircraft Engine Research Laboratory remotely operate a Wright R–3350 engine in the tunnel’s test section. Four of the engines were used to power the B–29 Superfortress, a critical weapon in the Pacific theater during World War II. The wind tunnel, which had been in operation for approximately six months, was the nation’s only wind tunnel capable of testing full-scale engines in simulated altitude conditions. The soundproof control room was used to operate the wind tunnel and control the engine being run in the test section. The operators worked with assistants in the adjacent Exhauster Building and Refrigeration Building to manage the large altitude simulation systems. The operator at the center console controlled the tunnel’s drive fan and operated the engine in the test section. Two sets of pneumatic levers near his right forearm controlled engine fuel flow, speed, and cooling. Panels on the opposite wall, out of view to the left, were used to manage the combustion air, refrigeration, and exhauster systems. The control panel also displayed the master air speed, altitude, and temperature gauges, as well as a plethora of pressure, temperature, and airflow readings from different locations on the engine. The operator to the right monitored the manometer tubes to determine the pressure levels. Despite just being a few feet away from the roaring engine, the control room remained quiet during the tests.

Designing an Alternate Mission Operations Control Room

NASA Technical Reports Server (NTRS)

Montgomery, Patty; Reeves, A. Scott

2014-01-01

The Huntsville Operations Support Center (HOSC) is a multi-project facility that is responsible for 24x7 real-time International Space Station (ISS) payload operations management, integration, and control and has the capability to support small satellite projects and will provide real-time support for SLS launches. The HOSC is a service-oriented/ highly available operations center for ISS payloads-directly supporting science teams across the world responsible for the payloads. The HOSC is required to endure an annual 2-day power outage event for facility preventive maintenance and safety inspection of the core electro-mechanical systems. While complete system shut-downs are against the grain of a highly available sub-system, the entire facility must be powered down for a weekend for environmental and safety purposes. The consequence of this ground system outage is far reaching: any science performed on ISS during this outage weekend is lost. Engineering efforts were focused to maximize the ISS investment by engineering a suitable solution capable of continuing HOSC services while supporting safety requirements. The HOSC Power Outage Contingency (HPOC) System is a physically diversified compliment of systems capable of providing identified real-time services for the duration of a planned power outage condition from an alternate control room. HPOC was designed to maintain ISS payload operations for approximately three continuous days during planned HOSC power outages and support a local Payload Operations Team, International Partners, as well as remote users from the alternate control room located in another building.

14. INTERIOR VIEW OF PROPELLER STAND CONTROL ROOM. WrightPatterson ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. INTERIOR VIEW OF PROPELLER STAND CONTROL ROOM. - Wright-Patterson Air Force Base, Area B, Building No. 20A, Propeller Test Complex, Seventh Street, from E to G Streets, Dayton, Montgomery County, OH

16. View of Building 100 control room. 1987. On file ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

16. View of Building 100 control room. 1987. On file at NASA Glenn Research Center, Cleveland, Ohio. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Sound-field reproduction in-room using optimal control techniques: simulations in the frequency domain.

PubMed

Gauthier, Philippe-Aubert; Berry, Alain; Woszczyk, Wieslaw

2005-02-01

This paper describes the simulations and results obtained when applying optimal control to progressive sound-field reproduction (mainly for audio applications) over an area using multiple monopole loudspeakers. The model simulates a reproduction system that operates either in free field or in a closed space approaching a typical listening room, and is based on optimal control in the frequency domain. This rather simple approach is chosen for the purpose of physical investigation, especially in terms of sensing microphones and reproduction loudspeakers configurations. Other issues of interest concern the comparison with wave-field synthesis and the control mechanisms. The results suggest that in-room reproduction of sound field using active control can be achieved with a residual normalized squared error significantly lower than open-loop wave-field synthesis in the same situation. Active reproduction techniques have the advantage of automatically compensating for the room's natural dynamics. For the considered cases, the simulations show that optimal control results are not sensitive (in terms of reproduction error) to wall absorption in the reproduction room. A special surrounding configuration of sensors is introduced for a sensor-free listening area in free field.

133. NITROGEN SUPPLY PANEL ON SOUTH WALL OF CONTROL ROOM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

133. NITROGEN SUPPLY PANEL ON SOUTH WALL OF CONTROL ROOM (114), LSB (BLDG. 770) - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

143. MOBILE HIGH PRESSURE NITROGEN CART STORED IN CONTROL ROOM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

143. MOBILE HIGH PRESSURE NITROGEN CART STORED IN CONTROL ROOM (214), LSB (BLDG. 751) - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

137. VALVES ON SOUTH WALL OF LIQUID NITROGEN CONTROL ROOM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

137. VALVES ON SOUTH WALL OF LIQUID NITROGEN CONTROL ROOM (115), LSB (BLDG. 770) - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

11. ENGINE TEST CELL BUILDING INTERIOR. CONTROL ROOM FOR CELLS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. ENGINE TEST CELL BUILDING INTERIOR. CONTROL ROOM FOR CELLS 2 AND 4. LOOKING SOUTHEAST. - Fairchild Air Force Base, Engine Test Cell Building, Near intersection of Arnold Street & George Avenue, Spokane, Spokane County, WA

NFL Films music scoring stage and control room space

NASA Astrophysics Data System (ADS)

Berger, Russ; Schrag, Richard C.; Ridings, Jason J.

2003-04-01

NFL Films' new 200,000 sq. ft. corporate headquarters is home to an orchestral scoring stage used to record custom music scores to support and enhance their video productions. Part of the 90,000 sq. ft. of sound critical technical space, the music scoring stage and its associated control room are at the heart of the audio facilities. Driving the design were the owner's mandate for natural light, wood textures, and an acoustical environment that would support small rhythm sections, soloists, and a full orchestra. Being an industry leader in cutting-edge video and audio formats, the NFLF required that the technical spaces allow the latest in technology to be continually integrated into the infrastructure. Never was it more important for a project to hold true to the adage of ``designing from the inside out.'' Each audio and video space within the facility had to stand on its own with regard to user functionality, acoustical accuracy, sound isolation, noise control, and monitor presentation. A detailed look at the architectural and acoustical design challenges encountered and the solutions developed for the performance studio and the associated control room space will be discussed.

68. TURBINE HALL, LOOKING DOWN FROM THE CONTROL ROOM INTO ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

68. TURBINE HALL, LOOKING DOWN FROM THE CONTROL ROOM INTO TURBINE HALL AT UNITS 3, 5, AND 2) - Delaware County Electric Company, Chester Station, Delaware River at South end of Ward Street, Chester, Delaware County, PA

11. VIEW LOOKING EAST AT MODEL AIRCRAFT CONTROL ROOM; MODEL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. VIEW LOOKING EAST AT MODEL AIRCRAFT CONTROL ROOM; MODEL OF BOEING 737 AT TOP OF PHOTOGRAPH IN FULL-SCALE WIND TUNNEL. - NASA Langley Research Center, Full-Scale Wind Tunnel, 224 Hunting Avenue, Hampton, Hampton, VA

15. Interior view of unoccupied controlled computer room looking at ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. Interior view of unoccupied controlled computer room looking at exit door and office; northwest corner of unoccupied portion; view to south. - Ellsworth Air Force Base, Mess & Administration Building, 2279 Risner Drive, Blackhawk, Meade County, SD

5. VIEW TO SOUTH IN CONTROL ROOM ABOVE PUMP CHAMBER, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. VIEW TO SOUTH IN CONTROL ROOM ABOVE PUMP CHAMBER, SHOWING PUMP MOTOR AND STEEL BULKHEADS IN FLOOR FOR ACCESS TO PUMPS - Providence Sewage Treatment System, Reservoir Avenue Pumping Station, Reservoir & Pontiac Avenues, Providence, Providence County, RI

8. INTERIOR, FIRE ALARM CONTROL ROOM (NORTH OF MAIN GARAGE), ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. INTERIOR, FIRE ALARM CONTROL ROOM (NORTH OF MAIN GARAGE), FROM ENTRYWAY, LOOKING NORTH, SHOWING ADDITIONAL 'GAMEWELL' FIRE ALARM SYSTEMS. - Oakland Naval Supply Center, Firehouse, East of Fourth Street, between A & B Streets, Oakland, Alameda County, CA

Comprehensive Surgical Coaching Enhances Surgical Skill in the Operating Room: A Randomized Controlled Trial.

PubMed

Bonrath, Esther M; Dedy, Nicolas J; Gordon, Lauren E; Grantcharov, Teodor P

2015-08-01

The aim of the study was to determine whether individualized coaching improved surgical technical skill in the operating room to a higher degree than current residency training. Clinical training in the operating room is a valuable opportunity for surgeons to acquire skill and knowledge; however, it often remains underutilized. Coaching has been successfully used in various industries to enhance performance, but its role in surgery has been insufficiently investigated. This randomized controlled trial was conducted at one surgical training program. Trainees undergoing a minimally invasive surgery rotation were randomized to either conventional training (CT) or comprehensive surgical coaching (CSC). CT included ward and operating room duties, and regular departmental teaching sessions. CSC comprised performance analysis, debriefing, feedback, and behavior modeling. Primary outcome measures were technical performance as measured on global and procedure-specific rating scales, and surgical safety parameters, measured by error count. Operative performance was assessed by blinded video analysis of the first and last cases recorded by the participants during their rotation. Twenty residents were randomized and 18 completed the study. At posttraining the CSC group (n = 9) scored significantly higher on a procedure-specific skill scale compared with the CT group (n = 9) [median, 3.90 (interquartile range, 3.68-4.30) vs 3.60 (2.98-3.70), P = 0.017], and made fewer technical errors [10 (7-13) vs 18 (13-21), P = 0.003]. Significant within-group improvements for all skill metrics were only noted in the CSC group. Comprehensive surgical coaching enhances surgical training and results in skill acquisition superior to conventional training.

Improving Patients Experience in Peadiatric Emergency Waiting Room.

PubMed

Ehrler, Frederic; Siebert, Johan; Wipfli, Rolf; Duret, Cyrille; Gervaix, Alain; Lovis, Christian

2016-01-01

When visiting the emergency department, the perception of the time spent in the waiting room before the beginning of the care, may influence patients' experience. Based on models of service evaluation, highlighting the importance of informing people about their waiting process and their place in the queue, we have developed an innovative information screen aiming at improving perception of time by patients. Following an iterative process, a group of experts including computer scientists, ergonomists and caregivers designed a solution adapted to the pediatric context. The solution includes a screen displaying five lanes representing triage levels. Patients are represented by individual avatars, drawn sequentially in the appropriate line. The interface has been designed using gamification principle, aiming at increasing acceptance, lowering learning curve and improving satisfaction. Questionnaire based evaluation results revealed high satisfaction from the 278 respondents even if the informative content was not always completely clear.

76 FR 35130 - Pipeline Safety: Control Room Management/Human Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Parts...: Control Room Management/Human Factors AGENCY: Pipeline and Hazardous Materials Safety Administration... safety standards, risk assessments, and safety policies for natural gas pipelines and for hazardous...

30. Perimeter acquisition radar building room #318, showing radar control. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

30. Perimeter acquisition radar building room #318, showing radar control. Console and line printers - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

114. WEST SIDE OF LIQUID OXYGEN CONTROL ROOM (205). LIQUID ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

114. WEST SIDE OF LIQUID OXYGEN CONTROL ROOM (205). LIQUID NITROGEN (LN2) SUBCOOLER ON LEFT; SKID 8, LIQUID OXYGEN CONTROLLER FOR SWITCHING BETWEEN RAPID-LOAD AND TOPPING ON RIGHT. LIQUID OXYGEN LINE FROM SKID 9A AT RIGHT EDGE OF PHOTO. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Use of Recirculating Ventilation with Dust Filtration to Improve Wintertime Air Quality in a Swine Farrowing Room

PubMed Central

Anthony, T. Renée; Altmaier, Ralph; Jones, Samuel; Gassman, Rich; Park, Jae Hong; Peters, Thomas M.

2016-01-01

The performance of a recirculating ventilation system with dust filtration was evaluated to determine its effectiveness to improve the air quality in a swine farrowing room of a concentrated animal feeding operation (CAFO). Air was exhausted from the room (0.47 m3sec−1; 1000 cfm), treated with a filtration unit (Shaker-Dust Collector), and returned to the farrowing room to reduce dust concentrations while retaining heat necessary for livestock health. The air quality in the room was assessed over a winter, during which time limited fresh air is traditionally brought into the building. Over the study period, dust concentrations ranged from 0.005 to 0.31 mg m−3 (respirable) and 0.17 to 2.09 mg m−3 (inhalable). In-room dust concentrations were reduced (41% for respirable and 33% for inhalable) with the system in operation, while gas concentrations (ammonia [NH3], hydrogen sulfide [H2S], carbon monoxide [CO], carbon dioxide [CO2]) were unchanged. The position of the exhaust and return air systems provided reasonably uniform contaminant distributions, although the respirable dust concentrations nearest one of the exhaust ducts was statistically higher than other locations in the room, with differences averaging only 0.05 mg m−3. Throughout the study, CO2 concentrations consistently exceeded 1540 ppm (industry recommendations) and on eight of the 18 study days it exceeded 2500 ppm (50% of the ACGIH TLV), with significantly higher concentrations near a door to a temperature-controlled hallway that was typically often left open. Alternative heaters are recommended to reduce CO2 concentrations in the room. Contaminant concentrations were modeled using production and environmental factors, with NH3 related to the number of sow in the room and outdoor temperatures and CO2 related to the number of piglets and outdoor temperatures. The recirculating ventilation system provided dust reduction without increasing concentrations of hazardous gases. PMID:25950713

18. Historic plan of Building 100 control room. March 21, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

18. Historic plan of Building 100 control room. March 21, 1956. NASA GRC drawing number CE-101736. (On file at NASA Glenn Research Center). - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Mental workload measurement in operator control room using NASA-TLX

NASA Astrophysics Data System (ADS)

Sugarindra, M.; Suryoputro, M. R.; Permana, A. I.

2017-12-01

The workload, encountered a combination of physical workload and mental workload, is a consequence of the activities for workers. Central control room is one department in the oil processing company, employees tasked with monitoring the processing unit for 24 hours nonstop with a combination of 3 shifts in 8 hours. NASA-TLX (NASA Task Load Index) is one of the subjective mental workload measurement using six factors, namely the Mental demand (MD), Physical demand (PD), Temporal demand (TD), Performance (OP), Effort (EF), frustration levels (FR). Measurement of a subjective mental workload most widely used because it has a high degree of validity. Based on the calculation of the mental workload, there at 5 units (DTU, NPU, HTU, DIST and OPS) at the control chamber (94; 83.33; 94.67; 81, 33 and 94.67 respectively) that categorize as very high mental workload. The high level of mental workload on the operator in the Central Control Room is a requirement to have high accuracy, alertness and can make decisions quickly

INTERIOR OF SECOND FLOOR CONTROL ROOM OF FUEL STORAGE BUILDING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

INTERIOR OF SECOND FLOOR CONTROL ROOM OF FUEL STORAGE BUILDING (CPP-603). PHOTO TAKEN LOOKING SOUTHWEST. INL PHOTO NUMBER HD-54-19-2. Mike Crane, Photographer, 8/2005 - Idaho National Engineering Laboratory, Idaho Chemical Processing Plant, Fuel Reprocessing Complex, Scoville, Butte County, ID

Using human factors engineering to improve patient safety in the cardiovascular operating room.

PubMed

Gurses, Ayse P; Martinez, Elizabeth A; Bauer, Laura; Kim, George; Lubomski, Lisa H; Marsteller, Jill A; Pennathur, Priyadarshini R; Goeschel, Chris; Pronovost, Peter J; Thompson, David

2012-01-01

Despite significant medical advances, cardiac surgery remains a high risk procedure. Sub-optimal work system design characteristics can contribute to the risks associated with cardiac surgery. However, hazards due to work system characteristics have not been identified in the cardiovascular operating room (CVOR) in sufficient detail to guide improvement efforts. The purpose of this study was to identify and categorize hazards (anything that has the potential to cause a preventable adverse patient safety event) in the CVOR. An interdisciplinary research team used prospective hazard identification methods including direct observations, contextual inquiry, and photographing to collect data in 5 hospitals for a total 22 cardiac surgeries. We performed thematic analysis of the qualitative data guided by a work system model. 60 categories of hazards such as practice variations, high workload, non-compliance with evidence-based guidelines, not including clinicians' in medical device purchasing decisions were found. Results indicated that hazards are common in cardiac surgery and should be eliminated or mitigated to improve patient safety. To improve patient safety in the CVOR, efforts should focus on creating a culture of safety, increasing compliance with evidence based infection control practices, improving communication and teamwork, and designing better tools and technologies through partnership among all stakeholders.

Human factors engineering verification and validation for APR1400 computerized control room

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shin, Y. C.; Moon, H. K.; Kim, J. H.

2006-07-01

This paper introduces the Advanced Power Reactor 1400 (APR1400) HFE V and V activities the Korea Hydro Nuclear Plant Co. LTD. (KHNP) has performed for the last 10 years and some of the lessons learned through these activities. The features of APR1400 main control room include large display panel, redundant compact workstations, computer-based procedure, and safety console. Several iterations of human factors evaluations have been performed from small scale proof of concept tests to large scale integrated system tests for identifying human engineering deficiencies in the human system interface design. Evaluations in the proof of concept test were focused onmore » checking the presence of any show stopper problems in the design concept. Later evaluations were mostly for finding design problems and for assuring the resolution of human factors issues of advanced control room. The results of design evaluations were useful not only for refining the control room design, but also for licensing the standard design. Several versions of APR1400 mock-ups with dynamic simulation models of currently operating Korea Standard Nuclear Plant (KSNP) have been used for the evaluations with the participation of operators from KSNP plants. (authors)« less

IET control building (TAN620). interior room. sign says, "emergency equipment ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

IET control building (TAN-620). interior room. sign says, "emergency equipment for metal fires." INEEL negative no. HD-21-1-2 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

14. Historic view of engineer in Building 100 control room ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. Historic view of engineer in Building 100 control room examining data printout. 1957. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-46210. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

13. Historic view of Building 100 control room, showing personnel ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Historic view of Building 100 control room, showing personnel with data recording instrumentation. 1957. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-46211. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

The SmartOR: a distributed sensor network to improve operating room efficiency.

PubMed

Huang, Albert Y; Joerger, Guillaume; Fikfak, Vid; Salmon, Remi; Dunkin, Brian J; Bass, Barbara L; Garbey, Marc

2017-09-01

Despite the significant expense of OR time, best practice achieves only 70% efficiency. Compounding this problem is a lack of real-time data. Most current OR utilization programs require manual data entry. Automated systems require installation and maintenance of expensive tracking hardware throughout the institution. This study developed an inexpensive, automated OR utilization system and analyzed data from multiple operating rooms. OR activity was deconstructed into four room states. A sensor network was then developed to automatically capture these states using only three sensors, a local wireless network, and a data capture computer. Two systems were then installed into two ORs, recordings captured 24/7. The SmartOR recorded the following events: any room activity, patient entry/exit time, anesthesia time, laparoscopy time, room turnover time, and time of preoperative patient identification by the surgeon. From November 2014 to December 2015, data on 1003 cases were collected. The mean turnover time was 36 min, and 38% of cases met the institutional goal of ≤30 min. Data analysis also identified outlier cases (>1 SD from mean) in the domains of time from patient entry into the OR to intubation (11% of cases) and time from extubation to patient exiting the OR (11% of cases). Time from surgeon identification of patient to scheduled procedure start time was 11 min (institution bylaws require 20 min before scheduled start time), yet OR teams required 22 min on average to bring a patient into the room after surgeon identification. The SmartOR automatically and reliably captures data on OR room state and, in real time, identifies outlier cases that may be examined closer to improve efficiency. As no manual entry is required, the data are indisputable and allow OR teams to maintain a patient-centric focus.

28. SONAR CONTROL ROOM FORWARD LOOKING AFT SHOWING AN/SQS23G ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

28. SONAR CONTROL ROOM - FORWARD LOOKING AFT SHOWING AN/SQS-23G DETECTING-RANGING SET, MARK & CONTROL PANEL, CAN-55134 RECORDER, SPEED INDICATOR, VARIOUS ALARMS AND INTERNAL COMMUNICATION CIRCUITS. - U.S.S. HORNET, Puget Sound Naval Shipyard, Sinclair Inlet, Bremerton, Kitsap County, WA

15. Historic view of engineer in Building 100 control room ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. Historic view of engineer in Building 100 control room examining data printout. August 28, 1962. On file at NASA Plumbrook Research Facility, Sandusky, Ohio. NASA photo number C-61500. - Rocket Engine Testing Facility, GRC Building No. 100, NASA Glenn Research Center, Cleveland, Cuyahoga County, OH

Improving operating room efficiency in academic children's hospital using Lean Six Sigma methodology.

PubMed

Tagge, Edward P; Thirumoorthi, Arul S; Lenart, John; Garberoglio, Carlos; Mitchell, Kenneth W

2017-06-01

Lean Six Sigma (LSS) is a process improvement methodology that utilizes a collaborative team effort to improve performance by systematically identifying root causes of problems. Our objective was to determine whether application of LSS could improve efficiency when applied simultaneously to all services of an academic children's hospital. In our tertiary academic medical center, a multidisciplinary committee was formed, and the entire perioperative process was mapped, using fishbone diagrams, Pareto analysis, and other process improvement tools. Results for Children's Hospital scheduled main operating room (OR) cases were analyzed, where the surgical attending followed themselves. Six hundred twelve cases were included in the seven Children's Hospital operating rooms (OR) over a 6-month period. Turnover Time (interval between patient OR departure and arrival of the subsequent patient) decreased from a median 41min in the baseline period to 32min in the intervention period (p<0.0001). Turnaround Time (interval between surgical dressing application and subsequent surgical incision) decreased from a median 81.5min in the baseline period to 71min in the intervention period (p<0.0001). These results demonstrate that a coordinated multidisciplinary process improvement redesign can significantly improve efficiency in an academic Children's Hospital without preselecting specific services, removing surgical residents, or incorporating new personnel or technology. Prospective comparative study, Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

Human Factors Engineering Aspects of Modifications in Control Room Modernization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hugo, Jacques; Clefton, Gordon; Joe, Jeffrey

This report describes the basic aspects of control room modernization projects in the U.S. nuclear industry and the need for supplementary guidance on the integration of human factors considerations into the licensing and regulatory aspects of digital upgrades. The report pays specific attention to the integration of principles described in NUREG-0711 (Human Factors Engineering Program Review Model) and how supplementary guidance can help to raise general awareness in the industry regarding the complexities of control room modernization projects created by many interdependent regulations, standards and guidelines. The report also describes how human factors engineering principles and methods provided by variousmore » resources and international standards can help in navigating through the process of licensing digital upgrades. In particular, the integration of human factors engineering guidance and requirements into the process of licensing digital upgrades can help reduce uncertainty related to development of technical bases for digital upgrades that will avoid the introduction of new failure modes.« less

Institutional Tuberculosis Transmission. Controlled Trial of Upper Room Ultraviolet Air Disinfection: A Basis for New Dosing Guidelines.

PubMed

Mphaphlele, Matsie; Dharmadhikari, Ashwin S; Jensen, Paul A; Rudnick, Stephen N; van Reenen, Tobias H; Pagano, Marcello A; Leuschner, Wilhelm; Sears, Tim A; Milonova, Sonya P; van der Walt, Martie; Stoltz, Anton C; Weyer, Karin; Nardell, Edward A

2015-08-15

Transmission is driving the global tuberculosis epidemic, especially in congregate settings. Worldwide, natural ventilation is the most common means of air disinfection, but it is inherently unreliable and of limited use in cold climates. Upper room germicidal ultraviolet (UV) air disinfection with air mixing has been shown to be highly effective, but improved evidence-based dosing guidelines are needed. To test the efficacy of upper room germicidal air disinfection with air mixing to reduce tuberculosis transmission under real hospital conditions, and to define the application parameters responsible as a basis for proposed new dosing guidelines. Over an exposure period of 7 months, 90 guinea pigs breathed only untreated exhaust ward air, and another 90 guinea pigs breathed only air from the same six-bed tuberculosis ward on alternate days when upper room germicidal air disinfection was turned on throughout the ward. The tuberculin skin test conversion rates (>6 mm) of the two chambers were compared. The hazard ratio for guinea pigs in the control chamber converting their skin test to positive was 4.9 (95% confidence interval, 2.8-8.6), with an efficacy of approximately 80%. Upper room germicidal UV air disinfection with air mixing was highly effective in reducing tuberculosis transmission under hospital conditions. These data support using either a total fixture output (rather than electrical or UV lamp wattage) of 15-20 mW/m(3) total room volume, or an average whole-room UV irradiance (fluence rate) of 5-7 μW/cm(2), calculated by a lighting computer-assisted design program modified for UV use.

149. SOUTHEAST CORNER OF FUEL CONTROL ROOM (215), LSB (BLDG. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

149. SOUTHEAST CORNER OF FUEL CONTROL ROOM (215), LSB (BLDG. 751), WITH SKID 2 IN FOREGROUND; FUEL LINE TO LAUNCH VEHICLE ENTERING WALL ON LEFT BEHIND SKID 2 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

144. VIEW OF EAST WALL OF CONTROL ROOM (214), LSB ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

144. VIEW OF EAST WALL OF CONTROL ROOM (214), LSB (BLDG. 751). PNEUMATIC SUPPLY PANEL ON LEFT; NITROGEN AND HELIUM PIPING AT TOP; PURGE PANEL AT BOTTOM OF PHOTOGRAPH. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

VIEW OF HISTORIC SLATE SWITCHBOARD IN THE CONTROL ROOM OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW OF HISTORIC SLATE SWITCHBOARD IN THE CONTROL ROOM OF THE ELWHA POWERHOUSE, INCLUDING: METERS, PROTECTIVE RELAYS, AND SWITCHES. NOTE ADDITION OF PERSONAL COMPUTERS FOR POWER METERING AND OPERATIONS. PHOTO BY JET LOWE, HAER, 1995. - Elwha River Hydroelectric System, Elwha Hydroelectric Dam & Plant, Port Angeles, Clallam County, WA

Shaping the operating room and perioperative systems of the future: innovating for improved competitiveness.

PubMed

Seim, Andreas R; Sandberg, Warren S

2010-12-01

To review the current state of anesthesiology for operative and invasive procedures, with an eye toward possible future states. Anesthesiology is at once a mature specialty and in a crisis--requiring breakthrough to move forward. The cost of care now approaches reimbursement, and outcomes as commonly measured approach perfection. Thus, the cost of further improvements seems ready to topple the field, just as the specialty is realizing that seemingly innocuous anesthetic choices have long-term consequences, and better practice is required. Anesthesiologists must create more headroom between costs and revenues in order to sustain the academic vigor and creativity required to create better clinical practice. We outline three areas in which technological and organizational innovation in anesthesiology can improve competitiveness and become a driving force in collaborative efforts to develop the operating rooms and perioperative systems of the future: increasing the profitability of operating rooms; increasing the efficiency of anesthesia; and technological and organizational innovation to foster improved patient flow, communication, coordination, and organizational learning.

75 FR 5536 - Pipeline Safety: Control Room Management/Human Factors, Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Parts...: Control Room Management/Human Factors, Correction AGENCY: Pipeline and Hazardous Materials Safety... following correcting amendments: PART 192--TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM...

7. CONSTRUCTION PROGRESS VIEW (INTERIOR) OF CONTROL ROOM PANEL INSIDE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. CONSTRUCTION PROGRESS VIEW (INTERIOR) OF CONTROL ROOM PANEL INSIDE BUNKER. SHOWS OPENING TO CABLE CHASE, FOUR PULLEY DEVICES, POWER OUTLET, CONDUIT, AND EAST END WALL OF BUNKER. INEL PHOTO NUMBER 65-5441, TAKEN OCTOBER 20, 1965. - Idaho National Engineering Laboratory, Advanced Reentry Vehicle Fusing System, Scoville, Butte County, ID

Care in a birth room versus a conventional setting: a controlled trial.

PubMed Central

Klein, M; Papageorgiou, A; Westreich, R; Spector-Dunsky, L; Elkins, V; Kramer, M S; Gelfand, M M

1984-01-01

A controlled clinical trial was carried out to assess whether a birth room setting would influence the care of mothers and newborns. Of the 163 low-risk women enrolled, 49 (30%) manifested some prenatal risk and were excluded. The remaining 114 were allocated by strict alternation to a birth room or a conventional setting. Of the 56 women allocated to the birth room, 63% of the primiparas and 19% of the multiparas were later transferred. The numbers in the two settings who had oxytocin stimulation, epidural anesthesia, forceps delivery or cesarean section did not show statistically significant differences. The episiotomy rates were slightly lower in the birth room than in the conventional setting, and the rates of an intact perineum were higher in the birth room. Neither the Apgar scores nor the morbidity rates of the infants showed statistically significant differences related to the setting to which the mother had been allocated, although more infants from the conventional setting were admitted to a special care unit. Both "experimental" groups of women less often received routine perineal shaving, enemas or intravenous infusions than did an obstetrically similar nonexperimental comparison group. Despite the apparent inability in this setting for the birth room to influence the rate of major obstetric procedures (except for episiotomy) and outcomes, the authors believe that a birth room is desirable in tertiary care centres as well as in community hospitals. PMID:6388776

Effectiveness of in-room air filtration and dilution ventilation for tuberculosis infection control.

PubMed

Miller-Leiden, S; Lobascio, C; Nazaroff, W W; Macher, J M

1996-09-01

Tuberculosis (TB) is a public health problem that may pose substantial risks to health care workers and others. TB infection occurs by inhalation of airborne bacteria emitted by persons with active disease. We experimentally evaluated the effectiveness of in-room air filtration systems, specifically portable air filters (PAFs) and ceiling-mounted air filters (CMAFs), in conjunction with dilution ventilation, for controlling TB exposure in high-risk settings. For each experiment, a test aerosol was continuously generated and released into a full-sized room. With the in-room air filter and room ventilation system operating, time-averaged airborne particle concentrations were measured at several points. The effectiveness of in-room air filtration plus ventilation was determined by comparing particle concentrations with and without device operation. The four PAFs and three CMAFs we evaluated reduced room-average particle concentrations, typically by 30% to 90%, relative to a baseline scenario with two air-changes per hour of ventilation (outside air) only. Increasing the rate of air flow recirculating through the filter and/or air flow from the ventilation did not always increase effectiveness. Concentrations were generally higher near the emission source than elsewhere in the room. Both the air flow configuration of the filter and its placement within the room were important, influencing room air flow patterns and the spatial distribution of concentrations. Air filters containing efficient, but non-high efficiency particulate air (HEPA) filter media were as effective as air filters containing HEPA filter media.

Effectiveness of In-Room Air Filtration and Dilution Ventilation for Tuberculosis Infection Control.

PubMed

Miller-Leiden, S; Lohascio, C; Nazaroff, W W; Macher, J M

1996-09-01

Tuberculosis (TB) is a public health problem that may pose substantial risks to health care workers and others. TB infection occurs by inhalation of airborne bacteria emitted by persons with active disease. We experimentally evaluated the effectiveness of in-room air filtration systems, specifically portable air filters (PAFs) and ceiling-mounted air filters (CMAFs), in conjunction with dilution ventilation, for controlling TB exposure in high-risk settings. For each experiment, a test aerosol was continuously generated and released into a full-sized room. With the in-room air filter and room ventilation system operating, time-averaged airborne particle concentrations were measured at several points. The effectiveness of in-room air filtration plus ventilation was determined by comparing particle concentrations with and without device operation. The four PAFs and three CMAFs we evaluated reduced room-average particle concentrations, typically by 30% to 90%, relative to a baseline scenario with two air-changes per hour of ventilation (outside air) only. Increasing the rate of air flow recirculating through the filter and/or air flow from the ventilation did not always increase effectiveness. Concentrations were generally higher near the emission source than elsewhere in the room. Both the air flow configuration of the filter and its placement within the room were important, influencing room air flow patterns and the spatial distribution of concentrations. Air filters containing efficient, but non-high efficiency particulate air (HEPA) filter media were as effective as air filters containing HEPA filter media.

IET control building (TAN620). interior personnel service room. sign next ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

IET control building (TAN-620). interior personnel service room. sign next to shower stall says, "fight athlete's foot with sani-mist." INEEL negative no. HD-21-1-1 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Documentation of White Flight Control Room (WFCR), Building 30 during STS-109.

NASA Image and Video Library

2002-03-07

JSC2002-E-08460 (7 March 2002) --- Flight directors Jeff Hanley (standing) and Bryan P. Austin watch the large screens from their consoles in the shuttle flight control room (WFCR) in Houston’;s Mission Control Center (MCC) during the STS-109 Hubble Space Telescope (HST) servicing mission.

Motor Room, overall view to the west. The control cabinet ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Motor Room, overall view to the west. The control cabinet and cement pipes along the south wall are being temporarily stored in the Pumping Plant and are not part of the original equipment - Wellton-Mohawk Irrigation System, Pumping Plant No. 1, Bounded by Gila River & Union Pacific Railroad, Wellton, Yuma County, AZ

18. NORTH SIDE OF CONTROL ROOM SHOWING MAIN ELECTRIC PANEL ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

18. NORTH SIDE OF CONTROL ROOM SHOWING MAIN ELECTRIC PANEL ON LEFT, SIGNAL SWITCH BOX IN CENTER, AND SIGNAL RELAYS ON RIGHT. RESISTOR BANK BEHIND ON RIGHT. BRIDGE TENDER'S DESK BEHIND ON SOUTH SIDE. (Fred Small) - Burlington Northern Railroad Bridge, Spanning Willamette River at River Mile 6.9, Portland, Multnomah County, OR

12. "TAPE ROOM" LOCATED AT SOUTHEAST CORNER OF MAIN ROOM. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. "TAPE ROOM" LOCATED AT SOUTHEAST CORNER OF MAIN ROOM. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Instrumentation & Control Building, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, FACING NORTH - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, FACING SOUTHEAST - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 3, FACING EAST - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 4, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

DETAIL VIEW OF OPERATIONS MANAGEMENT ROOM, FIRING ROOM NO. 4, FACING WEST - Cape Canaveral Air Force Station, Launch Complex 39, Launch Control Center, LCC Road, East of Kennedy Parkway North, Cape Canaveral, Brevard County, FL

Improvement of Superplasticity in High-Mg Aluminum Alloys by Sacrifice of Some Room Temperature Formability

NASA Astrophysics Data System (ADS)

Jin, H.; Amirkhiz, B. Shalchi; Lloyd, D. J.

2018-03-01

The mechanical properties of fully annealed Al-4.6 wt pct Mg alloys with different levels of Mn and Fe have been characterized at room and superplastic forming (SPF) temperatures. The effects of Mn and Fe on the intermetallic phase, grain structure, and cavitation were investigated and correlated to the formability at different temperatures. Although both Mn and Fe contribute to the formation of Al6(Mn,Fe) phase, which refines the grain structure by particle-stimulated nucleation and Zener pinning, their effects are different. An increasing Mn reduces the room temperature formability due to the increasing number of intermetallic particles, but significantly improves the superplasticity by fine grain size-induced grain boundary sliding. Meanwhile, the Fe makes the constituent particles very coarse, resulting in reduced formability at all temperatures due to extensive cavitation. A combination of high Mn and low Fe is therefore beneficial to SPF, while low levels of both elements are good for cold forming. Consequently, the superplasticity of high-Mg aluminum alloys can be significantly improved by modifying the chemical composition with sacrifice of some room temperature formability.

Coaching Non-technical Skills Improves Surgical Residents' Performance in a Simulated Operating Room.

PubMed

Yule, Steven; Parker, Sarah Henrickson; Wilkinson, Jill; McKinley, Aileen; MacDonald, Jamie; Neill, Adrian; McAdam, Tim

2015-01-01

To investigate the effect of coaching on non-technical skills and performance during laparoscopic cholecystectomy in a simulated operating room (OR). Non-technical skills (situation awareness, decision making, teamwork, and leadership) underpin technical ability and are critical to the success of operations and the safety of patients in the OR. The rate of developing assessment tools in this area has outpaced development of workable interventions to improve non-technical skills in surgical training and beyond. A randomized trial was conducted with senior surgical residents (n = 16). Participants were randomized to receive either non-technical skills coaching (intervention) or to self-reflect (control) after each of 5 simulated operations. Coaching was based on the Non-Technical Skills For Surgeons (NOTSS) behavior observation system. Surgeon-coaches trained in this method coached participants in the intervention group for 10 minutes after each simulation. Primary outcome measure was non-technical skills, assessed from video by a surgeon using the NOTSS system. Secondary outcomes were time to call for help during bleeding, operative time, and path length of laparoscopic instruments. Non-technical skills improved in the intervention group from scenario 1 to scenario 5 compared with those in the control group (p = 0.04). The intervention group was faster to call for help when faced with unstoppable bleeding in the final scenario (no. 5; p = 0.03). Coaching improved residents' non-technical skills in the simulated OR compared with those in the control group. Important next steps are to implement non-technical skills coaching in the real OR and assess effect on clinically important process measures and patient outcomes. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Cervical Spine Collar Removal by Emergency Room Nurses: A Quality Improvement Project.

PubMed

Fontaine, Guillaume; Forgione, Massimo; Lusignan, Francis; Lanoue, Marc-André; Drouin, Simon

2018-05-01

The Canadian C-Spine Rule (CCR) is a clinical decision aid to facilitate the safe removal of cervical collars in the alert, orientated, low-risk adult trauma patient. Few health care settings have assessed initiatives to train charge nurses to use the CCR. This practice improvement project conducted in a secondary trauma center in Canada aimed to (1) train charge nurses of the emergency room to use the CCR, (2) monitor its use throughout the project period, and (3) compare the assessments of the charge nurses with those of emergency physicians. The project began with the creation of an interdisciplinary team. Clinical guidelines were established by the interdisciplinary project team. Nine charge nurses of the emergency room were then trained to use the CCR (3 on each 8-hour shift). The use of the CCR was monitored throughout the project period, from June 1 to October 5, 2016. The 3 aims of this practice improvement project were attained successfully. Over a 5-month period, 114 patients were assessed with the CCR. Charge nurses removed the cervical collars for 54 of 114 patients (47%). A perfect agreement rate (114 of 114 patients, 100%) was attained between the assessments of the nurses and those of physicians. This project shows that the charge nurses of a secondary trauma center can use the CCR safely on alert, orientated, and low-risk adult trauma patients as demonstrated by the agreement in the assessments of emergency room nurses and physicians. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Procedure and information displays in advanced nuclear control rooms: experimental evaluation of an integrated design.

PubMed

Chen, Yue; Gao, Qin; Song, Fei; Li, Zhizhong; Wang, Yufan

2017-08-01

In the main control rooms of nuclear power plants, operators frequently have to switch between procedure displays and system information displays. In this study, we proposed an operation-unit-based integrated design, which combines the two displays to facilitate the synthesis of information. We grouped actions that complete a single goal into operation units and showed these operation units on the displays of system states. In addition, we used different levels of visual salience to highlight the current unit and provided a list of execution history records. A laboratory experiment, with 42 students performing a simulated procedure to deal with unexpected high pressuriser level, was conducted to compare this design against an action-based integrated design and the existing separated-displays design. The results indicate that our operation-unit-based integrated design yields the best performance in terms of time and completion rate and helped more participants to detect unexpected system failures. Practitioner Summary: In current nuclear control rooms, operators frequently have to switch between procedure and system information displays. We developed an integrated design that incorporates procedure information into system displays. A laboratory study showed that the proposed design significantly improved participants' performance and increased the probability of detecting unexpected system failures.

Designing an Alternate Mission Operations Control Room

NASA Technical Reports Server (NTRS)

Montgomery, Patty; Reeves, A. Scott

2014-01-01

The Huntsville Operations Support Center (HOSC) is a multi-project facility that is responsible for 24x7 real-time International Space Station (ISS) payload operations management, integration, and control and has the capability to support small satellite projects and will provide real-time support for SLS launches. The HOSC is a serviceoriented/ highly available operations center for ISS payloads-directly supporting science teams across the world responsible for the payloads. The HOSC is required to endure an annual 2-day power outage event for facility preventive maintenance and safety inspection of the core electro-mechanical systems. While complete system shut-downs are against the grain of a highly available sub-system, the entire facility must be powered down for a weekend for environmental and safety purposes. The consequence of this ground system outage is far reaching: any science performed on ISS during this outage weekend is lost. Engineering efforts were focused to maximize the ISS investment by engineering a suitable solution capable of continuing HOSC services while supporting safety requirements. The HOSC Power Outage Contingency (HPOC) System is a physically diversified compliment of systems capable of providing identified real-time services for the duration of a planned power outage condition from an alternate control room. HPOC was designed to maintain ISS payload operations for approximately three continuous days during planned HOSC power outages and support a local Payload Operations Team, International Partners, as well as remote users from the alternate control room located in another building. This paper presents the HPOC architecture and lessons learned during testing and the planned maiden operational commissioning. Additionally, this paper documents the necessity of an HPOC capability given the unplanned HOSC Facility power outage on April 27th, 2011, as a result of the tornado outbreak that damaged the electrical grid to such a degree that

PBF Control Building (PER619). Interior in data acquisition room showing ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

PBF Control Building (PER-619). Interior in data acquisition room showing data racks. The system recorded multiple channels of data during tests. INEEL negative no. HD-41-8-1 - Idaho National Engineering Laboratory, SPERT-I & Power Burst Facility Area, Scoville, Butte County, ID

STS-118 Ascent/Entry Flight Control Team in White Flight Control Room (WFCR) with Flight Director Steve Stitch

NASA Image and Video Library

2007-07-20

JSC2007-E-41011 (20 July 2007) --- STS-118 Ascent/Entry flight control team pose for a group portrait in the space shuttle flight control room of Houston's Mission Control Center (MCC). Flight director Steve Stich (center right) and astronaut Tony Antonelli, spacecraft communicator (CAPCOM), hold the STS-118 mission logo.

11. Interior view of control room in Components Test Laboratory ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Interior view of control room in Components Test Laboratory (T-27), looking north. Photograph shows upgraded instrumentation, piping, and technological modifications installed in 1997-99 to accommodate component testing requirements for the Atlas V missile. - Air Force Plant PJKS, Systems Integration Laboratory, Components Test Laboratory, Waterton Canyon Road & Colorado Highway 121, Lakewood, Jefferson County, CO

16. NBS TOPSIDE CONTROL ROOM, THE NBS HYPERBARIC CHAMBER IS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

16. NBS TOPSIDE CONTROL ROOM, THE NBS HYPERBARIC CHAMBER IS VERY CLOSE TO THE WATER'S EDGE AND HERE FOR DIVER EMERGENCY SUPPORT. A MEDICAL STAFF IS LOCATED ON THE MARSHALL SPACE FLIGHT CENTER (MSFC) AND SUPPORTS THE NBS PERSONNEL WHEN HYPERBARIC CHAMBER OPERATION IS NECESSARY. - Marshall Space Flight Center, Neutral Buoyancy Simulator Facility, Rideout Road, Huntsville, Madison County, AL

36. ENGINE ROOM FROM STARBOARD SIDE OF CONTROL CONSOLE, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

36. ENGINE ROOM FROM STARBOARD SIDE OF CONTROL CONSOLE, LOOKING AT TWO DIESEL ENGINES, STAIRS LEAD UP TO CREW'S BERTHING. THIS IMAGE IS CLOSER TO THE STERN AND MORE ANGLED TOWARDS THE PORT THAN IMAGE 34. - U.S. Coast Guard Cutter WHITE LUPINE, U.S. Coast Guard Station Rockland, east end of Tillson Avenue, Rockland, Knox County, ME

A Pilot Study Investigating the Effects of Advanced Nuclear Power Plant Control Room Technologies: Methods and Qualitative Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

BLanc, Katya Le; Powers, David; Joe, Jeffrey

2015-08-01

Control room modernization is an important part of life extension for the existing light water reactor fleet. None of the 99 currently operating commercial nuclear power plants in the U.S. has completed a full-scale control room modernization to date. Nuclear power plant main control rooms for the existing commercial reactor fleet remain significantly analog, with only limited digital modernizations. Upgrades in the U.S. do not achieve the full potential of newer technologies that might otherwise enhance plant and operator performance. The goal of the control room upgrade benefits research is to identify previously overlooked benefits of modernization, identify candidate technologiesmore » that may facilitate such benefits, and demonstrate these technologies through human factors research. This report describes a pilot study to test upgrades to the Human Systems Simulation Laboratory at INL.« less

A HUMAN FACTORS META MODEL FOR U.S. NUCLEAR POWER PLANT CONTROL ROOM MODERNIZATION

DOE Office of Scientific and Technical Information (OSTI.GOV)

Joe, Jeffrey C.

Over the last several years, the United States (U.S.) Department of Energy (DOE) has sponsored human factors research and development (R&D) and human factors engineering (HFE) activities through its Light Water Reactor Sustainability (LWRS) program to modernize the main control rooms (MCR) of commercial nuclear power plants (NPP). Idaho National Laboratory (INL), in partnership with numerous commercial nuclear utilities, has conducted some of this R&D to enable the life extension of NPPs (i.e., provide the technical basis for the long-term reliability, productivity, safety, and security of U.S. NPPs). From these activities performed to date, a human factors meta model formore » U.S. NPP control room modernization can now be formulated. This paper discusses this emergent HFE meta model for NPP control room modernization, with the goal of providing an integrated high level roadmap and guidance on how to perform human factors R&D and HFE for those in the U.S. nuclear industry that are engaging in the process of upgrading their MCRs.« less

Efficiency of hydrogen peroxide in improving disinfection of ICU rooms.

PubMed

Blazejewski, Caroline; Wallet, Frédéric; Rouzé, Anahita; Le Guern, Rémi; Ponthieux, Sylvie; Salleron, Julia; Nseir, Saad

2015-02-02

The primary objective of this study was to determine the efficiency of hydrogen peroxide (H₂O₂) techniques in disinfection of ICU rooms contaminated with multidrug-resistant organisms (MDRO) after patient discharge. Secondary objectives included comparison of the efficiency of a vaporizator (HPV, Bioquell) and an aerosolizer using H₂O₂, and peracetic acid (aHPP, Anios) in MDRO environmental disinfection, and assessment of toxicity of these techniques. This prospective cross-over study was conducted in five medical and surgical ICUs located in one University hospital, during a 12-week period. Routine terminal cleaning was followed by H₂O₂ disinfection. A total of 24 environmental bacteriological samplings were collected per room, from eight frequently touched surfaces, at three time-points: after patient discharge (T0), after terminal cleaning (T1) and after H₂O₂ disinfection (T2). In total 182 rooms were studied, including 89 (49%) disinfected with aHPP and 93 (51%) with HPV. At T0, 15/182 (8%) rooms were contaminated with at least 1 MDRO (extended spectrum β-lactamase-producing Gram-negative bacilli 50%, imipenem resistant Acinetobacter baumannii 29%, methicillin-resistant Staphylococcus aureus 17%, and Pseudomonas aeruginosa resistant to ceftazidime or imipenem 4%). Routine terminal cleaning reduced environmental bacterial load (P <0.001) without efficiency on MDRO (15/182 (8%) rooms at T0 versus 11/182 (6%) at T1; P = 0.371). H₂O₂ technologies were efficient for environmental MDRO decontamination (6% of rooms contaminated with MDRO at T1 versus 0.5% at T2, P = 0.004). Patient characteristics were similar in aHPP and HPV groups. No significant difference was found between aHPP and HPV regarding the rate of rooms contaminated with MDRO at T2 (P = 0.313). 42% of room occupants were MDRO carriers. The highest rate of rooms contaminated with MDRO was found in rooms where patients stayed for a longer period of time, and where a patient

Action research to improve methods of delivery and feedback in an Access Grid Room environment

NASA Astrophysics Data System (ADS)

McArthur, Lynne C.; Klass, Lara; Eberhard, Andrew; Stacey, Andrew

2011-12-01

This article describes a qualitative study which was undertaken to improve the delivery methods and feedback opportunity in honours mathematics lectures which are delivered through Access Grid Rooms. Access Grid Rooms are facilities that provide two-way video and audio interactivity across multiple sites, with the inclusion of smart boards. The principal aim was to improve the student learning experience, given the new environment. The specific aspects of the course delivery that the study focused on included presentation of materials and provision of opportunities for interaction between the students and between students and lecturers. The practical considerations in the delivery of distance learning are well documented in the literature, and similar problems arise in the Access Grid Room environment; in particular, those of limited access to face-to-face interaction and the reduction in peer support. The nature of the Access Grid Room classes implies that students studying the same course can be physically situated in different cities, and possibly in different countries. When studying, it is important that students have opportunity to discuss new concepts with others; particularly their peers and their lecturer. The Access Grid Room environment also presents new challenges for the lecturer, who must learn new skills in the delivery of materials. The unique nature of Access Grid Room technology offers unprecedented opportunity for effective course delivery and positive outcomes for students, and was developed in response to a need to be able to interact with complex data, other students and the instructor, in real-time, at a distance and from multiple sites. This is a relatively new technology and as yet there has been little or no studies specifically addressing the use and misuse of the technology. The study found that the correct placement of cameras and the use of printed material and smart boards were all crucial to the student experience. In addition, the

Control Technologies for Room Air-conditioner and Packaged Air-conditioner

NASA Astrophysics Data System (ADS)

Ito, Nobuhisa

Trends of control technologies about air-conditioning machineries, especially room or packaged air conditioners, are presented in this paper. Multiple air conditioning systems for office buildings are mainly described as one application of the refrigeration cycle control technologies including sensors for thermal comfort and heating/ cooling loads are also described as one of the system control technologies. Inverter systems and related technologies for driving variable speed compressors are described in both case of including induction motors and brushless DC motors. Technologies for more accurate control to meet various kind of regulations such as ozone layer destruction, energy saving and global warming, and for eliminating harmonic distortion of power source current, as a typical EMC problem, will be urgently desired.

14. NBS REMOTE MANIPULATOR SIMULATOR (RMS) CONTROL ROOM. THE RMS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. NBS REMOTE MANIPULATOR SIMULATOR (RMS) CONTROL ROOM. THE RMS CONTROL PANEL IS IDENTICAL TO THE SHUTTLE ORBITER AFT FLIGHT DECK WITH ALL RMS SWITCHES AND CONTROL KNOBS FOR INVOKING ANY POSSIBLE FLIGHT OPERATIONAL MODE. THIS INCLUDES ALL COMPUTER AIDED OPERATIONAL MODES, AS WELL AS FULL MANUAL MODE. THE MONITORS IN THE AFT FLIGHT DECK WINDOWS AND THE GLASSES THE OPERATOR WEARS PROVIDE A 3-D VIDEO PICTURE TO AID THE OPERATOR WITH DEPTH PERCEPTION WHILE OPERATING THE ARM. THIS IS REQUIRED BECAUSE THE RMS OPERATOR CANNOT VIEW RMS MOVEMENTS IN THE WATER WHILE AT THE CONTROL PANEL. - Marshall Space Flight Center, Neutral Buoyancy Simulator Facility, Rideout Road, Huntsville, Madison County, AL

130. VIEW OF CONTROL ROOM (114), LSB (BLDG. 770), FROM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

130. VIEW OF CONTROL ROOM (114), LSB (BLDG. 770), FROM WEST. HYDRAULIC PUMPING UNIT (HPU) IN CENTER OF PHOTO, FACING NORTH. NITROGEN SUPPLY PANEL ON SOUTH WALL (LEFT EDGE OF PHOTO); RELAY BOX FOR HPU ON SOUTH WALL BEHIND HPU. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

IET. Control and equipment building (TAN620). Details and room finish ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

IET. Control and equipment building (TAN-620). Details and room finish schedule. Ralph M. Parsons 902-4-ANP-620-A 322. Approved by INEEL Classification Office for public release. INEEL index code no. 035-0629-00-693-106907 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

Workflows and individual differences during visually guided routine tasks in a road traffic management control room.

PubMed

Starke, Sandra D; Baber, Chris; Cooke, Neil J; Howes, Andrew

2017-05-01

Road traffic control rooms rely on human operators to monitor and interact with information presented on multiple displays. Past studies have found inconsistent use of available visual information sources in such settings across different domains. In this study, we aimed to broaden the understanding of observer behaviour in control rooms by analysing a case study in road traffic control. We conducted a field study in a live road traffic control room where five operators responded to incidents while wearing a mobile eye tracker. Using qualitative and quantitative approaches, we investigated the operators' workflow using ergonomics methods and quantified visual information sampling. We found that individuals showed differing preferences for viewing modalities and weighting of task components, with a strong coupling between eye and head movement. For the quantitative analysis of the eye tracking data, we propose a number of metrics which may prove useful to compare visual sampling behaviour across domains in future. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

American ASTP crewmen briefed on operation of consoles in main control room

NASA Image and Video Library

1975-04-25

S75-25619 (25 April 1975) --- A group of American ASTP crewmen is briefed on the operation of the consoles in the main control room at the ASTP flight control center at the Cosmonaut Training Center (Star City) near Moscow. The astronauts were in the Soviet Union for ASTP joint crew training with the Soviet ASTP crewmen. PHOTO COURTESY: USSR ACADEMY OF SCIENCES

PBF Reactor Building (PER620) as seen from control room window ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

PBF Reactor Building (PER-620) as seen from control room window in PER-619. Photographer stood just outside window. Note exposed communication cables on desert surface. Date: July 2004. INEEL negative no. HD-41-9-3 - Idaho National Engineering Laboratory, SPERT-I & Power Burst Facility Area, Scoville, Butte County, ID

The heat is on: room temperature affects laboratory equipment--an observational study.

PubMed

Butler, Julia M; Johnson, Jane E; Boone, William R

2013-10-01

To evaluate the effect of ambient room temperature on equipment typically used in in vitro fertilization (IVF). We set the control temperature of the room to 20 °C (+/-0.3) and used CIMScan probes to record temperatures of the following equipment: six microscope heating stages, four incubators, five slide warmers and three heating blocks. We then increased the room temperature to 26 °C (+/-0.3) or decreased it to 17 °C (+/-0.3) and monitored the same equipment again. We wanted to determine what role, if any, changing room temperature has on equipment temperature fluctuation. There was a direct relationship between room temperature and equipment temperature stability. When room temperature increased or decreased, equipment temperature reacted in a corresponding manner. Statistical differences between equipment were found when the room temperature changed. What is also noteworthy is that temperature of equipment responded within 5 min to a change in room temperature. Clearly, it is necessary to be aware of the affect of room temperature on equipment when performing assisted reproductive procedures. Room and equipment temperatures should be monitored faithfully and adjusted as frequently as needed, so that consistent culture conditions can be maintained. If more stringent temperature control can be achieved, human assisted reproduction success rates may improve.

Direct surgeon control of the computer in the operating room.

PubMed

Onceanu, Dumitru; Stewart, A James

2011-01-01

This paper describes the design and evaluation of a joystick-like device that allows direct surgeon control of the computer in the operating room. The device contains no electronic parts, is easy to use, is unobtrusive, has no physical connection to the computer, and makes use of an existing surgical tool. The device was tested in comparison to a mouse and to verbal dictation.

MTR, TRA603. CONTROL ROOM DETAILS. ACOUSTIC PLASTER CEILING, USHAPED CONSOLE, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

MTR, TRA-603. CONTROL ROOM DETAILS. ACOUSTIC PLASTER CEILING, U-SHAPED CONSOLE, INSTRUMENT PANELS, GLASS DOOR, ASPHALT TILE FLOOR AND COLORS. BLAW-KNOX 3150-803-11, 10/1950. INL INDEX NO. 531-0603-00-098-100570, REV. 3. - Idaho National Engineering Laboratory, Test Reactor Area, Materials & Engineering Test Reactors, Scoville, Butte County, ID

Inactivation of Poxviruses by Upper-Room UVC Light in a Simulated Hospital Room Environment

PubMed Central

McDevitt, James J.; Milton, Donald K.; Rudnick, Stephen N.; First, Melvin W.

2008-01-01

In the event of a smallpox outbreak due to bioterrorism, delays in vaccination programs may lead to significant secondary transmission. In the early phases of such an outbreak, transmission of smallpox will take place especially in locations where infected persons may congregate, such as hospital emergency rooms. Air disinfection using upper-room 254 nm (UVC) light can lower the airborne concentrations of infective viruses in the lower part of the room, and thereby control the spread of airborne infections among room occupants without exposing occupants to a significant amount of UVC. Using vaccinia virus aerosols as a surrogate for smallpox we report on the effectiveness of air disinfection, via upper-room UVC light, under simulated real world conditions including the effects of convection, mechanical mixing, temperature and relative humidity. In decay experiments, upper-room UVC fixtures used with mixing by a conventional ceiling fan produced decreases in airborne virus concentrations that would require additional ventilation of more than 87 air changes per hour. Under steady state conditions the effective air changes per hour associated with upper-room UVC ranged from 18 to 1000. The surprisingly high end of the observed range resulted from the extreme susceptibility of vaccinia virus to UVC at low relative humidity and use of 4 UVC fixtures in a small room with efficient air mixing. Increasing the number of UVC fixtures or mechanical ventilation rates resulted in greater fractional reduction in virus aerosol and UVC effectiveness was higher in winter compared to summer for each scenario tested. These data demonstrate that upper-room UVC has the potential to greatly reduce exposure to susceptible viral aerosols. The greater survival at baseline and greater UVC susceptibility of vaccinia under winter conditions suggest that while risk from an aerosol attack with smallpox would be greatest in winter, protective measures using UVC may also be most efficient at this

PBF Control Building (PER619) floor plan and elevations. Room numbers ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

PBF Control Building (PER-619) floor plan and elevations. Room numbers and functions. Roof plans for "high" roof and rest of roof. Ebasco Services 1205-PER/PER 619-A-1. Date: July 1965. INEEL index no. 760-0619-00-205-123022 - Idaho National Engineering Laboratory, SPERT-I & Power Burst Facility Area, Scoville, Butte County, ID

[Plug-in Based Centralized Control System in Operating Rooms].

PubMed

Wang, Yunlong

2017-05-30

Centralized equipment controls in an operating room (OR) is crucial to an efficient workflow in the OR. To achieve centralized control, an integrative OR needs to focus on designing a control panel that can appropriately incorporate equipment from different manufactures with various connecting ports and controls. Here we propose to achieve equipment integration using plug-in modules. Each OR will be equipped with a dynamic plug-in control panel containing physically removable connecting ports. Matching outlets will be installed onto the control panels of each equipment used at any given time. This dynamic control panel will be backed with a database containing plug-in modules that can connect any two types of connecting ports common among medical equipment manufacturers. The correct connecting ports will be called using reflection dynamics. This database will be updated regularly to include new connecting ports on the market, making it easy to maintain, update, expand and remain relevant as new equipment are developed. Together, the physical panel and the database will achieve centralized equipment controls in the OR that can be easily adapted to any equipment in the OR.

17. Perimeter acquisition radar building room #105, mechanical equipment room ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. Perimeter acquisition radar building room #105, mechanical equipment room no. 1; sign reads: Heat exchangers (shell and tube type). Provide precise temperature control of water for cooling critical electronic equipment - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

Effects of revised consultation room design on patient-physician communication.

PubMed

Ajiboye, Folaranmi; Dong, Fanglong; Moore, Justin; Kallail, K James; Baughman, Allison

2015-01-01

To evaluate the impact of a revised consultation room design on patient-physician interaction in an outpatient setting. The growth of ambulatory medical care makes outpatient facilities the primary point of health care contact for many Americans. However, the outpatient consultation room design remains largely unchanged, despite its increased use and the adoption of technology-mediated information sharing in clinical encounter. A randomized controlled trial used a postvisit questionnaire to assess six domains of interest (satisfaction with the visit and the consultation room, mutual respect, patient trust in the physician, communication quality, people-room interaction, and interpersonal-room interaction) in two different room designs (a traditional room and an experimental room in which a pedestal table had replaced the examination table). Interpersonal-room interaction was enhanced in the experimental consultation room when compared to the traditional consultation room (p = .0038). Participants in the experimental consultation room had better access to the computer screen, increased provider information sharing, and more time engaging providers in conversation about information on the monitor. Changing the layout of a consultation room has the potential to improve interpersonal communication through better information sharing. Clinicians who are interested in maximizing the benefits of their clinical encounter should consider changing the layout of their consultation room, especially the positioning of the computer screen. © The Author(s) 2014.

Plum Brook Reactor Facility Control Room during Facility Startup

NASA Image and Video Library

1961-02-21

Operators test the National Aeronautics and Space Administration’s (NASA) Plum Brook Reactor Facility systems in the months leading up to its actual operation. The “Reactor On” signs are illuminated but the reactor core was not yet ready for chain reactions. Just a couple weeks after this photograph, Plum Brook Station held a media open house to unveil the 60-megawatt test reactor near Sandusky, Ohio. More than 60 members of the print media and radio and television news services met at the site to talk with community leaders and representatives from NASA and Atomic Energy Commission. The Plum Brook reactor went critical for the first time on the evening of June 14, 1961. It was not until April 1963 that the reactor reached its full potential of 60 megawatts. The reactor control room, located on the second floor of the facility, was run by licensed operators. The operators manually operated the shim rods which adjusted the chain reaction in the reactor core. The regulating rods could partially or completely shut down the reactor. The control room also housed remote area monitoring panels and other monitoring equipment that allowed operators to monitor radiation sensors located throughout the facility and to scram the reactor instantly if necessary. The color of the indicator lights corresponded with the elevation of the detectors in the various buildings. The reactor could also shut itself down automatically if the monitors detected any sudden irregularities.

IMPROVED SYNTHESIS OF ROOM TEMPERATURE IONIC LIQUIDS

EPA Science Inventory

Room temperature ionic liquids (RTILs), molten salts comprised of N-alkylimidazolium cations and various anions, have received significant attention due to their commercial potential in a variety of chemical applications especially as substitutes for conventional volatile organic...

Improving operating room first start efficiency - value of both checklist and a pre-operative facilitator.

PubMed

Panni, M K; Shah, S J; Chavarro, C; Rawl, M; Wojnarwsky, P K; Panni, J K

2013-10-01

There are multiple components leading to improved operating room efficiency. We undertook a project focusing on first case starts; accounting for each delay component on a global basis. Our hypothesis was there would be a reduction in first start delays after we implemented strategies to address the issues identified through this accounting process. An orange sheet checklist was implemented, with specific items that needed to be clear prior to roll back to the operating room (OR), and an OR facilitator was employed to intervene whenever there were any missing items needed for a specific patient. We present the data from this quality improvement project over an 18-month period. Initially, 10.07 (± 0.73) delayed first starts occurred per day but declined steadily over time to a low of 4.95 (± 0.38) per day after 6 months (-49.2 %, P < 0.001). By the end of the project, the most common reasons for delay still included late surgical attending (19%), schedule changes (14%) as well as 'other reasons' (13%), but with an overall reduction per day of each. Total anaesthesia delay initially totalled 11% of the first start delays, but was negligible (< 1%) at the project's completion. While we have a challenging operating room environment based on our patient population, multiple trainees in both the surgery and anaesthesiology teams: an orange sheet - pre-operative checklist in addition to a dedicated pre-operative facilitator; allowed us to make a substantial improvement in our first start on time starts. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Environmental Cues in Double-Occupancy Rooms to Support Patients With Dementia.

PubMed

Motzek, Tom; Bueter, Kathrin; Marquardt, Gesine

2016-04-01

The purpose of this study was to evaluate the effectiveness of different environmental cues in double-occupancy rooms of an acute care hospital to support patients' abilities to identify their bed and wardrobe. The quasi-experiment was conducted on a geriatric ward of an acute care hospital. Patients with dementia were included (n = 42). To test the effectiveness of environmental cues, two rooms were enhanced with the environmental cue "color," two rooms with the cue "number," and two rooms with the cue "patient's name". Four rooms were not redesigned and were used as control rooms. For analysis, we pooled the intervention groups color and number (n = 14) and compared it with the control group (n = 22). The environmental cues color and number were significantly effective to improve the identification of the wardrobe from the third to the fifth day after admission. However, for the 10th-12th day after admission, we found no difference in results. Furthermore, results indicate improvements in the ability to identify the bed by using the environmental cues color and number. As this study indicated, the environmental cues color and number are helpful for these patients to identify their bed and wardrobe. However, these cues were most effective from the third to the fifth day after admission. To sustain their effectiveness on patients' identification abilities during their hospital stay, we discuss, whether verbal prompting and an ongoing mentioning of such cues, embedded in the daily work of nurses, could be beneficial. © The Author(s) 2015.

Apparel for Cleaner Clean Rooms

NASA Technical Reports Server (NTRS)

1983-01-01

In the 1960s NASA pioneered contamination control technology, providing a base from which aerospace contractors could develop control measures. NASA conducted special courses for clean room technicians and supervisors, and published a series of handbooks with input from various NASA field centers. These handbooks extended aerospace experience to the medical, pharmaceutical, electronics, and other industries where extreme cleanliness is important. American Hospital Supply Company (AHSC) felt that high technology products with increasingly stringent operating requirements in aerospace, electronics, pharmaceuticals and medical equipment manufacturing demanded improvement in contamination control techniques. After studying the NASA handbooks and visiting NASA facilities, the wealth of information gathered resulted in Micro-clean non-woven garments and testing equipment and procedures for evaluating effectiveness.

26. A typical outer rod room, or rack room, showing ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

26. A typical outer rod room, or rack room, showing the racks for the nine horizontal control rods (HCRs) that would be inserted or withdrawn from the pile to control the rate of reaction. In this case, it is the 105-F Reactor in February 1945. The view is looking away from the pile, which is out of the picture on the left. Several of the cooling water hose reels for the rods can be seen at the end of the racks near the wall. D-8323 - B Reactor, Richland, Benton County, WA

Report: EPA Could Improve Physical Access and Service Continuity/Contingency Controls for Financial and Mixed-Financial Systems Located at its Research Triangle Park Campus

EPA Pesticide Factsheets

Report #2006-P-00005, December 14, 2005. Controls needed to be improved in areas such as visitor access to facilities, use of contractor access badges, and general physical access to the NCC, computer rooms outside the NCC, and media storage rooms.

Improved scores for observed teamwork in the clinical environment following a multidisciplinary operating room simulation intervention.

PubMed

Weller, Jennifer M; Cumin, David; Civil, Ian D; Torrie, Jane; Garden, Alexander; MacCormick, Andrew D; Gurusinghe, Nishanthi; Boyd, Matthew J; Frampton, Christopher; Cokorilo, Martina; Tranvik, Magnus; Carlsson, Lisa; Lee, Tracey; Ng, Wai Leap; Crossan, Michael; Merry, Alan F

2016-08-05

We ran a Multidisciplinary Operating Room Simulation (MORSim) course for 20 complete general surgical teams from two large metropolitan hospitals. Our goal was to improve teamwork and communication in the operating room (OR). We hypothesised that scores for teamwork and communication in the OR would improve back in the workplace following MORSim. We used an extended Behavioural Marker Risk Index (BMRI) to measure teamwork and communication, because a relationship has previously been documented between BMRI scores and surgical patient outcomes. Trained observers scored general surgical teams in the OR at the two study hospitals before and after MORSim, using the BMRI. Analysis of BMRI scores for the 224 general surgical cases before and 213 cases after MORSim showed BMRI scores improved by more than 20% (0.41 v 0.32, p<0.001). Previous research suggests that this improved teamwork score would translate into a clinically important reduction in complications and mortality in surgical patients. We demonstrated an improvement in scores for teamwork and communication in general surgical ORs following our intervention. These results support the use of simulation-based multidisciplinary team training for OR staff to promote better teamwork and communication, and potentially improve outcomes for general surgical patients.

Giant room temperature magnetoelectric response in strain controlled nanocomposites

NASA Astrophysics Data System (ADS)

Rafique, Mohsin; Herklotz, Andreas; Dörr, Kathrin; Manzoor, Sadia

2017-05-01

We report giant magnetoelectric coupling at room temperature in a self-assembled nanocomposite of BiFeO3-CoFe2O4 (BFO-CFO) grown on a BaTiO3 (BTO) crystal. The nanocomposite consisting of CFO nanopillars embedded in a BFO matrix exhibits weak perpendicular magnetic anisotropy due to a small out-of-plane compression (˜0.3%) of the magnetostrictive (CFO) phase, enabling magnetization rotation under moderate in-plane compression. Temperature dependent magnetization measurements demonstrate strong magnetoelastic coupling between the BaTiO3 substrate and the nanocomposite film, which has been exploited to produce a large magnetoelectric response in the sample. The reorientation of ferroelectric domains in the BTO crystal upon the application of an electric field (E) alters the strain state of the nanocomposite film, thus enabling control of its magnetic anisotropy. The strain mediated magnetoelectric coupling coefficient α = μ o d M / d E calculated from remnant magnetization at room temperature is 2.6 × 10-7 s m-1 and 1.5 × 10-7 s m-1 for the out-of-plane and in-plane orientations, respectively.

The uncertainty room: strategies for managing uncertainty in a surgical waiting room.

PubMed

Stone, Anne M; Lammers, John C

2012-01-01

To describe experiences of uncertainty and management strategies for staff working with families in a hospital waiting room. A 288-bed, nonprofit community hospital in a Midwestern city. Data were collected during individual, semistructured interviews with 3 volunteers, 3 technical staff members, and 1 circulating nurse (n = 7), and during 40 hours of observation in a surgical waiting room. Interview transcripts were analyzed using constant comparative techniques. The surgical waiting room represents the intersection of several sources of uncertainty that families experience. Findings also illustrate the ways in which staff manage the uncertainty of families in the waiting room by communicating support. Staff in surgical waiting rooms are responsible for managing family members' uncertainty related to insufficient information. Practically, this study provided some evidence that staff are expected to help manage the uncertainty that is typical in a surgical waiting room, further highlighting the important role of communication in improving family members' experiences.

[Handling modern imaging procedures in a high-tech operating room].

PubMed

Hüfner, T; Citak, M; Imrecke, J; Krettek, C; Stübig, T

2012-03-01

Operating rooms are the central unit in the hospital network in trauma centers. In this area, high costs but also high revenues are generated. Modern operating theater concepts as an integrated model have been offered by different companies since the early 2000s. Our hypothesis is that integrative concepts for operating rooms, in addition to improved operating room ergonomics, have the potential for measurable time and cost savings. In our clinic, an integrated operating room concept (I-Suite, Stryker, Duisburg) was implemented after analysis of the problems. In addition to the ceiling-mounted arrangement, the system includes an endoscopy unit, a navigation system, and a voice control system. In the first 6 months (9/2005 to 2/2006), 112 procedures were performed in the integrated operating room: 34 total knee arthroplasties, 12 endoscopic spine surgeries, and 66 inpatient arthroscopic procedures (28 shoulder and 38 knee reconstructions). The analysis showed a daily saving of 22-45 min, corresponding to 15-30% of the daily changeover times, calculated to account for potential savings in the internal cost allocation of 225-450 EUR. A commercial operating room concept was evaluated in a pilot phase in terms of hard data, including time and cost factors. Besides the described effects further savings might be achieved through the effective use of voice control and the benefit of the sterile handle on the navigation camera, since waiting times for an additional nurse are minimized. The time of the procedure of intraoperative imaging is also reduced due to the ceiling-mounted concept, as the C-arm can be moved freely in the operating theater without hindering cables. By these measures and ensuing improved efficiency, the initial high costs for the implementation of the system may be cushioned over time.

Rooming-in Reduces Salivary Cortisol Level of Newborn

PubMed Central

De Bernardo, Giuseppe; Riccitelli, Marina; Giordano, Maurizio; Sordino, Desiree; Longini, Mariangela

2018-01-01

Background Rooming-in practice improves breastfeeding and reduces newborn stress reactivity. When this modality is not available, partial rooming-in after birth can be considered. Salivary cortisol levels (SCLs) are considered reliable biomarkers to indicate stress. Objective To test the hypothesis that rooming-in duration impacts neonatal stress response in hospitalized newborns. Design/methods Forty term newborns, enrolled in the Neonatology and Obstetrics Nursing, C.G. Ruesch, Naples, Italy, were divided, according to the mother's choice, into the study (SG; n = 20) and control (CG; n = 20) groups if they received full (24 hs) or partial (14 hs) rooming-in care, respectively. Saliva samples were collected from all babies between 7:00 a.m. and 8:00 a.m. of the 3rd day of life by using oral swab. Salivary cortisol levels were measured using an enzyme immunoassay kit (Salimetrics LLC, PA, USA). Results A statistically significant difference in the SCLs between SG and CG was found (median: 258 ng/dl versus 488.5 ng/dl; p = 0.048). Conclusions Data support the practice of full rooming-in care compared with partial rooming-in. The rooming-in duration clearly reduces SCLs and likely neonatal stress. These lower SCLs may have long-term positive effects reducing the risk of metabolic syndrome, high blood pressure, and cognitive and behavioural changes. PMID:29706798

Fisheye view from the back of the Flight control room of the MCC

NASA Image and Video Library

1984-10-06

Fisheye view from the back of the Flight Control Room (FCR) of the Mission Control Center (MCC). Visible are the Flight Directors console (left front), the CAPCOM console (right front) and the Payloads console. Some of the STS 41-G crew can be seen on a large screen at the front of the MCC along with a map tracking the progress of the orbiter.

Integrated Practice Improvement Solutions-Practical Steps to Operating Room Management.

PubMed

Chernov, Mikhail; Pullockaran, Janet; Vick, Angela; Leyvi, Galina; Delphin, Ellise

2016-10-01

Perioperative productivity is a vital concern for surgeons, anesthesiologists, and administrators as the OR is a major source of hospital elective admissions and revenue. Based on elements of existing Practice Improvement Methodologies (PIMs), "Integrated Practice Improvement Solutions" (IPIS) is a practical and simple solution incorporating aspects of multiple management approaches into a single open source framework to increase OR efficiency and productivity by better utilization of existing resources. OR efficiency was measured both before and after IPIS implementation using the total number of cases versus room utilization, OR/anesthesia revenue and staff overtime (OT) costs. Other parameters of efficiency, such as the first case on-time start and the turnover time (TOT) were measured in parallel. IPIS implementation resulted in increased numbers of surgical procedures performed by an average of 10.7%, and OR and anesthesia revenue increases of 18.5% and 6.9%, respectively, with a simultaneous decrease in TOT (15%) and OT for anesthesia staff (26%). The number of perioperative adverse events was stable during the two-year study period which involved a total of 20,378 patients. IPIS, an effective and flexible practice improvement model, was designed to quickly, significantly, and sustainably improve OR efficiency by better utilization of existing resources. Success of its implementation directly correlates with the involvement of and acceptance by the entire OR team and hospital administration.

An integrated set of UNIX based system tools at control room level

NASA Astrophysics Data System (ADS)

Potepan, F.; Scafuri, C.; Bortolotto, C.; Surace, G.

1994-12-01

The design effort of providing a simple point-and-click approach to the equipment access has led to the definition and realization of a modular set of software tools to be used at the ELETTRA control room level. Point-to-point equipment access requires neither programming nor specific knowledge of the control system architecture. The development and integration of communication, graphic, editing and global database modules are described in depth, followed by a report of their use in the first commissioning period.

Practice of Organisational Strategies of Improving Computer Rooms for Promoting Smart Education Using ICT Equipment

ERIC Educational Resources Information Center

Ogawa, Nobuyuki; Shimizu, Akira

2017-01-01

This paper describes our concrete efforts to improve the functions of the computer rooms in the Information Processing Center from among several organisational strategies which can assume a large role in the next-generation education, while examining the practice of active learning by the faculty in all classes using ICT equipment. We implemented…

Three MSC officials hold discussion in Mission Control room during Gemini 11

NASA Image and Video Library

1966-09-12

S66-52754 (12 Sept. 1966) --- Three key Manned Spacecraft Center (MSC) officials hold discussion in the Mission Control room during Gemini-11 activity. Left to right, are Donald K. Slayton, MSC Director of Flight Crew Operations; astronaut Alan B. Shepard Jr., Chief, MSC Astronaut Office; and George M. Low, MSC Deputy Director. Photo credit: NASA

The utilization of six sigma and statistical process control techniques in surgical quality improvement.

PubMed

Sedlack, Jeffrey D

2010-01-01

Surgeons have been slow to incorporate industrial reliability techniques. Process control methods were applied to surgeon waiting time between cases, and to length of stay (LOS) after colon surgery. Waiting times between surgeries were evaluated by auditing the operating room records of a single hospital over a 1-month period. The medical records of 628 patients undergoing colon surgery over a 5-year period were reviewed. The average surgeon wait time between cases was 53 min, and the busiest surgeon spent 291/2 hr in 1 month waiting between surgeries. Process control charting demonstrated poor overall control of the room turnover process. Average LOS after colon resection also demonstrated very poor control. Mean LOS was 10 days. Weibull's conditional analysis revealed a conditional LOS of 9.83 days. Serious process management problems were identified in both analyses. These process issues are both expensive and adversely affect the quality of service offered by the institution. Process control mechanisms were suggested or implemented to improve these surgical processes. Industrial reliability and quality management tools can easily and effectively identify process control problems that occur on surgical services. © 2010 National Association for Healthcare Quality.

Improving operating room productivity via parallel anesthesia processing.

PubMed

Brown, Michael J; Subramanian, Arun; Curry, Timothy B; Kor, Daryl J; Moran, Steven L; Rohleder, Thomas R

2014-01-01

Parallel processing of regional anesthesia may improve operating room (OR) efficiency in patients undergoes upper extremity surgical procedures. The purpose of this paper is to evaluate whether performing regional anesthesia outside the OR in parallel increases total cases per day, improve efficiency and productivity. Data from all adult patients who underwent regional anesthesia as their primary anesthetic for upper extremity surgery over a one-year period were used to develop a simulation model. The model evaluated pure operating modes of regional anesthesia performed within and outside the OR in a parallel manner. The scenarios were used to evaluate how many surgeries could be completed in a standard work day (555 minutes) and assuming a standard three cases per day, what was the predicted end-of-day time overtime. Modeling results show that parallel processing of regional anesthesia increases the average cases per day for all surgeons included in the study. The average increase was 0.42 surgeries per day. Where it was assumed that three cases per day would be performed by all surgeons, the days going to overtime was reduced by 43 percent with parallel block. The overtime with parallel anesthesia was also projected to be 40 minutes less per day per surgeon. Key limitations include the assumption that all cases used regional anesthesia in the comparisons. Many days may have both regional and general anesthesia. Also, as a case study, single-center research may limit generalizability. Perioperative care providers should consider parallel administration of regional anesthesia where there is a desire to increase daily upper extremity surgical case capacity. Where there are sufficient resources to do parallel anesthesia processing, efficiency and productivity can be significantly improved. Simulation modeling can be an effective tool to show practice change effects at a system-wide level.

Gesture-Controlled Interface for Contactless Control of Various Computer Programs with a Hooking-Based Keyboard and Mouse-Mapping Technique in the Operating Room

PubMed Central

Park, Ben Joonyeon; Jang, Taekjin; Choi, Jong Woo; Kim, Namkug

2016-01-01

We developed a contactless interface that exploits hand gestures to effectively control medical images in the operating room. We developed an in-house program called GestureHook that exploits message hooking techniques to convert gestures into specific functions. For quantitative evaluation of this program, we used gestures to control images of a dynamic biliary CT study and compared the results with those of a mouse (8.54 ± 1.77 s to 5.29 ± 1.00 s; p < 0.001) and measured the recognition rates of specific gestures and the success rates of tasks based on clinical scenarios. For clinical applications, this program was set up in the operating room to browse images for plastic surgery. A surgeon browsed images from three different programs: CT images from a PACS program, volume-rendered images from a 3D PACS program, and surgical planning photographs from a basic image viewing program. All programs could be seamlessly controlled by gestures and motions. This approach can control all operating room programs without source code modification and provide surgeons with a new way to safely browse through images and easily switch applications during surgical procedures. PMID:26981146

Gesture-Controlled Interface for Contactless Control of Various Computer Programs with a Hooking-Based Keyboard and Mouse-Mapping Technique in the Operating Room.

PubMed

Park, Ben Joonyeon; Jang, Taekjin; Choi, Jong Woo; Kim, Namkug

2016-01-01

We developed a contactless interface that exploits hand gestures to effectively control medical images in the operating room. We developed an in-house program called GestureHook that exploits message hooking techniques to convert gestures into specific functions. For quantitative evaluation of this program, we used gestures to control images of a dynamic biliary CT study and compared the results with those of a mouse (8.54 ± 1.77 s to 5.29 ± 1.00 s; p < 0.001) and measured the recognition rates of specific gestures and the success rates of tasks based on clinical scenarios. For clinical applications, this program was set up in the operating room to browse images for plastic surgery. A surgeon browsed images from three different programs: CT images from a PACS program, volume-rendered images from a 3D PACS program, and surgical planning photographs from a basic image viewing program. All programs could be seamlessly controlled by gestures and motions. This approach can control all operating room programs without source code modification and provide surgeons with a new way to safely browse through images and easily switch applications during surgical procedures.

15. NBS TOP SIDE CONTROL ROOM. THE SUIT SYSTEMS CONSOLE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. NBS TOP SIDE CONTROL ROOM. THE SUIT SYSTEMS CONSOLE IS USED TO CONTROL AIR FLOW AND WATER FLOW TO THE UNDERWATER SPACE SUIT DURING THE TEST. THE SUIT SYSTEMS ENGINEER MONITORS AIR FLOW ON THE PANEL TO THE LEFT, AND SUIT DATA ON THE COMPUTER MONITOR JUST SLIGHTLY TO HIS LEFT. WATER FLOW IS MONITORED ON THE PANEL JUST SLIGHTLY TO HIS RIGHT AND TEST VIDEO TO HIS FAR RIGHT. THE DECK CHIEF MONITORS THE DIVER'S DIVE TIMES ON THE COMPUTER IN THE UPPER RIGHT. THE DECK CHIEF LOGS THEM IN AS THEY ENTER THE WATER, AND LOGS THEM OUT AS THEY EXIT THE WATER. THE COMPUTER CALCULATES TOTAL DIVE TIME. - Marshall Space Flight Center, Neutral Buoyancy Simulator Facility, Rideout Road, Huntsville, Madison County, AL

Light Water Reactor Sustainability Program Operator Performance Metrics for Control Room Modernization: A Practical Guide for Early Design Evaluation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ronald Boring; Roger Lew; Thomas Ulrich

2014-03-01

As control rooms are modernized with new digital systems at nuclear power plants, it is necessary to evaluate the operator performance using these systems as part of a verification and validation process. There are no standard, predefined metrics available for assessing what is satisfactory operator interaction with new systems, especially during the early design stages of a new system. This report identifies the process and metrics for evaluating human system interfaces as part of control room modernization. The report includes background information on design and evaluation, a thorough discussion of human performance measures, and a practical example of how themore » process and metrics have been used as part of a turbine control system upgrade during the formative stages of design. The process and metrics are geared toward generalizability to other applications and serve as a template for utilities undertaking their own control room modernization activities.« less

1. VIEW OF THE CONTROL ROOM FOR THE XY RETRIEVER. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. VIEW OF THE CONTROL ROOM FOR THE X-Y RETRIEVER. USING THE X-Y RETRIEVER, OPERATORS RETRIEVED PLUTONIUM METAL FROM THE PLUTONIUM STORAGE VAULTS (IN MODULE K) AND CONVEYED IT TO THE X-Y SHUTTLE AREA WHERE IT WAS CUT AND WEIGHED. FROM THE SHUTTLE AREA THE PLUTONIUM WAS CONVEYED TO MODULES A, J OR K FOR CASTING, OR MODULE B FOR ROLLING AND FORMING. (5/17/71) - Rocky Flats Plant, Plutonium Manufacturing Facility, North-central section of Plant, just south of Building 776/777, Golden, Jefferson County, CO

Advantages and Disadvantages of Physiological Assessment For Next Generation Control Room Design

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tuan Q. Tran; Ronald L. Boring; Donald D. Dudenhoeffer

2007-08-01

Abstract - We propose using non-obtrusive physiological assessment (e.g., eye tracking,) to assess human information processing errors (e.g., loss of vigilance) and limitations (e.g., workload) for advanced energy systems early in the design process. This physiological approach for assessing risk will circumvent many limitations of current risk methodologies such as subjective rating (e.g., rater’s biases) and performance modeling (e.g., risk assessment is scripted and is based upon the individual modeler’s judgment). Key uses will be to evaluate (early in the design process) novel control room equipment and configurations as well as newly developed automated systems that will inevitably place amore » high information load on operators. The physiological risk assessment tool will allow better precision in pinpointing problematic design issues and will provide a “real-time” assessment of risk. Furthermore, this physiological approach would extend the state-of-the-art of human reliability methods from a “static” measure to more “dynamic.” This paper will discuss a broad range of the current popular online performance gauges as well as its advantages and disadvantages for use in next generation control room.« less

Perceived Parental Care and Control among Israeli Female Adolescents Presenting to Emergency Rooms after Self-Poisoning

ERIC Educational Resources Information Center

Diamond, Gary M.; Didner, Hila; Waniel, Ariela; Priel, Beatriz; Asherov, Jack; Arbel, Shosh

2005-01-01

Levels of perceived parental care and control among 24 female Israeli adolescents presenting at emergency rooms after a self-poisoning act of low lethality were compared to those found among 23 non-self-harming, community controls. Adolescents' perceived levels of parental care and control were measured via both adolescents' self-report and…

Cost-benefit analysis of different air change rates in an operating room environment.

PubMed

Gormley, Thomas; Markel, Troy A; Jones, Howard; Greeley, Damon; Ostojic, John; Clarke, James H; Abkowitz, Mark; Wagner, Jennifer

2017-12-01

Hospitals face growing pressure to meet the dual but often competing goals of providing a safe environment while controlling operating costs. Evidence-based data are needed to provide insight for facility management practices to support these goals. The quality of the air in 3 operating rooms was measured at different ventilation rates. The energy cost to provide the heating, ventilation, and air conditioning to the rooms was estimated to provide a cost-benefit comparison of the effectiveness of different ventilation rates currently used in the health care industry. Simply increasing air change rates in the operating rooms tested did not necessarily provide an overall cleaner environment, but did substantially increase energy consumption and costs. Additionally, and unexpectedly, significant differences in microbial load and air velocity were detected between the sterile fields and back instrument tables. Increasing the ventilation rates in operating rooms in an effort to improve clinical outcomes and potentially reduce surgical site infections does not necessarily provide cleaner air, but does typically increase operating costs. Efficient distribution or management of the air can improve quality indicators and potentially reduce the number of air changes required. Measurable environmental quality indicators could be used in lieu of or in addition to air change rate requirements to optimize cost and quality for an operating room and other critical environments. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

ATLAS Virtual Visits: Bringing the World into the ATLAS Control Room

NASA Astrophysics Data System (ADS)

Goldfarb, S.

2012-12-01

The newfound ability of Social Media to transform public communication back to a conversational nature provides HEP with a powerful tool for Outreach and Communication. By far, the most effective component of nearly any visit or public event is that fact that the students, teachers, media, and members of the public have a chance to meet and converse with real scientists. While more than 30,000 visitors passed through the ATLAS Visitor Centre in 2011, nearly 7 billion did not have a chance to make the trip. Clearly this is not for lack of interest. Rather, the costs of travel, in terms of time and money, and limited parking, put that number somewhat out of reach. On the other hand, during the LHC “First Physics” event of 2010, more than 2 million visitors joined the experiment control rooms via webcast for the celebration. This document presents a project developed for the ATLAS Experiment's Outreach and Education program that complements the webcast infrastructure with video conferencing and wireless sound systems, allowing the public to interact with hosts in the control room with minimal disturbance to the shifters. These “Virtual Visits” have included high school classes, LHC Masterclasses, conferences, expositions and other events in Europe, USA, Japan and Australia, to name a few. We discuss the technology used, potential pitfalls (and ways to avoid them), and our plans for the future.

APOLLO XIII CREW - MISSION OPERATIONS CONTROL ROOM (MOCR) - APOLLO XII - LUNAR EXTRAVEHICULAR ACTIVITY (EVA) - MSC

NASA Image and Video Library

1969-11-21

S69-59525 (19 Nov. 1969) --- Overall view of activity in the Mission Operations Control Room (MOCR) in the Mission Control Center (MCC), Building 30, during the Apollo 12 lunar landing mission. When this picture was made the first Apollo 12 extravehicular activity (EVA) was being televised from the surface of the moon. Photo credit: NASA

Control of the Environment in the Operating Room.

PubMed

Katz, Jonathan D

2017-10-01

There is a direct relationship between the quality of the environment of a workplace and the productivity and efficiency of the work accomplished. Components such as temperature, humidity, ventilation, drafts, lighting, and noise each contribute to the quality of the overall environment and the sense of well-being of those who work there.The modern operating room is a unique workplace with specific, and frequently conflicting, environmental requirements for each of the inhabitants. Even minor disturbances in the internal environment of the operating room can have serious ramifications on the comfort, effectiveness, and safety of each of the inhabitants. A cool, well-ventilated, and dry climate is optimal for many members of the surgical team. Any significant deviation from these objectives raises the risk of decreased efficiency and productivity and adverse surgical outcomes. A warmer, more humid, and quieter environment is necessary for the patient. If these requirements are not met, the risk of surgical morbidity and mortality is increased. An important task for the surgical team is to find the correct balance between these 2 opposed requirements. Several of the components of the operating room environment, especially room temperature and airflow patterns, are easily manipulated by the members of the surgical team. In the following discussion, we will examine these elements to better understand the clinical ramifications of adjustments and accommodations that are frequently made to meet the requirements of both the surgical staff and the patient.

Implementing Delivery Room Checklists and Communication Standards in a Multi-Neonatal ICU Quality Improvement Collaborative.

PubMed

Bennett, Stacie C; Finer, Neil; Halamek, Louis P; Mickas, Nick; Bennett, Mihoko V; Nisbet, Courtney C; Sharek, Paul J

2016-08-01

The 2015 American Academy of Pediatrics Neonatal Resuscitation Program (NRP) and International Liaison Committee on Resuscitation (ILCOR) resuscitation guidelines state, "It is still suggested that briefing and debriefing techniques be used whenever possible for neonatal resuscitation." Effective communication and reliable delivery of evidence-based best practices are critical aspects of the 2015 NRP guidelines. To promote optimal communication and best practice-focused checklists use during active neonatal resuscitation, the Readiness Bundle (RB) was integrated within the larger change package deployed in the California Perinatal Quality Care Collaborative's (CPQCC) 12-month Delivery Room Management Quality Improvement Collaborative. The RB consisted of (1) a checklist for high-risk neonatal resuscitations and (2) briefings and debriefings to improve teamwork and communication in the delivery room (DR). Implementation of the RB was encouraged, compliance with the RB was tracked monthly up through 6 months after the completion of the collaborative, and satisfaction with the RB was evaluated. Twenty-four neonatal intensive care units (NICUs) participated in the CPQCCDR collaborative. Before the initiation of the collaborative, the elements of the RB were complied with in 0 of 740 reported deliveries (0%). During the 12-month collaborative, compliance with the RB improved to a median of 71%, which was surpassed in the 6-month period after the collaborative ended (80%). One-hundred percent of responding NICUs would recommend the RB to other NICUs working on improving DR management. The RB was rapidly adopted, with compliance sustained for 6 months after completion of the collaborative. Inclusion of the RB in the next generation of the NRP guidelines is encouraged.

Color coding of control room displays: the psychocartography of visual layering effects.

PubMed

Van Laar, Darren; Deshe, Ofer

2007-06-01

To evaluate which of three color coding methods (monochrome, maximally discriminable, and visual layering) used to code four types of control room display format (bars, tables, trend, mimic) was superior in two classes of task (search, compare). It has recently been shown that color coding of visual layers, as used in cartography, may be used to color code any type of information display, but this has yet to be fully evaluated. Twenty-four people took part in a 2 (task) x 3 (coding method) x 4 (format) wholly repeated measures design. The dependent variables assessed were target location reaction time, error rates, workload, and subjective feedback. Overall, the visual layers coding method produced significantly faster reaction times than did the maximally discriminable and the monochrome methods for both the search and compare tasks. No significant difference in errors was observed between conditions for either task type. Significantly less perceived workload was experienced with the visual layers coding method, which was also rated more highly than the other coding methods on a 14-item visual display quality questionnaire. The visual layers coding method is superior to other color coding methods for control room displays when the method supports the user's task. The visual layers color coding method has wide applicability to the design of all complex information displays utilizing color coding, from the most maplike (e.g., air traffic control) to the most abstract (e.g., abstracted ecological display).

Simulator training to automaticity leads to improved skill transfer compared with traditional proficiency-based training: a randomized controlled trial.

PubMed

Stefanidis, Dimitrios; Scerbo, Mark W; Montero, Paul N; Acker, Christina E; Smith, Warren D

2012-01-01

We hypothesized that novices will perform better in the operating room after simulator training to automaticity compared with traditional proficiency based training (current standard training paradigm). Simulator-acquired skill translates to the operating room, but the skill transfer is incomplete. Secondary task metrics reflect the ability of trainees to multitask (automaticity) and may improve performance assessment on simulators and skill transfer by indicating when learning is complete. Novices (N = 30) were enrolled in an IRB-approved, blinded, randomized, controlled trial. Participants were randomized into an intervention (n = 20) and a control (n = 10) group. The intervention group practiced on the FLS suturing task until they achieved expert levels of time and errors (proficiency), were tested on a live porcine fundoplication model, continued simulator training until they achieved expert levels on a visual spatial secondary task (automaticity) and were retested on the operating room (OR) model. The control group participated only during testing sessions. Performance scores were compared within and between groups during testing sessions. : Intervention group participants achieved proficiency after 54 ± 14 and automaticity after additional 109 ± 57 repetitions. Participants achieved better scores in the OR after automaticity training [345 (range, 0-537)] compared with after proficiency-based training [220 (range, 0-452; P < 0.001]. Simulator training to automaticity takes more time but is superior to proficiency-based training, as it leads to improved skill acquisition and transfer. Secondary task metrics that reflect trainee automaticity should be implemented during simulator training to improve learning and skill transfer.

Human factor engineering based design and modernization of control rooms with new I and C systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Larraz, J.; Rejas, L.; Ortega, F.

2012-07-01

Instrumentation and Control (I and C) systems of the latest nuclear power plants are based on the use of digital technology, distributed control systems and the integration of information in data networks (Distributed Control and Instrumentation Systems). This has a repercussion on Control Rooms (CRs), where the operations and monitoring interfaces correspond to these systems. These technologies are also used in modernizing I and C systems in currently operative nuclear power plants. The new interfaces provide additional capabilities for operation and supervision, as well as a high degree of flexibility, versatility and reliability. An example of this is the implementationmore » of solutions such as compact stations, high level supervision screens, overview displays, computerized procedures, new operational support systems or intelligent alarms processing systems in the modernized Man-Machine Interface (MMI). These changes in the MMI are accompanied by newly added Software (SW) controls and new solutions in automation. Tecnatom has been leading various projects in this area for several years, both in Asian countries and in the United States, using in all cases international standards from which Tecnatom own methodologies have been developed and optimized. The experience acquired in applying this methodology to the design of new control rooms is to a large extent applicable also to the modernization of current control rooms. An adequate design of the interface between the operator and the systems will facilitate safe operation, contribute to the prompt identification of problems and help in the distribution of tasks and communications between the different members of the operating shift. Based on Tecnatom experience in the field, this article presents the methodological approach used as well as the most relevant aspects of this kind of project. (authors)« less

Seismometer reading viewed in ALSEP Room in Misson Control during Apollo 17

NASA Technical Reports Server (NTRS)

1972-01-01

The seismometer readings from the impact made by the Apollo 17 Saturn S-IVB stage when it struck the lunar surface are viewed in the ALSEP Room in the Misson Control Center at Houston by Dr. Maurice Ewing, professor of geophysics of the Universtiy of Texas at Galveston. The seismic tracings are from sensings made by seismometers of Apollo Lunar Surface Experiments Packages left on the Moon during earlier Apollo lunar landing missions.

The Ground Control Room as an Enabling Technology in the Unmanned Aerial System

NASA Technical Reports Server (NTRS)

Gear, Gary; Mace, Thomas

2007-01-01

This viewgraph presentation reviews the development of the ground control room as an required technology for the use of an Unmanned Aerial system. The Unmanned Aerial system is a strategic component of the Global Observing System, which will serve global science needs. The unmanned aerial system will use the same airspace as manned aircraft, therefore there will be unique telemetry needs.

Improved Operating Room Efficiency via Constraint Management: Experience of a Tertiary-Care Academic Medical Center.

PubMed

Kimbrough, Charles W; McMasters, Kelly M; Canary, Jeff; Jackson, Lisa; Farah, Ian; Boswell, Mark V; Kim, Daniel; Scoggins, Charles R

2015-07-01

Suboptimal operating room (OR) efficiency is a universal complaint among surgeons. Nonetheless, maximizing efficiency is critical to institutional success. Here, we report improvement achieved from low-cost, low-technology measures instituted within a tertiary-care academic medical center/Level I trauma center. Improvements in preadmission testing and OR scheduling, including appointing a senior nurse anesthetist to help direct OR use, were instituted in March 2012. A retrospective review of prospectively maintained OR case data was performed to evaluate time periods before and after program implementation, as well as to assess trends over time. Operating room performance metrics were compared using Mann-Whitney and chi-squared tests. Changes over time were analyzed using linear regression. Data including all surgical cases were available for a 36-month period; 10 months (6,581 cases) before program implementation and 26 months afterward (17,574 cases). Dramatic improvement was seen in first-case on-time starts, which increased from 39.3% to 83.8% (p < 0.0001). Additionally, the percent utilization of available OR time demonstrated a steady increase (p < 0.001). After an initial lag, case volume also improved, evident by an increase observed in the 12-month rolling average of cases per month (p < 0.001). The increase in case volume occurred during peak OR time (7 am to 5 pm), and did not result from adding cases after hours (5 pm to 11 pm). After many years of what seemed an insoluble problem, simple changes fostering collaboration among services, including active management of the OR schedule and transparent data, have resulted in substantial improvement in OR efficiency and case volume. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Augmenting Photoinduced Charge Transport in a Single-Component Gel System: Controlled In Situ Gel-Crystal Transformation at Room Temperature.

PubMed

Satapathy, Sitakanta; Prabakaran, Palani; Prasad, Edamana

2018-04-20

Smart single-component materials with versatile functions require pre-programming of a higher order molecular assembly. An electroactive supergelator (c=0.07 wt %) triphenylamine core-appended poly(aryl ether) dendron (TPAPAE) is described, where substantial dendritic effects improve the order and crystallinity by switching the local minima from self-assembled molecular wires to thermodynamically favorable global minima of ordered crystals, ripened within the fibers. Controlled in situ phase change at room temperature ultimately stabilized the mixed valence states in the single-component supramolecular assembly with photoluminescence and photoinduced charge transport amplified by two orders of magnitude. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

New thinking for the boiler room.

PubMed

Rose, Wayne

2008-09-01

Wayne Rose, marketing manager at integrated plant room manufacturer Armstrong Integrated Systems, explains how increasing use of off-site manufacture, the latest 3D modelling technology, and advances in control technology, are revolutionising boiler room design and construction.

Human Factors Guidance for Control Room and Digital Human-System Interface Design and Modification, Guidelines for Planning, Specification, Design, Licensing, Implementation, Training, Operation and Maintenance

DOE Office of Scientific and Technical Information (OSTI.GOV)

R. Fink, D. Hill, J. O'Hara

2004-11-30

Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces.

[Significance of working environment improvement based on determination of source of harmful substance--example of an endoscope syringe room using glutaraldehyde].

PubMed

Tashiro, Hiraku; Oda, Susumu; Mori, Koji

2004-03-01

Because a worker complained of irritated eyes and throat due to glutaraldehyde (GA) in an endoscope syringe room, the automated endoscope washers and GA liquid stored in reserve were isolated in a separate room. A ventilation system was installed in this room, and the packing of the automated endoscope washers was changed. However, since the obnoxious smell of GA still remained in the endoscope syringe room, we had to determine the source of the smell. A plastic bucket with a cap was found to be filled with GA for disinfection of the endoscope apparatus. GA had evaporated when dispersed around the bucket, resulting in the obnoxious smell. The plastic bucket was replaced with a different type of container. Moreover, GA from the separate room did not affect the concentration of GA in the working area because the separate room for the automated endoscope washers had twice the ventilation volume proposed by the guidelines of the Society of Gastroenterology Nurses and Associates of the USA and the Healthcare Engineering Association of Japan. Consequently, we reconfirmed the significance of working environment improvement after clarifying the source of the harmful substance.

[Improving operating room efficiency: an observational and multidimensional approach in the San Camillo-Forlanini Hospital, Rome].

PubMed

Mitello, Lucia; D'Alba, Fabrizio; Milito, Francesca; Monaco, Cinzia; Orazi, Daniela; Battilana, Daniela; Marucci, Anna Rita; Longo, Angelo; Latina, Roberto

2017-01-01

The management of operating rooms (ORs) is a complex process which requires an effective organizational scheme. In order to amore convinient allocation of resources a rigorous monitoring plan is needed to ensure operating rooms performances. All the necessary actions should be taken to improve the quality of the planning and scheduling procedure. Between April-December, 2016 an organizational analysis has been carried out on the performances of the A.O. S. Camillo-Forlanini Hospital Operating Block applying the "process management" approach to the ORs efficiency. The project involved two different surgical areas of the same operating block the multi-specialist and elective surgery and cardio-vascular surgery . The analyses of the processes was made through the product, patient and safety approach and from different points of view: the "asis", process and stakeholder perspectives. Descriptive statistics was used to process raw data and Student's t-distribution was used to assess the difference between the two means (significant p value ˂0,05). The Coefficient of Variation (CV) was used to describe the variabilityamong data. The asis approach allowed us to describe the ORs inbound activities. For both operating block the most demanding weekly commitments in terms of time turned out to be the inventory management procedures of controlling and stocking medicines, general medical supplies and instruments (130[DS=±14] for BOE and 30[DS=±18] for CCH. The average time spent on preparing the operating room, separately calculated starting from the first surgical case, was of 27 minutes (SD=± 17) while for the following surgical procedures preparation time decreased to 15 minutes (SD= ± 10), which highlighted a meaningful difference of 12 minutes. A great variability was registered in CCH due to the unpredictability of these operations (CV 82%). The stakeholders' perspective revealed a reasonable level of satisfaction among nurses and surgeons (2.9 vs 2.3, respectively

[Single-family rooms for neonatal intensive care units impacts on preterm newborns, families, and health-care staff. A systematic literature review].

PubMed

Servel, A-C; Rideau Batista Novais, A

2016-09-01

The quality of the environment is an essential point in the care of preterm newborns. The design of neonatal intensive care units (NICUs) (open-bay, single-patient room, single-family room) directly affects both the preterm newborns and their caregivers (parents, healthcare staff). The aim of this systematic review was to evaluate the impact of single-family rooms on the preterm newborn, its parents, and the staff. Single-family rooms improve outcome for the preterm newborn, with increasing parental involvement and better control of the environment (fewer inappropriate stimulations such as high levels of noise and illumination). This kind of NICU design also improves parental and staff satisfaction. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Firing Room 2 in Launch Control Center at KSC during Apollo 9 countdown test

NASA Image and Video Library

1969-02-23

S69-25880 (23 Feb. 1969) --- Overall view of Firing Room 2 in the Launch Control Center, Launch Complex 39, Kennedy Space Center, during an Apollo 9 Countdown Demonstration Test. Astronauts James A. McDivitt, David R. Scott, and Russell L. Schweickart were participating in a training exercise in preparation for their scheduled 10-day Earth-orbital space mission.

The evaluation the magnitude radiation exposure dose rate in digital radiography room design

NASA Astrophysics Data System (ADS)

Dwiyanto, Agung; Setia Budi, Wahyu; Hardiman, Gagoek

2017-12-01

This study discusses the dose rate in digital radiography room, buit according to meet the provisions of KEMENKES No.1014 / Menkes / SK / XI / 2008 and Regulation of BAPETEN No. 8 / 2011. The provisions primary concern of radiation safety, not comfort, by considering the space design. There are five aspects to consider in designing the space: functionality, comfort, security, movement activities and aesthetics. However provisions only met three aspects of the design, which are a function, security and movement activity. Therefore, it is necessary to evaluate digital radiography room in terms of its ability to control external radiation exposure to be safe and comfortable The dose rate is measured by the range of primary and secondary radiation in the observation points by using Surveymeter. All data are obtained by the preliminary survey prior to the study. Furthermore, the review of digital radiography room is done based on architectural design theory. The dose rate for recommended improvement room is recalculated using the same method as the actual room with the help of computer modeling. The result of dose rate calculation at the inner and outer part of digital radiography observation room shows that in-room dose for a week at each measuring point exceeds the allowable dose limit both for staff and public. During a week of observation, the outdoor dose at some measuring points exceeds the dose limit set by the KEMENKES No.1014 / Menkes / SK / XI / 2008 and Regulation BEPETEN No 8/2011. Meanwhile, the result of dose rate calculation in the inner and outer part of the improved digital radiography room can meet the applicable regulations better.

Supplemental treatment of air in airborne infection isolation rooms using high-throughput in-room air decontamination units.

PubMed

Bergeron, Vance; Chalfine, Annie; Misset, Benoît; Moules, Vincent; Laudinet, Nicolas; Carlet, Jean; Lina, Bruno

2011-05-01

Evidence has recently emerged indicating that in addition to large airborne droplets, fine aerosol particles can be an important mode of influenza transmission that may have been hitherto underestimated. Furthermore, recent performance studies evaluating airborne infection isolation (AII) rooms designed to house infectious patients have revealed major discrepancies between what is prescribed and what is actually measured. We conducted an experimental study to investigate the use of high-throughput in-room air decontamination units for supplemental protection against airborne contamination in areas that host infectious patients. The study included both intrinsic performance tests of the air-decontamination unit against biological aerosols of particular epidemiologic interest and field tests in a hospital AII room under different ventilation scenarios. The unit tested efficiently eradicated airborne H5N2 influenza and Mycobacterium bovis (a 4- to 5-log single-pass reduction) and, when implemented with a room extractor, reduced the peak contamination levels by a factor of 5, with decontamination rates at least 33% faster than those achieved with the extractor alone. High-throughput in-room air treatment units can provide supplemental control of airborne pathogen levels in patient isolation rooms. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Designing an Easy-to-use Executive Conference Room Control System

NASA Astrophysics Data System (ADS)

Back, Maribeth; Golovchinsky, Gene; Qvarfordt, Pernilla; van Melle, William; Boreczky, John; Dunnigan, Tony; Carter, Scott

The Usable Smart Environment project (USE) aims at designing easy-to-use, highly functional, next-generation conference rooms. Our first design prototype focuses on creating a “no wizards” room for an American executive; that is, a room the executive could walk into and use by himself, without help from a technologist. A key idea in the USE framework is that customization is one of the best ways to create a smooth user experience. As the system needs to fit both with the personal leadership style of the executive and the corporation’s meeting culture, we began the design process by exploring the work flow in and around meetings attended by the executive.

NASA researchers in gold control room during an F-15 HiDEC flight

NASA Technical Reports Server (NTRS)

1993-01-01

NASA researchers monitor equipment in the mission control Gold room at the Dryden Flight Research Center, Edwards, California, during a flight of an F-15 Highly Integrated Digital Electronic Control (HIDEC) research aircraft. The system was developed on the F-15 to investigate and demonstrate methods of obtaining optimum aircraft performance. The major elements of HIDEC were a Digital Electronic Flight Control System (DEFCS), a Digital Electronic Engine Control (DEEC), an on-board general purpose computer, and an integrated architecture to allow all components to 'talk to each other.' Unlike standard F-15s, which have a mechanical and analog electronic flight control system, the HIDEC F-15 also had a dual-channel, fail-safe digital flight control system programmed in Pascal. It was linked to the Military Standard 1553B and a H009 data bus which tied all the other electronic systems together.

Improved algorithms and methods for room sound-field prediction by acoustical radiosity in arbitrary polyhedral rooms.

PubMed

Nosal, Eva-Marie; Hodgson, Murray; Ashdown, Ian

2004-08-01

This paper explores acoustical (or time-dependent) radiosity--a geometrical-acoustics sound-field prediction method that assumes diffuse surface reflection. The literature of acoustical radiosity is briefly reviewed and the advantages and disadvantages of the method are discussed. A discrete form of the integral equation that results from meshing the enclosure boundaries into patches is presented and used in a discrete-time algorithm. Furthermore, an averaging technique is used to reduce computational requirements. To generalize to nonrectangular rooms, a spherical-triangle method is proposed as a means of evaluating the integrals over solid angles that appear in the discrete form of the integral equation. The evaluation of form factors, which also appear in the numerical solution, is discussed for rectangular and nonrectangular rooms. This algorithm and associated methods are validated by comparison of the steady-state predictions for a spherical enclosure to analytical solutions.

Improved algorithms and methods for room sound-field prediction by acoustical radiosity in arbitrary polyhedral rooms

NASA Astrophysics Data System (ADS)

Nosal, Eva-Marie; Hodgson, Murray; Ashdown, Ian

2004-08-01

This paper explores acoustical (or time-dependent) radiosity-a geometrical-acoustics sound-field prediction method that assumes diffuse surface reflection. The literature of acoustical radiosity is briefly reviewed and the advantages and disadvantages of the method are discussed. A discrete form of the integral equation that results from meshing the enclosure boundaries into patches is presented and used in a discrete-time algorithm. Furthermore, an averaging technique is used to reduce computational requirements. To generalize to nonrectangular rooms, a spherical-triangle method is proposed as a means of evaluating the integrals over solid angles that appear in the discrete form of the integral equation. The evaluation of form factors, which also appear in the numerical solution, is discussed for rectangular and nonrectangular rooms. This algorithm and associated methods are validated by comparison of the steady-state predictions for a spherical enclosure to analytical solutions.

Mission Operations Control Room Activities during STS-2 mission

NASA Technical Reports Server (NTRS)

1981-01-01

Mission Operations Control Room (MOCR) activities during STS-2 mission. President Ronald Reagan is briefed by Dr. Christopher C. Kraft, Jr., JSC Director, who points toward the orbiter spotter on the projection plotter at the front of the MOCR (39499); President Reagan joking with STS-2 astronauts during space to ground conversation (39500); Mission Specialist/Astronaut Sally K. Ride communicates with the STS-2 crew from the spacecraft communicator console (39501); Charles R. Lewis, bronze team Flight Director, monitors activity from the STS-2 crew. He is seated at the flight director console in MOCR (39502); Eugene F. Kranz, Deputy Director of Flight Operations at JSC answers a question during a press conference on Nov. 13, 1981. He is flanked by Glynn S. Lunney, Manager, Space Shuttle Program Office, JSC; and Dr. Christopher C. Kraft, Jr., Director of JSC (39503).

Operators in the Plum Brook Reactor Facility Control Room

NASA Image and Video Library

1970-03-21

Donald Rhodes, left, and Clyde Greer, right, monitor the operation of the National Aeronautics and Space Administration’s (NASA) Plum Brook Reactor Facility from the control room. The 60-megawatt test reactor, NASA’s only reactor, was the eighth largest test reactor in the world. The facility was built by the Lewis Research Center in the late 1950s to study the effects of radiation on different materials that could be used to construct nuclear propulsion systems for aircraft or rockets. The reactor went critical for the first time in 1961. For the next two years, two operators were on duty 24 hours per day working on the fission process until the reactor reached its full-power level in 1963. Reactor Operators were responsible for monitoring and controlling the reactor systems. Once the reactor was running under normal operating conditions, the work was relatively uneventful. Normally the reactor was kept at a designated power level within certain limits. Occasionally the operators had to increase the power for a certain test. The shift supervisor and several different people would get together and discuss the change before boosting the power. All operators were required to maintain a Reactor Operator License from the Atomic Energy Commission. The license included six months of training, an eight-hour written exam, a four-hour walkaround, and testing on the reactor controls.

Concept and design engineering: endourology operating room.

PubMed

Sabnis, Ravindra; Ganesamoni, Raguram; Mishra, Shashikant; Sinha, Lokesh; Desai, Mahesh R

2013-03-01

A dedicated operating room with fluoroscopic imaging capability and adequate data connectivity is important to the success of any endourology program. Proper understanding of the recent developments in technology in relation to operating room is necessary before planning an endourology operating room. An endourology operating room is a fluorocompatible operating room with enough space to accommodate equipment like multiple flat monitors to display video, C-arm with its monitor, ultrasonography machine, laser machine, intracorporeal lithotripsy unit, irrigation pumps and two large trolleys with instruments. This operating room is integrated with devices to continuously record and archive data from endovision and surface cameras, ultrasound and fluoroscopy. Moreover, advances made in data relay systems have created seamless two-way communication between the operating room and electronic medical records, radiological picture archiving and communication system, classroom, auditorium and literally anywhere in the world. A dedicated endourology operating room is required for any hospital, which has a significant amount of endourology procedures. A custom-made integrated endourology operating room will facilitate endourology procedures, smoothen the workflow in operating room and improve patient outcomes. Meticulous planning and involving experts in the field are critical for the success of the project.

Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling.

PubMed

Van Houdenhoven, Mark; van Oostrum, Jeroen M; Hans, Erwin W; Wullink, Gerhard; Kazemier, Geert

2007-09-01

An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques. We applied advanced mathematical algorithms in combination with scenarios that model relaxation of various organizational barriers using prospectively collected data. The setting is the main inpatient OR department of a university hospital, which sets its surgical case schedules 2 wk in advance using a block planning method. The main outcome measures are the number of freed OR blocks and OR utilization. Lowering organizational barriers and applying mathematical algorithms can yield a 4.5% point increase in OR utilization (95% confidence interval 4.0%-5.0%). This is obtained by reducing the total required OR time. Efficient OR departments can further improve their efficiency. The paper shows that a radical cultural change that comprises the use of mathematical algorithms and lowering organizational barriers improves OR utilization.

Exposure of hospital operating room personnel to potentially harmful environmental agents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sass-Kortsak, A.M.; Purdham, J.T.; Bozek, P.R.

1992-03-01

Epidemiologic studies of risk to reproductive health arising from the operating room environment have been inconclusive and lack quantitative exposure information. This study was undertaken to quantify exposure of operating room (OR) personnel to anesthetic agents, x-radiation, methyl methacrylate, and ethylene oxide and to determine how exposure varies with different operating room factors. Exposures of anesthetists and nurses to these agents were determined in selected operating rooms over three consecutive days. Each subject was asked to wear an x-radiation dosimeter for 1 month. Exposure to anesthetic agents was found to be influenced by the age of the OR facility, typemore » of surgical service, number of procedures carried out during the day, type of anesthetic circuitry, and method of anesthesia delivery. Anesthetists were found to have significantly greater exposures than OR nurses. Exposure of OR personnel to ethylene oxide, methyl methacrylate, and x-radiation were well within existing standards. Exposure of anesthetists and nurses to anesthetic agents, at times, was in excess of Ontario exposure guidelines, despite improvements in the control of anesthetic pollution.« less

Snoezelen Room and Childbirth Outcome: A Randomized Clinical Trial.

PubMed

Jamshidi Manesh, Mansoureh; Kalati, Mahnaz; Hosseini, Fatemeh

2015-05-01

One of the strategies for a good outcome and pain free childbearing is to design the delivery room. The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women. This study was a randomized controlled clinical trial consists of 100 childbearing women. They were randomly divided into 2 groups. The experimental group went to snoezelen room when their cervix dilation was 4 cm, while the control group went to physiologic delivery room with the same cervix dilation. The mean ± SD of VAS (Visual Analogue Scale) pain intensity of the experimental and control groups before the intervention were 5.1 ± 1.95 and 5.58 ± 1.62, respectively (P = 0.13). The mean ± SD of VAS pain intensity scores of the experimental and control groups after 3 hours spending in their assigned rooms were 5.26 ± 0.86 and 9.56 ± 1.48, respectively (P = 0.01). The mean ± SD of the first stage scores of the experimental and control groups were 6.95 ± 0.97 and 8.41 ± 0.67, respectively (P = 0.042). About 92% of participants' intervention vs. 66% of control participants had perinea laceration (P = 0.041). According to the findings of the present study, distracting senses in snoezelen room decreases mother's pain intensity, the length of labor, and incidence of episiotomy.

HFE safety reviews of advanced nuclear power plant control rooms

NASA Technical Reports Server (NTRS)

Ohara, John

1994-01-01

Advanced control rooms (ACR's) will utilize human-system interface (HSI) technologies that may have significant implications for plant safety in that they will affect the operator's overall role and means of interacting with the system. The Nuclear Regulatory Commission (NRC) reviews the human factors engineering (HFE) aspects of HSI's to ensure that they are designed to good HFE principles and support performance and reliability in order to protect public health and safety. However, the only available NRC guidance was developed more than ten years ago, and does not adequately address the human performance issues and technology changes associated with ACR's. Accordingly, a new approach to ACR safety reviews was developed based upon the concept of 'convergent validity'. This approach to ACR safety reviews is described.

Report for Task 8.4: Development of Control Room Layout Recommendations

DOE Office of Scientific and Technical Information (OSTI.GOV)

McDonald, Robert

Idaho National Laboratory (INL) has contracted Institutt for Energiteknikk (IFE) to support in the development of an end state vision for the US Nuclear industry and in particular for a utility that is currently moving forward with a control room modernization project. This support includes the development of an Overview display and technical support in conducting an operational study. Development of operational scenarios to be conducted using a full scope simulator at the INL HSSL. Additionally IFE will use the CREATE modelling tool to provide 3-D views of the potential and possible end state view after the completion of digitalmore » upgrade project.« less

Indoor aldehydes concentration and emission rate of formaldehyde in libraries and private reading rooms

NASA Astrophysics Data System (ADS)

Kim, Jeonghoon; Kim, Seojin; Lee, Kiyoung; Yoon, Dongwon; Lee, Jiryang; Ju, DaeYoung

2013-06-01

Aldehydes are of particularly interest due to their potential adverse impact on human health. Formaldehyde is one of the most abundant indoor pollutants. To improve indoor air quality, identifying and removing the major emission sources of formaldehyde would be desirable. The purposes of this study were to determine aldehyde concentrations in libraries and reading rooms and to identify emission sources of formaldehyde in private reading rooms. Indoor aldehyde concentrations were quantified at 66 facilities, including public libraries, children's libraries, public reading rooms, and private reading rooms, in the Seoul metropolitan area. Emission fluxes of formaldehyde from the surfaces of desks, chairs, floors, walls, and ceilings in 19 private reading rooms were measured using a passive emission colorimetric sensor. Indoor aldehyde (formaldehyde, acetaldehyde, propioaldehyde, benzaldehyde, and hexaldehyde) levels were significantly higher than outdoor levels. Indoor formaldehyde geometric mean concentrations in private reading rooms (119.3 μg m-3) were significantly higher than in public libraries (29.2 μg m-3), children's libraries (29.3 μg m-3), and public reading rooms (40.8 μg m-3). Indoor formaldehyde levels were associated with relative humidity. In private reading rooms, the emission rates from desks (255.5 ± 214.8 μg h-1) and walls (231.7 ± 192.3 μg h-1) were significantly higher than that from chairs (79.6 ± 88.5 μg h-1). Desks (31%) and walls (29%) were the major emission sources of formaldehyde in 14 facilities in which measurements exceeded the indoor standard of 100 μg m-3. The age of interior materials was a significant factor for indoor formaldehyde emission flux. Controlling the emission rates of desks and walls is recommended to improve formaldehyde concentrations in private reading rooms.

Instituting a filtration/pressurization system to reduce dust concentrations in a control room at a mineral processing plant

PubMed Central

Noll, J.; Cecala, A.; Hummer, J.

2016-01-01

The National Institute for Occupational Safety and Health has observed that many control rooms and operator compartments in the U.S. mining industry do not have filtration systems capable of maintaining low dust concentrations in these areas. In this study at a mineral processing plant, to reduce respirable dust concentrations in a control room that had no cleaning system for intake air, a filtration and pressurization system originally designed for enclosed cabs was modified and installed. This system was composed of two filtering units: one to filter outside air and one to filter and recirculate the air inside the control room. Eighty-seven percent of submicrometer particles were reduced by the system under static conditions. This means that greater than 87 percent of respirable dust particles should be reduced as the particle-size distribution of respirable dust particles is greater than that of submicrometer particles, and filtration systems usually are more efficient in capturing the larger particles. A positive pressure near 0.02 inches of water gauge was produced, which is an important component of an effective system and minimizes the entry of particles, such as dust, into the room. The intake airflow was around 118 cfm, greater than the airflow suggested by the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) for acceptable indoor air quality. After one year, the loading of the filter caused the airflow to decrease to 80 cfm, which still produces acceptable indoor air quality. Due to the loading of the filters, the reduction efficiency for submicrometer particles under static conditions increased to 94 percent from 87 percent. PMID:26834293

Photographic art in exam rooms may reduce white coat hypertension.

PubMed

Harper, Michael B; Kanayama-Trivedi, Stacy; Caldito, Gloria; Montgomery, David; Mayeaux, E J; DelRosso, Lourdes M

2015-12-01

Blood pressure (BP) elevation in medical office settings in patients who are normotensive in nonmedical settings is an effect known as 'white coat hypertension'. This phenomenon is thought to be due to situational anxiety caused by the experience of visiting a doctor and the anxiety-inducing nature of the medical office. Our study was designed to determine if carefully selected photographic art could counter the anxiety that causes white coat hypertension and lead to lower BP recordings in some patients. 117 adults, non-pregnant patients from the Louisiana State University Health Sciences Center Family Medicine Resident Clinic participated in this study. After the triage nurse measured the BP, the patients were randomly placed in either an exam room with standard medical posters (control room) or in an exam room with photographic art (photo room). The BP was measured in the exam room. After the medical visit, the patients switched rooms and the BP was measured a third time. The patients were asked to fill out a questionnaire to identify room preference. On average, the BP obtained in the control rooms was higher than that obtained in the photo rooms. There was a statistically significant difference between the mean arterial pressure, systolic BP and diastolic BP between the control room and the photo room. Landscape photographic art may have the beneficial effect of reducing BP in medical office examination rooms. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Prevention of healthcare-associated infections in neonates: room for improvement.

PubMed

Legeay, C; Bourigault, C; Lepelletier, D; Zahar, J R

2015-04-01

Infants in neonatal intensive care units (NICUs) are highly susceptible to infection due to the immaturity of their immune systems. Healthcare-associated infections (HCAIs) are associated with prolonged hospital stay, and represent a significant risk factor for neurological development problems and death. Improving HCAI control is a priority for NICUs. Many factors contribute to the occurrence of HCAIs in neonates such as poor hand hygiene, low nurse-infant ratios, environmental contamination and unnecessary use of antibiotics. Prevention is based on improving neonatal management, avoiding unnecessary use of central venous catheters, restricting use of antibiotics and H2 blockers, and introducing antifungal prophylaxis if necessary. Quality improvement interventions to reduce HCAIs in neonates seem to be the cornerstone of infection control. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Use of Lean methodology to improve operating room efficiency in hospitals across the Kingdom of Saudi Arabia.

PubMed

Hassanain, Mazen; Zamakhshary, Mohammed; Farhat, Ghada; Al-Badr, Ahmed

2017-04-01

The objective of this study was to assess whether an intervention on process efficiency using the Lean methodology leads to improved utilization of the operating room (OR), as measured by key performance metrics of OR efficiency. A quasi-experimental design was used to test the impact of the intervention by comparing pre-intervention and post-intervention data on five key performance indicators. The ORs of 12 hospitals were selected across regions of the Kingdom of Saudi Arabia (KSA). The participants were patients treated at these hospitals during the study period. The intervention comprised the following: (i) creation of visual dashboards that enable starting the first case on time; (ii) use of computerized surgical list management; (iii) optimization of time allocation; (iv) development of an operating model with policies and procedures for the pre-anesthesia clinic; and (iv) creation of a governance structure with policies and procedures for day surgeries. The following were the main outcome measures: on-time start for the first case, room turnover times, percent of overrun cases, average weekly procedure volume and OR utilization. The hospital exhibited statistically significant improvements in the following performance metrics: on-time start for the first case, room turnover times and percent of overrun cases. A statistically significant difference in OR utilization or average weekly procedure volumes was not detected. The implementation of a Lean-based intervention targeting process efficiency applied in ORs across various KSA hospitals resulted in encouraging results on some metrics at some sites, suggesting that the approach has the potential to produce significant benefit in the future. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Interior of display area (room 101), looking south towards TV ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Interior of display area (room 101), looking south towards TV control panel room (room 139) at far left corner. The stairway leads to the commander's quarters and the senior battle viewing bridge at top right. Control and communication consoles at the right - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

West wall, display area (room 101), view 1 of 4: ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

West wall, display area (room 101), view 1 of 4: southwest corner, showing stairs to commander's quarters and viewing bridge, windows to controller's room (room 102), south end of control consoles, and holes in pedestal floor for computer equipment cables (tape drive I/O?) - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

Snoezelen Room and Childbirth Outcome: A Randomized Clinical Trial

PubMed Central

Jamshidi Manesh, Mansoureh; Kalati, Mahnaz; Hosseini, Fatemeh

2015-01-01

Background: One of the strategies for a good outcome and pain free childbearing is to design the delivery room. Objectives: The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women. Patients and Methods: This study was a randomized controlled clinical trial consists of 100 childbearing women. They were randomly divided into 2 groups. The experimental group went to snoezelen room when their cervix dilation was 4 cm, while the control group went to physiologic delivery room with the same cervix dilation. Results: The mean ± SD of VAS (Visual Analogue Scale) pain intensity of the experimental and control groups before the intervention were 5.1 ± 1.95 and 5.58 ± 1.62, respectively (P = 0.13). The mean ± SD of VAS pain intensity scores of the experimental and control groups after 3 hours spending in their assigned rooms were 5.26 ± 0.86 and 9.56 ± 1.48, respectively (P = 0.01). The mean ± SD of the first stage scores of the experimental and control groups were 6.95 ± 0.97 and 8.41 ± 0.67, respectively (P = 0.042). About 92% of participants’ intervention vs. 66% of control participants had perinea laceration (P = 0.041). Conclusions: According to the findings of the present study, distracting senses in snoezelen room decreases mother’s pain intensity, the length of labor, and incidence of episiotomy. PMID:26082849

The influence of room temperature on Mg isotope measurements by MC-ICP-MS.

PubMed

Zhang, Xing-Chao; Zhang, An-Yu; Zhang, Zhao-Feng; Huang, Fang; Yu, Hui-Min

2018-03-24

We observed that the accuracy and precision of magnesium (Mg) isotope analyses could be affected if the room temperature oscillated during measurements. To achieve high quality Mg isotopic data, it is critical to evaluate how the unstable room temperature affects Mg isotope measurements by multi-collector inductively coupled plasma mass spectrometry (MC-ICP-MS). We measured the Mg isotopes for the reference material DSM-3 using MC-ICP-MS under oscillating room temperatures in spring. For a comparison, we also measured the Mg isotopes under stable room temperatures, which was achieved by the installation of an improved temperature control system in the laboratory. The δ 26 Mg values measured under oscillating room temperatures have a larger deviation (δ 26 Mg from -0.09 to 0.08‰, with average δ 26 Mg = 0.00 ± 0.08 ‰) than those measured under a stable room temperature (δ 26 Mg from -0.03 to 0.03‰, with average δ 26 Mg = 0.00 ± 0.02 ‰) using the same MC-ICP-MS system. The room temperature variation can influence the stability of MC-ICP-MS. Therefore, it is critical to keep the room temperature stable to acquire high precise and accurate isotopic data when using MC-ICP-MS, especially when using the sample-standard bracketing (SSB) correction method. This article is protected by copyright. All rights reserved.

Wind-driven roof turbines: a novel way to improve ventilation for TB infection control in health facilities.

PubMed

Cox, Helen; Escombe, Rod; McDermid, Cheryl; Mtshemla, Yolanda; Spelman, Tim; Azevedo, Virginia; London, Leslie

2012-01-01

Tuberculosis transmission in healthcare facilities contributes significantly to the TB epidemic, particularly in high HIV settings. Although improving ventilation may reduce transmission, there is a lack of evidence to support low-cost practical interventions. We assessed the efficacy of wind-driven roof turbines to achieve recommended ventilation rates, compared to current recommended practices for natural ventilation (opening windows), in primary care clinic rooms in Khayelitsha, South Africa. Room ventilation was assessed (CO₂ gas tracer technique) in 4 rooms where roof turbines and air-intake grates were installed, across three scenarios: turbine, grate and window closed, only window open, and only turbine and grate open, with concurrent wind speed measurement. 332 measurements were conducted over 24 months. For all 4 rooms combined, median air changes per hour (ACH) increased with wind speed quartiles across all scenarios. Higher median ACH were recorded with open roof turbines and grates, compared to open windows across all wind speed quartiles. Ventilation with open turbine and grate exceeded WHO-recommended levels (60 Litres/second/patient) for 95% or more of measurements in 3 of the 4 rooms; 47% in the remaining room, where wind speeds were lower and a smaller diameter turbine was installed. High room ventilation rates, meeting recommended thresholds, may be achieved using wind-driven roof turbines and grates, even at low wind speeds. Roof turbines and air-intake grates are not easily closed by staff, allowing continued ventilation through colder periods. This simple, low-cost technology represents an important addition to our tools for TB infection control.

Wind-Driven Roof Turbines: A Novel Way to Improve Ventilation for TB Infection Control in Health Facilities

PubMed Central

Cox, Helen; Escombe, Rod; McDermid, Cheryl; Mtshemla, Yolanda; Spelman, Tim; Azevedo, Virginia; London, Leslie

2012-01-01

Objective Tuberculosis transmission in healthcare facilities contributes significantly to the TB epidemic, particularly in high HIV settings. Although improving ventilation may reduce transmission, there is a lack of evidence to support low-cost practical interventions. We assessed the efficacy of wind-driven roof turbines to achieve recommended ventilation rates, compared to current recommended practices for natural ventilation (opening windows), in primary care clinic rooms in Khayelitsha, South Africa. Methods Room ventilation was assessed (CO2 gas tracer technique) in 4 rooms where roof turbines and air-intake grates were installed, across three scenarios: turbine, grate and window closed, only window open, and only turbine and grate open, with concurrent wind speed measurement. 332 measurements were conducted over 24 months. Findings For all 4 rooms combined, median air changes per hour (ACH) increased with wind speed quartiles across all scenarios. Higher median ACH were recorded with open roof turbines and grates, compared to open windows across all wind speed quartiles. Ventilation with open turbine and grate exceeded WHO-recommended levels (60 Litres/second/patient) for 95% or more of measurements in 3 of the 4 rooms; 47% in the remaining room, where wind speeds were lower and a smaller diameter turbine was installed. Conclusion High room ventilation rates, meeting recommended thresholds, may be achieved using wind-driven roof turbines and grates, even at low wind speeds. Roof turbines and air-intake grates are not easily closed by staff, allowing continued ventilation through colder periods. This simple, low-cost technology represents an important addition to our tools for TB infection control. PMID:22253742

Radiation design and control features of a hospital room for a low dose rate remote afterloading unit

DOE Office of Scientific and Technical Information (OSTI.GOV)

Glasgow, G.P.; Corrigan, K.W.

We have renovated, and used for four years, a small 3.4 m x 4.3 m conventional patient second floor hospital room to accommodate a low dose rate remote afterloading unit containing 13 GBq (0.35 Ci) of {sup 137}Cs. Supplemental room shielding consists of a power assisted door (536 kg, 1.7 cm thickness of lead), 1.3 cm lead wall shielding at selected wall locations and on a projector shield beneath the bed, and 0.6 cm of lead over the floor above. Radiation control features consisted of a room interior radiation detector independent of the remote afterloading unit, a redundant patient/nurse communicationmore » system, a remote control system, a door interlock system to insert and retract the radioactive pellets, and a visible and audible status indictator system located at a nearby nurses` work station. Renovation costs (in 1990 dollars) were $383 per square foot; total project costs were $187,000. Nursing personnel radiation exposure was reduced from about 6 {mu}Sv (mg Ra eq){sup -1} (0.6 mrem (mg Ra eq){sup -1}) to about 0.7 {mu}Sv (mg Ra eq){sup -1} (0.07 mrem (mg Ra eq){sup -1}), almost a tenfold reduction. 6 refs., 2 figs., 1 tab.« less

33. SITE BUILDING 002 SCANNER BUILDING MECHANICAL ROOM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

33. SITE BUILDING 002 - SCANNER BUILDING - MECHANICAL ROOM 105, VIEW OF CHILLER ROOM MOTOR CONTROL CENTER. - Cape Cod Air Station, Technical Facility-Scanner Building & Power Plant, Massachusetts Military Reservation, Sandwich, Barnstable County, MA

Room-Temperature Quantum Cloning Machine with Full Coherent Phase Control in Nanodiamond

PubMed Central

Chang, Yan-Chun; Liu, Gang-Qin; Liu, Dong-Qi; Fan, Heng; Pan, Xin-Yu

2013-01-01

In contrast to the classical world, an unknown quantum state cannot be cloned ideally, as stated by the no-cloning theorem. However, it is expected that approximate or probabilistic quantum cloning will be necessary for different applications, and thus various quantum cloning machines have been designed. Phase quantum cloning is of particular interest because it can be used to attack the Bennett-Brassard 1984 (BB84) states used in quantum key distribution for secure communications. Here, we report the first room-temperature implementation of quantum phase cloning with a controllable phase in a solid-state system: the nitrogen-vacancy centre of a nanodiamond. The phase cloner works well for all qubits located on the equator of the Bloch sphere. The phase is controlled and can be measured with high accuracy, and the experimental results are consistent with theoretical expectations. This experiment provides a basis for phase-controllable quantum information devices. PMID:23511233

A HUMAN AUTOMATION INTERACTION CONCEPT FOR A SMALL MODULAR REACTOR CONTROL ROOM

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le Blanc, Katya; Spielman, Zach; Hill, Rachael

Many advanced nuclear power plant (NPP) designs incorporate higher degrees of automation than the existing fleet of NPPs. Automation is being introduced or proposed in NPPs through a wide variety of systems and technologies, such as advanced displays, computer-based procedures, advanced alarm systems, and computerized operator support systems. Additionally, many new reactor concepts, both full scale and small modular reactors, are proposing increased automation and reduced staffing as part of their concept of operations. However, research consistently finds that there is a fundamental tradeoff between system performance with increased automation and reduced human performance. There is a need to addressmore » the question of how to achieve high performance and efficiency of high levels of automation without degrading human performance. One example of a new NPP concept that will utilize greater degrees of automation is the SMR concept from NuScale Power. The NuScale Power design requires 12 modular units to be operated in one single control room, which leads to a need for higher degrees of automation in the control room. Idaho National Laboratory (INL) researchers and NuScale Power human factors and operations staff are working on a collaborative project to address the human performance challenges of increased automation and to determine the principles that lead to optimal performance in highly automated systems. This paper will describe this concept in detail and will describe an experimental test of the concept. The benefits and challenges of the approach will be discussed.« less

The effect of mentoring on clinical perioperative competence in operating room nursing students.

PubMed

Mirbagher Ajorpaz, Neda; Zagheri Tafreshi, Mansoureh; Mohtashami, Jamileh; Zayeri, Farid; Rahemi, Zahra

2016-05-01

The aim of this study was to investigate the effects of mentoring on the clinical perioperative competence of nursing operating room students in Iran. Mentoring is an essential part of clinical education, which has been studied in different populations of students. However, there is a need to assess its effectiveness in operating room students' competence. A randomised controlled trial was performed. Sixty nursing operating room students were randomly assigned to experimental and control groups. Both the control and experimental groups had routine training in the form of faculty supervision. The experimental group had an additional mentoring program. Using the Persian Perceived Perioperative Competence Scale-Revised, clinical competence was compared between the two groups, before and after the intervention. Using SPSS 19, descriptive and inferential statistics, including chi-square and t-tests, were conducted. In the experimental group, the difference between the mean scores of clinical competence before (19·43 ± 2·80) and after (27·86 ± 1·87) the intervention was significant (p ≤ 0·001). After intervention, the difference between the mean scores of the control (3·9 ± 0·15) and experimental (8·61 ± 0·68) groups was significant (p ≤ 0·003). Findings affirmed the positive effect of mentorship programmes on clinical competence in nursing operating room students. Mentoring is an effective method for preparing nursing students in practice. Health care systems may improve as a result of staff-student relationships that ultimately increase the quality care for patients. © 2016 John Wiley & Sons Ltd.

Mission Operations Control Room Activities during STS-2 mission

NASA Technical Reports Server (NTRS)

1981-01-01

Mission Operations Control Room (MOCR) activities during STS-2 mission. President Ronald Reagan and Dr. Christopher C. Kraft, Jr., look toward the orbiter spotter on the projection plotter at the front of the MOCR. Also present are Astronaut Daniel C. Brandenstein, seated left, and NASA Administrator James M. Beggs standing left of center. In the foreground, Dr. Hans Mark, Deputy NASA Administrator, briefs Michael Deaver, Special Assistant to President Reagan (39504); President Reagan speaks to the STS-2 crew during the second day of their mission. On hand in MOCR were NASA Administrator James M. Beggs and Deputy Administrator Hans Mark (standing behind the president but mostly out of frame) and Dr. Kraft on the right. Eugene F. Kranz, Deputy Director of Flight Operations can be seen in the background seated at the Flight Operations Directorate (FOD) console. Also present is Astronaut Daniel C. Brandenstein, seated left, who turned the communications over to Mr. Reagan (39505).

Cost-Benefit of Improving the Efficiency of Room Air Conditioners (Inverter and Fixed Speed) in India

DOE Office of Scientific and Technical Information (OSTI.GOV)

Phadke, Amol; Shah, Nihar; Abhyankar, Nikit

Improving efficiency of air conditioners (ACs) typically involves improving the efficiency of various components such as compressors, heat exchangers, expansion valves, refrigerant,and fans. We estimate the incremental cost of improving the efficiency of room ACs based on the cost of improving the efficiency of its key components. Further, we estimate the retail price increase required to cover the cost of efficiency improvement, compare it with electricity bill savings, and calculate the payback period for consumers to recover the additional price of a more efficient AC. The finding that significant efficiency improvement is cost effective from a consumer perspective is robustmore » over a wide range of assumptions. If we assume a 50% higher incremental price compared to our baseline estimate, the payback period for the efficiency level of 3.5 ISEER is 1.1 years. Given the findings of this study, establishing more stringent minimum efficiency performance criteria (one-star level) should be evaluated rigorously considering significant benefits to consumers, energy security, and environment« less

Controlling the selective formation of calcium sulfate polymorphs at room temperature.

PubMed

Tritschler, Ulrich; Van Driessche, Alexander E S; Kempter, Andreas; Kellermeier, Matthias; Cölfen, Helmut

2015-03-23

Calcium sulfate is a naturally abundant and technologically important mineral with a broad scope of applications. However, controlling CaSO4 polymorphism and, with it, its final material properties still represents a major challenge, and to date there is no universal method for the selective production of the different hydrated and anhydrous forms under mild conditions. Herein we report the first successful synthesis of pure anhydrite from solution at room temperature. We precipitated calcium sulfate in alcoholic media at low water contents. Moreover, by adjusting the amount of water in the syntheses, we can switch between the distinct polymorphs and fine-tune the outcome of the reaction, yielding either any desired CaSO4 phase in pure state or binary mixtures with predefined compositions. This concept provides full control over phase selection in CaSO4 mineralization and may allow for the targeted fabrication of corresponding materials for use in various areas. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

[Telemetric monitoring reduces visits to the emergency room and cost of care in patients with chronic heart failure].

PubMed

Pérez-Rodríguez, Gilberto; Brito-Zurita, Olga Rosa; Sistos-Navarro, Enrique; Benítez-Aréchiga, Zaria Margarita; Sarmiento-Salazar, Gloria Leticia; Vargas-Lizárraga, José Feliciano

2015-01-01

Tele-cardiology is the use of information technologies that help prolong survival, improve quality of life and reduce costs in health care. Heart failure is a chronic disease that leads to high care costs. To determine the effectiveness of telemetric monitoring for controlling clinical variables, reduced emergency room visits, and cost of care in a group of patients with heart failure compared to traditional medical consultation. A randomized, controlled and open clinical trial was conducted on 40 patients with Heart failure in a tertiary care centre in north-western Mexico. The patients were divided randomly into 2 groups of 20 patients each (telemetric monitoring, traditional medical consultation). In each participant was evaluated for: blood pressure, heart rate and body weight. The telemetric monitoring group was monitored remotely and traditional medical consultation group came to the hospital on scheduled dates. All patients could come to the emergency room if necessary. The telemetric monitoring group decreased their weight and improved control of the disease (P=.01). Systolic blood pressure and cost of care decreased (51%) significantly compared traditional medical consultation group (P>.05). Admission to the emergency room was avoided in 100% of patients in the telemetric monitoring group. In patients with heart failure, the telemetric monitoring was effective in reducing emergency room visits and saved significant resources in care during follow-up. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Clean room survey and assessment, volume 5, appendix H

NASA Technical Reports Server (NTRS)

1991-01-01

The scope of this task is to perform a comparative analysis of the various Environmental Control Life Support System (ECLSS) options for different growth scenarios. The Space Station Freedom ECLSS design and existing ground-based clean room facilities are used as a baseline for comparison. Specifically addressed here are the ground based clean room facilities at the Marshall Space Flight Center (MSFC). Given here is an evaluation of the facilities, equipment, technologies, and procedures used to maintain specified environments in typical aerospace industrial areas. Twenty-five specific clean rooms are evaluated. The objectives were to collect, compare, and catalog data for each specified facility in the areas of engineering and design, construction materials, work stations, contamination control, particulate elimination, entry systems, and instrumentation, and to make recommendations concerning enhancements required to assure an efficient and orderly evolution of MSFC clean room environmental control facilities.

Robust isothermal electric control of exchange bias at room temperature

NASA Astrophysics Data System (ADS)

Binek, Christian

2011-03-01

Voltage-controlled spintronics is of particular importance to continue progress in information technology through reduced power consumption, enhanced processing speed, integration density, and functionality in comparison with present day CMOS electronics. Almost all existing and prototypical solid-state spintronic devices rely on tailored interface magnetism, enabling spin-selective transmission or scattering of electrons. Controlling magnetism at thin-film interfaces, preferably by purely electrical means, is a key challenge to better spintronics. Currently, most attempts to electrically control magnetism focus on potentially large magnetoelectric effects of multiferroics. We report on our interest in magnetoelectric Cr 2 O3 (chromia). Robust isothermal electric control of exchange bias is achieved at room temperature in perpendicular anisotropic Cr 2 O3 (0001)/CoPd exchange bias heterostructures. This discovery promises significant implications for potential spintronics. From the perspective of basic science, our finding serves as macroscopic evidence for roughness-insensitive and electrically controllable equilibrium boundary magnetization in magnetoelectric antiferromagnets. The latter evolves at chromia (0001) surfaces and interfaces when chromia is in one of its two degenerate antiferromagnetic single domain states selected via magnetoelectric annealing. Theoretical insight into the boundary magnetization and its role in electrically controlled exchange bias is gained from first-principles calculations and general symmetry arguments. Measurements of spin-resolved ultraviolet photoemission, magnetometry at Cr 2 O3 (0001) surfaces, and detailed investigations of the unique exchange bias properties of Cr 2 O3 (0001)/CoPd including its electric controllability provide macroscopically averaged information about the boundary magnetization of chromia. Laterally resolved X-ray PEEM and temperature dependent MFM reveal detailed microscopic information of the chromia

[Comprehensive system integration and networking in operating rooms].

PubMed

Feußner, H; Ostler, D; Kohn, N; Vogel, T; Wilhelm, D; Koller, S; Kranzfelder, M

2016-12-01

A comprehensive surveillance and control system integrating all devices and functions is a precondition for realization of the operating room of the future. Multiple proprietary integrated operation room systems are currently available with a central user interface; however, they only cover a relatively small part of all functionalities. Internationally, there are at least three different initiatives to promote a comprehensive systems integration and networking in the operating room: the Japanese smart cyber operating theater (SCOT), the American medical device plug-and-play interoperability program (MDPnP) and the German secure and dynamic networking in operating room and hospital (OR.NET) project supported by the Federal Ministry of Education and Research. Within the framework of the internationally advanced OR.NET project, prototype solution approaches were realized, which make short-term and mid-term comprehensive data retrieval systems probable. An active and even autonomous control of the medical devices by the surveillance and control system (closed loop) is expected only in the long run due to strict regulatory barriers.

Use of computer-assisted drug therapy outside the operating room.

PubMed

Singh, Preet Mohinder; Borle, Anuradha; Goudra, Basavana G

2016-08-01

The number of procedures performed in the out-of-operating room setting under sedation has increased many fold in recent years. Sedation techniques aim to achieve rapid patient turnover through the use of short-acting drugs with minimal residual side-effects (mainly propofol and opioids). Even for common procedures, the practice of sedation delivery varies widely among providers. Computer-based sedation models have the potential to assist sedation providers and offer a more consistent and safer sedation experience for patients. Target-controlled infusions using propofol and other short-acting opioids for sedation have shown promising results in terms of increasing patient safety and allowing for more rapid wake-up times. Target-controlled infusion systems with real-time patient monitoring can titrate drug doses automatically to maintain optimal depth of sedation. The best recent example of this is the propofol-based Sedasys sedation system. Sedasys redefined individualized sedation by the addition of an automated clinical parameter that monitors depth of sedation. However, because of poor adoption and cost issues, it has been recently withdrawn by the manufacturer. Present automated drug delivery systems can assist in the provision of sedation for out-of-operating room procedures but cannot substitute for anesthesia providers. Use of the available technology has the potential to improve patient outcomes, decrease provider workload, and have a long-term economic impact on anesthesia care delivery outside of the operating room.

Operating Room Performance Improves after Proficiency-Based Virtual Reality Cataract Surgery Training.

PubMed

Thomsen, Ann Sofia Skou; Bach-Holm, Daniella; Kjærbo, Hadi; Højgaard-Olsen, Klavs; Subhi, Yousif; Saleh, George M; Park, Yoon Soo; la Cour, Morten; Konge, Lars

2017-04-01

To investigate the effect of virtual reality proficiency-based training on actual cataract surgery performance. The secondary purpose of the study was to define which surgeons benefit from virtual reality training. Multicenter masked clinical trial. Eighteen cataract surgeons with different levels of experience. Cataract surgical training on a virtual reality simulator (EyeSi) until a proficiency-based test was passed. Technical performance in the operating room (OR) assessed by 3 independent, masked raters using a previously validated task-specific assessment tool for cataract surgery (Objective Structured Assessment of Cataract Surgical Skill). Three surgeries before and 3 surgeries after the virtual reality training were video-recorded, anonymized, and presented to the raters in random order. Novices (non-independently operating surgeons) and surgeons having performed fewer than 75 independent cataract surgeries showed significant improvements in the OR-32% and 38%, respectively-after virtual reality training (P = 0.008 and P = 0.018). More experienced cataract surgeons did not benefit from simulator training. The reliability of the assessments was high with a generalizability coefficient of 0.92 and 0.86 before and after the virtual reality training, respectively. Clinically relevant cataract surgical skills can be improved by proficiency-based training on a virtual reality simulator. Novices as well as surgeons with an intermediate level of experience showed improvement in OR performance score. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Precipitation hardening behaviour of Al-Mg-Si alloy processed by cryorolling and room temperature rolling

NASA Astrophysics Data System (ADS)

Hussain, Maruff; Nageswara rao, P.; Singh, Dharmendra; Jayaganthan, R.

2018-04-01

The precipitation hardenable aluminium alloy (Al-Mg-Si) plates were solutionized and subjected to rolling at room temperature and liquid nitrogen temperature (RTR, CR) up to a true strain of ∼2.7. The rolled sheets were uniformly aged at room temperature and above room temperature (125 °C) to induce precipitation. The rolled and aged samples were analysed using differential scanning calorimetry (DSC), X-ray diffraction (XRD), transmission electron microscopy (TEM), hardness and tensile tests. The strength and ductility were simultaneously improved after controlled ageing of the cryorolled (CR) and room temperature rolled (RTR) samples. However, the increment in strength is more in RTR material than CR material with same ductility. Transmission electron microscopy analysis revealed the formation of ultrafine grains (UFG) filled with dislocations and nanosized precipitates in the CR and RTR conditions after ageing treatment. The behaviour of CR and RTR alloy is same under natural ageing conditions.

Patient room lighting influences on sleep, appraisal and mood in hospitalized people.

PubMed

Giménez, Marina C; Geerdinck, Leonie M; Versteylen, Mathijs; Leffers, Pieter; Meekes, Gaby J B M; Herremans, Hannelore; de Ruyter, Boris; Bikker, Jan Willem; Kuijpers, Petra M J C; Schlangen, Luc J M

2017-04-01

Irregular 24 h light/dark cycles with night-time light exposure and a low amplitude are disruptive for sleep, mood and circadian rhythms. Nevertheless such lighting conditions are quite common in medical care facilities. A controlled clinical trial among 196 cardiology ward patients (mean age 66.5 ± 13.1 years SD) investigated how a patient room lighting intervention affects sleep, appraisal and mood across hospitalization. Patients were either assigned to a standardly-lit room or to a room with an interventional lighting system offering a dynamic 24 h light/dark cycle with low nocturnal light exposure and 2 h of bright light (1750 lux) during daytime. Measures included wrist actigraphy and questionnaires assessing alertness, sleep quality, anxiety, depression and lighting appraisal. The median length of hospitalization was 5 days in both study arms. Subjective scores on sleep, alertness, anxiety and depression did not differ between arms. Lighting appraisal in intervention rooms was better as compared to standardly-lit rooms, both in patients (P < 0.001) and staff (P < 0.005). Actigraphic sleep duration of patients improved by 5.9 min (95% CI: 0.6-11.2; P = 0.03 intervention × time effect) per hospitalization day with interventional lighting instead of standard lighting. After 5 days of hospitalization, sleep duration in the lighting intervention rooms increased by 29 min, or a relative 7.3%, as compared to standardly-lit rooms. A 24 h lighting system with enhanced daytime brightness and restricted nocturnal light exposure can improve some aspects of appraisal and objective sleep in hospital patients. More clinical research is needed to establish the best lighting strategy to promote healing and wellbeing within healthcare settings. © 2016 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

Western Aeronautical Test Range (WATR) Mission Control Gold Room During X-29 Flight

NASA Technical Reports Server (NTRS)

1989-01-01

The mission control Gold room is seen here during a research flight of the X-29 at the Dryden Flight Research Center, Edwards, California. All aspects of a research mission are monitored from one of two of these control rooms at Dryden. Dryden and its control rooms are part of the Western Aeronautical Test Range (WATR). The WATR consists of a highly automated complex of computer controlled tracking, telemetry, and communications systems and control room complexes that are capable of supporting any type of mission ranging from system and component testing, to sub-scale and full-scale flight tests of new aircraft and reentry systems. Designated areas are assigned for spin/dive tests; corridors are provided for low, medium, and high-altitude supersonic flight; and special STOL/VSTOL facilities are available at Ames Moffett and Crows Landing. Special use airspace, available at Edwards, covers approximately twelve thousand square miles of mostly desert area. The southern boundary lies to the south of Rogers Dry Lake, the western boundary lies midway between Mojave and Bakersfield, the northern boundary passes just south of Bishop, and the eastern boundary follows about 25 miles west of the Nevada border except in the northern areas where it crosses into Nevada. Two X-29 aircraft, featuring one of the most unusual designs in aviation history, flew at the Ames-Dryden Flight Research Facility (now the Dryden Flight Research Center, Edwards, California) from 1984 to 1992. The fighter-sized X-29 technology demonstrators explored several concepts and technologies including: the use of advanced composites in aircraft construction; variable-camber wing surfaces; a unique forward- swept wing and its thin supercritical airfoil; strakes; close-coupled canards; and a computerized fly-by-wire flight control system used to maintain control of the otherwise unstable aircraft. Research results showed that the configuration of forward-swept wings, coupled with movable canards, gave

5. INSTRUMENT ROOM INTERIOR, SHOWING BACKS OF CONSOLE LOCKERS. Looking ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. INSTRUMENT ROOM INTERIOR, SHOWING BACKS OF CONSOLE LOCKERS. Looking northeast to firing control room passageway. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Firing Control Building, Test Area 1-100, northeast end of Test Area 1-100 Road, Boron, Kern County, CA

A HUMAN FACTORS ENGINEERING PROCESS TO SUPPORT HUMAN-SYSTEM INTERFACE DESIGN IN CONTROL ROOM MODERNIZATION

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kovesdi, C.; Joe, J.; Boring, R.

The primary objective of the United States (U.S.) Department of Energy (DOE) Light Water Reactor Sustainability (LWRS) program is to sustain operation of the existing commercial nuclear power plants (NPPs) through a multi-pathway approach in conducting research and development (R&D). The Advanced Instrumentation, Information, and Control (II&C) System Technologies pathway conducts targeted R&D to address aging and reliability concerns with legacy instrumentation and control (I&C) and other information systems in existing U.S. NPPs. Control room modernization is an important part following this pathway, and human factors experts at Idaho National Laboratory (INL) have been involved in conducting R&D to supportmore » migration of new digital main control room (MCR) technologies from legacy analog and legacy digital I&C. This paper describes a human factors engineering (HFE) process that supports human-system interface (HSI) design in MCR modernization activities, particularly with migration of old digital to new digital I&C. The process described in this work is an expansion from the LWRS Report INL/EXT-16-38576, and is a requirements-driven approach that aligns with NUREG-0711 requirements. The work described builds upon the existing literature by adding more detail around key tasks and decisions to make when transitioning from HSI Design into Verification and Validation (V&V). The overall objective of this process is to inform HSI design and elicit specific, measurable, and achievable human factors criteria for new digital technologies. Upon following this process, utilities should have greater confidence with transitioning from HSI design into V&V.« less

Cost-Benefit of Improving the Efficiency of Room Air Conditioners (Inverter and Fixed Speed) in India

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shah, Nihar; Abhyankar, Nikit; Park, Won Young

Improving efficiency of air conditioners (ACs) typically involves improving the efficiency of various components such as compressors, heat exchangers, expansion valves, refrigerant and fans. We estimate the incremental cost of improving the efficiency of room ACs based on the cost of improving the efficiency of its key components. Further, we estimate the retail price increase required to cover the cost of efficiency improvement, compare it with electricity bill savings, and calculate the payback period for consumers to recover the additional price of a more efficient AC. We assess several efficiency levels, two of which are summarized below in the report.more » The finding that significant efficiency improvement is cost effective from a consumer perspective is robust over a wide range of assumptions. If we assume a 50% higher incremental price compared to our baseline estimate, the payback period for the efficiency level of 3.5 ISEER is 1.1 years. Given the findings of this study, establishing more stringent minimum efficiency performance criteria (one star level) should be evaluated rigorously considering significant benefits to consumers, energy security and environment.« less

NASA personnel in a control room during the successful second flight of the X-43A aircraft

NASA Image and Video Library

2004-03-27

NASA personnel in a control room during the successful second flight of the X-43A aircraft. front row, left to right: Randy Voland, LaRC Propulsion; Craig Christy, Boeing Systems; Dave Reubush, NASA Hyper-X Deputy Program Manager; and Vince Rausch, NASA Hyper-X Program Manager. back row, left to right: Bill Talley, DCI/consultant; Pat Stoliker, DFRC Director (Acting) of Research Engineering; John Martin, LaRC G&C; and Dave Bose, AMA/Controls.

Device- and system-independent personal touchless user interface for operating rooms : One personal UI to control all displays in an operating room.

PubMed

Ma, Meng; Fallavollita, Pascal; Habert, Séverine; Weidert, Simon; Navab, Nassir

2016-06-01

In the modern day operating room, the surgeon performs surgeries with the support of different medical systems that showcase patient information, physiological data, and medical images. It is generally accepted that numerous interactions must be performed by the surgical team to control the corresponding medical system to retrieve the desired information. Joysticks and physical keys are still present in the operating room due to the disadvantages of mouses, and surgeons often communicate instructions to the surgical team when requiring information from a specific medical system. In this paper, a novel user interface is developed that allows the surgeon to personally perform touchless interaction with the various medical systems, switch effortlessly among them, all of this without modifying the systems' software and hardware. To achieve this, a wearable RGB-D sensor is mounted on the surgeon's head for inside-out tracking of his/her finger with any of the medical systems' displays. Android devices with a special application are connected to the computers on which the medical systems are running, simulating a normal USB mouse and keyboard. When the surgeon performs interaction using pointing gestures, the desired cursor position in the targeted medical system display, and gestures, are transformed into general events and then sent to the corresponding Android device. Finally, the application running on the Android devices generates the corresponding mouse or keyboard events according to the targeted medical system. To simulate an operating room setting, our unique user interface was tested by seven medical participants who performed several interactions with the visualization of CT, MRI, and fluoroscopy images at varying distances from them. Results from the system usability scale and NASA-TLX workload index indicated a strong acceptance of our proposed user interface.

[Operation room management in quality control certification of a mainstream hospital].

PubMed

Leidinger, W; Meierhofer, J N; Schüpfer, G

2006-11-01

We report the results of our study concerning the organisation of operating room (OR) capacity planned 1 year in advance. The use of OR is controlled using 2 global controlling numbers: a) the actual time difference between the expected optimal and previously calculated OR running time and b) the punctuality of starting the first operation in each OR. The focal point of the presented OR management concept is a consensus-oriented decision-making and steering process led by a coordinator who achieves a high degree of acceptance by means of comprehensive transparency. Based on the accepted running time, the optimal productivity of OR's (OP_A(%) can be calculated. In this way an increase of the overall capacity (actual running time) of ORs was from 40% to over 55% was achieved. Nevertheless, enthusiasm and teamwork from all persons involved in the system are vital for success as well as a completely independent operating theatre manager. Using this concept over 90% of the requirements for the new certification catalogue for hospitals in Germany was achieved.

Advanced visualization platform for surgical operating room coordination: distributed video board system.

PubMed

Hu, Peter F; Xiao, Yan; Ho, Danny; Mackenzie, Colin F; Hu, Hao; Voigt, Roger; Martz, Douglas

2006-06-01

One of the major challenges for day-of-surgery operating room coordination is accurate and timely situation awareness. Distributed and secure real-time status information is key to addressing these challenges. This article reports on the design and implementation of a passive status monitoring system in a 19-room surgical suite of a major academic medical center. Key design requirements considered included integrated real-time operating room status display, access control, security, and network impact. The system used live operating room video images and patient vital signs obtained through monitors to automatically update events and operating room status. Images were presented on a "need-to-know" basis, and access was controlled by identification badge authorization. The system delivered reliable real-time operating room images and status with acceptable network impact. Operating room status was visualized at 4 separate locations and was used continuously by clinicians and operating room service providers to coordinate operating room activities.

Improved photoluminescence characteristics of order-disorder AlGaInP quantum wells at room and elevated temperatures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mukherjee, Kunal; Fitzgerald, Eugene A.; Deotare, Parag B.

2015-04-06

A set of nominally undoped CuPt-B type ordered (Al{sub x}Ga{sub 1−x}){sub 0.5}In{sub 0.5}P quantum-wells with disordered (Al{sub 0.7}Ga{sub 0.3}){sub 0.5}In{sub 0.5}P barriers were grown and characterized using transmission electron microscopy and photoluminescence spectroscopy. Such structures are potentially beneficial for light emitting devices due to the possibility of greater carrier confinement, reduced scattering into the indirect valleys, and band-offset adjustment beyond what is possible with strain and composition. Furthermore, the possibility of independently tuning the composition and the order-parameter of the quantum-well allows for the decoupling of the carrier confinement and the aluminum content and aids in the identification of carriermore » loss mechanisms. In this study, sharp order-disorder interfaces were achieved via the control of growth temperature between 650 °C and 750 °C using growth pauses. Improved high-temperature (400 K) photoluminescence intensity was obtained from quantum-wells with ordered Ga{sub 0.5}In{sub 0.5}P as compared to disordered Ga{sub 0.5}In{sub 0.5}P due to greater confinement. Additionally, in the ordered samples with a higher Al/Ga ratio to counter the band-gap reduction, the photoluminescence intensity at high temperature was as bright as that from conventional disordered heterostructures and had slightly improved wavelength stability. Room-temperature time-resolved luminescence measurements indicated a longer radiative lifetime in the ordered quantum-well with reduced scattering into the barrier. These results show that in samples of good material quality, the property controlling the luminescence intensity is the carrier confinement and not the presence of ordering or the aluminum content.« less

[Cleanliness in the operating room].

PubMed

Suzuki, Toshiyasu

2010-05-01

With regard to recent findings in the cleanliness of the operating room, concerning handwashing and performing operations, the traditional method of excessive scrubbing using a brush is not effective, and handwashing using only an alcohol-containing antiseptic hand rub (rubbing method) has become common practice. Use of a brush has already been abolished in some medical institutions. In addition, sterilized water used for handwashing when performing operations has no scientific basis and use of tap water is considered sufficient. Furthermore, the concept of operating room zoning has also undergone a dramatic change. It was discovered that a layout focusing on work efficiency is more desirable than the one that follows an excessively rigid zoning pattern. One-footwear System not requiring change of shoes also has various advantages in improving the efficiency of the operation room, and this is thought to become commonplace in the future.

Auto identification technology and its impact on patient safety in the Operating Room of the Future.

PubMed

Egan, Marie T; Sandberg, Warren S

2007-03-01

Automatic identification technologies, such as bar coding and radio frequency identification, are ubiquitous in everyday life but virtually nonexistent in the operating room. User expectations, based on everyday experience with automatic identification technologies, have generated much anticipation that these systems will improve readiness, workflow, and safety in the operating room, with minimal training requirements. We report, in narrative form, a multi-year experience with various automatic identification technologies in the Operating Room of the Future Project at Massachusetts General Hospital. In each case, the additional human labor required to make these ;labor-saving' technologies function in the medical environment has proved to be their undoing. We conclude that while automatic identification technologies show promise, significant barriers to realizing their potential still exist. Nevertheless, overcoming these obstacles is necessary if the vision of an operating room of the future in which all processes are monitored, controlled, and optimized is to be achieved.

Cryogenic strength improvement by utilizing room-temperature deformation twinning in a partially recrystallized VCrMnFeCoNi high-entropy alloy

PubMed Central

Jo, Y. H.; Jung, S.; Choi, W. M.; Sohn, S. S.; Kim, H. S.; Lee, B. J.; Kim, N. J.; Lee, S.

2017-01-01

The excellent cryogenic tensile properties of the CrMnFeCoNi alloy are generally caused by deformation twinning, which is difficult to achieve at room temperature because of insufficient stress for twinning. Here, we induced twinning at room temperature to improve the cryogenic tensile properties of the CrMnFeCoNi alloy. Considering grain size effects on the critical stress for twinning, twins were readily formed in the coarse microstructure by cold rolling without grain refinement by hot rolling. These twins were retained by partial recrystallization and played an important role in improving strength, allowing yield strengths approaching 1 GPa. The persistent elongation up to 46% as well as the tensile strength of 1.3 GPa are attributed to additional twinning in both recrystallized and non-recrystallization regions. Our results demonstrate that non-recrystallized grains, which are generally avoided in conventional alloys because of their deleterious effect on ductility, can be useful in achieving high-strength high-entropy alloys. PMID:28604656

Changing Operating Room Culture: Implementation of a Postoperative Debrief and Improved Safety Culture.

PubMed

Magill, Stephen T; Wang, Doris D; Rutledge, W Caleb; Lau, Darryl; Berger, Mitchel S; Sankaran, Sujatha; Lau, Catherine Y; Imershein, Sarah G

2017-11-01

Patient safety is foundational to neurosurgical care. Postprocedural "debrief" checklists have been proposed to improve patient safety, but data about their use in neurosurgery are limited. Here, we implemented an initiative to routinely perform postoperative debriefs and evaluated the impact of debriefing on operating room (OR) safety culture. A 10-question safety attitude questionnaire (SAQ) was sent to neurosurgical OR staff at a major academic medical center before and 18 months after the implementation of a postoperative debriefing initiative. Rates of debrief compliance and changes in attitudes before and after the survey were evaluated. The survey used a Likert scale and analyzed with standard statistical methods. After the debrief initiative, the rate of debriefing increased from 51% to 86% of cases for the neurosurgery service. Baseline SAQ responses found that neurosurgeons had a more favorable perception of OR safety than did anesthesiologists and nurses. After implementation of the postoperative debriefing process, perceptions of OR safety significantly improved for neurosurgeons, anesthesiologists, and nurses. Furthermore, the disparity between nurses and surgeons was no longer significant. After debrief implementation, neurosurgical OR staff had improved perceptions of patient safety compared with surgical services that did not commonly perform debriefing. Debriefing identified OR efficiency concerns in 26.9% of cases, and prevention of potential adverse events/near misses was reported in 8% of cases. Postoperative debriefing can be effectively introduced into the OR and improves the safety culture after implementation. Debriefing is an effective tool to identify OR inefficiencies and potential adverse events. Copyright © 2017 Elsevier Inc. All rights reserved.

Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls.

PubMed

Simon, Michael; Maben, Jill; Murrells, Trevor; Griffiths, Peter

2016-07-01

A wide range of patient benefits have been attributed to single room hospital accommodation including a reduction in adverse patient safety events. However, studies have been limited to the US with limited evidence from elsewhere. The aim of this study was to assess the impact on safety outcomes of the move to a newly built all single room acute hospital. A natural experiment investigating the move to 100% single room accommodation in acute assessment, surgical and older people's wards. Move to 100% single room accommodation compared to 'steady state' and 'new build' control hospitals. Falls, pressure ulcer, medication error, meticillin-resistant Staphylococcus aureus and Clostridium difficile rates from routine data sources were measured over 36 months. Five of 15 time series in the wards that moved to single room accommodation revealed changes that coincided with the move to the new all single room hospital: specifically, increased fall, pressure ulcer and Clostridium difficile rates in the older people's ward, and temporary increases in falls and medication errors in the acute assessment unit. However, because the case mix of the older people's ward changed, and because the increase in falls and medication errors on the acute assessment ward did not last longer than six months, no clear effect of single rooms on the safety outcomes was demonstrated. There were no changes to safety events coinciding with the move at the new build control site. For all changes in patient safety events that coincided with the move to single rooms, we found plausible alternative explanations such as case-mix change or disruption as a result of the re-organization of services after the move. The results provide no evidence of either benefit or harm from all single room accommodation in terms of safety-related outcomes, although there may be short-term risks associated with a move to single rooms. © The Author(s) 2016.

Improved room-temperature luminescence of core-shell InGaAs/GaAs nanopillars via lattice-matched passivation

NASA Astrophysics Data System (ADS)

Komolibus, Katarzyna; Scofield, Adam C.; Gradkowski, Kamil; Ochalski, Tomasz J.; Kim, Hyunseok; Huffaker, Diana L.; Huyet, Guillaume

2016-02-01

Optical properties of GaAs/InGaAs/GaAs nanopillars (NPs) grown on GaAs(111)B were investigated. Employment of a mask-etching technique allowed for an accurate control over the geometry of NP arrays in terms of both their diameter and separation. This work describes both the steady-state and time-resolved photoluminescence of these structures as a function of the ensemble geometry, composition of the insert, and various shell compounds. The effects of the NP geometry on a parasitic radiative recombination channel, originating from an overgrown lateral sidewall layer, are discussed. Optical characterization reveals a profound influence of the core-shell lattice mismatch on the carrier lifetime and emission quenching at room temperature. When the lattice-matching conditions are satisfied, an efficient emission from the NP arrays at room temperature and below the band-gap of silicon is observed, clearly highlighting their potential application as emitters in optical interconnects integrated with silicon platforms.

Economic analysis of linking operating room scheduling and hospital material management information systems for just-in-time inventory control.

PubMed

Epstein, R H; Dexter, F

2000-08-01

Operating room (OR) scheduling information systems can decrease perioperative labor costs. Material management information systems can decrease perioperative inventory costs. We used computer simulation to investigate whether using the OR schedule to trigger purchasing of perioperative supplies is likely to further decrease perioperative inventory costs, as compared with using sophisticated, stand-alone material management inventory control. Although we designed the simulations to favor financially linking the information systems, we found that this strategy would be expected to decrease inventory costs substantively only for items of high price ($1000 each) and volume (>1000 used each year). Because expensive items typically have different models and sizes, each of which is used by a hospital less often than this, for almost all items there will be no benefit to making daily adjustments to the order volume based on booked cases. We conclude that, in a hospital with a sophisticated material management information system, OR managers will probably achieve greater cost reductions from focusing on negotiating less expensive purchase prices for items than on trying to link the OR information system with the hospital's material management information system to achieve just-in-time inventory control. In a hospital with a sophisticated material management information system, operating room managers will probably achieve greater cost reductions from focusing on negotiating less expensive purchase prices for items than on trying to link the operating room information system with the hospital's material management information system to achieve just-in-time inventory control.

Factors Affecting Acoustics and Speech Intelligibility in the Operating Room: Size Matters.

PubMed

McNeer, Richard R; Bennett, Christopher L; Horn, Danielle Bodzin; Dudaryk, Roman

2017-06-01

< .0001) and 0.718 (P < .0001), respectively, while after controlling for VR, partial correlations were -0.322 (P = .169) and 0.381 (P < .05), respectively. Our results suggest that the size and contents of an OR can predict a range of psychoacoustic indices of speech intelligibility. Specifically, increasing OR size correlated with worse speech intelligibility, while increasing amounts of OR contents correlated with improved speech intelligibility. This study provides valuable descriptive data and a predictive method for identifying existing ORs that may benefit from acoustic modifiers (eg, sound absorption panels). Additionally, it suggests that room dimensions and projected clinical use should be considered during the design phase of OR suites to optimize acoustic performance.

Factors Affecting Acoustics and Speech Intelligibility in the Operating Room: Size Matters

PubMed Central

Bennett, Christopher L.; Horn, Danielle Bodzin; Dudaryk, Roman

2017-01-01

, partial correlations were 0.825 (P < .0001) and 0.718 (P < .0001), respectively, while after controlling for VR, partial correlations were −0.322 (P = .169) and 0.381 (P < .05), respectively. CONCLUSIONS: Our results suggest that the size and contents of an OR can predict a range of psychoacoustic indices of speech intelligibility. Specifically, increasing OR size correlated with worse speech intelligibility, while increasing amounts of OR contents correlated with improved speech intelligibility. This study provides valuable descriptive data and a predictive method for identifying existing ORs that may benefit from acoustic modifiers (eg, sound absorption panels). Additionally, it suggests that room dimensions and projected clinical use should be considered during the design phase of OR suites to optimize acoustic performance. PMID:28525511

LPV Controller Interpolation for Improved Gain-Scheduling Control Performance

NASA Technical Reports Server (NTRS)

Wu, Fen; Kim, SungWan

2002-01-01

In this paper, a new gain-scheduling control design approach is proposed by combining LPV (linear parameter-varying) control theory with interpolation techniques. The improvement of gain-scheduled controllers can be achieved from local synthesis of Lyapunov functions and continuous construction of a global Lyapunov function by interpolation. It has been shown that this combined LPV control design scheme is capable of improving closed-loop performance derived from local performance improvement. The gain of the LPV controller will also change continuously across parameter space. The advantages of the newly proposed LPV control is demonstrated through a detailed AMB controller design example.

Room Acoustics

NASA Astrophysics Data System (ADS)

Kuttruff, Heinrich; Mommertz, Eckard

The traditional task of room acoustics is to create or formulate conditions which ensure the best possible propagation of sound in a room from a sound source to a listener. Thus, objects of room acoustics are in particular assembly halls of all kinds, such as auditoria and lecture halls, conference rooms, theaters, concert halls or churches. Already at this point, it has to be pointed out that these conditions essentially depend on the question if speech or music should be transmitted; in the first case, the criterion for transmission quality is good speech intelligibility, in the other case, however, the success of room-acoustical efforts depends on other factors that cannot be quantified that easily, not least it also depends on the hearing habits of the listeners. In any case, absolutely "good acoustics" of a room do not exist.

Wash room, bunkhouse, first floor interior. This room is a ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Wash room, bunkhouse, first floor interior. This room is a screened porch with the original sinks extant. Light and ventilation was borrowed from the wash room into the toilets and bathing rooms. - Sespe Ranch, Bunkhouse, 2896 Telegraph Road, Fillmore, Ventura County, CA

Staff corridor (room 206, representing rooms 301, 305, 401, 405, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Staff corridor (room 206, representing rooms 301, 305, 401, 405, 501, and 505), looking south towards the staff corridor vestibule (room 206A, representing rooms 305A, 405A, and 505A). - California State Office Building No. 1, 915 Capitol Mall, Sacramento, Sacramento County, CA

The operating room of the future: observations and commentary.

PubMed

Satava, Richard M

2003-09-01

The Operating Room of the Future is a construct upon which to develop the next generation of operating environments for the patient, surgeon, and operating team. Analysis of the suite of visions for the Operating Room of the Future reveals a broad set of goals, with a clear overall solution to create a safe environment for high-quality healthcare. The vision, although planned for the future, is based upon iteratively improving and integrating current systems, both technology and process. This must become the Operating Room of Today, which will require the enormous efforts described. An alternative future of the operating room, based upon emergence of disruptive technologies, is also presented.

Adult and pediatric anesthesia/sedation for gastrointestinal procedures outside of the operating room.

PubMed

Michel Foehn, Esther R

2015-08-01

This review presents current trends of safe and efficient anesthesia and sedation for adults and children for gastrointestinal procedures outside of the operating room with a special focus on total intravenous anesthesia (TIVA), target-controlled infusion (TCI), intravenous or topical lidocaine, and the use of the video laryngoscope. The concepts of a well tolerated and adequate anesthesia or sedation for gastrointestinal procedures outside of the operating room have to meet the needs of the adult and pediatric patients and the special requests of the gastroenterologists. Anesthesia and sedation of adults for gastrointestinal procedures with TIVA or TCI and spontaneous breathing is well established. Many institutions perform anesthesia for pediatric patients undergoing gastrointestinal procedures with an inhalational agent, especially in young children and for short procedures. Unlike adults, in young children the airways frequently must be secured with a tracheal tube or laryngeal mask. Respiration may be spontaneous, assisted, or controlled. TIVA and TCI are increasingly chosen for older children and longer procedures. A local anesthetic administered intravenously or topically to the upper airways and the use of the video laryngoscope can facilitate the insertion of the endoscope. Both anesthesiologists and nonanesthesiologists have to achieve a consensus and develop quality-improvement strategies to provide safe and efficient anesthesia and sedation for gastrointestinal procedures outside of the operating room for pediatric and adult patients. Techniques using TIVA, TCI, intravenous or topical application of lidocaine, and the video laryngoscope may improve and facilitate gastrointestinal procedures for the patients, the anesthesiologists, and the gastroenterologists.

Control centers design for ergonomics and safety.

PubMed

Quintana, Leonardo; Lizarazo, Cesar; Bernal, Oscar; Cordoba, Jorge; Arias, Claudia; Monroy, Magda; Cotrino, Carlos; Montoya, Olga

2012-01-01

This paper shows the general design conditions about ergonomics and safety for control centers in the petrochemical process industry. Some of the topics include guidelines for the optimized workstation design, control room layout, building layout, and lighting, acoustical and environmental design. Also takes into account the safety parameters in the control rooms and centers design. The conditions and parameters shown in this paper come from the standards and global advances on this topic on the most recent publications. And also the work was supplemented by field visits of our team to the control center operations in a petrochemical company, and technical literature search efforts. This guideline will be useful to increase the productivity and improve the working conditions at the control rooms.

Defect healing at room temperature in pentacene thin films and improved transistor performance

NASA Astrophysics Data System (ADS)

Kalb, Wolfgang L.; Meier, Fabian; Mattenberger, Kurt; Batlogg, Bertram

2007-11-01

We report on a healing of defects at room temperature in the organic semiconductor pentacene. This peculiar effect is a direct consequence of the weak intermolecular interaction which is characteristic of organic semiconductors. Pentacene thin-film transistors were fabricated and characterized by in situ gated four-terminal measurements. Under high vacuum conditions (base pressure of order 10-8mbar ), the device performance is found to improve with time. The effective field-effect mobility increases by as much as a factor of 2 and mobilities up to 0.45cm2/Vs were achieved. In addition, the contact resistance decreases by more than an order of magnitude and there is a significant reduction in current hysteresis. Oxygen and nitrogen exposure as well as annealing experiments show the improvement of the electronic parameters to be driven by a thermally promoted process and not by chemical doping. In order to extract the spectral density of trap states from the transistor characteristics, we have implemented a powerful scheme which allows for a calculation of the trap densities with high accuracy in a straightforward fashion. We show the performance improvement to be due to a reduction in the density of shallow traps ⩽0.15eV from the valence band edge, while the energetically deeper traps are essentially unaffected. This work contributes to an understanding of the shallow traps in organic semiconductors and identifies structural point defects within the grains of the polycrystalline thin films as a major cause.

Sound levels in modern rodent housing rooms are an uncontrolled environmental variable with fluctuations mainly due to human activities

PubMed Central

Lauer, Amanda M.; May, Bradford J.; Hao, Ziwei Judy; Watson, Julie

2009-01-01

Noise in animal housing facilities is an environmental variable that can affect hearing, behavior and physiology in mice. The authors measured sound levels in two rodent housing rooms (room 1 and room 2) during several periods of 24 h. Room 1, which was subject to heavy personnel traffic, contained ventilated racks and static cages that housed large numbers of mice. Room 2 was accessed by only a few staff members and contained only static cages that housed fewer mice. In both rooms, background sound levels were about 80 dB, and transient noises caused sound levels to temporarily rise 30–40 dB above the baseline level; such peaks occurred frequently during work hours (8:30 AM to 4:30 PM) and infrequently during non-work hours. Noise peaks during work hours in room 1 occurred about two times as often as in room 2 (P = 0.01). Use of changing stations located in the rooms caused background noise to increase by about 10 dB. Loud noise and noise variability were attributed mainly to personnel activity. Attempts to reduce noise should concentrate on controlling sounds produced by in-room activities and experimenter traffic; this may reduce the variability of research outcomes and improve animal welfare. PMID:19384312

Improvement in Patient Transfer Process From the Operating Room to the PICU Using a Lean and Six Sigma-Based Quality Improvement Project.

PubMed

Gleich, Stephen J; Nemergut, Michael E; Stans, Anthony A; Haile, Dawit T; Feigal, Scott A; Heinrich, Angela L; Bosley, Christopher L; Tripathi, Sandeep

2016-08-01

Ineffective and inefficient patient transfer processes can increase the chance of medical errors. Improvements in such processes are high-priority local institutional and national patient safety goals. At our institution, nonintubated postoperative pediatric patients are first admitted to the postanesthesia care unit before transfer to the PICU. This quality improvement project was designed to improve the patient transfer process from the operating room (OR) to the PICU. After direct observation of the baseline process, we introduced a structured, direct OR-PICU transfer process for orthopedic spinal fusion patients. We performed value stream mapping of the process to determine error-prone and inefficient areas. We evaluated primary outcome measures of handoff error reduction and the overall efficiency of patient transfer process time. Staff satisfaction was evaluated as a counterbalance measure. With the introduction of the new direct OR-PICU patient transfer process, the handoff communication error rate improved from 1.9 to 0.3 errors per patient handoff (P = .002). Inefficiency (patient wait time and non-value-creating activity) was reduced from 90 to 32 minutes. Handoff content was improved with fewer information omissions (P < .001). Staff satisfaction significantly improved among nearly all PICU providers. By using quality improvement methodology to design and implement a new direct OR-PICU transfer process with a structured multidisciplinary verbal handoff, we achieved sustained improvements in patient safety and efficiency. Handoff communication was enhanced, with fewer errors and content omissions. The new process improved efficiency, with high staff satisfaction. Copyright © 2016 by the American Academy of Pediatrics.

Effects of improved home heating on asthma in community dwelling children: randomised controlled trial.

PubMed

Howden-Chapman, Philippa; Pierse, Nevil; Nicholls, Sarah; Gillespie-Bennett, Julie; Viggers, Helen; Cunningham, Malcolm; Phipps, Robyn; Boulic, Mikael; Fjällström, Pär; Free, Sarah; Chapman, Ralph; Lloyd, Bob; Wickens, Kristin; Shields, David; Baker, Michael; Cunningham, Chris; Woodward, Alistair; Bullen, Chris; Crane, Julian

2008-09-23

To assess whether non-polluting, more effective home heating (heat pump, wood pellet burner, flued gas) has a positive effect on the health of children with asthma. Randomised controlled trial. Households in five communities in New Zealand. 409 children aged 6-12 years with doctor diagnosed asthma. Installation of a non-polluting, more effective home heater before winter. The control group received a replacement heater at the end of the trial. The primary outcome was change in lung function (peak expiratory flow rate and forced expiratory volume in one second, FEV(1)). Secondary outcomes were child reported respiratory tract symptoms and daily use of preventer and reliever drugs. At the end of winter 2005 (baseline) and winter 2006 (follow-up) parents reported their child's general health, use of health services, overall respiratory health, and housing conditions. Nitrogen dioxide levels were measured monthly for four months and temperatures in the living room and child's bedroom were recorded hourly. Improvements in lung function were not significant (difference in mean FEV(1) 130.7 ml, 95% confidence interval -20.3 to 281.7). Compared with children in the control group, however, children in the intervention group had 1.80 fewer days off school (95% confidence interval 0.11 to 3.13), 0.40 fewer visits to a doctor for asthma (0.11 to 0.62), and 0.25 fewer visits to a pharmacist for asthma (0.09 to 0.32). Children in the intervention group also had fewer reports of poor health (adjusted odds ratio 0.48, 95% confidence interval 0.31 to 0.74), less sleep disturbed by wheezing (0.55, 0.35 to 0.85), less dry cough at night (0.52, 0.32 to 0.83), and reduced scores for lower respiratory tract symptoms (0.77, 0.73 to 0.81) than children in the control group. The intervention was associated with a mean temperature rise in the living room of 1.10 degrees C (95% confidence interval 0.54 degrees C to 1.64 degrees C) and in the child's bedroom of 0.57 degrees C (0.05 degrees C

An intervention for noise control of blast furnace in steel industry.

PubMed

Golmohammadi, Rostam; Giahi, Omid; Aliabadi, Mohsen; Darvishi, Ebrahim

2014-01-01

Noise pollution is currently a major health risk factor for workers in industries. The aim of this study was to investigate noise pollution and implement a control intervention plan for blast furnace in a steel industry. The measurement of sound pressure level (SPL) along with frequency analysis was done with the sound-level-meter Cell-450. Personal noise exposure was performed using dosimeter TES-1345 calibrated with CEL-282. Before planning noise controls, acoustic insulation properties of the furnace control unit and workers' rest room were assessed. Control room and workers' rest room were redesigned in order to improve acoustical condition. The SPL before intervention around the Blast Furnace was 90.3 dB (L) and its dominant frequency was 4000 Hz. Besides, noise transmission loss of the control and rest rooms were 10.3 dB and 4.2 dB, respectively. After intervention, noise reduction rates in the control and rest rooms were 27.4 dB and 27.7 dB, respectively. The workers' noise dose before and after the intervention was 240% and less than 100%, respectively. Improvement the workroom acoustic conditions through noise insulation can be considered effective method for preventing workers exposure to harmful noise.

Crew resource management: using aviation techniques to improve operating room safety.

PubMed

Ricci, Michael A; Brumsted, John R

2012-04-01

Since the publication of the Institute of Medicine report estimating nearly 100,000 deaths per year from medical errors, hospitals and physicians have a renewed focus upon error reduction. We implemented a surgical crew resource management (CRM) program for all operating room (OR) personnel. In our academic medical center, 19,000 procedures per year are performed in 27 operating rooms. Mandatory CRM training was implemented for all peri-operative personnel. Aviation techniques introduced included a pre-operative checklist and brief, post-operative debrief, read and initial files, and various other aviation-based techniques. Compliance with conduct of the brief/debrief was monitored as well as wrong-site surgeries and retained foreign body events. The malpractice insurance database for claims was also queried for the period prior to and after training. Initial training was accomplished for 517 people, including all anesthesiologists, surgeons, nurses, technicians, and OR assistants. Pre-operative briefing increased from 6.7 to 99% within 4 mo. Wrong site surgeries and retained foreign bodies decreased from a high of seven in 2007 to none in 2008, but, after 14 mo without additional training, these rose to five in 2009. Malpractice expenses (payouts and legal fees) totaled $793,000 (2003-2007), but have been zero since 2008. CRM training and implementation had an impact on reducing the incidence of wrong site surgery and retained foreign bodies in our operating rooms. However, constant reinforcement and refresher training is necessary for sustained results. Though no one technique can prevent all errors, CRM can effect culture change, producing a safer environment.

Is single room hospital accommodation associated with differences in healthcare-associated infection, falls, pressure ulcers or medication errors? A natural experiment with non-equivalent controls

PubMed Central

Maben, Jill; Murrells, Trevor; Griffiths, Peter

2016-01-01

Objectives A wide range of patient benefits have been attributed to single room hospital accommodation including a reduction in adverse patient safety events. However, studies have been limited to the US with limited evidence from elsewhere. The aim of this study was to assess the impact on safety outcomes of the move to a newly built all single room acute hospital. Methods A natural experiment investigating the move to 100% single room accommodation in acute assessment, surgical and older people’s wards. Move to 100% single room accommodation compared to ‘steady state’ and ‘new build’ control hospitals. Falls, pressure ulcer, medication error, meticillin-resistant Staphylococcus aureus and Clostridium difficile rates from routine data sources were measured over 36 months. Results Five of 15 time series in the wards that moved to single room accommodation revealed changes that coincided with the move to the new all single room hospital: specifically, increased fall, pressure ulcer and Clostridium difficile rates in the older people’s ward, and temporary increases in falls and medication errors in the acute assessment unit. However, because the case mix of the older people’s ward changed, and because the increase in falls and medication errors on the acute assessment ward did not last longer than six months, no clear effect of single rooms on the safety outcomes was demonstrated. There were no changes to safety events coinciding with the move at the new build control site. Conclusion For all changes in patient safety events that coincided with the move to single rooms, we found plausible alternative explanations such as case-mix change or disruption as a result of the re-organization of services after the move. The results provide no evidence of either benefit or harm from all single room accommodation in terms of safety-related outcomes, although there may be short-term risks associated with a move to single rooms. PMID:26811373

Robotic assistance improves intracorporeal suturing performance and safety in the operating room while decreasing operator workload.

PubMed

Stefanidis, Dimitrios; Wang, Fikre; Korndorffer, James R; Dunne, J Bruce; Scott, Daniel J

2010-02-01

Intracorporeal suturing is one of the most difficult laparoscopic tasks. The purpose of this study was to assess the impact of robotic assistance on novice suturing performance, safety, and workload in the operating room. Medical students (n = 34), without prior laparoscopic suturing experience, were enrolled in an Institutional Review Board-approved, randomized protocol. After viewing an instructional video, subjects were tested in intracorporeal suturing on two identical, live, porcine Nissen fundoplication models; they placed three gastro-gastric sutures using conventional laparoscopic instruments in one model and using robotic assistance (da Vinci) in the other, in random order. Each knot was objectively scored based on time, accuracy, and security. Injuries to surrounding structures were recorded. Workload was assessed using the validated National Aeronautics and Space Administration (NASA) task load index (TLX) questionnaire, which measures the subjects' self-reported performance, effort, frustration, and mental, physical, and temporal demands of the task. Analysis was by paired t-test; p < 0.05 was considered significant. Compared with laparoscopy, robotic assistance enabled subjects to suture faster (595 +/- 22 s versus 459 +/- 137 s, respectively; p < 0.001), achieve higher overall scores (0 +/- 1 versus 95 +/- 128, respectively; p < 0.001), and commit fewer errors per knot (1.15 +/- 1.35 versus 0.05 +/- 0.26, respectively; p < 0.001). Subjects' overall score did not improve between the first and third attempt for laparoscopic suturing (0 +/- 0 versus 0 +/- 0; p = NS) but improved significantly for robotic suturing (49 +/- 100 versus 141 +/- 152; p < 0.001). Moreover, subjects indicated on the NASA-TLX scale that the task was more difficult to perform with laparoscopic instruments compared with robotic assistance (99 +/- 15 versus 57 +/- 23; p < 0.001). Compared with standard laparoscopy, robotic assistance significantly improved intracorporeal suturing

Medication room madness: calming the chaos.

PubMed

Conrad, Carole; Fields, Willa; McNamara, Tracey; Cone, Maryann; Atkins, Patricia

2010-01-01

Nurses work in stressful environments, encountering interruptions and distractions at almost every turn. The aim of this medication safety project was to improve the physical design and organizational layout of the medication room, reduce nurse interruptions and distractions, and create a standard medication process for enhanced patient safety and efficiency. This successful change improved the medication administration process, decreased medication errors, and enhanced nursing satisfaction.

Single-Use Energy Sources and Operating Room Time for Laparoscopic Hysterectomy: A Randomized Controlled Trial.

PubMed

Holloran-Schwartz, M Brigid; Gavard, Jeffrey A; Martin, Jared C; Blaskiewicz, Robert J; Yeung, Patrick P

2016-01-01

To compare the intraoperative direct costs of a single-use energy device with reusable energy devices during laparoscopic hysterectomy. A randomized controlled trial (Canadian Task Force Classification I). An academic hospital. Forty-six women who underwent laparoscopic hysterectomy from March 2013 to September 2013. Each patient served as her own control. One side of the uterine attachments was desiccated and transected with the single-use device (Ligasure 5-mm Blunt Tip LF1537 with the Force Triad generator). The other side was desiccated and transected with reusable bipolar forceps (RoBi 5 mm), and transected with monopolar scissors using the same Covidien Force Triad generator. The instrument approach used was randomized to the attending physician who was always on the patient's left side. Resident physicians always operated on the patient's right side and used the converse instruments of the attending physician. Start time was recorded at the utero-ovarian pedicle and end time was recorded after transection of the uterine artery on the same side. Costs included the single-use device; amortized costs of the generator, reusable instruments, and cords; cleaning and packaging of reusable instruments; and disposal of the single-use device. Operating room time was $94.14/min. We estimated that our single use-device cost $630.14 and had a total time savings of 6.7 min per case, or 3.35 min per side, which could justify the expense of the device. The single-use energy device had significant median time savings (-4.7 min per side, p < .001) and total intraoperative direct cost savings ($254.16 per case). A single-use energy device that both desiccates and cuts significantly reduced operating room time to justify its own cost, and it also reduced total intraoperative direct costs during laparoscopic hysterectomy in our institution. Operating room cost per minute varies between institutions and must be considered before generalizing our results. Copyright © 2016

37. INTERIOR VIEW TO THE WEST OF ROOM 203, THE ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

37. INTERIOR VIEW TO THE WEST OF ROOM 203, THE CONTROL ROOM FOR THE DISASSEMBLY BAY. - Nevada Test Site, Reactor Maintenance Assembly & Dissassembly Facility, Area 25, Jackass Flats, Junction of Roads F & G, Mercury, Nye County, NV

Locker Room Maintenance Made Easy.

ERIC Educational Resources Information Center

Theel, James

1998-01-01

Provides examples on ways to make locker room maintenance easier and their use more student-friendly. Improvements include use of indoor-outdoor carpeting with numerous floor drains to cut mildew buildup, adequate ventilation to reduce musty smells, better hot water management, ceramic tiles to reduce water-damage repair and painting needs, and…

116. VIEW OF NORTH SIDE OF LANDLINE INSTRUMENTATION ROOM (206), ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

116. VIEW OF NORTH SIDE OF LANDLINE INSTRUMENTATION ROOM (206), LSB (BLDG. 751), WITH CABINETS ON EAST SIDE OF ROOM FACING WEST. THE ROW OF CABINETS ON EAST SIDE OF ROOM INCLUDES LEFT TO RIGHT: CABLE DISTRIBUTION UNITS, AUTOPILOT CONTROLS, AND POWER DISTRIBUTION UNITS. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

One size fits all? Mixed methods evaluation of the impact of 100% single-room accommodation on staff and patient experience, safety and costs

PubMed Central

Maben, Jill; Penfold, Clarissa; Simon, Michael; Anderson, Janet E; Robert, Glenn; Pizzo, Elena; Hughes, Jane; Murrells, Trevor; Barlow, James

2016-01-01

Background and objectives There is little strong evidence relating to the impact of single-room accommodation on healthcare quality and safety. We explore the impact of all single rooms on staff and patient experience; safety outcomes; and costs. Methods Mixed methods pre/post ‘move’ comparison within four nested case study wards in a single acute hospital with 100% single rooms; quasi-experimental before-and-after study with two control hospitals; analysis of capital and operational costs associated with single rooms. Results Two-thirds of patients expressed a preference for single rooms with comfort and control outweighing any disadvantages (sense of isolation) felt by some. Patients appreciated privacy, confidentiality and flexibility for visitors afforded by single rooms. Staff perceived improvements (patient comfort and confidentiality), but single rooms were worse for visibility, surveillance, teamwork, monitoring and keeping patients safe. Staff walking distances increased significantly post move. A temporary increase of falls and medication errors in one ward was likely to be associated with the need to adjust work patterns rather than associated with single rooms per se. We found no evidence that single rooms reduced infection rates. Building an all single-room hospital can cost 5% more with higher housekeeping and cleaning costs but the difference is marginal over time. Conclusions Staff needed to adapt their working practices significantly and felt unprepared for new ways of working with potentially significant implications for the nature of teamwork in the longer term. Staff preference remained for a mix of single rooms and bays. Patients preferred single rooms. PMID:26408568

Automated Fall Detection With Quality Improvement “Rewind” to Reduce Falls in Hospital Rooms

PubMed Central

Rantz, Marilyn J.; Banerjee, Tanvi S.; Cattoor, Erin; Scott, Susan D.; Skubic, Marjorie; Popescu, Mihail

2014-01-01

The purpose of this study was to test the implementation of a fall detection and “rewind” privacy-protecting technique using the Microsoft® Kinect™ to not only detect but prevent falls from occurring in hospitalized patients. Kinect sensors were placed in six hospital rooms in a step-down unit and data were continuously logged. Prior to implementation with patients, three researchers performed a total of 18 falls (walking and then falling down or falling from the bed) and 17 non-fall events (crouching down, stooping down to tie shoe laces, and lying on the floor). All falls and non-falls were correctly identified using automated algorithms to process Kinect sensor data. During the first 8 months of data collection, processing methods were perfected to manage data and provide a “rewind” method to view events that led to falls for post-fall quality improvement process analyses. Preliminary data from this feasibility study show that using the Microsoft Kinect sensors provides detection of falls, fall risks, and facilitates quality improvement after falls in real hospital environments unobtrusively, while taking into account patient privacy. PMID:24296567

Personal sound zone reproduction with room reflections

NASA Astrophysics Data System (ADS)

Olik, Marek

Loudspeaker-based sound systems, capable of a convincing reproduction of different audio streams to listeners in the same acoustic enclosure, are a convenient alternative to headphones. Such systems aim to generate "sound zones" in which target sound programmes are to be reproduced with minimum interference from any alternative programmes. This can be achieved with appropriate filtering of the source (loudspeaker) signals, so that the target sound's energy is directed to the chosen zone while being attenuated elsewhere. The existing methods are unable to produce the required sound energy ratio (acoustic contrast) between the zones with a small number of sources when strong room reflections are present. Optimization of parameters is therefore required for systems with practical limitations to improve their performance in reflective acoustic environments. One important parameter is positioning of sources with respect to the zones and room boundaries. The first contribution of this thesis is a comparison of the key sound zoning methods implemented on compact and distributed geometrical source arrangements. The study presents previously unpublished detailed evaluation and ranking of such arrangements for systems with a limited number of sources in a reflective acoustic environment similar to a domestic room. Motivated by the requirement to investigate the relationship between source positioning and performance in detail, the central contribution of this thesis is a study on optimizing source arrangements when strong individual room reflections occur. Small sound zone systems are studied analytically and numerically to reveal relationships between the geometry of source arrays and performance in terms of acoustic contrast and array effort (related to system efficiency). Three novel source position optimization techniques are proposed to increase the contrast, and geometrical means of reducing the effort are determined. Contrary to previously published case studies, this

Human factors dimensions in the evolution of increasingly automated control rooms for near-earth satellites

NASA Technical Reports Server (NTRS)

Mitchell, C. M.

1982-01-01

The NASA-Goddard Space Flight Center is responsible for the control and ground support for all of NASA's unmanned near-earth satellites. Traditionally, each satellite had its own dedicated mission operations room. In the mid-seventies, an integration of some of these dedicated facilities was begun with the primary objective to reduce costs. In this connection, the Multi-Satellite Operations Control Center (MSOCC) was designed. MSOCC represents currently a labor intensive operation. Recently, Goddard has become increasingly aware of human factors and human-machine interface issues. A summary is provided of some of the attempts to apply human factors considerations in the design of command and control environments. Current and future activities with respect to human factors and systems design are discussed, giving attention to the allocation of tasks between human and computer, and the interface for the human-computer dialogue.

Computational model of gamma irradiation room at ININ

NASA Astrophysics Data System (ADS)

Rodríguez-Romo, Suemi; Patlan-Cardoso, Fernando; Ibáñez-Orozco, Oscar; Vergara Martínez, Francisco Javier

2018-03-01

In this paper, we present a model of the gamma irradiation room at the National Institute of Nuclear Research (ININ is its acronym in Spanish) in Mexico to improve the use of physics in dosimetry for human protection. We deal with air-filled ionization chambers and scientific computing made in house and framed in both the GEANT4 scheme and our analytical approach to characterize the irradiation room. This room is the only secondary dosimetry facility in Mexico. Our aim is to optimize its experimental designs, facilities, and industrial applications of physical radiation. The computational results provided by our model are supported by all the known experimental data regarding the performance of the ININ gamma irradiation room and allow us to predict the values of the main variables related to this fully enclosed space to within an acceptable margin of error.

Locker Room Talk.

ERIC Educational Resources Information Center

Fickes, Michael

1999-01-01

Examines the trends in college and university sports and recreation center locker rooms as envisioned by a specialist. Features of the modern locker room and the different levels of locker room design are explained. Final comments discuss whether college and university facility managers are inclined to move to high-end locker rooms. (GR)

Interior. Balance room for chemistry laboratory. Storage room for glassware ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Interior. Balance room for chemistry laboratory. Storage room for glassware and reference room with frequently used chemistry and chemical engineering texts. - Thomas A. Edison Laboratories, Building No. 2, Main Street & Lakeside Avenue, West Orange, Essex County, NJ

Room with a View: Ethical Encounters in Room 13

ERIC Educational Resources Information Center

Grube, Vicky

2012-01-01

In this article, the author describes ethical encounters in Room 13, a schoolroom where children made what they wanted, posed their own questions, and ran an art room like a small business. In Room 13 children had the responsibility to maintain all aspects of the art studio. Specific decisions fell to an annually elected management team, a small…

West elevation, southwest firstfloor room, main block. This room is ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

West elevation, southwest first-floor room, main block. This room is believed to be the one referred to as the "Committee Room" in institutional records. - Lazaretto Quarantine Station, Wanamaker Avenue and East Second Street, Essington, Delaware County, PA

14. INTERIOR VIEW TO THE EAST OF EQUIPMENT IN ROOM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. INTERIOR VIEW TO THE EAST OF EQUIPMENT IN ROOM 3, FLOW CONTROL ROOM, BUILDING 3113/3113A. - Nevada Test Site, Test Cell A Facility, Test Cell A Building & Addition, Area 25, Jackass Flats, Road F, Mercury, Nye County, NV

57. VIEW LOOKING NORTHWEST OF SIGNAL POWER CONDITIONING ROOM LOCATED ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

57. VIEW LOOKING NORTHWEST OF SIGNAL POWER CONDITIONING ROOM LOCATED OVER CONTROL ROOM MEZZANINE. SHOWN WITHIN THE BRICK PARTITIONS ARE SIGNAL VOLTAGE AUTOTRANSFORMERS. - New York, New Haven & Hartford Railroad, Cos Cob Power Plant, Sound Shore Drive, Greenwich, Fairfield County, CT

Effects of sodium benzoate on storage stability of previously improved beverage from tamarind (Tamarindus indica L.).

PubMed

Adeola, Abiodun A; Aworh, Ogugua C

2014-01-01

The effect of sodium benzoate on the quality attributes of improved tamarind beverage during storage was investigated. Tamarind beverages were produced according to a previously reported improved method, with or without chemical preservatives (100 mg/100 mL sodium benzoate). Tamarind beverage produced according to traditional processing method served as the control. The tamarind beverages were stored for 4 months at room (29 ± 2°C) and refrigerated (4-10°C) temperatures. Samples were analyzed, at regular intervals, for chemical, sensory, and microbiological qualities. Appearance of coliforms or overall acceptability score of 5.9 was used as deterioration index. The control beverages deteriorated by 2nd and 10th days at room and refrigerated temperatures, respectively. Improved tamarind beverage produced without the inclusion of sodium benzoate was stable for 3 and 5 weeks at room and refrigerated temperatures, respectively. Sodium benzoate extended the shelf life of the improved tamarind beverage to 6 and 13 weeks, respectively, at room and refrigerated temperatures.

[Operating Room Nurses' Experiences of Securing for Patient Safety].

PubMed

Park, Kwang Ok; Kim, Jong Kyung; Kim, Myoung Sook

2015-10-01

This study was done to evaluate the experience of securing patient safety in hospital operating rooms. Experiential data were collected from 15 operating room nurses through in-depth interviews. The main question was "Could you describe your experience with patient safety in the operating room?". Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. The core category of experience with patient safety in the operating room was 'trying to maintain principles of patient safety during high-risk surgical procedures'. The participants used two interactional strategies: 'attempt continuous improvement', 'immersion in operation with sharing issues of patient safety'. The results indicate that the important factors for ensuring the safety of patients in the operating room are manpower, education, and a system for patient safety. Successful and safe surgery requires communication, teamwork and recognition of the importance of patient safety by the surgical team.

12. VIEW OF OPERATING ROOMRCA COMMUNICATION REC STATION (THIS ROOM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. VIEW OF OPERATING ROOM-RCA COMMUNICATION REC STATION (THIS ROOM WAS ORIGINALLY A MOTOR GENERATOR FACILITY AND SUPPLIED DC POWER TO AN EARLIER GENERATION OF POINT-TO-POINT RECEIVERS ON SECOND FLOOR). VIEW SHOWS TRANSMITTER CONTROL STATION AND AUDIO CONTROL STATION (LEFT, WATKINS-JOHNSON WJ-8718-23. HP RECEIVERS AND KENWOOD R-5000 COMMUNICATIONS RECEIVERS (220 DEGREES). - Marconi Radio Sites, Receiving, Point Reyes Station, Marin County, CA

In Situ Operating Room-Based Simulation: A Review.

PubMed

Owei, Lily; Neylan, Christopher J; Rao, Raghavendra; Caskey, Robert C; Morris, Jon B; Sensenig, Richard; Brooks, Ari D; Dempsey, Daniel T; Williams, Noel N; Atkins, Joshua H; Baranov, Dimitry Y; Dumon, Kristoffel R

To systematically review the literature surrounding operating room-based in situ training in surgery. A systematic review was conducted of MEDLINE. The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, and employed the Population, Intervention, Comparator, Outcome (PICO) structure to define inclusion/exclusion criteria. The Kirkpatrick model was used to further classify the outcome of in situ training when possible. The search returned 308 database hits, and ultimately 19 articles were identified that met the stated PICO inclusion criteria. Operating room-based in situ simulation is used for a variety of purposes and in a variety of settings, and it has the potential to offer unique advantages over other types of simulation. Only one randomized controlled trial was conducted comparing in situ simulation to off-site simulation, which found few significant differences. One large-scale outcome study showed improved perinatal outcomes in obstetrics. Although in situ simulation theoretically offers certain advantages over other types of simulation, especially in addressing system-wide or environmental threats, its efficacy has yet to be clearly demonstrated. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

High-density magnetoresistive random access memory operating at ultralow voltage at room temperature.

PubMed

Hu, Jia-Mian; Li, Zheng; Chen, Long-Qing; Nan, Ce-Wen

2011-11-22

The main bottlenecks limiting the practical applications of current magnetoresistive random access memory (MRAM) technology are its low storage density and high writing energy consumption. Although a number of proposals have been reported for voltage-controlled memory device in recent years, none of them simultaneously satisfy the important device attributes: high storage capacity, low power consumption and room temperature operation. Here we present, using phase-field simulations, a simple and new pathway towards high-performance MRAMs that display significant improvements over existing MRAM technologies or proposed concepts. The proposed nanoscale MRAM device simultaneously exhibits ultrahigh storage capacity of up to 88 Gb inch(-2), ultralow power dissipation as low as 0.16 fJ per bit and room temperature high-speed operation below 10 ns.

High-density magnetoresistive random access memory operating at ultralow voltage at room temperature

PubMed Central

Hu, Jia-Mian; Li, Zheng; Chen, Long-Qing; Nan, Ce-Wen

2011-01-01

The main bottlenecks limiting the practical applications of current magnetoresistive random access memory (MRAM) technology are its low storage density and high writing energy consumption. Although a number of proposals have been reported for voltage-controlled memory device in recent years, none of them simultaneously satisfy the important device attributes: high storage capacity, low power consumption and room temperature operation. Here we present, using phase-field simulations, a simple and new pathway towards high-performance MRAMs that display significant improvements over existing MRAM technologies or proposed concepts. The proposed nanoscale MRAM device simultaneously exhibits ultrahigh storage capacity of up to 88 Gb inch−2, ultralow power dissipation as low as 0.16 fJ per bit and room temperature high-speed operation below 10 ns. PMID:22109527

7. INTERIOR OF SOUTH MAIN BUILDING ROOM AND OPEN DOOR ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. INTERIOR OF SOUTH MAIN BUILDING ROOM AND OPEN DOOR TO SHED ADDITION, OPEN DOOR TO NORTH MAIN BUILDING ROOM, AND CLOSED DOOR TO BATHROOM. VIEW TO NORTHWEST. - Bishop Creek Hydroelectric System, Control Station, Hydrographer's Office, Bishop Creek, Bishop, Inyo County, CA

Clean Room in the Zero Gravity Research Facility

NASA Image and Video Library

1968-07-21

A technician prepares a test sample in the Zero Gravity Research Facility clean room at the National Aeronautics and Space Administration (NASA) Lewis Research Center. The Zero Gravity Research Facility contained a drop tower which provided five seconds of microgravity during freefall in its 450-foot deep vacuum chamber. The facility has been used for a variety of studies relating to the behavior of fluids and flames in microgravity. During normal operations, a cylindrical 3-foot diameter and 11-foot long vehicle was used to house the experiments, instrumentation, and high speed cameras. The 4.5-foot long and 1.5-foot wide rectangular vehicle, seen in this photograph, was used less frequently. A 3-foot diameter orb was used for the special ten-second drops in which the package was pneumatically shot to the top of the tower then dropped. The facility also contained a control room, shop offices, tool and equipment rooms, and this clean room. The 242.5-foot long and 19.5-foot wide clean room was equipped with specialized cleaning equipment. In the 1960s the room was rated as a class 10,000 clean room, but I was capable of meeting the class 100 requirements. The room included a fume hood, ultrasonic cleaner, and a laminar flow station which operated as a class 100 environment. The environment in the clean room was maintained at 71° F and a relative humidity of 45- percent.

Perinatal nursing education for single-room maternity care: an evaluation of a competency-based model.

PubMed

Janssen, Patricia A; Keen, Lois; Soolsma, Jetty; Seymour, Laurie C; Harris, Susan J; Klein, Michael C; Reime, Birgit

2005-01-01

To evaluate the success of a competency-based nursing orientation programme for a single-room maternity care unit by measuring improvement in self-reported competency after six months. Single-room maternity care has challenged obstetrical nurses to provide comprehensive nursing care during all phases of the in-hospital birth experience. In this model, nurses provide intrapartum, postpartum and newborn care in one room. To date, an evaluation of nursing education for single-room maternity care has not been published. A prospective cohort design comparing self-reported competencies prior to starting work in the single-room maternity care and six months after. Nurses completed a competency-based education programme in which they could select from a menu of learning methods and content areas according to their individual needs. Learning methods included classroom lectures, self-paced learning packages, and preceptorships in the clinical area. Competencies were measured by a standardized perinatal self-efficacy tool and a tool developed by the authors for this study, the Single-Room Maternity Care Competency Tool. A paired analysis was undertaken to take into account the paired (before and after) nature of the design. Scores on the perinatal self-efficacy scale and the single-room maternity care competency tool were improved. These differences were statistically significant. Improvements in perinatal and single-room maternity care-specific competencies suggest that our education programme was successful in preparing nurses for their new role in the single-room maternity care setting. This conclusion is supported by reported increases in nursing and patient satisfaction in the single-room maternity care compared with the traditional labour/delivery and postpartum settings. An education programme tailored to the learning needs of experienced clinical nurses contributes to improvements in nursing competencies and patient care.

Temperature-controlled airflow ventilation in operating rooms compared with laminar airflow and turbulent mixed airflow.

PubMed

Alsved, M; Civilis, A; Ekolind, P; Tammelin, A; Andersson, A Erichsen; Jakobsson, J; Svensson, T; Ramstorp, M; Sadrizadeh, S; Larsson, P-A; Bohgard, M; Šantl-Temkiv, T; Löndahl, J

2018-02-01

To evaluate three types of ventilation systems for operating rooms with respect to air cleanliness [in colony-forming units (cfu/m 3 )], energy consumption and comfort of working environment (noise and draught) as reported by surgical team members. Two commonly used ventilation systems, vertical laminar airflow (LAF) and turbulent mixed airflow (TMA), were compared with a newly developed ventilation technique, temperature-controlled airflow (T c AF). The cfu concentrations were measured at three locations in an operating room during 45 orthopaedic procedures: close to the wound (<40cm), at the instrument table and peripherally in the room. The operating team evaluated the comfort of the working environment by answering a questionnaire. LAF and T c AF, but not TMA, resulted in less than 10cfu/m 3 at all measurement locations in the room during surgery. Median values of cfu/m 3 close to the wound (250 samples) were 0 for LAF, 1 for T c AF and 10 for TMA. Peripherally in the room, the cfu concentrations were lowest for T c AF. The cfu concentrations did not scale proportionally with airflow rates. Compared with LAF, the power consumption of T c AF was 28% lower and there was significantly less disturbance from noise and draught. T c AF and LAF remove bacteria more efficiently from the air than TMA, especially close to the wound and at the instrument table. Like LAF, the new T c AF ventilation system maintained very low levels of cfu in the air, but T c AF used substantially less energy and provided a more comfortable working environment than LAF. This enables energy savings with preserved air quality. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

At Your Request(®) room service dining improves patient satisfaction, maintains nutritional status, and offers opportunities to improve intake.

PubMed

Doorduijn, Astrid S; van Gameren, Yvonne; Vasse, Emmelyne; de Roos, Nicole M

2016-10-01

Malnutrition in hospitals may be combatted by improving the meal service. To evaluate whether At Your Request(®), a meal service concept by Sodexo with a restaurant style menu card and room service, improved patient satisfaction, nutritional status, and food intake compared to the traditional 3-meals per day service. We prospectively collected data in Hospital Gelderse Vallei (Ede, the Netherlands) before (2011/2012; n = 168, age 63 ± 15 y) and after (2013/2014; n = 169, 66 ± 15 y) implementing At Your Request(®). Patient satisfaction increased after implementing At Your Request(®) from 7.5 to 8.1 (scale 1-10) and from 124.5 to 132.9 points on a nutrition-related quality of life questionnaire (p < 0.05). Body weight and handgrip strength did not significantly change in both periods. At admission, more patients in the At Your Request(®) period had risk of malnutrition (MUST ≥ 1; 47 vs 37). MUST scores improved in 18 patients in both periods. With At Your Request(®) 0.92 g protein per kg (g/kg) bodyweight was ordered. Protein intake based on food records from patients on an energy and protein enriched diet was 0.84 g/kg during At Your Request(®) (n = 38) versus 0.91 g/kg during the traditional meal service (n = 34). At Your Request(®) is a highly rated hospital menu concept that helps patients to maintain nutritional status. The concept offers options for improving the intake of specific nutrients and foods, which should be evaluated in further studies. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Metoprolol improves survival in severe traumatic brain injury independent of heart rate control.

PubMed

Zangbar, Bardiya; Khalil, Mazhar; Rhee, Peter; Joseph, Bellal; Kulvatunyou, Narong; Tang, Andrew; Friese, Randall S; O'Keeffe, Terence

2016-02-01

Multiple prior studies have suggested an association between survival and beta-blocker administration in patients with severe traumatic brain injury (TBI). However, it is unknown whether this benefit of beta-blockers is dependent on heart rate control. The aim of this study was to assess whether rate control affects survival in patients receiving metoprolol with severe TBI. Our hypothesis was that improved survival from beta-blockade would be associated with a reduction in heart rate. We performed a 7-y retrospective analysis of all blunt TBI patients at a level-1 trauma center. Patients aged >16 y with head abbreviated injury scale 4 or 5, admitted to the intensive care unit (ICU) from the operating room or emergency room (ER), were included. Patients were stratified into two groups: metoprolol and no beta-blockers. Using propensity score matching, we matched the patients in two groups in a 1:1 ratio controlling for age, gender, race, admission vital signs, Glasgow coma scale, injury severity score, mean heart rate monitored during ICU admission, and standard deviation of heart rate during the ICU admission. Our primary outcome measure was mortality. A total of 914 patients met our inclusion criteria, of whom 189 received beta-blockers. A propensity-matched cohort of 356 patients (178: metoprolol and 178: no beta-blockers) was created. Patients receiving metoprolol had higher survival than those patients who did not receive beta-blockers (78% versus 68%; P = 0.04); however, there was no difference in the mean heart rate (89.9 ± 13.9 versus 89.9 ± 15; P = 0.99). Nor was there a difference in the mean of standard deviation of the heart rates (14.7 ± 6.3 versus 14.4 ± 6.5; P = 0.65) between the two groups. In Kaplan-Meier survival analysis, patients who received metoprolol had a survival advantage (P = 0.011) compared with patients who did not receive any beta-blockers. Our study shows an association with improved survival in patients with severe TBI receiving

Improving cardiac operating room to intensive care unit handover using a standardised handover process.

PubMed

Gleicher, Yehoshua; Mosko, Jeffrey David; McGhee, Irene

2017-01-01

Handovers from the cardiovascular operating room (CVOR) to the cardiovascular intensive care unit (CVICU) are complex processes involving the transfer of information, equipment and responsibility, at a time when the patient is most vulnerable. This transfer is typically variable in structure, content and execution. This variability can lead to the omission and miscommunication of critical information leading to patient harm. We set out to improve the quality of patient handover from the CVOR to the CVICU by introducing a standardised handover protocol. This study is an interventional time-series study over a 4-month period at an adult cardiac surgery centre. A standardised handover protocol was developed using quality improvement methodologies. The protocol included a handover content checklist and introduction of a formal 'sterile cockpit' timeout. Implementation of the protocol was refined using monthly iterative Plan-Do-Study-Act. The primary outcome was the quality of handovers, measured by a Handover Score, comprising handover content, teamwork and patient care planning indicators. Secondary outcomes included handover duration, adherence to the standardised handover protocol and handover team satisfaction surveys. 37 handovers were observed (6 pre intervention and 31 post intervention). The mean handover score increased from 6.5 to 14.0 (maximum 18 points). Specific improvements included fewer handover interruptions and more frequent postoperative patient care planning. Average handover duration increased slightly from 2:40 to 2:57 min. Caregivers noted improvements in teamwork, content received and patient care planning. The majority (>95%) agreed that the intervention was a valuable addition to the CVOR to CVICU handover process. Implementation of a standardised handover protocol for postcardiac surgery patients was associated with fewer interruptions during handover, more reliable transfer of critical content and improved patient care planning.

Statistical process control as a tool for controlling operating room performance: retrospective analysis and benchmarking.

PubMed

Chen, Tsung-Tai; Chang, Yun-Jau; Ku, Shei-Ling; Chung, Kuo-Piao

2010-10-01

There is much research using statistical process control (SPC) to monitor surgical performance, including comparisons among groups to detect small process shifts, but few of these studies have included a stabilization process. This study aimed to analyse the performance of surgeons in operating room (OR) and set a benchmark by SPC after stabilized process. The OR profile of 499 patients who underwent laparoscopic cholecystectomy performed by 16 surgeons at a tertiary hospital in Taiwan during 2005 and 2006 were recorded. SPC was applied to analyse operative and non-operative times using the following five steps: first, the times were divided into two segments; second, they were normalized; third, they were evaluated as individual processes; fourth, the ARL(0) was calculated;, and fifth, the different groups (surgeons) were compared. Outliers were excluded to ensure stability for each group and to facilitate inter-group comparison. The results showed that in the stabilized process, only one surgeon exhibited a significantly shorter total process time (including operative time and non-operative time). In this study, we use five steps to demonstrate how to control surgical and non-surgical time in phase I. There are some measures that can be taken to prevent skew and instability in the process. Also, using SPC, one surgeon can be shown to be a real benchmark. © 2010 Blackwell Publishing Ltd.

Effects of improved home heating on asthma in community dwelling children: randomised controlled trial

PubMed Central

Pierse, Nevil; Nicholls, Sarah; Gillespie-Bennett, Julie; Viggers, Helen; Cunningham, Malcolm; Phipps, Robyn; Boulic, Mikael; Fjällström, Pär; Free, Sarah; Lloyd, Bob; Wickens, Kristin; Shields, David; Baker, Michael; Cunningham, Chris; Woodward, Alistair; Bullen, Chris; Crane, Julian

2008-01-01

Objective To assess whether non-polluting, more effective home heating (heat pump, wood pellet burner, flued gas) has a positive effect on the health of children with asthma. Design Randomised controlled trial. Setting Households in five communities in New Zealand. Participants 409 children aged 6-12 years with doctor diagnosed asthma. Interventions Installation of a non-polluting, more effective home heater before winter. The control group received a replacement heater at the end of the trial. Main outcome measures The primary outcome was change in lung function (peak expiratory flow rate and forced expiratory volume in one second, FEV1). Secondary outcomes were child reported respiratory tract symptoms and daily use of preventer and reliever drugs. At the end of winter 2005 (baseline) and winter 2006 (follow-up) parents reported their child’s general health, use of health services, overall respiratory health, and housing conditions. Nitrogen dioxide levels were measured monthly for four months and temperatures in the living room and child’s bedroom were recorded hourly. Results Improvements in lung function were not significant (difference in mean FEV1 130.7 ml, 95% confidence interval −20.3 to 281.7). Compared with children in the control group, however, children in the intervention group had 1.80 fewer days off school (95% confidence interval 0.11 to 3.13), 0.40 fewer visits to a doctor for asthma (0.11 to 0.62), and 0.25 fewer visits to a pharmacist for asthma (0.09 to 0.32). Children in the intervention group also had fewer reports of poor health (adjusted odds ratio 0.48, 95% confidence interval 0.31 to 0.74), less sleep disturbed by wheezing (0.55, 0.35 to 0.85), less dry cough at night (0.52, 0.32 to 0.83), and reduced scores for lower respiratory tract symptoms (0.77, 0.73 to 0.81) than children in the control group. The intervention was associated with a mean temperature rise in the living room of 1.10°C (95% confidence interval 0.54°C to 1.64�

Nurses' Perceptions of Pediatric Intensive Care Unit Environment and Work Experience After Transition to Single-Patient Rooms.

PubMed

Kudchadkar, Sapna R; Beers, M Claire; Ascenzi, Judith A; Jastaniah, Ebaa; Punjabi, Naresh M

2016-09-01

The architectural design of the pediatric intensive care unit may play a major role in optimizing the environment to promote patients' sleep while improving stress levels and the work experience of critical care nurses. To examine changes in nurses' perceptions of the environment of a pediatric critical care unit for promotion of patients' sleep and the nurses' work experience after a transition from multipatient rooms to single-patient rooms. A cross-sectional survey of nurses was conducted before and after the move to a new hospital building in which all rooms in the pediatric critical care unit were single-patient rooms. Nurses reported that compared with multipatient rooms, single-patient private rooms were more conducive to patients sleeping well at night and promoted a more normal sleep-wake cycle (P < .001). Monitors/alarms and staff conversations were the biggest factors that adversely influenced the environment for sleep promotion in both settings. Nurses were less annoyed by noise in single-patient rooms (33%) than in multipatient rooms (79%; P < .001) and reported improved exposure to sunlight. Use of single-patient rooms rather than multipatient rooms improved nurses' perceptions of the pediatric intensive care unit environment for promoting patients' sleep and the nurses' own work experience. ©2016 American Association of Critical-Care Nurses.

Operating Room Time Savings with the Use of Splint Packs: A Randomized Controlled Trial

PubMed Central

Gonzalez, Tyler A.; Bluman, Eric M.; Palms, David; Smith, Jeremy T.; Chiodo, Christopher P.

2016-01-01

Background: The most expensive variable in the operating room (OR) is time. Lean Process Management is being used in the medical field to improve efficiency in the OR. Streamlining individual processes within the OR is crucial to a comprehensive time saving and cost-cutting health care strategy. At our institution, one hour of OR time costs approximately $500, exclusive of supply and personnel costs. Commercially prepared splint packs (SP) contain all components necessary for plaster-of-Paris short-leg splint application and have the potential to decrease splint application time and overall costs by making it a more lean process. We conducted a randomized controlled trial comparing OR time savings between SP use and bulk supply (BS) splint application. Methods: Fifty consecutive adult operative patients on whom post-operative short-leg splint immobilization was indicated were randomized to either a control group using BS or an experimental group using SP. One orthopaedic surgeon (EMB) prepared and applied all of the splints in a standardized fashion. Retrieval time, preparation time, splint application time, and total splinting time for both groups were measured and statistically analyzed. Results: The retrieval time, preparation time and total splinting time were significantly less (p<0.001) in the SP group compared with the BS group. There was no significant difference in application time between the SP group and BS group. Conclusion: The use of SP made the process of splinting more lean. This has resulted in an average of 2 minutes 52 seconds saved in total splinting time compared to BS, making it an effective cost-cutting and time saving technique. For high volume ORs, use of splint packs may contribute to substantial time and cost savings without impacting patient safety. PMID:26894212

123. UMBILICAL MAST PUMP ROOM (209), LSB (BLDG. 751). PUMP ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

123. UMBILICAL MAST PUMP ROOM (209), LSB (BLDG. 751). PUMP ON LEFT; HYDRAULIC CONTROL PANEL FOR UMBILICAL MAST AND TRENCH DOORS IN CENTER OF ROOM, FACING WEST. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

A Stable Room-Temperature Luminescent Biphenylmethyl Radical.

PubMed

Ai, Xin; Chen, Yingxin; Feng, Yuting; Li, Feng

2018-03-05

There is only one family of room-temperature luminescent radicals, the triphenylmethyl radicals, to date. Herein, we synthesize a new stable room-temperature luminescent radical, (N-carbazolyl)bis(2,4,6-tirchlorophenyl)methyl radical (CzBTM), which has improved properties compared to the triphenylmethyl radicals. X-ray crystallography, electron paramagnetic resonance spectroscopy, and magnetic susceptibility measurements confirmed the radical structure. CzBTM shows room-temperature deep-red to near-infrared emission in various solutions. Both thermal and photo stability were significantly enhanced by the replacement of trichlorobenzene by the carbazole moiety. The electroluminescence results of CzBTM verify its potential application to circumvent the problem of triplet harvesting in traditional fluorescent OLEDs. A new family of stable luminescent radicals based on CzBTM is anticipated. © 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

104. ARAIII. Interior view of room 110 in ARA607 used ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

104. ARA-III. Interior view of room 110 in ARA-607 used as data acquisition control room. Camera facing northeast. Ineel photo no. 81-103. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

Numerical modeling of cold room's hinged door opening and closing processes

NASA Astrophysics Data System (ADS)

Carneiro, R.; Gaspar, P. D.; Silva, P. D.; Domingues, L. C.

2016-06-01

The need of rationalize energy consumption in agrifood industry has fasten the development of methodologies to improve the thermal and energy performances of cold rooms. This paper presents a three-dimensional (3D) transient Computational Fluid Dynamics (CFD) modelling of a cold room to evaluate the air infiltration rate through hinged doors. A species transport model is used for modelling the tracer gas concentration decay technique. Numerical predictions indicate that air temperature difference between spaces affects the air infiltration. For this case study, the infiltration rate increases 0.016 m3 s-1 per K of air temperature difference. The knowledge about the evolution of air infiltration during door opening/closing times allows to draw some conclusions about its influence on the air conditions inside the cold room, as well as to suggest best practices and simple technical improvements that can minimize air infiltration, and consequently improve thermal performance and energy consumption rationalization.

Perceived parental care and control among Israeli female adolescents presenting to emergency rooms after self-poisoning.

PubMed

Diamond, Gary M; Didner, Hila; Waniel, Ariela; Priel, Beatriz; Asherov, Jack; Arbel, Shosh

2005-01-01

Levels of perceived parental care and control among 24 female Israeli adolescents presenting at emergency rooms after a self-poisoning act of low lethality were compared to those found among 23 non-self-harming, community controls. Adolescents' perceived levels of parental care and control were measured via both adolescents' self-report and independent objective ratings of adolescents' unconstrained descriptions of their parents. Adolescents also completed a standardized psychological symptom checklist. Data from both measurement perspectives indicated that adolescents evidencing self-poisoning behavior perceived their mothers as less caring and more controlling--a parenting style characterized as "affectionless control"--than did the comparison group. Independent ratings of adolescents' descriptions of their parents suggested that those exhibiting self-poisoning also perceived their fathers as less caring. These effects were not moderated by level of psychological symptoms. The findings are consistent with those from previous research showing an association between perceived parental care and control and various self-harming behaviors among adolescents, and highlight the need for research on the potential clinical utility of employing family-based, attachment-promoting psychosocial interventions with this population.

Implementation and evaluation of an interprofessional simulation-based education program for undergraduate nursing students in operating room nursing education: a randomized controlled trial.

PubMed

Wang, Rongmei; Shi, Nianke; Bai, Jinbing; Zheng, Yaguang; Zhao, Yue

2015-07-09

The present study was designed to implement an interprofessional simulation-based education program for nursing students and evaluate the influence of this program on nursing students' attitudes toward interprofessional education and knowledge about operating room nursing. Nursing students were randomly assigned to either the interprofessional simulation-based education or traditional course group. A before-and-after study of nursing students' attitudes toward the program was conducted using the Readiness for Interprofessional Learning Scale. Responses to an open-ended question were categorized using thematic content analysis. Nursing students' knowledge about operating room nursing was measured. Nursing students from the interprofessional simulation-based education group showed statistically different responses to four of the nineteen questions in the Readiness for Interprofessional Learning Scale, reflecting a more positive attitude toward interprofessional learning. This was also supported by thematic content analysis of the open-ended responses. Furthermore, nursing students in the simulation-based education group had a significant improvement in knowledge about operating room nursing. The integrated course with interprofessional education and simulation provided a positive impact on undergraduate nursing students' perceptions toward interprofessional learning and knowledge about operating room nursing. Our study demonstrated that this course may be a valuable elective option for undergraduate nursing students in operating room nursing education.

132. WEST SIDE OF MECHANICAL AND ELECTRICAL ROOM (210), LSB ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

132. WEST SIDE OF MECHANICAL AND ELECTRICAL ROOM (210), LSB (BLDG. 751), QUALITY CONTROL BOARD ON LEFT. SOUTH SIDE OF TRANSFORMER ROOM (212) ON RIGHT SIDE OF PHOTOGRAPH, THROUGH OPEN DOORS. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Standard work for room entry: Linking lean, hand hygiene, and patient-centeredness.

PubMed

O'Reilly, Kristin; Ruokis, Samantha; Russell, Kristin; Teves, Tim; DiLibero, Justin; Yassa, David; Berry, Hannah; Howell, Michael D

2016-03-01

Healthcare-associated infections are costly and fatal. Substantial front-line, administrative, regulatory, and research efforts have focused on improving hand hygiene. While broad agreement exists that hand hygiene is the most important single approach to infection prevention, compliance with hand hygiene is typically only about 40%(1). Our aim was to develop a standard process for room entry in the intensive care unit that improved compliance with hand hygiene and allowed for maximum efficiency. We recognized that hand hygiene is a single step in a substantially more complicated process of room entry. We applied Lean engineering techniques to develop a standard process that included both physical steps and also standard communication elements from provider to patients and families and created a physical environment to support this. We observed meaningful improvement in the performance of the new standard as well as time savings for clinical providers with each room entry. We also observed an increase in room entries that included verbal communication and an explanation of what the clinician was entering the room to do. The design and implementation of a standardized room entry process and the creation of an environment that supports that new process has resulted in measurable positive outcomes on the medical intensive care unit, including quality, patient experience, efficiency, and staff satisfaction. Designing a process, rather than viewing tasks that need to happen in close proximity in time (either serially or in parallel) as unrelated, simplifies work for staff and results in higher compliance to individual tasks. Copyright © 2015 Elsevier Inc. All rights reserved.

A multidimensional framework for assessing patient room configurations.

PubMed

Pati, Debajyoti; Harvey, Thomas E; Reyers, Evelyn; Evans, Jennie; Waggener, Laurie; Serrano, Marjorie; Saucier, Rachel; Nagle, Tina

2009-01-01

A framework for multidimensional assessment of patient room configurations is presented. Twenty-three issues are considered and categorized under six domains of assessment: (1) patient safety, (2) staff efficiency, (3) circulation, (4) infection control, (5) patient considerations, and (6) family amenities. Use of the framework to rank issues by importance and assess six alternative patient room configurations by a diverse group of experts in a symposium is described. One of the key questions posed during inpatient room design is the location of the bathroom. What issues are affected by the variations in room configuration that arise from bathroom location? A complete articulation of the issues that potentially are affected by room configuration is not available in the literature. The list of issues was developed by the authors in preparation for a symposium. The symposium was organized in May 2007 and attended by 14 experts from four institutions. Six alternative room configurations were used. Variations in the configurations included: (1) three same-handed and three mirror-image rooms; (2) three outboard, two inboard, and one nested bathroom; and (3) three rooms with footwall bathrooms and three with headwall bathrooms. In a four-step process, the attendees ranked the issues, discussed them in detail, rated each room configuration against each issue on a seven-point suitability scale, and conducted an overall assessment of the six configurations. Based on the ratings and rankings provided by the symposium participants, outboard bathroom locations were found to be most suitable, followed by nested and inboard configurations. Furthermore, configurations with patient bathrooms located on the footwall were rated as more suitable than headwall locations. The authors recommend, however, that the framework be used to determine a suitable room configuration in a specific context, rather than to identify configurations that will perform well universally.

Evaluation of a visual layering methodology for colour coding control room displays.

PubMed

Van Laar, Darren; Deshe, Ofer

2002-07-01

Eighteen people participated in an experiment in which they were asked to search for targets on control room like displays which had been produced using three different coding methods. The monochrome coding method displayed the information in black and white only, the maximally discriminable method contained colours chosen for their high perceptual discriminability, the visual layers method contained colours developed from psychological and cartographic principles which grouped information into a perceptual hierarchy. The visual layers method produced significantly faster search times than the other two coding methods which did not differ significantly from each other. Search time also differed significantly for presentation order and for the method x order interaction. There was no significant difference between the methods in the number of errors made. Participants clearly preferred the visual layers coding method. Proposals are made for the design of experiments to further test and develop the visual layers colour coding methodology.

[The endoscopic operating room OR 1].

PubMed

Dubuisson, J B; Chapron, C

2003-04-01

During the last few years, the development of surgical laparoscopy has been the major turning point, and the most important progress in the field of surgery. The specific installation requirements of surgical laparoscopy, as well as the technological progress proper to this surgical technique, justify the need of a new organization of the operating theatre. The new operating room OR 1 is especially designed to fit and satisfy the requirements of a modern operating theatre, where surgical laparoscopy plays a major role. The organization and the design of this new operating room (OR 1) rely on 2 main concepts: architectural, and computerized, through 2 PC systems SCB and AIDA. The main objectives of this new concept are: allowing the surgeon to control and command all the functions and the instruments, as well as the lighting of the room and the operating field; managing the surgical data and images required for medical files; establishing a communication network either from the inside or outside the sterile zone.

Single molecule dynamics at a mechanically controllable break junction in solution at room temperature.

PubMed

Konishi, Tatsuya; Kiguchi, Manabu; Takase, Mai; Nagasawa, Fumika; Nabika, Hideki; Ikeda, Katsuyoshi; Uosaki, Kohei; Ueno, Kosei; Misawa, Hiroaki; Murakoshi, Kei

2013-01-23

The in situ observation of geometrical and electronic structural dynamics of a single molecule junction is critically important in order to further progress in molecular electronics. Observations of single molecular junctions are difficult, however, because of sensitivity limits. Here, we report surface-enhanced Raman scattering (SERS) of a single 4,4'-bipyridine molecule under conditions of in situ current flow in a nanogap, by using nano-fabricated, mechanically controllable break junction (MCBJ) electrodes. When adsorbed at room temperature on metal nanoelectrodes in solution to form a single molecule junction, statistical analysis showed that nontotally symmetric b(1) and b(2) modes of 4,4'-bipyridine were strongly enhanced relative to observations of the same modes in solid or aqueous solutions. Significant changes in SERS intensity, energy (wavenumber), and selectivity of Raman vibrational bands that are coincident with current fluctuations provide information on distinct states of electronic and geometrical structure of the single molecule junction, even under large thermal fluctuations occurring at room temperature. We observed the dynamics of 4,4'-bipyridine motion between vertical and tilting configurations in the Au nanogap via b(1) and b(2) mode switching. A slight increase in the tilting angle of the molecule was also observed by noting the increase in the energies of Raman modes and the decrease in conductance of the molecular junction.

Display Developer for Firing Room Applications

NASA Technical Reports Server (NTRS)

Bowman, Elizabeth A.

2013-01-01

The firing room at Kennedy Space Center (KSC) is responsible for all NASA human spaceflight launch operations, therefore it is vital that all displays within the firing room be properly tested, up-to-date, and user-friendly during a launch. The Ground Main Propulsion System (GMPS) requires a number of remote displays for Vehicle Integration and Launch (VIL) Operations at KSC. My project is to develop remote displays for the GMPS using the Display Services and Framework (DSF) editor. These remote displays will be based on model images provided by GMPS through PowerPoint. Using the DSF editor, the PowerPoint images can be recreated with active buttons associated with the correct Compact Unique Identifiers (CUIs). These displays will be documented in the Software Requirements and Design Specifications (SRDS) at the 90% GMPS Design Review. In the future, these remote displays will be available for other developers to improve, edit, or add on to so that the display may be incorporated into the firing room to be used for launches.

Bacterial contamination of ex vivo processed PBPC products under clean room conditions.

PubMed

Ritter, Markus; Schwedler, Joachim; Beyer, Jörg; Movassaghi, Kamran; Mutters, Reinier; Neubauer, Andreas; Schwella, Nimrod

2003-11-01

Patients undergoing high-dose radio- and/or chemotherapy and autologous or allogeneic PBPC transplantation are at high risk for infections owing to profound immunosuppression. In this study, the rate of microbial contamination of ex vivo processed PBPC products was analyzed, comparing preparation under clean room conditions to standard laboratory conditions. After implementation of good manufacturing practice conditions in the two participating institutions, the microbial contamination rate of 366 PBPC harvests from 198 patients was determined under certified clean room conditions (Group A) from 2000 until 2002. To investigate influence of improved environmental conditions along with other parameters, this set of samples was compared with a historical control set of 1413 PBPC products, which have been processed ex vivo under a clean bench in a regular laboratory room and were harvested from 626 patients (Group B) from 1989 until 2000. In Group B microbial contamination was found in 74 PBPC products (5.2%) from 57 patients. In Group A microbial growth was detected in 3 leukapheresis products (0.8%) from 3 patients. After exclusion of PBPC products, which were probably contaminated before manipulation, statistical analysis showed a significant difference (chi2= 10.339; p < 0.001). These data suggest an impact of clean room conditions on the bacterial contamination rate of PBPC products. To identify confounding variables, variables like technique of leukapheresis, culture methodology, and microbial colonization of central venous catheters were taken into account. Further variables might be identified in following studies.

Human factors aspects of control room design: Guidelines and annotated bibliography

NASA Technical Reports Server (NTRS)

Mitchell, C. M.; Stewart, L. J.; Bocast, A. K.; Murphy, E. D.

1982-01-01

A human factors analysis of the workstation design for the Earth Radiation Budget Satellite mission operation room is discussed. The relevance of anthropometry, design rules, environmental design goals, and the social-psychological environment are discussed.

VIEW OF PDP ROOM WITH FLOOR AT LEVEL +15’ AND ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW OF PDP ROOM WITH FLOOR AT LEVEL +15’ AND SHEAVE RACK ABOVE, LOOKING SOUTH. ON THE LEFT SIDE, CABLES GO THROUGH THE WALL TOWARD THE PDP CONTROL ROOM AREA - Physics Assembly Laboratory, Area A/M, Savannah River Site, Aiken, Aiken County, SC

Effect of automated ultraviolet C-emitting device on decontamination of hospital rooms with and without real-time observation of terminal room disinfection.

PubMed

Penno, Katie; Jandarov, Roman A; Sopirala, Madhuri M

2017-11-01

We studied the effectiveness of an ultraviolet C (UV-C) emitter in clinical settings and compared it with observed terminal disinfection. We cultured 22 hospital discharge rooms at a tertiary care academic medical center. Phase 1 (unobserved terminal disinfection) included cultures of 11 high-touch environmental surfaces (HTSs) after terminal room disinfection (AD) and after the use of a UV-C-emitting device (AUV). Phase 2 (observed terminal disinfection) included cultures before terminal room disinfection (BD), AD, and AUV. Zero-inflated Poisson regression compared mean colony forming units (CFU) between the groups. Two-sample proportion tests identified significance of the observed differences in proportions of thoroughly cleaned HTSs (CFU < 5). Significant P value was determined using the Bonferroni corrected threshold of α = .05/12 = .004. We obtained 594 samples. Risk of overall contamination was 0.48 times lower in the AUV group than in the AD group (P < .001), with 1.04 log 10 reduction. During phase 1, overall proportion of HTSs with <5 CFUs increased in AUV versus AD by 0.12 (P = .001). During phase 2, it increased in AD versus BD by 0.45 (P < .001), with no significant difference between AD and AUV (P = .02). Use of UV-C with standard cleaning significantly reduced microbial burden and improved the thoroughness of terminal disinfection. We found no further benefit to UV-C use if standard terminal disinfection was observed. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Improved alignment and operating room efficiency with patient-specific instrumentation for TKA.

PubMed

Renson, Luc; Poilvache, Pascal; Van den Wyngaert, Hans

2014-12-01

Achieving accurate alignment in total knee arthroplasty (TKA) remains a concern. Patient-specific instrumentation (PSI) produced using preoperative 3D models was developed to offer surgeons a simplified, reliable, efficient and customised TKA procedure. In this prospective study, 60 patients underwent TKA with conventional instrumentation and 71 patients were operated on using PSI. The primary endpoint was surgical time. Secondary endpoints included operating room (OR) time, the number of instrument trays used and postoperative radiographic limb alignment. Compared to conventional instrumentation, PSI significantly reduced total surgical time by 8.9 ± 3.3 min (p=0.038), OR time by 8.6 ± 4.2 min (p=0.043), and the number of instrument trays by six trays (p<0.001). Mechanical axis malalignment of the lower limb of >3° was observed in 13% of PSI patients versus 29% with conventional instrumentation (p=0.043). PSI predicted the size of the femoral and tibial components actually used in 85.9% and 78.9% of cases, respectively. PSI improves alignment, surgical and OR time, reduces the number of instruments trays used compared to conventional instrumentation in patients undergoing TKA and results in fewer outliers in overall mechanical alignment in the coronal plane. Prospective comparative therapeutic study. Copyright © 2014 Elsevier B.V. All rights reserved.

[Interface interconnection and data integration in implementing of digital operating room].

PubMed

Feng, Jingyi; Chen, Hua; Liu, Jiquan

2011-10-01

The digital operating-room, with highly integrated clinical information, is very important for rescuing lives of patients and improving quality of operations. Since equipments in domestic operating-rooms have diversified interface and nonstandard communication protocols, designing and implementing an integrated data sharing program for different kinds of diagnosing, monitoring, and treatment equipments become a key point in construction of digital operating room. This paper addresses interface interconnection and data integration for commonly used clinical equipments from aspects of hardware interface, interface connection and communication protocol, and offers a solution for interconnection and integration of clinical equipments in heterogeneous environment. Based on the solution, a case of an optimal digital operating-room is presented in this paper. Comparing with the international solution for digital operating-room, the solution proposed in this paper is more economical and effective. And finally, this paper provides a proposal for the platform construction of digital perating-room as well as a viewpoint for standardization of domestic clinical equipments.

Electric field control of ferromagnetism at room temperature in GaCrN (p-i-n) device structures

NASA Astrophysics Data System (ADS)

El-Masry, N. A.; Zavada, J. M.; Reynolds, J. G.; Reynolds, C. L.; Liu, Z.; Bedair, S. M.

2017-08-01

We have demonstrated a room temperature dilute magnetic semiconductor based on GaCrN epitaxial layers grown by metalorganic chemical vapor deposition. Saturation magnetization Ms increased when the GaCrN film is incorporated into a (p-GaN/i-GaCrN/n-GaN) device structure, due to the proximity of mediated holes present in the p-GaN layer. Zero field cooling and field cooling were measured to ascertain the absence of superparamagnetic behavior in the films. A (p-GaN/i-GaCrN/n-GaN) device structure with room temperature ferromagnetic (FM) properties that can be controlled by an external applied voltage has been fabricated. In this work, we show that the applied voltage controls the ferromagnetic properties, by biasing the (p-i-n) structure. With forward bias, ferromagnetism in the GaCrN layer was increased nearly 4 fold of the original value. Such an enhancement is due to carrier injection of holes into the Cr deep level present in the i-GaCrN layer. A "memory effect" for the FM behavior of the (p-i-n) GaCrN device structure persisted for 42 h after the voltage bias was turned off. These measurements also support that the observed ferromagnetism in the GaCrN film is not due to superparamagnetic clusters but instead is a hole-mediated phenomenon.

Full-movement neuromuscular electrical stimulation improves plantar flexor spasticity and ankle active dorsiflexion in stroke patients: a randomized controlled study.

PubMed

Wang, Yong-Hui; Meng, Fei; Zhang, Yang; Xu, Mao-Yu; Yue, Shou-Wei

2016-06-01

To investigate whether full-movement neuromuscular electrical stimulation, which can generate full range of movement, reduces spasticity and/or improves motor function more effectively than control, sensory threshold-neuromuscular electrical stimulation, and motor threshold-neuromuscular electrical stimulation in sub-acute stroke patients. A randomized, single-blind, controlled study. Physical therapy room and functional assessment room. A total of 72 adult patients with sub-acute post-stroke hemiplegia and plantar flexor spasticity. Patients received 30-minute sessions of neuromuscular electrical stimulation on the motor points of the extensor hallucis and digitorum longus twice a day, five days per week for four weeks. Composite Spasticity Scale, Ankle Active Dorsiflexion Score, and walking time in the Timed Up and Go Test were assessed at pretreatment, posttreatment, and at two-week follow-up. After four weeks of treatment, when comparing interclass pretreatment and posttreatment, only the full-movement neuromuscular electrical stimulation group had a significant reduction in the Composite Spasticity Scale (mean % reduction = 19.91(4.96)%, F = 3.878, p < 0.05) and improvement in the Ankle Active Dorsiflexion Score (mean scores = 3.29(0.91), F = 3.140, p < 0.05). Furthermore, these improvements were maintained two weeks after the treatment ended. However, there were no significant differences in the walking time after four weeks of treatment among the four groups (F = 1.861, p > 0.05). Full-movement neuromuscular electrical stimulation with a stimulus intensity capable of generating full movement can significantly reduce plantar flexor spasticity and improve ankle active dorsiflexion, but cannot decrease walking time in the Timed Up and Go Test in sub-acute stroke patients. © The Author(s) 2015.

NASA researchers in gold control room during an F-15 HiDEC flight, John Orme and Gerard Schkolnik

NASA Technical Reports Server (NTRS)

1993-01-01

NASA researchers Gerard Schkolnik (left) and John Orme monitor equipment in the control room at the Dryden Flight Research Center, Edwards, California, during a flight of an F-15 Highly Integrated Digital Electronic Control (HIDEC) research aircraft. The system was developed on the F-15 to investigate and demonstrate methods of obtaining optimum aircraft performance. The major elements of HIDEC were a Digital Electronic Flight Control System (DEFCS), a Digital Electronic Engine Control (DEEC), an on-board general purpose computer, and an integrated architecture to allow all components to 'talk to each other.' Unlike standard F-15s, which have a mechanical and analog electronic flight control system, the HIDEC F-15 also had a dual-channel, fail-safe digital flight control system programmed in Pascal. It was linked to the Military Standard 1553B and a H009 data bus which tied all the other electronic systems together.

AS-7 improved in vitro quality of red blood cells prepared from whole blood held overnight at room temperature.

PubMed

Veale, Margaret F; Healey, Geraldine; Sran, Amrita; Payne, Katherine A; Zia, Majid; Sparrow, Rosemary L

2015-01-01

Extended room temperature (RT) hold of whole blood (WB) may affect the quality of red blood cell (RBC) components produced from these donations. The availability of better RBC additive solutions (ASs) may help reduce the effects. A new AS, AS-7 (SOLX, Haemonetics Corporation), was investigated for improved in vitro quality of RBCs prepared from WB held overnight at RT. Sixteen WB units were held for 21.4 hours ± 40 minutes at 22°C on cooling plates before processing. Each pair of ABO-matched WB units were pooled, divided into a WB filter pack containing saline-adenine-glucose-mannitol (control) and a LEUKOSEP WB-filter pack containing SOLX, and processed according to manufacturer's instructions. RBCs were stored at 2 to 6°C and sampled weekly until expiry. Glycophorin A (GPA+) and annexin V-binding microparticles (MPs) were quantitated using flow cytometry. Osmotic fragility, intracellular pH (pHi), adenosine triphosphate (ATP), 2,3-diphosphoglycerate (2,3-DPG), and routine quality variables were measured. Adhesion of RBCs to human endothelial cells (ECs) was evaluated by flow perfusion under low shear stress (0.5 dyne/cm(2) ), similar to low blood flow in microvessels. ATP and 2,3-DPG levels were improved for SOLX-RBCs. SOLX-RBCs maintained higher pHi, increased resistance to hypotonic stress, and reduced numbers of GPA+ MPs. No significant difference was observed between annexin V binding to MPs or adhesion of RBCs to ECs under shear stress. SOLX-stored RBCs showed increased osmotic resistance, pHi, and reduced GPA+ MPs and together with higher ATP and 2,3-DPG levels demonstrated improved in vitro RBC quality measures during 42 days of storage. © 2014 AABB.

133. View of former oil switch breaker room (on second ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

133. View of former oil switch breaker room (on second floor, north of the control room), looking south. The oil switch breakers were replaced with vacuum switches, along the wall to the right. Photo by Jet Lowe, HAER, 1989. - Puget Sound Power & Light Company, White River Hydroelectric Project, 600 North River Avenue, Dieringer, Pierce County, WA

146. View of oil filter room in basement (Room B1) ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

146. View of oil filter room in basement (Room B-1) where oil used in lubrication in generator room is cleaned and recycled. The two tanks in the foreground each have capacities of 2,100 gallons. Photo by Jet Lowe, HAER, 1989. - Puget Sound Power & Light Company, White River Hydroelectric Project, 600 North River Avenue, Dieringer, Pierce County, WA

MACHINE ROOM FROM DOORWAY TO COMMUNICATIONS ROOM, VIEW FACING SOUTHWEST. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

MACHINE ROOM FROM DOORWAY TO COMMUNICATIONS ROOM, VIEW FACING SOUTHWEST. - Naval Air Station Barbers Point, World War II Command Center, Midway Street east of Lexington Avenue, Ewa, Honolulu County, HI

Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department.

PubMed

Thomas, Anita A; Uspal, Neil G; Oron, Assaf P; Klein, Eileen J

2016-12-01

Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians. Outcomes included JIT room use, trainee procedural confidence, and frequency of supervisor intervention during procedures. Thirty-one of 32 supervising physicians (97%) and 122 of 186 residents (66%) completed the survey, with 71% of trainees reporting improved confidence, and 68% reporting improved procedural skills ( P  < .05, +1.4-point average skills improvement on a 5-point Likert scale). Trainees perceived no difference among supervising physicians intervening in procedures with or without JIT room use ( P  = .30, paired difference -0.0 points). Nearly all supervisors reported improved trainee procedural confidence, and 77% reported improved trainee procedural skills after JIT room use ( P  < .05, paired difference +1.8 points); 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared with 42% with JIT room use ( P  < .05, paired difference -0.4 points). Use of the JIT room led to improved trainee confidence and supervisor reports of less procedural intervention. Although it carries financial and time costs, an in situ JIT room may be important for convenient JIT training.

Implementation of Fuzzy Decision to Control Patient Room Facilities using Eye Blink

NASA Astrophysics Data System (ADS)

Zaeni, Ilham A. E.; Wibawa, Aji P.; Aripriharta; Sendari, Siti

2018-04-01

This study proposed the implementation of Fuzzy decision to control patient’s room facilities. In this study, four icons were sequentially displayed on the computer screen. The icons representing four option that can be selected by the patient is including switch the light on/off, switch the fan on/off, moving the bed’s backrest downward, and moving the bed’s backrest upward. The eye blink was extracted from subject’s electroencephalograph (EEG) signals which acquired from the FP1 region. The attention was also extracted from subject’s EEG signals to ensure that subject concentrate to the task. The eye blink and attention level were used for Fuzzy decision inputs, while the output is a decision that states the selection is valid or not. The selected option is the command that appears on the screen when the selection is valid. In this study, subjects were asked to choose each command several times and the accuracy was computed based on the number of correct selection.

Time-out Rooms in Residential Treatment Centers

ERIC Educational Resources Information Center

Endres, V. Joseph; Goke, Douglas H.

1973-01-01

Among professionals, the use of the time-out room for the control of disturbed children in residential centers evokes varied and sometimes opposing opinions. This study is based on a questionnaire submitted to 50 residential treatment centers. (Editor)

Interior. Storage room for glassware and reference room with frequentlyused ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Interior. Storage room for glassware and reference room with frequently-used chemistry and chemical engineering texts. - Thomas A. Edison Laboratories, Building No. 2, Main Street & Lakeside Avenue, West Orange, Essex County, NJ

Children's preferences concerning ambiance of dental waiting rooms.

PubMed

Panda, A; Garg, I; Shah, M

2015-02-01

Despite many advances in paediatric dentistry, the greatest challenge for any paediatric dentist is to remove the anxiety related to a dental visit and have a child patient to accept dental treatment readily. Minor changes made in the waiting room design can have a major effect on the way any child perceives the upcoming dental experience. This study was carried out to determine children's preferences regarding the dental waiting area so as to improve their waiting experience and reduce their preoperative anxiety before a dental appointment. This was a cross-sectional descriptive study using survey methodology. A questionnaire designed to evaluate children's preferences regarding the waiting room was distributed to new paediatric patients, aged between 6 and 11 years of age, attending an outpatient dental facility and was completed by 212 children (127 males, 85 females). The analyses were carried out on cross-tables using Phi (for 2×2 tables) or Cramer's V (for larger than 2×2 tables) to assess responses to the questionnaire items across age groups and gender. A majority of children preferred music and the ability to play in a waiting room. They also preferred natural light and walls with pictures. They preferred looking at an aquarium or a television and sitting on beanbags and chairs and also preferred plants and oral hygiene posters Repetious. The results obtained from this study may help the dental team decide on an appropriate design of their paediatric waiting room so as to make children comfortable in the dental environment and improve delivery of health care.

Status quo and current trends of operating room management in Germany.

PubMed

Baumgart, André; Schüpfer, Guido; Welker, Andreas; Bender, Hans-Joachim; Schleppers, Alexander

2010-04-01

Ongoing healthcare reforms in Germany have required strenuous efforts to adapt hospital and operating room organizations to the needs of patients, new technological developments, and social and economic demands. This review addresses the major developments in German operating room management research and current practice. The introduction of the diagnosis-related group system in 2003 has changed the incentive structure of German hospitals to redesign their operating room units. The role of operating room managers has been gradually changing in hospitals in response to the change in the reimbursement system. Operating room managers are today specifically qualified and increasingly externally hired staff. They are more and more empowered with authority to plan and control operating rooms as profit centers. For measuring performance, common perioperative performance indicators are still scarcely implemented in German hospitals. In 2008, a concerted time glossary was established to enable consistent monitoring of operating room performance with generally accepted process indicators. These key performance indicators are a consistent way to make a procedure or case - and also the effectiveness of the operating room management - more transparent. In the presence of increasing financial pressure, a hospital's executives need to empower an independent operating room management function to achieve the hospital's economic goals. Operating room managers need to adopt evidence-based methods also from other scientific fields, for example management science and information technology, to further sustain operating room performance.

Benefits of Leapfrogging to Superefficiency and Low Global Warming Potential Refrigerants in Room Air Conditioning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shah, Nihar; Wei, Max; Letschert, Virginie

2015-10-01

Hydrofluorocarbons (HFCs) emitted from uses such as refrigerants and thermal insulating foam, are now the fastest growing greenhouse gases (GHGs), with global warming potentials (GWP) thousands of times higher than carbon dioxide (CO2). Because of the short lifetime of these molecules in the atmosphere, mitigating the amount of these short-lived climate pollutants (SLCPs) provides a faster path to climate change mitigation than control of CO2 alone. This has led to proposals from Africa, Europe, India, Island States, and North America to amend the Montreal Protocol on Substances that Deplete the Ozone Layer (Montreal Protocol) to phase-down high-GWP HFCs. Simultaneously, energymore » efficiency market transformation programs such as standards, labeling and incentive programs are endeavoring to improve the energy efficiency for refrigeration and air conditioning equipment to provide life cycle cost, energy, GHG, and peak load savings. In this paper we provide an estimate of the magnitude of such GHG and peak electric load savings potential, for room air conditioning, if the refrigerant transition and energy efficiency improvement policies are implemented either separately or in parallel. We find that implementing HFC refrigerant transition and energy efficiency improvement policies in parallel for room air conditioning, roughly doubles the benefit of either policy implemented separately. We estimate that shifting the 2030 world stock of room air conditioners from the low efficiency technology using high-GWP refrigerants to higher efficiency technology and low-GWP refrigerants in parallel would save between 340-790 gigawatts (GW) of peak load globally, which is roughly equivalent to avoiding 680-1550 peak power plants of 500MW each. This would save 0.85 GT/year annually in China equivalent to over 8 Three Gorges dams and over 0.32 GT/year annually in India equivalent to roughly twice India’s 100GW solar mission target. While there is some uncertainty associated

21. Perimeter acquisition radar building room #200, electrical equipment room ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

21. Perimeter acquisition radar building room #200, electrical equipment room - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

8. VIEW OF ROOM 101 (ASSEMBLY ROOM) FROM NORTHEAST CORNER ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. VIEW OF ROOM 101 (ASSEMBLY ROOM) FROM NORTHEAST CORNER SHOWING FLEXIBLE AIR-CONDITIONING DUCT - Vandenberg Air Force Base, Space Launch Complex 3, Vehicle Support Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

VIEW OF DINING ROOM DOORWAY, FIRST FLOOR HALL, LIVING ROOM ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

VIEW OF DINING ROOM DOORWAY, FIRST FLOOR HALL, LIVING ROOM DOORWAY, AND FIREPLACE OF PAULINE KILKER HOUSE, FACING EAST. - Pauline Kilker House, 1410 North Lincoln Avenue-3300 West Laurel Street, Tampa, Hillsborough County, FL

Operating room briefings and wrong-site surgery.

PubMed

Makary, Martin A; Mukherjee, Arnab; Sexton, J Bryan; Syin, Dora; Goodrich, Emmanuelle; Hartmann, Emily; Rowen, Lisa; Behrens, Drew C; Marohn, Michael; Pronovost, Peter J

2007-02-01

Wrong-site surgery can be a catastrophic event for a patient, caregiver, and institution. Although communication breakdowns have been identified as the leading cause of wrong-site surgery, the efficacy of preventive strategies remains unknown. This study evaluated the impact of operating room briefings on coordination of care and risk for wrong-site surgery. We administered a case-based version of the Safety Attitudes Questionnaire (SAQ) to operating room (OR) staff at an academic medical center, before and after initiation of an OR briefing program. Items questioned overall coordination and awareness of the surgical site. Response options ranged from 1 (disagree strongly) to 5 (agree strongly). MANOVA was used to compare caregiver assessments before and after the implementation of briefings, and the percentage of OR staff agreeing or disagreeing with each question was reported. The prebriefing response rate was 85% (306 of 360 respondents), and the postbriefing response rate was 75% (116 of 154). Respondents included surgeons (34.9%), anesthesiologists (14.0%), and nurses (44.4%). Briefings were associated with caregiver perceptions of reduced risk for wrong-site surgery and improved collaboration [F (6,390)=10.15, p < 0.001]. Operating room caregiver assessments of briefing and wrong-site surgery issues improved for 5 of 6 items, eg, "Surgery and anesthesia worked together as a well-coordinated team" (67.9% agreed prebriefing, 91.5% agreed postbriefing, p < 0.0001), and "A preoperative discussion increased my awareness of the surgical site and side being operated on" (52.4% agreed prebriefing, 64.4% agreed postbriefing, p < 0.001). OR briefings significantly reduce perceived risk for wrong-site surgery and improve perceived collaboration among OR personnel.

V-ROOM: a virtual meeting system with intelligent structured summarisation

NASA Astrophysics Data System (ADS)

James, Anne E.; Nanos, Antonios G.; Thompson, Philip

2016-10-01

With the growth of virtual organisations and multinational companies, virtual collaboration tasks are becoming more important for employees. This paper describes the development of a virtual meeting system called V-ROOM. An exploration of facilities required in such a system has been conducted. The findings highlighted that intelligent systems are needed, especially since information that individuals have to know and process is vast. The survey results showed that meeting summarisation is one of the most important new features that should be added to virtual meeting systems for enterprises. This paper highlights the innovative methods employed in V-ROOM to produce relevant meeting summaries. V-ROOM's approach is compared to other methods from the literature, and it is shown how the use of metadata provided by parts of the V-ROOM system can improve the quality of summaries produced.

Pilot study of a sensory room in an acute inpatient psychiatric unit.

PubMed

Novak, Theresa; Scanlan, Justin; McCaul, Damien; MacDonald, Nathan; Clarke, Timothy

2012-10-01

The use of sensory rooms (also known as comfort rooms) to reduce seclusion rates has generated a great deal of interest. This study examined the outcomes associated with the introduction of a sensory room in an acute inpatient psychiatric unit. Consumers rated distress and staff rated a variety of disturbed behaviours before and after each use of the room. Items used during each episode were recorded. Use of the room was associated with significant reductions in distress and improvements in a range of disturbed behaviours. Those individuals who used the weighted blanket reported significantly greater reductions in distress and clinician-rated anxiety than those who did not. No changes were noted in rates of seclusion or aggression. The sensory room was an effective intervention to ameliorate distress and disturbed behaviour, although this did not translate into reductions in overall rates of seclusion or aggression. Weighted blankets appear to be particularly useful.

13. WEIGHING ROOM Fish were lifted up from tower by ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. WEIGHING ROOM Fish were lifted up from tower by conveyor, controlled by buttons above the two sets of vertical electrical conduits. They entered the weighing room through the shielded window on the left (shielding missing from the window on the right), were weighed and then transported to the holding tanks. - Hovden Cannery, 886 Cannery Row, Monterey, Monterey County, CA

8. Perimeter acquisition radar power plant room #211, battery equipment ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Perimeter acquisition radar power plant room #211, battery equipment room; showing battery racks. The dc power of these batteries is distributed to motor-control centers, the annunciator system, and fire alarm and tripping circuits - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Power Plant, In Limited Access Area, Southwest of PARB at end of Service Road B, Nekoma, Cavalier County, ND

Ornamental indoor plants in hospital rooms enhanced health outcomes of patients recovering from surgery.

PubMed

Park, Seong-Hyun; Mattson, Richard H

2009-09-01

Clinical trials have not been reported concerning the health benefits of viewing indoor plants on stress and recovery of surgical patients within a hospital setting. Using various medical and psychologic measurements, this study performed a randomized clinical trial with surgical patients to evaluate whether plants in hospital rooms have therapeutic influences. Ninety (90) patients recovering from a hemorrhoidectomy were randomly assigned to either control or plant rooms. With half the patients, live plants were placed in their rooms during postoperative recovery periods. Data collected for each patient included length of hospitalization, analgesics used for postoperative pain control, vital signs, ratings of pain intensity, pain distress, anxiety and fatigue, the State-Trait Anxiety Inventory Form Y-1, the Environmental Assessment Scale, and the Patient's Room Satisfaction Questionnaire. Viewing plants during the recovery period had a positive influence linking directly to health outcomes of surgical patients. Patients in hospital rooms with plants and flowers had significantly more positive physiologic responses evidenced by lower systolic blood pressure, and lower ratings of pain, anxiety, and fatigue than patients in the control room. Patients with plants also felt more positively about their rooms and evaluated them with higher satisfaction when compared with patients in similar rooms without plants. Based on patients' comments, plants brightened up the room environment, reduced stress, and also conveyed positive impressions of hospital employees caring for patients. Findings of this study confirmed the therapeutic value of plants in the hospital environment as a noninvasive, inexpensive, and effective complementary medicine for surgical patients. Health care professionals and hospital administrators need to consider the use of plants and flowers to enhance healing environments for patients.

[Domestic and family violence against women: a case-control study with victims treated in emergency rooms].

PubMed

Garcia, Leila Posenato; Duarte, Elisabeth Carmen; Freitas, Lúcia Rolim Santana de; Silva, Gabriela Drummond Marques da

2016-01-01

This study aimed to identify factors associated with treatment of victims of domestic and family violence in emergency rooms in Brazil. This is a case-control study based on the Surveillance System for Violence and Accidents (VIVA), 2011. Women ≥ 18 years who were victims of family and domestic violence were selected as cases and compared to accident victims (controls). Adjusted odds ratios were estimated by unconditional logistic regression. 623 cases and 10,120 controls were included. Risk factors according to the adjusted analysis were younger age (18-29 years), low schooling, lack of paid work, alcohol consumption, having sought treatment in a different health service, and violence on weekends or at night or in the early morning hours. The study concludes that domestic and family violence shows alcohol consumption as a strongly associated factor. Days and hours with the highest ocurrence reveal the need to adjust emergency services to treat victims.

30 CFR 57.4262 - Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms...

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Underground transformer stations, combustible... and Control Firefighting Equipment § 57.4262 Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. Transformer stations, storage...

30 CFR 57.4262 - Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Underground transformer stations, combustible... and Control Firefighting Equipment § 57.4262 Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. Transformer stations, storage...

30 CFR 57.4262 - Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms...

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Underground transformer stations, combustible... and Control Firefighting Equipment § 57.4262 Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. Transformer stations, storage...

30 CFR 57.4262 - Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms...

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Underground transformer stations, combustible... and Control Firefighting Equipment § 57.4262 Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. Transformer stations, storage...

30 CFR 57.4262 - Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Underground transformer stations, combustible... and Control Firefighting Equipment § 57.4262 Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. Transformer stations, storage...

17. Interior view of vestibule separating locker rooms, changing rooms ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. Interior view of vestibule separating locker rooms, changing rooms and restroom beyond; southwest corner of unoccupied portion; view to northwest. - Ellsworth Air Force Base, Mess & Administration Building, 2279 Risner Drive, Blackhawk, Meade County, SD

STS-127 Firing Room

NASA Image and Video Library

2009-07-11

NASA mission managers watch the latest weather radar on a monitor in Firing Room Four of the Launch Control Center at NASA's Kennedy Space Center in Cape Canaveral, Florida, Sunday, July 12, 2009. Endeavour is set to launch at 7:13p.m. EDT with the crew of STS-127 and start a 16-day mission that will feature five spacewalks and complete construction of the Japan Aerospace Exploration Agency's Kibo laboratory. Photo Credit: (NASA/Bill Ingalls)

STS-127 Firing Room

NASA Image and Video Library

2009-07-11

Bob Cabana, Director of NASA's Kennedy Space Center talks with other mission managers in Firing Room Four of the Launch Control Center at NASA's Kennedy Space Center in Cape Canaveral, Florida, Sunday, July 12, 2009. Endeavour is set to launch at 7:13p.m. EDT with the crew of STS-127 and start a 16-day mission that will feature five spacewalks and complete construction of the Japan Aerospace Exploration Agency's Kibo laboratory. Photo Credit: (NASA/Bill Ingalls)

Arbitrary helicity control of circularly polarized light from lateral-type spin-polarized light-emitting diodes at room temperature

NASA Astrophysics Data System (ADS)

Nishizawa, Nozomi; Aoyama, Masaki; Roca, Ronel C.; Nishibayashi, Kazuhiro; Munekata, Hiro

2018-05-01

We demonstrate arbitrary helicity control of circularly polarized light (CPL) emitted at room temperature from the cleaved side facet of a lateral-type spin-polarized light-emitting diode (spin-LED) with two ferromagnetic electrodes in an antiparallel magnetization configuration. Driving alternate currents through the two electrodes results in polarization switching of CPL with frequencies up to 100 kHz. Furthermore, tuning the current density ratio in the two electrodes enables manipulation of the degree of circular polarization. These results demonstrate arbitrary electrical control of polarization with high speed, which is required for the practical use of lateral-type spin-LEDs as monolithic CPL light sources.

The effect of preheated versus room-temperature skin disinfection on bacterial colonization during pacemaker device implantation: a randomized controlled non-inferiority trial.

PubMed

Wistrand, Camilla; Söderquist, Bo; Magnusson, Anders; Nilsson, Ulrica

2015-01-01

In clinical practice, patients who are awake often comment that cold surgical skin disinfectant is unpleasant. This is not only a problem of patients' experience; heat loss during the disinfection process is a problem that can result in hypothermia. Evidence for the efficacy of preheated disinfection is scarce. We tested whether preheated skin disinfectant was non-inferior to room-temperature skin disinfectant on reducing bacterial colonization during pacemaker implantation. This randomized, controlled, non-inferiority trial included 220 patients allocated to skin disinfection with preheated (36 °C) or room-temperature (20 °C) chlorhexidine solution in 70 % ethanol. Cultures were obtained by swabbing at 4 time-points; 1) before skin disinfection (skin surface), 2) after skin disinfection (skin surface), 3) after the incision (subcutaneously in the wound), and 4) before suturing (subcutaneously in the wound). The absolute difference in growth between patients treated with preheated versus room-temperature skin disinfectant was zero (90 % CI -0.101 to 0.101; preheated: 30 of 105 [28.6 %] vs. room-temperature: 32 of 112 [28.6 %]). The pre-specified margin for statistical non-inferiority in the protocol was set at 10 % for the preheated disinfectant. There were no significant differences between groups regarding SSIs three month postoperatively, which occurred in 0.9 % (1 of 108) treated with preheated and 1.8 % (2 of 112) treated with room-temperature skin disinfectant. Preheated skin disinfection is non-inferior to room-temperature disinfection in bacterial reduction. We therefore suggest that preheated skin disinfection become routine in clean surgery. The study is registered at ClinicalTrials.gov (NCTO2260479).

Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department

PubMed Central

Thomas, Anita A.; Uspal, Neil G.; Oron, Assaf P.; Klein, Eileen J.

2016-01-01

Background  Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. Objective  We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. Methods  Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians. Outcomes included JIT room use, trainee procedural confidence, and frequency of supervisor intervention during procedures. Results  Thirty-one of 32 supervising physicians (97%) and 122 of 186 residents (66%) completed the survey, with 71% of trainees reporting improved confidence, and 68% reporting improved procedural skills (P < .05, +1.4-point average skills improvement on a 5-point Likert scale). Trainees perceived no difference among supervising physicians intervening in procedures with or without JIT room use (P = .30, paired difference −0.0 points). Nearly all supervisors reported improved trainee procedural confidence, and 77% reported improved trainee procedural skills after JIT room use (P < .05, paired difference +1.8 points); 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared with 42% with JIT room use (P < .05, paired difference −0.4 points). Conclusions  Use of the JIT room led to improved trainee confidence and supervisor reports of less procedural intervention. Although it carries financial and time costs, an in situ JIT room may be important for convenient JIT training. PMID:28018542

Assessment of terminal cleaning in pediatric isolation rooms: Options for low-resource settings.

PubMed

Dramowski, Angela; Whitelaw, Andrew; Cotton, Mark F

2016-12-01

Few studies have evaluated terminal cleaning in low-resource settings. Adequacy of pediatric isolation room terminal cleaning was evaluated using quantitative bacterial surface cultures, ATP bioluminescence assays, and fluorescent high-touch surface markers at Tygerberg Children's Hospital in South Africa (August 1, 2014-October 31, 2015). Cleaning adequacy was assessed by comparing pre- and postcleaning measurements. Influence of verbal feedback was determined by comparing cleaners' first and subsequent cleaning episodes. Cleaning methods were compared for cost, time, and feasibility. Adequacy of terminal cleaning was evaluated in 25 isolation rooms after hospitalization for pulmonary tuberculosis (n = 13), respiratory (n = 5) and enteric viruses (n = 5), pertussis (n = 1), and methicillin-resistant Staphylococcus aureus (n = 1). Mean aerobic colony counts and mean ATP relative light units declined between pre- and postcleaning evaluations (39 ± 41 to 15 ± 30 [P < .001] and 72 ± 40 to 23 ± 11 [P < .001]). Fluorescent marker removal was initially poor, but improved significantly at subsequent cleaning episodes (17 out of 78 [22%] to 121 out of 198 [61%]; P < .001); mean aerobic colony counts and ATP values also declined significantly following feedback. Cost, time, and resources required for ATP and surface cultures far exceeded that required for fluorescent markers. Adequacy of isolation room cleaning improved following feedback to cleaning staff. Fluorescent markers are an inexpensive option for cleaning evaluation and training in low-resource settings. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Neural networks improve brain cancer detection with Raman spectroscopy in the presence of operating room light artifacts

NASA Astrophysics Data System (ADS)

Jermyn, Michael; Desroches, Joannie; Mercier, Jeanne; Tremblay, Marie-Andrée; St-Arnaud, Karl; Guiot, Marie-Christine; Petrecca, Kevin; Leblond, Frederic

2016-09-01