Science.gov

Sample records for wards zylna choroba

  1. [Interface ward round].

    PubMed

    Fischer, Martin Rudolf; Wölfel, Teresa; Schmidmaier, Ralf

    2016-01-01

    Ward rounds are the pivot point of the daily routine on internal medicine wards. They are crucial to the interprofessional team to inform the patient and his relatives, to gather new information as well as to plan further diagnostics, evaluation of prognosis and therapy. Furthermore, medical rounds provide an important setting for situational learning and reflection of alternatives of action in terms of evidence based medicine. The war round is a vital component of the patient-doctor communication and contributes strongly to patient safety. PMID:26710200

  2. Improving ward management.

    PubMed

    Walker, Hilary; Etches, Cheryl

    This article describes the development, implementation and evaluation of an audit process--the nursing annual audit review--to improve nursing management systems on wards in a large NHS foundation trust. It is set in the context of healthcare governance and improving the quality of services provided by healthcare organisations. PMID:17288355

  3. Publications Philip Ward

    E-print Network

    Ishida, Yuko

    , M., P. Ward, A. Moya, and F. J. Ayala. Natural populations of Trypanosoma cruzi, the agent of Chagas. Genetic relatedness and colony organization in a species complex of ponerine ants. I. Phenotypic. Genetic relatedness and colony organization in a species complex of ponerine ants. II. Patterns of sex

  4. 15. New York Connecting Railroad: Wards Island Viaduct. Wards Island, ...

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

    15. New York Connecting Railroad: Wards Island Viaduct. Wards Island, New York Co., NY. Sec. 4207, MP 7.65. - Northeast Railroad Corridor, Amtrak Route between New Jersey/New York & New York/Connecticut State Lines, New York, New York County, NY

  5. Teaching a 'good' ward round.

    PubMed

    Powell, Natalie; Bruce, Christopher G; Redfern, Oliver

    2015-04-01

    Ward rounds are a vital part of hospital medicine and junior doctors play a key role in their delivery. Despite the importance of ward rounds to patient care and experience, we believe that junior doctors may lack the training and skills to carry them out most effectively. We designed a simulation-based training session focusing on ward round skills themed to key patient safety issues and have delivered the training to over 100 learners (medical students and foundation year one doctors). Few learners had any prior training in ward rounds. The session was highly valued by all participants and surveys completed both before and after the session showed statistically significant improvements in confidence in leading and documenting ward rounds. In addition, 94% of final year medical students and 93% of doctors felt such training should be included in the undergraduate curriculum. We believe there is a current gap in training around ward round skills and would strongly encourage simulation-based ward round training to be developed for undergraduates. Further sessions following qualification may then consolidate and develop ward round skills adapted to the level of the doctor. PMID:25824064

  6. Fifth Ward Enrichment Program Mission

    E-print Network

    Aazhang, Behnaam

    Fifth Ward Enrichment Program Mission: To empower boys to become, mentor, and case-manage a maximum of 200 boys at five school sites. The School with teenage boys. Address: 4014 Market Street, Suite W145 Houston, Texas

  7. Flourishing Ethics Terrell Ward Bynum

    E-print Network

    De Montfort University

    Flourishing Ethics Terrell Ward Bynum Research Center on Computing & Society, Southern Connecticut a new ethical theory that has begun to coalesce from the works of several scholars in the international computer ethics community. I call the new theory `Flourishing Ethics' because of its Aristotelian roots

  8. Solution to the Ward identities for superamplitudes

    E-print Network

    Elvang, Henriette

    Supersymmetry and R-symmetry Ward identities relate on-shell amplitudes in a supersymmetric field theory. We solve these Ward identities for N [superscript K] MHV amplitudes of the maximally supersymmetric =4 and =8 theories. ...

  9. Safer Wards: reducing violence on older people's mental health wards

    PubMed Central

    Brown, Juliette; Fawzi, Waleed; McCarthy, Cathy; Stevenson, Carmel; Kwesi, Solomon; Joyce, Maggie; Dusoye, Jenny; Mohamudbucus, Yasin; Shah, Amar

    2015-01-01

    Through the Safer Wards project we aimed to reduce the number of incidents of physical violence on older people's mental health wards. This was done using quality improvement methods and supported by the Trust's extensive programme of quality improvement, including training provided by the Institute for Healthcare Improvement. Violence can be an indicator of unmet needs in this patient population, with a negative effect on patient care and staff morale. Reducing harm to patients and staff is a strategic aim of our Trust. We established a multi-disciplinary group who led on the project on each ward and used a Pareto diagram to establish the focus of our work. We established a dashboard of measures based on our incident reporting system Datix, including number of incidents of violence, days between incidents, days of staff sickness, days between staff injury, use of restraint, and use of rapid tranquilisation (the last two being balancing measures in the reduction of violence). Each team identified factors driving physical violence on the wards, under headings of unmet patient needs, staff needs and staff awareness, which included lack of activity and a safe and therapeutic environment. Using driver diagrams, we identified change ideas that included hourly rounding (proactive checks on patient well-being), the addition of sensory rooms, flexible leave for patients, and a structured activity programme. We also introduced exercise to music, therapeutic groups led by patients, and focused on discharge planning and pet therapy, each of which starting sequentially over the course of a one year period from late 2013 and subject to a cycle of iterative learning using PDSA methods. The specific aim was a 20% decrease in violent incidents on three wards in City and Hackney, and Newham. Following our interventions, days between violent incidents increased from an average of three to an average of six. Days between staff injury due to physical violence rose from an average of eight (one violent incident resulting in staff injury every eight days) to 22 (one incident every 22 days). Incidents of physical violence reduced from 63 in 2013 to 39 in 2014. We were also able to quantify reduced costs associated with reduction in violence. The success of this project in our view lay in the involvement of ward staff in understanding the problems and generating local solutions which were also broadly evidenced based. Patients were also closely involved in generating ideas. We are currently incorporating much of this work into routine practice in order to sustain improvement, as well as continuing to generate new ideas for further improvement while using the skills learnt in this process to address other problems. PMID:26734353

  10. Safer Wards: reducing violence on older people's mental health wards.

    PubMed

    Brown, Juliette; Fawzi, Waleed; McCarthy, Cathy; Stevenson, Carmel; Kwesi, Solomon; Joyce, Maggie; Dusoye, Jenny; Mohamudbucus, Yasin; Shah, Amar

    2015-01-01

    Through the Safer Wards project we aimed to reduce the number of incidents of physical violence on older people's mental health wards. This was done using quality improvement methods and supported by the Trust's extensive programme of quality improvement, including training provided by the Institute for Healthcare Improvement. Violence can be an indicator of unmet needs in this patient population, with a negative effect on patient care and staff morale. Reducing harm to patients and staff is a strategic aim of our Trust. We established a multi-disciplinary group who led on the project on each ward and used a Pareto diagram to establish the focus of our work. We established a dashboard of measures based on our incident reporting system Datix, including number of incidents of violence, days between incidents, days of staff sickness, days between staff injury, use of restraint, and use of rapid tranquilisation (the last two being balancing measures in the reduction of violence). Each team identified factors driving physical violence on the wards, under headings of unmet patient needs, staff needs and staff awareness, which included lack of activity and a safe and therapeutic environment. Using driver diagrams, we identified change ideas that included hourly rounding (proactive checks on patient well-being), the addition of sensory rooms, flexible leave for patients, and a structured activity programme. We also introduced exercise to music, therapeutic groups led by patients, and focused on discharge planning and pet therapy, each of which starting sequentially over the course of a one year period from late 2013 and subject to a cycle of iterative learning using PDSA methods. The specific aim was a 20% decrease in violent incidents on three wards in City and Hackney, and Newham. Following our interventions, days between violent incidents increased from an average of three to an average of six. Days between staff injury due to physical violence rose from an average of eight (one violent incident resulting in staff injury every eight days) to 22 (one incident every 22 days). Incidents of physical violence reduced from 63 in 2013 to 39 in 2014. We were also able to quantify reduced costs associated with reduction in violence. The success of this project in our view lay in the involvement of ward staff in understanding the problems and generating local solutions which were also broadly evidenced based. Patients were also closely involved in generating ideas. We are currently incorporating much of this work into routine practice in order to sustain improvement, as well as continuing to generate new ideas for further improvement while using the skills learnt in this process to address other problems. PMID:26734353

  11. Psychiatric wards: places of safety?

    PubMed

    Jones, J; Nolan, P; Bowers, L; Simpson, A; Whittington, R; Hackney, D; Bhui, K

    2010-03-01

    In recent years, the purpose and quality of provision delivered in acute inpatient psychiatric settings have been increasingly questioned. Studies from a service user perspective have reported that while some psychiatric inpatients feel safe and cared for, others feel their time in hospital is neither safe nor therapeutic. This paper explores the experiences of service users on acute inpatient psychiatric wards in England, with a particular focus on their feelings of safety and security. Interviews were conducted with 60 psychiatric inpatients in England. The majority of service users felt safe in hospital and felt supported by staff and other service users. However, anything that threatened their sense of security such as aggression, bullying, theft, racism and the use of alcohol and drugs on the ward, made some respondents feel insecure and unsafe. Psychiatric wards are still perceived by many as volatile environments, where service users feel forced to devise personal security strategies in order to protect themselves and their property. It would appear that there remains much to do before research findings and policies are implemented in ways that facilitate all service users to derive the maximum benefit from their inpatient experience. PMID:20465757

  12. Present use of five-day wards.

    PubMed Central

    Davies, R; Cliff, K S; Waters, W E

    1981-01-01

    A survey of five-day wards serving medical and surgical specialties indicated that 30 such units were operating in England in 1979. Six mixed surgical specialty, eight mixed specialty (medicine and surgery), four medical investigation, and 12 single specialty wards had opened since 1969. There was a varied, and often low, use of these wards. Nurse-staffing levels and allocation of operating theatre time also varied considerably. In busy wards nurse-staffing levels were high and access to operating theatre time reasonable. Medical investigation wards showed some of the highest levels of occupancy and throughput. The potential savings and service improvements that can result from five-day wards have yet to be realised on a wide scale. PMID:6788227

  13. 4GL ward management system.

    PubMed Central

    Brandejs, J. F.

    1991-01-01

    After many years of extensive research of computerized information systems for nursing, inpatient care, clinics and HMOs, laboratories, diagnostic imaging, pharmacy and other services, an integrated Ward Patient Management system was developed. A mature, relational data base management system (RDBMS) ORACLE was selected as the design tool. The system is running under VMS, DOS and UNIX operating systems and ORACLE version 6 on nearly all computer platforms, although multiprocessors are preferred. A host of potentials and pitfalls is associated with the implementation of this new approach to Patient Management. PMID:1807662

  14. PHOTOCOPY OF A 1942 ARCHITECTURAL DRAWING TITLED: "STANDARD WARD, WARDJH. ...

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

    PHOTOCOPY OF A 1942 ARCHITECTURAL DRAWING TITLED: "STANDARD WARD, WARD-J-H. FLOOR, FOUNDATION AND FRAMING PLANS." OCTOBER 31, 1942. - Madigan Hospital, Standard & Combination Wards, Bounded by Wilson & McKinley Avenues & Garfield & Lincoln Streets, Tacoma, Pierce County, WA

  15. Developing a general ward nursing dashboard.

    PubMed

    Russell, Margot; Hogg, Maggie; Leach, Stuart; Penman, Mags; Friel, Susan

    2014-12-15

    The seventh and final article in the series on Leading Better Care explores some of the challenges in clinical practice relating to the use of data and making information meaningful to senior charge nurses and ward sisters. It describes the collaborative approach taken by NHS Lanarkshire, which involved nursing staff, programme leads and the eHealth team in the development of a general ward nursing dashboard as a means of ensuring safe, effective person-centred care. The article also illustrates how this web-based data-reporting programme is used to support clinical practice. PMID:25492791

  16. Henry Ward Beecher: A Nation's Tribune.

    ERIC Educational Resources Information Center

    Chandler, Daniel Ross

    Henry Ward Beecher was America's most prominent 19th century liberal preacher and a major spokesperson for New England Transcendentalism. His philosophy integrated four fundamental themes: the creation of a moral code based on the internalization of values and peer group pressures, the establishment of the reform ideal of the impartial nonpartisan…

  17. [Quality of medication storage on hospital wards].

    PubMed

    Burnat, Pascal; Dupont, Hélène; Koch, Isabelle; Le Garlantezec, Patrick; Oulieu, Sylvie; Dussart, Claude

    2015-03-01

    In order to meet regulations and limit the risks for patients, the quality of medication storage on hospital wards requires practical actions. They concern mainly the management of the emergency medication cabinets, conditions regarding supply and cold storage under controlled temperatures. Failures in the system may result in nurses carrying out risky procedures. PMID:26145140

  18. A QUANTUM WARD CORRESPONDENCE 1. Introduction 1

    E-print Network

    Patnaik, Manish M.

    groups. While the theory of compact quantum groups has been well-studied from the point of view of ConnesA QUANTUM WARD CORRESPONDENCE CONTENTS 1. Introduction 1 2. Recollections from Noncommutative Algebraic Geometry 2 3. Quantum Twistor Geometry 4 4. Algebras of Exterior Differential Forms on Quantum

  19. "Ward v. Wilbanks": Counselor Educators Respond

    ERIC Educational Resources Information Center

    Burkholder, David; Hall, Stephanie F.; Burkholder, Jessica

    2014-01-01

    This article investigated 71 counselor educators' perspectives and pedagogical practices related to "Ward v. Wilbanks" (2009) and the American Counseling Association (ACA) response to the case. The authors used qualitative content analysis to identify 6 themes from survey data: (a) views on gatekeeping and student training; (b)…

  20. Dealing with Scabies in a Hospital Ward.

    PubMed

    Clavagnier, Isabelle

    2015-01-01

    A case of scabies has been diagnosed in the Medical Ward where Sophie works, and the hospital is having to take appropriate measures. Scabies mites can spread quickly, and staff who are in contact with the infected patient risk catching the parasites and contaminating their own family in turn. One of the night nurses is probably infected. PMID:26365648

  1. Lessons Learned Conducting User Studies in a Dialysis Ward

    E-print Network

    Connelly, Kay

    Lessons Learned Conducting User Studies in a Dialysis Ward Abstract In this paper, we describe lessons learned while conducting user studies in a dialysis ward. We learned that we must be more aware in a dialysis ward to help us develop an assistive system for dialysis patients to monitor their nutritional

  2. An epidemiological study of falls on integrated general medical wards.

    PubMed

    Vassallo, M; Azeem, T; Pirwani, M F; Sharma, J C; Allen, S C

    2000-12-01

    Reducing falls in hospital requires an environmental as well as a patient-orientated approach. We studied patient and ward characteristics relating to falls in an acute setting. In a prospective open observational study, we examined fall characteristics in two nuclear designed wards (A and B) and a longitudinal ward (C). We recorded 63 falls among 1609 patients. Ward C had the most falls (31 vs 18/14; p = 0.01), fall positive days (29 vs 15/10; p = 0.002) and fallers (27 vs 13/12; p = 0.001; OR 2.54, CI--1.41-4.57). Ward C had a higher cumulative risk of falls (p = 0.006) and fall positive days (p = 0.003). Choice of ward was a significant independent risk factor for falls (p = 0.01) when controlled for age, sex, and diagnostic variation between the wards. Most falls were intrinsic (A 66.7%, B 64.2%, C 61.3%, p = 0.45). A significantly higher proportion of falls on ward C occurred by the bed (p = 0.04). Significant differences exist between the wards, and fall reduction programmes should identify and compensate for adverse ward-related factors to increase the effectiveness of patient-targeted fall risk assessments. PMID:11221278

  3. Role of ultrasound in the labor ward.

    PubMed

    Barber, Miguel A; Gutierrez, Luisa; Plasencia, Walter; Valle, Leonor; Garcia-Hernandez, Jose A

    2010-08-01

    Intrapartum ultrasound is commonly used to evaluate fetal vitality, presentation and status as well as placental location. Health professionals are increasingly using intrapartum ultrasound for advanced applications that have not yet been shown to be effective by controlled research studies, using advanced ultrasound technologies such as bi-dimensional ultrasound, color ultrasound, pulsed Doppler ultrasound and three-dimensional ultrasound. This article reviews the current applications of intrapartum ultrasound and considers which advanced technologies can add to the standard of care in the delivery ward. PMID:20370328

  4. 18. View looking NE up corridor showing Wards Island Viaduct ...

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

    18. View looking NE up corridor showing Wards Island Viaduct in foreground and Randalls Island Viaduct in background. Wards Island, New York Co., NY. Sec. 4207, MP 8.02. - Northeast Railroad Corridor, Amtrak Route between New Jersey/New York & New York/Connecticut State Lines, New York, New York County, NY

  5. 2. STREETSCAPE SHOWING NORTH ENDS OF STANDARD AND COMBINATION WARDS ...

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

    2. STREETSCAPE SHOWING NORTH ENDS OF STANDARD AND COMBINATION WARDS ON RAMP NO. 4. ON LEFT IS BUILDING NO. 9952-B, FOLLOWED BY THE B (NORTH) SIDES OF BUILDING NOS. 9953-9958. - Madigan Hospital, Standard & Combination Wards, Bounded by Wilson & McKinley Avenues & Garfield & Lincoln Streets, Tacoma, Pierce County, WA

  6. 1. STREETSCAPE WITH THE SOUTH ENDS OF STANDARD WARDS ON ...

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

    1. STREETSCAPE WITH THE SOUTH ENDS OF STANDARD WARDS ON RAMP NO. 4 ON WEST SIDE OF COMPLEX. CAMERA IS POINTED NORTHWEST. IN RIGHT FOREGROUND IN BUILDING NO. 9930-A, FOLLOWED BY THE A (SOUTH) SIDES OF BUILDING NOS. 9931-9937. - Madigan Hospital, Standard & Combination Wards, Bounded by Wilson & McKinley Avenues & Garfield & Lincoln Streets, Tacoma, Pierce County, WA

  7. Broadband Microphone Arrays for Speech Acquisition Darren B. Ward

    E-print Network

    Botea, Adi

    : Darren Ward Room 2C-545 Bell Labs 600 Mountain Ave Murray Hill, NJ 07974 USA Phone: +1-908-582-5601 FaxBroadband Microphone Arrays for Speech Acquisition Darren B. Ward Acoustics and Speech Research Dept. Bell Labs, Lucent Technologies Murray Hill, NJ 07974, USA Robert C. Williamson Dept

  8. Subjective odour levels in an air - conditioned hospital ward.

    PubMed

    Rae, A; Smith, R M

    1976-03-01

    Tests were carried out in an experimental air-conditioned hospital ward to determine what effect the mechanical ventilation and recirculation rates had on subjective odour levels in the ward. Odour conditions in the ward were not found to deteriorate with decreasing mechanical ventilation rate or increasing recirculation rate, but to fall into two distinct categories, which have been termed 'Acute' and 'Intermittent Background' conditions. 'Acute' conditions, where a particularly foul malodour prevailed in one or more rooms of the ward, were a rarity in the experimental general surgical ward; they occurred only twice during the testing period of approximately two years, and the mechanical ventilation rates tested were incapable of dealing with them. 'Intermittent Background' conditions, which are not attributable to a general prevailing odour level but rather to specific low level odour producing events, were satisfactory even under the most extreme test condition of three mechanical air changes per hour and 80% recirculation. PMID:15677196

  9. Improving fluid balance monitoring on the wards

    PubMed Central

    Jeyapala, Sobanakumari; Gerth, Alice; Patel, Aarti; Syed, Nazia

    2015-01-01

    Clinical experience and nursing metrics have consistently identified poor documentation of fluid balance monitoring at Milton Keynes University Hospital, compromising patient safety and quality of care. This project aimed to increase the percentage of fluid balance charts correctly completed on the wards. Three areas for improvement were identified: understanding the importance of good fluid balance monitoring, correct identification of patients requiring monitoring, and ease of completion of fluid balance charts. Three interventions were deployed on two acute medical awards in consecutive cycles; 1) small group education for staff, 2) creation of board magnets to aid the multidisciplinary team to identify patients requiring monitoring, 3) modification of the current fluid balance chart. Questionnaires were utilised to highlight improvements with current charts and measured staff awareness pre and post education. Each intervention was implemented for one week followed by daily surveys for four days to monitor compliance. Initial results showed a range of 6-12 charts used daily per ward. Of these 0-45% of them were correctly filled. Post education there was a reduced number of inappropriate charts. Introduction of board magnets improved correlation between doctors and nurses in identification of patients (52% before, 77% after magnets). Following modification there was a subjective improvement in the quality of chart completion. This study highlighted that understanding and use of fluid balance monitoring can be improved for nurses, health care assistants (HCAs), and doctors. These improvements allow better documentation and safer patient care. As a result, Milton Keynes University Hospital is investing in magnets and modified charts for a Trust-wide pilot.

  10. Developing a ward round checklist to improve patient safety

    PubMed Central

    Hale, Gordon; McNab, Duncan

    2015-01-01

    Checklists have been shown to improve care and reduce morbidity and mortality in the healthcare setting.[1] Their application in safety-critical industries outside of medicine continues to offer a strong argument for their application to medicine.[2] The daily in-patient medical ward round is a complex process and includes multiple potential risks to patient safety. This project aims to evaluate the effectiveness of a ward round review checklist on one general medical ward in a district general hospital in the UK. A baseline audit was performed, examining case-notes for a set of pre-defined outcome measures relevant to patient safety. Compliance with documentation of each outcome measure was assessed prior to the introduction of a ward round checklist. This was followed by a quality improvement project through the use of PDSA cycles, with the aim of introducing and developing a ward round checklist over a nine month period. Following the introduction of a checklist, overall compliance with documentation of each outcome measure improved from 45% to 89%. In conclusion, a quality improvement project involving the introduction of a ward round checklist for daily use has resulted in improved documentation of outcome measures that are relevant to patient safety. Teamwork and leadership skills from clinicians committed to improving patient safety is essential to sustaining improvements in traditional ward round practice.

  11. Los Angeles County Poor Farm, Patient Ward Nos. 210 & ...

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

    Los Angeles County Poor Farm, Patient Ward Nos. 210 & 211 - Type B Plan, 7601 Imperial Highway; bounded by Esperanza Street, Laurel Street, Flores Street, and Descanso Street, Downey, Los Angeles County, CA

  12. Elevation of north facades of #156158 (triple wards) National ...

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

    Elevation of north facades of #156-158 (triple wards) - National Home for Disabled Volunteer Soldiers, Pacific Branch, Mental Health Buildings, 11301 Wilshire Boulevard, West Los Angeles, Los Angeles County, CA

  13. Los Angeles County Poor Farm, Patient Wards 201, 202, 203, ...

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

    Los Angeles County Poor Farm, Patient Wards 201, 202, 203, 204, 205, 206, 207, 208 & 209 - Type A Plan, 7601 Imperial Highway; bounded by Esperanza Street, Hawthorn Avenue, Laurel Street, and Descanso Street, Downey, Los Angeles County, CA

  14. B Vitamin May Help Ward Off Some Skin Cancers

    MedlinePLUS

    ... nih.gov/medlineplus/news/fullstory_155264.html B Vitamin May Help Ward Off Some Skin Cancers Study ... 2015 (HealthDay News) -- A cheap and readily available vitamin supplement appears to reduce a person's risk of ...

  15. 16. BUILDING 1049, SECOND FLOOR WARD WITH CUBICLE ADDITIONS. ...

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

    16. BUILDING 1049, SECOND FLOOR WARD WITH CUBICLE ADDITIONS. - Presidio of San Francisco, Letterman General Hospital, Building No. 12, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  16. 15. BUILDING 1049, SECOND FLOOR HALLWAY LOOK SOUTH FROM WARD. ...

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

    15. BUILDING 1049, SECOND FLOOR HALLWAY LOOK SOUTH FROM WARD. - Presidio of San Francisco, Letterman General Hospital, Building No. 12, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  17. 14. BUILDING 1049, SECOND FLOOR HALLWAY LOOKING NORTH INTO WARD. ...

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

    14. BUILDING 1049, SECOND FLOOR HALLWAY LOOKING NORTH INTO WARD. - Presidio of San Francisco, Letterman General Hospital, Building No. 12, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  18. Environmentalism in American Pedagogy: The Legacy of Lester Ward.

    ERIC Educational Resources Information Center

    Tanner, Laurel N.; Tanner, Daniel

    1987-01-01

    A review is presented of the legacy of Lester Frank Ward, widely recognized as the architect of environmentalism in American pedagogy and the creator of some of the most fundamental ideas about American curriculum. (CB)

  19. Ward rounds are an essential component of good basic care.

    PubMed

    Smith, Joan

    2015-01-27

    In my day, we called intentional rounding 'ward rounds' or 'the back round'. It puzzles me that the prime minister is championing a £450,000 study to see if they lead to better care (News December 17). PMID:25605106

  20. Word Association Norms, Mutual Information, and Lexicography Kenneth Ward Church

    E-print Network

    Word Association Norms, Mutual Information, and Lexicography Kenneth Ward Church Bell Laboratories Murray Hill, N.J. Patrick Hanks CoLlins Publishers Glasgow, Scotland Abstract The term word assaciation

  1. Why patients need leaders: introducing a ward safety checklist

    PubMed Central

    Amin, Yogen; Grewcock, Dave; Andrews, Steve; Halligan, Aidan

    2012-01-01

    The safety and consistency of the care given to hospital inpatients has recently become a particular political and public concern. The traditional ‘ward round’ presents an obvious opportunity for systematically and collectively ensuring that proper standards of care are being achieved for individual patients. This paper describes the design and implementation of a ‘ward safety checklist’ that defines a set of potential risk factors that should be checked on a daily basis, and offers multidisciplinary teams a number of prompts for sharing and clarifying information between themselves, and with the patient, during a round. The concept of the checklist and the desire to improve ward rounds were well received in many teams, but the barriers to adoption were informative about the current culture on many inpatient wards. Although the ‘multidisciplinary ward round’ is widely accepted as good practice, the medical and nursing staff in many teams are failing to coordinate their workloads well enough to make multidisciplinary rounds a working reality. ‘Nursing’ and ‘medical’ care on the ward have become ‘de-coupled’ and the potential consequences for patient safety and good communication are largely self-evident. This problem is further complicated by a medical culture which values the primacy of clinical autonomy and as a result can be resistant to perceived attempts to ‘systematize’ medical care through instruments such as checklists. PMID:22977047

  2. Why patients need leaders: introducing a ward safety checklist.

    PubMed

    Amin, Yogen; Grewcock, Dave; Andrews, Steve; Halligan, Aidan

    2012-09-01

    The safety and consistency of the care given to hospital inpatients has recently become a particular political and public concern. The traditional 'ward round' presents an obvious opportunity for systematically and collectively ensuring that proper standards of care are being achieved for individual patients. This paper describes the design and implementation of a 'ward safety checklist' that defines a set of potential risk factors that should be checked on a daily basis, and offers multidisciplinary teams a number of prompts for sharing and clarifying information between themselves, and with the patient, during a round. The concept of the checklist and the desire to improve ward rounds were well received in many teams, but the barriers to adoption were informative about the current culture on many inpatient wards. Although the 'multidisciplinary ward round' is widely accepted as good practice, the medical and nursing staff in many teams are failing to coordinate their workloads well enough to make multidisciplinary rounds a working reality. 'Nursing' and 'medical' care on the ward have become 'de-coupled' and the potential consequences for patient safety and good communication are largely self-evident. This problem is further complicated by a medical culture which values the primacy of clinical autonomy and as a result can be resistant to perceived attempts to 'systematize' medical care through instruments such as checklists. PMID:22977047

  3. Stress Among Iranian Nurses in Critical Wards

    PubMed Central

    Hashemian, Seyed Mohammad Reza; Farzanegan, Behrooz; Fathi, Mohammad; Ardehali, Seyed Hossein; Vahedian-Azimi, Amir; Asghari-Jafarabadi, Mohammad; Hajiesmaeili, Mohammadreza

    2015-01-01

    Background: Stress has been recognized as a significant psychosocial and physiologic component in educational and practical processes. Objectives: The purpose of present study was to survey stress among Iranian nurses in critical wards. Patients and Methods: In this cross-sectional study, 3643 anonymous questionnaires were disseminated among nurses in different hospitals in Tehran, Iran, by utilizing multistage random sampling. The questionnaire consisted of two sections: demographic characteristics and a 22-item list on a five-point Likert scale. The association of variables with stress was evaluated using hierarchical logistic regression. Results: A total of 3043 completed questionnaires were completed and returned (response rate, 83.53%). Age (> 33 years, 1571 (51.63%); < 33 years old, 1472 (48.37%)), marital status (single, 188 (6.18%); married, 2685 (88.24%); and widow, 170 (5.59%)), working shift (morning, 605 (19.88%); evening, 631 (20.74%); night, 603 (19.82%); and rotation, 1204 (39.57%)), and the years of experience of nurses (1 - 5 years, 413 (13.57%); 6 - 10 years, 589 (19.36%); 11 - 15 years, 832 (27.34%); 16 - 20 years, 758 (24.91%); and 21-25 years, 451 (14.82%)) had significant association with the level of stress (P < 0.05 for all parameters). However, sex (male, 937 (30.79%); and female, 2106 (69.21%)), education (associate, 444 (14.59%); baccalaureate, 2250 (73.94%); and master, 349 (11.47%)), and body mass index (> 24.6 kg/m2, 2514 (49.75%); and < 24.6 kg/m2, 1529 (50.25%)) showed no significant association with the level of stress (P > 0.05 for all parameters). Conclusions: Considering the personal and background characteristics of personnel and understanding their association with stress and stressful situations encompasses the ability to persevere and adapt to contextual stressors. PMID:26380798

  4. Pharmacognostic standardization of Turnera aphrodisiaca Ward.

    PubMed

    Kumar, Suresh; Taneja, Ruchi; Sharma, Anupam

    2006-01-01

    Turnera aphrodisiaca Ward (Turneraceae) has been used traditionally as an aphrodisiac, stimulant, nerve tonic, and laxative and in kidney, menstrual, and pregnancy disorders. Despite a long tradition of use in the treatment of various ailments, no systematic phytochemical and pharmacological work has ever been carried out on T. aphrodisiaca. The authors suggest that the major stumbling block in systematic exploration of the plant is non-availability of authentic plant material. In the present investigation, various pharmacognostic standards for the plant have been generated so that authentic T. aphrodisiaca could be explored for its traditional claims. Microscopically, T. aphrodisiaca leaf showed the presence of abundant unicellular, warty, non-glandular trichomes, anomocytic stomata, and a large number of calcium oxalate crystals along the veins. Powdered stem of the plant showed lignified spiral and pitted tracheidal vessels, and pericyclic fibers were observed in powder microscopy of stem. Total ash of the aerial parts of T. aphrodisiaca was approximately eight and four times more than acid-insoluble and water-soluble ash, respectively. The water-soluble extractive value of the plant was slightly higher than its ethanol-soluble extractive value. Volatile oil content of T. aphrodisiaca was found to be 0.44% (wt/vol), the thin-layer chromatography of which exhibited seven spots using toluene:ethyl acetate (93:7 vol/vol) as mobile phase. Thin-layer chromatography of the petroleum ether extract showed nine spots using hexane:dichloromethane (1:1 vol/vol), while the chloroform extract showed 11 spots using toluene:ethyl acetate:glacial acetic acid (35:4:1 by volume). Phytochemically, the plant was found to contain alkaloids, cyanogenic glycosides, steroids, saponins, flavonoids, tannins, carbohydrates, and proteins. PMID:16822212

  5. Hypoglycaemia monitoring in a medical receiving ward

    PubMed Central

    Ellis, Ryan

    2015-01-01

    It has been suggested that current care for diabetes inpatients remains inadequate and that greater attention is required for high quality management. In this project the aspect of hypoglycaemia was studied in a busy medical receiving ward at the Glasgow Royal Infirmary. A large proportion of inpatients have diabetes and episodes of hypoglycaemia experienced by this population can delay discharge and indeed be detrimental to health. Thus it is important from both an organisational and patient perspective to manage this population well. In this project BM machine data was analysed to identify patients who were hypoglycaemic. These patients were then tracked down to study the subsequent management and compared this against recommended guidance. Following this an intervention was made to promote identification, management, documentation, and prevention of hypoglycaemia. This was deliberately a simple intervention involving discussions with staff and provision of basic documented guidance next to every BM machine. In the first phase 17 patients were identified and in a second and third phase 16 patients each time were further identified. Patients in the study were both type 1 and type 2 diabetics. Initial results in phase I were compared to results in phase II and III respectively. This intervention produced significant improvements in management with correct monitoring of low BMs (i.e. upon identification of low BM repeat within 1 hour) improving from 47% to 100% (for Phase II and III). Also, recording of preventative measures of hypoglycaemia improved from 35% to 88% and 94% with an improvement from 24% to 69% and 75% in recording of treatment given if needed. In conclusion, the study successfully demonstrated that simple measures can significantly improve the quality care of inpatient diabetic patients in relation to hypoglycaemia management.

  6. Sexual dysfunctions in the patients hospitalized in psychiatric wards compared to other specialized wards in Isfahan, Iran, in 2012

    PubMed Central

    Ahmadzadeh, Gholamhossain; Shahin, Ali

    2015-01-01

    Background: Having pleasurable sexual intercourses plays a major role in marital life satisfaction. Many of the medical and psychiatric disorders may affect the sexual function of the patients. The present study aims to investigate the relative frequency of sexual dysfunctions in the patients hospitalized in psychiatric wards and that of the patients in other specialized wards. Materials and Methods: This study is a descriptive-analytical, cross-sectional one, carried out on 900 patients hospitalized in psychiatric, cardiac, orthopedic, ophthalmology, and dermatology and plastic surgery wards of 5 hospitals in Isfahan. Data collection tools included demographic questionnaire and Arizona Sexual Experiences Scale (ASEX). Results: Sexual dysfunction in the patients hospitalized in psychiatric wards (38%) was significantly higher than in the patients in other wards (27%), (P = 0.00). Among the patients hospitalized in psychiatric wards, those with bipolar disorder (37.3%) had the highest prevalence rate of sexual dysfunction. The patients with schizophrenia, major depression, substance abuse, and anxiety disorders had the following rates respectively. Among the patients in non-psychiatric wards, those in cardiac wards (37.1%) had the highest prevalence rate of sexual dysfunction. There was a significant relationship between the drug uses, mostly psychiatric drugs especially anti-psychotics, and the occurrence of sexual dysfunction. Conclusion: Considering the significant relative frequency of sexual dysfunction in psychiatric patients and undesired effects of simultaneous occurrence of both of these disorders in the patients, more emphasis is recommended to be placed on the prevention and proper treatment of these disorders in the patients. PMID:26623400

  7. Ward Valley status report: Science versus politics. Which will win?

    SciTech Connect

    Pasternak, A.D.

    1996-10-01

    The State of California has issued a license to US Ecology, Inc. to construct and operate a disposal facility for low-level radioactive waste (LLRW) at the remote, arid Ward Valley site in the Mojave Desert. The license and certification of the associated environmental documentation have been upheld by the California courts. The Ward Valley license is the first and, so far, only license to be issued for a new LLRW disposal facility pursuant to the Low-Level Radioactive Waste Policy Act enacted in 1980 and amended in 1985. However, the dates of construction and operation of the disposal facility are uncertain because the federal government has refused to sell land in Ward Valley to the State of California for the site of the Southwestern Compact`s regional disposal facility. The Clinton Administration`s repeated excuses for delaying the land transfer, and the circumstances of these delays, indicate that prospects for success of the Ward Valley project, and perhaps the Policy Act itself, depend on the outcome of a battle between science and politics. In view of these delays by the administration, Congressional action to Transfer the Ward Valley lands to California will serve both state and federal goals for safe disposal of LLRW.

  8. Creating a simulated Mental Health Ward: lessons learned.

    PubMed

    Rossetti, Jeanette; Musker, Kathleen; Smyth, Siobhan; Byrne, Evelyn; Maney, Catherine; Selig, Kristen; Jones-Bendel, Trish

    2014-10-01

    The future of psychiatric-mental health nursing depends on the preparation of nurses who will meet the mental health care needs of society. The current article discusses the development of the "Mental Health Ward," a simulated mental health experience that was offered for the first time to undergraduate baccalaureate nursing students at a Midwestern university in the United States. The Mental Health Ward is an innovative simulated hospital environment that includes the use of standardized patients and role play scenarios, resulting in a full mission simulation whereby students learn various psychiatric diagnoses and practice various pertinent skills, including nursing assessments, admission and discharge processes, medication administration, and therapeutic communication. Lessons learned by faculty and students in formulating the Mental Health Ward are presented. PMID:25207558

  9. Ward rounds: the next focus for quality improvement?

    PubMed

    Bradfield, Owen M

    2010-05-01

    The Garling Report, published in November 2008, was a public inquiry into the provision and governance of Acute Care Services in New South Wales Public Hospitals. Garling's 139 recommendations, aimed at modernising clinical care and equipment, include better supervision of junior staff, multidisciplinary teamwork, structured clinical handover and improved culture within health services. Garling also made specific recommendations about ward rounds, arguing that they should be daily, supervised and multidisciplinary. Given the importance of ward rounds in planning and evaluating treatment, implementation of these recommendations will require further evidence, engagement of senior clinicians and cultural change. This article discusses some of the barriers to Garling's recommendations. PMID:20497732

  10. 14. Photocopy of ca. 1891 rendering of Receiving Ward, built ...

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

    14. Photocopy of ca. 1891 rendering of Receiving Ward, built at west end 1892-94. Designed by George W. Hewitt and his brother, William D. Hewitt of Philadelphia. - Hospital of Protestant Episcopal Church in Philadelphia, Front Street & Lehigh Avenue, Philadelphia, Philadelphia County, PA

  11. 19. View of southeast corner of East Ward Street and ...

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

    19. View of southeast corner of East Ward Street and South McDonald Avenue, facing southeast. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  12. 13. View of south side of East Ward Street east ...

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

    13. View of south side of East Ward Street east of Sibett Avenue, facing southwest. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  13. 4. View of north side of East Ward Street west ...

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

    4. View of north side of East Ward Street west of Dewey Avenue, facing northeast. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  14. 1. View of north side of East Ward Street west ...

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

    1. View of north side of East Ward Street west of North Coweta Avenue, facing northwest. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  15. 2. View of north side of East Ward Street east ...

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

    2. View of north side of East Ward Street east of North Coweta Avenue, facing northeast. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  16. 3. View of north side of East Ward Street midblock ...

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

    3. View of north side of East Ward Street midblock between North Coweta Avenue and Dewey Avenue. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  17. 21. View of south side of East Ward Street midblock ...

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

    21. View of south side of East Ward Street midblock between South McDonald Avenue and Fales Avenue, facing southeast. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  18. 14. View of southwest corner of East Ward Street and ...

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

    14. View of southwest corner of East Ward Street and South McDonald Avenue, facing southwest. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  19. 5. View of northwest corner of East Ward Street and ...

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

    5. View of northwest corner of East Ward Street and Dewey Avenue, facing northwest. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  20. 8. View of south side of East Ward Street midblock ...

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

    8. View of south side of East Ward Street midblock between South Coweta Avenue and Sibett Avenue, facing southwest. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  1. 12. View of south side of East Ward Street west ...

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

    12. View of south side of East Ward Street west of Sibett Avenue, facing southwest. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  2. 7. View of south side of East Ward Street east ...

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

    7. View of south side of East Ward Street east of South Coweta Avenue, facing southwest. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  3. 10. View of north side of East Ward Street midblock ...

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

    10. View of north side of East Ward Street midblock between Dewey Avenue and North McDonald Avenue, facing northeast. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  4. 6. Views of southeast corner of East Ward Street and ...

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

    6. Views of southeast corner of East Ward Street and South Coweta Avenue, facing southeast. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  5. 17. View of north side of East Ward Street east ...

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

    17. View of north side of East Ward Street east of North McDonald Avenue, facing northwest. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  6. 11. View of north side of East Ward Street midblock ...

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

    11. View of north side of East Ward Street midblock between Dewey AVenue and North McDonald Avenue, facing northeast. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  7. 15. View of north side of East Ward Street at ...

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

    15. View of north side of East Ward Street at the intersection with North McDonald Avenue, facing northeast. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  8. 16. View of northeast corner of East Ward Street and ...

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

    16. View of northeast corner of East Ward Street and North McDonald Avenue, facing northeast. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  9. 18. View of north side of East Ward Street at ...

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

    18. View of north side of East Ward Street at the intersection with North Dart Street, facing northwest. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  10. 20. View of south side of East Ward Street east ...

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

    20. View of south side of East Ward Street east of South McDonald Avenue, facing southeast. - Gaskin Avenue Neighborhood, Bounded by Dart Street to east, CSX Railroad to south, Pearl & Madison Avenues to west, & Wilson & Gordon Streets to north, Douglas, Coffee County, GA

  11. (Pluri)harmonic morphisms and the Penrose-Ward transform

    E-print Network

    Radu Pantilie

    2015-03-09

    We show that, in quaternionic geometry, the Ward transform is a manifestation of the functoriality of the basic correspondence between the $\\rho$-quaternionic manifolds and their twistor spaces. We apply this fact, together with the Penrose transform, to obtain existence results for hypercomplex manifolds and for harmonic morphisms from hyper-Kaehler manifolds.

  12. 17. New York Connecting Railroad: Little Hell Gate Bridge. Wards ...

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

    17. New York Connecting Railroad: Little Hell Gate Bridge. Wards Island, New York Co., NY. Sec. 4207, MP 8.02. - Northeast Railroad Corridor, Amtrak Route between New Jersey/New York & New York/Connecticut State Lines, New York, New York County, NY

  13. Families' views on ward rounds in neonatal units

    PubMed Central

    Bramwell, R; Weindling, M; t for

    2005-01-01

    Objective: To discover parental preferences about visiting during ward rounds. Design: Survey using a short structured interview Setting and participants: Families of babies cared for in a regional neonatal intensive care unit. Results: Eighty six respondents, no refusals. Sixty three had visited during a ward round, and 13 had come in especially for the round. About half had overheard conversations about other babies or thought discussions about their baby had been overheard. Concerns about these experiences were only expressed by respondents who had actually experienced overhearing. Parents and families had little information about the ward round, held diverse views, and expressed different priorities. They described a mixture of concerns about communication, practicalities, and issues of ethics and principle. Confidentiality was a matter of concern for some, but many parents expected some sharing of information between families on the unit. Conclusions: Units should consider: the information they have for parents about ward rounds; the possibility that consultations may be overheard; the opportunities for parents to communicate with the clinical team. PMID:16113156

  14. TILTING SATURN. I. ANALYTIC MODEL William R. Ward

    E-print Network

    Hamilton, Douglas P.

    TILTING SATURN. I. ANALYTIC MODEL William R. Ward Department of Space Studies, Southwest Research@astro.umd.edu Receivved 2003 December 30; accepted 2004 July 15 ABSTRACT The tilt of Saturn's spin axis to its orbit plane to gravitational perturbations of Saturn by the planet Neptune. A similarity between the precession period

  15. WARD L. LAMBERT GYMNASIUM (LAMB) BUILDING EMERGENCY PLAN

    E-print Network

    Pittendrigh, Barry

    WARD L. LAMBERT GYMNASIUM (LAMB) BUILDING EMERGENCY PLAN **A hardcopy of the LAMB BEP is available Address jonl@purdue.edu Office/Room Number LAMB 9B Facility Manager, if applicable Name Jon T Laswell Phone Number 765-337-3229 Email Address jonl@purdue.edu Office/Room Number LAMB 9B Safety Manager if ap

  16. DNS Zones Revisited Ward van Wanrooij, Aiko Pras

    E-print Network

    Pras, Aiko

    DNS Zones Revisited Ward van Wanrooij, Aiko Pras Abstract - Recent research suggests that, due investigates the correct configuration of DNS zones, by checking if main configuration requirements, recommendations and best- practices rules have been followed. Our research shows that almost one out of four zones

  17. 20. West Elevation and Section, Ward 'K', Letterman General Hospital, ...

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

    20. West Elevation and Section, Ward 'K', Letterman General Hospital, Presidio of San Francisco, Cal. Sheet No. 2. May 1917. BUILDING 1049. - Presidio of San Francisco, Letterman General Hospital, Building No. 12, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  18. 19. First and Second Floors. Ward 'K', Letterman General Hospital, ...

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

    19. First and Second Floors. Ward 'K', Letterman General Hospital, Presidio of San Francisco, Cal. Sheet No. 1. May 1917. BUILDING 1049. - Presidio of San Francisco, Letterman General Hospital, Building No. 12, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  19. How many species of prokaryotes are there? Bess B. Ward*

    E-print Network

    Ward, Bess

    Commentary How many species of prokaryotes are there? Bess B. Ward* Geosciences Department, Princeton University, Princeton, NJ 08544 The microorganisms classified in the two prokaryotic domains of prokaryotes. Less than 30 years ago, the answer to the even more fundamental question ``How many individuals

  20. Power Systems Engineering Research Center Dennis Ray Ward Jewell

    E-print Network

    Power Systems Engineering Research Center Dennis Ray Ward Jewell Executive Director, Power Systems-Learjet Fellow Madison, WI 53706-1691 Director, Power Quality Laboratory djray@engr.wisc.edu Wichita State an overview of the Power Systems Engineering Research Center (PSERC), a National Science Foundation Industry

  1. Voice Activation of a Robotic VehicleVoice Activation of a Robotic Vehicle Dornesia WardDornesia Ward

    E-print Network

    Gray, Jeffrey G.

    to control a Lego Mindstorms NXT robot. The b t' t i t ll d th h th t i i f i d OBJECTIVES This project-based operating system for LeGO Mindstorms platforms. 3 5 The robot is a product of LEGO. The LEGO Mindstorms NXTVoice Activation of a Robotic VehicleVoice Activation of a Robotic Vehicle Dornesia Ward

  2. Youth Health Coordinating Council Ward 8 Secret Health Clinic Shopper Report

    ERIC Educational Resources Information Center

    Behrens, Donna

    2010-01-01

    There are over 70,000 residents in Ward 8, the poorest area of Washington, DC and along with Ward 7, it's most geographically remote. Approximately 36% of the Ward 8 population consists of children and youth, 18 years or younger. Children in the District of Columbia are at greater risk for poorer health and life outcomes than children in other…

  3. 78 FR 14543 - Ward Transformer Superfund Site; Raleigh, Wake County, NC; Notice of Settlement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... AGENCY Ward Transformer Superfund Site; Raleigh, Wake County, NC; Notice of Settlement AGENCY... Agency has entered into a settlement at the Ward Transformer Superfund Site located in Raleigh, Wake... EPA Region 4 contact Ms. Paula V. Painter. Submit your comments by Site name Ward...

  4. 75 FR 81269 - Ward Transformer Superfund Site Raleigh, Wake County, NC; Notice of Settlements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... AGENCY Ward Transformer Superfund Site Raleigh, Wake County, NC; Notice of Settlements AGENCY... Ward Transformer Superfund Site located in Raleigh, Wake County, North Carolina for publication. DATES... your comments, identified by Docket ID No. EPA-RO4- SFUND-2010-1053 or Site name Ward...

  5. A system of air recirculation and antibacterial surface treatment in a surgical ward

    PubMed Central

    Ayliffe, G. A. J.; Beard, M. A.; Filbey, J.

    1962-01-01

    A system of surface treatment with an antibacterial agent and air recirculation through treated filters was set up in a 15-bedded surgical ward, using an adjacent 10-bedded ward as a control. Nasal, wound, and urinary cross-infection was studied in both wards for over one year. Total bacterial counts and counts of Staphylococcus pyogenes were made from settle plates and blanket sweep plates. After the installation of the system aerial contamination in the test ward was reduced appreciably more than in the control ward. The number of blankets contaminated with Staph. pyogenes was similar in both wards. There was no significant difference in wound, nasal, or urinary cross-infection between the two wards. PMID:13863501

  6. Ward identities and relations between conductivities and viscosities in holography

    E-print Network

    Carlos Hoyos; David Rodríguez Fernández

    2015-11-12

    We derive relations between viscosities and momentum conductivity in $2+1$ dimensions by finding a generalization of holographic Ward identities for the energy-momentum tensor. The generalization is novel in the sense that it goes beyond the usual identities obtained from holographic renormalization. Our results are consistent with previous field theory analysis. The main tools we use are a constant `probability current' in the gravity dual, that we are able to define for any system of linear ODEs, and parity symmetry.

  7. Rare Earth ? See Rare Earth, by Ward and Brownlee

    E-print Network

    Walter, Frederick M.

    Rare Earth ? See Rare Earth, by Ward and Brownlee #12;N to date N = N* fs fGHZfp nH fl fi fc L/T ·N Earth is "Just Right" Yes, life on Earth has adapted to Earth, but ... Earth has just the right mass to be ·Tectonically-active ·Retain an atmosphere Earth has had a stable climate The Sun is particularly inactive

  8. The Changing Pattern of Hospital Admission to Medical Wards

    PubMed Central

    Noor, Sufian K.; Elmadhoun, Wadie M.; Bushara, Sarra O.; Ahmed, Mohamed H.

    2015-01-01

    Objectives: This study aimed to determine the pattern of hospital admissions and patient outcomes in medical wards at Atbara Teaching Hospital in River Nile State, Sudan. Methods: This retrospective cross-sectional study was conducted from August 2013 to July 2014 and included all patients admitted to medical wards at the Atbara Teaching Hospital during the study period. Morbidity and mortality data was obtained from medical records. Diseases were categorised using the World Health Organization’s International Classification of Diseases (ICD) coding system. Results: A total of 2,614 patient records were analysed. The age group with the highest admissions was the 56–65-year-old age group (19.4%) and the majority of patients were admitted for one week or less (86.4%). Non-communicable diseases constituted 71.8% of all cases. According to ICD classifications, patients were admitted most frequently due to infectious or parasitic diseases (19.7%), followed by diseases of the circulatory (16.4%), digestive (16.4%) and genito-urinary (13.8%) systems. The most common diseases were cardiovascular disease (16.4%), malaria (11.3%), gastritis/peptic ulcer disease (9.8%), urinary tract infections (7.2%) and diabetes mellitus (6.9%). The mortality rate was 4.7%. Conclusion: The burden of non-communicable diseases was found to exceed that of communicable diseases among patients admitted to medical wards at the Atbara Teaching Hospital. PMID:26629380

  9. Computer-aided geological characterization of a sandstone reservoir, North Ward Estes field, Ward and Winkler Counties, Texas

    SciTech Connect

    Wylie, A.S. Jr.; Davidsen, E.K.; Gillespie, J.D.; Butler, R.S.

    1988-01-01

    The North Ward Estes field is located along the western edge of the Central Basin platform in Ward and Winkler Counties, Texas. The field is part of an upper Guadalupian productive trend that extends uninterrupted for 90 mi on the edge of the platform. The North Ward Estes field has produced over 350 million bbl of oil (one-third of the trend's cumulative production) from more than 3,000 wells since its discovery in 1929. Production in the field is from back-reef lagoonal siliciclastics (sandstones) of the Yates, Seven Rivers, and Queen Formations. A correlation scheme was developed for the field based on laterally continuous key dolomites that bracket the productive sands and segment the reservoir into discrete mappable units. Applying this scheme, more than 60,000 correlation markers were selected and loaded into a computer database. Concurrently, 15 million curve feet of log data and 30,000 ft of core analysis data were digitized. Core analyses were depth corrected. Logs were normalized using a 60-ft interval of laterally continuous anhydritic dolomite. Core porosity data were cross plotted vs. bulk-density log values to develop equations (transforms) for derivation of porosity. Corrections for hole rugosity, overburden pressure, and lithologic complications were applied to refine the porosity transform. Structure and porosity-feet maps were then merged with fluid contact and water saturation data to calculate volumetrics.

  10. Education for Ward Nurses Influences the Quality of Inpatient's Bowel Preparation for Colonoscopy

    PubMed Central

    Lee, Yoo Jin; Kim, Eun Soo; Park, Kyung Sik; Cho, Kwang Bum; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok

    2015-01-01

    Abstract Although adequate bowel preparation is a prerequisite for colonoscopy, preparation among inpatients is often suboptimal. This study aimed to evaluate the impact of ward nurse education on the quality of bowel preparation of inpatients. A prospective, double-blinded, non-randomized, controlled study was performed. Expert endoscopists provided enhanced education to nurses who belonged to an “educated ward” followed by training that was repeated every week for 1 month. The primary outcome was the quality of the bowel preparation, which was based on the Ottawa Bowel Preparation Scale (OBPS). Patient compliance and their subjective feelings and the factors affecting inadequate bowel preparation were also analyzed. One hundred three inpatients in the educated ward and 102 patients in the control ward were enrolled. Baseline data were comparable between the 2 wards. The mean values of the total OBPS scores were 4.42?±?2.23 and 6.15?±?2.38 in the educated and control wards, respectively (P?ward was significantly lower than that in the control ward (31.1% vs 58.8%, P?ward was superior to that in the control ward (P<0.001). Control patients were more likely to be anxious before colonoscopy (P?ward showed higher level of satisfaction (P?=?0.001) and better sleep quality (P?ward nurse education (OR 2.365, P?=?0.025), constipation (OR 6.517, P?Ward nurse education effectively improved the quality of bowel preparation, and relevant colonoscopic outcomes among inpatients. Additional efforts are needed to control constipation and to encourage additional water ingestion in inpatients for better bowel preparation. PMID:26313794

  11. The educational value of ward rounds for junior trainees.

    PubMed

    Laskaratos, Faidon-Marios; Wallace, Deirdre; Gkotsi, Despoina; Burns, Aine; Epstein, Owen

    2015-01-01

    The ward round (WR) is a complex task and medical teachers are often faced with the challenge of finding a balance between service provision and clinical development of learners. The educational value of WRs is an under-researched area. This short communication aims to evaluate the educational role of WRs for junior trainees and provides insight into current practices. It also identifies obstacles to effective teaching/training in this setting and provides suggestions for improving the quality of WR teaching. PMID:25907002

  12. The educational value of ward rounds for junior trainees

    PubMed Central

    Laskaratos, Faidon-Marios; Wallace, Deirdre; Gkotsi, Despoina; Burns, Aine; Epstein, Owen

    2015-01-01

    The ward round (WR) is a complex task and medical teachers are often faced with the challenge of finding a balance between service provision and clinical development of learners. The educational value of WRs is an under-researched area. This short communication aims to evaluate the educational role of WRs for junior trainees and provides insight into current practices. It also identifies obstacles to effective teaching/training in this setting and provides suggestions for improving the quality of WR teaching. PMID:25907002

  13. Ward identities and chiral anomalies for coupled fermionic chains

    SciTech Connect

    Costa, L. C.; Ferraz, A.; Mastropietro, Vieri

    2013-12-15

    Coupled fermionic chains are usually described by an effective model written in terms of bonding and anti-bonding fermionic fields with linear dispersion in the vicinities of the respective Fermi points. We derive for the first time exact Ward Identities (WI) for this model, proving the existence of chiral anomalies which verify the Adler-Bardeen non-renormalization property. Such WI are expected to play a crucial role in the understanding of the thermodynamic properties of the system. Our results are non-perturbative and are obtained analyzing Grassmann functional integrals by means of constructive quantum field theory methods.

  14. Ward identities, B ? V transition form factors and applications

    NASA Astrophysics Data System (ADS)

    Paracha, M. Ali; El-Bennich, Bruno; Aslam, M. Jamil; Ahmed, Ishtiaq

    2015-07-01

    Long distance effects are studied in the rare exclusive semileptonic B(d,s) ? V?+?- decays, where V denotes a K* or ? meson. The form factors, which describe the meson transition amplitudes in the effective Hamiltonian approach, are calculated by means of Ward identities, experimental constraints and extrapolated within a general vector meson dominance framework. These form factors are then compared to the ones obtained in Lattice QCD simulations, with Light Cone Sum Rules and a Dyson-Schwinger equation approach. Additionally, the Bd ? K*?+?- and Bs ? ??+?- branching ratios are computed and the differential branching fractions are given as a function of the squared-momentum transfer.

  15. Job enrichment, work motivation, and job satisfaction in hospital wards: testing the job characteristics model.

    PubMed

    Kivimäki, M; Voutilainen, P; Koskinen, P

    1995-03-01

    This study investigated work motivation and job satisfaction at hospital wards with high and low levels of job enrichment. Primary nursing was assumed to represent a highly enriched job, whereas functional nursing represented a job with a low level of enrichment. Five surgical wards were divided into these two categories based on the structured interviews with head nurses. Work motivation and job satisfaction among ward personnel were assessed by a questionnaire. The ward personnel occupying highly enriched jobs reported significantly higher work motivation and satisfaction with the management than the personnel occupying jobs with a low level of enrichment. PMID:7735655

  16. Multi-Criteria Knapsack Problem for Disease Selection in an Observation Ward

    NASA Astrophysics Data System (ADS)

    Lurkittikul, N.; Kittithreerapronchai, O.

    2014-06-01

    The aging population and the introduction of Thailand universal healthcare have increased inpatients and outpatients to public hospitals, particularly to a hospital that provides special and comprehensive health services. Many inpatient wards have experienced large influx of inpatients as the hospitals have to admit all patients regardless their conditions. These overcrowding wards cause stress to medical staffs, block access between medical departments, hospital-acquired infections, and ineffective uses of resources. One way to manage such inundated inpatient is to select some patients whose conditions require less clinical attention or whose lengths of stay are predictable and short and, then, place them at an observation ward. This intermediate ward increases turnover of beds and reduces unnecessary paperwork as patients are considered to be outpatients. In this article, we studied inpatient data of a tertiary care hospital in which an observation ward was considered to alleviate the overcrowding problem at Internal Medicine Department. The analysis of data showed that the hospital can balance inpatient flow by managing a group of patients who is admitted because of treatments ordered by its special clinics. Having explored several alternatives, we suggested patient selection criteria and proposed a layout at an observation ward. The hospital should increase medical beds in a new building ward because the current observation ward can handle 27.3% of total short stay patients, while the observation ward is projected to handle 80% of total short stay patients.

  17. A virtual psychiatric ward for orientating patients admitted for the first time.

    PubMed

    Lau, Wai-Chi; Choi, Kup-Sze; Chung, Wai-Yee

    2010-12-01

    Misconceptions about psychiatric wards frequently cause newly admitted mental patients to stay away from these wards despite their need for treatment. Although ward orientation is typically conducted by nurses in an attempt to help patients to adapt to the new environment, it is considered time-consuming, and the method of orientation and the explanations given may vary among different nurses. This situation calls for a more effective and standardized approach to orientating mental patients on their first admission. To this end, a computer-based interactive virtual environment was developed based on a real psychiatric ward by using virtual reality (VR) technologies. It enables the patient to navigate around to gain understanding about the ward through a virtual guided tour. The effectiveness of this VR orientation approach was investigated by a randomized controlled trial with consecutive sampling. Fifty-four Chinese participants were randomly assigned to undergo ward orientation by either using the VR-based approach or reading text-based electronic information sheets about the ward with a computer. Subjective and objective measures were obtained respectively using the Chinese version of the State-Trait Anxiety Inventory questionnaire and the heart-rate variability measurement before and after the intervention. In addition, a test on the level of understanding about the ward was administered at the end of the session. The results showed that the VR orientation approach is helpful in reducing patients' anxiety while also improving their level of understanding about the ward. PMID:21142988

  18. Quadratic isocurvature cross-correlation, Ward identity, and dark matter

    NASA Astrophysics Data System (ADS)

    Chung, Daniel J. H.; Yoo, Hojin; Zhou, Peng

    2013-06-01

    Sources of isocurvature perturbations and large non-Gaussianities include field degrees of freedom whose vacuum expectation values are smaller than the expansion rate of inflation. The inhomogeneities in the energy density of such fields are quadratic in the fields to leading order in the inhomogeneity expansion. Although it is often assumed that such isocurvature perturbations and inflaton-driven curvature perturbations are uncorrelated, this is not obvious from a direct computational point of view due to the form of the minimal gravitational interactions. We thus compute the irreducible gravitational contributions to the quadratic isocurvature-curvature cross-correlation. We find a small but nondecaying cross-correlation, which in principle serves as a measurable prediction of this large class of isocurvature perturbations. We apply our cross-correlation result to two dark matter isocurvature perturbation scenarios: QCD axions and wimpzillas. On the technical side, we utilize a gravitational Ward identity in a novel manner to demonstrate the gauge invariance of the computation. Furthermore, the detailed computation is interpreted in terms of a soft-? theorem and a gravitational Ward identity. Finally, we also identify explicitly all the counterterms that are necessary for renormalizing the isocurvature perturbation composite operator in inflationary cosmological backgrounds.

  19. Mothers’ Satisfaction Rate from Hospital Cares in Hematology- Oncology Ward

    PubMed Central

    Boroumand, H; Moshki, M; Khajavi, A; Hashemizadeh, H

    2015-01-01

    Background Satisfaction evaluation is a good way to assess hospital conditions. In Health Care System, parentscan be also as children's main supporters, thus they may act as patient's viewpoints' representatives.This study aimed to evaluate mother’s satisfaction of hospital care in hematology – oncology ward in Dr Sheikh hospital. Materials and Methods A Cross-sectional descriptive analytic study was conducted using Pediatric Family Satisfaction (PFS) questionnaire and interviewing with 164 mothers duringMarchto February2013. The obtained data were analyzed using SPSS -16 software and descriptive statistics. Results The mean age of mothers and children was31.2±5.8, and 7.95 4/66 years.The children were 64 % male and 36 % femael. A large number of mothers (%56 (describedtheir satisfaction about medical care as moderate,(%70.7) reported their satisfaction about nursing care at very high level and(36.5 %) reported satisfaction about welfare services at high level(59%)and describe overall satisfaction at very high level . The totals mean of mothers’ satisfaction ratewas 121.8 ± 10.8. The mean of medical care, nursing care, welfare services was 2.9±34.1,4.6±50 and4.8± 32.9 respectively. Conclusion Overall satisfaction with medical, nursing and welfare staff was acceptable. For more satisfaction, it is widely recommended to improve veinipuncture by nurses, Physicians should inform parents about the tests results, and finally disturbance in ward with noise should be controled.

  20. Using league tables to reduce missed dose medication errors on mental healthcare of older people wards

    PubMed Central

    Cottney, Alan

    2015-01-01

    The unintentional omission of medication is one of the most commonly-reported administration errors on hospital wards throughout the world. The omission of a dose of medication can severely harm the patient affected, but to date there is limited evidence about cost-effective means for reducing the incidence of such errors. The current report describes a quality improvement project, conducted on the mental healthcare of older people (MHCOP) wards in East London NHS Foundation Trust, which led to a greater than 90% reduction in the rate of unintentionally omitted doses of medication. The project involved the publication of a fortnightly league table which ranked each of the wards by how many doses they had missed, with the ward missing the fewest doses receiving a prize. PDSA cycles were used to refine the concept, with the final incarnation of the fortnightly league table also incorporating the publication of a poster for each ward which showed how many weeks it had been since the ward missed a dose, and the ward's overall trend in missed doses. The project has resulted in the average missed dose rate on the MCHOP wards decreasing from 1.07% to 0.07%. In real terms, this represents a reduction from an estimated 2878 to 188 missed doses per year on the six MHCOP wards. By greatly reducing the risk of patients experiencing adverse drug events as a result of missed doses, this project has given rise to a potential cost-saving of around £34,000 per year across the wards studied. The use of league tables represents a simple, cost-effective means of tackling the problem of doses of medication being unintentionally omitted on hospital wards.

  1. The cleaning of ward floors and the bacteriological study of floor-cleaning machines

    PubMed Central

    Bate, J. G.

    1961-01-01

    Current trends in ward flooring materials and cleaning methods are considered from the point of view of the hospital bacteriologist. Methods employed in an investigation into the bacteriological safety of a number of floor-cleaning machines are described, and some considerations governing the choice of vacuum cleaners for ward use are discussed. Images PMID:13687726

  2. 77 FR 10960 - Security Zone, East River and Bronx Kill; Randalls and Wards Islands, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-24

    ...1625-AA87 Security Zone, East River and Bronx Kill; Randalls and Wards Islands, NY AGENCY...the waters of the East River and Bronx Kill, in the vicinity of Randalls and Wards...from a portion of the East River and Bronx Kill when public officials are scheduled...

  3. A general-practitioner ward in a new district general hospital

    PubMed Central

    Woodward, J. W.

    1976-01-01

    So far there are relatively few general-practitioner wards in district general hospitals in the National Health Service. The work of one such general-practitioner ward at Queen Mary's Hospital, Sidcup, is described and the advantages of this system of care for patients and doctors discussed. PMID:978642

  4. Authenticity in Learning--Nursing Students' Experiences at a Clinical Education Ward

    ERIC Educational Resources Information Center

    Manninen, Katri; Henriksson, Elisabet Welin; Scheja, Max; Silen, Charlotte

    2013-01-01

    Purpose: This study aims to explore and understand first year nursing students' experiences of learning at a clinical education ward. Design/methodology/approach: The setting is a clinical education ward for nursing students at a department of infectious diseases. A qualitative study was carried out exploring students' encounters with patients,…

  5. Training in General Surgery Ward Call: A Resident-Student Buddy System

    PubMed Central

    Maurice, Andrew; Hann, Angus

    2015-01-01

    There is a paucity of literature regarding medical student experiences of after hours hospital ward call. It was observed at our institution that medical students had minimal experience in ward call, yet were required to undertake such shifts as interns after graduation. We implemented a buddy system in which a medical student shadowed a general surgery resident for a ward call shift. Final year medical students were recruited from the local university at a tertiary teaching hospital after institutional approval. Each student attended a 4 hour evening shift on a general surgery ward with a supervising resident. A survey detailing attitudes and expectations of ward call was completed before and after the experience. Nine students enrolled in the project. Familiarity of expectations of what is required of an intern on a ward call shift improved significantly after the experience (3.1/5 to 4.1/5, p = 0.002). After hours work experience was reported as useful both before and after the study (4.5/5 to 4.7/5, p = 0.47). Students and doctors involved unanimously felt the experience was worthwhile. After hours ward call experience is useful for a final year medical student. More studies are required to further define the role of after hours ward call experiences during medical training.

  6. An increased incidence of Enterobacter cloacae in a cardiovascular ward.

    PubMed

    Kanemitsu, K; Endo, S; Oda, K; Saito, K; Kunishima, H; Hatta, M; Inden, K; Kaku, M

    2007-06-01

    Routine surveillance in a cardiovascular ward showed that the incidence of Enterobacter cloacae isolated from sputum and oropharyngeal cultures in June 2004 increased to 27.6% (8/29) compared to 5.5% (12/219) from the rest of the hospital during the same period (OR=13.2; 95% CI 2.97-58.7; P<0.05). While an increase in E. cloacae pneumonia was not verified, an investigation was undertaken by the infection control team to prevent an outbreak. The estimate of relative risk for E. cloacae infection was based on a case-control study which measured exposure to intubation, history of a stay in the intensive care unit (ICU) and oral care between patients with E. cloacae and those negative for E. cloacae. An odds ratio of 13.2 suggested cross-contamination via the transoesophageal echocardiography (TOE) probe in the ICU prior to transfer to the cardiovascular ward. Pulsed-field gel electrophoresis and antibiogram patterns were also consistent with this hypothesis. Intervention was undertaken in the form of enforcing the disinfection of TOE probes using a 0.55% phtharal solution and the use of a single-use sheath to protect the probe from recontamination. Following intervention, the incidence rate returned to previous levels. This report illustrates the limitations in the effectiveness of current nosocomial surveillance strategies due to the retrospective nature of analysis. Improved surveillance methods such as data-mining tools specifically applicable to the institution, patient population, region and country are needed to increase the sensitivity of detecting unrecognized outbreaks, including cross-contamination. PMID:17512633

  7. Holomorphic Vector Bundles Corresponding to some Soliton Solutions of the Ward Equation

    NASA Astrophysics Data System (ADS)

    Zhu, Xiujuan

    2015-12-01

    Holomorphic vector bundles corresponding to the static soliton solution of the Ward equation were explicitly presented by Ward in terms of a meromorphic framing. Bundles (for simplicity, "bundle" is to be taken throughout to mean "holomorphic vector bundle") corresponding to all Ward k-soliton solutions whose extended solutions have only simple poles, and some Ward 2-soliton solutions whose extended solutions have only a second-order pole, were explicitly described by us in a previous paper. In this paper, we go on to present some bundles corresponding to soliton-antisoliton solutions of the Ward equation, and Ward 3-soliton solutions whose extended solutions have a simple pole and a double pole. To give some more interpretation of the bundles, we study the second Chern number of the corresponded bundles and find that it can be obtained directly from the patching matrices. We also point out some information about bundles corresponding to Ward soliton solutions whose extended solutions have general pole data at the end of the paper.

  8. Investigation into the acceptability of door locking to staff, patients, and visitors on acute psychiatric wards.

    PubMed

    Muir-Cochrane, Eimear; van der Merwe, Marie; Nijman, Henk; Haglund, Kristina; Simpson, Alan; Bowers, Len

    2012-02-01

    There is disagreement among psychiatric professionals about whether the doors of acute psychiatric wards should be kept locked to prevent patients from leaving and harming themselves or others. This study explored patient, staff, and visitor perceptions about the acceptability of locking the ward door on acute psychiatric inpatient wards. Interviews were conducted with 14 registered nurses, 15 patients, and six visitors from three different acute wards. Findings revealed commonalities across all groups, with general agreement that locking the door reduced absconding. Staff expressed feelings of guilt, embarrassment, and fear of being blamed when a patient absconded. Staff also reported that open wards created anxious vigilance to prevent an abscond and increased workload in allocating staff to watch the door, whereas staff on partially-locked doors also perceived an increased workload in letting people in and out of the ward. Patients had mixed feelings about the status of the door, expressing depression, a sense of stigma, and low self-esteem when the door was locked. The issue of balancing safety and security on acute psychiatric wards against the autonomy of patients is not easily resolved, and requires focused research to develop innovative nursing practices. PMID:21740492

  9. The relationship between leadership, teamworking, structure, burnout and attitude to patients on acute psychiatric wards

    PubMed Central

    Nijman, Henk; Simpson, Alan; Jones, Julia

    2010-01-01

    Background Conflict (aggression, substance use, absconding, etc.) and containment (coerced medication, manual restraint, etc.) threaten the safety of patients and staff on psychiatric wards. Previous work has suggested that staff variables may be significant in explaining differences between wards in their rates of these behaviours, and that structure (ward organisation, rules and daily routines) might be the most critical of these. This paper describes the exploration of a large dataset to assess the relationship between structure and other staff variables. Methods A multivariate cross-sectional design was utilised. Data were collected from staff on 136 acute psychiatric wards in 26 NHS Trusts in England, measuring leadership, teamwork, structure, burnout and attitudes towards difficult patients. Relationships between these variables were explored through principal components analysis (PCA), structural equation modelling and cluster analysis. Results Principal components analysis resulted in the identification of each questionnaire as a separate factor, indicating that the selected instruments assessed a number of non-overlapping items relevant for ward functioning. Structural equation modelling suggested a linear model in which leadership influenced teamwork, teamwork structure; structure burnout; and burnout feelings about difficult patients. Finally, cluster analysis identified two significantly distinct groups of wards: the larger of which had particularly good leadership, teamwork, structure, attitudes towards patients and low burnout; and the second smaller proportion which was poor on all variables and high on burnout. The better functioning cluster of wards had significantly lower rates of containment events. Conclusion The overall performance of staff teams is associated with differing rates of containment on wards. Interventions to reduce rates of containment on wards may need to address staff issues at every level, from leadership through to staff attitudes. PMID:20082064

  10. Productive Ward initiative promotes better communication between mental health teams and ensures timely discharge for patients.

    PubMed

    Lennard, C

    2014-02-01

    The Productive Ward is an initiative whereby nursing staff are empowered to bring about changes in the workplace to streamline systems and release time to care for patients. It is an evidence-based approach, which brings about improved clinical and safety outcomes. This paper discusses how three of the Productive Ward Modules - Ward Round, Admissions and Planned Discharge, and Patient Status At a Glance - have meshed to promote better communication and working between inpatient nursing and medical teams, Home Treatment Team and Community Mental Health Team, and to endeavour to ensure timely discharge for patients. PMID:23157208

  11. Strange and Charm Quark Spins from Anomalous Ward Identity

    E-print Network

    Ming Gong; Yi-Bo Yang; Andrei Alexandru; Terrence Draper; Keh-Fei Liu

    2015-11-11

    We present a calculation of the strange and charm quark contributions to the nucleon spin from anomalous Ward identity (AWI). It is performed with overlap valence quarks on 2+1-flavor domain-wall fermion gauge configurations on a $24^3 \\times 64$ lattice with the light sea mass at $m_{\\pi} = 330$ MeV. To satisfy the AWI, the overlap fermion for the pseudoscalar density and the overlap Dirac operator for the topological density, which do not have multiplicative renormalization, are used to renormalize the form factor of the local axial-vector current at finite $q^2$. For the charm quark, we find the positive pseudoscalar term almost cancels the negative topological term for each $q^2$, leading to a very small net contribution. For the strange quark, the pseudoscalar term is less positive than that of the charm and this results in a negative strange quark spin when combined with the topological contribution. The $g_A(q^2)$ at $q^2 =0$ is obtained by a global fit of the pseudoscalar and the topological form factors, together with $g_A(q^2)$ and the induced pseudoscalar form factor $h_A(q^2)$ at finite $q^2$. The chiral extrapolation to the physical pion mass gives $\\Delta s + \\Delta {\\bar{s}} = - 0. 084(12)(21)$ which is consistent with that from the recent global analysis of deep inelastic scattering experiments.

  12. Sodium serum levels in hypoalbuminemic adults at general medical wards.

    PubMed

    da Cunha, D F; Barbosa, A A; Manfrin, A; Tiveron, F S; da Cunha, S F

    1999-01-01

    Hypoalbuminemia may cause interstitial edema and hemodilution, which we hypothesized may influence serum sodium levels. Our purpose was to compare serum sodium levels of hospitalized adults with or without hypoalbuminemia. All sodium and albumin serum levels of 142 adults hospitalized at general medical wards over a six-month period were searched at a University Hospital mainframe computer. Relevant laboratory data and clinical details were also registered. Hypoalbuminemia was defined by serum albumin concentration < 3.3 g/dl Fisher, Mann-Whitney, and Student's t tests were applied to compare groups with or without hypoalbuminemia. Ninety-nine patients, classified as hypoalbuminemic, had lower blood hemoglobin (10.68 +/- 2.62 vs. 13.54 +/- 2.41), and sodium (135.1 +/- 6.44 vs. 139.9 +/- 4.76 mEq/l) and albumin (2.74 +/- 0.35 vs. 3.58 +/- 0.28 g/dl) serum levels than non-hypoalbuminemic (n = 43). Pearson's coefficient showed a significant direct correlation between albumin and sodium serum levels (r = 0.40) and between serum albumin and blood hemoglobin concentration (r = 0.46). Our results suggest that hypoalbuminemic adults have lower serum sodium levels than those without hypoalbuminemia, a phenomenon that may be at least partially attributed to body water retention associated with acute phase response syndrome. PMID:10513064

  13. Profiling psychotropic discharge medication from a children's psychiatric ward.

    PubMed

    Akram, Gazala

    2015-10-01

    Background Community prescribing of medication to treat psychiatric illness in children is increasing. However, details about medication prescribed at discharge from psychiatric inpatient services for children are scarce. Objectives Characterise the nature of psychotropic medication prescribed on discharge from a children's psychiatric ward over a 15-year period. Method Retrospective analysis of discharge summary letters of all discharges occurring between Jan 1997 to Dec 2012. Results 234 children (152 males and 82 females) were discharged with 117 (50 %) prescribed psychotropic medication at discharge. 133 medicines were prescribed (stimulants n = 49, antipsychotics n = 31, antidepressants n = 22, mood stabilisers n = 1, other ADHD medication n = 11, melatonin n = 10, benzodiazepines n = 7, other n = 2). Risperidone was the most popular antipsychotic at a mean daily dose of 1 mg (range 0.25-4 mg). Fifty per cent were given an unlicensed medicine or a licensed drug was used in an unlicensed manner, of which risperidone was the most common (n = 14). Sleep disturbance and tics were most often treated using unlicensed/off label medication (n = 10). Conclusion Psychotropic medication is routinely used in inpatient children's services, with the majority of use confined to stimulants and atypical antipsychotics. Much of the antipsychotic use is for unlicensed indications or at unlicensed doses. PMID:25893488

  14. The Mind-Body Connection - How to Fight Stress and Ward Off Illness

    MedlinePLUS

    ... Issues The Mind-Body Connection How to Fight Stress and Ward Off Illness Past Issues / Winter 2008 ... system's ability to fight disease." Dangers of Chronic Stress Unhealthy levels of stress come in many guises. ...

  15. LIMITS FOR QUEUES AS THE WAITING ROOM GROWS Daniel P. Heyman Ward Whitt

    E-print Network

    Whitt, Ward

    LIMITS FOR QUEUES AS THE WAITING ROOM GROWS by Daniel P. Heyman Ward Whitt Bell Communications Research AT&T Bell Laboratories Red Bank, NJ 07701 Murray Hill, NJ 07974 May 11, 1988 #12;ABSTRACT We study

  16. Supporting Nested Locking in Multiprocessor Real-Time Systems Bryan C. Ward and James H. Anderson

    E-print Network

    Anderson, James

    Supporting Nested Locking in Multiprocessor Real-Time Systems Bryan C. Ward and James H. Anderson Department of Computer Science, University of North Carolina at Chapel Hill Abstract This paper presents

  17. A Stochastic Parts Program and Noun Phrase Parser for Unrestricted Text Kenneth Ward Church

    E-print Network

    A Stochastic Parts Program and Noun Phrase Parser for Unrestricted Text Kenneth Ward Church Bell Laboratories 600 Mountain Ave. Murray Hill, N.J., USA 201-582-5325 alice!k-wc It is well-known that part

  18. Classifying nursing organization in wards in Norwegian hospitals: self-identification versus observation

    PubMed Central

    2010-01-01

    Background The organization of nursing services could be important to the quality of patient care and staff satisfaction. However, there is no universally accepted nomenclature for this organization. The objective of the current study was to classify general hospital wards based on data describing organizational practice reported by the ward nurse managers, and then to compare this classification with the name used in the wards to identify the organizational model (self-identification). Methods In a cross-sectional postal survey, 93 ward nurse managers in Norwegian hospitals responded to questions about nursing organization in their wards, and what they called their organizational models. K-means cluster analysis was used to classify the wards according to the pattern of activities attributed to the different nursing roles and discriminant analysis was used to interpret the solutions. Cross-tabulation was used to validate the solutions and to compare the classification obtained from the cluster analysis with that obtained by self-identification. The bootstrapping technique was used to assess the generalizability of the cluster solution. Results The cluster analyses produced two alternative solutions using two and three clusters, respectively. The three-cluster solution was considered to be the best representation of the organizational models: 32 team leader-dominated wards, 23 primary nurse-dominated wards and 38 wards with a hybrid or mixed organization. There was moderate correspondence between the three-cluster solution and the models obtained by self-identification. Cross-tabulation supported the empirical classification as being representative for variations in nursing service organization. Ninety-four per cent of the bootstrap replications showed the same pattern as the cluster solution in the study sample. Conclusions A meaningful classification of wards was achieved through an empirical cluster solution; this was, however, only moderately consistent with the self-identification. This empirical classification is an objective approach to variable construction and can be generally applied across Norwegian hospitals. The classification procedure used in the study could be developed into a standardized method for classifying hospital wards across health systems and over time. PMID:20181125

  19. Ophthalmology hospital wards contamination to pathogenic free living Amoebae in Iran.

    PubMed

    Lasjerdi, Zohreh; Niyyati, Maryam; Lorenzo-Morales, Jacob; Haghighi, Ali; Taghipour, Niloofar

    2015-09-01

    The present study was conducted to determine the occurrence of potentially pathogenic free-living amoeba in ophthalmology wards in reference hospitals in Iran. Since an increasing number of Acanthamoeba Keratitis cases after eye surgery and eye trauma have been recently observed in this country, it could be possible that the disinfection procedures undertaken in the clinical setting may not have a good hygiene and disinfection procedures, hence the aim of this study. Therefore, 42 dust and biofilm samples were collected from different areas of ophthalmology wards and checked for the presence of FLA using morphological criteria, PCR based analysis and DNA sequencing. Of the 42 samples from dust and biofilm sources, 18(42.86%) isolates were found to contain FLA and 12(92.3%) isolates belonged to Acanthamoeba T4 genotype. Isolation of the pathogenic genotype T4 from medical instruments, including slit lamp in corneal wards, may be a threat for patients undergoing eye surgery in these wards. Other FLA isolated in this study included Acanthamoeba genotype T5, Vahlkampfia sp, Naegleria australiensis, Vermamoeba vermiformis and Echinamoeba exudans. To our knowledge, this is the first report of the presence of potentially pathogenic FLA in ophthalmology wards in Iran. Improved disinfection methods and monitoring of hospitals ward are thus necessary in this area in order to minimize the risk of infection in patients. PMID:26204177

  20. [Airborne Fungal Aerosol Concentration and Distribution Characteristics in Air- Conditioned Wards].

    PubMed

    Zhang, Hua-ling; Feng, He-hua; Fang, Zi-liang; Wang, Ben-dong; Li, Dan

    2015-04-01

    The effects of airborne fungus on human health in the hospital environment are related to not only their genera and concentrations, but also their particle sizes and distribution characteristics. Moreover, the mechanisms of aerosols with different particle sizes on human health are different. Fungal samples were obtained in medicine wards of Chongqing using a six-stage sampler. The airborne fungal concentrations, genera and size distributions of all the sampling wards were investigated and identified in detail. Results showed that airborne fungal concentrations were not correlated to the diseases or personnel density, but were related to seasons, temperature, and relative humidity. The size distribution rule had roughly the same for testing wards in winter and summer. The size distributions were not related with diseases and seasons, the percentage of airborne fungal concentrations increased gradually from stage I to stage III, and then decreased dramatically from stage V to stage VI, in general, the size of airborne fungi was a normal distribution. There was no markedly difference for median diameter of airborne fungi which was less 3.19 ?m in these wards. There were similar dominant genera in all wards. They were Aspergillus spp, Penicillium spp and Alternaria spp. Therefore, attention should be paid to improve the filtration efficiency of particle size of 1.1-4.7 ?m for air conditioning system of wards. It also should be targeted to choose appropriate antibacterial methods and equipment for daily hygiene and air conditioning system operation management. PMID:26164895

  1. Hidden on the ward: the abuse of children in hospitals.

    PubMed

    Kendrick, A; Taylor, J

    2000-03-01

    Hidden on the ward: the abuse of children in hospitals While there have been a small number of high profile cases of the abuse of children by hospital staff, there has been relatively little attention paid to the child protection issues for children staying in hospitals. Drawing on a conceptual framework from work on institutional abuse, we identify three types of abuse: physical and sexual abuse; programme abuse; and system abuse. Physical and sexual abuse can be perpetrated by medical professionals and hospital workers, it can be perpetrated by other children, or it can be perpetrated by the child's own parent(s). Research evidence from the United States of America (USA) suggests that the rate of abuse in hospitals is higher than in the family home. Programme abuse occurs when treatment and care falls below normally accepted standards. Recently, a tragic case of programme abuse concerned the unacceptably high death rate of babies undergoing heart surgery at Bristol Royal Infirmary. System abuse is the most difficult to define but concerns the way in which child health services fail to meet the needs of children. Recent reports have highlighted inadequate services for children and young people, lack of priority given to children's services, and geographical inequalities in the provision of services. Three crucial aspects in safeguarding children from abuse are highlighted: listening to children; the selection support and training of staff; and external systems of inspection, monitoring and standards. The recent British government agenda which has placed quality at the centre of National Health Service (NHS) developments are discussed. Only by addressing the abuse of children in hospital openly and honestly will effective child protection be possible. PMID:10718875

  2. Post-acute surgical ward round proforma improves documentation

    PubMed Central

    Al-Mahrouqi, Haitham; Oumer, Ramadan; Tapper, Richard; Roberts, Ross

    2013-01-01

    In health care, record keeping of doctor-patient encounters is vital for quality patient care and medico-legal reasons. We audited the documentation of post-acute consultant ward round (PACWR) in our department before and six months after an introduction of a proforma (standard form). The clinical notes of all patients admitted acutely under General Surgery over a period of one week before and one week after the introduction of a proforma were reviewed to note whether time and date, signature, impression and dietary plan were documented after PACWR. The nurses were also surveyed on the day of the PACWR for their certainty regarding the dietary plan of their patients and whether they had to contact the surgical team for clarification. There were 108 and 103 patients eligible for the first and second study periods respectively. After the introduction of the proforma, there was a statistically significant improvement in the documentation of time and date (37% vs. 72%, p-value < 0.01) and impression (40% vs. 61%, p-value < 0.01). Improvement in the documentation of the dietary plan reached statistical significant only when the analysis was restricted to the cases where a proforma was filled out (78 out of 103 patients). Introduction of the proforma had no statistically significant impact on the nurses’ certainty regarding their patients’ dietary plan and the number of times they had to contact the surgical teams. In conclusion, PACWR proforma improves overall documentation. This will help in avoiding adverse effects on patient care and medico-legal ramifications.

  3. [METHOTREXATE - GENOTOXIC AND TERATOGENIC FOR MEDICAL STAFF OF ONCOLOGY WARDS?].

    PubMed

    Kupczewska-Dobecka, Ma?gorzata

    2015-01-01

    Methotrexate (MTX) is one of the most widely used cytostatic drugs belonging to the folic acid antagonists. It is a substance non-classified as a carcinogen in the European Union and by the International Agency for Research on Cancer (IARC) as there is no evidence of its carcinogenicity to humans and animals. Nevertheless, MTX has been placed on the list of dangerous drugs used in chemotherapy, mainly due to geniotoxic and teratogenic effects, causing developmental toxicity and reproductive toxicity. Methotrexate was determined in the hospital ward air during the preparation of a medicament at a level of 0.3 mg/m3, as well as on protective gloves and preparatory room surfaces. In most research projects MTX was identified in the urine of health care workers, pharmacists and nursing staff. The highest cumulative concentration of MTX in 112 urine samples was 1416 mg in workers preparing infusions for patients. Studies carried out in pharmacies revealed the presence of MTX in 60% of tests, and the maximum concentration of 15 ng/cm2 surface of the tray to count tablets. Legal exposure limit values for MTX in the work environment have not yet been established. Occupational exposure limits have been established by some manufacturers at the level of 0.0003-0.0025 mg/m3. There is an urgent need to establish normative values. It should also be emphasized that MTX is absorbed through the skin, which may significantly-increase the exposure and measuring its concentration in the work environment may not be sufficient to estimate the actual exposure. PMID:26294316

  4. Exploring the potential impact of hospital ward-based pharmacy interns on drug safety.

    PubMed

    Schorr, S G; Eickhoff, C; Feldt, S; Hohmann, C; Schulz, M

    2014-04-01

    Clinical pharmacists play an important role in improving drug safety on hospital wards. However, little is known about the impact of pharmacy interns. The objective of our study was, therefore, to investigate the impact of hospital ward-based pharmacy interns on drug safety. This study was conducted as part of the project "P-STAT 2: Pharmacy interns on the ward" on 14 surgical wards in seven hospitals in Germany and a total of 27 pharmacy interns participated. All patients admitted to the participating wards from 1st June 2008 until 31st October 2008 and from 1st December 2008 till 30th April 2009 were included. The pharmacy interns were involved in medication reconciliation, and identifying, resolving, and preventing drug-related problems (DRPs) using the classification system APS-Doc. A total of 6,551 patients were included. Patients received on average (+/- SD) 4.4 +/- 3.9 drugs. The pharmacy interns detected a total of 4,085 DRPs and on average 0.6 +/- 1.2 DRPs per patient. Most frequently detected DRPs were potential drug-drug interactions (n = 591, 14%), missing drug strength, when different strengths were available (n = 373, 9%), and incomplete medication record (n = 296, 7%). The pharmacy interns conducted an intervention for 98% (n = 4,011) of all DRPs. According to their documentation, 74% of the DRPs (n = 3,038) were solved. Drugs which were most often related with DRPs were simvastatin, diclofenac, and ibuprofen. This is the very first study exploring the potential impact of pharmacy interns on drug safety on surgical wards in Europe. Pharmacy interns can play an important role to improve drug safety on hospital wards. PMID:24791599

  5. Learning from positively deviant wards to improve patient safety: an observational study protocol

    PubMed Central

    Baxter, Ruth; Taylor, Natalie; Kellar, Ian; Lawton, Rebecca

    2015-01-01

    Introduction Positive deviance is an asset-based approach to improvement which has recently been adopted to improve quality and safety within healthcare. The approach assumes that solutions to problems already exist within communities. Certain groups or individuals identify these solutions and succeed despite having the same resources as others. Within healthcare, positive deviance has previously been applied at individual or organisational levels to improve specific clinical outcomes or processes of care. This study explores whether the positive deviance approach can be applied to multidisciplinary ward teams to address the broad issue of patient safety among elderly patients. Methods and analysis Preliminary work analysed National Health Service (NHS) Safety Thermometer data from 34 elderly medical wards to identify 5 ‘positively deviant’ and 5 matched ‘comparison’ wards. Researchers are blinded to ward status. This protocol describes a multimethod, observational study which will (1) assess the concurrent validity of identifying positively deviant elderly medical wards using NHS Safety Thermometer data and (2) generate hypotheses about how positively deviant wards succeed. Patient and staff perceptions of safety will be assessed on each ward using validated surveys. Correlation and ranking analyses will explore whether this survey data aligns with the routinely collected NHS Safety Thermometer data. Staff focus groups and researcher fieldwork diaries will be completed and qualitative thematic content analysis will be used to generate hypotheses about the strategies, behaviours, team cultures and dynamics that facilitate the delivery of safe patient care. The acceptability and sustainability of strategies identified will also be explored. Ethics and dissemination The South East Scotland Research Ethics Committee 01 approved this study (reference: 14/SS/1085) and NHS Permissions were granted from all trusts. Findings will be published in peer-reviewed, scientific journals, and presented at academic conferences. Trial registration number This study is registered on the UK Clinical Research Network Study Portfolio (reference number—18050). PMID:26656985

  6. Bacterial air contamination of operating theatres and surgical wards of a university teaching hospital.

    PubMed

    Njoku-Obi, A N; Ojiegbe, G C

    1993-06-01

    A study of the level and significance of air contamination in the four operating theatres and four surgical wards of the University of Nigeria Teaching Hospital, Enugu, Nigeria was carried out. A total of 48 air samples were taken from each of the operating theatres while a total of 36 air samples were taken from each surgical ward, using a "Casella slit Sampler". The means of the bacterial carrying particles per cubic foot of air varied, from theatre to theatre, from 12.29 to 14.29 (in the mornings) and 9.79 to 11.4 (in the evening). Statistically, these differences were insignificant (t-value < 1.96). Recognised pathogens were not recovered from both the air and the fomites in the operating theatres. However, free-living fungi were isolated. The air of the surgical wards showed levels of contamination from 20.39 to 35.28 (in the mornings) and 20.33 to 39.55 (in the evenings) bacterial carrying particles per cu.ft. of air. The differences between the counts in the mornings and evenings were also not statistically significant. Some pathogens were isolated from the air in the wards. The findings indicated that the level of air contamination of the surgical wards influenced the rates of post-operative wound sepsis. PMID:7839891

  7. Leadership support for ward managers in acute mental health inpatient settings.

    PubMed

    Bonner, Gwen; McLaughlin, Sue

    2014-05-01

    This article shares findings of work undertaken with a group of mental health ward managers to consider their roles through workshops using an action learning approach. The tensions between the need to balance the burden of administrative tasks and act as clinical role models, leaders and managers are considered in the context of providing recovery-focused services. The group reviewed their leadership styles, broke down the administrative elements of their roles using activity logs, reviewed their working environments and considered how recovery focused they believed their wards to be. Findings support the notion that the ward manager role in acute inpatient settings is at times unmanageable. Administration is one aspect of the role for which ward managers feel unprepared and the high number of administrative tasks take them away from front line clinical care, leading to frustration. Absence from clinical areas reduces opportunities for role modeling good clinical practice to other staff. Despite the frustrations of administrative tasks, overall the managers thought they were supportive to their staff and that their wards were recovery focused. PMID:24779763

  8. Wireless technology in the evolution of patient monitoring on general hospital wards.

    PubMed

    Sahandi, R; Noroozi, S; Roushan, G; Heaslip, V; Liu, Y

    2010-01-01

    The evolution of patient monitoring on general hospital wards is discussed. Patients on general wards are monitored according to the severity of their conditions, which can be subjective at best. A report by the Commission for Healthcare Audit and Inspection in 2008 indicated dissatisfaction with patient monitoring. Commitment to providing quality health service by healthcare organizations encourages the implementation of other mechanisms for patient care. Remote patient monitoring (RPM), by supplementing the role of nurses, can improve efficiency and patient care on general wards. Developments in technology made it possible for wireless sensors to measure and transmit physiological data from patients to a control room for monitoring and recording. Two approaches in the application of wireless ZigBee sensor networks are discussed and their performances compared in a simulation environment. The role of RPM in early detection of deteriorating patients' conditions, reducing morbidity and mortality rates are also discussed. PMID:19929237

  9. Reducing conflict and containment rates on acute psychiatric wards: The Safewards cluster randomised controlled trial

    PubMed Central

    Bowers, Len; James, Karen; Quirk, Alan; Simpson, Alan; Stewart, Duncan; Hodsoll, John

    2015-01-01

    Background Acute psychiatric wards manage patients whose actions may threaten safety (conflict). Staff act to avert or minimise harm (containment). The Safewards model enabled the identification of ten interventions to reduce the frequency of both. Objective To test the efficacy of these interventions. Design A pragmatic cluster randomised controlled trial with psychiatric hospitals and wards as the units of randomisation. The main outcomes were rates of conflict and containment. Participants Staff and patients in 31 randomly chosen wards at 15 randomly chosen hospitals. Results For shifts with conflict or containment incidents, the experimental condition reduced the rate of conflict events by 15% (95% CI 5.6–23.7%) relative to the control intervention. The rate of containment events for the experimental intervention was reduced by 26.4% (95% CI 9.9–34.3%). Conclusions Simple interventions aiming to improve staff relationships with patients can reduce the frequency of conflict and containment. Trial registration IRSCTN38001825. PMID:26166187

  10. The ethics of space, design and color in an oncology ward.

    PubMed

    Andritsch, Elisabeth; Stöger, Herbert; Bauernhofer, Thomas; Andritsch, Hans; Kasparek, Anne-Katrin; Schaberl-Moser, Renate; Ploner, Ferdinand; Samonigg, Hellmut

    2013-06-01

    Change affects all areas of healthcare organizations and none more so than each aspect of the oncology ward, beginning with the patient's room. It is there that the issues faced by the major players in healing environments - administrator, caregiver, family member, and, most importantly, the patient - come sharply into focus. Hospitals are building new facilities or renovating old ones in order to adapt to new environmental demands of patient care and security. Driven by ethical and professional responsibility, the oncological team headed by Professor Hellmut Samonigg of Graz Medical University Graz pursued a vision of designing a model oncology ward unique in Europe. Friedensreich Hundertwasser, the world-famous artist, was the creative force behind the design. The oncology ward became a place of healing, permeated with a colorful sense of life and harmonious holistic care. The successful outcome was confirmed by the extraordinarily positive feedback by patients, families, and healthcare staff. PMID:22883931

  11. Experience based co-design reduces formal complaints on an acute mental health ward

    PubMed Central

    Springham, Neil; Robert, Glenn

    2015-01-01

    An acute mental health triage ward at Oxleas NHS Foundation Trust was attracting high levels of formal service user and family complaints. The Trust used experience based co-design to examine the issues and redesign procedures. This resulted in an immediate eradication of formal complaints for a period of 23 months. This paper describes two outcomes: firstly, the successful adaptations made to the experience based co-design methodology from its origins in physical care, in order to ensure it was safe and effective in an acute mental health setting; and, secondly, the changes made to the ward as a result of this quality improvement intervention. PMID:26734433

  12. Assessment of knowledge among patients of surgical wards regarding clinical symptoms and diagnostics of the most common malignant tumors

    PubMed Central

    Koz?owska, El?bieta

    2013-01-01

    Aim of the study The aim of this work was to evaluate the knowledge of symptoms and prophylaxis among hospitalized patients. Material and methods The research was carried in the Provincial Hospital in Bydgoszcz (i.e. general surgery, gynecology and obstetrics, urology, breast surgery and thoracic surgery). 250 hospitalized patients took part in the tests, as well as 50 healthy people. The scientific method used was a specially designed questionnaire. The Bioethics Committee of Collegium Medicum of Miko?aj Kopernik University in Bydgoszcz approved these tests. Results Patients from the Breast Diseases Ward had better knowledge about cancers than the control group. Symptoms of lung cancer were known to both groups to the same extent. Patients from the Clinical Ward of Thoracic Surgery were very knowledgeable about lung cancer, but they did not know anything about other malignant types of cancer. Patients from Gynecology and Obstetrics wards are better than the control group only at knowledge about symptoms and screening of cervix cancer. Patients from the Urology Ward have the best knowledge about screening of prostate cancer and colon cancer. Those hospitalized at the Surgery Ward do not know symptoms of colon cancer, but they have knowledge about its screening. Conclusions Patients from the Clinical Ward of Thoracic and Cancer Surgery and the Clinical Surgery Ward had the least knowledge about malignant tumors.Patients from Urology, Gynecology and Obstetrics wards have better knowledge about malignant tumors treated there. PMID:23788944

  13. WA-RD 470.1 June 1999 Demand Forecasting for Rural Transit

    E-print Network

    WA-RD 470.1 June 1999 Demand Forecasting for Rural Transit This summary describes the key findings Transit." The objective of this project was to test the applicability of the new Workbook model in nonmetropolitan areas in Washington State (Clallam Transit System, Jefferson Transit Authority, and Pacific

  14. Investigating the prevention of hospital-acquired infection through standardized teaching ward rounds in clinical nursing.

    PubMed

    Zhang, R

    2015-01-01

    This study aimed to explore the effect of standardized teaching ward rounds in clinical nursing on preventing hospital-acquired infection. The experimental group comprised 120 nursing students from our hospital selected between June 2010 and June 2012. The control group consisted of 120 nursing students selected from May 2008 to May 2010. Traditional teaching ward rounds for nursing education were carried out with the control group, while a standardized teaching ward round was carried out with the experimental group. The comprehensive application of nursing abilities and skills, the mastering of situational infection knowledge, and patient satisfaction were compared between the two groups. The applied knowledge of nursing procedures and the pass rate on comprehensive skill tests were significantly higher in the experimental group than in the control group (P < 0.05). The rate of mastery of sterilization and hygiene procedures was also higher in the experimental group than in the control group (P < 0.05). The patient satisfaction rate with infection control procedures in the experimental group time period was 98.09%, which was significantly higher than patient satisfaction in the control group time period (93.05%, P < 0.05). Standardized teaching ward rounds for nursing education expanded the knowledge of the nursing staff in controlling hospital-acquired infection and enhanced the ability of comprehensive application and awareness of infection control procedures. PMID:25966144

  15. 76 FR 37002 - Safety Zone; Central Astoria Independence Celebration Fireworks Event, Wards Island, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... Fireworks Event, Wards Island, NY AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Coast... event in time to publish a NPRM followed by a final rule before the effective date. The Coast Guard was notified of this event on February 24, 2011. This event is a reoccurring marine event with a...

  16. The Loreto basin formed by rapid west-ward tilting and asymmetric subsidence with-

    E-print Network

    Dorsey, Becky

    ABSTRACT The Loreto basin formed by rapid west- ward tilting and asymmetric subsidence with subsidence histories and stratigraphic evolution. Sedimentary rocks of the Loreto basin are divided into four stratigraphic se- quences that record discrete phases of fault- controlled subsidence and basin filling. Se

  17. TERRESTRIAL ROCK VARNISH: A KEY TO UNDERSTANDING THE SURFACE COMPOSITION OF MARS. J. G. Ward1

    E-print Network

    Kirkland, Laurel

    TERRESTRIAL ROCK VARNISH: A KEY TO UNDERSTANDING THE SURFACE COMPOSITION OF MARS. J. G. Ward1 , L produces a strong spectral band contrast. This also gives varnish its shiny appearance. On Earth rock on the rocks [4, 5]. Manganese-concentrating bacteria, which bloom during wet periods, oxidize the manganese

  18. Wavelet Transforms in the JPEG-2000 Standard Michael D. Adams and Rabab Ward

    E-print Network

    Adams, Michael D.

    Wavelet Transforms in the JPEG-2000 Standard Michael D. Adams and Rabab Ward Dept. of Elec@ieee.org and rababw@ece.ubc.ca Abstract Studied are numerous issues associated with wavelet transforms in the JPEG efficiency is investigated. The information presented herein may prove beneficial to those devel- oping JPEG

  19. Case-based Reasoning for Situation-aware Ambient Intelligence: A Hospital Ward

    E-print Network

    Aamodt, Agnar

    Case-based Reasoning for Situation-aware Ambient Intelligence: A Hospital Ward Evaluation Study is on the situation awareness task, and more spec as being able to per- ceive their environment, being aware of the presence of people and other agents

  20. Constructing and Evaluating a Validity Argument for the Final-Year Ward Simulation Exercise

    ERIC Educational Resources Information Center

    Till, Hettie; Ker, Jean; Myford, Carol; Stirling, Kevin; Mires, Gary

    2015-01-01

    The authors report final-year ward simulation data from the University of Dundee Medical School. Faculty who designed this assessment intend for the final score to represent an individual senior medical student's level of clinical performance. The results are included in each student's portfolio as one source of evidence of the student's…

  1. DELANEY AND WARD Radar Development at Lincoln Laboratory: An Overview of the First Fifty Years

    E-print Network

    Herr, Hugh

    · DELANEY AND WARD Radar Development at Lincoln Laboratory: An Overview of the First Fifty Years VOLUME 12, NUMBER 2, 2000 LINCOLN LABORATORY JOURNAL 147 Radar Development at Lincoln Laboratory of the first fifty years of radar development at Lincoln Laboratory. It begins by reviewing early Laboratory

  2. "Living My Native Life Deadly": Red Lake, Ward Churchill, and the Discourses of Competing Genocides

    ERIC Educational Resources Information Center

    Byrd, Jodi A.

    2007-01-01

    In an attempt to understand how rival narratives of genocide compete even at the cost of disavowing other historical experiences, this article considers how the U.S. national media represented and framed Red Lake in the wake of Ward Churchill's emergence on the national radar. The first section of this article examines how nineteenth-century…

  3. QSM GRANT RECIPIENTS 2011 -2012 Aimee Cowell Fifth Ward Junior High School St. Tammany

    E-print Network

    Harms, Kyle E.

    QSM GRANT RECIPIENTS 2011 - 2012 Aimee Cowell Fifth Ward Junior High School St. Tammany Aleta Overby JonesboroHodge High School Jackson Alexis DeFreese Cypress Springs Elementary Lincoln Alice M Hebert Jennings High School Jefferson Davis Amanda Holland Summerfield Elementary Caddo Amber Perr J

  4. COORDINATINGTURN-TAKINGWITH GAZE David G.Novick, Brian Hansen andKaren Ward

    E-print Network

    Novick, David G.

    COORDINATINGTURN-TAKINGWITH GAZE David G.Novick, Brian Hansen andKaren Ward Centerfor Spoken the role of gaze in coordinating tum-taking in mixed-initiative conversation and specificallyhow gaze laboratory task.We extend previous studies by explicating gaze patterns in face-to-face conversations

  5. Improving medication management for patients: the effect of a pharmacist on post-admission ward rounds

    PubMed Central

    Fertleman, M; Barnett, N; Patel, T

    2005-01-01

    ??Problem: Medication management in the NHS has been highlighted by the UK Department of Health as an area for improvement. Pharmacist participation on post-take (post-admission) ward rounds was shown to reduce medication errors and reduced prescribing costs in the USA and in UK teaching hospitals, which can contribute to improved medication management. We sought to demonstrate the problem in our hospital by collecting data on prescribing practice from three consecutive general medical post-take ward rounds. Setting: Northwick Park Hospital, a district general hospital in north-west London, which provides acute medical services to a population of 300 000. Strategy for change: A pharmacist was invited to become a member of the post-take ward round team that reviewed medical patients admitted within the preceding 24 hours. Patients also continued to receive care from a ward based pharmacist. Patient notes were analysed for cost of drugs on admission and discharge, discrepancies between admission drug history and pharmacist history, number of admission drugs stopped before discharge, and pharmacist recommendations. Pharmacist recommendations and actions were classified using a National Patient Safety Agency risk matrix. Effects of change: Discrepancies between the admission and the pharmacist derived drug history were noted in 26 of 50 in the pre-intervention group and 52 of 53 in the intervention group. The annual drug cost per patient following discharge increased by £181 in the pre-intervention group and by £122 in the intervention group. Five pre-admission drugs were stopped in three pre-intervention patients saving £276 per annum, while the 42 drugs stopped in 19 intervention patients saved £4699 per annum. No ward based pharmacist recommendations were recorded in the pre-intervention group. Recommendations regarding drug choice, dose, and need for drug treatment were most common; 58 minor, 48 moderate and four major risks to patients were potentially avoided. Lessons learnt: The presence of a pharmacist on a post-take ward round improved the accuracy of drug history documentation, reduced prescribing costs, and decreased the potential risk to patients in our hospital. As a result of this work a full time pharmacist has now been funded to attend daily post-take ward rounds on a permanent basis. PMID:15933319

  6. Characterisation of Clostridium difficile Hospital Ward–Based Transmission Using Extensive Epidemiological Data and Molecular Typing

    PubMed Central

    Wyllie, David H.; Dingle, Kate E.; Harding, Rosalind M.; O'Connor, Lily; Griffiths, David; Vaughan, Ali; Finney, John; Wilcox, Mark H.; Crook, Derrick W.; Peto, Tim E. A.

    2012-01-01

    Background Clostridium difficile infection (CDI) is a leading cause of antibiotic-associated diarrhoea and is endemic in hospitals, hindering the identification of sources and routes of transmission based on shared time and space alone. This may compromise rational control despite costly prevention strategies. This study aimed to investigate ward-based transmission of C. difficile, by subdividing outbreaks into distinct lineages defined by multi-locus sequence typing (MLST). Methods and Findings All C. difficile toxin enzyme-immunoassay-positive and culture-positive samples over 2.5 y from a geographically defined population of ?600,000 persons underwent MLST. Sequence types (STs) were combined with admission and ward movement data from an integrated comprehensive healthcare system incorporating three hospitals (1,700 beds) providing all acute care for the defined geographical population. Networks of cases and potential transmission events were constructed for each ST. Potential infection sources for each case and transmission timescales were defined by prior ward-based contact with other cases sharing the same ST. From 1 September 2007 to 31 March 2010, there were means of 102 tests and 9.4 CDIs per 10,000 overnight stays in inpatients, and 238 tests and 15.7 CDIs per month in outpatients/primary care. In total, 1,276 C. difficile isolates of 69 STs were studied. From MLST, no more than 25% of cases could be linked to a potential ward-based inpatient source, ranging from 37% in renal/transplant, 29% in haematology/oncology, and 28% in acute/elderly medicine to 6% in specialist surgery. Most of the putative transmissions identified occurred shortly (?1 wk) after the onset of symptoms (141/218, 65%), with few >8 wk (21/218, 10%). Most incubation periods were ?4 wk (132/218, 61%), with few >12 wk (28/218, 13%). Allowing for persistent ward contamination following ward discharge of a CDI case did not increase the proportion of linked cases after allowing for random meeting of matched controls. Conclusions In an endemic setting with well-implemented infection control measures, ward-based contact with symptomatic enzyme-immunoassay-positive patients cannot account for most new CDI cases. Please see later in the article for the Editors' Summary PMID:22346738

  7. Improving the inpatient oncology experience through a new consultant ward round

    PubMed Central

    Navani, Vishal

    2014-01-01

    Regular consultant ward rounds have been shown to reduce the length of stay and improve the discharge planning for patients (1). To balance the competing demands of outpatient activity and inpatient oncology, it has been difficult to provide specialist care in our hospital. Previously, inpatients were managed primarily by the oncology specialist trainees, who are qualified in internal medicine, with an ad-hoc review by their named consultant. A regular consultant ward round was introduced for the first time on the 7/1/13. Each consultant was timetabled to give a twice weekly morning ward round on a rolling rota. To evaluate this intervention, a retrospective case note analysis was undertaken. This included all patients admitted under oncology for the two months preceding and succeeding the new ward round. For each patient the admission date, time to first consultant review, number of consultant reviews, time to discharge after consultant review, and discharge date was identified. A staff survey also took place. Statistical analysis was performed using Mann-Whitney U or Chi-Squared tests. 85 patient episodes met the inclusion criteria. Case notes were available for 63 episodes (74%). The average length of stay significantly decreased from 11 days to three and half days (p<0.05). The time to discharge after first consultant review also significantly decreased from six days to two days (p<0.05). The number of consultant reviews and time to first consultant review remained unchanged (p>0.05). The percentage of patients receiving a consultant review increased, from 54.3% to 71.4%, though this was not statistically significant. However it is likely such a large increase is clinically significant. Medical and nursing staff satisfaction also improved. This study suggests that a regular consultant ward round improves length of stay for patients. This is possibly because an increase in patients received a consultant review and that the treatment and discharge decisions were expedited after such a review.

  8. Safewards: a new model of conflict and containment on psychiatric wards

    PubMed Central

    Bowers, L

    2014-01-01

    Accessible summary Rates of violence, self-harm, absconding and other incidents threatening patients and staff safety vary a great deal by hospital ward. Some wards have high rates, other low. The same goes for the actions of staff to prevent and contain such incidents, such as manual restraint, coerced medication, etc. The Safewards Model provides a simple and yet powerful explanation as to why these differences in rates occur. Six features of the inpatient psychiatric system have the capacity to give rise to flashpoints from which adverse incidents may follow. The Safewards Model makes it easy to generate ideas for changes that will make psychiatric wards safer for patients and staff. Abstract Conflict (aggression, self-harm, suicide, absconding, substance/alcohol use and medication refusal) and containment (as required medication, coerced intramuscular medication, seclusion, manual restraint, special observation, etc.) place patients and staff at risk of serious harm. The frequency of these events varies between wards, but there are few explanations as to why this is so, and a coherent model is lacking. This paper proposes a comprehensive explanatory model of these differences, and sketches the implications on methods for reducing risk and coercion in inpatient wards. This Safewards Model depicts six domains of originating factors: the staff team, the physical environment, outside hospital, the patient community, patient characteristics and the regulatory framework. These domains give risk to flashpoints, which have the capacity to trigger conflict and/or containment. Staff interventions can modify these processes by reducing the conflict-originating factors, preventing flashpoints from arising, cutting the link between flashpoint and conflict, choosing not to use containment, and ensuring that containment use does not lead to further conflict. We describe this model systematically and in detail, and show how this can be used to devise strategies for promoting the safety of patients and staff. PMID:24548312

  9. French national survey of inpatient adverse events prospectively assessed with ward staff

    PubMed Central

    Michel, Philippe; Quenon, Jean Luc; Djihoud, Ahmed; Tricaud?Vialle, Sophie; de Sarasqueta, Anne Marie

    2007-01-01

    Objectives To estimate the incidence of adverse events in medical and surgical activity in public and private hospitals, and to assess the clinical situation of patients and the active errors. Design Prospective assessment of adverse events by external senior nursing and doctor investigators with ward staff. Setting Random three?stage stratified cluster sampling of stays or fractions of stay in a 7?day observation period for each ward. Participants 8754 patients observed in 292 wards in 71 hospitals, over 35?234 hospitalisation days. Main outcome measures Number of adverse events in relation to number of days of hospitalisation. Results The incidence density of adverse events was 6.6 per 1000?days of hospitalisation (95% CI 5.7 to 7.5), of which 35% were preventable. Invasive procedures were the source of half the adverse events, of which 20% were preventable. Adverse events related to the psychological sphere and pain were mostly considered as preventable. Ward staff found it difficult to assess the role of care management in the occurrence of adverse events: 41% of adverse events were expected because of the disease itself, and could have occurred in the absence of the related medical management. Conclusion At the national level in France, every year 120?000–190?000 adverse events during hospitalisation can be considered as preventable. Areas such as perioperative period and geriatric units should receive closer attention. As adverse events occurred more commonly in vulnerable patients, who are not specifically targeted by clinical guidance, practising evidence?based medicine is not likely to prevent all cases. Therefore clinical risk management should prioritise empowerment of local staff, provision of favourable conditions within the organisation, and staff training based on simple tools appropriate for ward?level identification and analysis of adverse events. PMID:17913779

  10. Prospective cohort study protocol to describe the transfer of patients from intensive care units to hospital wards

    PubMed Central

    Buchner, Denise L; Bagshaw, Sean M; Dodek, Peter; Forster, Alan J; Fowler, Robert A; Lamontagne, François; Turgeon, Alexis F; Potestio, Melissa; Stelfox, Henry T

    2015-01-01

    Introduction The transfer of patient care between the intensive care unit (ICU) and the hospital ward is associated with increased risk of medical error and adverse events. This study will describe patient transfer from ICU to hospital ward by documenting (1) patient, family and provider experiences related to ICU transfer, (2) communication between stakeholders involved in ICU transfer, (3) adverse events that follow ICU transfer and (4) opportunities to improve ICU to hospital ward transfer. Methods This is a mixed methods prospective observational study of ICU to hospital ward transfer practices in 10 ICUs across Canada. We will recruit 50 patients at each site (n=500) who are transferred from ICU to hospital ward, and distribute surveys to enrolled patients, family members, and healthcare providers (ICU and ward physicians and nurses) after patient transfer. A random sample of 6 consenting study participants (patients, family members, healthcare providers) from each study site (n=60) will be offered an opportunity to participate in interviews to further describe stakeholders’ experience with ICU to hospital ward transfer. We will abstract information from patient health records to identify clinical data and use of transfer tools, and identify adverse events that are related to the transfer. Ethics and Dissemination Research ethics board approval has been obtained at the coordinating study centre (UofC REB13-0021) and 5 study sites (UofA Pro00050646; UBC-PHC H14-01667; Sunnybrook 336-2014; QCH 14-07; Sherbrooke 14-172). Dissemination of the findings will provide a comprehensive description of transfer from ICU to hospital ward in Canada including the uptake of validated or local transfer tools, a conceptual framework of the experiences and needs of stakeholders in the ICU transfer process, a summary of adverse events experienced by patients after transfer from ICU to hospital ward, and opportunities to guide quality improvement efforts. PMID:26155820

  11. Noise at night in hospital general wards: a mapping of the literature.

    PubMed

    Fillary, Julie; Chaplin, Hema; Jones, Gill; Thompson, Angela; Holme, Anita; Wilson, Patricia

    English NHS inpatient surveys consistently identify that noise at night in hospitals and its impact on patients' sleep is a persisting problem that needs addressing. To identify how noise at night in hospital affects patients on general wards and the range of interventions aimed at reducing the problem, a systematic mapping of the literature was undertaken. All primary studies and relevant literature published January 2003-July 2013 were included. Key issues identified in the literature included noise levels and causes, impact on patient experience, and lack of staff awareness. Interventions to reduce noise were targeted at staff education, behaviour modification, care organisation and environmental solutions. The scoping suggested that when compared with specialist units, there is little evidence on effective interventions reducing disturbance from night-time noise on general wards. The available evidence suggests a whole systems approach should be adopted to aid quality sleep and promote recovery. PMID:26018021

  12. From Paper to PDA: Design and Evaluation of a Clinical Ward Instruction on a Mobile Device

    NASA Astrophysics Data System (ADS)

    Kanstrup, Anne Marie; Stage, Jan

    Mobile devices with small screens and minimal facilities for interaction are increasingly being used in complex human activities for accessing and processing information, while the user is moving. This paper presents a case study of the design and evaluation of a mobile system, which involved transformation of complex text and tables to digital format on a PDA. The application domain was an emergency medical ward, and the user group was junior registrars. We designed a PDA-based system for accessing information, focusing on the ward instruction, implemented a prototype and evaluated it for usability and utility. The evaluation results indicate significant problems in the interaction with the system as well as the extent to which the system is useful for junior registrars in their daily work.

  13. Risk Assessment Tool for Pressure Ulcer Development in Indian Surgical Wards.

    PubMed

    Kumari, Sushma; Sharma, Deborshi; Rana, Anshika; Pathak, Reetesh; Lal, Romesh; Kumar, Ajay; Biswal, U C

    2015-06-01

    The aims of this paper were to compare the predictive validity of three pressure ulcer (PU) risk scales-the Norton scale, the Braden scale, and the Waterlow scale-and to choose the most appropriate calculator for predicting PU risk in surgical wards of India. This is an observational prospective cohort study in a tertiary educational hospital in New Delhi among 100 surgical ward patients from April to July 2011. The main outcomes measured included sensitivity, specificity, positive predictive value (PVP) and negative predictive value (PVN), and the area under the curve of the receiver operating characteristic (ROC) curve of the three PU risk assessment scales. Based on the cutoff points found most appropriate in this study, the sensitivity, specificity, PVP, and PVN were as follows: the Norton scale (cutoff, 16) had the values of 95.6, 93.5, 44.8, and 98.6, respectively; the Braden scale (cutoff, 17) had values of 100, 89.6, 42.5, and 100, respectively; and the Waterlow scale (cutoff, 11) had 91.3, 84.4, 38.8, and 97, respectively. According to the ROC curve, the Norton scale is the most appropriate tool. Factors such as physical condition, activity, mobility, body mass index (BMI), nutrition, friction, and shear are extremely significant in determining risk of PU development (p?wards. BMI, mobility, activity, nutrition, friction, and shear are the most significant factors in Indian surgical ward settings with necessity for future comparison with established scales. PMID:26246703

  14. Custom active RFId solution for children tracking and identifying in a resuscitation ward.

    PubMed

    Iadanza, Ernesto; Dori, Fabrizio

    2009-01-01

    In this work is discussed an active RFId system to track and identify patients in a children's critical care ward. The technical solutions may be very different according to the patients type, age and cognitive conditions and according to the hospital shapes. The proposed system to track and identify patients has been developed taking into account all the constraints induced by the particular environment. The system is composed of five different hardware devices and a tracking software, purposely designed and realized. PMID:19964116

  15. [open quotes]Victory[close quotes] a matter of perception in Ward Valley dispute

    SciTech Connect

    Newman, P.

    1994-02-17

    This article concerns the legal battle over the siting of Ward Valley, a proposed low-level nuclear waste site in California's Mojave Desert. The discussion centers around a judge's decision to deny a pretrial request for adjudicatory hearings to determine the site's suitability as a repository. The site is within an area designated as territory for the desert tortoise by the U.S. Fish and Wildlife Service.

  16. OnWARD: ontology-driven web-based framework for multi-center clinical studies.

    PubMed

    Tran, Van-Anh; Johnson, Nathan; Redline, Susan; Zhang, Guo-Qiang

    2011-12-01

    With a large percentage of clinical trials still using paper forms as the primary data collection tool, there is much potential for increasing efficiency through web-based data collection systems, especially for large-scale multi-center trials. This paper presents OnWARD, an ontology-driven, secure, rapidly-deployed, web-based framework supporting data capture for large-scale multi-center clinical research. Our approach is developed using the agile methodology to provide a flexible, user-centered dynamic form generator, which can be quickly deployed and customized for any clinical study without the need of deep technical expertise. Because of the flexible framework, the data management system can be extended to accommodate a large variety of data types, including genetic, genomic and proteomic data. In this paper, we demonstrate the initial deployment of OnWARD for a Phase II multi-center clinical trial after a development period of merely three months. The study utilizes 23 clinical report forms containing more than 1500 data points. Preliminary evaluation results show that OnWARD exceeded expectations of the clinical investigators in efficiency, flexibility and ease in setting up. PMID:21924379

  17. Numerical Transform Inversion to Analyze Teletraffic Models Gagan L. Choudhury, a David M. Lucantoni a and Ward Whitt b

    E-print Network

    Whitt, Ward

    . Lucantoni a and Ward Whitt b a AT&T Bell Laboratories, Holmdel, NJ 07733­3030, USA b AT&T Bell Laboratories, Murray Hill, NJ 07974­0636, USA We describe recently developed algorithms for numerically inverting

  18. GPUSync: A Framework for Real-Time GPU Management Glenn A. Elliott, Bryan C. Ward, and James H. Anderson

    E-print Network

    Anderson, James

    GPUSync: A Framework for Real-Time GPU Management Glenn A. Elliott, Bryan C. Ward, and James H. Anderson Department of Computer Science, University of North Carolina at Chapel Hill Abstract This paper

  19. Unfulfilled expectations: a narrative study of individuals’ experiences of being a patient on an acute psychiatric inpatient ward in Scotland 

    E-print Network

    Stenhouse, Rosemary Clare

    2009-01-01

    This study examines people’s experiences of being a patient on an acute psychiatric inpatient ward in Scotland. Within the existing research base few studies focus on the patient’s experience of acute psychiatric inpatient ...

  20. Making the ward a more efficient place: a qualitative evaluation of the impact of the Vista 90 trolley

    PubMed Central

    Ahluwalia, Nikhil

    2013-01-01

    A significant amount of professional time is wasted during a medical ward round retrieving patient notes from the ward trolley. If the efficiency of this non-clinical, non-functional interaction could be improved it would save time, maintain continuity and have financial implications. One identified constraint was the structure of the traditional ward trolley; a stationary filing tray with vertical sleeves. During ward round, time is spent returning and retrieving each patients notes from outside the patient bay and additional time may be wasted if the notes are misplaced or in use elsewhere. To resolve this, the ‘Vista 90’ trolley with horizontal, transparent trays, is portable and has an ergonomic writing surface was selected as a potential second generation replacement. An assessment of the impact of the Vista 90 trolley over the traditional trolley in the clinical setting was carried out on Erringham (medical) Ward, Worthing Hospital, West Sussex Hospital Trust, UK. This was by way of qualitative analysis performed by semi-structured interview of 12 doctors and other healthcare professionals who regularly interacted with the Vista 90 and traditional trolley in December 2012. The audit found that those interviewed preferred using the Vista 90 trolley over its predecessor as it improved the efficiency of the ward round and subsequent clinical work. It's mobility allowed it to be easily transported with the ward round, reducing disruption during a consultation and between consecutives ones. The ergonomic writing surface was noted to improve legibility of documentation due to greater comfort and if placed appropriately, did not interfere with the doctor-patient interaction. The financial savings of this greater efficiency was found to be of significance and justify the cost of the Vista 90 within two weeks.

  1. Protocol for an exploration of knowledge sharing for improved discharge from a mental health ward

    PubMed Central

    Rowley, Emma; Wright, Nicola; Waring, Justin; Gregoriou, Kyri; Chopra, Arun

    2014-01-01

    Introduction Strategies to reduce hospital admissions for mental health service users have received vast amounts of attention, yet the transfer of care from hospital to the community has been ignored. The discharge process is complex, messy, disjointed and inefficient, relying on cross-agency and organisational working. Focusing on one acute mental health admission ward, we will investigate whether the discharge process for people with severe mental health problems can be enhanced through the creation, implementation and utilisation of a knowledge sharing proforma that is used on their admission to the ward. Methods and analysis The project uses qualitative interviews to understand the complex processes associated with being admitted and discharged from inpatient mental health wards. Practitioners will be asked to identify and map the relevant stakeholders involved in admission and discharge, and discuss any problems with the process. The study team will work with clinicians to develop a knowledge collection proforma, which will be piloted for 2?months. Qualitative interviews will be carried out to collect reflections on the experiences of using the tool, with data used for further refinement of the intervention. Baseline and repeat quantitative measures will be taken to illustrate any changes to length of stay and readmission rates achieved as a result of the study. Ethics and dissemination A key issue is that participants are able to comment frankly on something that is a core part of their work, without fear or reprise. It is equally important that all participants are offered the opportunity to develop and coproduce the knowledge collection proforma, in order that the intervention produced is fit for purpose and usable in the real world, away from a research environment. The study has received ethical approval from Nottingham University Business School ethics committee, and has all appropriate National Health Service research governance clearances. PMID:25273812

  2. The permeable institution: an ethnographic study of three acute psychiatric wards in London.

    PubMed

    Quirk, Alan; Lelliott, Paul; Seale, Clive

    2006-10-01

    In Asylums, Goffman [1961. Asylums. London: Penguin] identified some permeable features of the old mental hospitals but presented them as exceptions to the rule and focused on their impermeable aspects. We argue that this emphasis is no longer valid and offer an alternative ideal type that better represents the reality of everyday life in contemporary 'bricks and mortar' psychiatric institutions. We call this the "permeable institution". The research involved participant observation of between 3 and 4 months and interviews with patients, patient advocates and staff on 3 psychiatric wards. Evidence for permeability includes that ward membership is temporary and changes rapidly (patients tend to have very short stays and staff turnover is high); patients maintain contact with the outside world during their stay; and institutional identities are blurred to the point where visitors or new patients can easily mistake staff and patients for one another. Permeability has both positive consequences (e.g., reduced risk of institutionalism), and negative consequences (e.g., unwanted people coming into hospital to cause trouble, and illicit drug use among patients). Staff employ various methods to regulate their ward's permeability, within certain parameters. The metaphor of the total/closed institution remains valuable, but it fails to capture the highly permeable nature of the psychiatric institutions we studied. Analysts may therefore find the permeable institution a more helpful reference point or ideal type against which to examine and compare empirical cases. Perhaps most helpful is to conceptualise a continuum of institutional permeability with total and permeable institutions at each extreme. PMID:16806622

  3. Fibrinolytic Therapy in CCU Instead of Emergency Ward: How It Affects Door to Needle Time?

    PubMed Central

    Zeraati, Fatemeh; Homayounfar, Shahram; Esna-Ashari, Farzaneh; Khalili, Marzieh

    2014-01-01

    Background: The door-to-needle-time (DNT) is considered a standard time for scheduling thrombolysis for acute ST-segment elevation of myocardial infarction and this time can be reduced by minimizing the delay in starting thrombolytic treatment once the patient has reached to the hospital. This study was carried out on a sample of Iranian patients with acute myocardial infarction to determine the DNT in those after changing schedule of thrombolysis during 8 years from emergency to coronary care unit (CCU). Methods: A descriptive cross-sectional study was carried out on all consecutive patients with a confirmed diagnosis of acute myocardial infarction admitted to the emergency ward of Ekbatan Hospital in Hamadan, Iran, within 2011 and had an indication of fibrinolytic therapy, which 47 patients were finally indicated to receive streptokinase in the part of CCU. Results: The mean time interval between arrival at the hospital and electrocardiogram (ECG) assessment was 6.30 min, taking ECG and patient's admission was 21.6 min and transferring the patient from admission to CCU ward was 31.9. The time between transferring the patients to CCU ward and fibrinolytic administration order and the time between its ordering and infusion was 31.2 min and 14.0 min respectively. In sum, the DNT was estimated 84.48 ± 53.00 min ranged 30-325 min that was significantly more than standard DNT (P <0.01). Furthermore, DNT mean in this study is significantly more than a study conducted 8 years ago in the same hospital (P <0.01). Conclusions: The DNT is higher than the standard level and higher than the estimated level in the past. This shows that DNT was longer after transferring to CCU. PMID:24829715

  4. Non-Invasive Continuous Respiratory Monitoring on General Hospital Wards: A Systematic Review

    PubMed Central

    van Loon, Kim; van Zaane, Bas; Bosch, Els J.; Kalkman, Cor J.; Peelen, Linda M.

    2015-01-01

    Background Failure to recognize acute deterioration in hospitalized patients may contribute to cardiopulmonary arrest, unscheduled intensive care unit admission and increased mortality. Purpose In this systematic review we aimed to determine whether continuous non-invasive respiratory monitoring improves early diagnosis of patient deterioration and reduces critical incidents on hospital wards. Data Sources Studies were retrieved from Medline, Embase, CINAHL, and the Cochrane library, searched from 1970 till October 25, 2014. Study Selection Electronic databases were searched using keywords and corresponding synonyms ‘ward’, ‘continuous’, ‘monitoring’ and ‘respiration’. Pediatric, fetal and animal studies were excluded. Data Extraction Since no validated tool is currently available for diagnostic or intervention studies with continuous monitoring, methodological quality was assessed with a modified tool based on modified STARD, CONSORT, and TREND statements. Data Synthesis Six intervention and five diagnostic studies were included, evaluating the use of eight different devices for continuous respiratory monitoring. Quantitative data synthesis was not possible because intervention, study design and outcomes differed considerably between studies. Outcomes estimates for the intervention studies ranged from RR 0.14 (0.03, 0.64) for cardiopulmonary resuscitation to RR 1.00 (0.41, 2.35) for unplanned ICU admission after introduction of continuous respiratory monitoring, Limitations The methodological quality of most studies was moderate, e.g. ‘before-after’ designs, incomplete reporting of primary outcomes, and incomplete clinical implementation of the monitoring system. Conclusions Based on the findings of this systematic review, implementation of routine continuous non-invasive respiratory monitoring on general hospital wards cannot yet be advocated as results are inconclusive, and methodological quality of the studies needs improvement. Future research in this area should focus on technology explicitly suitable for low care settings and tailored alarm and treatment algorithms. PMID:26658343

  5. Improving VTE risk assessment at point of admission to a tertiary centre cardiology ward

    PubMed Central

    Wilson, Rachel

    2015-01-01

    Cardiology wards are generally high turnover units, which may receive primary PCI, high-risk NSTEMI patients, and other general cardiac admissions from a large geographical area. Many centres also provide national specialist services for rarer cardiac conditions for which admissions may be lengthy. Cardiac patients have significant risk factors for venous thromboembolism (VTE) as immobility may be due to systolic dysfunction, attachment to continuous monitoring and predisposition to chest pain, or cardiac syncope. It is recommended by NICE that an initial VTE risk assessment is undertaken at the time of patient admission, with reassessment within 24 hours. For this purpose a risk assessment tool is featured on the front of many Trust drug charts. It is noted that this risk assessment is electronic in other trusts. We undertook an audit into the drug chart documentation of VTE risk assessment on the cardiology ward and the Coronary Care Unit (CCU) at The Royal Free Hospital. It was evident that documentation of VTE risk assessment was poor. The audit interventions were; a teaching presentation to the cardiology department, an educational poster, several update emails to the department and the identification of a ‘VTE risk assessment champion’ to audit ongoing compliance. Following these measures the second audit round demonstrated that documentation of initial risk assessment was slightly improved, but significant improvement was seen in documentation of risk assessment at 24 hours post admission. Results from a third audit cycle indicated that the improvement in initial VTE risk assessment was sustained, and that there was a significant sustained improvement in risk assessment at 24 hours (p <0.05). Recommendations for sustained improvement included: redesigning the drug chart so that the VTE risk assessment tool was linked to the VTE prophylaxis prescription box, and designating the responsibility of the initial VTE risk assessment to the on call junior doctor who receives admissions on to the ward.

  6. Implementation of a ward round pro-forma to improve adherence to best practice guidelines

    PubMed Central

    Boland, Xavier

    2015-01-01

    Our aim was firstly to assess adherence to best practice guidelines for the prevention of healthcare associated causes of inpatient mortality and morbidity by junior doctors. Secondly, we wanted to measure the impact of a ward round checklist on rates of adherence. The rates of correct prescribing of antibiotics, venous thrombo-embolism prophylaxis, and oxygen (pro re nata) as well as correctly completed paperwork for peripheral venous cannulas were measured in a spot audit of all medical notes of patients on a medical assessment unit. This was repeated two weeks and two months after the introduction of a specifically designed ward round checklist for junior doctors. Initial audit of 40 patient notes confirmed generally poor compliance with best practice guidelines in the prescription of antibiotics (58% correctly prescribed) and oxygen (42%), and in the use cannula care plans (39%). Venous thrombo-embolism prophylaxis prescribing on the other hand was widespread (82%). The introduction and extensive use of the ward round checklist did not have a significant impact on these figures as shown in the two following stop audits (30 and 36 notes respectively). Checklists are helpful in providing a structured and systematic approach to complex tasks and have been shown to have a measurable impact in improving patient care. Their effectiveness is however limited by their uptake and regular correct use. Obstructing issues include poor understanding of the need for change in practice, lack of individual accountability and variable involvement of clinical leaders. These issues must be addressed together in order to effect a successful change in clinical practice.

  7. The utilisation of the MUST nutritional screening tool on vascular surgical wards

    PubMed Central

    Tewari, Nilanjana; Rodrigues, Jeremy; Bothamley, Lydia; Altaf, Nishath; Awad, Sherif

    2013-01-01

    Whilst malnutrition is prevalent in approximately 40% of general surgical patients, the prevalence of malnutrition and nutritional screening practices amongst vascular patients remain unknown. The Malnutrition Universal Screening Tool (MUST) is recommended for risk screening and provides 3 scores for risk classification: 0=low risk, 1=intermediate risk, 2=high risk. The aim of this preliminary study was to evaluate the use of MUST on vascular wards. This prospective study was undertaken in a tertiary referral vascular unit in the UK. Patient demographics, utilisation of MUST by nursing staff (N-MUST) and referral to nutritional support teams (NST) were studied. When MUST was not completed by nursing staff, the study team (S-MUST) performed it. Fifty-three patients, median (interquartile range, IQR) age 67 (59-75) years were initially studied. For N-MUST: Overall MUST score was recorded in 18/25 (72%) patients, of whom 1 (4%) scored 2, whilst the remainder scored 0. For S-MUST: Overall MUST scores were recorded in 28 patients, MUST=0 in 75% and ?2 in 21%. An educational session on use of MUST was delivered to nursing staff, as well as a Trust-wide educational initiative to improve assessment of nutritional status and, after a 2-month period, the study was repeated. The second cohort comprised forty-two patients, median (IQR) age 72 (64–79) years. For N-MUST: Overall MUST score was recorded in 37/40 (93%) patients, of whom 3 (8%) scored ?2. For S-MUST: Overall MUST scores were recorded in 2 patients, MUST = 0 in 67% and ?2 in 33%. Despite the ease of use of MUST, it was under-utilised on vascular wards. However, following provision of a dedicated educational programme to ward nursing staff, utilisation of MUST for risk scoring patients on admission increased to over 90%.

  8. Youth Water Camp: Ward County 4-H program educates students about water conservation, quality 

    E-print Network

    Supercinski, Danielle

    2008-01-01

    stream_source_info Youth water camp.pdf.txt stream_content_type text/plain stream_size 5692 Content-Encoding ISO-8859-1 stream_name Youth water camp.pdf.txt Content-Type text/plain; charset=ISO-8859-1 tx H2O | pg. 24... A plant chemist directs Water Camp youth in basic water analysis at a local power plant during a tour. Story by Danielle Supercinski Ward County 4-H program educates students about water conservation, quality In January 1991, a committee...

  9. S.A. Yost, C. Glosser and B.F.L. Ward PAPER-0063 PRECISION CALCULATIONS OF W AND Z PRODUCTION

    E-print Network

    Yost, Scott

    S.A. Yost, C. Glosser and B.F.L. Ward PAPER-0063 PRECISION CALCULATIONS OF W AND Z PRODUCTION AT THE LHC: PROGRESS IN PRECISION LUMINOSITY STUDIES S.A. YOST, C. GLOSSER AND B.F.L. WARD DEPARTMENT grant pst.clg.980342. 1 #12;S.A. Yost, C. Glosser and B.F.L. Ward PAPER-0063 2 Yennie

  10. Examination of particulate matter and heavy metals and their effects in at-risk wards in Washington, DC

    NASA Astrophysics Data System (ADS)

    Greene, Natasha Ann

    One of the major contributions to pollution in the Washington, DC urban environment is particulate matter (PM). Quite often, ambient airborne toxics are closely associated with fine PM (PM2.5). We have performed high-resolution aerosol measurements of PM2.5 in four wards (Ward 1, 4, 5, and 7) of Washington, DC during two intensive observational periods (IOP). The first IOP occurred during the summer of 2003 (June 23rd to August 8th). The second IOP transpired during the late fall season of 2003 (October 20th to December 4 th). The measurement platform consisted of a Laser Particle Counter (LPC) and a Quartz Crystal Microbalance Cascade Impactor (QCM) to obtain both in-situ number and mass density distributions across the measurement sites. The data shows spatial distributions of particulate matter characterized as a function of size and mass properties. The QCM analyses show significant levels (> 15 mug/m3) of ward-averaged PM2.5 in Wards 4, 1, and 7 respectively during the summer IOP. However, all wards were less than the EPA National Ambient Air Quality Standard (NAAQS) of 15 mug/m 3 during the fall IOP ward-averaged measurements. Yet, investigations of the site-averaged measurements during the fall revealed some specific locations in Ward 4 that exceeded the NAAQS. Results also show that the aerosol mass density peaked in the 0.3 mum mode during the summer IOP and in the 0.15 mum mode during the fall IOP. The number density peaked in the 0.3--0.5 mum size range. Accordingly, the distributions have also been analyzed as a function of meteorological factors, such as wind speed and direction via NOAA HYSPLIT trajectories. One important attribute to this study is the evaluation of risks amongst IBC subgroups (youth, adults, elderly, black, white, hispanic, male, and female) for bath pediatric asthma rates and the onset of lung cancer over a lifetime (70-year period) when exposed to these levels of particulates. It has been determined that there are individual excess risks associated with inhalation of PM2.5 and the selected heavy metals chromium, arsenic, and cadmium. Particularly, Ward 4 has generated higher risks than the other three investigated wards for both health effects.

  11. Between-ward disparities in colorectal cancer incidence and screening in Washington DC.

    PubMed

    Chatterjee, Sharmila; Chattopadhyay, Amit; Levine, Paul H

    2015-12-01

    This study aims to investigate the incidence and determinants of colorectal cancer (CRC) and its screening in District of Columbia (DC), and identify modifiable risk factors. Data (2000-2009) from the DC Cancer Registry, Behavioral Risk Factor Surveillance System (BRFSS-DC) and Surveillance Epidemiology and End Results (SEER) were used to estimate CRC incidence in eight DC Wards. Risk factors and CRC screening were analyzed using uni-, bi-, and multivariable statistical methods with survey procedures in SAS (version 9.2) including binary, unconditional multivariable logistic regression analysis. Factors measured included stage of diagnosis, age, gender, race/ethnicity, smoking, alcohol, exercise, body weight, health insurance, education, employment, and income. Over the study time, CRC screening increased from 48.4% to 68.6%. Mean age at diagnosis was 67years. CRC incidence is high in DC. Furthermore, CRC incidence rates in DC below 50years age were higher than the SEER18 average. Disparities exist between CRC incidence and screening among DC Wards. Identified risk factors for CRC are smoking, obesity, and low physical activity; screening was less prevalent among the uninsured and low socio-economic group. Local variations in CRC occurrence exist and may vary from average national experiences. Identification of local regions which vary from national trends in disease occurrence is important for comprehensive understanding of the disease in the community. PMID:26344423

  12. Meson-Baryon-Baryon Vertex Function and the Ward-Takahashi Identity

    E-print Network

    Siwen Wang; Manoj K. Banerjee

    1996-07-15

    Ohta proposed a solution for the well-known difficulty of satisfying the Ward-Takahashi identity for a photo-meson-baryon-baryon amplitude ($\\gamma$MBB) when a dressed meson-baryon-baryon (MBB) vertex function is present. He obtained a form for the $\\gamma$MBB amplitude which contained, in addition to the usual pole terms, longitudinal seagull terms which were determined entirely by the MBB vertex function. He arrived at his result by using a Lagrangian which yields the MBB vertex function at tree level. We show that such a Lagrangian can be neither hermitian nor charge conjugation invariant. We have been able to reproduce Ohta's result for the $\\gamma$MBB amplitude using the Ward-Takahashi identity and no other assumption, dynamical or otherwise, and the most general form for the MBB and $\\gamma$MBB vertices. However, contrary to Ohta's finding, we find that the seagull terms are not robust. The seagull terms extracted from the $\\gamma$MBB vertex occur unchanged in tree graphs, such as in an exchange current amplitude. But the seagull terms which appear in a loop graph, as in the calculation of an electromagnetic form factor, are, in general, different. The whole procedure says nothing about the transverse part of the ($\\gamma$MBB) vertex and its contributions to the amplitudes in question.

  13. Challenges of the ward round teaching based on the experiences of medical clinical teachers

    PubMed Central

    Arabshahi, Kamran Soltani; Haghani, Fariba; Bigdeli, Shoaleh; Omid, Athar; Adibi, Peyman

    2015-01-01

    Background: Holding educational sessions in a clinical environment is a major concern for faculty members because of its special difficulties and restrictions. This study attempts to recognize the challenges of the ward round teaching through investigating the experiences of clinical teachers in 2011. Materials and Methods: This qualitative research is carried out through purposive sampling with maximum variation from among the clinical teachers of major departments in Isfahan University of Medical Sciences (9 persons). The sampling continued until data saturation. Data were collected through semi-structured interview and analyzed through Collaizzi method. Data reliability and validity was confirmed through the four aspects of Lincoln and Guba method (credibility, conformability, transferability, and dependability). Results: Three major themes and their related sub-themes (minor themes) were found out including the factors related to the triad of clinical teaching (patient, learner, and clinical teacher) (concern about patient's welfare, poor preparation, lack of motivation, ethical problems), factors related to the educational environment (stressful environment, humiliating environment and poor communication) and the factors related to the educational system of the clinical environment (poor organizing and arrangement of resources, poor system's monitoring, bad planning and inadequate resource). Conclusion: Ward round teaching has many concerns for teachers, and this should be recognized and resolved by authorities and teachers. If these problems are not resolved, it would affect the quality of clinical teaching. PMID:26109975

  14. Constructing and evaluating a validity argument for the final-year ward simulation exercise.

    PubMed

    Till, Hettie; Ker, Jean; Myford, Carol; Stirling, Kevin; Mires, Gary

    2015-12-01

    The authors report final-year ward simulation data from the University of Dundee Medical School. Faculty who designed this assessment intend for the final score to represent an individual senior medical student's level of clinical performance. The results are included in each student's portfolio as one source of evidence of the student's capability as a practitioner, professional, and scholar. Our purpose in conducting this study was to illustrate how assessment designers who are creating assessments to evaluate clinical performance might develop propositions and then collect and examine various sources of evidence to construct and evaluate a validity argument. The data were from all 154 medical students who were in their final year of study at the University of Dundee Medical School in the 2010-2011 academic year. To the best of our knowledge, this is the first report on an analysis of senior medical students' clinical performance while they were taking responsibility for the management of a simulated ward. Using multi-facet Rasch measurement and a generalizability theory approach, we examined various sources of validity evidence that the medical school faculty have gathered for a set of six propositions needed to support their use of scores as measures of students' clinical ability. Based on our analysis of the evidence, we would conclude that, by and large, the propositions appear to be sound, and the evidence seems to support their proposed score interpretation. Given the body of evidence collected thus far, their intended interpretation seems defensible. PMID:25808311

  15. A ward-based writing coach program to improve the quality of nursing documentation.

    PubMed

    Jefferies, Diana; Johnson, Maree; Nicholls, Daniel; Lad, Shushila

    2012-08-01

    A ward-based writing coach program was piloted at a metropolitan hospital in Australia to produce a quality improvement in nursing documentation. This paper describes the education program, which consisted of two writing workshops, each of one-hour duration followed by one-to-one coaching of nurses. This program could be carried out in any clinical area as a part of the regular education program. Nurses are encouraged to view their documentation practices in a critical light to ensure that the documentation is meaningful to readers within or outside the profession. The importance of nursing documentation as a communication tool for all health care professionals is emphasised. Barriers to meaning, such as fragmentary language or the use of unofficial abbreviations, are discussed. Nurses are also encouraged to document the patient's condition, care and response to care using defined principles for nursing documentation. This program would be transferrable to any clinical setting looking for a ward-based education program for nursing documentation. PMID:21982050

  16. Teaching teamwork: an evaluation of an interprofessional training ward placement for health care students

    PubMed Central

    Morphet, Julia; Hood, Kerry; Cant, Robyn; Baulch, Julie; Gilbee, Alana; Sandry, Kate

    2014-01-01

    The establishment of interprofessional teamwork training in the preprofessional health care curriculum is a major challenge for teaching faculties. Interprofessional clinical placements offer an opportunity for teamwork education, as students in various professions can work and learn together. In this sequential, mixed-method study, focus group and survey techniques were used to evaluate students’ educational experiences after 2-week ward-based interprofessional clinical placements. Forty-five senior nursing, medicine, and other health care students cared for patients in hospital wards under professional supervision, with nursing-medicine student “teams” leading care. Thirty-six students attended nine exit focus groups. Five central themes that emerged about training were student autonomy and workload, understanding of other professional roles, communication and shared knowledge, interprofessional teamwork/collaboration, and the “inner circle”, or being part of the unit team. The learning environment was described as positive. In a postplacement satisfaction survey (n=38), students likewise rated the educational experience highly. In practicing teamwork and collaboration, students were able to rehearse their future professional role. We suggest that interprofessional clinical placements be regarded as an essential learning experience for senior preprofessional students. More work is needed to fully understand the effect of this interactive program on students’ clinical learning and preparation for practice. PMID:25028569

  17. Bottom-up regulation of a pole-ward migratory predator population

    PubMed Central

    van den Hoff, John; McMahon, Clive R.; Simpkins, Graham R.; Hindell, Mark A.; Alderman, Rachael; Burton, Harry R.

    2014-01-01

    As the effects of regional climate change are most pronounced at polar latitudes, we might expect polar-ward migratory populations to respond as habitat suitability changes. The southern elephant seal (Mirounga leonina L.) is a pole-ward migratory species whose populations have mostly stabilized or increased in the past decade, the one exception being the Macquarie Island population which has decreased continuously over the past 50 years. To explore probable causes of this anomalous trend, we counted breeding female seals annually between 1988 and 2011 in order to relate annual rates of population change (r) to foraging habitat changes that have known connections with atmospheric variability. We found r (i) varied annually from ?0.016 to 0.021 over the study period, (ii) was most effected by anomalous atmospheric variability after a 3 year time lag was introduced (R = 0.51) and (iii) was associated with sea-ice duration (SID) within the seals’ foraging range at the same temporal lag. Negative r years may be extrapolated to explain, at least partially, the overall trend in seal abundance at Macquarie Island; specifically, increasing SID within the seals foraging range has a negative influence on their abundance at the island. Evidence is accruing that suggests southern elephant seal populations may respond positively to a reduced sea-ice field. PMID:24619437

  18. Bottom-up regulation of a pole-ward migratory predator population.

    PubMed

    van den Hoff, John; McMahon, Clive R; Simpkins, Graham R; Hindell, Mark A; Alderman, Rachael; Burton, Harry R

    2014-05-01

    As the effects of regional climate change are most pronounced at polar latitudes, we might expect polar-ward migratory populations to respond as habitat suitability changes. The southern elephant seal (Mirounga leonina L.) is a pole-ward migratory species whose populations have mostly stabilized or increased in the past decade, the one exception being the Macquarie Island population which has decreased continuously over the past 50 years. To explore probable causes of this anomalous trend, we counted breeding female seals annually between 1988 and 2011 in order to relate annual rates of population change (r) to foraging habitat changes that have known connections with atmospheric variability. We found r (i) varied annually from -0.016 to 0.021 over the study period, (ii) was most effected by anomalous atmospheric variability after a 3 year time lag was introduced (R = 0.51) and (iii) was associated with sea-ice duration (SID) within the seals' foraging range at the same temporal lag. Negative r years may be extrapolated to explain, at least partially, the overall trend in seal abundance at Macquarie Island; specifically, increasing SID within the seals foraging range has a negative influence on their abundance at the island. Evidence is accruing that suggests southern elephant seal populations may respond positively to a reduced sea-ice field. PMID:24619437

  19. Trends and inequalities in cardiovascular disease mortality across 7932 English electoral wards, 1982–2006: Bayesian spatial analysis

    PubMed Central

    Asaria, Perviz; Fortunato, Lea; Fecht, Daniela; Tzoulaki, Ioanna; Abellan, Juan Jose; Hambly, Peter; de Hoogh, Kees; Ezzati, Majid; Elliott, Paul

    2012-01-01

    Background Cardiovascular disease (CVD) mortality has more than halved in England since the 1980s, but there are few data on small-area trends. We estimated CVD mortality by ward in 5-year intervals between 1982 and 2006, and examined trends in relation to starting mortality, region and community deprivation. Methods We analysed CVD death rates using a Bayesian spatial technique for all 7932 English electoral wards in consecutive 5-year intervals between 1982 and 2006, separately for men and women aged 30–64 years and ?65 years. Results Age-standardized CVD mortality declined in the majority of wards, but increased in 186 wards for women aged ?65 years. The decline was larger where starting mortality had been higher. When grouped by deprivation quintile, absolute inequality between most- and least-deprived wards narrowed over time in those aged 30–64 years, but increased in older adults; relative inequalities worsened in all four age–sex groups. Wards with high CVD mortality in 2002–06 fell into two groups: those in and around large metropolitan cities in northern England that started with high mortality in 1982–86 and could not ‘catch up’, despite impressive declines, and those that started with average or low mortality in the 1980s but ‘fell behind’ because of small mortality reductions. Conclusions Improving population health and reducing health inequalities should be treated as related policy and measurement goals. Ongoing analysis of mortality by small area is essential to monitor local effects on health and health inequalities of the public health and healthcare systems. PMID:23129720

  20. Four Simple Ward Based Initiatives to Reduce Unnecessary In-Hospital Patient Stay: A Quality Improvement Project

    PubMed Central

    Shabbir, Asad; Wali, Gorav; Steuer, Alan

    2015-01-01

    Prolonged hospital stay not only increases financial stress on the National Health Service but also exposes patients to an unnecessarily high risk of adverse ward events. Each day accumulates approximately £225 in bed costs with additional risks of venousthromboembolism, hospital acquired infections, prescription errors, and falls. Despite being medically fit for discharge (MFFD), patients awaiting care packages with prolonged length of stay (LoS) have poorer outcomes and experience increased rates of mortality as a result. A six cycle prospective audit was carried out to investigate if four simple ward based initiatives could optimise patient flow through a medical ward and reduce LoS of inpatients awaiting social packages and placement. The four daily initiatives were: A morning board round between nurses and doctors to prioritise new or sick patients for early review.A post ward round meeting between the multidisciplinary team to expedite rehabilitation and plan discharges early.An evening board round to highlight which patients needed discharge paperwork for the next day to alleviate the wait for pharmacy.A ‘computer on wheels’ on ward rounds so investigations could be ordered and reviewed at the bedside allowing more time to address patient concerns. A control month in August 2013 and five intervention cycles were completed between September 2013 and January 2014. Prior to intervention, mean time taken for patients to be discharged with a package of care, once declared MFFD, was 25 days. With intervention this value dropped to 1 day. The total LoS fell from 46 days to 16 days. It was also found that the time taken from admission to MFFD status was reduced from 21 days to 15 days. In conclusion this data shows that with four simple modifications to ward behaviour unnecessary inpatient stay can be significantly reduced.

  1. Anti-anxiety activity studies of various extracts of Turnera aphrodisiaca Ward.

    PubMed

    Kumar, Suresh; Sharma, Anupama

    2005-01-01

    Turnera aphrodisiaca Ward (Turneraceae) has been used traditionally for treatment of anxiety neurosis and as an aphrodisiac. Yet, the plant has never been subjected to systematic biological investigation. In the present investigation, petroleum ether (60-80 degrees C), chloroform, methanol, and water extracts of T. aphrodisiaca aerial parts were evaluated for anti-anxiety activity in mice using elevated plus-maze apparatus. Among all the extracts, only methanol exhibited significant anti-anxiety activity at a dose of 25 mg/kg with respect to control as well as standard (diazepam, 2 mg/kg). The bioactive methanol extract was shaken with petroleum ether, chloroform, and n-butyl alcohol, and all the shakings as well as the remaining methanol extract (RME) were further evaluated for anxiolytic activity. Butanol fraction and RME were found to exhibit anxiolytic activity in mice at the dose of 10 mg/kg and 75 mg/kg, respectively. PMID:16635964

  2. An exploratory study of research utilization by nurses in general medical and surgical wards.

    PubMed

    Rodgers, S

    1994-11-01

    An exploratory study into research utilization is described. Firstly an agreed definition of research utilization was arrived at through consultation with a range of nurses in both academia and clinical practice. Potential factors that may influence research utilization were identified through a review of current research on research utilization and through a period of fieldwork carried out on two hospital wards in Scotland. The findings indicate that research utilization appears to be a complicated issue and cannot be decontextualized or fractionated in order to lead to an understanding but must address multiple factors simultaneously. This paper refers to research that may be utilized in clinical nursing practice rather than in education or nursing management. The impact of research in clinical practice on education and nursing management is not discounted but the focus of this study is on the influence that research may have on the actual delivery of patient care and, in this sense, education and management developments are encompassed. PMID:7538155

  3. Comparison of automatic oscillometric arterial pressure measurement with conventional auscultatory measurement in the labour ward.

    PubMed

    Hasan, M A; Thomas, T A; Prys-Roberts, C

    1993-02-01

    We have compared two non-invasive methods of arterial pressure (AP) measurement used in labour wards: an automatic oscillometric measurement obtained by Dinamap 1846, and a conventional auscultatory measurement obtained by midwives. A total of 369 AP measurements were recorded, involving 28 normotensive and hypertensive pregnant women during labour, with or without extradural analgesia. Compared with the midwife group, the Dinamap group had a greater systolic AP, by 2.7 mm Hg (P < 0.01) and smaller diastolic AP, by 9.8 mm Hg (P < 0.01). The correlations between the two methods were highly significant, but the limits of agreement were relatively wide for both systolic and diastolic AP measurements. We conclude that a clinically important difference exists in diastolic AP measurements. Dinamap diastolic AP must be corrected using a regression equation, or simply by adding 10 mm Hg, before being compared with the available normal and hypertensive AP values. PMID:8435255

  4. Drug-related problems in medical wards of Tikur Anbessa specialized hospital, Ethiopia

    PubMed Central

    Ayalew, Mohammed Biset; Megersa, Teshome Nedi; Mengistu, Yewondwossen Taddese

    2015-01-01

    Objective: This study was aimed to determine the prevalence of drug-related problems (DRPs), identify the most common drugs, and drug classes involved in DRPs as well as associated factors with the occurrence of DRPs. Methods: A prospective cross-sectional study was conducted on 225 patients admitted to medical wards of Tikur Anbessa Specialized Hospital, Addis Ababa from March to June 2014. Data regarding patient characteristics, medications, diagnosis, length of hospitalization, investigation, and laboratory results were collected using data abstraction forms through review of patients’ medical card and medication charts. Identified DRPs were recorded and classified using DRP registration forms. The possible intervention measures for the identified DRPs were proposed and communicated to either the physician or the patient. Data were entered into Epi Info 7 and analyzed using SPSS version 21 (IBM Corp. Released 2012, Armonk, NY: IBM Corp). Findings: DRPs were found in 52% of study subjects. A drug-drug interaction (48% of all DRPs) was the most common DRP followed by adverse drug reaction (23%). Anti-infectives and gastrointestinal medicines were commonly involved in DRPs. Drugs with the highest drug risk ratio were gentamycin, warfarin, nifedipine, and cimetidine. The number of drugs taken by the patient per day is an important risk factor for DRPs. Conclusion: DRPs are common among medical ward patients. Polypharmacy has a significant association with the occurrence of DRP. Drugs such as gentamycin, warfarin, nifedipine, and cimetidine have the highest probability of causing DRP. So, patients who are taking either of these drugs or polypharmacy should be closely assessed for identification and timely correction of DRPs.

  5. Impact of a hand hygiene educational programme on hospital-acquired infections in medical wards.

    PubMed

    Monistrol, O; Calbo, E; Riera, M; Nicolás, C; Font, R; Freixas, N; Garau, J

    2012-12-01

    Improvement in hand hygiene (HH) compliance has been associated with a decrease in the incidence of hospital-acquired infection (HAI) and hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) infection/colonization. We aimed to evaluate the impact of a multimodal intervention in medical wards on HH compliance, alcohol-based hand rub (AHR) consumption and incidence of HAI and HA-MRSA. A before-after intervention study and an assessment 1 year later were conducted in three internal medicine wards. HH compliance during routine patient care was monitored using the WHO HH observation method. AHR consumption was registered. HAI incidence was actively sought during the PRE and POST periods. HAI risk factors were prospectively recorded and incidence density was calculated. A total of 825 patients were prospectively followed in the PRE period and 868 patients in the POST period. We observed 1531 opportunities for HH in PRE and POST periods and 450 1 year later. HH compliance improved from 54.3% to 75.8% (p 0.005) and remained 75.8% at follow-up. AHR consumption increased from 10.5 to 27.2 L/1000 hospital-days and 31.5 L/1000 hospital-days at follow-up. Incidence density of HAI was 6.93 and 6.96/1000 hospital-days in the PRE and POST intervention periods, respectively. HA-MRSA incidence density was 0.92 in the PRE period vs. 0.25/1000 hospital-days in the POST period (p 0.2) and 0.15/1000 hospital-days (p 0.1) 1 year later. A sustained increase in AHR consumption was followed by an improvement in HH compliance after a multimodal campaign. A trend for lower incidence density of new hospital-acquired MRSA was detected in the POST intervention and follow-up periods. PMID:22192567

  6. Quality of bedside teaching in internal wards of Qaem and Imam Reza hospitals in Mashhad

    PubMed Central

    Jamaazghandi, Alireza; Emadzadeh, Ali; Vakili, Vida; Bazaz, Seyed Mojtaba Mousavi

    2015-01-01

    Background: Bedside teaching is a patient-based teaching method in medical education. The present study has been conducted with the aim of investigating the quality of bedside teaching in the internal wards of Qaem and Imam Reza Educational Hospitals. Methods: This study follows a mixed qualitative-quantitative approach using checklists on educational clinical rounds in Imam Reza and Qaem Hospitals in Mashhad. In the first stage consisting of qualitative study, the parts related to the quality of bedside teaching were recognized and a checklist was designed in three domains of patient comfort (8 questions), targeted teaching (14 questions) and group dynamics (8 questions), and its reliability and validity were verified. In the next step, data were collected and then analyzed using SPSS 16 software through statistical techniques of independent t-test, one-way ANOVA and variance analysis. Results: In total, 113 educational rounds were investigated in this study. Among them, 59 (52.2%) and 54 (47.8%) educational rounds have been investigated in Imam Reza and Qaem Hospitals, respectively. The average total score of bedside teaching was 180.8 out of 300 in the internal wards of both Imam Reza and Qaem Hospitals. Conclusion: The results of this study showed that generally the quality of bedside teaching in Imam Reza and Qaem Hospitals of Mashhad is low according to the qualitative standards considered in this study. Holding educational workshops along with more familiarity of the professors with effective bedside teaching strategies could be effective in improving the quality of educational rounds. PMID:26396735

  7. Physician experience and outcomes among patients admitted to general internal medicine teaching wards

    PubMed Central

    McAlister, Finlay A.; Youngson, Erik; Bakal, Jeffrey A.; Holroyd-Leduc, Jayna; Kassam, Narmin

    2015-01-01

    Background: Physician scores on examinations decline with time after graduation. However, whether this translates into declining quality of care is unknown. Our objective was to determine how physician experience is associated with negative outcomes for patients admitted to hospital. Methods: We conducted a retrospective cohort study involving all patients admitted to general internal medicine wards over a 2-year period at all 7 teaching hospitals in Alberta, Canada. We used files from the Alberta College of Physicians and Surgeons to determine the number of years since medical school graduation for each patient’s most responsible physician. Our primary outcome was the composite of in-hospital death, or readmission or death within 30 days postdischarge. Results: We identified 10 046 patients who were cared for by 149 physicians. Patient characteristics were similar across physician experience strata, as were primary outcome rates (17.4% for patients whose care was managed by physicians in the highest quartile of experience, compared with 18.8% in those receiving care from the least experienced physicians; adjusted odds ratio [OR] 0.88, 95% confidence interval [CI] 0.72–1.06). Outcomes were similar between experience quartiles when further stratified by physician volume, most responsible diagnosis or complexity of the patient’s condition. Although we found substantial variability in length of stay between individual physicians, there were no significant differences between physician experience quartiles (mean adjusted for patient covariates and accounting for intraphysician clustering: 7.90 [95% CI 7.39–8.42] d for most experienced quartile; 7.63 [95% CI 7.13–8.14] d for least experienced quartile). Interpretation: For patients admitted to general internal medicine teaching wards, we saw no negative association between physician experience and outcomes commonly used as proxies for quality of inpatient care. PMID:26283716

  8. Evaluation of Potential Drug - Drug Interactions in General Medicine Ward of Teaching Hospital in Southern India

    PubMed Central

    Ahmad, Akram; Khan, Muhammad Umair; Ivan, Rahul; Dasari, Ram; Revanker, Megha; Pravina, A.; Kuriakose, Sheetal

    2015-01-01

    Background: Polypharmacy is considered as one of the major risk factors in precipitation of drug-drug interactions (DDIs). Patient population at high risk include the elderly and patients with co morbidities as they are usually prescribed with more number of drugs. Critical evaluation of such prescriptions by pharmacist could result in identification and reduction of such problems. Objective: The study aims to assess the prevalence, severity and significance of potential DDI (pDDI) in general medicine wards of South Indian tertiary care teaching hospital. Materials and Method: A prospective observational study was conducted in a general medicine ward for a period of six months (September 2012 to February 2013). The socio-demographic, clinical characteristics and medication prescribed was documented in a specially designed form. Analysis was carried out to assess the prevalence, severity and significance of identified pDDIs using Micromedex. Descriptive and Univariate analysis were used to report the findings. Results: A total of 404 case records reviewed, 78 (19.3%) patients had pDDIs. A total of 139 (34.4%) pDDIs were reported during the study period. Majority (53.95%, n=75) of the interactions were moderate in intensity and significant in nature (53.23%, n=74). Positive association between number of pDDIs and age was observed. Conclusion: The prevalence of pDDIs was 19.3% which is lesser then previously reported studies from India. Patient with more co-morbidities and elders were observed with more pDDIs. The study highlighted the need to effectively monitor and patients prevent pDDIs to improve patient safety. PMID:25859467

  9. An Exploratory Evaluation of the Ward and Hudson Offending Pathways Model with Sex Offenders Who Have Intellectual Disability

    ERIC Educational Resources Information Center

    Langdon, Peter E.; Maxted, Helen; Murphy, Glynis H.

    2007-01-01

    Background: It was predicted that offenders with intellectual disability (ID) categorised according to Ward & Hudson's (1998b) self-regulation theory as having an "Approach" goal would have higher levels of distorted cognitions, less victim empathy, and a history of more prolific offending compared to those with an "Avoidant" goal. Offenders…

  10. STOCHASTIC LIMIT LAWS FOR SCHEDULE MAKESPANS E. G. COFFMAN, Jr., 1 Leopold FLATTO 2 and Ward WHITT 3

    E-print Network

    Coffman Jr., E. G.

    STOCHASTIC LIMIT LAWS FOR SCHEDULE MAKESPANS E. G. COFFMAN, Jr., 1 Leopold FLATTO 2 and Ward WHITT: leopold@research.att.com 3 Room 2C­178; email: wow@research.att.com #12; 1. Introduction An integer m â?? 2

  11. Over the last 3 years,extensive fractures have appeared in the ~3000-yr-old Ward Hunt Ice

    E-print Network

    Vincent, Warwick F.

    was the catastrophic drainage of a fresh water lake that was dammed behind the ice shelf.This"epishelf"lake represented,552 Fig.1.This RADARSAT image (30 August 2002) of theWard Hunt Ice Shelf shows the serpentine crack

  12. PROJECT TITLE: Developing a Recycling Plan in a New York City Elementary School TEAM MEMBERS: Miriam N. Ward & Blake Wells

    E-print Network

    Wolberg, George

    PROJECT TITLE: Developing a Recycling Plan in a New York City Elementary School TEAM MEMBERS Developing a Recycling Plan in a NYC Elementary School 2 TABLE OF CONTENTS Chapters Page I. Abstract 3 II. Publications 91 F. Waste Audit 110 #12;M. N. Ward, B. Wells Developing a Recycling Plan in a NYC Elementary

  13. Effect of Contact Line Curvature on Solid-Fluid Surface Tensions Without Line Tension C. A. Ward* and Jiyu Wu

    E-print Network

    Ward, Charles A.

    Effect of Contact Line Curvature on Solid-Fluid Surface Tensions Without Line Tension C. A. Ward neglected adsorption at the solid-liquid interface and its effect on the surface tension of this interface-liquid interface can be determined, as can the surface tensions of the solid-liquid and solid-vapor interfaces. DOI

  14. Photonic Crystal Aqueous Metal Cation Sensing Sanford A. Asher,* Anjal C. Sharma, Alexander V. Goponenko, and Michelle M. Ward

    E-print Network

    Asher, Sanford A.

    material could be used in the field to visually determine metal cation concentrations in drinking water important application would be to evaluate drinking water purity.1,2 It would be most useful, Alexander V. Goponenko, and Michelle M. Ward Department of Chemistry, Chevron Science Center, University

  15. Modeling Hair Using Level-of-Detail Representations Kelly Ward Ming C. Lin Joohi Lee Susan Fisher Dean Macri

    E-print Network

    North Carolina at Chapel Hill, University of

    Modeling Hair Using Level-of-Detail Representations Kelly Ward Ming C. Lin Joohi Lee Susan Fisher http://gamma.cs.unc.edu/HSLOD/ Abstract: We present a novel approach for modeling hair using level-of-detail representations. The set of representations include individual strands, hair clusters, and hair strips

  16. "Extraordinary Understandings" of Composition at the University of Chicago: Frederick Champion Ward, Kenneth Burke, and Henry W. Sams

    ERIC Educational Resources Information Center

    Beasley, James P.

    2007-01-01

    While Richard Weaver, R. S. Crane, Richard McKeon, and Robert Streeter have been most identified with rhetoric at the University of Chicago and its institutional return in the 1950s, the archival record demonstrates that Frederick Champion Ward, dean of the undergraduate "College" from 1947 to 1954, and Henry W. Sams, director of English in the…

  17. Workplace Learning: An analysis of students' expectations of learning on the ward in the Department of Internal Medicine

    PubMed Central

    Köhl-Hackert, Nadja; Krautter, Markus; Andreesen, Sven; Hoffmann, Katja; Herzog, Wolfgang; Jünger, Jana; Nikendei, Christoph

    2014-01-01

    Background: Learning on the ward as a practice-oriented preparation for the future workplace plays a crucial role in the medical education of future physicians. However, students’ ward internship is partially problematic due to condensed workflows on the ward and the high workload of supervising physicians. For the first time in a German-speaking setting, students’ expectations and concerns about their internship on the ward are examined in a qualitative analysis regarding their internal medicine rotation within clinical medical education. Methods: Of a total of 168 medical students in their 6th semester at the Medical Faculty of Heidelberg, 28 students (m=8, f=20, Ø 23.6 years) took part in focus group interviews 3 to 5 days prior to their internship on the internal medicine ward within their clinical internal medicine rotation. Students were divided into four different focus groups. The protocols were transcribed and a content analysis was conducted based on grounded theory. Results: We gathered a total of 489 relevant individual statements. The students hope for a successful integration within the ward team, reliable and supportive supervisors and supervision in small groups. They expect to face the most common diseases, to train the most important medical skills, to assume full responsibility for their own patients and to acquire their own medical identity. The students fear an insufficient time frame to achieve their aims. They are also concerned they will have too little contact with patients and inadequate supervision. Conclusion: For the development and standardization of effective student internships, the greatest relevance should be attributed to guidance and supervision by professionally trained and well-prepared medical teachers, entailing a significant increase in staff and costs. A structural framework is required in order to transfer the responsibility for the treatment of patients to the students at an early stage in medical education and in a longitudinal manner. The data suggest that the development and establishment of guidelines for medical teachers associated with clearly defined learning objectives for the students’ internships are urgently needed. Based on our findings, we provide first recommendations and suggest possible solutions. PMID:25489343

  18. Community-Based Wetland Restoration Workshop in the Lower Ninth Ward, New Orleans

    NASA Astrophysics Data System (ADS)

    Wang, H. F.; Craig, L.; Ross, J. A.; Zepeda, L.; Carpenter, Q.

    2010-12-01

    Since 2007 a workshop class of University of Wisconsin-Madison students has participated in a community-based project in New Orleans to investigate the feasibility of restoring the Bayou Bienvenue Wetland Triangle (BBWT), which is adjacent to the Lower 9th Ward in New Orleans. This 440-acre region is currently open water but was a cypress forest until the 1970s. Restoration would provide protection from storm surges, restored ecological services, and recreational use. The workshop introduced students to the multidisciplinary skills needed to work effectively with the complex and interconnected issues within a project involving many stakeholders. The stakeholders included the Center for Sustainable Engagement and Development (CSED), Lower 9th Ward residents, non-profits (e.g., Sierra Club, Environmental Defense, Lake Pontchartrain Basin Foundation, National Wildlife Federation), government agencies (e.g., New Orleans Sewerage and Water Board, Army Corps of Engineers), neighborhood groups (e.g., Holy Cross Neighborhood Association, The Village), and universities (Tulane, U. of New Orleans, LSU, U. Colorado-Denver, Southeastern Louisiana). The course ran initially as a Water Resources Management practicum in the first two summers and then as a broader multidisciplinary project with student expertise in hydrology, social science, law, planning, policy analysis, community development, GIS, public health, environmental education and ecological restoration. The project divided into three main components: wetland science, social science, and land tenure and planning. Principal activities in wetland science were to monitor water levels and water quality, inventory flora and fauna, and plant grasses on small “floating islands.” The principal social science activity was to conduct a neighborhood survey about knowledge of the wetland and interest in its restoration. The land tenure and planning activity was to investigate ownership and transfer of property within the wetland because it had been platted with large areas privately owned. A self-published workshop report was produced each of the first three years. Bayou Bienvenue Wetland Triangle with downtown New Orleans in the background. Photo by Travis Scott, U. of Wisconsin-Madison, 2007.

  19. Feasibility of Progressive Strength Training Implemented in the Acute Ward after Hip Fracture Surgery

    PubMed Central

    Kronborg, Lise; Bandholm, Thomas; Palm, Henrik; Kehlet, Henrik; Kristensen, Morten Tange

    2014-01-01

    Importance Patients with a hip fracture lose more than 50% knee-extension strength in the fractured limb within one week of surgery. Hence, immediate progressive strength training following hip fracture surgery may be rational, but the feasibility unknown. Objective To examine the feasibility of in-hospital progressive strength training implemented in the acute ward following hip fracture surgery, based on pre-specified criteria for feasibility. Design, Setting and Patients A prospective cohort study conducted in an acute orthopedic hip fracture unit at a university hospital. A consecutive sample of 36 patients, 18 with a cervical and 18 with a trochanteric hip fracture (27 women and 9 men, mean (SD) age of 79.4 (8.3) years) were included between June and December 2012. Intervention A daily (on weekdays) program of progressive knee-extension strength training for the fractured limb, using ankle weight cuffs in 3 sets of 10 repetition maximum loadings. Main outcomes and Measures The primary outcome was the change in training load (kg) during the knee-extension strength training. The secondary outcomes were changes in hip fracture-related pain and maximal isometric knee-extension strength. Results The strength training was commenced at a mean of 2.4 (0.7) days after surgery. The training loads (kilograms lifted) increased from 1.6 (0.8) to 4.3 (1.7) kg over 4.3 (2.2) training sessions (P<.001). The maximal isometric knee-extension strength of the fractured limb increased from 0.37 (0.2) to 0.61 (0.3) Nm/kg (P<.001), while the average strength deficit in the fractured limb decreased from 50% to 32% (% non-fractured, P<.001). Only 3 of 212 sessions were not performed because of severe hip fracture-related pain. Conclusion and Relevance Progressive knee-extension strength training of the fractured limb commenced in the acute ward seems feasible, and may reduce strength asymmetry between limbs without hip pain interfering. The clinical efficacy needs confirmation in a randomized controlled design. Trial Registration ClinicalTrials.gov ID: NCT01616030 PMID:24699276

  20. Patients’ approaches to students’ learning at a clinical education ward-an ethnographic study

    PubMed Central

    2014-01-01

    Background It is well known that patients’ involvement in health care students’ learning is essential and gives students opportunities to experience clinical reasoning and practice clinical skills when interacting with patients. Students encounter patients in different contexts throughout their education. However, looking across the research providing evidence about learning related to patient-student encounters reveals a lack of knowledge about the actual learning process that occurs in encounters between patients and students. The aim of this study was to explore patient-student encounters in relation to students’ learning in a patient-centered health-care setting. Methods An ethnographic approach was used to study the encounters between patients and students. The setting was a clinical education ward for nursing students at a university hospital with eight beds. The study included 10 observations with 11 students and 10 patients. The observer followed one or two students taking care of one patient. During the fieldwork observational and reflective notes were taken. After each observation follow-up interviews were conducted with each patient and student separately. Data were analyzed using an ethnographic approach. Results The most striking results showed that patients took different approaches in the encounters with students. When the students managed to create a good atmosphere and a mutual relationship, the patients were active participants in the students’ learning. If the students did not manage to create a good atmosphere, the relationship became one-way and the patients were passive participants, letting the students practice on their bodies but without engaging in a dialogue with the students. Conclusions Patient-student encounters, at a clinical education ward with a patient-centred pedagogical framework, can develop into either a learning relationship or an attending relationship. A learning relationship is based on a mutual relationship between patients and students resulting in patients actively participating in students’ learning and they both experience it as a joint action. An attending relationship is based on a one-way relationship between patients and students resulting in patients passively participating by letting students to practice on their bodies but without engaging in a learning dialogue with the students. PMID:24989155

  1. [Patients with drug dependence can be treated in a ward for alcohol dependence on certain conditions].

    PubMed

    Naruse, Nobuya

    2009-04-01

    The treatment for drug dependence in Japan only focuses on detoxification and psychotic disorders, treatment facilities for this study are limited. My proposal for this problem is to improve this situation by having the alcohol treatment ward accept the drug dependency patients. However, drug dependency in-patient treatment has the following concerns, 1. Most patients have tendencies of violence. 2. Motivation and continuation of treatment by the patient is difficult. 3. Breaking rules and deviational conduct. 4. Disintegration of conduct. 5. Disorder of uniformity of group treatment. 6. Lack of specialized resources. In a response to these problems, I am presenting some techniques now on practice at Saitama Prefecture Psychiatric Hospital. Some of these important points are, 1. Building a treatment relationship before admission. 2. Establishing motivation before admission. 3. Stabilization of mental condition before admission. 4. Establishing an explanation and consensus about admission treatment. 5. Knowledge of the craving phase stage and its effects. 6. Devise the program to focus on recovery.7. Create an atmosphere to encourage participation in alcohol and drug dependency groups. 8. Preserve the balance of the program which respects the originality of both groups. I sincerely hope that the above devises will allow the opportunity for the alcohol treatment facilities to open up to the drug dependent patients in the future. PMID:19489443

  2. [Enhancing the capability of medical team to manage aggressive events in acute psychiatric wards].

    PubMed

    Chi, Mei-Ting; Jeang, Shiow-Rong; Pan, Chih-Chuan; Leu, Shu-Jen; Chueh, Ching-Mo

    2008-04-01

    Incidences of violence in acute psychiatric ward can lead to not only facility destructions, but also mental, physical injuries and even medical disputes. As part of efforts to enhance medical team abilities to manage aggressive events, this study aimed to provide references for reducing both aggressive events and resultant damage. Over two-thirds (69%) of all unanticipated occurrences registered by our unit in 2003-2004 were classed as "aggressive events", i.e. there were 27 occurrences (0.09%) in which 0.04% resulted in staff injury. Events were mainly attributable to psychiatric symptoms, poor impulse control and interpersonal conflicts. For this study, we used several intervention methods, including categorizing patients by "risk of violence" rank, revising the hospital's standard operation processes for handling violence and revising the nursing rules to enhance nurse skills at managing violent events, countering patient violence, helping patients safely vent their anger and physical force, listening to relax music and conducting behavior modification. As a result, aggressive event prediction sensitivity increased from 56% to 100%, with successful prevention rates reaching 80%. The rate of aggressive event occurrence reduced from 0.09% to 0.06% and staff injuries decreased from 0.04% to 0.02%. Intervention methods employed were shown to be quite effective. If medical teams elsewhere enhanced their sensitivity and abilities to avoid aggressive events, injury and damages could be prevented and medical care quality enhanced. PMID:18393210

  3. Anti-anxiety Activity Studies on Homoeopathic Formulations of Turnera aphrodisiaca Ward.

    PubMed

    Kumar, Suresh; Sharma, Anupam

    2005-03-01

    Turnera aphrodisiaca Ward (Turneraceae) has been traditionally used for the treatment of anxiety neurosis, and as an aphrodisiac. Mother tinctures (85% ethanol extracts) of T. aphrodisiaca have also been used for the treatment of central nervous system disorders. In the present investigation, T. aphrodisiaca mother tinctures formulated by three reputed manufacturers of homoeopathic medicines (NLK, DWSG and SBL) were evaluated for their anxiolytic activity. Dried mother tinctures of T. aphrodisiaca were subjected to anxiolytic activity evaluation at various doses, i.e. 50, 75, 100, 125 or 150 mg/kg p.o. in mice using elevated plus maze apparatus. Dried mother tinctures exhibited significant anxiolytic activity at 50 mg/kg (NLK), 75 mg/kg (DWSG) and 125 mg/kg (SBL), respectively, with reference to control as well as standard (diazepam, 2 mg/kg p.o.). Mother tinctures of T. aphrodisiaca available in the market, have significant anxiolytic activity. Amongst the three mother tinctures of T. aphrodisiaca analyzed, the dry residue of NLK possesses the highest amount of anxiolytic constituent(s). To ensure uniformity and consistency of biological effects in herbal formulations, these should be standardized on the basis of bioactive markers. The authors are actively involved in isolating the bioactive constituent(s) from T. aphrodisiaca so that the plant can be standardized on the basis of biologically active constituent(s). PMID:15864356

  4. Improving Peripherally Inserted Central Catheter (PICC) care on a Trauma and Orthopaedics ward

    PubMed Central

    Piorkowska, Marta; Al-Raweshidy, Zahra; Yeong, Keefai

    2013-01-01

    Peripherally Inserted Central Catheter (PICC) blockage rate was audited over a two month period on the Trauma & Orthopaedics ward at our District General Hospital. A 70% (five out of seven) PICC blockage rate was observed. High blockage rates lead to potential treatment complications, delays in delivery of treatment, increase in costs, and reduction in patient satisfaction. The factors contributing to the significant blockage rate include, long and contradictory PICC care guidelines, no information sheets in the patient notes, lack of training and awareness about care of, and flushing of, PICC lines, and lack of accountability for PICC flushing. Our project aimed to achieve a greater rate of PICC patency. We produced one succinct and comprehensive PICC care guideline, carried out staff training sessions, introduced a sticker reminding staff to flush the PICC line after use, and introduced a prescription of weekly heparin saline and PRN saline flushes (for monitoring and accountability). We used questionnaires to assess competency of hospital staff pre-teaching (doctors 6%, nurses 0%), and post-teaching (doctors 70%, nurses 38%). Blockage rate data post-intervention is pending. Education improved awareness of guidelines amongst staff and we anticipate that the proposed interventions will translate into reduced blockage rates, improving patient outcomes and reducing costs.

  5. Improving multidisciplinary communication at ward board rounds using video enhanced reflective practice

    PubMed Central

    Hellier, Cyril; Tully, Vicki; Forrest, Sandra; Jaggard, Pamela; MacRae, Morag; Habicht, Dirk; Greene, Alexandra; Collins, Karen

    2015-01-01

    The priority to ensure patient safety and use resources effectively, demands attention and innovation. Video enhanced reflective practice (VERP) provides training based upon analysis of film clips of one's professional practice to develop practical insight into the processes of communication, so that effective changes can be made to ongoing behaviour and practice. In this case the focus was on multi-disciplinary communication within daily board rounds on an acute medicine and care of the elderly ward. Baseline assessment and post intervention testing of perceptions of change by both full and core team were undertaken to establish the impact of VERP training. In addition pre and post focus group discussion and film analysis supplemented evaluation. The findings support the view that after VERP training of a core team, board rounds were seen as consistently easier to participate in, providing improved focus, were more efficient in goal setting and resulting in better care for patients as well as improved pathways to discharge. This suggests benefits to the communication “culture” of a multidisciplinary team resulting in increased benefits for the wider team. It is concluded that the use of tailored VERP training for personal, professional and team development is relevant, feasible, and worthy of further testing and investigation.

  6. An infinite set of Ward identities for adiabatic modes in cosmology

    SciTech Connect

    Hinterbichler, Kurt; Hui, Lam; Khoury, Justin E-mail: lh399@columbia.edu

    2014-01-01

    We show that the correlation functions of any single-field cosmological model with constant growing-modes are constrained by an infinite number of novel consistency relations, which relate N+1-point correlation functions with a soft-momentum scalar or tensor mode to a symmetry transformation on N-point correlation functions of hard-momentum modes. We derive these consistency relations from Ward identities for an infinite tower of non-linearly realized global symmetries governing scalar and tensor perturbations. These symmetries can be labeled by an integer n. At each order n, the consistency relations constrain — completely for n = 0,1, and partially for n ? 2 — the q{sup n} behavior of the soft limits. The identities at n = 0 recover Maldacena's original consistency relations for a soft scalar and tensor mode, n = 1 gives the recently-discovered conformal consistency relations, and the identities for n ? 2 are new. As a check, we verify directly that the n = 2 identity is satisfied by known correlation functions in slow-roll inflation.

  7. Dietary lipids and blood cholesterol: quantitative meta-analysis of metabolic ward studies.

    PubMed Central

    Clarke, R.; Frost, C.; Collins, R.; Appleby, P.; Peto, R.

    1997-01-01

    OBJECTIVE: To determine the quantitative importance of dietary fatty acids and dietary cholesterol to blood concentrations of total, low density lipoprotein, and high density lipoprotein cholesterol. DESIGN: Meta-analysis of metabolic ward studies of solid food diets in healthy volunteers. SUBJECTS: 395 dietary experiments (median duration 1 month) among 129 groups of individuals. RESULTS: Isocaloric replacement of saturated fats by complex carbohydrates for 10% of dietary calories resulted in blood total cholesterol falling by 0.52 (SE 0.03) mmol/l and low density lipoprotein cholesterol falling by 0.36 (0.05) mmol/l. Isocaloric replacement of complex carbohydrates by polyunsaturated fats for 5% of dietary calories resulted in total cholesterol falling by a further 0.13 (0.02) mmol/l and low density lipoprotein cholesterol falling by 0.11 (0.02) mmol/l. Similar replacement of carbohydrates by monounsaturated fats produced no significant effect on total or low density lipoprotein cholesterol. Avoiding 200 mg/day dietary cholesterol further decreased blood total cholesterol by 0.13 (0.02) mmol/l and low density lipoprotein cholesterol by 0.10 (0.02) mmol/l. CONCLUSIONS: In typical British diets replacing 60% of saturated fats by other fats and avoiding 60% of dietary cholesterol would reduce blood total cholesterol by about 0.8 mmol/l (that is, by 10-15%), with four fifths of this reduction being in low density lipoprotein cholesterol. PMID:9006469

  8. Does gender matter? Differences between students at an interprofessional training ward.

    PubMed

    Lindh Falk, Annika; Hammar, Mats; Nyström, Sofia

    2015-11-01

    Studies on graduates' transitions from education into clinical work highlight inequalities concerning how women and men experience their professional learning and development. This study explores how female and male students from different programs within the health care education system (i.e. medicine, nursing, occupational therapy, and physiotherapy programmes) experience an interprofessional training ward (IPTW) as a part of their professional identity formation. Students from the medicine, nursing, physiotherapy, and occupational therapy programmes collaborate in teams during two weeks at one of three IPTWs at the medical school, Linköping University. They together take the responsibility for diagnosis, treatment, and rehabilitation of the patients, albeit with professional supervisors as support. During 2010 to 2011, 454 (93%) of the 488 students who practiced at the IPTWs answered a questionnaire on their experiences of the IPTW. The students stated that the IPTW had positively influenced their professional development. The female and male medical students were significantly less positive than other female and male students, respectively, concerning the value of IPTW. The male students from all programmes were slightly, but significantly, less positive than all the female students. These findings show that students "do gender" as an integral part of the educational practice. It is important to scrutinise the IPTW as an educational practice, influencing students' preparation for future work. Gender should be discussed not only during the IPTW rotation but also in general during the curriculum for all healthcare programmes. PMID:26652634

  9. Use of copper alloy for preventing transmission of methicillin-resistant Staphylococcus aureus contamination in the dermatology ward.

    PubMed

    Niiyama, Nanako; Sasahara, Takeshi; Mase, Hiroshi; Abe, Michiko; Saito, Haruo; Katsuoka, Kensei

    2013-05-01

    Metallic copper has been shown significantly to reduce methicillin-resistant Staphylococcus aureus (MRSA) contamination of the ambient surroundings of the beds of MRSA-carrying patients in dermatology wards. The aim of this study was to determine whether a bed sheet made of copper-coated film will reduce the spread of MRSA contamination in the environment of a heavily-colonized patient. The bacterial count was highest on the bed sheet. MRSA cell counts on the surface of the non-film-coated control sheet were high (6,600-11,000 colony forming units (cfu)), but those on the copper film were considerably lower (20-130 cfu). Use of metallic copper on the bed sheets of patients who are likely to be a source of MRSA contamination may help to prevent the spread of MRSA contamination in hospital wards. PMID:23038099

  10. A journey filled with emotions--mothers' experiences of breastfeeding their preterm infant in a Swedish neonatal ward.

    PubMed

    Björk, Maria; Thelin, Anna; Peterson, Inger; Hammarlund, Kina

    2012-03-01

    The study took place in a 10-bed neonatal ward in a hospital in the south of Sweden and includes mothers having given birth to a preterm infant born before the 37th week of gestation. The aim of the study was to illuminate mothers' experiences of breastfeeding a preterm infant in a neonatal ward. Data collection includes written protocols from twelve mothers. These protocols were analysed thematically. The results indicate that the mothers should be offered a private place where they can breastfeed or express breastmilk, and that the breastmilk should not be placed in a shared area. The mothers described that they did not want to be separated from their preterm infant during the night. Finally, they also pointed out the importance of support from the health professionals for establishing an exclusive breastfeeding regime. PMID:22724310

  11. Finite One-Loop Calculations in Quantum Gravity Graviton Self-Energy, Perturbative Gauge Invariance and Slavnov-Ward Identities

    E-print Network

    Grillo, N

    1999-01-01

    In this paper we show that the one-loop graviton self-energy contribution is ultraviolet finite, without introducing counterterms, and cutoff-free in the framework of causal perturbation theory. In addition, it satisfies the gravitational Slavnov-Ward identities for the two-point connected Green function. The condition of perturbative gauge invariance to second order for loop graphs is proved. Corrections to the Newtonian potential are also derived.

  12. Finite One-Loop Calculations in Quantum Gravity: Graviton Self-Energy, Perturbative Gauge Invariance and Slavnov-Ward Identities

    E-print Network

    Nicola Grillo

    2000-06-22

    In this paper we show that the one-loop graviton self-energy contribution is ultraviolet finite, without introducing counterterms, and cutoff-free in the framework of causal perturbation theory. In addition, it satisfies the gravitational Slavnov-Ward identities for the two-point connected Green function. The condition of perturbative gauge invariance to second order for loop graphs is proved. Corrections to the Newtonian potential are also derived.

  13. An Australian hospital-based student training ward delivering safe, client-centred care while developing students' interprofessional practice capabilities.

    PubMed

    Brewer, Margo L; Stewart-Wynne, Edward G

    2013-11-01

    Royal Perth Hospital, in partnership with Curtin University, established the first interprofessional student training ward in Australia, based on best practice from Europe. Evaluation of the student and client experience was undertaken. Feedback from all stakeholders was obtained regularly as a key element of the quality improvement process. An interprofessional practice program was established with six beds within a general medical ward. This provided the setting for 2- to 3-week clinical placements for students from medicine, nursing, physiotherapy, occupational therapy, social work, pharmacy, dietetics and medical imaging. Following an initial trial, the training ward began with 79 students completing a placement. An interprofessional capability framework focused on the delivery of high quality client care and effective teamwork underpins this learning experience. Quantitative outcome data showed not only an improvement in students' attitudes towards interprofessional collaboration but also acquisition of a high level of interprofessional practice capabilities. Qualitative outcome data from students and clients was overwhelmingly positive. Suggestions for improvement were identified. This innovative learning environment facilitated the development of the students' knowledge, skills and attitudes required for interprofessional, client centred collaborative practice. Staff reported a high level of compliance with clinical safety and quality. PMID:24299579

  14. Prevalence of potential drug-drug interactions among internal medicine ward in University of Gondar Teaching Hospital, Ethiopia

    PubMed Central

    Bhagavathula, Akshaya Srikanth; Berhanie, Alemayehu; Tigistu, Habtamu; Abraham, Yishak; Getachew, Yosheph; Khan, Tahir Mehmood; Unakal, Chandrashekhar

    2014-01-01

    Objective To determine the prevalence, clinical significance and the associated risk factors of potential drug-drug interactions (DDIs) at internal medicine ward of University of Gondar (UOG) hospital. Method A prospective cross-sectional study was conducted on patients treated in internal medicine ward of UOG hospital from April 29, 2013 to June 2, 2013. Data was collected from medical records and by interviewing the patients face to face. Descriptive analysis was conducted for back ground characteristics and logistic regression was used to determine the associated risk factors. Result In our study, we have identified a total number of 413 potential DDIs and 184 types of interacting combinations with 4.13 potential DDIs per patient. Among 413 potential DDIs most were of moderate interactions 61.2% (n=253) followed by 26% (n=107) of minor interactions and 12.8% (n=53) of major interactions. There was significant association of occurrence of potential DDIs only with taking three or more medications. Conclusion We have recorded a high rate of prevalence of potential DDI in the internal medicine ward of UOG hospital and a high number of clinically significant DDIs which the most prevalent DDI were of moderate severity. Careful selection of drugs and active pharmaceutical care is encouraged in order to avoid negative consequences of these interactions. PMID:25183081

  15. Integrating care for high-risk patients in England using the virtual ward model: lessons in the process of care integration from three case sites

    PubMed Central

    Lewis, Geraint; Vaithianathan, Rhema; Wright, Lorraine; Brice, Mary R; Lovell, Paul; Rankin, Seth; Bardsley, Martin

    2013-01-01

    Background Patients at high risk of emergency hospitalisation are particularly likely to experience fragmentation in care. The virtual ward model attempts to integrate health and social care by offering multidisciplinary case management to people at high predicted risk of unplanned hospitalisation. Objective To describe the care practice in three virtual ward sites in England and to explore how well each site had achieved meaningful integration. Method Case studies conducted in Croydon, Devon and Wandsworth during 2011–2012, consisting of semi-structured interviews, workshops, and site visits. Results Different versions of the virtual wards intervention had been implemented in each site. In Croydon, multidisciplinary care had reverted back to one-to-one case management. Conclusions To integrate successfully, virtual ward projects should safeguard the multidisciplinary nature of the intervention, ensure the active involvement of General Practitioners, and establish feedback processes to monitor performance such as the number of professions represented at each team meeting. PMID:24250284

  16. NUMERICAL SOLUTION OF PIECEWISESTATIONARY M t / G t / 1 QUEUES Gagan L. Choudhury, 1 David M. Lucantoni 2 and Ward Whitt 3

    E-print Network

    Whitt, Ward

    . Lucantoni 2 and Ward Whitt 3 AT&T Bell Laboratories May 21, 1993 Revision: January 27, 1995 (This paper has­178, Murray Hill, NJ 07974­0636 #12; Abstract We develop an algorithm for computing the (exact

  17. Interprofessional Collaboration on an Internal Medicine Ward: Role Perceptions and Expectations among Nurses and Residents

    PubMed Central

    Muller-Juge, Virginie; Cullati, Stéphane; Blondon, Katherine S.; Hudelson, Patricia; Maître, Fabienne; Vu, Nu V.; Savoldelli, Georges L.; Nendaz, Mathieu R.

    2013-01-01

    Background Effective interprofessional collaboration requires that team members share common perceptions and expectations of each other's roles. Objective Describe and compare residents’ and nurses’ perceptions and expectations of their own and each other’s professional roles in the context of an Internal Medicine ward. Methods A convenience sample of 14 residents and 14 nurses volunteers from the General Internal Medicine Division at the University Hospitals of Geneva, Switzerland, were interviewed to explore their perceptions and expectations of residents’ and nurses’ professional roles, for their own and the other profession. Interviews were analysed using thematic content analysis. The same respondents also filled a questionnaire asking their own intended actions and the expected actions from the other professional in response to 11 clinical scenarios. Results Three main themes emerged from the interviews: patient management, clinical reasoning and decision-making processes, and roles in the team. Nurses and residents shared general perceptions about patient management. However, there was a lack of shared perceptions and expectations regarding nurses’ autonomy in patient management, nurses’ participation in the decision-making process, professional interdependence, and residents’ implication in teamwork. Results from the clinical scenarios showed that nurses’ intended actions differed from residents’ expectations mainly regarding autonomy in patient management. Correlation between residents’ expectations and nurses’ intended actions was 0.56 (p?=?0.08), while correlation between nurses’ expectations and residents’ intended actions was 0.80 (p<0.001). Conclusions There are discordant perceptions and unmet expectations among nurses and residents about each other’s roles, including several aspects related to the decision-making process. Interprofessional education should foster a shared vision of each other’s roles and clarify the boundaries of autonomy of each profession. PMID:23469027

  18. Outcome Risk Factors during Respiratory Infections in a Paediatric Ward in Antananarivo, Madagascar 2010–2012

    PubMed Central

    Rajatonirina, Soatiana; Razanajatovo, Norosoa Harline; Ratsima, Elisoa Hariniana; Orelle, Arnaud; Ratovoson, Rila; Andrianirina, Zo Zafitsara; Andriatahina, Todisoa; Ramparany, Lovasoa; Herindrainy, Perlinot; Randrianirina, Frédérique; Heraud, Jean-Michel; Richard, Vincent

    2013-01-01

    Background Acute respiratory infections are a leading cause of infectious disease-related morbidity, hospitalisation and mortality among children worldwide, and particularly in developing countries. In these low-income countries, most patients with acute respiratory infection (ARI), whether it is mild or severe, are still treated empirically. The aim of the study was to evaluate the risk factors associated with the evolution and outcome of respiratory illnesses in patients aged under 5 years old. Materials and Methods We conducted a prospective study in a paediatric ward in Antananarivo from November 2010 to July 2012 including patients under 5 years old suffering from respiratory infections. We collected demographic, socio-economic, clinical and epidemiological data, and samples for laboratory analysis. Deaths, rapid progression to respiratory distress during hospitalisation, and hospitalisation for more than 10 days were considered as severe outcomes. We used multivariate analysis to study the effects of co-infections. Results From November 2010 to July 2012, a total of 290 patients were enrolled. Co-infection was found in 192 patients (70%). Co-infections were more frequent in children under 36 months, with a significant difference for the 19–24 month-old group (OR: 8.0). Sixty-nine percent (230/290) of the patients recovered fully and without any severe outcome during hospitalisation; the outcome was scored as severe for 60 children and nine patients (3%) died. Risk factors significantly associated with worsening evolution during hospitalisation (severe outcome) were admission at age under 6 months (OR?=?5.3), comorbidity (OR?=?4.6) and low household income (OR?=?4.1). Conclusion Co-mordidity, low-income and age under 6 months increase the risk of severe outcome for children infected by numerous respiratory pathogens. These results highlight the need for implementation of targeted public health policy to reduce the contribution of respiratory diseases to childhood morbidity and mortality in low income countries. PMID:24069161

  19. Epidemiology of Methicillin-Susceptible Staphylococcus aureus in a Neonatology Ward.

    PubMed

    Achermann, Yvonne; Seidl, Kati; Kuster, Stefan P; Leimer, Nadja; Durisch, Nina; Ajdler-Schäffler, Evelyne; Karrer, Stephan; Senn, Gabriela; Holzmann-Bürgel, Anne; Wolfensberger, Aline; Leone, Antonio; Arlettaz, Romaine; Zinkernagel, Annelies S; Sax, Hugo

    2015-11-01

    OBJECTIVE In-hospital transmission of methicillin-susceptible Staphylococcus aureus (MSSA) among neonates remains enigmatic. We describe the epidemiology of MSSA colonization and infection in a 30-bed neonatal ward. DESIGN Multimodal outbreak investigation SETTING A public 800-bed tertiary care university hospital in Switzerland METHODS Investigations in 2012-2013, triggered by a MSSA infection cluster, included prospective MSSA infection surveillance, microbiologic screening of neonates and environment, onsite observations, and a prospective cohort study. MSSA isolates were characterized by pulsed-field gel electrophoresis (PFGE) and selected isolates were examined for multilocus sequence type (MLST) and virulence factors. RESULTS Among 726 in 2012, 30 (4.1%) patients suffered from MSSA infections including 8 (1.1%) with bacteremia. Among 655 admissions in 2013, 13 (2.0%) suffered from MSSA infections including 2 (0.3%) with bacteremia. Among 177 neonates screened for S. aureus carriage, overall 77 (44%) tested positive. A predominant PFGE-1-ST30 strain was identified in 6 of 30 infected neonates (20%) and 30 of 77 colonized neonates (39%). This persistent clone was pvl-negative, tst-positive and belonged to agr group III. We found no environmental point source. MSSA carriage was associated with central vascular catheter use but not with a particular midwife, nurse, physician, or isolette. Observed healthcare worker behavior may have propagated transmission via hands and fomites. Despite multimodal interventions, clonal transmission and colonization continued and another clone, PFGE-6-ST5, became predominant. CONCLUSIONS Hospital-acquired MSSA clones represent a high proportion of MSSA colonization but not MSSA infections in neonate inpatients. In contrast to persisting MSSA, transmission infection rates decreased concurrently with interventions. It remains to be established whether eradication of hospital-acquired MSSA strains would reduce infection rates further. Infect. Control Hosp. Epidemiol. 2015;36(11):1305-1312. PMID:26290400

  20. Hand contamination during routine care in medical wards: the role of hand hygiene compliance.

    PubMed

    Monistrol, Olga; López, M Liboria; Riera, Montserrat; Font, Roser; Nicolás, Carme; Escobar, Miguel Angel; Freixas, Núria; Garau, Javier; Calbo, Esther

    2013-04-01

    The hands of healthcare workers (HCWs) are the most common vehicle for the transmission of micro-organisms from patient to patient and within the healthcare environment. The aim of this study was to evaluate the impact of a multimodal campaign on the type and amount of resident and transient flora and the presence of potential risk factors for hand contamination during routine care. A before-after (PRE and POST periods) interventional study was carried out in medical wards of a tertiary care hospital. Eighty-nine samples were analysed. Samples were cultured immediately before patient contact using a glove-juice method. Data collected included socio-demographic and risk factors for hand contamination. Flora was measured as log10 c.f.u. ml(-1) and evaluated by comparing median values in the PRE and POST periods. Transient flora was isolated from the hands of 67.4 and 46.1 % of HCWs in the PRE and POST periods, respectively (P<0.001). Enterobacteriaceae, Pseudomonas spp. and meticillin-sensitive Staphylococcus aureus were the predominant contaminants. Resident flora was isolated from 92.1 % of HCWs in the PRE period and from 70.8 % in the POST period (P<0.001). The meticillin-resistant coagulase-negative staphylococci log10 c.f.u. count ml(-1) decreased from 1.96 ± 1.2 to 0.89 ± 1.2 (mean ± s d; P<0.001), and the global flora count decreased from 2.77 ± 1.1 to 1.56 ± 1.4 (P<0.001). In the POST period, the wearing of fewer rings (P<0.001), shorter fingernail length (P = 0.008), a shorter time since recent hand hygiene (HH) (P = 0.007) and an increased use of alcohol-based hand rub instead of soap (P<0.001) were documented. The HH multimodal strategy reduced the number of risk factors and the level of HCW hand contamination. PMID:23329322

  1. "Driving the devil away": qualitative insights into miraculous cures for AIDS in a rural Tanzanian ward

    PubMed Central

    2010-01-01

    Background The role of religious beliefs in the prevention of HIV and attitudes towards the infected has received considerable attention. However, little research has been conducted on Faith Leaders' (FLs) perceptions of antiretroviral therapy (ART) in the developing world. This study investigated FLs' attitudes towards different HIV treatment options (traditional, medical and spiritual) available in a rural Tanzanian ward. Methods Qualitative interviews were conducted with 25 FLs purposively selected to account for all the denominations present in the area. Data was organised into themes using the software package NVIVO-7. The field work guidelines were tailored as new topics emerged and additional codes progressively added to the coding frame. Results Traditional healers (THs) and FLs were often reported as antagonists but duality prevailed and many FLs simultaneously believed in traditional healing. Inter-denomination mobility was high and guided by pragmatism. Praying for the sick was a common practice and over one third of respondents said that prayer could cure HIV. Being HIV-positive was often seen as "a punishment from God" and a consequence of sin. As sinning could result from "the work of Satan", forgiveness was possible, and a "reconciliation with God" deemed as essential for a favourable remission of the disease. Several FLs believed that "evil spirits" inflicted through witchcraft could cause the disease and claimed that they could cast "demons" away. While prayers could potentially cure HIV "completely", ART use was generally not discouraged because God had "only a part to play". The perceived potential superiority of spiritual options could however lead some users to interrupt treatment. Conclusions The roll-out of ART is taking place in a context in which the new drugs are competing with a diversity of existing options. As long as the complementarities of prayers and ART are not clearly and explicitly stated by FLs, spiritual options may be interpreted as a superior alternative and contribute to hampering adherence to ART. In contexts where ambivalent attitudes towards the new drugs prevail, enhancing FLs understanding of ART's strengths and pitfalls is an essential step to engage them as active partners in ART scale-up programs. PMID:20646300

  2. Psychological distress in mothers of children admitted to a nutritional rehabilitation unit in Malawi - a comparison with other paediatric wards.

    PubMed

    Colman, Sarah; Stewart, Robert C; MacArthur, Christine; Kennedy, Neil; Tomenson, Barbara; Creed, Francis

    2015-10-01

    In a previous study we found a very high prevalence of psychological distress in mothers of children admitted to a nutritional rehabilitation unit (NRU) in Malawi, Africa. The objective of this study was to compare the prevalence and severity of maternal distress within the NRU with that in other paediatric wards. Given the known association between poor maternal psychological well-being and child undernutrition in low- and middle-income countries, we hypothesised that distress would be higher among NRU mothers. Mothers of consecutive paediatric inpatients in a NRU, a high-dependency (and research) unit and an oncology ward were assessed for psychological distress using the Self-Reporting Questionnaire (SRQ). Two hundred sixty-eight mothers were interviewed (90.3% of eligible). The prevalence of SRQ score ?8 was 35/150 {23.3% [95% confidence interval (CI) 16.8- 30.9%]} on the NRU, 13/84 [15.5% (95% CI 8.5-25.0%)] on the high-dependency unit and 7/34 [20.6% (95% CI 8.7-37.9%)] on the oncology ward (?(2) ?=?2.04, P?=?0.36). In linear regression analysis, the correlates of higher SRQ score were child diarrhoea on admission, child diagnosed with tuberculosis, and maternal experience of abuse by partner; child height-for-age z-score fell only just outside significance (P?=?0.05). In summary, we found no evidence of greater maternal distress among the mothers of severely malnourished children within the NRU compared with mothers of paediatric inpatients with other severe illnesses. However, in support of previous research findings, we found some evidence that poor maternal psychological well-being is associated with child stunting and diarrhoea. PMID:24224802

  3. One-loop calculations in quantum gravity: graviton self-energy, perturbative gauge invariance and Slavnov-Ward identities

    NASA Astrophysics Data System (ADS)

    Grillo, Nicola

    2001-01-01

    In this paper we calculate the one-loop graviton self-energy within the framework of causal perturbation theory. Because of this regularization/renormalization scheme, the result is ultraviolet finite, without introducing counterterms, and cut-off-free. In addition, it satisfies the gravitational Slavnov-Ward identities for the two-point connected Green function. The latter are also investigated from the point of view of a perturbative formulation of operator gauge invariance. Then, the condition of perturbative gauge invariance to second order for loop graphs is proved. Corrections to the Newtonian potential coming from the graviton self-energy are also derived.

  4. Prevalence of body dysmorphic disorder on a psychiatric inpatient ward and the value of a screening question.

    PubMed

    Veale, David; Akyüz, Elvan U; Hodsoll, John

    2015-12-15

    The aim of this study was to estimate the prevalence of body dysmorphic disorder (BDD) on an inpatient ward in the UK with a larger sample than previously studied and to investigate the value of a simple screening question during an assessment interview. Four hundred and thirty two consecutive admissions were screened for BDD on an adult psychiatric ward over a period of 13 months. Those who screened positive had a structured diagnostic interview for BDD. The prevalence of BDD was estimated to be 5.8% (C.I. 3.6-8.1%). Our screening question had a slightly low specificity (76.6%) for detecting BDD. The strength of this study was a larger sample size and narrower confidence interval than previous studies. The study adds to previous observations that BDD is poorly identified in psychiatric inpatients. BDD was identified predominantly in those presenting with depression, substance misuse or an anxiety disorder. The screening question could be improved by excluding those with weight or shape concerns. Missing the diagnosis is likely to lead to inappropriate treatment. PMID:26404769

  5. [Patient record based ward rounds as an example of coordination between doctors and nurses "courses of action"].

    PubMed

    Nadot Ghanem, Nicole

    2013-06-01

    Working in the hospital field is characterized by collective work that requires collaboration and coordination. Characterizing the way, in which individual activities contribute to the construction of a collective activity, is an important issue to better understand teamwork. A phenomenological research approach was applied to analyze the situated activity of nurses and physicians during patient record based ward rounds, according to the theoretical and methodological frame of "course of action" Our findings revealed ward rounds comprising not only an information exchange but a privileged space and moment of construction of knowledge and coordination. Two processes were derived from the actors' commitments and concerns, and from their articulation: "seeking to contribute to a shared interpretation of the situation" and "seeking to develop a precise working knowledge of the situation". These processes contribute to characterize the coordination between the professionals involved in hospital care. Future educational activities for health care professionals should consider the importance of the perception of and meanings for the involved professionals and consider training actions to foster reflecting on and during action. PMID:23923739

  6. Preliminary study of the fungal ecology at the haematology and medical-oncology ward in Bamako, Mali.

    PubMed

    Niaré-Doumbo, Safiatou; Normand, Anne Cécile; Diallo, Yacouba Lazarre; Dembelé, Abdoul Karim; Thera, Mahamadou A; Diallo, Dapa; Piarroux, Renaud; Doumbo, Ogobara; Ranque, Stéphane

    2014-08-01

    Data on fungal epidemiology in sub-Saharan African countries are scarce. This exploratory study aimed to characterize the fungal flora at the Onco-Haematology ward of the National Teaching Hospital of Point G in Bamako, Mali. A cross-sectional survey was conducted in the dry and in the rainy seasons. Nasal swab and sputum samples were collected from the hospitalized patients while airborne fungal spores were collected using electrostatic dust-fall collectors. Fungi were identified by their morphological characteristics and MALDI-TOF mass spectrometry. Candida albicans was the most frequent yeast species colonizing patients; Aspergillus species were isolated in 86 % of the patients and were the main airborne environmental contaminants. Overall, airborne fungal contamination rates increased from 33.8 % in the dry to 66.2 % in the rainy season (p < 0.001). The most frequent Aspergillus species were Aspergillus niger (36.6 %) and Aspergillus flavus (32.92 %). In contrast, Aspergillus fumigatus (5.43 %) was relatively rare. This high level of fungal exposure raises concern regarding the management of at-risk patients in this Onco-Haematology ward and stresses the need for strengthening the mycological diagnostic capacities to accompany the implementation of adapted fungal infection prevention and management policies. PMID:24889723

  7. Genetic dissimilarity and selection of putative mutants of Terra Maranhão plantain cultivar using the Ward-MLM strategy.

    PubMed

    Reis, R V; Amorim, E P; Amorim, V B O; Ferreira, C F; Pestana, R K N; Ledo, C A S; Gonçalves, Z; Borém, A

    2015-01-01

    The objective of this study was to evaluate genetic variability and select putative mutants of Terra Maranhão plantain cultivar (AAB genome) subjected to gamma radiation based on agronomic data and inter simple sequence repeat molecular marker profiles using the Ward-MLM strategy. A total of 233 irradiated plants and 41 controls were assessed. The agronomic and molecular data were subjected to the Ward-MLM statistical algorithm in the SAS program. Cluster analysis was performed by the average distance method (UPGMA), based on the distance matrix of the Gower algorithm, and the cophenetic correlation coefficient calculated using the R software. The distance between the putative mutants ranged from 0.321 to 0.524, with an average distance of 0.426, and a cophenetic correlation coefficient of 0.79. Three putative mutants, which were selected based on the best agronomic traits and low height, will undergo further evaluation in the next stages of the banana breeding program at Embrapa. These results describe the first attempt of using combined data of Terra Maranhão plantain cultivar for the purpose of selecting mutants and assessing genetic variability. PMID:26634499

  8. Close encounters in a pediatric ward: measuring face-to-face proximity and mixing patterns with wearable sensors

    E-print Network

    Isella, L; Barrat, A; Cattuto, C; Colizza, V; Broeck, W Van den; Gesualdo, F; Pandolfi, E; Ravà, L; Rizzo, C; Tozzi, A E; 10.1371/journal.pone.0017144

    2011-01-01

    Nosocomial infections place a substantial burden on health care systems and represent a major issue in current public health, requiring notable efforts for its prevention. Understanding the dynamics of infection transmission in a hospital setting is essential for tailoring interventions and predicting the spread among individuals. Mathematical models need to be informed with accurate data on contacts among individuals. We used wearable active Radio-Frequency Identification Devices to detect face-to-face contacts among individuals with a spatial resolution of about 1.5 meters, and a time resolution of 20 seconds. The study was conducted in a general pediatrics hospital ward, during a one-week period, and included 119 participants. Nearly 16,000 contacts were recorded during the study, with a median of approximately 20 contacts per participants per day. Overall, 25% of the contacts involved a ward assistant, 23% a nurse, 22% a patient, 22% a caregiver, and 8% a physician. The majority of contacts were of brief ...

  9. Effect of Education on Stress of Exposure to Sharps Among Nurses in Emergency and Trauma Care Wards

    PubMed Central

    Moayed, Malihe Sadat; Mahmoudi, Hosein; Ebadi, Abbas; Salary, Mohammad Mehdi; Danial, Zahra

    2015-01-01

    Background: Health care services can cause injuries to medical staff. One of these injuries is exposure to needle-sticks. This can result in the transmission of blood-borne diseases, such as HIV and hepatitis B; the staff undergo continuous stress. Thus, it is necessary to use some method to reduce this stress. Objectives: The purpose of this study was to examine the effect of education based on the stabilization model on stress induced exposure to needle sticks among nurses working in emergency and trauma wards. Patients and Methods: This Quast- Experiental Study was performed on 35 nurses working in emergency and trauma wards of our hospital in October-December 2013. Data were collected using a two-part questionnaire; Reliability and validity of the questionnaire were confirmed (? = 0. 92 and ICC = 0.94).Data were analyzed using SPSS version 20. The one-sample Kolmogorov-Smirnov test, independent t-test and paired sample t-test were also used. Results: The mean and standard deviation of stress experienced by nurses before and after the intervention were 64.94 ± 15.67 and 43.91 ± 10.73, respectively. Findings indicated that education decrease needle stick stress in nurses significantly (P < 0.001). Conclusions: According to the results of this study, the stress level induced due to needle-stick exposure and its complications is high and interventions for reduction are essential. PMID:26290853

  10. Bacterial Epidemiology and Antimicrobial Resistance in the Surgery Wards of a Large Teaching Hospital in Southern Italy

    PubMed Central

    Esposito, Silvano; Gioia, Renato; De Simone, Giuseppe; Noviello, Silvana; Lombardi, Domenico; Di Crescenzo, Vincenzo Giuseppe; Filippelli, Amelia; Rega, Maria Rosaria; Massari, Angelo; Elberti, Maria Giovanna; Grisi, Lucilla; Boccia, Giovanni; De Caro, Francesco; Leone, Sebastiano

    2015-01-01

    Objectives Surgical infections represent an increasingly important problem for the National Health System. In this study we retrospectively evaluated the bacterial epidemiology and antimicrobial susceptibility of the microorganisms concerned as well as the utilization of antibiotics in the General and Emergency Surgery wards of a large teaching hospital in southern Italy in the period 2011–2013. Methods Data concerning non-duplicate bacterial isolates and antimicrobial susceptibility were retrieved from the Vitek 2 database. The pharmacy provided data about the consumption of antibiotics in the above reported wards. Chi-square or Fisher’s exact test were used. Results In all, 94 Gram-negative were isolated in 2011, 77 in 2012, and 125 in 2013, Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa always being the most frequently isolated microorganisms. A. baumannii showed high rates of resistance to carbapenems (with values of 100% in 2011 and 2012) and low rates of resistance to tigecycline, colistin and amikacin. In the same years, there were respectively 105, 93, and 165 Gram-positive isolated. The rate of MRSA isolates ranged from 66% to 75% during the study period. Conclusions Our results show no significant increase in antimicrobial resistance over the period in question, and a higher rate of both MRSA isolates and resistance to carbapenems in A. baumannii compared with other European data. PMID:26075047

  11. Gentner, D., Brem, S., Ferguson, R. W., Wolff, P., Markman, A. B., & Forbus, K. D. (1997). Analogy and creativity in the works of Johannes Kepler. In T. B. Ward, S. M. Smith, & J. Vaid (Eds.), Creative thought: An

    E-print Network

    Forbus, Kenneth D.

    1997-01-01

    ). Analogy and creativity in the works of Johannes Kepler. In T. B. Ward, S. M. Smith, & J. Vaid (Eds: American Psychological Association. Analogy and Creativity in the Works of Johannes Kepler Dedre Gentner in themselves." -Johannes Kepler Analogy is often linked with creative thought (Finke, 1990, 1995; Finke, Ward

  12. Very Low Levels of Physical Activity in Older Patients During Hospitalization at an Acute Geriatric Ward: A Prospective Cohort Study.

    PubMed

    Villumsen, Morten; Jorgensen, Martin Gronbech; Andreasen, Jane; Rathleff, Michael Skovdal; Mølgaard, Carsten Møller

    2015-10-01

    Lack of activity during hospitalization may contribute to functional decline. The purpose of this study was to investigate (1) the time spent walking during hospitalization by geriatric patients referred to physical and/or occupational therapy and (2) the development in time spent walking during hospitalization. In this observational study, 24-hr accelerometer data (ActivPal) were collected from inclusion to discharge in 124 patients at an acute geriatric ward. The median time spent walking was 7 min per day. During the first quartile of hospitalization, the patients spent 4 (IQR:1;11) min per day walking, increasing to 10 (IQR:1;29) min during the last quartile. Improvement in time spent walking was primarily observed in the group able to perform the Timed Up & Go task at admission. When walking only 7 min per day, patients could be classified as inactive and at risk for functional decline; nonetheless, the physical activity level increased significantly during hospitalization. PMID:25415513

  13. [Dealing with parents facing imminent death of their neonate: introducing palliative care in maternity wards and neonatal intensive care units].

    PubMed

    Storme, Laurent; de Mézerac, Isabelle

    2010-06-01

    Following antenatal diagnosis of a lethal disorder, some parents are so overwhelmed by grief that therapeutic abortion is seen as the least traumatic option. However, the impending death and anticipated mourning create a particularly complex emotional situation. When faced with such dramatic circumstances, some parents seek to restore meaning to their parenthood by accompanying their baby through to the end of its life. Methods derived from hospice care may be appropriate in such situations, considering the unborn child as "a living being among the living ", pregnancy as the first chapter of every life, and death as a natural process. This approach, which may be adopted in maternity wards and neonatal intensive care units, requires the medical team to provide consistent information to the parents and to ensure their close involvement. These new parental demands must be clearly understood if they are to be met as effectively as possible. PMID:21513125

  14. Sensory signals and neuronal groups involved in guiding the sea-ward motor behavior in turtle hatchlings of Chelonia agassizi

    NASA Astrophysics Data System (ADS)

    Fuentes, A. L.; Camarena, V.; Ochoa, G.; Urrutia, J.; Gutierrez, G.

    2007-05-01

    Turtle hatchlings orient display sea-ward oriented movements as soon as they emerge from the nest. Although most studies have emphasized the role of the visual information in this process, less attention has been paid to other sensory modalities. Here, we evaluated the nature of sensory cues used by turtle hatchlings of Chelonia agassizi to orient their movements towards the ocean. We recorded the time they took to crawl from the nest to the beach front (120m long) in control conditions and in visually, olfactory and magnetically deprived circumstances. Visually-deprived hatchlings displayed a high degree of disorientation. Olfactory deprivation and magnetic field distortion impaired, but not abolished, sea-ward oriented movements. With regard to the neuronal mapping experiments, visual deprivation reduced dramatically c-fos expression in the whole brain. Hatchlings with their nares blocked revealed neurons with c-fos expression above control levels principally in the c and d areas, while those subjected to magnetic field distortion had a wide spread activation of neurons throughout the brain predominantly in the dorsal ventricular ridge The present results support that Chelonia agassizi hatchlings use predominantly visual cues to orient their movements towards the sea. Olfactory and magnetic cues may also be use but their influence on hatchlings oriented motor behavior is not as clear as it is for vision. This conclusion is supported by the fact that in the absence of olfactory and magnetic cues, the brain turns on the expression of c- fos in neuronal groups that, in the intact hatchling, are not normally involved in accomplishing the task.

  15. Can a multi-factorial assessment and interventional programme decrease inpatient falls in an elderly care ward?

    PubMed Central

    Gibson, Rebecca SJ; Heaney, April; Hull, Karen

    2013-01-01

    Each year approximately 282,000 inpatient falls are reported to the National Patient Safety Agency (NPSA). A significant number result in death, or moderate to severe injury. (1) Research shows that falls may be reduced by 18 to 31% through multi-factorial assessments and interventions. (4) If a fall cannot be prevented, the patient should receive a prompt and effective response to achieve the best possible recovery and avoidance of further falls. Using ‘Plan-Do-Study-Act’ learning cycles, our aims were to decrease the inpatient falls rate in an Elderly Care ward by 20% and to improve post-fall care. A baseline audit reviewed incident report forms to establish the number of falls per 1000 patient bed days for one calendar year; the baseline falls rate was 14.70 falls per 1000 bed days between November 2010 and October 2011. A care plan to highlight at-risk patients and allow adaptation of care, a ‘walking-stick’ incentive poster to encourage nursing staff, and post-fall guidelines, were introduced. Feedback sessions with ward staff and a re-audit were organised subsequent to each intervention. Completion of the care plan was monitored to improve compliance. A re-audit at one year was conducted to assess impact. Feedback was positive regarding the interventions. Monthly monitoring of care plans achieved a compliance rate of 89% and highlighted up to 81% of patients were considered high-risk. The inpatient falls rate, re-audited at one year, was 12.44 falls / 1000 patient bed days, November 2011 to October 2012; a 15.4% reduction. This study demonstrates a 15.4% reduction in falls through use of a multi-factorial assessment and care plan and an incentive poster. As we are yet to obtain our initial goal of 20%, implementation and re-audit is ongoing.

  16. Which Medication Is the Patient Taking at Admission to the Emergency Ward? Still Unclear Despite the Swedish Prescribed Drug Register

    PubMed Central

    Engqvist, Ida; Wyss, Katja; Asker-Hagelberg, Charlotte; Bergman, Ulf; Odar-Cederlöf, Ingegerd; Stiller, Carl-Olav; Fryckstedt, Jessica

    2015-01-01

    Introduction Correct information on patients’ medication is crucial for diagnosis and treatment in the Emergency Department. The aim of this study was to investigate the concordance between the admission chart and two other records of the patient’s medication. Methods This cohort study includes data on 168 patients over 18 years admitted to the Emergency Ward between September 1 and 30, 2008. The record kept by the general practitioner and the patient record of dispensed drugs in the Swedish Prescribed Drug Register were compared to the admission chart record. Results Drug record discrepancies of potential clinical significance between the admission chart record and the Swedish Prescribed Drug Register or general practitioner record were present in 79 and 82 percent, respectively. For 63 percent of the studied patients the admission chart record did not include all drugs registered in the Swedish Prescribed Drug Register. For 62 percent the admission chart record did not include all drugs registered in the general practitioner record. In addition, for 32 percent of the patients the admission chart record included drugs not registered in the Swedish Prescribed Drug Register and for 52 percent the admission chart record included drugs not found in the general practitioner record. The most discordant drug classes were cardiovascular and CNS-active drugs. Clinically significant drug record discrepancies were more frequent in older patients with multiple medication and caregivers. Conclusion The apparent absence of an accurate record of the patient’s drugs at admission to the Emergency Ward constitutes a potential patient safety hazard. The available sources in Sweden, containing information on the drugs a particular patient is taking, do not seem to be up to date. These results highlight the importance of an accurate list of currently used drugs that follows the patient and can be accessed upon acute admission to the hospital. PMID:26068920

  17. USING PV MODULE AND LINE FREQUENCY RESPONSE DATA TO CREATE ROBUST ARC FAULT Jay Johnson*, Scott Kuszmaul**, Ward Bower**, and David Schoenwald**

    E-print Network

    2011 National Electrical Code requires new photovoltaic systems on or penetrating a building to include, Article 690.11 was added to the United States 2011 National Electrical Code [1]. The new law requires arc*, Scott Kuszmaul**, Ward Bower**, and David Schoenwald** * Corresponding Author Sandia National

  18. SERVER STAFFING TO MEET TIMEVARYING DEMAND Otis B. Jennings, 1 Avishai Mandelbaum, 2 William A. Massey 3 and Ward Whitt 4

    E-print Network

    Whitt, Ward

    . Massey 3 and Ward Whitt 4 AT&T Bell Laboratories September 12, 1994 Revision: July 11, 1995 to AT&T Bell Laboratories. 3 AT&T Bell Laboratories, Room 2C­120, Murray Hill, NJ 07974­0636. 4 AT&T Bell Laboratories, Room 2C­178, Murray Hill, NJ 07974­0636. #12; Abstract We consider a multiserver

  19. Visualizing the Loss of Diversity in Genetic Programming Jason M. Daida, David J. Ward, Adam M. Hilss, Stephen L. Long, Mark R. Hodges, and

    E-print Network

    Fernandez, Thomas

    Visualizing the Loss of Diversity in Genetic Programming Jason M. Daida, David J. Ward, Adam M in genetic and evolutionary computation: namely, that diversity helps to escape premature convergence in understanding the dynamics that underlie genetic programming (GP). Emphasis is given toward understanding

  20. Chelator-induced inhibition of copper metalloenzymes in denitrifying bacteria James W. Moffett,a,* Caroline B. Tuit,b,1 and B. B. Ward b

    E-print Network

    Ward, Bess

    by denitrifiers with NiRS, in oxygen- minimum zones where soluble iron is relatively abundant (Moffett et al. 2007 in the field. Ward et al. (2008) evaluated the control of denitrification in incubations of water from the three major oxygen-minimum zones of the world ocean and concluded that organic carbon availability

  1. Reducing short-stay hospital admissions by ruling out non-ST elevation myocardial infarction and estimating coronary artery disease likelihood on an emergency department observation ward

    PubMed Central

    Wiese, Martin

    2013-01-01

    Chest pain is an important presentation in adult patients attending emergency departments (ED). The process of ruling out an acute coronary syndrome (ACS) conventionally requires a short in-patient stay. This places a significant burden on healthcare systems. Recent developments have encouraged us to explore the role of an ED observation ward in the management of these patients. We designed and implemented two proformas (‘flowformas’). The first provides integrated guidance and documentation for the management of chest pain in the ED. In patients determined to be at low risk of short-term adverse outcomes the ACS rule-out process is now completed on the ED observation ward rather than on the cardio-respiratory admission ward. The second proforma is used before discharge to determine the likelihood of underlying coronary artery disease (CAD), thereby allowing risk-based follow-up arrangements to be made. We collected data on all patients admitted to EDU on the NSTEMI rule-out pathway over a 12-month period. Between Feb 2012 and Feb 2013, 816 patients fulfilling the criteria were admitted on the pathway. 67 patients (8%) required admission due to ACS. 15 patients were admitted on two, and one on three occasions. In conclusion, it is possible to deliver ACS rule-out on an emergency observation ward. This reduces healthcare costs and shortens hospital stay.

  2. Spatial variation of heart failure and air pollution in Warwickshire, UK: an investigation of small scale variation at the ward-level

    PubMed Central

    Bennett, Oscar; Kandala, Ngianga-Bakwin; Ji, Chen; Linnane, John; Clarke, Aileen

    2014-01-01

    Objectives To map using geospatial modelling techniques the morbidity and mortality caused by heart failure within Warwickshire to characterise and quantify any influence of air pollution on these risks. Design Cross-sectional. Setting Warwickshire, UK. Participants Data from all of the 105 current Warwickshire County wards were collected on hospital admissions and deaths due to heart failure. Results In multivariate analyses, the presence of higher mono-nitrogen oxide (NOx) in a ward (3.35:1.89, 4.99), benzene (Ben) (31.9:8.36, 55.85) and index of multiple deprivation (IMD; 0.02: 0.01, 0.03), were consistently associated with a higher risk of heart failure morbidity. Particulate matter (Pm; ?12.93: ?20.41, ?6.54) was negatively associated with the risk of heart failure morbidity. No association was found between sulfur dioxide (SO2) and heart failure morbidity. The risk of heart failure mortality was higher in wards with a higher NOx (4.30: 1.68, 7.37) and wards with more inhabitants 50+ years old (1.60: 0.47, 2.92). Pm was negatively associated (?14.69: ?23.46, ?6.50) with heart failure mortality. SO2, Ben and IMD scores were not associated with heart failure mortality. There was a prominent variation in heart failure morbidity and mortality risk across wards, the highest risk being in the regions around Nuneaton and Bedworth. Conclusions This study showed distinct spatial patterns in heart failure morbidity and mortality, suggesting the potential role of environmental factors beyond individual-level risk factors. Air pollution levels should therefore be taken into account when considering the wider determinants of public health and the impact that changes in air pollution might have on the health of a population. PMID:25468504

  3. Microbial Contamination on Used Surgical Masks among Hospital Personnel and Microbial Air Quality in their Working Wards: A Hospital in Bangkok

    PubMed Central

    Luksamijarulkul, Pipat; Aiempradit, Natkitta; Vatanasomboon, Pisit

    2014-01-01

    Objective To assess the relationship of bacterial and fungal contamination on used surgical masks worn by the hospital personnel and microbial air quality in their working wards. Methods This is a cross-sectional study of 230 used surgical masks collected from 214 hospital personnel, and 215 indoor air samples collected from their working wards to culture for bacterial and fungal counts. This study was carried out at the hospital in Bangkok. Group or genus of isolated bacteria and fungi were preliminarily identified by Gram’s stain and lacto-phenol cotton blue. Data were analyzed using paired t-test and Pearson’s correlation coefficient at the significant level of p<0.050. Results Means and standard deviation of bacterial and fungal contamination on inside area of the used masks were 47 ± 56 and 15 ± 9 cfu/ml/piece, and on outside area were 166 ± 199 and 34 ± 18 cfu/ml/piece, respectively, p<0.001. The bacterial and fungal contamination on used masks from hospital personnel working in the male and female medical wards and out-patient department, as well as the bacterial and fungal counts of the indoor air sample collected from the same area were relatively higher than the other wards. The predominant isolated bacteria and fungi contaminated on inside and outside areas of the used masks and air samples were similar (Staphylococcus spp. and Aspergillus spp.; respectively). For its relationship, results found that bacterial and fungal counts in air samples showed significantly positive correlation with the bacterial contamination load on outside area of the used masks, r=0.16, p=0.018 and r=0.21, p=0.003, respectively. Conclusion High bacterial contamination on outside area of the used masks was demonstrated, and it showed a significant correlation with microbial air quality of working wards. PMID:25337311

  4. A survey of the quality of nursing services for brain trauma patients in the emergency wards of hospitals in Guilan Province, Iran (2012)

    PubMed Central

    Majidi, Seyed Ali; Ayoubian, Ali; Mardani, Sheida; Hashemidehaghi, Zahra

    2014-01-01

    Background: Head trauma is the main cause of disabilities and death among young people, and the side effects of head trauma pose some of the greatest medical challenges. Rapid diagnosis and the use of proper treatments can prevent more severe brain damage. The purpose of this research was to determine the quality of nursing services provided to brain trauma patients in hospitals in Guilan Province, Iran. Methods: The study was conducted as a descriptive, cross-sectional study in the emergency wards of selected hospitals in Guilan in 2012. The research population was comprised of all the brain trauma patients in these hospitals. We developed a two-section questionnaire, ascertained its validity, and determined that it had a reliability of 88% (Cronbach’s alpha). Subsequently, we used the questionnaire for gathering data. The data were analyzed using SPSS statistical software, and descriptive analysis tests (frequency rate and average) and deductive analyses tests (chi-squared) also were used. Results: The results showed that the quality of health services provided to brain-trauma patients in the emergency ward was at the moderate level of 58.8% of the cases and at a low level in 41.2% of the cases. Conclusion: Based on the results that showed that the services were of moderate quality, the staff members in the emergency ward were required to update their knowledge and use the required measures to minimize or prevent side effects in brain-trauma patients; clearly, mastery of such measures was a real need among the emergency ward’s staff. PMID:25763140

  5. Governing patient safety: lessons learned from a mixed methods evaluation of implementing a ward-level medication safety scorecard in two English NHS hospitals

    PubMed Central

    Ramsay, Angus I G; Turner, Simon; Cavell, Gillian; Oborne, C Alice; Thomas, Rebecca E; Cookson, Graham; Fulop, Naomi J

    2014-01-01

    Background Relatively little is known about how scorecards presenting performance indicators influence medication safety. We evaluated the effects of implementing a ward-level medication safety scorecard piloted in two English NHS hospitals and factors influencing these. Methods We used a mixed methods, controlled before and after design. At baseline, wards were audited on medication safety indicators; during the ‘feedback’ phase scorecard results were presented to intervention wards on a weekly basis over 7?weeks. We interviewed 49 staff, including clinicians and managers, about scorecard implementation. Results At baseline, 18.7% of patients (total n=630) had incomplete allergy documentation; 53.4% of patients (n=574) experienced a drug omission in the preceding 24?h; 22.5% of omitted doses were classified as ‘critical’; 22.1% of patients (n=482) either had ID wristbands not reflecting their allergy status or no ID wristband; and 45.3% of patients (n=237) had drugs that were either unlabelled or labelled for another patient in their drug lockers. The quantitative analysis found no significant improvement in intervention wards following scorecard feedback. Interviews suggested staff were interested in scorecard feedback and described process and culture changes. Factors influencing scorecard implementation included ‘normalisation’ of errors, study duration, ward leadership, capacity to engage and learning preferences. Discussion Presenting evidence-based performance indicators may potentially influence staff behaviour. Several practical and cultural factors may limit feedback effectiveness and should be considered when developing improvement interventions. Quality scorecards should be designed with care, attending to evidence of indicators’ effectiveness and how indicators and overall scorecard composition fit the intended audience. PMID:24029440

  6. Do “trainee-centered ward rounds” help overcome barriers to learning and improve the learning satisfaction of junior doctors in the workplace?

    PubMed Central

    Acharya, Vikas; Reyahi, Amir; Amis, Samuel M; Mansour, Sami

    2015-01-01

    Ward rounds are widely considered an underutilized resource with regard to medical education, and therefore, a project was undertaken to assess if the initiation of “trainee-centered ward rounds” would help improve the confidence, knowledge acquisition, and workplace satisfaction of junior doctors in the clinical environment. Data were collated from junior doctors, registrar grade doctors, and consultants working in the delivery suite at Luton and Dunstable University Hospital in Luton over a 4-week period in March–April 2013. A review of the relevant literature was also undertaken. This pilot study found that despite the reservations around time constraints held by both junior and senior clinicians alike, feedback following the intervention was largely positive. The junior doctors enjoyed having a defined role and responsibility during the ward round and felt they benefited from their senior colleagues’ feedback. Both seniors and junior colleagues agreed that discussing learning objectives prior to commencing the round was beneficial and made the round more learner-orientated; this enabled maximal learner-focused outcomes to be addressed and met. The juniors were generally encouraged to participate more during the round and the consultants endeavored to narrate their decision-making, both were measures that led to greater satisfaction of both parties. This was in keeping with the concept of “Legitimate peripheral participation” as described by Lave and Wenger. Overall, trainee-centered ward rounds did appear to be effective in overcoming some of the traditional barriers to teaching in the ward environment, although further work to formalize and quantify these findings, as well as using greater sample sizes from different hospital departments and the inclusion of a control group, is needed. PMID:26508899

  7. Unintended Medication Discrepancies Associated with Reliance on Prescription Databases for Medication Reconciliation on Admission to a General Medical Ward

    PubMed Central

    Kalb, Kelli; Shalansky, Stephen; Legal, Michael; Khan, Nadia; Ma, Irene; Hunte, Garth

    2009-01-01

    Background: In a recent study, 50% of the patients who were admitted to a hospital’s general medicine ward had at least one error in medication orders at the time of admission related to inaccuracies in the medication history. The use of computerized prescription databases has been suggested as a way to improve medication reconciliation at the time of admission. Objective: To quantify and describe unintended discrepancies between a best possible medication history and medications ordered on admission to the general medicine ward in a hospital with routine access to a provincial outpatient prescription database (British Columbia’s PharmaNet). Methods: This prospective study involved 20 patients who were regularly using at least 4 prescription medications before admission to hospital. The best possible medication history for each patient (based on a review of the medical chart and the PharmaNet record and an interview with the patient) was compared with the physician’s admission orders to identify any discrepancies. The frequency and perceived severity of discrepancies, graded independently by 3 physicians, were compared with observations from a similar study conducted at a hospital where a prescription database was not available. Results: The 20 patients were recruited between September 2005 and January 2006. For 8 patients (40%), information in the PharmaNet database was consistent with the prescription medication list obtained during the best possible medication history at the time of admission. For the other 12 patients, a total of 30 unintended discrepancies were identified, 13 (43%) of which were classified as having potential for moderate or severe harm. The proportion of patients with unintended discrepancies was similar to that for the comparison cohort (60% versus 54%). Although the percentage of discrepancies involving omissions was lower than in the comparison population (37% versus 46%), these results were offset by a higher proportion of commission discrepancies (27% versus 0%). Conclusion: Unintended discrepancies were frequent, despite use of the PharmaNet database at the time of admission. Inconsistencies between the PharmaNet record and patients’ actual medication use, coupled with failure to verify PharmaNet data with patients, were likely contributing factors. PMID:22478906

  8. Catheter associated urinary tract infection (CA-UTI) incidence in an Internal Medicine Ward of a Northern Italian Hospital.

    PubMed

    Izzo, Ilaria; Lania, Donatella; Bella, Daniele; Formaini Marioni, Cesare; Coccaglio, Romana; Colombini, Paolo

    2015-09-01

    Catheter-associated urinary tract infections (CA-UTI) are estimated to be the most frequent nosocomial infections (40%). A catheter is introduced to 10-25% of inpatients, and is often left on site for a long period of time. We carried out a prospective study on inpatients of our Internal Medicine ward to assess the incidence of CA-UTI under the implementation of corrective action. All inpatients who underwent introduction of a urinary catheter upon or after admission to our ward were included in the study. Patients with bacteriuria or positive urine culture before catheterization, others with less than 24 hours catheterism, or bearing a catheter on admission were all excluded from the study. CA-UTI diagnosis was assessed on the basis of CDC 2009 guidelines. The investigation was held between June 2010 and March 2013 in five steps or phases. In the first phase open circuit drainage catheterism was used, in the second phase close circuit drainage catheterism was introduced, while in the third phase disposable lubrification was added to closed circuit drainage catheterism. In the next step (phase 4) we introduced number of days of catheterism control and nurse training; in the last phase (5) emptying urine collection bags on a container was added. In phase 1 we estimated six UTIs out of 18 patients (incidence 33%), in phase 2 we had four infections out of 10 patients (40%). Given the results, we had to reflect on the quality of the procedures of catheter positioning and management . Where feasible, we improved technical practices and during follow-up there was evidence of CA-UTI in 10 patients over 25 (phase 3, 40%), and eight infections over 25 (phase 4, 32%). Once all these steps had been implemented, in phase 5 we determined a sharp reduction in CA-UTI (2 patients over 27, or 7.5%, p=0.025). This improvement was particularly evident in the rate of infection per days of catheter, which was reduced from 43.4/1000 to 13.6/1000. Although the statistical power of the present study has its limitations, we attained a significant reduction in catheter-associated UTIs through the implementation of close circuit catheterism and improvements in care practices. PMID:26397293

  9. The periodicities in and biometeorological relationships with bed occupancy of an acute psychiatric ward in Antwerp, Belgium

    NASA Astrophysics Data System (ADS)

    Maes, M.; de Meyer, F.; Peeters, D.; Meltzer, H.; Schotte, C.; Scharpe, S.; Cosyns, P.

    1993-06-01

    Recently, some investigators have established a seasonal pattern in normal human psychology, physiology and behaviour, and in the incidence of psychiatric psychopathology. In an attempt to elucidate the chronopsy and meteotropism in the latter, we have examined the chronograms of, and the biometeorological relationships to bed occupancy of the psychiatric ward of the Antwerp University Hospital during three consecutive calendar years (1987 1989). Weather data for the vicinity were provided by a local meteorological station and comprise mean atmospheric pressure, air temperature, relative humidity, wind speed and minutes of sunlight and precipitation/day. The number of psychiatric beds occupied during the study period exhibited a significant seasonal variation. Peaks in bed occupancy were observed in March and November, with lows in August. An important part of the variability in the number of beds occupied could be explained by the composite effects of weather variables of the preceding weeks. Our results suggest that short-term fluctuations in atmospheric activity may dictate some of the periodicities in psychiatric psychopathology.

  10. A prospective study of incidence of medication-related problems in general medicine ward of a tertiary care hospital

    PubMed Central

    Movva, Ramya; Jampani, Anusha; Nathani, Jyothsna; Pinnamaneni, Sri Harsha; Challa, Siva Reddy

    2015-01-01

    The study is aimed to assess the incidence of drug-related problems (DRPs) and provide pharmacist interventions for identified DRPs. A prospective, observational study was conducted among 189 patients with cardiovascular disease who were aged 18 years or older and admitted to the general medicine in-patient ward. During the 6 months study period, the incidence of DRPs was identified using Pharmaceutical Care Network Europe Foundation classification system version 6.2. A total of 189 patients were screened for DRPs. Among them, 130 patients have at least one DRP. A total of 416 DRPs were identified (on average, 2.2 DRPs per each patient). Of the 416 DRPs, 125 (30.04%) interventions were accepted, 7 (1.68%) interventions were not accepted, while remaining (68.26%) accepted but no action taken. The results of the study indicate that incidence of DRPs is substantial and pharmacist-led interventions resulted in resolution of DRPs. This represents the need for the active role of the clinical pharmacist in the developing countries like India.

  11. Sauti Za Wananchi “voice of the people”: patient satisfaction on the medical wards at a Kenyan Referral Hospital

    PubMed Central

    Stone, Geren Starr; Jerotich, Tecla Sum; Cheriro, Betsy Rono; Kiptoo, Robert Sitienei; Crowe, Susie Joanne; Koros, Elijah Kipkorir; Muthoni, Doreen Mutegi; Onalo, Paul Theodore

    2014-01-01

    Introduction Patient satisfaction is one indicator of healthcare quality. Few studies have examined the inpatient experiences in resource-scarce environments in sub-Saharan Africa. Methods To examine patient satisfaction on the public medical wards at a Kenyan referral hospital, we performed a cross-sectional survey focused on patients’ satisfaction with medical information and their relationship with staffing and hospital routine. Ratings of communication with providers, efforts to protect privacy, information about costs, food, and hospital environment were also elicited. Results Overall, the average patient satisfaction rating was 64.7, nearly midway between “average” and “good” Higher rated satisfaction was associated with higher self-rated general health scores and self-rated health gains during the hospitalization (p = 0.023 and p = 0.001). Women who shared a hospital bed found privacy to be “below average” to “poor” Most men (72.7%) felt information about costs was insufficient. Patients rated food and environmental quality favorably while also frequently suggesting these areas could be improved. Conclusion Overall, patients expressed satisfaction with the care provided. These ratings may reflect modest patients’ expectations as well as acceptable circumstances and performance. Women expressed concern about privacy while men expressed a desire for more information on costs. Inconsistencies were noted between patient ratings and free response answers. PMID:25469201

  12. Effect of the maternity ward system on the lactation success of low-income urban Mexican women.

    PubMed

    Perez-Escamilla, R; Segura-Millán, S; Pollitt, E; Dewey, K G

    1992-11-01

    We compared the lactation performance of 165 healthy mothers who planned to breastfeed and gave birth by vaginal delivery, without complications to a healthy infant in either a nursery (NUR) (n = 58) or a rooming-in hospital where formula supplementation was not allowed. In the rooming-in hospital, women were randomly assigned to a group that received breastfeeding guidance during the hospital stay (RIBFG) (n = 53) or to a control group (RI) (n = 54). Women were interviewed in the hospital and at 8, 70 and 135 days post-partum (pp). The groups were similar in socio-economic, demographic, anthropometric, previous breastfeeding experience and prenatal care variables. Non-parametric survival analyses adjusting for potential confounding factors show that breastfeeding guidance had a positive impact (P < or = 0.05) on breastfeeding duration among primiparous women who delivered in the rooming-in hospital. Among primiparae, the RI and RIBFG groups had higher (P < or = 0.05) full breastfeeding rates than the NUR group in the short term. In the longer term, only the difference between the RIBFG and the NUR group remained statistically significant. The maternity ward system did not have a statistically significant effect on the lactation performance of multiparae. PMID:1486816

  13. An IBCLC in the Maternity Ward of a Mother and Child Hospital: A Pre- and Post-Intervention Study

    PubMed Central

    Chiurco, Antonella; Montico, Marcella; Brovedani, Pierpaolo; Monasta, Lorenzo; Davanzo, Riccardo

    2015-01-01

    Published evidence on the impact of the integration of International Board Certified Lactation Consultants (IBCLCs) for breastfeeding promotion is growing, but still relatively limited. Our study aims at evaluating the effects of adding an IBCLC for breastfeeding support in a mother and child hospital environment. We conducted a prospective study in the maternity ward of our maternal and child health Institute, recruiting 402 mothers of healthy term newborns soon after birth. The 18-month intervention of the IBCLC (Phase II) was preceded (Phase I) by data collection on breastfeeding rates and factors related to breastfeeding, both at hospital discharge and two weeks later. Data collection was replicated just before the end of the intervention (Phase III). In Phase III, a significantly higher percentage of mothers: (a) received help to breastfeed, and also received correct information on breastfeeding and community support, (b) started breastfeeding within two hours from delivery, (c) reported a good experience with the hospital staff. Moreover, the frequency of sore and/or cracked nipples was significantly lower in Phase III. However, no difference was found in exclusive breastfeeding rates at hospital discharge or at two weeks after birth. PMID:26308018

  14. Developing and testing an intervention to prevent homelessness among individuals discharged from psychiatric wards to shelters and 'No Fixed Address'.

    PubMed

    Forchuk, C; MacClure, S K; Van Beers, M; Smith, C; Csiernik, R; Hoch, J; Jensen, E

    2008-09-01

    Shelter data in a recent study revealed discharges from psychiatric facilities to shelters or the street occurred at least 194 times in 2002 in London, Ontario, Canada. This problem must be addressed to reduce the disastrous effects of such discharge, including re-hospitalization and prolonged homelessness. An intervention was developed and tested to prevent homelessness associated with discharge directly to no fixed address. A total of 14 participants at-risk of being discharged without housing were enrolled, with half randomized into the intervention group. The intervention group was provided with immediate assistance in accessing housing and assistance in paying their first and last month's rent. The control group received usual care. Data was collected from participants prior to discharge, at 31 and 6-months post-discharge. All the individuals in the intervention group maintained housing after 3 and 6 months. All but one individual in the control group remained homeless after 3 and 6 months. The exception joined the sex trade to avoid homelessness. The results of this pilot were so dramatic that randomizing to the control group was discontinued. Discussions are underway to routinely implement the intervention. Systemic improvements can prevent homelessness for individuals being discharged from psychiatric wards. PMID:18768009

  15. Predicting inpatient violence in acute psychiatric wards using the Brøset-Violence-Checklist: a multicentre prospective cohort study.

    PubMed

    Abderhalden, C; Needham, I; Miserez, B; Almvik, R; Dassen, T; Haug, H-J; Fischer, J E

    2004-08-01

    The Norwegian Brøset-Violence-Checklist (BVC) is one of the few instruments that is suitable for short-term prediction of violence of psychiatric inpatients by nursing staff in routine care. The instrument assesses the presence or absence of six behaviours or states frequently observed before a violent incident. We conducted a study to elucidate whether the predictive properties of the BVC are retained in other psychiatric settings than the original north-Norwegian validation dataset. During their admission period, 219 consecutive patients admitted to six acute psychiatric wards were assessed as to the risk for attack using a German version of the BVC (BVC-G). Data on preventive measures were concurrently collected. Aggressive incidents were registered using an instrument equivalent to the Staff Observation of Aggression Scale (SOAS-R). Fourteen attacks towards staff were observed with incident severity ranging from 5 to 18 of a possible 22 points. BVC-G sensitivity was 64.3%, the specificity 93.9%, the positive predictive value 11.1%, and the area under the receiver operating characteristic curve 0.88. In some false positive cases intense preventive measures had been implemented. The predictive accuracy of the BVC-G proved consistent with the Norwegian original. PMID:15255916

  16. Risk Factors and Scoring System for Predicting Bacterial Resistance to Cefepime as Used Empirically in Haematology Wards

    PubMed Central

    El Maaroufi, Hicham; Goubard, Agathe; Redjoul, Rabah; Legrand, Patrick; Pautas, Cécile; Mikdame, Mohamed; Doghmi, Kamal; Toma, Andréa; Maury, Sébastien; Schwarzinger, Michael; Cordonnier, Catherine

    2015-01-01

    Objectives. Bacterial resistance is of growing concern in haematology wards. As the inappropriate administration of empirical antibacterial may alter survival, we studied risk factors for resistance to our usual empirical first-line antibacterial therapy, cefepime. Methods. We retrospectively studied 103 first episodes of bacteraemia recorded in our haematology department over 2.5 years. Risk factors for cefepime-resistance were identified by multivariate logistic regression with backward selection (P < 0.05). A scoring system for predicting cefepime-resistance was built on independent factor, with an internal validation by the bootstrap resampling technique. Results. 38 (37%) episodes were due to Gram-negative bacteria. Fifty (49%) were due to bacteria resistant to cefepime. Cefepime resistance was significantly associated with a decreased survival at day 30 (P < 0.05). Three risk factors were independently associated with cefepime-resistance: acute lymphoblastic leukaemia; ?18 days since hospital admission; and receipt of any ?-lactam in the last month. Patients with ?2 of these risk factors had a probability of 86% (CI 95%, 25 to 100%) to carry a cefepime-resistant strain. Conclusion. Using our scoring system should reduce the indication of very broad antibacterial regimens in the empirical, first-line treatment of febrile hematology patients in more than 80% of the cases. PMID:26075276

  17. Infant feeding policies in maternity wards and their effect on breast-feeding success: an analytical overview.

    PubMed Central

    Pérez-Escamilla, R; Pollitt, E; Lönnerdal, B; Dewey, K G

    1994-01-01

    OBJECTIVES. The purpose of this review is to examine the plausibility of a causal relationship between maternity ward practices and lactation success. METHODS. Studies were located with MEDLINE, from our personal files, and by contacting researchers working in this field. Of the 65 studies originally reviewed, 18 met our inclusion criteria (i.e., hospital-based intervention, experimental design with randomization procedures, or quasi-experimental design with adequate documentation). RESULTS. Meta-analysis indicated that commercial discharge packs had an adverse effect on lactation performance. The impact of early mother-infant contact on lactation success was unclear. Rooming-in and breast-feeding guidance in a rooming-in context had a beneficial impact on breast-feeding among primiparae. Breast-feeding on demand was positively associated with lactation success. In-hospital formula supplementation of 48 mL per day was not associated with poor breast-feeding performance. CONCLUSIONS. Hospital-based breast-feeding interventions can have a beneficial effect on lactation success, particularly among primiparous women. PMID:8279619

  18. A Case of Neurological Symptoms and Severe Urinary Retention on a Pediatric Ward: Is this Conversion Disorder?

    PubMed Central

    Parmar, Varinderjit; Roberts, Nasreen

    2013-01-01

    Objective a) To illustrate the etiological role of sexual and physical abuse in the development of childhood conversion disorder b) to highlight the importance of collaborative care in cases of conversion disorder c) to identify particular areas or needs for future research in the topic. Method We discuss the case of a fifteen-year old girl who was admitted to pediatrics with medically unexplained neurological complaints, chiefly urinary retention. Psychiatry was consulted after all organic work up was completed. Patient was transferred to the psychiatry ward and we present the unfolding of this case. Pediatrics and psychiatry generated a collaborative management plan. Results The patient presented, initially, with tremors, severe urinary retention and constipation. After her second admission to pediatrics, for severe urinary retention, the girl disclosed chronic sexual and physical abuse and neglect. Conclusions Conversion symptoms often occur in cases of severe psychosocial stresses including sexual and physical abuse. This case highlights the importance of interdisciplinary professional collaboration in the management of complex presentations with unexplained symptoms and psychosocial stressors. PMID:23390435

  19. Nurses' knowledge, attitudes, and current practice of daily oral hygiene care to patients on acute aged care wards in two Australian hospitals.

    PubMed

    Gibney, J; Wright, C; Sharma, A; Naganathan, V

    2015-11-01

    This study aimed to identify nurses' knowledge, attitudes, and current practice in relation to oral hygiene (OH) by means of a questionnaire. It was conducted on the aged care wards of two acute tertiary referral hospitals in New South Wales, Australia. We found that 74% of nurses have a set OH practice. Fifty-four percent of nurses learn their OH practice at university or TAFE. The main nurse qualification is a registered nurse (72%). Denture cleaning, toothbrushing, and swabbing the mouth with a toothette are the main OH practices. Nurses (99%) considered OH to be important. The main barriers to conducting OH practices were patient behaviors, lack of time and staff, and patient physical difficulties. Nurses considered OH important however patient behaviors impact on their ability to undertake the task. Education institutions and hospitals should consider the joint development of a formal OH procedure and training package that can be used on acute geriatric care wards. PMID:26297474

  20. A stepped wedge, cluster controlled trial of an intervention to improve safety and quality on medical wards: the HEADS-UP study protocol

    PubMed Central

    Pannick, Samuel; Beveridge, Iain; Ashrafian, Hutan; Long, Susannah J; Athanasiou, Thanos; Sevdalis, Nick

    2015-01-01

    Introduction The majority of preventable deaths in healthcare are due to errors on general wards. Staff perceptions of safety correlate with patient survival, but effectively translating ward teams’ concerns into tangibly improved care remains problematic. The Hospital Event Analysis Describing Significant Unanticipated Problems (HEADS-UP) trial evaluates a structured, multidisciplinary team briefing, capturing safety threats and adverse events, with rapid feedback to clinicians and service managers. This is the first study to rigorously assess a simpler intervention for general medical units, alongside an implementation model applicable to routine clinical practice. Methods/analysis 7 wards from 2 hospitals will progressively incorporate the intervention into daily practice over 14?months. Wards will adopt HEADS-UP in a pragmatic sequence, guided by local clinical enthusiasm. Initial implementation will be facilitated by a research lead, but rapidly delegated to clinical teams. The primary outcome is excess length of stay (a surplus stay of 24?h or more, compared to peer institutions’ Healthcare Resource Groups-predicted length of stay). Secondary outcomes are 30-day readmission or excess length of stay; in-hospital death or death/readmission within 30?days; healthcare-acquired infections; processes of escalation of care; use of traditional incident-reporting systems; and patient safety and teamwork climates. HEADS-UP will be analysed as a stepped wedge cluster controlled trial. With 7840 patients, using best and worst case predictions, the study would achieve between 75% and 100% power to detect a 2–14% absolute risk reduction in excess length of stay (two-sided p<0.05). Regression analysis will use generalised linear mixed models or generalised estimating equations, and a time-to-event regression model. A qualitative analysis will evaluate facilitators and barriers to HEADS-UP implementation and impact. Ethics and dissemination Participating institutions’ Research and Governance departments approved the study. Results will be published in peer-reviewed journals and at conference presentations. Trial registration number ISRCTN34806867. PMID:26100026

  1. Methicillin-Resistant Staphylococcus aureus (MRSA) Contamination in Bedside Surfaces of a Hospital Ward and the Potential Effectiveness of Enhanced Disinfection with an Antimicrobial Polymer Surfactant

    PubMed Central

    Yuen, John W. M.; Chung, Terence W. K.; Loke, Alice Y.

    2015-01-01

    The aim in this study was to assess the effectiveness of a quaternary ammonium chloride (QAC) surfactant in reducing surface staphylococcal contamination in a routinely operating medical ward occupied by patients who had tested positive for methicillin-resistant Staphylococcus aureus (MRSA). The QAC being tested is an antibacterial film that is sprayed onto a surface and can remain active for up to 8 h. A field experimental study was designed with the QAC plus daily hypochlorite cleaning as the experimental group and hypochlorite cleaning alone as the control group. The method of swabbing on moistened surfaces was used for sampling. It was found that 83% and 77% of the bedside surfaces of MRSA-positive and MRSA-negative patients respectively were contaminated with staphylococci at 08:00 hours, and that the staphylococcal concentrations increased by 80% at 1200 h over a 4-hour period with routine ward and clinical activities. Irrespective of the MRSA status of the patients, high-touch surfaces around the bed-units within the studied medical ward were heavily contaminated (ranged 1 to 276 cfu/cm2 amongst the sites with positive culture) with staphylococcal bacteria including MRSA, despite the implementation of daily hypochlorite wiping. However, the contamination rate dropped significantly from 78% to 11% after the application of the QAC polymer. In the experimental group, the mean staphylococcal concentration of bedside surfaces was significantly (p < 0.0001) reduced from 4.4 ± 8.7 cfu/cm2 at 08:00 hours to 0.07 ± 0.26 cfu/cm2 at 12:00 hours by the QAC polymer. The results of this study support the view that, in addition to hypochlorite wiping, the tested QAC surfactant is a potential environmental decontamination strategy for preventing the transmission of clinically important pathogens in medical wards. PMID:25768241

  2. Radiologic manifestation of pulmonary tuberculosis in children admitted in pediatric ward-Massih Daneshvari Hospital: a 5-year retrospective study.

    PubMed

    Boloursaz, Mohmmad Reza; Khalilzadeh, Soheila; Baghaie, Nooshin; Khodayari, Amir Ali; Velayati, Ali Akbar

    2010-01-01

    Despite the extensive preventive and therapeutic measures present against tuberculosis (TB), this disease still remains as one of the important causes of mortality and morbidity in the world. Considering the high incidence of TB in children, rareness of its' clinical features and complexity of bacteriologic diagnosis in this age group paraclinical studies, especially radiologic evaluations, is useful for reaching a final diagnosis. This 5 year study was conducted in National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Massih Daneshvari Hospital, Tehran, Iran. This retrospective study was conducted on 70 children (43 (61%) female and 27 (38.5%) male) aged between 5 months to 15 years old during a five year period (from 2001-2006) in pediatric ward. It was performed on children who were confirmed to have TB by various clinical, bacteriologic and radiologic features and tuberculin skin test. We studied the radiologic features of pulmonary TB in these children. Right lung involvement was observed in 65%, left lung 23% and bilateral involvement was detected in 12%. Also middle and superior lobes were the most common lobes affected. The commonest radiographic feature was hilar (mediastinal) lymphadenopathy; 70% detected on chest x-ray (CXR) and 85% on CT scan. Lymph nodes on right side were affected more; 25% were calcified. Also nodular infiltration of lung parenchyma was observed in 35% of CXRS and 61% of CT scans. This was followed by patchy consolidation detected in 25% and 35% of CXRs and CT scans respectively. We also observed that children <3 yr. of age had the highest lymph node involvement but the least parenchymal lesions as compared to older children. It is concluded that primary TB is the most common form of pulmonary TB in children. This could be in the form of hilar lymphadenopathy with or without lung parenchymal involvement. Also radiologic features could provide valuable information in regard to diagnosis, treatment and follow-up of pulmonary TB in children. PMID:21279938

  3. Delivering dementia care differently—evaluating the differences and similarities between a specialist medical and mental health unit and standard acute care wards: a qualitative study of family carers’ perceptions of quality of care

    PubMed Central

    Spencer, Karen; Foster, Pippa; Whittamore, Kathy H; Goldberg, Sarah E; Harwood, Rowan H

    2013-01-01

    Objectives To examine in depth carers’ views and experiences of the delivery of patient care for people with dementia or delirium in an acute general hospital, in order to evaluate a specialist Medical and Mental Health Unit (MMHU) compared with standard hospital wards. This qualitative study complemented the quantitative findings of a randomised controlled trial. Design Qualitative semistructured interviews were conducted with carers of patients with cognitive impairment admitted to hospital over a 4-month period. Setting A specialist MMHU was developed in an English National Health Service acute hospital aiming to deliver the best-practice care. Specialist mental health staff were integrated with the ward team. All staff received enhanced training in dementia, delirium and person-centred care. A programme of purposeful therapeutic and leisure activities was introduced. The ward environment was optimised to improve patient orientation and independence. A proactive and inclusive approach to family carers was encouraged. Participants 40 carers who had been recruited to a randomised controlled trial comparing the MMHU with standard wards. Results The main themes identified related closely to family carers’ met or unmet expectations and included activities and boredom, staff knowledge, dignity and fundamental care, the ward environment and communication between staff and carers. Carers from MMHU were aware of, and appreciated, improvements relating to activities, the ward environment and staff knowledge and skill in the appropriate management of dementia and delirium. However, communication and engagement of family carers were still perceived as insufficient. Conclusions Our data demonstrate the extent to which the MMHU succeeded in its goal of providing the best-practice care and improving carer experience, and where deficiencies remained. Neither setting was perceived as neither wholly good nor wholly bad; however, greater satisfaction (and less dissatisfaction) with care was experienced by carers from MMHU compared with standard care wards. PMID:24362015

  4. Medically unexplained illness and the diagnosis of hysterical conversion reaction (HCR) in women’s medicine wards of Bangladeshi hospitals: a record review and qualitative study

    PubMed Central

    2012-01-01

    Background Frequent reporting of cases of hysterical conversion reaction (HCR) among hospitalized female medical patients in Bangladesh’s public hospital system led us to explore the prevalence of “HCR” diagnoses within hospitals and the manner in which physicians identify, manage, and perceive patients whom they diagnose with HCR. Methods We reviewed admission records from women’s general medicine wards in two public hospitals to determine how often and at what point during hospitalization patients received diagnoses of HCR. We also interviewed 13 physicians about their practices and perceptions related to HCR. Results Of 2520 women admitted to the selected wards in 2008, 6% received diagnoses of HCR. HCR patients had wide-ranging symptoms including respiratory distress, headaches, chest pain, convulsions, and abdominal complaints. Most doctors diagnosed HCR in patients who had any medically-unexplained physical symptom. According to physician reports, women admitted to medical wards for HCR received brief diagnostic evaluations and initial treatment with short-acting tranquilizers or placebo agents. Some were referred to outpatient psychiatric treatment. Physicians reported that repeated admissions for HCR were common. Physicians noted various social factors associated with HCR, and they described failures of the current system to meet psychosocial needs of HCR patients. Conclusions In these hospital settings, physicians assign HCR diagnoses frequently and based on vague criteria. We recommend providing education to increase general physicians’ awareness, skill, and comfort level when encountering somatization and other common psychiatric issues. Given limited diagnostic capacity for all patients, we raise concern that when HCR is used as a "wastebasket" diagnosis for unexplained symptoms, patients with treatable medical conditions may go unrecognized. We also advocate introducing non-physician hospital personnel to address psychosocial needs of HCR patients, assist with triage in a system where both medical inpatient beds and psychiatric services are scarce commodities, and help ensure appropriate follow up. PMID:23088583

  5. The Teamwork Assessment Scale: A Novel Instrument to Assess Quality of Undergraduate Medical Students' Teamwork Using the Example of Simulation-based Ward-Rounds

    PubMed Central

    Kiesewetter, Jan; Fischer, Martin R.

    2015-01-01

    Background: Simulation-based teamwork trainings are considered a powerful training method to advance teamwork, which becomes more relevant in medical education. The measurement of teamwork is of high importance and several instruments have been developed for various medical domains to meet this need. To our knowledge, no theoretically-based and easy-to-use measurement instrument has been published nor developed specifically for simulation-based teamwork trainings of medical students. Internist ward-rounds function as an important example of teamwork in medicine. Purposes: The purpose of this study was to provide a validated, theoretically-based instrument that is easy-to-use. Furthermore, this study aimed to identify if and when rater scores relate to performance. Methods: Based on a theoretical framework for teamwork behaviour, items regarding four teamwork components (Team Coordination, Team Cooperation, Information Exchange, Team Adjustment Behaviours) were developed. In study one, three ward-round scenarios, simulated by 69 students, were videotaped and rated independently by four trained raters. The instrument was tested for the embedded psychometric properties and factorial structure. In study two, the instrument was tested for construct validity with an external criterion with a second set of 100 students and four raters. Results: In study one, the factorial structure matched the theoretical components but was unable to separate Information Exchange and Team Cooperation. The preliminary version showed adequate psychometric properties (Cronbach’s ?=.75). In study two, the instrument showed physician rater scores were more reliable in measurement than those of student raters. Furthermore, a close correlation between the scale and clinical performance as an external criteria was shown (r=.64) and the sufficient psychometric properties were replicated (Cronbach’s ?=.78). Conclusions: The validation allows for use of the simulated teamwork assessment scale in undergraduate medical ward-round trainings to reliably measure teamwork by physicians. Further studies are needed to verify the applicability of the instrument. PMID:26038684

  6. Differences in ward-to-cath lab systolic blood pressure predicts long-term adverse outcomes after drug-eluting stent implantation.

    PubMed

    Her, Ae-Young; Ann, Soe Hee; Lee, Jun Ho; Kim, Jong Min; Kim, Yong Hoon; Garg, Scot; Singh, Gillian Balbir; Shin, Eun-Seok

    2015-11-01

    We sought to investigate the effect of ward-to-cath lab blood pressure (BP) differences on long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES). There are limited data available on the association between PCI with DES and BP differences on long-term clinical outcomes. This study enrolled 994 patients who underwent PCI with DES from March 2003 to August 2007. Resting BP was measured in a ward environment before transfer to the cardiac catheterization lab (cath lab), and again when the patient was laid down on the cath lab table. Patients were divided into two groups according to the difference in ward-to-cath lab systolic BP. Large difference group (n = 383) was defined as the absolute systolic difference of >20 mmHg and small difference group (n = 424) as the absolute systolic difference of ?20 mmHg. The primary endpoints were all-cause mortality, cardiac death, nonfatal myocardial infarction and stroke. A total of 807 patients (mean age 60 ± 10 years, 522 males) received follow-up for 5.1 ± 2.4 years. The rate of all-cause mortality was significantly higher in the large difference group compared to the small difference group (6.6 vs. 2.8 %; adjusted hazard ratio (HR) 2.43; 95 % confidence interval (CI) 1.22-4.83; p = 0.012). There were higher cardiac deaths seen in the large difference group compared to the small difference group (3.9 vs. 1.4 %; adjusted HR 2.84; 95 % CI 1.1-7.31; p = 0.031). Stroke (2.4 vs. 1.2 %, p = 0.125) and TVR (3.7 vs. 1.7 %, p = 0.051) had higher trends in the large difference group compared to the small difference group. The composite of primary endpoints (all-cause mortality, cardiac death, nonfatal MI and stroke) occurred more frequently in the large difference group compared to the small difference group (10.0 vs. 6.4 %; adjusted HR 1.71; 95 % CI 1.04-2.81; p = 0.033). A difference in ward-to-cath lab systolic BP of >20 mmHg may contribute to increased adverse outcomes in the form of all-cause mortality and cardiac deaths in patients undergoing PCI with DES. PMID:25062712

  7. Use of audit and feedback with fluorescent targeting to achieve rapid improvements in room cleaning in the intensive care unit and ward settings.

    PubMed

    Ragan, Kelsey; Khan, Anjum; Zeynalova, Nurana; McKernan, Patricia; Baser, Karine; Muller, Matthew P

    2012-04-01

    Environmental contamination of high-touch surfaces in patient rooms can lead to the transmission of clinically significant pathogens; thus, such surfaces should be cleaned routinely and thoroughly. Fluorescent targeting can be used to provide feedback to frontline cleaning staff on the thoroughness of room cleaning, which can result in substantial improvements in performance. We demonstrate that auditing with fluorescent targeting can be implemented in both the ward and intensive care unit settings using only modest resources, resulting in rapid improvements in cleaning thoroughness. PMID:21820762

  8. Standardized Glycemic Management with a Computerized Workflow and Decision Support System for Hospitalized Patients with Type 2 Diabetes on Different Wards

    PubMed Central

    Neubauer, Katharina M.; Höll, Bernhard; Aberer, Felix; Donsa, Klaus; Augustin, Thomas; Schaupp, Lukas; Spat, Stephan; Beck, Peter; Fruhwald, Friedrich M.; Schnedl, Christian; Rosenkranz, Alexander R.; Lumenta, David B.; Kamolz, Lars-Peter; Plank, Johannes; Pieber, Thomas R.

    2015-01-01

    Abstract Background: This study investigated the efficacy, safety, and usability of standardized glycemic management by a computerized decision support system for non-critically ill hospitalized patients with type 2 diabetes on four different wards. Materials and Methods: In this open, noncontrolled intervention study, glycemic management of 99 patients with type 2 diabetes (62% acute admissions; 41 females; age, 67±11 years; hemoglobin A1c, 65±21?mmol/mol; body mass index, 30.4±6.5?kg/m2) on clinical wards (Cardiology, Endocrinology, Nephrology, Plastic Surgery) of a tertiary-care hospital was guided by GlucoTab® (Joanneum Research GmbH [Graz, Austria] and Medical University of Graz [Graz, Austria]), a mobile decision support system providing automated workflow support and suggestions for insulin dosing to nurses and physicians. Results: Adherence to insulin dosing suggestions was high (96.5% bolus, 96.7% basal). The primary outcome measure, percentage of blood glucose (BG) measurements in the range of 70–140?mg/dL, occurred in 50.2±22.2% of all measurements. The overall mean BG level was 154±35?mg/dL. BG measurements in the ranges of 60–70?mg/dL, 40–60?mg/dL, and <40?mg/dL occurred in 1.4%, 0.5%, and 0.0% of all measurements, respectively. A regression analysis showed that acute admission to the Cardiology Ward (+30?mg/dL) and preexisting home insulin therapy (+26?mg/dL) had the strongest impact on mean BG. Acute admission to other wards had minor effects (+4?mg/dL). Ninety-one percent of the healthcare professionals felt confident with GlucoTab, and 89% believed in its practicality and 80% in its ability to prevent medication errors. Conclusions: An efficacious, safe, and user-accepted implementation of GlucoTab was demonstrated. However, for optimized personalized patient care, further algorithm modifications are required. PMID:26355756

  9. The association between air pollution and weather conditions with increase in the number of admissions of asthmatic patients in emergency wards: a case study in Kermanshah

    PubMed Central

    Khamutian, Razieh; Najafi, Farid; Soltanian, Mohammad; Shokoohizadeh, Mohamad Javad; Poorhaghighat, Saeedeh; Dargahi, Abdollah; Sharafi, Kiomars; Afshari, Alireza

    2015-01-01

    Background: Industrialization and urbanization had a devastating impact on public health and caused an increase in health related morbidity and mortality. In fact, asthma is a chronic condition which is considered as one of the significant challenges of public health. In this study, we investigated the association of air pollution and weather conditions with excess emergency ward admissions of asthmatic patients in Kermanshah hospitals. Methods: This was an ecological study. The total number of hospital admissions to emergency wards from all related and major hospitals of Kermanshah was collected from September 2008 through August 2009. In addition, data on air pollution as well as meteorological data were collected from the Environmental Protection Agency and Meteorological Organization of Kermanshah. To determine the association between the number of hospitalization due to asthma with those parameters, Poisson regression was used. Results: The results of Poisson regression revealed a significant association between carbon monoxide, ozone, nitrogen dioxide and temperature with emergency room visits due to asthma in Kermanshah. No associations were found for sulfur dioxide or for particulate matter. Conclusion: This study provides further evidence for the significant effect of monoxide carbon on asthma; and it suggests that temperature may have a role in the exacerbation of asthma. However, due to the multi-factorial nature of asthma, other factors also play a major role in the development and exacerbation of this illness. PMID:26478887

  10. Clinical Documentation and Data Transfer from Ebola and Marburg Virus Disease Wards in Outbreak Settings: Health Care Workers’ Experiences and Preferences

    PubMed Central

    Bühler, Silja; Roddy, Paul; Nolte, Ellen; Borchert, Matthias

    2014-01-01

    Understanding human filovirus hemorrhagic fever (FHF) clinical manifestations and evaluating treatment strategies require the collection of clinical data in outbreak settings, where clinical documentation has been limited. Currently, no consensus among filovirus outbreak-response organisations guides best practice for clinical documentation and data transfer. Semi-structured interviews were conducted with health care workers (HCWs) involved in FHF outbreaks in sub-Saharan Africa, and with HCWs experienced in documenting and transferring data from high-risk areas (isolation wards or biosafety level 4 laboratories). Methods for data documentation and transfer were identified, described in detail and categorised by requirement for electricity and ranked by interviewee preference. Some methods involve removing paperwork and other objects from the filovirus disease ward without disinfection. We believe that if done properly, these methods are reasonably safe for certain settings. However, alternative methods avoiding the removal of objects, or involving the removal of paperwork or objects after non-damaging disinfection, are available. These methods are not only safer, they are also perceived as safer and likely more acceptable to health workers and members of the community. The use of standardised clinical forms is overdue. Experiments with by sunlight disinfection should continue, and non-damaging disinfection of impregnated paper, suitable tablet computers and underwater cameras should be evaluated under field conditions. PMID:24556792

  11. Unexplained Falls Are Frequent in Patients with Fall-Related Injury Admitted to Orthopaedic Wards: The UFO Study (Unexplained Falls in Older Patients).

    PubMed

    Chiara, Mussi; Gianluigi, Galizia; Pasquale, Abete; Alessandro, Morrione; Alice, Maraviglia; Gabriele, Noro; Paolo, Cavagnaro; Loredana, Ghirelli; Giovanni, Tava; Franco, Rengo; Giulio, Masotti; Gianfranco, Salvioli; Niccolò, Marchionni; Andrea, Ungar

    2013-01-01

    To evaluate the incidence of unexplained falls in elderly patients affected by fall-related fractures admitted to orthopaedic wards, we recruited 246 consecutive patients older than 65 (mean age 82 ± 7 years, range 65-101). Falls were defined "accidental" (fall explained by a definite accidental cause), "medical" (fall caused directly by a specific medical disease), "dementia-related" (fall in patients affected by moderate-severe dementia), and "unexplained" (nonaccidental falls, not related to a clear medical or drug-induced cause or with no apparent cause). According to the anamnestic features of the event, older patients had a lower tendency to remember the fall. Patients with accidental fall remember more often the event. Unexplained falls were frequent in both groups of age. Accidental falls were more frequent in younger patients, while dementia-related falls were more common in the older ones. Patients with unexplained falls showed a higher number of depressive symptoms. In a multivariate analysis a higher GDS and syncopal spells were independent predictors of unexplained falls. In conclusion, more than one third of all falls in patients hospitalized in orthopaedic wards were unexplained, particularly in patients with depressive symptoms and syncopal spells. The identification of fall causes must be evaluated in older patients with a fall-related injury. PMID:23533394

  12. Implementation and Operational Research: Implementation of Routine Counselor-Initiated Opt-Out HIV Testing on the Adult Medical Ward at Kamuzu Central Hospital, Lilongwe, Malawi.

    PubMed

    LaCourse, Sylvia M; Chester, Frances M; Matoga, Mitch; Munthali, Charles; Nsona, Dominic; Haac, Bryce; Hoffman, Irving F; Hosseinipour, Mina C

    2015-05-01

    The optimal approach of provider-initiated HIV testing and counseling (PITC) for inpatients in high-burden settings is unknown. We prospectively evaluated the implementation of task shifting from clinician-referral to counselor-initiated PITC on the medical wards of Kamuzu Central Hospital, Malawi. Most of patients (1905/3154, 60.4%) had an unknown admission HIV status. Counselors offered testing to 66.6% (1268/1905). HIV prevalence was 39.3%. Counselor-initiated PITC significantly increased HIV testing by 79% (643/2957 vs. 1228/3154), resulting in an almost 2-fold increase in patients with known HIV status (2447/3154 vs. 1249/3154) (both P < 0.0001), with 18.4% of those tested receiving a new diagnosis of HIV. PMID:25622063

  13. mu-Squared Dependent Deviation of the Non Perturbative ZA,MOM from the True Axial Renormalisation Constant, Implied by Ward Identity

    E-print Network

    Ph. Boucaud; J. -P. Leroy; A. Le Yaouanc; J. Micheli; O. Pène; J. Rodriguez-Quintero

    2015-04-02

    It is recalled why, as already stated in a previous paper, there seems to be an inconsistency in identifying the non perturbative ZA,MOM as the renormalisation of the axial current, or equivalently, in setting as normalisation condition that the renormalised vertex=1 at p^2 = mu^2 at some renormalisation scale mu, where p is the momentum in the legs. Indeed, unlike the vector case, the Ward-Takahashi (WT) identity for the axial current is shown to imply both the renormalisation scale independence of ZA and a mu2 dependence of ZA,MOM. This mu^2 dependence is simply related to certain invariants in the pseudoscalar vertex and can persist in the chiral limit due to the spontaneous breaking of chiral symmetry (pion pole). It is seen clearly in the mu^2 dependence of some lattice calculations of ZA,MOM/ZV,MOM near the chiral limit.

  14. Evaluation of the Use and Reasons for Not Using a Helmet by Motorcyclists Admitted to the Emergency Ward of Shahid Bahonar Hospital in Kerman

    PubMed Central

    Faryabi, Javad; Rajabi, Mahboobeh; Alirezaee, Shahin

    2014-01-01

    Background: Motorcycle crashes are the cause of severe morbidity and mortality especially because of head injuries. It seems that wearing a helmet has an effective role in protection against head injuries. Nevertheless, motorcyclists usually have no tendency to wear a helmet when driving in cities and have several reasons for this behavior. Objectives: This study aimed to evaluate the use and reasons for not using a helmet by motorcyclists admitted to an emergency ward of a trauma hospital due to accident in Kerman, Iran. Patients and Methods: This study was carried out by recoding the opinions of motorcyclists who had been transferred to the emergency ward of Shahid Bahonar Hospital (Kerman/Iran). Since no data was available on the frequency of the use of helmets, a pilot study was carried out and a sample size of 377 was determined for the main study. Then a researcher-made questionnaire was used to investigate the motorcyclists’ reasons for not using a helmet. Results: Only 21.5% of the motorcyclists had been wearing helmets at the time of the accident. The most frequent reasons for not using a helmet were the heavy weight of the helmet (77%), feeling of heat (71.4%), pain in the neck (69.4%), feeling of suffocation (67.7%), limitation of head and neck movements (59.6%) and all together, physical discomfort was the main cause of not wearing a helmet during motorcycle rides. Conclusions: In general, it appears that it is possible to increase the use of helmets by eliminating its physical problems, and increasing the knowledge of community members in relation to the advantages of helmet use, which will result in a significant decrease in traumas resulting from motorcycle accidents. PMID:25599066

  15. Clinical and Organizational Factors Related to the Reduction of Mechanical Restraint Application in an Acute Ward: An 8-Year Retrospective Analysis

    PubMed Central

    Di Lorenzo, Rosaria; Miani, Fiorenza; Formicola, Vitantonio; Ferri, Paola

    2014-01-01

    Background: The purpose of this study was to describe the frequency of mechanical restraint use in an acute psychiatric ward and to analyze which variables may have significantly influenced the use of this procedure. Methods: This retrospective study was conducted in the Servizio Psichiatrico di Diagnosi e Cura (SPDC) of Modena Centro. The following variables of our sample, represented by all restrained patients admitted from 1-1-2005 to 31-12-2012, were analyzed: age, gender, nationality, psychiatric diagnoses, organic comorbidity, state and duration of admission, motivation and duration of restraints, nursing shift and hospitalization day of restraint, number of patients admitted at the time of restraint and institutional changes during the observation period. The above variables were statistically compared with those of all other non-restrained patients admitted to our ward in the same period. Results: Mechanical restraints were primarily used as a safety procedure to manage aggressive behavior of male patients, during the first days of hospitalization and night shifts. Neurocognitive disorders, organic comorbidity, compulsory state and long duration of admission were statistically significantly related to the increase of restraint use (p<.001, multivariate logistic regression). Institutional changes, especially more restricted guidelines concerning restraint application, were statistically significantly related to restraint use reduction (p<.001, chi2 test, multivariate logistic regression). Conclusion: The data obtained highlight that mechanical restraint use was influenced not only by clinical factors, but mainly by staff and policy factors, which have permitted a gradual but significant reduction in the use of this procedure through a multidimensional approach. PMID:25320635

  16. Assessment of the MSF triage system, separating patients into different wards pending Ebola virus laboratory confirmation, Kailahun, Sierra Leone, July to September 2014.

    PubMed

    Vogt, Florian; Fitzpatrick, Gabriel; Patten, Gabriela; van den Bergh, Rafael; Stinson, Kathryn; Pandolfi, Luigi; Squire, James; Decroo, Tom; Declerck, Hilde; Van Herp, Michel

    2015-12-17

    Prevention of nosocomial Ebola virus (EBOV) infection among patients admitted to an Ebola management centre (EMC) is paramount. Current Médecins Sans Frontières (MSF) guidelines recommend classifying admitted patients at triage into suspect and highly-suspect categories pending laboratory confirmation. We investigated the performance of the MSF triage system to separate patients with subsequent EBOV-positive laboratory test (true-positive admissions) from patients who were initially admitted on clinical grounds but subsequently tested EBOV-negative (false-positive admissions). We calculated standard diagnostic test statistics for triage allocation into suspect or highly-suspect wards (index test) and subsequent positive or negative laboratory results (reference test) among 433 patients admitted into the MSF EMC Kailahun, Sierra Leone, between 1 July and 30 September 2014. 254 (59%) of admissions were classified as highly-suspect, the remaining 179 (41%) as suspect. 276 (64%) were true-positive admissions, leaving 157 (36.3%) false-positive admissions exposed to the risk of nosocomial EBOV infection. The positive predictive value for receiving a positive laboratory result after being allocated to the highly-suspect ward was 76%. The corresponding negative predictive value was 54%. Sensitivity and specificity were 70% and 61%, respectively. Results for accurate patient classification were unconvincing. The current triage system should be changed. Whenever possible, patients should be accommodated in single compartments pending laboratory confirmation. Furthermore, the initial triage step on whether or not to admit a patient in the first place must be improved. What is ultimately needed is a point-of-care EBOV diagnostic test that is reliable, accurate, robust, mobile, affordable, easy to use outside strict biosafety protocols, providing results with quick turnaround time. PMID:26727011

  17. Reiki and related therapies in the dialysis ward: an evidence-based and ethical discussion to debate if these complementary and alternative medicines are welcomed or banned

    PubMed Central

    2013-01-01

    Background Complementary and Alternative Medicines (CAMs) are increasingly practiced in the general population; it is estimated that over 30% of patients with chronic diseases use CAMs on a regular basis. CAMs are also used in hospital settings, suggesting a growing interest in individualized therapies. One potential field of interest is pain, frequently reported by dialysis patients, and seldom sufficiently relieved by mainstream therapies. Gentle-touch therapies and Reiki (an energy based touch therapy) are widely used in the western population as pain relievers. By integrating evidence based approaches and providing ethical discussion, this debate discusses the pros and cons of CAMs in the dialysis ward, and whether such approaches should be welcomed or banned. Discussion In spite of the wide use of CAMs in the general population, few studies deal with the pros and cons of an integration of mainstream medicine and CAMs in dialysis patients; one paper only regarded the use of Reiki and related practices. Widening the search to chronic pain, Reiki and related practices, 419 articles were found on Medline and 6 were selected (1 Cochrane review and 5 RCTs updating the Cochrane review). According to the EBM approach, Reiki allows a statistically significant but very low-grade pain reduction without specific side effects. Gentle-touch therapy and Reiki are thus good examples of approaches in which controversial efficacy has to be balanced against no known side effect, frequent free availability (volunteer non-profit associations) and easy integration with any other pharmacological or non pharmacological therapy. While a classical evidence-based approach, showing low-grade efficacy, is likely to lead to a negative attitude towards the use of Reiki in the dialysis ward, the ethical discussion, analyzing beneficium (efficacy) together with non maleficium (side effects), justice (cost, availability and integration with mainstream therapies) and autonomy (patients’ choice) is likely to lead to a permissive-positive attitude. Summary This paper debates the current evidence on Reiki and related techniques as pain-relievers in an ethical framework, and suggests that physicians may wish to consider efficacy but also side effects, contextualization (availability and costs) and patient’s requests, according also to the suggestions of the Society for Integrative Oncology (tolerate, control efficacy and side effects). PMID:23799960

  18. Application of low-pressure gas chromatography-ion-trap mass spectrometry to the analysis of the essential oil of Turnera diffusa (Ward.) Urb.

    PubMed

    Godoi, Ana F L; Vilegas, Wagner; Godoi, Ricardo H M; Van Vaeck, Luc; Van Grieken, René

    2004-02-20

    Turnera diffusa Willd. var. afrodisiaca (Ward) Urb. (syn. T. aphrodisiaca) belongs to the family of Turneraceae and is an aromatic plant growing wild in the subtropical regions of America and Africa. It is widely used in the traditional medicine as e.g. anti-cough, diuretic, and aphrodisiac agent. This work presents a 3 min chromatographic analysis using low-pressure (LP) gas chromatography (GC)-ion-trap (IT) mass spectrometry (MS). The combination of a deactivated 0.6 m x 0.10 mm i.d., restrictor with a wide-bore CP-Wax 52 capillary column (10 m x 0.53 mm i.d., 1 microm) reduces the analysis time by a factor of 3-7 in comparison to the use of a conventional narrow bore column. Chromatographic conditions have been optimized to achieve the fastest separation with the highest signal/noise ratio in MS detection. These results allow fast and reliable quality control of the essential oil to be achieved. PMID:14971493

  19. Anammox moving bed biofilm reactor pilot at the 26th Ward wastewater treatment plants in Brooklyn, New York: start-up, biofilm population diversity and performance optimization.

    PubMed

    Mehrdad, M; Park, H; Ramalingam, K; Fillos, J; Beckmann, K; Deur, A; Chandran, K

    2014-01-01

    New York City Environmental Protection in conjunction with City College of New York assessed the application of the anammox process in the reject water treatment using a moving bed biofilm reactor (MBBR) located at the 26th Ward wastewater treatment plant, in Brooklyn, NY. The single-stage nitritation/anammox MBBR was seeded with activated sludge and consequently was enriched with its own 'homegrown' anammox bacteria (AMX). Objectives of this study included collection of additional process kinetic and operating data and assessment of the effect of nitrogen loading rates on process performance. The initial target total inorganic nitrogen removal of 70% was limited by the low alkalinity concentration available in the influent reject water. Higher removals were achieved after supplementing the alkalinity by adding sodium hydroxide. Throughout startup and process optimization, quantitative real-time polymerase chain reaction (qPCR) analyses were used for monitoring the relevant species enriched in the biofilm and in the suspension. Maximum nitrogen removal rate was achieved by stimulating the growth of a thick biofilm on the carriers, and controlling the concentration of dissolved oxygen in the bulk flow and the nitrogen loading rates per surface area; all three appear to have contributed in suppressing nitrite-oxidizing bacteria activity while enriching AMX density within the biofilm. PMID:25401307

  20. Frequency and clinical outcome of potentially harmful drug metabolic interactions in patients hospitalized on internal and pulmonary medicine wards: focus on warfarin and cisapride.

    PubMed

    Laine, K; Forsström, J; Grönroos, P; Irjala, K; Kailajärvi, M; Scheinin, M

    2000-10-01

    Drug metabolic interactions present potential risks in patient care, but their frequency and relative importance as a clinical problem remains unclear. To assess the frequency and clinical outcome of potentially harmful drug metabolic interactions in hospitalized patients, the authors performed a survey of the medication data of patients treated on internal and pulmonary medicine wards in a university hospital. The database was searched for concomitantly administered drug pairs that would, according to Hansten and Horn's drug interaction database, carry a high risk for a clinically harmful metabolic drug interaction. Coadministrations involving warfarin or cisapride were subjected to further analysis regarding clinical outcome. A total of 142 patients were exposed to 150 interactions with potentially harmful clinical outcome, resulting in a frequency of 0.9% (95% CI 0.7% to 1.0%). Inhibition of warfarin metabolism by metronidazole produced significant overanticoagulation as evidenced by elevated international normalized ratio values, whereas inducers (rifampicin and phenobarbital) of warfarin metabolism significantly reduced the efficacy of warfarin. One case of minor bleeding and one case of clavicular vein thrombosis were detected as possible consequences of disturbed anticoagulation. The coadministration of cisapride and erythromycin significantly prolonged the corrected QT (QTc) interval and was associated with clinical symptoms of cardiac arrhythmias. Coadministration of cisapride with fluconazole or miconazole was not associated with prolongation of the QTc interval or cardiac sequelae. Evaluations of patient materials are needed to assess the clinical relevance of metabolic drug interactions. PMID:11034253

  1. Nurse managers' perceptions related to their leadership styles, knowledge, and skills in these areas-a viewpoint: case of health centre wards in Finland.

    PubMed

    Vesterinen, Soili; Suhonen, Marjo; Isola, Arja; Paasivaara, Leena; Laukkala, Helena

    2013-01-01

    The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles-visionary, coaching, affiliate, democratic, commanding, and isolating-were reflected on. Almost all respondents in every age group considered four leadership styles-visionary, coaching, affiliate, and democratic-to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers' abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit's success and employees' job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing. PMID:23691356

  2. Non-existence of the Luttinger-Ward functional and misleading convergence of skeleton diagrammatic series for Hubbard-like models

    E-print Network

    Evgeny Kozik; Michel Ferrero; Antoine Georges

    2015-04-17

    The Luttinger-Ward functional $\\Phi[\\mathbf{G}]$, which expresses the thermodynamic grand potential in terms of the interacting single-particle Green's function $\\mathbf{G}$, is found to be ill-defined for fermionic models with the Hubbard on-site interaction. In particular, we show that the self-energy $\\mathbf{\\Sigma}[\\mathbf{G}] \\propto \\delta\\Phi[\\mathbf{G}]/\\delta \\mathbf{G}$ is not a single-valued functional of $\\mathbf{G}$: in addition to the physical solution for $\\mathbf{\\Sigma}[\\mathbf{G}]$, there exists at least one qualitatively distinct unphysical branch. This result is demonstrated for several models: the Hubbard atom, the Anderson impurity model, and the full two-dimensional Hubbard model. Despite this pathology, the skeleton Feynman diagrammatic series for $\\mathbf{\\Sigma}$ in terms of $\\mathbf{G}$ is found to converge at least for moderately low temperatures. However, at strong interactions, its convergence is to the unphysical branch. This reveals a new scenario of breaking down of diagrammatic expansions. In contrast, the bare series in terms of the non-interacting Green's function $\\mathbf{G}_0$ converges to the correct physical branch of $\\mathbf{\\Sigma}$ in all cases currently accessible by diagrammatic Monte Carlo. Besides their conceptual importance, these observations have important implications for techniques based on the explicit summation of diagrammatic series.

  3. Psychiatric Nursing in Integrated Wards Accommodating Both Female and Male Patients: A Historic Pioneering Reform Initiative Implemented by the Institute of Psychiatry, a Unit of the Federal University of Rio De Janeiro, Brazil.

    PubMed

    Bandeira, Paloma Mello; Haddad P Souza, Cynthia; da Silva Guimarães, Juliana C; de Almeida Filho, Antonio José; de Almeida Peres, Maria Angélica

    2015-10-01

    The purpose of this research is to analyze aspects of the sexuality of people with mental disorders, an issue that influenced nursing care in the mixed nursing wards of the Institute of Psychiatry at the Federal University of Rio de Janeiro between 1996-2002. A qualitative Historical Social Study methodology used written and oral texts that were analyzed drawing on Michel Foucault's ideas about sexuality. Results of the study indicate that a rupture occurred in the distribution model according to gender at the Psychiatric Hospitalization Unit. This, in turn, influenced nursing care. From this study, we conclude that accommodating patients in mixed wards better facilitates the psychosocial rehabilitation process and changes nursing teams' conceptions about the sexuality of people with mental disorders. PMID:26514257

  4. Influence of structural evolution on reservoir development and distribution in the Silurian Fusselman: Vermejo-Moore Hopper field, Loving and Ward Counties, Texas

    SciTech Connect

    Colleary, W.M.; Hulme, J.R. ); Crafton, J.W. Gas Research Institute, Chicago, IL )

    1992-04-01

    The Vermejo-Moore Hooper field lies in the deep Delaware basin adjacent to the Pecos River in Loving and Ward counties, Texas. Discovered in 1973, the field produces dry gas from the Fusselman and Ellenburger formations. The Fusselman reservoir has produced over 400 bcf of gas from depths between 18,500 and 19,200 ft. The field primarily is a structural trap, but the distribution of reserves in the reservoir suggests a strong stratigraphic component. The reservoir is composed of fractured dolomites and cherts of the Silurian Fusselman and overlying Wristen formations. Unconformities and their accompanying diagenetic processes play a major role in the reservoir. The occurrence of pervasive dolomitization and nodular cherts are interpreted to indicate diagenesis associated with subaerial exposure and karsting. Thick sections also may be absent due to erosion over paleostructures, and preserved in flanking positions. Detailed paleostructural interpretation of the Vermejo-Moore Hooper field reveals a history of recurrent movement of the basement and demonstrates the influence of structural growth on the development and distribution of porosity and permeability in the Fusselman reservoir. Early structural growth can influence the distribution of both depositional facies and erosional processes. Paleostructure maps in the Silurian-Devonian indicate that a series of northwest-southeast-trending, low-relief structures existed during the Silurian. Growth of these structures through the Devonian can be documented and the presence of fault-bounded basement blocks can be inferred. The influence of this structural growth on the development of the reservoir is also demonstrated.

  5. [Factors related to the slowdown in the reduction of the tuberculosis incidence rate in Osaka City--structure of the high incidence rate of tuberculosis in Osaka City analyzed by administrative-ward group, five-year period and age group].

    PubMed

    Takatorige, T; Aoki, Y; Tanigake, C; Ruful, A; Tatara, K

    2000-09-01

    The tuberculosis incidence rate in Osaka City is the highest in Japan. We analyzed the incidence rate in Osaka City in five-year period from 1978 to 1997, namely, 1978-1982 (period I), 1983-1987 (period II), 1988-1992 (period III), and 1993-1997 (period IV). Until the first half of 1980, the tuberculosis incidence rate in Osaka City had been dropping every year, but the rate of decline has been slowed substantially or even stopped since 1983. The incidence rate ratio of Osaka City compared with the national rate was 2.0 to 2.3 from 1970 to 1975, but it has been increasing from 1983 and is now higher than 3. We divided 24 wards of Osaka City into five groups based on selected employment indicators of population 15 years of age and over of 1995 National Census. Group A consists of two wards characterized by extremely high unemployment rate, Group B of four wards by high unemployment rate and high rate of manufacturing workers, Group C of six wards by high rate of non-manufacturing workers (tertiary industry workers), Group D of five wards by high rate of manufacturing workers, and Group E of seven wards by residential areas. The incidence rate of Group A had been declining during periods I and II but started to rise after period III. The rates of Group B and C had been declining from period I to II but the decline slowed down substantially even for every age class in periods III and IV. The incidence rates of Groups D and E have been falling. The incidence rate of the 50-69 year-old age group has been increasing substantially. The proportion of newly registered patients in Group A to all patients of Osaka City increased from 25.2% in period I to 32.7% in period IV. The number of newly registered patients of the 40-69 age class in Group A accounted for 45.1% of that in Osaka City in period IV. The slowdown in the reduction of the tuberculosis incidence rate has occurred not in all, but in only a few wards and it is a typical phenomenon of the middle-aged in those wards. It would be worth investigating whether a substantial decline in the tuberculosis incidence rate in Osaka City cannot be achieved by means of uniform control measures for all wards. Intensified tuberculosis control measures should focus on patients in specific wards and age groups. PMID:11068370

  6. CURRICULUM VITAE MICHAEL J. WARD

    E-print Network

    Fournier, John J.F.

    . · Citizenship: Canadian citizen. EDUCATION · Ph.D. Applied Mathematics, Caltech 6/88. · Thesis: `Asymptotic Watson Research Lab, Yorktown Heights, New York, sum- mers of 1985-1993: Supervisor: Dr. Farouk Odeh term 1998. · Steacie Fellowship for 1998-1999 awarded by NSERC. · Coxeter-James Prize awarded

  7. Application of a trigger tool in near real time to inform quality improvement activities: a prospective study in a general medicine ward

    PubMed Central

    Wong, Brian M; Dyal, Sonia; Etchells, Edward E; Knowles, Sandra; Gerard, Lauren; Diamantouros, Artemis; Mehta, Rajin; Liu, Barbara; Baker, G Ross; Shojania, Kaveh G

    2015-01-01

    Background Retrospective record review using trigger tools remains the most widely used method for measuring adverse events (AEs) to identify targets for improvement and measure temporal trends. However, medical records often contain limited information about factors contributing to AEs. We implemented an augmented trigger tool that supplemented record review with debriefing front-line staff to obtain details not included in the medical record. We hypothesised that this would foster the identification of factors contributing to AEs that could inform improvement initiatives. Method A trained observer prospectively identified events in consecutive patients admitted to a general medical ward in a tertiary care academic medical centre (November 2010 to February 2011 inclusive), gathering information from record review and debriefing front-line staff in near real time. An interprofessional team reviewed events to identify preventable and potential AEs and characterised contributing factors using a previously published taxonomy. Results Among 141 patients, 14 (10%; 95% CI 5% to 15%) experienced at least one preventable AE; 32 patients (23%; 95% CI 16% to 30%) experienced at least one potential AE. The most common contributing factors included policy and procedural problems (eg, routine protocol violations, conflicting policies; 37%), communication and teamwork problems (34%), and medication process problems (23%). However, these broad categories each included distinct subcategories that seemed to require different interventions. For instance, the 32 identified communication and teamwork problems comprised 7 distinct subcategories (eg, ineffective intraprofessional handovers, poor interprofessional communication, lacking a shared patient care, paging problems). Thus, even the major categories of contributing factors consisted of subcategories that individually related to a much smaller subset of AEs. Conclusions Prospective application of an augmented trigger tool identified a wide range of factors contributing to AEs. However, the majority of contributing factors accounted for a small number of AEs, and more general categories were too heterogeneous to inform specific interventions. Successfully using trigger tools to stimulate quality improvement activities may require development of a framework that better classifies events that share contributing factors amenable to the same intervention. PMID:25749028

  8. Improving the Quality of Assessment and Management of Hypoglycaemia in Hospitalised Patients with Diabetes Mellitus by Introducing ‘Hypo Boxes’ to General Medical Wards with a Specialist Interest in Diabetes

    PubMed Central

    Livingstone, Rachel; Boyle, James

    2015-01-01

    Diabetes is becoming more prevalent in the UK and this is represented in the in-patient cohort, such that 1 in 6 hospital patients have diabetes (1). The UK National Diabetes In-Patient Audit in 2012 estimated that 30% of patients experience one episode of hypoglycaemia during admission. Hypoglycaemia is associated with increased morbidity and mortality, and longer length of hospital stay. It is therefore important that hypoglycaemia is managed promptly and effectively to reduce associated morbidity. The Joint British Diabetes Society recommends that all wards should have access to ‘Hypo Boxes’ (2). We assessed all episodes of hypoglycaemia (<4.0 mmol/l) in the diabetes wards in over a 4 week period. ‘Hypo Boxes’ were installed to the wards and the appropriateness of treatment and time to correction of hypoglycaemia was re-assessed. Assessment of hypoglycaemia pre-intervention revealed 45 episodes of hypoglycaemia in 14 patients, and 42% (n=19) of episodes were deemed to have been treated appropriately. Only 17.8% of episodes were corrected within 30 minutes, and 33.3% were corrected within 60 minutes. A third of patients (35%) did not have a further blood glucose checked. Following intervention, there was a marked improvement in management. The proportion of appropriately managed episodes increased to 82% (n=35) and management of episodes of severe hypoglycaemia (<3.0 mmol/l) increased to 94%. The time to correction increased with 40% of episodes corrected to >4.0 mmol/l within 30 minutes, and a further 54% between 30-60 minutes. In conclusion, the introduction of ‘Hypo Boxes’ improved the assessment and management of hypoglycaemia.

  9. iMu arrayS:The biOMechanicS Of baSeball piTching eric berKSOn Md, ryan aylWard MS, JaMeS zachazeWSKi dpT,aTc, JOSeph paradiSO phd,ThOMaS J. gill Md

    E-print Network

    0 iMu arrayS:The biOMechanicS Of baSeball piTching eric berKSOn Md, ryan aylWard MS, JaMeS zachaze measurements of acceleration and velocity could improve kinematic analysis of baseball pitching. To assess of acceleration and angular velocity. Simultaneous testing of a single professional baseball pitcher

  10. Anisakid nematodes (Nematoda: Anisakidae) from the marine fishes Plectropomus laevis Lacépède (Serranidae) and Sphyraena qenie Klunzinger (Sphyraenidae) off New Caledonia, including two new species of Hysterothylacium Ward & Magath, 1917.

    PubMed

    Moravec, František; Justine, Jean-Lou

    2015-11-01

    Based on light and scanning electron microscopical studies, two new species of Hysterothylacium Ward & Magath, 1917 (Nematoda: Anisakidae) are described from the digestive tract of perciform fishes off New Caledonia: H. alatum n. sp. from Plectropomus laevis (Lacépède) (Serranidae) and H. sphyraenae n. sp. from Sphyraena qenie Klunzinger (Sphyraenidae). The former species (H. alatum) is mainly characterised by its large body (male 42.05 mm, gravid females 51.18-87.38 mm long), the shape of the dorsal lip, conspicuously broad cervical alae, a short caecum and a long ventricular appendix, the length of the spicules (925 µm), the number (25 pairs) and distribution of the genital papillae and the tail tip bearing numerous minute cuticular protuberances. The other species (H. sphyraenae) is mainly characterised by the presence of narrow lateral alae, a short caecum and a long ventricular appendix, the length (762-830 µm) and shape of the spicules, the number (37-38 pairs) and arrangement of the genital papillae, and by the tail tip which lacks any distinct cuticular projections visible under the light microscope. In addition, and unidentifiable at the species level, conspicuously large (45.71-66.10 mm long) larvae of Contracaecum Railliet & Henry, 1912, were found in the body cavity of P. laevis, which serves as a paratenic host for this parasite. PMID:26446541

  11. Genetics Home Reference: Romano-Ward syndrome

    MedlinePLUS

    ... cell membrane. These channels transport positively charged atoms (ions), such as potassium and sodium, into and out of cells. In cardiac muscle, ion channels play critical roles in maintaining the heart's ...

  12. Ward management: education for senior staff nurses.

    PubMed

    Reed, Sarah

    2008-04-01

    The key professional challenges for senior staff nurses relate to managerial rather than clinical issues, but there appears to be a lack of educational preparation for the managerial roles expected of them. An educational service was developed, implemented and evaluated in a specialist paediatric unit to address senior staff nurses' concerns related to managerial aspects of their role. An organisational development model was used to negotiate a work-based learning programme that incorporated practice competencies. This was undertaken at an Agenda for Change implementation site, which enabled the Knowledge and Skills Framework (KSF) to be trialled in practice. The educational programme was evaluated positively and practice competency evaluations highlighted how the KSF dimensions provided a usable and relevant breakdown of managerial and leadership issues. The framework provided a professional development tool for staff wishing to progress their managerial knowledge and skills while under supervision. PMID:18500139

  13. Natural Language III Kenneth Ward Church

    E-print Network

    : 'directive-command.' " In the oral presentation, Allen also suggested that there might be some intonational-media approach to generation. Sometimes a picture is more appropriate than an explanation in English. Both pictures and English text have constraints. Text should not be ungrammatical, or very awkward. So, too

  14. 11 Ward St. Somerville, MA 02143

    E-print Network

    Colton, Jonathan S.

    surface. If rolled into a ball and dropped, the material bounces like an elastic material. In addition an elastic solid than a liquid. However since these "crosslinks" are dynamic (with a characteristic time At short times the Silly PuttyTM bounces like an elastic solid At very short times (the impact of a bullet

  15. Could Eating Fish Help Ward Off Depression?

    MedlinePLUS

    ... of psychology training at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, said ... of psychology training, Montefiore Medical Center and Albert Einstein College of Medicine, New York City; Sept. 10, ...

  16. Methods of Transposition of Nurses between Wards

    NASA Astrophysics Data System (ADS)

    Miyazaki, Shigeji; Masuda, Masakazu

    In this paper, a computer-implemented method for automating the transposition of a hospital’s nursing staff is proposed. The model is applied to the real case example ‘O’ hospital, which performs a transposition of its nursing staff once a year. Results are compared with real data obtained from this hospital’s current manual transposition system. The proposed method not only significantly reduces the time taken to construct the transposition, thereby significantly reducing management labor costs, but also is demonstrated to increase nurses’ levels of satisfaction with the process.

  17. Using Exercise to Ward Off Depression.

    ERIC Educational Resources Information Center

    Nicoloff, George; Schwenk, Thomas L.

    1995-01-01

    Exercise can be as effective as psychotherapy and antidepressant therapy in treating mild-to-moderate depression, and even more effective when used in conjunction with them. Exercise can also be preventive therapy for those not clinically depressed. The paper explains how best to work exercise into a depressed patient's therapy. (Author/SM)

  18. Reservoir characterization of Yates Formation (Permian, Guadalupian), South Ward field, Ward County, Texas 

    E-print Network

    Dronamraju, Sharma

    1997-01-01

    , with pyrite and salt pits; (6) dolostones with predominantly mudstones and wackestones. Sandstones are sub-arkosic and differ in matrix and cement composition. Depositional environments of the clastics facies vary from shallow marine to continental, eolian...

  19. Significance of anaerobic ammonium oxidation in the Bess B. Ward

    E-print Network

    Ward, Bess

    , Princeton University, Princeton, NJ 08544, USA A missing link in the nitrogen cycle has recently been found recently discovered metabolism in bacteria, this time in the nitrogen (N) cycle. The anammox bacterium has nitrogen cycle must be evaluated to answer two questions: Does it change the overall magnitude of the flux

  20. Nitrification BB Ward, Princeton University, Princeton, NJ, USA

    E-print Network

    Ward, Bess

    Introduction Nitrification is an essential process in the nitrogen cycle of soils, natural waters. It is the preferred nitrogen source for many plants and algae. Nitrate is not only a nutrient, but the substrate cannot use dinitrogen gas as a nitrogen source, so denitrification represents a loss term for fixed

  1. Evaluating an alternating mattress on an elderly rehabilitation ward.

    PubMed

    Gleeson, Deborah

    Pressure ulcer prevention is a primary requirement for the NHS. Robust nursing procedures and the provision of pressure-relieving equipment is vital in meeting this requirement. However, the Department of Health also regards making considerable financial savings as a fundamental requirement. There is a firm clinical consensus among national and international bodies that patients at a high risk of developing pressure ulcers, or with existing tissue damage, should be cared for on an alternating (pressure-relieving) mattress system. This evaluation process looks at the performance of the lower cost Air-Flo(®) 8 Acute alternating (pressure-relieving) mattress system to see if it is effective in meeting the needs of patients. The outcomes suggest that when combined with a pressure ulcer management plan and turning schedule the Air-Flo(®) 8 Acute performed well, giving an option to continue to care for high-risk patients with an empirically proven effective therapy, while making considerable financial savings. PMID:26110990

  2. Action-Coordinating Prosody Nigel G. Ward, Saiful Abu

    E-print Network

    Ward, Nigel

    @acm.org, sabu@miners.utep.edu Abstract Prosody can play a role in the coordination of action. This pa- per run and jump to avoid obstacles, and coordinate and synchronize their movements to solve problems. We Analysis (PCA) over time-spread features can discover multi- modal patterns of behavior. 2. The fact

  3. TheWay ForWard The Alfred lerner College

    E-print Network

    Firestone, Jeremy

    and emphasize evidence-based analytics methods to enrich the experience for our undergraduate and grad- uate that highlights our experience-driven learning and evidence-based analytics methods. our recruiting, communications and marketing will feature our centers and facil- ities, like the exelonTrading Center, the $1

  4. Residential mobility among patients admitted to acute psychiatric wards.

    PubMed

    Tulloch, Alex D; Fearon, Paul; David, Anthony S

    2011-07-01

    Residential mobility among those with mental disorders is consistently associated with hospital admission. We studied 4485 psychiatric admissions in South London, aiming to describe the prevalence, timing and associations of residential moves occurring in association with admission. Moves tended to cluster around discharge; 15% of inpatients moved during admission or up to 28 days after discharge. The strongest associations were with younger age (especially 16-25 years) and homelessness. Unadjusted effects of gender, marital status and previous service use were mediated by homelessness. Possible mechanisms for the associations with homelessness and younger age are discussed. PMID:21612971

  5. Applying developmental programming to clinical obstetrics: my ward round.

    PubMed

    Painter, R C

    2015-10-01

    The theory of developmental programming is supported by accumulating evidence, both observational and experimental. The direct application of the principles of developmental programming by clinicians to benefit pregnant women remains an area of limited attention. Examining a selection of inpatients at an obstetric referral center, I searched for situations in which clinical decision making could be driven by the principles of developmental programming. I also looked for situations in which the clinical research agenda could be dictated by these concepts. In the decision to undertake preventive measures to avoid preeclampsia, the offspring's perspective may support more liberal application of calcium and aspirin. Consideration of the long-term health perspective of the offspring could drive choices in the management of obesity and diabetes in pregnancy. The administration of corticosteroids in women delivering by elective cesarean at term may have modest short-term benefits, but additional trials are necessary to investigate long-term offspring health. The offspring of women suffering hyperemesis gravidarum may benefit from nutritional therapy. The long-term health of the offspring could affect couples' choice for IVF or expectant management. Applying the principles of developmental programming to the management of pregnant women could drive clinical decision making and is driving the clinical research agenda. Increasingly, developmental programming concepts are becoming an integral part of clinical practice, as well as determining the choice of outcomes in trials in obstetrics and fertility medicine. The presented cases underscore the need for more research to guide clinical practice. PMID:25966622

  6. The Average Profile of Suffix Trees Mark Daniel Ward

    E-print Network

    Ward, Mark Daniel

    the internal and external profiles of suffix trees. 1 Introduction. The profile parameter of a tree data) nodes located on a given level. The profile parameter of various tree data struc- tures has recently are crucial, for instance, in data compression, leader elec- tions, molecular biology, etc. Due to space

  7. Reflections by clinical nurse specialists on changing ward practice.

    PubMed

    Thomas, Catherine; Ramcharan, Angie

    In September 2010, palliative care clinical nurse specialists at North Middlesex University Hospital Trust introduced competencies for all nurses in setting up and using syringe drivers. This was done after the trust identified a high level of clinical incidents involving syringe drivers. This article discusses how the competencies were implemented and assessed, explores the importance of understanding change management to achieve change, and how different leadership styles affect changes to practice. PMID:21957520

  8. Characterization of a recombination event excluding the Harvey-ras-1 (H-ras-1) locus in a Ramano-Ward Long QT syndrome family linked to Chromosome 11q15 and isolation of a polymorphic repeat telomeric to H-ras-1

    SciTech Connect

    Russell, M.W.; Brody, L.C.; Munroe, D.

    1994-09-01

    The Romano-Ward Long QT syndrome (RWLQTS) has been linked to 11p15.5 in several large families but demonstrates genetic heterogeneity, since in other families the RWLQTS phenotype is not linked to 11p15. To date, no recombinants between the H-Ras-1 locus and RWLQTS in families linked to 11p15 have been published. In a large family, we demonstrate linkage of RWLQTS to marker D11S932 on chromosome 11p15.4 with a LOD score of 3.14 ({theta}=0;90% penetrance). An unaffected individual and her two unaffected offspring inherited the affected haplotype for the H-ras-1 region telomeric to D11S932. All three have QTc measurements of {le} 0.40 seconds and no history of syncope, making the diagnosis of RWLQTS extremely unlikely. This suggests that, although the gene for the RWlQTS is linked to 11p15 in this family, a recombination event may have occurred that separated the RWLQTS gene from the affected H-ras-1 region haplotype. To investigate a possible telomeric recombination event, cosmids telomeric to H-ras-1 were isolated. A highly polymorphic, complex CA/CT repeat marker (78% heterozygosity) was characterized and its location telomeric to H-ras-1 verified by interphase FISH. The same three unaffected individuals had the affected allele for this marker, ruling our recombination telomeric to H-ras-1 but proximal to the new marker. As the most telemeric marker on 11p to date, this marker will aid the physical and genetic mapping of the 11p telomere. The potential recombination event in this family apparently excludes H-ras-1 as a candidate gene and may aid the localization of the RWLQTS gene linked to 11p15.5. However, it remains a possibility that another genetic locus on 11p15, in addition to the one near the H-ras-1 gene, can cause the RWLQTS phenotype. This is the first report of recombination between H-ras-1 and RWLQTS in a family linked to 11p15.

  9. The facies, environments of deposition and cyclicity of the Yates Formation, North Ward-Estes field, Ward County, Texas 

    E-print Network

    Johnson, Ronnie Delane

    1997-01-01

    of the Central Basin Platform. The Yates Formation consists of sub-arkosic sandstones and siltstones and dolomitic mudstones and wackestones. It has sharp contacts with the carbonates of the underlying Seven Rivers Formation and evaporite-rich beds...

  10. Preventing homelessness after discharge from psychiatric wards: perspectives of consumers and staff.

    PubMed

    Forchuk, Cheryl; Godin, Mike; Hoch, Jeffrey S; Kingston-Macclure, Shani; Jeng, Momodou S; Puddy, Liz; Vann, Rebecca; Jensen, Elsabeth

    2013-03-01

    After spending time in the hospital, psychiatric clients are often discharged to homeless shelters or the streets, which can place a burden on health care systems. This study examined the effects of an intervention in which psychiatric clients from acute (n = 219) and tertiary (n = 32) sites were provided with predischarge assistance in securing housing. A program evaluation design was used to examine the effectiveness of the intervention. Qualitative data were available through interviews, focus groups, and monthly meetings. The results highlight several benefits of the intervention and show that homelessness can be reduced by connecting housing support, income support, and psychiatric care. PMID:23394964

  11. Ward Valley and the Federal Low-Level Radioactive Waste Policy Act

    SciTech Connect

    Pasternak, A.D.

    1996-03-01

    In his State of the Union Address delivered on 23 January 1996, President Clinton said, speaking generally, {open_quotes}Passing a law - even the best possible law - is only a first step. The next step is to make it work.{close_quotes} The president is right, of course; faithful execution of any law is the key. Unfortunately, this lesson appears lost on his own administration when it comes to making the Low-Level Radioactive Waste Policy Act work. That act is one of the most important environmental laws of the 1980s. It was designed by Congress and the state governors to assure both sufficient disposal capacity for low-level radioactive waste (LLRW) and regional equity in the siting of new disposal facilities. Former Congressman Morris Udall (D-Ariz.), who was chairman of the House Interior Committee and a congressional environmental leader, was author of the act. No state has done more to make the law work than California. No state has made more progress toward developing a new disposal facility for low-level radioactive waste as mandated by the act. But further progress, that is, actual construction and operation of a disposal facility, has been stymied by the federal administration, which has refused to convey federal desert lands to California for use as the site of the proposed disposal facility.

  12. Prevalence and Clinical Features of Patients with the Cardiorenal Syndrome Admitted to an Internal Medicine Ward

    PubMed Central

    Gigante, Antonietta; Liberatori, Marta; Gasperini, Maria Ludovica; Sardo, Liborio; Di Mario, Francesca; Dorelli, Barbara; Barbano, Biagio; Rosato, Edoardo; Rossi Fanelli, Filippo; Amoroso, Antonio

    2014-01-01

    Background Many patients admitted to a Department of Internal Medicine have different degrees of heart and kidney dysfunction. Mortality, morbidity and cost of care greatly increase when cardiac and renal diseases coexist. Methods A retrospective cohort study was conducted on 1,087 patients admitted from December 2009 to December 2012 to evaluate the prevalence of the cardiorenal syndrome (CRS) and clinical features. Results Out of 1,087 patients discharged from our unit during the study period, 190 (17.5%) were diagnosed as having CRS and classified into five types. CRS was more common in males (68.9%). CRS type 1 was associated with higher age (79.9 ± 8.9 years) and accounted for 61.5% of all deaths (p < 0.001), representing a risk factor for mortality (OR 4.23, 95% CI 1.8-10). Congestive heart failure was significantly different among the five CRS types (p < 0.0001) with a greater frequency in type 1 patients. Infectious diseases were more frequent in CRS types 1, 3 and 5 (p < 0.05). Pneumonia presented a statistically higher frequency in CRS types 1 and 5 compared to other classes (p < 0.01), and community-acquired infections were statistically more frequent in CRS types 1 and 5 (p < 0.05). The distribution of community-acquired pneumonia was different among the classes (p < 0.01) with a higher frequency in CRS types 1, 3 and 5. Conclusion CRS is a condition that is more frequently observed in the clinical practice. The identification of predisposing trigger factors, such as infectious diseases, particularly in the elderly, plays a key role in reducing morbidity and mortality. An early recognition can be useful to optimize therapy, encourage a multidisciplinary approach and prevent complications. PMID:25254030

  13. Treme/7th Ward Griots: A New Orleans Ethnic Heritage Program. Field Edition.

    ERIC Educational Resources Information Center

    1979

    Three units comprise the New Orleans Ethnic Heritage Program developed for students in grade 8. Objectives are to increase student appreciation of New Orleans cultural heritage, help them understand their own racial and ethnic groups, and build analytical and evaluative decision making skills. The units are entitled "The Ethnic Heritage of New…

  14. LLW Notes Supplement, May/June 1994: Ward Valley, California: Legal issues in summary

    SciTech Connect

    Norris, C.; Lovinger, T.

    1994-12-31

    This document is a digest of the major issues raised by the petitioners for the superior court`s consideration and of the responses to those issues that were supplied by the state respondents. The issues have been extracted from a joint memorandum filed by the petitioners on March 9. The responses are taken from the state respondents` April 6 memorandum. The superior court`s decision about the merit of each issue - as reported in the court`s May 4 order - is also included. This information is necessarily summary in nature. Persons interested in a detailed explanation of these lawsuits are directed to the parties` memorandums of March 9 and April 6, as well as to the court`s May 4 order.

  15. Fertility Models for Statistical Natural Language Understanding Stephen Della Pietra , Mark Epstein, Salim Roukos, Todd Ward

    E-print Network

    Fertility Models for Statistical Natural Language Understanding Stephen Della Pietra °, Mark Translation Group's concept of fertil- ity (Brown et al., 1993) to the generation of clumps for natural- lish as many disjoint clump of words. We present two fertility models which attempt to capture

  16. CD5 helps aspiring regulatory T cells ward off unwelcome cytokine advances.

    PubMed

    Palin, Amy C; Love, Paul E

    2015-03-17

    The role of co-receptor molecules in the generation of inducible regulatory T cells (iTregs) remains incompletely defined. In this issue of Immunity, Henderson et al. (2015) show that CD5 regulates iTreg cell induction by rendering emerging iTreg cells refractory to signals mediated by effector-differentiating cytokines. PMID:25786168

  17. Accumulation of Nitrogen Oxides in Copper-Limited Cultures of Denitrifying Julie Granger; Bess B. Ward

    E-print Network

    Ward, Bess

    Accumulation of Nitrogen Oxides in Copper-Limited Cultures of Denitrifying Bacteria Julie Granger, by the American Society of Lim~lologyand Oceanography. lllc. Accumulation of nitrogen oxides in copper of Pseudornonas stutzeri and Paracoccus denitrificansresulted in accumulation of nitrous oxide (N,O) gas compared

  18. Preliminary report on the lignite resources of the Niobe area, Burke and Ward counties, North Dakota

    USGS Publications Warehouse

    Owen, Hal E.

    1977-01-01

    Two lignite beds, the Niobe and the Bonus, occur at strippable depths within the Niobe area. The Niobe bed averages 5 feet (1.5 meters) in thickness and the Bonus bed averages 8 feet (2.4 meters) in thickness. These beds lie in the lower part of the Sentinel Butte Member of the Fort Union Formation (Paleocene). The demonstrated resources of both beds combined is 122 million tons (110 million tonnes), all of which are under less than 120 feet (37 meters) of overburden. The overburden consists of glacial till and shale. The lateral continuity of the coal has been locally interrupted by faulting, glacial outwash channels, and erosion. Folding and/or faulting occurs parallel to the Missouri Coteau escarpment and faulting occurs roughly perpendicular to the escarpment.

  19. 77 FR 10960 - Security Zone, East River and Bronx Kill; Randalls and Wards Islands, NY

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-24

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA87 Security Zone, East River and Bronx Kill; Randalls and... establishing a temporary security zone on the waters of the East River and Bronx Kill, in the vicinity of... is intended to restrict vessels from a portion of the East River and Bronx Kill when public...

  20. Controls on Nitrogen Loss Processes in Chesapeake Bay Sediments Andrew R. Babbin* and Bess B. Ward

    E-print Network

    Ward, Bess

    of a seven week incubation ultimately leading to nitrogen loss via denitrification and anaerobic ammonium, and anaerobic ammonium oxidation (anammox), the autotrophic synthesis of N2 from ammonium and nitrite. In the case of heterotrophic denitrification, carbon dioxide is liberated during nitrate-based respiration

  1. Modelling Non-verbal Sounds for Speech Recognition Wayne Ward1

    E-print Network

    , cough, clearing throat, etc. Environmental noise can be phone rings, door slams, other speakers, BREATI-INOISE, CLEAR_THROAT, COUGH, DOOR_SLAM, MOUTFLNOISE, MUMBLE, RUSTLE, PHONE_RING, SNIFF, SNEEZE

  2. Note on Adiabatic Modes and Ward Identities In A Closed Universe

    E-print Network

    Xiao, Xiao

    2014-01-01

    As statements regarding the soft limit of cosmological correlation functions, consistency relations are known to exist in any flat FRW universe. In this letter we explore the possibility of finding such relations in a spatially closed universe, where the soft limit $\\textbf{q}\\rightarrow 0$ does not exist in any rigorous sense. Despite the absence of spatial infinity of the spatial slices, we find the adiabatic modes and their associated consistency relations in a toy universe with background topology $R\\times S^2$. Flat FRW universe adiabatic modes are recovered via taking the large radius limit $R\\gg \\mathcal{H}^{-1}$, for which we are living in a small local patch of Hubble size on the sphere. It is shown that both dilation and translation adiabatic modes in the local patch are recovered by a global dilation on the sphere, acting at different places.

  3. Note on Adiabatic Modes and Ward Identities In A Closed Universe

    E-print Network

    Xiao Xiao

    2014-07-31

    As statements regarding the soft limit of cosmological correlation functions, consistency relations are known to exist in any flat FRW universe. In this letter we explore the possibility of finding such relations in a spatially closed universe, where the soft limit $\\textbf{q}\\rightarrow 0$ does not exist in any rigorous sense. Despite the absence of spatial infinity of the spatial slices, we find the adiabatic modes and their associated consistency relations in a toy universe with background topology $R\\times S^2$. Flat FRW universe adiabatic modes are recovered via taking the large radius limit $R\\gg \\mathcal{H}^{-1}$, for which we are living in a small local patch of Hubble size on the sphere. It is shown that both dilation and translation adiabatic modes in the local patch are recovered by a global dilation on the sphere, acting at different places.

  4. Palestinian Children in the Hemato-Oncology Ward of an Israeli Hospital

    PubMed Central

    Nehari, Miri; Bielorai, Bella; Toren, Amos

    2008-01-01

    Purpose An encounter between Palestinian parents of children with cancer and Israeli medical staff is a very special situation where “potential enemies” interact in a caring, trusting and intimate relationship for long periods of time. Our aim was to study the psychological and cultural encounter in order to understand the dynamics involved. Method The study is a qualitative one. Data was collected by way of structured in-depth interviews. Participants were physicians and nurses employed in the department, and Palestinian parents accompanying their children who were hospitalized during the research period. Results Six main themes emerged from the analysis of the interviews: (1) The decision to come to Israel for treatment. (2) The “meeting points” of the two peoples: the Israeli check points and the Palestinian Authority permits. (3) Encounter with the Israeli hospital. (4) Relationship between medical staff and parents. (5) Language and cultural barriers. (6) Emotions, thoughts and behaviors during high security tension. Conclusion The interviews depict a poignant picture of the unique encounter between Israeli Doctors and nurses and Palestinian parents. The psychological mechanism used by parents and doctors is “splitting”-having a dichotomized, simple emotional-perceptual picture of a situation with no conflicts. Nurses use another psychological mechanism in addition which enables them to contain the paradox and the conflict. PMID:21892260

  5. Malondialdehyde-Deoxyguanosine Adduct Formation in Workers of Pathology Wards. The Role of Air Formaldehyde Exposure

    PubMed Central

    Romanazzi, Valeria; Munnia, Armelle; Piro, Sara; Allione, Alessandra; Ricceri, Fulvio; Guarrera, Simonetta; Pignata, Cristina; Matullo, Giuseppe; Wang, Poguang; Giese, Roger W.; Peluso, Marco

    2010-01-01

    Background Formaldehyde is a ubiquitous pollutant to which humans are exposed. Pathologists can experience high formaldehyde exposure levels. Formaldehyde – among other properties – induce oxidative stress and free radicals, which react with DNA and lipids, leading to oxidative damage and lipid peroxidation, respectively. We measured the levels of air-formaldehyde exposure in a group of Italian pathologists and controls. We analyzed the effect of formaldehyde exposure on leukocyte malondialdehyde-deoxyguanosine adducts (M1-dG), a biomarker of oxidative stress and lipid peroxidation. We studied the relationship between air-formaldehyde and M1-dG adducts. Methods Air-formaldehyde levels were measured by personal air samplers. M1-dG adducts were analyzed by 32P-postlabelling assay. Results Reduction rooms pathologists were significantly exposed to air-formaldehyde in respect to controls and to the pathologists working in other laboratory areas (p<0.001). A significant difference for M1-dG adducts between exposed pathologists and controls was found (p=0.045). The effect becomes stronger when the evaluation of air-formaldehyde exposure was based on personal samplers (p=0.018). Increased M1dG adduct levels were only found in individuals exposed to air-formaldehyde concentrations higher than 66 ?g/m3. When the exposed workers and controls were subgrouped according to smoking, M1-dG tended to increase in all the subjects but a significant association between M1-dG and air-formaldehyde was only found in not smokers (p= 0.009). Air formaldehyde played a role positive but not significant (r = 0.355, p = 0.075, Pearson correlation) in the formation of M1-dG, only in not smokers. Conclusions Working in the reduction rooms and to be exposed to air-formaldehyde concentrations higher than 66 ?g/m3 is associated with increased levels of M1-dG adducts. PMID:20707408

  6. Facilitating the transition from physiology to hospital wards through an interdisciplinary case study of septic shock

    PubMed Central

    2014-01-01

    Background In order to develop clinical reasoning, medical students must be able to integrate knowledge across traditional subject boundaries and multiple disciplines. At least two dimensions of integration have been identified: horizontal integration, bringing together different disciplines in considering a topic; and vertical integration, bridging basic science and clinical practice. Much attention has been focused on curriculum overhauls, but our approach is to facilitate horizontal and vertical integration on a smaller scale through an interdisciplinary case study discussion and then to assess its utility. Methods An interdisciplinary case study discussion about a critically ill patient was implemented at the end of an organ system-based, basic sciences module at New York University School of Medicine. Three clinical specialists—a cardiologist, a pulmonologist, and a nephrologist—jointly led a discussion about a complex patient in the intensive care unit with multiple medical problems secondary to septic shock. The discussion emphasized the physiologic underpinnings behind the patient’s presentation and the physiologic considerations across the various systems in determining proper treatment. The discussion also highlighted the interdependence between the cardiovascular, respiratory, and renal systems, which were initially presented in separate units. After the session students were given a brief, anonymous three-question free-response questionnaire in which they were asked to evaluate and freely comment on the exercise. Results Students not only took away physiological principles but also gained an appreciation for various thematic lessons for bringing basic science to the bedside, especially horizontal and vertical integration. The response of the participants was overwhelmingly positive with many indicating that the exercise integrated the material across organ systems, and strengthened their appreciation of the role of physiology in understanding disease presentations and guiding appropriate therapy. Conclusions Horizontal and vertical integration can be presented effectively through a single-session case study, with complex patient cases involving multiple organ systems providing students opportunities to integrate their knowledge across organ systems while emphasizing the importance of physiology in clinical reasoning. Furthermore, having several clinicians from different specialties discuss the case together can reinforce the matter of integration across multiple organ systems and disciplines in students’ minds. PMID:24725336

  7. Ward identities and gauge flow for M-theory in N =3 superspace

    NASA Astrophysics Data System (ADS)

    Upadhyay, Sudhaker

    2015-09-01

    We derive the Becchi-Rouet-Stora-Tyutin (BRST) symmetry, Slavnov-Taylor identities, and Nielsen identities for the Aharony-Bergman-Jafferis-Maldacena theories in N =3 harmonic superspace. Further, the gauge dependence of one-particle irreducible amplitudes in this superconformal Chern-Simons theory is shown to be generated by a canonical flow with respect to the extended Slavnov-Taylor identity, induced by the extended BRST transformations (including the BRST transformations of the gauge parameters).

  8. Acknowledgments in Human-Computer Interaction Karen Ward and Peter A. Heeman

    E-print Network

    ), Closely related to acknowledgments are repeti- tions, in which the conversant provides a stronger signal-human conversation will provide us with the guidance we need. At the same time, we cannot always look to current Clark and Schaefer (1989), who describe a hierarchy of meth- ods by which one conversant may signal

  9. Number Forms in the Brain Joey Tang, Jamie Ward, and Brian Butterworth

    E-print Network

    Butterworth, Brian

    number and space. Here we report the first neuroimaging study of number-form synesthesia, investigating on word­color or grapheme­color synesthesia. & INTRODUCTION ``Number forms'' (NFs), mental images, neurological damage led to both loss of the NF and to an inability to calculate (Spalding & Zangwill, 1950

  10. $35-Million Helps Cornell University Recruit Faculty and Ward off Poachers

    ERIC Educational Resources Information Center

    June, Audrey Williams

    2008-01-01

    When it comes to building a top-notch faculty, racing to land prominent scholars is only half the battle for colleges. The other half: Fighting off poachers intent on swiping the college's existing talented mid-career professors. At Cornell University, a $35-million gift announced by officials in late September will give the institution an edge in…

  11. To appear in Laurence R. Horn and Gregory Ward (eds.) Handbook of Pragmatics. Oxford: Blackwell

    E-print Network

    Jurafsky, Daniel

    Pragmatics and Computational Linguistics Dan Jurafsky 1 Introduction These days there's a computational, the early computational work drew very strongly from the linguistic literature of the period. This enables us to closely com- pare the ways that computational linguistic and non-computational linguistic ap

  12. Estimating Potential Infection Transmission Routes in Hospital Wards Using Wearable Proximity Sensors

    E-print Network

    Barrat, Alain

    1,2 , Corinne Re´gis2 , Byeul-a Kim7 , Brigitte Comte7 , Nicolas Voirin1,2 * 1 Hospices Civils de description and quantification of contacts in hospitals provides key information for HAIs epidemiology

  13. Ward identities and consistency relations for the large scale structure with multiple species

    SciTech Connect

    Peloso, Marco; Pietroni, Massimo E-mail: pietroni@pd.infn.it

    2014-04-01

    We present fully nonlinear consistency relations for the squeezed bispectrum of Large Scale Structure. These relations hold when the matter component of the Universe is composed of one or more species, and generalize those obtained in [1,2] in the single species case. The multi-species relations apply to the standard dark matter + baryons scenario, as well as to the case in which some of the fields are auxiliary quantities describing a particular population, such as dark matter halos or a specific galaxy class. If a large scale velocity bias exists between the different populations new terms appear in the consistency relations with respect to the single species case. As an illustration, we discuss two physical cases in which such a velocity bias can exist: (1) a new long range scalar force in the dark matter sector (resulting in a violation of the equivalence principle in the dark matter-baryon system), and (2) the distribution of dark matter halos relative to that of the underlying dark matter field.

  14. A review of "The Politics of Liberty in England and Revolutionary America." by Lee Ward 

    E-print Network

    Geoffrey M. Vaughan

    2005-01-01

    the period for the first time, but not as an undergraduate. This makes its best audience difficult to discern, but any- one would profit from the read. Caroline Castiglione. Patrons and Adversaries: Nobles and Villagers in Italian Politics, 1640... litigiousness, which erupted in the Cahiers de dol?ances of 1788 and in the Great Fear, the peasant uprising in the first month of the French Revolution. There has been less study of village politics in Italy, especially for readers of English. Thus Caroline...

  15. Self-Replication of Mesa Patterns in Reaction-Diffusion T. KOLOKOLNIKOV , M.J. WARD

    E-print Network

    Ward, Michael Jeffrey

    Preprint 1 Self-Replication of Mesa Patterns in Reaction-Diffusion Systems T. KOLOKOLNIKOV , M of a mesa self-replication event that ultimately leads to the creation of additional mesas. The initiation of Nishiura and Ueyema [Physica D, 130, No. 1, (1999), pp. 73­104], believed to be responsible for self-replication

  16. A critical assessment of monitoring practices, patient deterioration, and alarm fatigue on inpatient wards: a review

    PubMed Central

    2014-01-01

    Approximately forty million surgeries take place annually in the United States, many of them requiring overnight or lengthier post operative stays in the over five thousand hospitals that comprise our acute healthcare system. Leading up to this Century, it was common for most hospitalized patients and their families to believe that being surrounded by well-trained nurses and physicians assured their safety. That bubble burst with the Institute of Medicine’s 1999 report: To Err Is Human, followed closely by its 2001 report: Crossing the Quality Chasm. This review article discusses unexpected, potentially lethal respiratory complications known for being difficult to detect early, especially in postoperative patients recovering on hospital general care floors (GCF). We have designed our physiologic explanations and simplified cognitive framework to give our front line clinical nurses a thorough, easy-to-recall understanding of just how these events evolve, and how to detect them early when most amenable to treatment. Our review will also discuss currently available practices in general care floor monitoring that can both improve patient safety and significantly reduce monitor associated alarm fatigue. PMID:25093041

  17. 3D Shape Analysis of the Supraspinatus Muscle Aaron D. Ward1

    E-print Network

    Hamarneh, Ghassan

    OF SCAPULA Fig. 1. Diagram of shoulder anatomy indicating location of the supraspinatus. Adapted from Grey's Anatomy [6]. of the surfaces. In section 4 we give our results, and in section 5 we make some concluding

  18. 75 FR 81269 - Ward Transformer Superfund Site Raleigh, Wake County, NC; Notice of Settlements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ...Paula@epa.gov. FOR FURTHER INFORMATION CONTACT: Paula V. Painter at 404/562-8887. Dated: December 14, 2010. Anita L. Davis, Chief, Superfund Enforcement & Information Management Branch, Superfund Division. [FR Doc. 2010-32459...

  19. Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards.

    PubMed

    Curtis, Sarah; Gesler, Wilbert; Wood, Victoria; Spencer, Ian; Mason, James; Close, Helen; Reilly, Joseph

    2013-11-01

    This paper contributes to the international literature examining design of inpatient settings for mental health care. Theoretically, it elaborates the connections between conceptual frameworks from different strands of literature relating to therapeutic landscapes, social control and the social construction of risk. It does so through a discussion of the substantive example of research to evaluate the design of a purpose built inpatient psychiatric health care facility, opened in 2010 as part of the National Health Service (NHS) in England. Findings are reported from interviews or discussion groups with staff, patients and their family and friends. This paper demonstrates a strong, and often critical awareness among members of staff and other participants about how responsibilities for risk governance of 'persons' are exercised through 'technical safety' measures and the implications for therapeutic settings. Our participants often emphasised how responsibility for technical safety was being invested in the physical infrastructure of certain 'places' within the hospital where risks are seen to be 'located'. This illuminates how the spatial dimensions of social constructions of risk are incorporated into understandings about therapeutic landscapes. There were also more subtle implications, partly relating to 'Panopticist' theories about how the institution uses technical safety to supervise its own mechanisms, through the observation of staff behaviour as well as patients and visitors. Furthermore, staff seemed to feel that in relying on technical safety measures they were, to a degree, divesting themselves of human responsibility for risks they are required to manage. However, their critical assessment showed their concerns about how this might conflict with a more therapeutic approach and they contemplated ways that they might be able to engage more effectively with patients without the imposition of technical safety measures. These findings advance our thinking about the construction of therapeutic landscapes in theory and in practice. PMID:23916450

  20. INTERNAL PARASITES OF THE SEBAGO SALMON By Henry B. Ward, Ph. D.

    E-print Network

    _n II 53 Parasites of Atlantic salmon, with tabulated summary _________________________________ 1153 studies of Atlantic salmon, I was designated to join a party engaged in a biological survey of Lake Sebago summary, which concerns chiefly the European or Atlantic salmon, since this species is the only one

  1. Learning clinical communication on ward-rounds: an ethnographic case study

    E-print Network

    Quilligan, Sally

    2014-08-26

    the framework of the Calgary–Cambridge guide (Silverman et al. 2013). Thematic analysis of interviews involved three steps: familiarisation with the data by listening to tapes and reading transcripts; developing a thematic framework by producing codes which... S. 2011. Subjectivity, self and personal agency. In: Malloch M, Cairns L, Evans K, O’Connor B, editors. Workplace learning. London: Sage. Brown J. 2010. Transferring clinical communication skills from the classroom to the clinical environment...

  2. Brain injury and deprivation of liberty on neurosciences wards: 'a gilded cage is still a cage'.

    PubMed

    Ashby, Gillian Alice; Griffin, Colette; Agrawal, Niruj

    2015-10-01

    In March 2014, a UK Supreme Court case, known as Cheshire West, reached a judgement that greatly expanded the group of people in England and Wales who could be considered deprived of their liberty when under the care of the state. This now includes anyone meeting what is known as the 'acid test': whether the person is under 'continuous supervision and control' and 'not free to leave'. The case concerned three people with learning disability, living in community residential placements; all were judged to have been deprived of their liberty, despite being apparently content, and having 'relative normality' for people in their situation. Many people consider the case to apply to hospital settings. Clearly, many neurosciences inpatients are under 'continuous supervision and control'. This might include being told when to eat or sleep, what medication to take or being under close nursing observation. Many also are not free to leave because of safety concerns. Inpatients may also be eligible for detention under Mental Health Act-if they have a mental disorder sufficient to warrant this-such as a risk to that person's health or safety, or the safety of others. Thus, we have a confusing combination of two laws that might apply. This article aims to demystify the legal background and apply it to clinical practice in England and Wales and elsewhere. PMID:26038584

  3. An Audit of Ward Experience as a Tool for Teaching Diagnosis in Pulmonary Medicine

    ERIC Educational Resources Information Center

    Kale, Madhav K.; and others

    1969-01-01

    Analyzes and compares diagnoses made over a five-year period to determine whether differences between diagnoses of students and those of specialists justified further verification by specialized staff, and whether the proportion of such differences had changed with time because of more effective teaching. (WM)

  4. Calcrete profiles and porosity development in the Wagon Wheel (Pennsylvanian) field, Ward County, Texas

    SciTech Connect

    Abegg, F.E. ); Grover, G.A. )

    1990-05-01

    The Cisco and Canyon formations in the Wagon Wheel field, located on the western edge of the Central Basin platform, contain 10-15 previously unrecognized calcrete profiles, providing excellent evidence of repeated Late Pennsylvanian subaerial exposure. Evidence for calcretes includes (1) rhizoliths, (2) alveolar texture, (3) circumgranular cracking, (4) tangential needle fibers, (5) calcrete glaebules, (6) light shifts in {delta}{sup 13}C profiles, (7) autobrecciation, and (8) laminated crusts. Extreme lateral variability of calcrete profiles makes correlation of subaerial exposure surfaces difficult. Porosity within calcrete profiles is occluded, providing a seal for underlying reservoir facies. Porosity in the Wagon Wheel field is strongly facies dependent. Porous intervals consist of lenticular skeletal grainstone-packstone facies, typically capped by calcrete profiles. Repeated meteoric phreatic lenses established during Late Pennsylvanian exposure events are interpreted to have formed moldic porosity through selective dissolution in strata containing mineralogically metastable allochems. Secondary porosity development, however, is often balanced by precipitation of eogenetic calcite cement. Therefore, meteoric diagenesis associated with Wagon Wheel calcrete development commonly occludes and only rarely enhances primary porosity. Two stages of calcite cementation are recognized: (1) an early pore-rimming nonferroan nonluminescent calcite cement with thin moderate to brightly luminescent microzones, and (2) a later ferroan, dully luminescent calcite cement with broad, indistinct zones. Truncated cements in Cisco- and Canyon-derived lithoclasts indicate nonluminescent cement was precipitated from oxidizing meteoric phreatic waters. Microzones were precipitated during brief periods of stagnation in the phreatic lenses.

  5. Every ward is a 'Nut Island'? Preventing good health-care teams 'going bad'.

    PubMed

    McKimm, Judy; Coupe, Bryony; Edwards, Luke; Gibson, Russell; Morgan, Holly; Paramore, Louise; Ramcharn, Meera

    2015-08-01

    This article explores how Levy's 'Nut Island effect' can be used to help identify health-care teams at risk of becoming isolated, disenchanted and separated physically and psychologically from senior management. Such isolation can lead to disastrous effects. PMID:26255920

  6. Script for the Minor Third video, Feb 10, 2014, Nigel Ward (title side)

    E-print Network

    Ward, Nigel

    , will ideally say "yes" and come running. (If he's a good boy and still small.) By the way, there's a power! Johny might say this if he's up in a tree wanting Mom to look at him. With the pitch drop it's again

  7. HDR IMAGE CONSTRUCTION FROM MULTI-EXPOSED STEREO LDR IMAGES Ning Sun, Hassan Mansour, Rabab Ward

    E-print Network

    Mansour, Hassan

    artifacts in the final HDR image. Existing methods generate HDR images of good qual- ity for still or slow and can lead to significant artifacts in high motion scenes. Recently, adaptive normalized cross im- age areas that are saturated [7]. In this paper, we are interested in a multi-exposure stereo

  8. Directions for Research on Spoken Dialog Systems, Broadly Defined Nigel G. Ward

    E-print Network

    Ward, Nigel

    and surface-goal completion. The results are all around us, from crudely scripted up- selling attempts at fast food restaurants to stilted di- alog systems that tediously elicit the pieces of infor- mation needed to a misperception that industry is addressing these issues. A resource that would help progress here would

  9. n insidious threat lurks in the dark corners of hospital wards.

    E-print Network

    Feig, Andrew

    a glucosyltransferase functionality that targets a family of Ras-like G-proteins, disrupting their function upon act as a small molecule chaperone to facilitate the insertion of the protein into the membrane, thusA and TcdB are very large proteins (on the order of 300 kDa). They share 48% identity and in vitro behave

  10. From Classroom to Boardroom and Ward: Developing Generic Intercultural Skills in Diverse Disciplines

    ERIC Educational Resources Information Center

    Barker, Michelle C.; Mak, Anita S.

    2013-01-01

    A strategic approach to internationalize learning in higher education institutions is to use the curriculum and classroom cultural diversity to create opportunities to broaden students' intercultural perspectives, appreciate sociocultural variability in professional practice, and improve their intercultural interaction skills. There is no…

  11. Estimating Potential Infection Transmission Routes in Hospital Wards Using Wearable Proximity Sensors

    E-print Network

    Vanhems, Philippe; Cattuto, Ciro; Pinton, Jean-François; Khanafer, Nagham; Régis, Corinne; Kim, Byeul-a; Comte, Brigitte; Voirin, Nicolas

    2013-01-01

    Contacts between patients, patients and health care workers (HCWs) and among HCWs represent one of the important routes of transmission of hospital-acquired infections (HAI). A detailed description and quantification of contacts in hospitals provides key information for HAIs epidemiology and for the design and validation of control measures. We used wearable sensors to detect close-range interactions ("contacts") between individuals in the geriatric unit of a university hospital. Contact events were measured with a spatial resolution of about 1.5 meters and a temporal resolution of 20 seconds. The study included 46 HCWs and 29 patients and lasted for 4 days and 4 nights. 14037 contacts were recorded. The number and duration of contacts varied between mornings, afternoons and nights, and contact matrices describing the mixing patterns between HCW and patients were built for each time period. Contact patterns were qualitatively similar from one day to the next. 38% of the contacts occurred between pairs of HCWs...

  12. Pair Potential of Charged Colloidal Stars K. Addas,2,* A. Ward,1

    E-print Network

    Fraden, Seth

    , Massachusetts 02454, USA 2 Rowland Institute at Harvard, Cambridge, Massachusetts 02142, USA 3 Department of Chemistry, Wellesley College, Wellesley, Massachusetts 02481, USA 4 Departamento de Fi´sica Teo´rica de la, as shown in Fig. 1. Stiffer than DNA [8], these viral brushes represent a new class of stars

  13. Constraints on the IR behaviour of gluon and ghost propagator from Ward-Slavnov-Taylor identities

    E-print Network

    Ph. Boucaud; J. P. Leroy; A. Le Yaouanc; J. Micheli; O. Pène; A. Y. Lokhov; J. Rodríguez-Quintero; C. Roiesnel

    2007-01-15

    We consider the constraints of the Slavnov-Taylor identity of the IR behaviour of gluon and ghost propagators and their compatibility with solutions of the ghost Dyson-Schwinger equation and with the lattice picture.

  14. Automatic Discovery of Simply-Composable Prosodic Elements Nigel G. Ward

    E-print Network

    Ward, Nigel

    with a composi- tion rule, and to then use it to infer the elements; the reverse of the classical strategy size, number of cars, age, education level, food budget, and so on, the first underlying factor may be some- thing like socioeconomic status, the second may be related to age, the third may be gender

  15. Discussing Patient Management Online: The Impact of Roles on Knowledge Construction for Students Interning at the Paediatric Ward

    ERIC Educational Resources Information Center

    De Wever, Bram; Van Winckel, Myriam; Valcke, Martin

    2008-01-01

    The objectives of this study are to explore the use of asynchronous discussion groups during medical students' clinical rotation in paediatrics. In particular, the impact of role assignment on the level of knowledge construction through social negotiation is studied. Case-based asynchronous discussion groups were introduced to enhance reflection…

  16. Pain, agitation, and behavioural problems in people with dementia admitted to general hospital wards: a longitudinal cohort study

    PubMed Central

    Sampson, Elizabeth L.; White, Nicola; Lord, Kathryn; Leurent, Baptiste; Vickerstaff, Victoria; Scott, Sharon; Jones, Louise

    2015-01-01

    Abstract Pain is underdetected and undertreated in people with dementia. We aimed to investigate the prevalence of pain in people with dementia admitted to general hospitals and explore the association between pain and behavioural and psychiatric symptoms of dementia (BPSD). We conducted a longitudinal cohort study of 230 people, aged above 70, with dementia and unplanned medical admissions to 2 UK hospitals. Participants were assessed at baseline and every 4 days for self-reported pain (yes/no question and FACES scale) and observed pain (Pain Assessment in Advanced Dementia scale [PAINAD]) at movement and at rest, for agitation (Cohen–Mansfield Agitating Inventory [CMAI]) and BPSD (Behavioural Pathology in Alzheimer Disease Scale [BEHAVE-AD]). On admission, 27% of participants self-reported pain rising to 39% on at least 1 occasion during admission. Half of them were able to complete the FACES scale, this proportion decreasing with more severe dementia. Using the PAINAD, 19% had pain at rest and 57% had pain on movement on at least 1 occasion (in 16%, this was persistent throughout the admission). In controlled analyses, pain was not associated with CMAI scores but was strongly associated with total BEHAVE-AD scores, both when pain was assessed on movement (? = 0.20, 95% confidence interval [CI] = 0.07-0.32, P = 0.002) and at rest (? = 0.41, 95% CI = 0.14-0.69, P = 0.003). The association was the strongest for aggression and anxiety. Pain was common in people with dementia admitted to the acute hospital and associated with BPSD. Improved pain management may reduce distressing behaviours and improve the quality of hospital care for people with dementia. PMID:25790457

  17. New Short Tandem Repeat-Based Molecular Typing Method for Pneumocystis jirovecii Reveals Intrahospital Transmission between Patients from Different Wards

    PubMed Central

    Gits-Muselli, Maud; Peraldi, Marie-Noelle; de Castro, Nathalie; Delcey, Véronique; Menotti, Jean; Guigue, Nicolas; Hamane, Samia; Raffoux, Emmanuel; Bergeron, Anne; Valade, Sandrine; Molina, Jean-Michel; Bretagne, Stéphane; Alanio, Alexandre

    2015-01-01

    Pneumocystis pneumonia is a severe opportunistic infection in immunocompromised patients caused by the unusual fungus Pneumocystis jirovecii. Transmission is airborne, with both immunocompromised and immunocompetent individuals acting as a reservoir for the fungus. Numerous reports of outbreaks in renal transplant units demonstrate the need for valid genotyping methods to detect transmission of a given genotype. Here, we developed a short tandem repeat (STR)-based molecular typing method for P. jirovecii. We analyzed the P. jirovecii genome and selected six genomic STR markers located on different contigs of the genome. We then tested these markers in 106 P. jirovecii PCR-positive respiratory samples collected between October 2010 and November 2013 from 91 patients with various underlying medical conditions. Unique (one allele per marker) and multiple (more than one allele per marker) genotypes were observed in 34 (32%) and 72 (68%) samples, respectively. A genotype could be assigned to 55 samples (54 patients) and 61 different genotypes were identified in total with a discriminatory power of 0.992. Analysis of the allelic distribution of the six markers and minimum spanning tree analysis of the 61 genotypes identified a specific genotype (Gt21) in our hospital, which may have been transmitted between 10 patients including six renal transplant recipients. Our STR-based molecular typing method is a quick, cheap and reliable approach to genotype Pneumocystis jirovecii in hospital settings and is sensitive enough to detect minor genotypes, thus enabling the study of the transmission and pathophysiology of Pneumocystis pneumonia. PMID:25933203

  18. Monitoring Ambulation of Patients in Geriatric Rehabilitation Wards: The Accuracy of Clinicians' Prediction of Patients' Walking Time

    ERIC Educational Resources Information Center

    Cheung, Vivian H. Y.; Salih, Salih A.; Crouch, Alisa; Karunanithi, Mohanraj K.; Gray, Len

    2012-01-01

    The aim of this study is to determine whether clinicians' estimates of patients' walking time agree with those determined by accelerometer devices. The walking time was measured using a waist-mounted accelerometer device everyday during the patients' waking hours. At each weekly meeting, clinicians estimated the patients' average daily walking…

  19. Contaminated handwashing sinks as the source of a clonal outbreak of KPC-2-producing Klebsiella oxytoca on a hematology ward.

    PubMed

    Leitner, Eva; Zarfel, Gernot; Luxner, Josefa; Herzog, Kathrin; Pekard-Amenitsch, Shiva; Hoenigl, Martin; Valentin, Thomas; Feierl, Gebhard; Grisold, Andrea J; Högenauer, Christoph; Sill, Heinz; Krause, Robert; Zollner-Schwetz, Ines

    2015-01-01

    We investigated sinks as possible sources of a prolonged Klebsiella pneumonia carbapenemase (KPC)-producing Klebsiella oxytoca outbreak. Seven carbapenem-resistant K. oxytoca isolates were identified in sink drains in 4 patient rooms and in the medication room. Investigations for resistance genes and genetic relatedness of patient and environmental isolates revealed that all the isolates harbored the blaKPC-2 and blaTEM-1 genes and were genetically indistinguishable. We describe here a clonal outbreak caused by KPC-2-producing K. oxytoca, and handwashing sinks were a possible reservoir. PMID:25348541

  20. Mirror mirror on the ward, who’s the most narcissistic of them all? Pathologic personality traits in health care

    PubMed Central

    Bucknall, Vittoria; Burwaiss, Suendoss; MacDonald, Deborah; Charles, Kathy; Clement, Rhys

    2015-01-01

    Background: Stereotypes in medicine have become exaggerated for the purpose of workplace amusement. Our objective was to assess the levels of “dark triad” personality traits expressed by individuals working in different health care specialties in comparison with the general population. Methods: We conducted a prospective, cross-sectional study within multiple departments of a UK secondary care teaching hospital. A total of 248 health care professionals participated, and 159 members of the general population were recruited as a comparison group. We measured 3 personality traits — narcissism, Machiavellianism and psychopathy — through the validated self-reported personality questionnaires Narcissistic Personality Inventory (NPI), MACH-IV and the Levenson Self-Report Psychopathy Scale (LSRP), respectively. Results: Health care professionals scored significantly lower on narcissism, Machiavellianism and psychopathy (mean scores 12.0, 53.0 and 44.7, respectively) than the general population (p < 0.001). Nursing professionals exhibited a significantly higher level of secondary psychopathy than medical professionals (p = 0.04, mean LSRP score 20.3). Within the cohort of medical professionals, surgeons expressed significantly higher levels of narcissism (p = 0.03, mean NPI score 15.0). Interpretation: Health care professionals expressed low levels of dark triad personality traits. The suggestion that health care professionals are avaricious and untrustworthy may be refuted, even for surgeons. PMID:26644545

  1. Close Encounters in a Pediatric Ward: Measuring Face-to-Face Proximity and Mixing Patterns with Wearable

    E-print Network

    Barrat, Alain

    Background: Nosocomial infections place a substantial burden on health care systems and represent one Rizzo4 , Alberto Eugenio Tozzi2 * 1 Complex Networks and Systems Group, Institute for Scientific for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanita` Rome, Rome, Italy Abstract

  2. Goldstone theorem, Hugenholtz-Pines theorem, and Ward-Takahashi relation in finite volume Bose-Einstein condensed gases

    SciTech Connect

    Enomoto, Hiroaki . E-mail: enomotohiroaki@akane.waseda.jp; Okumura, Masahiko . E-mail: okumura@aoni.waseda.jp; Yamanaka, Yoshiya . E-mail: yamanaka@waseda.jp

    2006-08-15

    We construct an approximate scheme based on the concept of the spontaneous symmetry breakdown, satisfying the Goldstone theorem, for finite volume Bose-Einstein condensed gases in both zero and finite temperature cases. In this paper, we discuss the Bose-Einstein condensation in a box with periodic boundary condition and do not assume the thermodynamic limit. When energy spectrum is discrete, we found that it is necessary to deal with the Nambu-Goldstone mode explicitly without the Bogoliubov's prescription, in which zero-mode creation- and annihilation-operators are replaced with a c-number by hand, for satisfying the Goldstone theorem. Furthermore, we confirm that the unitarily inequivalence of vacua in the spontaneous symmetry breakdown is true for the finite volume system.

  3. Structure of the H-induced vacancy reconstruction of the ,,0001... surface of beryllium Karsten Pohl* and E. Ward Plummer

    E-print Network

    Pohl, Karsten

    points out,1 the covalent radius of the hydrogen atom is more variable than that of other atoms, ranging diffraction data shows that 1 3 of the Be top layer atoms are removed to form a honeycomb structure, hydrogen is able to form bulk phases with a variety of met- als, a well-studied example is palladium

  4. Therapeutic relationships and involuntary treatment orders: service users' interactions with health-care professionals on the ward.

    PubMed

    Wyder, Marianne; Bland, Robert; Blythe, Andrew; Matarasso, Beth; Crompton, David

    2015-04-01

    There is increasing evidence that an involuntary hospital admission and treatment can undermine the therapeutic relationship. While good relationships with staff are important factors influencing long-term recovery, there is little information on how people experience their relationships with staff while under an involuntary treatment order (ITO). Twenty-five involuntary inpatients were interviewed about their experiences of an ITO. The interviews were analysed by a general inductive approach. Participants described the following themes: (i) the ITO admission was a daunting and frightening experience; (ii) staff behaviours and attitudes shaped their experiences in hospital; (iii) importance of staff listening to their concerns; (iv) importance of having a space to make sense of their experiences; (v) importance of staff ability to look beyond their illness and diagnosis; and (vi) importance of staff working in partnership. These findings highlight that when using recovery principles, such as an empathic engagement with the patients' lived experience, forging partnerships with patients in treatment decision-making to enhance agency, an involuntary treatment order does not have to limit the ability to establish positive relationships. PMID:25628260

  5. The rapid disintegration of Arctic sea ice, like the Ward Hunt Ice Shelf in Canada, is a cause for

    E-print Network

    Stocker, Thomas

    Thomas Stocker, who co-chairs a working group of the prestigious Intergovernmental Panel on Climate, making them more efficient in terms of heating. Also, savings can be made in private mobility. swissinfo there are developments in the climate system that need to be studied very carefully, for example variations of solar

  6. Mathematical models for assessing the role of airflow on the risk of airborne infection in hospital wards

    PubMed Central

    Noakes, Catherine J.; Sleigh, P. Andrew

    2009-01-01

    Understanding the risk of airborne transmission can provide important information for designing safe healthcare environments with an appropriate level of environmental control for mitigating risks. The most common approach for assessing risk is to use the Wells–Riley equation to relate infectious cases to human and environmental parameters. While it is a simple model that can yield valuable information, the model used as in its original presentation has a number of limitations. This paper reviews recent developments addressing some of the limitations including coupling with epidemic models to evaluate the wider impact of control measures on disease progression, linking with zonal ventilation or computational fluid dynamics simulations to deal with imperfect mixing in real environments and recent work on dose–response modelling to simulate the interaction between pathogens and the host. A stochastic version of the Wells–Riley model is presented that allows consideration of the effects of small populations relevant in healthcare settings and it is demonstrated how this can be linked to a simple zonal ventilation model to simulate the influence of proximity to an infector. The results show how neglecting the stochastic effects present in a real situation could underestimate the risk by 15 per cent or more and that the number and rate of new infections between connected spaces is strongly dependent on the airflow. Results also indicate the potential danger of using fully mixed models for future risk assessments, with quanta values derived from such cases less than half the actual source value. PMID:19812072

  7. Effect of Adsorption on the Surface Tensions of Solid-Fluid Interfaces C. A. Ward* and Jiyu Wu

    E-print Network

    Ward, Charles A.

    of not predicting an infinite amount adsorbed when the pressure is equal to the saturation-vapor pressure. Five , is shown to be the ratio of the liquid-phase pressure at the three-phase line, PL(z3), to the saturation-vapor when the pressure is equal the saturation-vapor pressure cannot be applied because the integral does

  8. THE TIMEDEPENDENT ERLANG LOSS MODEL WITH RETRIALS Nathaniel Grier, William A. Massey, Tyrone McKoy 1 and Ward Whitt

    E-print Network

    Whitt, Ward

    ­dimensional continuous­time Markov chain (CTMC) {(Q c (t), Q r (t)) : t # 0}, as depicted in Figure 1. There are L lines (t), Q r (t)) a non­stationary CTMC on the state space {0, 1, . . . , L} � Z+ , where Z+ is the set of nonnegative integers. We give the forward equations characterizing this CTMC in Section 2. Our model has µ c

  9. Evaluation of organizational maturity based on people capacity maturity model in medical record wards of Iranian hospitals

    PubMed Central

    Yarmohammadian, Mohammad H.; Tavakoli, Nahid; Shams, Assadollah; Hatampour, Farzaneh

    2014-01-01

    Context: People capacity maturity model (PCMM) is one of the models which focus on improving organizational human capabilities. Aims: The aim of this model's application is to increase people ability to attract, develop, motivate, organize and retain the talents needed to organizational continuous improvement. Settings and Design: In this study, we used the PCMM for investigation of organizational maturity level in medical record departments of governmental hospitals and determination strengths and weaknesses of their staff capabilities. Materials and Methods: This is an applied research and cross sectional study in which data were collected by questionnaires to investigation of PCMM model needs in medical record staff of governmental hospitals at Isfahan, Iran. We used the questionnaire which has been extracted from PCMM model and approved its reliability with Cronbach's Alpha 0.96. Statistical Analysis Used: Data collected by the questionnaire was analyzed based on the research objectives using SPSS software and in accordance with research questions descriptive statistics were used. Results: Our findings showed that the mean score of medical record practitioners, skill and capability in governmental hospitals was 35 (62.5%) from maximum 56 (100%). There is no significant relevance between organizational maturity and medical record practitioners, attributes. Conclusions: Applying PCMM model is caused increasing staff and manager attention in identifying the weaknesses in the current activities and practices, so it will result in improvement and developing processes. PMID:25077147

  10. American and Arab perceptions of an Arabic turn-taking cue Nigel G. Ward, Yaffa Al Bayyari

    E-print Network

    Ward, Nigel

    , and that this tendency can be substantially alleviated by training. Keywords: cross-cultural interaction, dialog, loudness and timing -- have been a frequent topic of study in the fields of cross-cultural apply experimental methods to the study of cross-cultural interpretations of the "nuts and bolts." One

  11. VISUALLY-FAVORABLE TONE-MAPPING WITH HIGH COMPRESSION PERFORMANCE Zicong Mai, Hassan Mansour, Panos Nasiopoulos and Rabab Ward

    E-print Network

    Mansour, Hassan

    Research Council of Canada (NSERC). Fig. 1. Backward-compatible HDR video/image compression. 2. PROBLEMVISUALLY-FAVORABLE TONE-MAPPING WITH HIGH COMPRESSION PERFORMANCE Zicong Mai, Hassan Mansour, Panos of the tone-mapped image together with the compression efficiency. The proposed TMO is formulated

  12. Contaminated Handwashing Sinks as the Source of a Clonal Outbreak of KPC-2-Producing Klebsiella oxytoca on a Hematology Ward

    PubMed Central

    Leitner, Eva; Zarfel, Gernot; Luxner, Josefa; Herzog, Kathrin; Pekard-Amenitsch, Shiva; Hoenigl, Martin; Valentin, Thomas; Feierl, Gebhard; Grisold, Andrea J.; Högenauer, Christoph; Sill, Heinz; Krause, Robert

    2014-01-01

    We investigated sinks as possible sources of a prolonged Klebsiella pneumonia carbapenemase (KPC)-producing Klebsiella oxytoca outbreak. Seven carbapenem-resistant K. oxytoca isolates were identified in sink drains in 4 patient rooms and in the medication room. Investigations for resistance genes and genetic relatedness of patient and environmental isolates revealed that all the isolates harbored the blaKPC-2 and blaTEM-1 genes and were genetically indistinguishable. We describe here a clonal outbreak caused by KPC-2-producing K. oxytoca, and handwashing sinks were a possible reservoir. PMID:25348541

  13. Therapeutic milieu approaches within a high security hospital: a qualitative analysis of patients' experiences of ward-talking-groups 

    E-print Network

    Geddes, Jacqueline

    2015-07-03

    Background: Research has shown that staff-patient relationships within secure forensic services appear to be influenced by an ethos of institutional control, most evident in the tensions of developing meaningful therapeutic ...

  14. John P. Ward John R. King Adrian J. Koerber Julie M. Croft R. Elizabeth Sockett Paul Williams

    E-print Network

    in the biofilm. The model also predicts that travelling waves of quorum sensing behaviour can occur within, R.E. Sockett: Division of Genetics, School of Clinical Laboratory Sciences, Queens Medical Centre penetration of harmful agents and behavioural shifts which enhance resistance to such agents [35

  15. A Decolonizing Encounter: Ward Churchill and Antonia Darder in Dialogue. Counterpoints: Studies in the Postmodern Theory of Education. Volume 430

    ERIC Educational Resources Information Center

    Orelus, Pierre W., Ed.

    2012-01-01

    "A Decolonizing Encounter" examines the effects of western colonialism on historically marginalized and colonized populations living both in the West and the "third world". Specifically, it explores crucial issues such as the decolonizing of schools and communities of color; the decentralization of power of the capitalist and colonial state;…

  16. Public health assessment for Vega Baja Solid Waste Disposal, Rio Abajo Ward/La Trocha, Vega Baja County, Puerto Rico, Region 2: CERCLIS Number PRD980512669. Final report

    SciTech Connect

    1998-11-30

    The Vega Baja Waste Disposal Site is a public health hazard because long-term exposure to lead in soil in some yards cause harmful effects in children. Children and especially preschool children who live in yards with elevated levels of soil lead might be exposed to small amounts of lead when they accidentally swallow soil and dust that cling to their hands. The level of lead in garden vegetables from the site is not a public health threat. It is safe for residents to grow and eat garden vegetables. ATSDR recommends that EPA prevent long-term exposure to lead-contaminated soil where lead levels are consistently elevated. ATSDR also recommends that EPA consult with ATSDR officials to ensure that Superfund activities to stop exposure to lead-contaminated soil at the site continues to be protective of public health.

  17. "We Have to Be Satisfied with the Scraps": South African Nurses' Experiences of Care on Adult Psychiatric Intellectual Disability Inpatient Wards

    ERIC Educational Resources Information Center

    Capri, Charlotte; Buckle, Chanellé

    2015-01-01

    Background: Migrating nursing labour inadvertently reinforces South Africa's care drain, contributes to a global care crisis and forces us to reconsider migration motivation. This paper highlights issues that complicate psychiatric intellectual disability nursing care and identifies loci for change in an attempt to redress this care challenge.…

  18. , 20140661, published 13 August 20142812014Proc. R. Soc. B Prashant P. Sharma, Evelyn E. Schwager, Cassandra G. Extavour and Ward C. Wheeler

    E-print Network

    Alwes, Frederike

    : Scorpiones, opisthosoma, Arthropoda, bauplan, tagmosis Author for correspondence: Prashant P. Sharma e, Cambridge, MA 02138, USA The evolutionary success of the largest animal phylum, Arthropoda, has been The evolutionary success of Arthropoda is attributed to their segmented bauplan and its modularization through

  19. Randomized double-blind placebo-controlled trial of 40 mg/day of atorvastatin in reducing the severity of sepsis in ward patients (ASEPSIS Trial)

    PubMed Central

    2012-01-01

    Introduction Several observational studies suggest that statins modulate the pathophysiology of sepsis and may prevent its progression. The aim of this study was to determine if the acute administration of atorvastatin reduces sepsis progression in statin naïve patients hospitalized with sepsis. Methods A single centre phase II randomized double-blind placebo-controlled trial. Patients with sepsis were randomized to atorvastatin 40 mg daily or placebo for the duration of their hospital stay up to a maximum of 28-days. The primary end-point was the rate of sepsis progressing to severe sepsis during hospitalization. Results 100 patients were randomized, 49 to the treatment with atorvastatin and 51 to placebo. Patients in the atorvastatin group had a significantly lower conversion rate to severe sepsis compared to placebo (4% vs. 24% p = 0.007.), with a number needed to treat of 5. No significant difference in length of hospital stay, critical care unit admissions, 28-day and 12-month readmissions or mortality was observed. Plasma cholesterol and albumin creatinine ratios were significantly lower at day 4 in the atorvastatin group (p < 0.0001 and p = 0.049 respectively). No difference in adverse events between the two groups was observed (p = 0.238). Conclusions Acute administration of atorvastatin in patients with sepsis may prevent sepsis progression. Further multi-centre trials are required to verify these findings. Trial Registration International Standard Randomized Control Trial Registry ISRCTN64637517. PMID:23232151

  20. PhD Project: Understanding adaptation to climate in the UK: 1800-2000 Supervisors: Professor Mike Hulme (Environmental Sciences), Dr Paul Warde (History)

    E-print Network

    Hulme, Mike

    PhD Project: Understanding adaptation to climate in the UK: 1800-2000 Supervisors: Professor Mike to the processes of adaptation. Adaptation to climate change is now a major area of research and also of significant policy development. Yet the dominant perspective on adaptation is futuristic and predictive

  1. "Junior Doctor Decision Making: Isn't that an Oxymoron?" A Qualitative Analysis of Junior Doctors' Ward-Based Decision-Making

    ERIC Educational Resources Information Center

    Bull, Stephanie; Mattick, Karen; Postlethwaite, Keith

    2013-01-01

    Unacceptable levels of adverse healthcare events, combined with changes to training, have put the spotlight on junior doctor decision-making. This study aimed to describe the decisions made by junior doctors and the contextual factors influencing how decisions were made and justified. Stimulated recall interviews with 20 junior doctors across five…

  2. Analysis of Join-the-Shortest-Queue Routing for Web Server Farms Varun Gupta Mor Harchol-Balter Karl Sigman Ward Whitt

    E-print Network

    Gupta, Varun

    farms are better modeled as Processor Sharing (PS) server farms. We provide the first approximate.1 Motivation The server farm is a popular architecture for computing centers. A server farm consists of a front resource at a web server is often the uplink bandwidth. This bandwidth is shared by all files requested

  3. Analysis of JointheShortestQueue Routing for Web Server Farms # Varun Gupta Mor HarcholBalter Karl Sigman Ward Whitt

    E-print Network

    Gupta, Varun

    farms are better modeled as Processor Sharing (PS) server farms. We provide the first approximate.1 Motivation The server farm is a popular architecture for computing centers. A server farm consists of a front resource at a web server is often the uplink bandwidth. This bandwidth is shared by all files requested

  4. PhD position in Molecular Design and Evolution The Laboratory of Artificial Metalloenzymes of the University of Basel (Prof. Ward) and the ETH

    E-print Network

    Daraio, Chiara

    for a highly motivated, talented, and qualified PhD student with a background (MSc, diploma, or equivalent) in applied microbiology, molecular bio(techno)logy, or chemical biology. The PhD student will be part of our in biological systems and acquire extensive expertise in strain engineering and molecular design and evolution

  5. Discharged from a mental health admission ward: is it safe to go home? A review on the negative outcomes of psychiatric hospitalization

    PubMed Central

    Loch, Alexandre Andrade

    2014-01-01

    Before psychiatry emerged as a medical discipline, hospitalizing individuals with mental disorders was more of a social stigmatizing act than a therapeutic act. After the birth of the mental health disciplines, psychiatric hospitalization was legitimized and has proven to be indispensable, preventing suicides and helping individuals in need. However, despite more than a century passing since this legitimization occurred, psychiatric hospitalization remains a controversial issue. There is the question of possible negative outcomes after a psychiatric admission ceases to take its protective effect, and even of whether the psychiatric admission itself is related to a negative setback after discharge. This review aims to summarize some of the most important negative outcomes after discharge from a psychiatric institution. These experiences were organized into two groups: those after a brief psychiatric hospitalization, and those after a long-stay admission. The author further suggests possible ways to minimize these adversities, emphasizing the need of awareness related to this important issue. PMID:24812527

  6. Prospective monitoring study: isolating Legionella pneumophila in a hospital water system located in the obstetrics and gynecology ward after eradication of Legionella anisa and reconstruction of shower units.

    PubMed

    Koide, Michio; Owan, Tomoko; Nakasone, Chikara; Yamamoto, Natsuo; Haranaga, Shusaku; Higa, Futoshi; Tateyama, Masao; Yamane, Nobuhisa; Fujita, Jiro

    2007-02-01

    We previously reported on the sporadic contamination by Legionella anisa of shower units and sink taps at Ryukyu University Hospital. Starting in July 2003, the neonatal area underwent an 8-month reconstruction, and in March 2005, the boiler system was replaced. We therefore examined shower water and tap water for the presence of Legionella just after replacement of the boiler system. In 3 of the 8 water samples collected from the remodeled area, we isolated Legionella pneumophila serogroup 1 and L. anisa. Moreover, L. pneumophila serogroup 1 was isolated in 4 of the 5 water samples gathered from the unreconstructed area of the same floor. Random amplified polymorphic DNA analysis suggested that a single clone of L. pneumophila might exist throughout the floors of the water distribution system. We replaced the shower units at the Legionella-positive site, and began flushing the sink-faucets with water heated to 55N for at least 1 h every morning. As a result, Legionella was not subsequently isolated in water samples. In this prospective study, we identified a central contamination by L. pneumophila serogroup 1 and showed that flushing with hot tap water was effective to counter this situation. PMID:17314417

  7. THE TIME-DEPENDENT ERLANG LOSS MODEL WITH RETRIALS Nathaniel Grier, William A. Massey, Tyrone McKoy1 and Ward Whitt

    E-print Network

    Whitt, Ward

    -dimensional continuous-time Markov chain (CTMC) {(Qc(t), Qr(t)) : t 0}, as depicted in Figure 1. There are L lines that these assumptions make (Qc(t), Qr(t)) a non-stationary CTMC on the state space {0, 1, . . . , L} Ã? Z+, where Z+ is the set of nonnegative integers. We give the forward equations characterizing this CTMC in Section 2. Our

  8. YEAR AUTHOR TITLE 2012 Aditi, Padhi Urban Centre for Justice Re-Investment: Rehabilitation in Treme-Seventh Ward, New Orleans

    E-print Network

    Chrispell, John

    : Encouraging Variation within a Regulated Environment 2012 Davis, Elizabeth Manufactured Innovation: A study-Place: Establishing Identity in the Occupiable Threshold 2012 Kauffmann, Zachary A. Inter-Connections: An Architecture

  9. Does music make the ward go round? The role of staff attitudes and burnout in the use of music for people with dementia 

    E-print Network

    Papageorgiou, Emilia

    2013-07-02

    Introduction: The evidence-base for the effectiveness of music on people with dementia is unclear, yet music is frequently used in the care of people with dementia. Little is known about formal dementia caregivers’ views ...

  10. The Effect of Educational Intervention on Nurses’ Attitudes Toward the Importance of Family-Centered Care in Pediatric Wards in Iran

    PubMed Central

    Rostami, Forouzan; Syed Hassan, Syed Tajuddin; Yaghmai, Farideh; Ismaeil, Suriani Binti; BinSuandi, Turiman

    2015-01-01

    Introduction: Family-centered care sustains the unity of the child’s and the family’s health. The aim of this study was to determine nurses’ attitudes toward parents’ participation in the care of their hospitalized children in Iran in 2015. Methods: In this experimental study, 200 pediatric nurses from hospitals affiliated with the Shaheed Beheshti University of Medical Sciences in Tehran were selected using the multi-stage, random-sampling method. Data were gathered using a questionnaire that covered demographic information and nurses’ attitudes. The questionnaire consisted of 31 items and was completed by the nurses in three stages: 1) before intervention (pre-test), 2) immediately after intervention (post-test), and 3) three months after intervention (follow-up). The data were analyzed via SPSS software and using descriptive and analytical methods. Descriptive statistics, the Spearman Correlation Coefficient, and Repeated Measure Analysis (the Bonferroni method) were used to assess the data. Results: The results indicated that there was a significant increase in the mean score of attitude after intervention [M (pre) = 3.35%, M (post) = 3.97%, p < 0.001)]. Most of subjects had neutral attitudes toward family participation in their children’s care. There were no significant relationship between the nurses’ socio-demographic characteristics and their attitudes. Conclusion: The nurses’ attitudes toward the family’s participation in the care of their hospitalized children were moderate. The nurses’ attitudes should be improved by taking part in continuous training programs. PMID:26435826

  11. Clinical Risk Factors of Death From Pneumonia in Children with Severe Acute Malnutrition in an Urban Critical Care Ward of Bangladesh

    PubMed Central

    Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Ashraf, Hasan; Faruque, Abu S. G.; Bardhan, Pradip Kumar; Hossain, Md Iqbal; Shahid, Abu S. M. S. B.; Shahunja, K. M.; Das, Sumon Kumar; Imran, Gazi; Ahmed, Tahmeed

    2013-01-01

    Background Risks of death are high when children with pneumonia also have severe acute malnutrition (SAM) as a co-morbidity. However, there is limited published information on risk factors of death from pneumonia in SAM children. We evaluated clinically identifiable factors associated with death in under-five children who were hospitalized for the management of pneumonia and SAM. Methods For this unmatched case-control design, SAM children of either sex, aged 0–59 months, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) during April 2011 to July 2012 with radiological pneumonia were studied. The SAM children with pneumonia who had fatal outcome constituted the cases (n?=?35), and randomly selected SAM children with pneumonia who survived constituted controls (n?=?105). Results The median (inter-quartile range) age (months) was comparable among the cases and the controls [8.0 (4.9, 11.0) vs. 9.7 (5.0, 18.0); p?=?0.210)]. In logistic regression analysis, after adjusting for potential confounders, such as vomiting, abnormal mental status, and systolic hypotension (<70 mm of Hg) in absence of dehydration, fatal cases of severely malnourished under-five children with pneumonia were more often hypoxemic (OR?=?23.15, 95% CI?=?4.38–122.42), had clinical dehydration (some/severe) (OR?=?9.48, 95% CI?=?2.42–37.19), abdominal distension at admission (OR?=?4.41, 95% CI?=?1.12–16.52), and received blood transfusion (OR?=?5.50, 95% CI?=?1.21–24.99) for the management of crystalloid resistant systolic hypotension. Conclusion and Significance We identified hypoxemia, clinical dehydration, and abdominal distension as the independent predictors of death in SAM children with pneumonia. SAM children with pneumonia who required blood transfusion for the management of crystalloid resistant systolic hypotension were also at risk for death. Thus, early identification and prompt management of these simple clinically recognizable predictors of death and discourage the use of blood transfusion for the management of crystalloid resistant systolic hypotension may help reduce deaths in such population. PMID:24040043

  12. Solid-State Terahertz Sources for Space Applications F. Maiwald, J.C. Pearson, J.S. Ward, E. Schlecht, G. Chattopadhyay1

    E-print Network

    Chattopadhyay, Goutam

    temperature. Furthermore, the selected materials must have adequate thermal conductivity to accommodate performed with absorptive material around the chain to reduce interference. High-yield steel is utilized for

  13. Surface-thermal capacity of D2O from measurements made during steady-state evaporation Fei Duan and C. A. Ward

    E-print Network

    Ward, Charles A.

    number is less than 100, it is found that the interface is quiescent and thermal conduction thermocapillary flow occurs, and thermal conduction no longer supplies energy at a sufficient rate to evaporate associated with Marangoni- Bénard convection 5 was not present in these experiments. Thermal conduction

  14. Surface thermal capacity and its effects on the boundary conditions at fluid-fluid interfaces Kausik S. Das and C. A. Ward*

    E-print Network

    Ward, Charles A.

    . If STD convection is neglected, thermal conduction must supply the energy to evaporate the liquid at the mea- sured rate. The apparatus indicated in Fig. 1 was used to determine if thermal conduction these profiles, the energy transport to the interface by thermal conduction was deter- mined and compared

  15. Judging Thieves of Attention: Commentary on "Assessing Cognitive Distraction in the Automobile," by Strayer, Turrill, Cooper, Coleman, Medeiros-Ward, and Biondi (2015).

    PubMed

    Hancock, Peter A; Sawyer, Ben D

    2015-12-01

    The laudable effort by Strayer and his colleagues to derive a systematic method to assess forms of cognitive distraction in the automobile is beset by the problem of nonstationary in driver response capacity. At the level of the overall goal of driving, this problem conflates actual on-road behavior; characterized by underspecified task satisficing, with our own understandable, scientifically inspired aspiration for measuring deterministic performance optimization. Measures of response conceived under this latter imperative are, at best, only shadowy reflections of the actual phenomenological experience involved in real-world vehicle control. Whether we, as a research community, can resolve this issue remains uncertain. However, we believe we can mount a positive attack on what is arguably another equally important dimension of the collision problem. PMID:26534852

  16. WORK TRIP ORIGINS AND DESTINATIONSEMPLOYMENT Brier Park/

    E-print Network

    Toronto, University of

    / Terrace Hill 14% East Ward 5% City of Kawartha Lakes Peterborough City of Peterborough Durham York City% North Ward/ Terrace Hill 10%, 9% East Ward 8%, 3% CITY OF BRANTFORD TOTAL EMPLOYMENT IN BRANTFORD: 37% Holmedale/ Henderson 8% Braneida 29% Echo Place 3% West Brant 7% Eagle Place 3% Downtown 14% North Ward

  17. Analysis of deaths between 2007 and 2012 of patients with cancer of the head and neck on a surgical ward at a regional centre and in an independent hospice.

    PubMed

    Fullarton, Marnie; Pybus, Simon; Mayland, Catriona; Rogers, Simon N

    2016-01-01

    Providing the best care for patients dying from cancer of the head and neck is crucial, and their complex, unpredictable needs, particularly at the end of life, mean that they are likely to die in institutional care. To evaluate the care given at the end of life we retrospectively reviewed the case notes of patients who died between 2007 and 2012 in a regional head and neck unit and a specialist palliative care unit (hospice). Deaths were categorised as sudden (rapid or unanticipated) or expected (gradual or anticipated). A total of 105 patients died, of whom 29 were excluded from analysis because records were missing. Of the remaining 76, 63 died in the head and neck unit and 13 in the hospice. Patients who died the hospice were younger (mean (SD) age 63.7 (11.0) years) than those who died in hospital (mean (SD) age 70.6 (11.9) years). Most had stage III or IV disease (head and neck unit 45/57, 79%, hospice 9/13, 69%). Death was sudden in 33 (43%) and expected in 43 (57%). Haemorrhage was the commonest cause of sudden death (n=13) and carcinomatosis (n=17) the commonest cause of expected death. Specialists in palliative care had been involved in the care of 13 patients who died suddenly (39%) and 34 whose deaths were expected (79%). The family was present at the time of death (or was aware of it) in 30 who died suddenly (91%) and in 40 (93%) whose deaths were expected. In patients with cancer of the head and neck death can be sudden because of unpredictable complications, and everyone should be aware of this. PMID:26611828

  18. SECULAR RESONANCE SWEEPING IN A SELFGRAVITATING PLANETESIMAL DISK, WITH APPLICATION TO THE KUIPER BELT. J. M. Hahn, Lunar and Planetary Institute, Houston TX 77058, USA, (hahn@lpi.usra.edu), W. R. Ward,

    E-print Network

    Hahn, Joseph M.

    Belt is the high orbital inclinations exhibited by Kuiper Belt Objects (KBOs). This swarm of distant distinct models have been offered as explanations for the Kuiper Belt's dynamical excitation: gravitational into inclined Kuiper Belt orbits by the giant planets [2], inclination­pumping due to the close passage

  19. Schultz, T. R. 2007. The fungus-growing ant genus Apterostigma in Dominican amber, pp. 425-436. In Snelling, R. R., B. L. Fisher, and P. S. Ward (eds). Advances in ant systematics

    E-print Network

    Miller, Scott

    in the text: American Museum of Natural History (AMNH), National Museum of Natural History (USNM, P.O. Box 37012 National Museum of Natural History Smithsonian Institution Washington, DC 20013): homage to E. O. Wilson ­ 50 years of contributions. Memoirs of the American Entomological Institute, 80

  20. 42 CFR 409.22 - Bed and board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.22 Bed and board. ...requires him to be isolated; (ii) The SNF has no semiprivate or ward accommodations; or (iii) The SNF semiprivate and ward accommodations...

  1. 42 CFR 409.22 - Bed and board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.22 Bed and board. ...requires him to be isolated; (ii) The SNF has no semiprivate or ward accommodations; or (iii) The SNF semiprivate and ward accommodations...

  2. 42 CFR 409.22 - Bed and board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.22 Bed and board. ...requires him to be isolated; (ii) The SNF has no semiprivate or ward accommodations; or (iii) The SNF semiprivate and ward accommodations...

  3. 42 CFR 409.22 - Bed and board.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.22 Bed and board. ...requires him to be isolated; (ii) The SNF has no semiprivate or ward accommodations; or (iii) The SNF semiprivate and ward accommodations...

  4. 42 CFR 409.22 - Bed and board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.22 Bed and board. ...requires him to be isolated; (ii) The SNF has no semiprivate or ward accommodations; or (iii) The SNF semiprivate and ward accommodations...

  5. 77 FR 39694 - National Currents Energy Services, LLC; Notice of Declaration of Intention and Petition for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    ...Services, LLC. e. Name of Project: Wards Island Tidal Energy Project. f. Location: The proposed Wards Island Tidal Energy Project will be located off the south...Island Sound in the Borough of Manhattan, New York City, NY. g....

  6. IEEETRANSACITONSON INFORMATIONTHEORY,VOL. 1~426,NO. 3, MAY 1980 305 Ternary Codes of Minimum Weight 6 and the

    E-print Network

    Sloane, Neil J. A.

    , Inc., Room 2C-363, Murray Hill, NJ 07974. H. N. Ward is with the Mathematics Department, University. SLOANE, FELLOW, IEEE, AND HAROLD N. WARD Abstmct-Self-orthogonal ternary codes of minimum weight 3 may

  7. 1050 Inorg. Chem. 1992, 31, 1050-1054 Contribution from the Department of Chemistry, Baker Laboratory,

    E-print Network

    Li, Jing

    .8%, Alfa Products, Ward Hill, MA), Fe (99.999%, Johnson Matthey Chemicals, Inc., London), and Te (99.999%, Alfa Products, Ward Hill, MA) were used as starting materials. NbCoTe, was first found in a reaction

  8. 5 CFR Appendix D to Subpart B of... - Nonappropriated Fund Wage and Survey Areas

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...: Fergus Flathead Hill Lewis and Clark Valley Yellowstone NEBRASKA Douglas-Sarpy Survey Area Nebraska... Pembina Steele Ward Survey Area North Dakota: Ward Area of Application. Survey area plus: North...

  9. 78 FR 44577 - Senior Executive Service Performance Review Board

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-24

    ...Peter S. Walke, James A. Walther, Kelli Walton, Kimberly H. Ward, Nancy L. Ward, Patrice Warrick, Thomas Wenchel, Rosemary Williams, Dwight M. Williams, Gerard J. Williams, Richard Winchell, Leigh Windham, Nicole Winkowski, Thomas S....

  10. Necrotizing Skin Infections

    MedlinePLUS

    ... for Signs of Skin Cancer, Doctors Advise (News) B Vitamin May Help Ward Off Some Skin Cancers Additional ... Day News by By Dennis Thompson HealthDay Reporter B Vitamin May Help Ward Off Some Skin Cancers WEDNESDAY, ...

  11. 42 CFR 409.22 - Bed and board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.22 Bed and board. (a) Semiprivate and ward... room if— (i) The patient's condition requires him to be isolated; (ii) The SNF has no semiprivate or ward accommodations; or (iii) The SNF semiprivate and ward accommodations are fully occupied by...

  12. 42 CFR 409.22 - Bed and board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.22 Bed and board. (a) Semiprivate and ward... room if— (i) The patient's condition requires him to be isolated; (ii) The SNF has no semiprivate or ward accommodations; or (iii) The SNF semiprivate and ward accommodations are fully occupied by...

  13. 42 CFR 409.22 - Bed and board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.22 Bed and board. (a) Semiprivate and ward... room if— (i) The patient's condition requires him to be isolated; (ii) The SNF has no semiprivate or ward accommodations; or (iii) The SNF semiprivate and ward accommodations are fully occupied by...

  14. 42 CFR 409.22 - Bed and board.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.22 Bed and board. (a) Semiprivate and ward... room if— (i) The patient's condition requires him to be isolated; (ii) The SNF has no semiprivate or ward accommodations; or (iii) The SNF semiprivate and ward accommodations are fully occupied by...

  15. 42 CFR 409.22 - Bed and board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.22 Bed and board. (a) Semiprivate and ward... room if— (i) The patient's condition requires him to be isolated; (ii) The SNF has no semiprivate or ward accommodations; or (iii) The SNF semiprivate and ward accommodations are fully occupied by...

  16. 2 0 1 4 2 0 1 5 A C A D E M I C Y E A R VCU SCHOOL OF ENGINEERING

    E-print Network

    Motai, Yuichi

    of North Carolina, Chapel Hill. Ward holds over 25 US patents including "Multi- Layer, Fluid Transmissive · Ram Gupta, Ph.D. · Ben Ward, Ph.D. Biomedical Engineering · Anathea Pepperl, Ph.D. Chemical & Life impact," said Gupta. Ben Ward, Ph.D. Associate Professor Ram B. Gupta, Ph.D. Associate Dean for Research

  17. SCIENTIFIC NOTE Phloeoxena signata (Dejean): Northern range extensions to Maryland and Tennessee, U.S.A.,

    E-print Network

    Miller, Scott

    the Tennessee River; same data except ``3 Km SE Childers Hill at Leigh Creek, 25 March 2002, R. Ward'' (1 and accompanying notes are as follows: ``Tennessee: Hamilton County, Harrison State Park, 19 March 2003, R. D. Ward, 5 Km W Southside, Chambers Creek, 30 Oct. 2004, R. Ward'' (1), forested bottom lands, inland from

  18. Evidence of the importance of specialist nursing care dealing with patients with feet at risk of tissue damage. Possible implications for reforms of NHS hospital care?

    PubMed

    Radley, David

    2014-02-01

    Recent media attention has highlighted recommendations from 'Future hospital: caring for medical patients' about specialist medical care being less ward-based. This article gives evidence of the value of specialist nursing in a particular patient group. Here we present data regarding foot care for patients on vascular surgical wards. Ward B recently started to regularly care for vascular patients prior to this study, whereas ward A was previously the only specialised vascular ward in the hospital. All patients on the wards were surveyed on 3 occasions and it was recorded whether each patient's feet were touching the bed footplate. 52% of patients on ward B vs. 23% of patients on ward A had their feet touching the end of the bed (p = 0.03, n = 57). After an intervention of targeted training, alterations to routine manual handling training, and monitoring by matrons, repeat data collection took place. Only 18% of patients on ward B had their feet touching the end of the bed post intervention (p = 0.03). There was no statistical difference between wards post intervention. While looking at a simple, but nonetheless important, aspect of patient care; this audit provides evidence of the importance that nursing staff are familiar with the challenges posed by a particular patient group. If plans for specialised medical care to work across the hospital come to fruition, some patients may be nursed by staff less familiar with their needs. Vigilance and training interventions are likely to be needed for developing problems. PMID:24388768

  19. A standardised storage solution for venepuncture/cannulation equipment could save an NHS hospital the equivalent of a whole junior doctor

    PubMed Central

    Lindley, Steven; Robertson, Ian

    2014-01-01

    Junior doctors, nursing staff, and phlebotomists spend a large proportion of their time taking blood samples and siting (venous) cannulae. Approximately 350 blood samples are taken daily across 25 wards at the Royal United Hospital Bath NHS Trust. There is no standard storage solution for venepuncture or cannulation equipment. On-call junior doctors cover most of the hospital's wards. Time is wasted locating essential equipment on unfamiliar wards and nurses are frequently interrupted to assist. These delays can compromise patient safety in emergencies as well as contributing to a source of daily inefficiency. Junior doctors were timed collecting equipment needed for venepuncture and cannulation on unfamiliar wards. Initial results suggested large variation between timings on different wards. The medical admissions unit (MAU), which organises items for venepuncture and cannulation on a single trolley, was 4 times quicker than the mean of all other wards. MAU mean time 21.0s vs. Non-standardised wards mean time 103.0s (p<0.0001). Estimates suggest approximately 47 hours per week (the equivalent of a fulltime doctor) could be saved by implementing a standard trust-wide storage solution. We set out to introduce the MAU trolley format to all adult inpatient wards. All ward managers agreed to implement the trolley. 18 wards (72% of adult inpatient wards) already possessed the ‘MAU style’ trolley, which we standardised using an easy-to-follow inventory and laminated draw inlays. Feedback was very positive from doctors and ward staff alike. We repeated timings to validate the change and successfully presented a business case to senior management for a further 10 trolleys (£3623.78) for full adult inpatient ward coverage. As junior doctors, we identified a common problem, tested solutions, and made early simple affordable changes. Initial work helped us present a compelling case for patient safety and efficiency improvements, releasing money to implement modest trust-wide quality improvement changes.

  20. Patient and organisational variables associated with pressure ulcer prevalence in hospital settings: a multilevel analysis

    PubMed Central

    Bredesen, Ida Marie; Bjøro, Karen; Gunningberg, Lena; Hofoss, Dag

    2015-01-01

    Objectives To investigate the association of ward-level differences in the odds of hospital-acquired pressure ulcers (HAPUs) with selected ward organisational variables and patient risk factors. Design Multilevel approach to data from 2 cross-sectional studies. Settings 4 hospitals in Norway were studied. Participants 1056 patients at 84 somatic wards. Primary outcome measure HAPU. Results Significant variance in the odds of HAPUs was found across wards. A regression model using only organisational variables left a significant variance in the odds of HAPUs across wards but patient variables eliminated the across-ward variance. In the model including organisational and patient variables, significant ward-level HAPU variables were ward type (rehabilitation vs surgery/internal medicine: OR 0.17 (95% CI 0.04 to 0.66)), use of preventive measures (yes vs no: OR 2.02 (95% CI 1.12 to 3.64)) and ward patient safety culture (OR 0.97 (95% CI 0.96 to 0.99)). Significant patient-level predictors were age >70 vs <70 (OR 2.70 (95% CI 1.54 to 4.74)), Braden scale total score (OR 0.73 (95% CI 0.67 to 0.80)) and overweight (body mass index 25–29.99?kg/m2) (OR 0.32 (95% CI 0.17 to 0.62)). Conclusions The fact that the odds of HAPU varied across wards, and that across-ward variance was reduced when the selected ward-level variables entered the explanatory model, indicates that the HAPU problem may be reduced by ward-level organisation of care improvements, that is, by improving the patient safety culture and implementation of preventive measures. Some wards may prevent pressure ulcers better than other wards. The fact that ward-level variation was eliminated when patient-level HAPU variables were included in the model indicates that even wards with the best HAPU prevention will be challenged by an influx of high-risk patients. PMID:26316647

  1. Ideal-quasi-Cauchy sequences

    E-print Network

    Huseyin Cakalli; Bipan Hazarika

    2012-03-09

    An ideal $I$ is a family of subsets of positive integers $\\textbf{N}$ which is closed under taking finite unions and subsets of its elements. A sequence $(x_n)$ of real numbers is said to be $I$-convergent to a real number $L$, if for each \\;$ \\varepsilon> 0$ the set $\\{n:|x_{n}-L|\\geq \\varepsilon\\}$ belongs to $I$. We introduce $I$-ward compactness of a subset of $\\textbf{R}$, the set of real numbers, and $I$-ward continuity of a real function in the senses that a subset $E$ of $\\textbf{R}$ is $I$-ward compact if any sequence $(x_{n})$ of points in $E$ has an $I$-quasi-Cauchy subsequence, and a real function is $I$-ward continuous if it preserves $I$-quasi-Cauchy sequences where a sequence $(x_{n})$ is called to be $I$-quasi-Cauchy when $(\\Delta x_{n})$ is $I$-convergent to 0. We obtain results related to $I$-ward continuity, $I$-ward compactness, ward continuity, ward compactness, ordinary compactness, ordinary continuity, $\\delta$-ward continuity, and slowly oscillating continuity.

  2. Article 10.5.5 Journal of Integer Sequences, Vol. 13 (2010),2

    E-print Network

    Whitt, Ward

    2010-01-01

    Queueing Theory Joseph Abate 900 Hammond Road Ridgewood, NJ 07450-2908 USA Ward Whitt Department for Bell polynomials, binomial moments, Catalan numbers, cumulant generating function, Lagrange expansion

  3. Characterization of an experimental system designed for pulsing dictyostelium with chemoattractant using a

    E-print Network

    Wang, Yan Mei

    movement to- wards an increasing concentration of chemoattractant. The present view of this organism-GFP response to cAMP . . . . . . . . . . . . . . . . . . . . . . . . . 8 4 Perfect Adaptation: Normalized

  4. View of room lined with posters beneath balcony seating ...

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

    View of room lined with posters beneath balcony seating - National Home for Disabled Volunteer Soldiers, Northwestern Branch, Ward Memorial Hall, 5000 West National Avenue, Milwaukee, Milwaukee County, WI

  5. 77 FR 67020 - Performance Review Board Appointments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-08

    ... Taylor, Willie Thompson, Thomas Thornhill, Alan Thorson, Robyn Toothman, Stephanie Tuggle, Benjamin Vela, David Velasco, Janine Ward, Joseph Weber, Wendi Welch, Ruth Wells, Sandra Wenk, Daniel Wessels,...

  6. 78 FR 64260 - Public Hearing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-28

    ... Sponsor and Facility: Talisman Energy USA Inc. (Fall Brook--C.O.P. Tioga State Forest), Ward Township.... Tioga State Forest), Ward Township, Tioga County, Pa. Application for renewal of surface water... Water Company (Susquehanna River and South Branch Codorus Creek), Lower Windsor and Spring...

  7. A review of "Social Relations and Urban Space: Norwich, 1600-1700" by Fiona Williamson 

    E-print Network

    Ward, Joseph P

    2015-01-01

    stream_source_info Ward review, SCN 73 3&4.pdf.txt stream_content_type text/plain stream_size 9827 Content-Encoding UTF-8 stream_name Ward review, SCN 73 3&4.pdf.txt Content-Type text/plain; charset=UTF-8 140 seventeenth...

  8. Group Therapy with Multiple Therapists in A Large Group.

    ERIC Educational Resources Information Center

    Herschleman, Philip; Freundlich, David

    The utilization of multiple therapists in large group therapy meetings has been found to be a significant improvement over the traditional ward meeting or patient-staff conference. The initially limited goals of reducing ward tension and acting out by means of patients ventilation were surpassed. Despite the size of the meetings it was often…

  9. Microfiber and steam for environmental cleaning during an outbreak.

    PubMed

    Abernethy, Mardi; Gillespie, Elizabeth; Snook, Kylie; Stuart, Rhonda L

    2013-11-01

    We report an outbreak of norovirus gastroenteritis occurring concurrently over two wards. Environmental cleaning was managed using two different methodologies: one ward utilized the traditional 2-step method, the other using microfiber-steam technology. Environmental cleaning using the microfiber-steam technology proved to be an effective and efficient cleaning methodology, appropriate for use during an outbreak situation. PMID:23685093

  10. Creative Imagination Is Stable across Technological Media: The Spore Creature Creator versus Pencil and Paper

    ERIC Educational Resources Information Center

    Cockbain, Jessica; Vertolli, Michael O.; Davies, Jim

    2014-01-01

    T. B. Ward (1994) investigated creativity by asking participants to draw alien creatures that they imagined to be from a planet very different from Earth. He found that participant drawings reliably contained features typical of common Earth animals. As a consequence, Ward concluded that creativity is structured. The present investigation predicts…

  11. NEWLIFEWITHINTHERUINSJeeEunAhn,ChelseaBrandt,MackenzieLeukart,BethMiller,ZawMyat,AndreaTonc,YojanaVazquez ROOSEVELTISLAND1637-PRESENT

    E-print Network

    , he designed the Smallpox Hospital and other public buildings on Roosevelt, Randall's, and Ward:arcles.washingtonpost.com Source:www.bc.edu #12;RENWICKBUILDINGS1856-1872 BLACKWELL'S ISLAND Smallpox Hospital (1856) Renwick, he designed the Smallpox Hospital and other public buildings on Roosevelt, Randall's, and Ward

  12. Thinking the Unthinkable: Exposing the Vulnerabilities in the NHS Response to Coordinated Terrorist

    E-print Network

    Johnson, Chris

    of activity. In the entire hospital there are few staff other than the nursing staff on the wards. Many of the nursing staff are agency and bank nurses who are in some cases working their first shift in the ward. None and the automatic fire doors close shut. Staff do not panic. On two of the upper floors nurses discover that some

  13. Potrero AvenuePotrero Avenue 23rdStreet23rdStreet

    E-print Network

    Martin, Gail

    Medicine 82 Hematology / Oncology Ward 86 Positive Health Ward 86 Building 90 Methadone Clinic Medical Specialties 92 Dermatology 92 TB Clinic 94 Building 1 Brain and Spinal Injury Center Building 4 - Avon for the Medical Group (CPG) Building 5 - Main Hospital Outpatient / Clinic Entrance 1001 Potrero near 22nd Street

  14. A Review of Monte Carlo Tests of Cluster Analysis.

    ERIC Educational Resources Information Center

    Milligan, Glenn W.

    1981-01-01

    Monte Carlo validation studies of clustering algorithms, including Ward's minimum variance hierarchical method, are reviewed. Caution concerning the uncritical selection of Ward's method for recovering cluster structure is advised. Alternative explanations for differential recovery performance are explored and recommendations are made for future…

  15. Future Grid: The Environment Future Grid Initiative White Paper

    E-print Network

    Future Grid: The Environment Future Grid Initiative White Paper Power Systems Engineering Research.S. Department of Energy White Paper Team Ward Jewell, Janet Twomey and Michael Overcash Wichita State University, 2012 #12;Information about this white paper For information about this white paper contact: Ward Jewell

  16. 77 FR 39694 - National Currents Energy Services, LLC; Notice of Declaration of Intention and Petition for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    ..., 2012. d. Applicant: National Currents Energy Services, LLC. e. Name of Project: Wards Island Tidal Energy Project. f. Location: The proposed Wards Island Tidal Energy Project will be located off the south... Long Island Sound in the Borough of Manhattan, New York City, NY. g. Filed Pursuant to: 18 CFR part...

  17. THE FOURIER-SERIES METHOD FOR INVERTING TRANSFORMS OF PROBABILITY DISTRIBUTIONS

    E-print Network

    Whitt, Ward

    Ward Whitt 900 Hammond Road AT&T Bell Laboratories Ridgewood, NJ 07450-2908 Room 2C-178 Murray Hill, NJ FOURIER-SERIES METHOD FOR INVERTING TRANSFORMS OF PROBABILITY DISTRIBUTIONS by Joseph Abate Ward Whitt 900 Hammond Road AT&T Bell Laboratories Ridgewood, NJ 07450-2908 Room 2C-178 Murray Hill, NJ 07974

  18. Molecular Cell Structure and Biological Importance

    E-print Network

    Hill, Chris

    ,* and Christopher P. Hill1,* 1Department of Biochemistry, University of Utah School of Medicine, Salt Lake City, UT- dues 140­300) that is flanked on both sides by regions that are predicted to be disordered (Ward et al that is expected to be unstructured (Ward et al., 2004) and a C-terminal domain (CTD) that adopts an SH2 fold

  19. THE FOURIERSERIES METHOD FOR INVERTING TRANSFORMS OF PROBABILITY DISTRIBUTIONS

    E-print Network

    Whitt, Ward

    Ward Whitt 900 Hammond Road AT&T Bell Laboratories Ridgewood, NJ 07450­2908 Room 2C­178 Murray Hill, NJ; THE FOURIER­SERIES METHOD FOR INVERTING TRANSFORMS OF PROBABILITY DISTRIBUTIONS by Joseph Abate Ward Whitt 900 Hammond Road AT&T Bell Laboratories Ridgewood, NJ 07450­2908 Room 2C­178 Murray Hill, NJ 07974

  20. EUROPEAN ORGANISATION FOR NUCLEAR RESEARCH CERNPHEP2007016

    E-print Network

    . Herten 9 , R.D. Heuer 24 , J.C. Hill 5 , D. Horvâ??ath 28,c , P. Igo­Kemenes 10 , K. Ishii 22 , H. Jeremie. Vossebeld 7,h , C.P. Ward 5 , D.R. Ward 5 , P.M. Watkins 1 , A.T. Watson 1 , N.K. Watson 1 , P.S. We

  1. EUROPEAN ORGANIZATION FOR NUCLEAR RESEARCH CERNPHEP/2004042

    E-print Network

    . Herten 10 , R.D. Heuer 25 , J.C. Hill 5 , K. Ho#man 9 , D. Horvâ??ath 29,c , P. Igo­Kemenes 11 , K. Ishii.Verzocchi 17 , H. Voss 8,q , J. Vossebeld 8,h , C.P. Ward 5 , D.R. Ward 5 , P.M. Watkins 1 , A

  2. Some Essential Environmental Ingredients for Sex Offender Reintegration

    ERIC Educational Resources Information Center

    Boer, Douglas P.

    2013-01-01

    Until the systematic work on the Good Lives Model (GLM) produced by Tony Ward, not a great deal of conceptual structure existed to provide sex offender treatment specialists with a theoretical underpinning for their work in helping offenders develop a better life as a way to prevent reoffending. However, the work of Ward and colleagues initially…

  3. Paper P1.5 in Preprints, 19th Conf. on Severe Local Storms, Minneapolis, MN (14-18 September 1998), Amer. Meteor. Soc., 85-88.

    E-print Network

    Doswell III, Charles A.

    ), Amer. Meteor. Soc., 85-88. A DEMONSTRATION OF VORTEX CONFIGURATIONS IN AN INEXPENSIVE TORNADO SIMULATOR Environmental Films, St. Johnsbury, Vermont 1. INTRODUCTION Tornado simulation models were pio- neered in the modern era of tornado re- search by the late Neil Ward (Ward 1972; Church and Snow 1993). The prototype

  4. BehavioralNeuroscience Copyright 1996 by the American PsychologicalAssociation, Inc. 1996, Vol. 110,No. 6, 1469-1477 0735-7044/96/$3.00

    E-print Network

    French, Jeffrey A.

    in both of the fetal alcohol exposed male groups. It appears that the androgen threshold for ejaculatory and stress combination interfered with ontogenetic patterns of T needed to fully masculinize the fetal of androgen at specific stages of perinatal development (see review by I. L. Ward & Ward, 1985). As a result

  5. Dolphin (Tursiops truncatus) echoic angular discrimination: Effects of object separation and complexity

    E-print Network

    Hawaii at Hilo, University of

    Dolphin (Tursiops truncatus) echoic angular discrimination: Effects of object separation-2294 Sonja J. Mevissen The Dolphin Institute, 420 Ward Ave., Suite 212, Honolulu, Hawaii Adam A. Pack-2294 and The Dolphin Institute, 420 Ward Ave., Suite 212, Honolulu, Hawaii Scott R. Roberts and Lea K. Carsrud

  6. An outbreak of serious Klebsiella infections related to food blenders.

    PubMed

    Kiddy, K; Josse, E; Griffin, N

    1987-03-01

    An investigation, including environmental sampling, was undertaken after four leukaemic patients on the same hospital ward developed serious infections with Klebsiella aerogenes, capsular type K14. The source of this organism, common to all four patients, was found to be a food blender used for preparing milk-based drinks on the ward. PMID:2883228

  7. CUNY -HUNTER COLLEGE Hunter College

    E-print Network

    Qiu, Weigang

    -2014. Margaret Bausman Bausman, M., Ward, S. L., and Pell, J. (In press - 2014). Beyond Satisfaction: Understanding and Promoting the Instructor-Librarian Relationship. New Review of Academic Librarianship, 20, 1-20. #12;Paper accepted: Pell, J., Ward, S. L. and Bausman, M. Can't Get No Satisfaction: Lessons Learned

  8. Under consideration for publication in the SIAM J. Multiscale Analysis and Simulation 1 Conditional Mean First Passage Times to Small Traps in a

    E-print Network

    Ward, Michael Jeffrey

    migrate to the peripheral lymphoid organs, which include lymph nodes. These are organized tissues where Searching Behaviour in Lymph Nodes M. I. DELGADO, M. J. WARD, D. COOMBS Monica Delgado, Michael J. Ward a large lymph node. The precise nature of the cell motion at the outer boundary of the lymph node

  9. Multiple-baseline analysis of a token economy for psychiatric inpatients.

    PubMed Central

    Nelson, G L; Cone, J D

    1979-01-01

    Twelve behaviors selected for reinforcement among 16 chronic psychiatric inpatients were divided into four classes: (a) personal hygiene, (b) personal management, (c) ward work, and (d) social skills. A token economy program was introduced for each class in a sequential, cumulative, multiple-baseline format. Corrections were included for methodological deficiencies frequently enountered in past studies. Treatment variables were systematically monitored, and target behavior rates, levels of global individual functioning, general ward behavior, and off-ward behavior were assessed during baseline, implementation, and probe periods. Results indicated abrupt and substantial increases in performance of most target behaviors, significant improvements in global individual functioning (p less than .025), positive changes in general ward behavior, and increases in social interaction during off-ward activities. The findings provide strong evidence for the efficacy of a token economy and indicate that the multiple-baseline design can be a useful method for evaluating token economy programs. PMID:489481

  10. LLW Notes, Volume 12, Number 2

    SciTech Connect

    Norris, C.; Brown, H.; Colsant, J.; Lovinger, T.; Scheele, L.; Shaker, M.A.

    1997-02-01

    Contents include the following articles: National Environmental Justice Advisory Council considers Ward Valley resolution; NGA urges Congressional and Presidential support for low-level radioactive waste compacts and transfer of federal land in Ward Valley; RFP issued for SEIS on Ward Valley land transfer; Illinois siting criteria finalized; Consideration of tribal concerns during Ward Valley siting process; State legislators` LLRW working group meets in D.C.; Upcoming state and compact events; Court calendar; Texas compact legislation introduced in Congress; Superfund reform is a priority for 105th Congress; High-level waste bill gets off to an early start; Fort Mojave petition NEJAC for Ward Valley resolution; EPA withdraws cleanup rule from OMB; Board ruling raises doubts about proposed Louisiana enrichment facility; DOE recommends external regulation by NRC; and Supplement--Background on environmental justice.

  11. Correlation between workplace and occupational burnout syndrome in nurses

    PubMed Central

    Ahmadi, Omid; Azizkhani, Reza; Basravi, Monem

    2014-01-01

    Background: This study was conducted to determine the effect of nurses’ workplace on burnout syndrome among nurses working in Isfahan's Alzahra Hospital as a reference and typical university affiliated hospital, in 2010. Materials and Methods: In this cross-sectional study, 100 nurses were randomly selected among those working in emergency, orthopedic, dialysis wards and intensive care unit (ICU). Required data on determination of occupational burnout rate among the nurses of these wards were collected using Maslach Burnout Inventory (MBI) standard and validated questionnaire. Nurses were selected using simple random sampling. Results: The multivariate ANOVA analysis showed that occupational burnout mean values of nurses working in orthopedic and dialysis wards were significantly less than those of nurses working in emergency ward and ICU (P = 0.01). There was also no significant difference between occupational burnout mean values of nurses working in emergency ward and ICU (P > 0.05). t-test showed that there was a difference between occupational burnout values of men and women, as these values for women were higher than those of men (P = 0.001). Conclusion: Results showed that occupational burnout mean values of nurses working in emergency ward and ICU were significantly more than those of nurses working in orthopedic and dialysis wards. PMID:24627852

  12. datamanagementgroup DEPARTMENT OF CIVIL ENGINEERING

    E-print Network

    Toronto, University of

    % * 4% * 2% 7% 3% %4%51%17 5% 3% 2% TRIPS MADE BY RESIDENTS OF TOWN OF RICHMOND HILL - WARD 1 Time: Made work trip Transit Pass Work at Home TOWN OF RICHMOND HILL - WARD 1 6,700 %2%88 9% 6% * 26% 25% 26 TO TOWN OF RICHMOND HILL - WARD 2 10,400 41,900 24.8% 6.8 35% 13% 4.7 32% 8% 14.9 4% 45% 27.821% 15% 28

  13. Measuring quality: how to empower staff to take control.

    PubMed

    Grant, Lisa; Proctor, Tony

    A vast amount of information relating to standards of patient care is collated from hospital wards, yet there is not always evidence that this information is discussed or acted upon by ward staff. Involving ward staff in setting up systems to monitor performance and then deciding how to address shortcomings uses their insights into care provision and gives them ownership over standards of care. The balanced scorecard is an effective tool for monitoring quality that can be applied to healthcare. This article discusses how to use it to develop and implement systems of measuring the quality of care. PMID:21410000

  14. Towards a process theory of Law: The jurisprudential implications of the process philosophy of Alfred North Whitehead 

    E-print Network

    Maclean, James B

    2008-01-01

    This thesis examines law from a mainly Whiteheadian, or ‘process’, perspective. Beginning with the judgement of Lord Justice Ward in the conjoined twins’ case, Re A, I identify a way of looking at law that centres on the ...

  15. 5. VIEW OF SITE, AREA B; LOG BUILDING AND BUNKHOUSE ...

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

    5. VIEW OF SITE, AREA B; LOG BUILDING AND BUNKHOUSE (Features 9 and 10) AT FAR LEFT AND HOUSE (Feature 13) AT CENTER (n.d.) - Gold Dust Mine, Mill & Camp Complex, Wards Gulch, Salmon, Lemhi County, ID

  16. in natural areas. M.S. Thesis. Gainesville, EL: University of Hupp, K.V.S., A.M. Eox, S.B. Wilson, E.L. Barnett and R.K.

    E-print Network

    in natural areas. M.S. Thesis. Gainesville, EL: University of Elorida. Hupp, K.V.S., A.M. Eox, S sexually via seed and vegeta- tively via adventitious shoots from spreading roots (Ward et al. 2008). Dense

  17. "Let's talk about it" - Using stories to improve care for older people: a practical guide 

    E-print Network

    Walker, Esther; Wilkinson, Heather; McCauley, Alexandra; Forbes, Alison

    A network for staff involved in caring for older people wherever that care takes place. Older people are cared for in a huge variety of care settings (hospital wards, care homes, day hospitals, out-patient clinics, in ...

  18. The material and energy flow through the abrasive waterjet machining and recycling processes

    E-print Network

    Kurd, Michael Omar, 1982-

    2004-01-01

    The purpose of this thesis was to investigate the material and energy flow through the abrasive waterjet machine and the WARD recycling machine. The goal was to track all of the material, water, abrasive, energy, air, and ...

  19. 5. Walled courtyard with basketball hoop between Buildings Nos. 9944B ...

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

    5. Walled courtyard with basketball hoop between Buildings Nos. 9944-B (left) and 9945-B (right). - Madigan Hospital, Detention Wards, Bounded by Wilson & McKinley Avenues & Garfield & Lincoln Streets, Tacoma, Pierce County, WA

  20. DALHOUSIE AGRICULTURAL CAMPUS DAY CARE 43 College Rd, P.O. Box 550 Truro, N S B2N 5E3

    E-print Network

    Lotze, Heike K.

    expectations for your child/ward at Daycare? Eating Habits: Hearty Eater Picky Eater Food Likes : Food Dislikes : Rest Time : Sleep Rest Usual Bedtime: ______________________ Known Allergies : Which of the following

  1. ESOURCESRHUMAN www.hooswell.com

    E-print Network

    Acton, Scott

    Michele Irvine and Danelia Robinson quit smoking together with Hoo's WellTobacco Cessation Welcome To Hoo you on your journey to better health. #12;GeT reWarded As an employee, you can earn rewards by taking

  2. Starting out - Introducing myself helped improve patients' experience and wellbeing.

    PubMed

    Wardman, Emily

    2015-11-25

    My management placement in the final year of training was on a trauma and orthopaedic ward. I had the opportunity to plan and prepare a service improvement project as part of my final dissertation. PMID:26602663

  3. (Minutes approved at January 31, 2014 Board of Trustees Meeting) COLLEGE OF CHARLESTON BOARD OF TRUSTEES

    E-print Network

    Kunkle, Tom

    , Director of the Sailing Program; and Ward Cromwell, Sailing Coach, to come forward to introduce members of the Sailing Team: Ali Blumenthal, junior from Bellport, New York, an all-American and one of the team

  4. Benjamin: NAP SACC Nutrition and Physical Activity Self-Assessment for Child Care

    Cancer.gov

    Ammerman, AS, Benjamin, SE, Sommers, JK, Ward, DS. 2004. The Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) environmental self-assessment instrument. Division of Public Health, NC DHHS, Raleigh, NC, and the Center for Health

  5. Contributions from the Biological Laboratory of the U. S. Fish Commission, Woods Hole, Massachusetts.

    E-print Network

    parasite occurs on the abdomen of the hermit, to which it is attached, back down ward, by its mandibles, marsupium very large, abdomen about half the length of thorax, distinct from it, 6-joint.ed, with five pair

  6. 3. VIEW OF BUILDING 128: EAST AND NORTH (GABLE END) ...

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

    3. VIEW OF BUILDING 128: EAST AND NORTH (GABLE END) SIDES FROM HOWE STREET, FACING SOUTHWEST. - Fort McPherson, World War II Station Hospital, Hospital Wards, Anderson Way & Howe Street, Atlanta, Fulton County, GA

  7. Middle Miocene extension in the Gulf Extensional Province, Baja California: Evidence from the southern Sierra Juarez

    E-print Network

    Lee, Jeff

    of north-south­striking, west-dip- ping normal faults, a secondary set of north-south­striking, east northwest- ward on the Pacific plate parallel to trans- form faults that define much of the plate boundary

  8. Spectral problems of optical waveguides and quantum graphs 

    E-print Network

    Ong, Beng Seong

    2006-10-30

    OF PHILOSOPHY Approved by: Chair of Committee, Peter Kuchment Committee Members, Joseph Ward Jay Walton Olga Kocharovskaya Head of Department, Al Boggess August 2006 Major Subject: Mathematics iii ABSTRACT Spectral Problems of Optical Waveguides and Quantum...

  9. 14. Historic American Buildings Survey, Laurence E. Tilley, Photographer April, ...

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

    14. Historic American Buildings Survey, Laurence E. Tilley, Photographer April, 1958 DETAIL OF WALLPAPER AND WOODWORK IN NORTHWEST PARLOR - Eliza Ward House, 2 George Street, Providence, Providence County, RI

  10. Leading Edge Cell 134, July 11, 2008 2008 Elsevier Inc. 9

    E-print Network

    Gerstein, Mark

    glycosylation. Her problem is straightfor- ward, known among text miners as infor- mation retrieval (IR-encoded facts and com- pactly summarize them, as a capable and tireless assistant would do. It is difficult

  11. Particle Physics Masterclass

    SciTech Connect

    Helio Takai

    2009-04-10

    Students from six local high schools -- Farmingdale, Sachem East, Shoreham, Smithtown East, Ward Melville, and William Floyd -- came to Brookhaven National Laboratory to experience research with particle physicist Helio Takai. They were among more than 6,

  12. Techniques and Probes for the Study of Xenopus tropicalis Development

    E-print Network

    Amaya, Enrique

    processes. However, X. laevis has an allotetraploid genome precluding its use in for- ward genetic analysis be induced in a female every 1 to 2 months by injection of human chorionic gonadotropin. Xenopus embryos

  13. Analysis of factor productivity in agricultural systems in Zimbabwe and application of Geographic Information Systems in soil erosion prediction 

    E-print Network

    Mugabe, Phanuel

    1994-01-01

    Analysis was done to evaluate the utilization and productivity of agricultural factor inputs, calculate and simulate soil erosion rates using Geographic Information Systems (GIS) techniques in Nyota Ward of Chiweshe Communal Land, Zimbabwe...

  14. VOLUME 27 NUMBER 1 JOURNAL OFTHE ONTARIO FIELD ORNITHOLOGISTS

    E-print Network

    Martin, Paul R.

    - tion expanded northward from the Appalachian region into Ontario in the early 1900s, Manitoba-winged Warblers, historical- ly west of the Appalachians and south of the Great Lakes, began to expand north- ward

  15. Independent Scientific Review Panel for the Northwest Power & Conservation Council

    E-print Network

    Research Scientist at the U.S. Geological Survey in Corvallis, Oregon, an expert in wildlife, formerly with the U.S. Geological Survey. Bruce Ward, Fisheries Scientist, Ministry Of Environment, Aquatic ............................................................................................... 10 Improving the Review Process

  16. Independent Scientific Review Panel for the Northwest Power & Conservation Council

    E-print Network

    Research Scientist at the U.S. Geological Survey in Corvallis, Oregon, an expert in wildlife, formerly with the U.S. Geological Survey. Bruce Ward, Fisheries Scientist, Ministry Of Environment, Aquatic..................................................................................................................................... 1 The ISRP Review Process

  17. A Hierarchical Clustering Methodology for the Estimation of Toxicity

    EPA Science Inventory

    A Quantitative Structure Activity Relationship (QSAR) methodology based on hierarchical clustering was developed to predict toxicological endpoints. This methodology utilizes Ward's method to divide a training set into a series of structurally similar clusters. The structural sim...

  18. Proceedings of the 5th International Workshop on Semantic Evaluation, ACL 2010, pages 321324, Uppsala, Sweden, 15-16 July 2010. c 2010 Association for Computational Linguistics

    E-print Network

    Introduction Temporal annotation of documents, i.e., the ex- traction and chronological ordering of events and temporal relation extraction since a competitive evaluation helps to drive for- ward research, and temporal

  19. 2001 IEEWASME lnternalionalConferenceon Advanced IntelligentMechatronicsProceedings

    E-print Network

    Mavroidis, Constantinos

    to the shift from product-orientedto- ward client-oriented production and from off-the-shelve generic robots with actuatorsand sensorsfor actively controlling module engagement and disengagement. They also need to be able

  20. Improving the lattice axial vector current

    E-print Network

    R. Horsley; Y. Nakamura; H. Perlt; P. E. L. Rakow; G. Schierholz; A. Schiller; J. M. Zanotti

    2015-11-17

    For Wilson and clover fermions traditional formulations of the axial vector current do not respect the continuum Ward identity which relates the divergence of that current to the pseudoscalar density. Here we propose to use a point-split or one-link axial vector current whose divergence exactly satisfies a lattice Ward identity, involving the pseudoscalar density and a number of irrelevant operators. We check in one-loop lattice perturbation theory with SLiNC fermion and gauge plaquette action that this is indeed the case including order $O(a)$ effects. Including these operators the axial Ward identity remains renormalisation invariant. First preliminary results of a nonperturbative check of the Ward identity are also presented.

  1. How Citizens and Politicians Talk About Their Carbon Footprint: A Discourse Analysis 

    E-print Network

    MacRitchie, Julie

    2010-06-30

    It has been suggested that the crisis of climate change is due to ‘a crisis of maladaptive human behaviour’ (Maloney and Ward, 1973, p. 583). Even though we are aware that our daily behaviours could be jeopardizing the environment...

  2. Is 4 the prime number? Relationship between degree of multilingualism, attentional control, competence level and acquisition age 

    E-print Network

    Ishaq, Masrita

    2009-07-03

    (Robertson, Ward, Ridgeway & Nimmo-Smith, 1994) which measures sustained attention (subtest 1), selective attention (subtest 2) and attentional switching (subtest 3). Secondly, it was predicted that languages, which are acquired earlier on in life, are higher...

  3. 76 FR 272 - Final Flood Elevation Determinations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-04

    ...confluence with Abners +717 Unincorporated Areas of Creek. Spartanburg County. Approximately 1.2 miles +776 upstream of Babe Wood Road. Wards Creek.......................... At the confluence with the +554 Unincorporated...

  4. 78 FR 78514 - Designation of One Individual and Three Entities Pursuant to Executive Order

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-26

    ...Road, Industrial Zone (4), Shwe Pyi Thar Township, Yangon, Burma; No. (40) Yangon-Mandalay Road, Kywe Sekan, Pyay Gyi Tagon Township, Mandalay, Burma; No. A/B (1-5), Paung Laung (24) Street, Ext., Ward (2), Nay...

  5. Interior, second floor north side of building toward east end ...

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

    Interior, second floor north side of building toward east end - Fitzsimons General Hospital, Open Air Tuberculosis Ward, West Pennington Avenue & North Hickey Street Southwest Corner, Aurora, Adams County, CO

  6. Interior, second floor south side of building toward east end ...

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

    Interior, second floor south side of building toward east end - Fitzsimons General Hospital, Open Air Tuberculosis Ward, West Pennington Avenue & North Hickey Street Southwest Corner, Aurora, Adams County, CO

  7. Exterior doorway detail south side of building (first floor) east ...

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

    Exterior doorway detail south side of building (first floor) east inset porch; interior staircase visible in background - Fitzsimons General Hospital, Open Air Tuberculosis Ward, West Pennington Avenue & North Hickey Street Southwest Corner, Aurora, Adams County, CO

  8. Interior, first floor southeast side of building, showing french doors ...

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

    Interior, first floor southeast side of building, showing french doors and interior windows - Fitzsimons General Hospital, Open Air Tuberculosis Ward, West Pennington Avenue & North Hickey Street Southwest Corner, Aurora, Adams County, CO

  9. Structure and tectonics of the Sumatra Fault Zone-Sundra Trench junction 

    E-print Network

    Handayani, Lina

    1999-01-01

    offshore from the southern tip of Sumatra southward across the shore-ward trench slope to the trench axis. However, little evidence has been published to show the connection. The Sunda Strait forearm region, where the subjection direction changes from...

  10. The effect of the Catholic revival on English fiction (1850-1900)

    E-print Network

    Baker, Pearl May

    1916-01-01

    mentions a Tractarian curate and vicar, and Amos Barton recognizes the existence of the Movement- Bar Chester Towers has one character somewhat affected by it - Mrs. Humphry Ward makes frequent allusions to it - Helbeck of Bannisdale mentions Newman...

  11. 24. DETAIL VIEW IN COAL TOWER No. 1 OF THE ...

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

    24. DETAIL VIEW IN COAL TOWER No. 1 OF THE LEVERS THAT MANIPULATE THE COAL BUCKETS, LOOKING OVER THE BOOM - Delaware County Electric Company, Chester Station, Delaware River at South end of Ward Street, Chester, Delaware County, PA

  12. Organic Broccoli Cultivar Trial Organic/Conventional Broccoli Plant

    E-print Network

    Stuart, Steven J.

    Organic Broccoli Cultivar Trial and Organic/Conventional Broccoli Plant Density Trial Brian K. Ward #12;#12;#12;Clemson/USDA ARS Broccoli Field Day #12;Belstar Sensory Raw Material (Unblanched) Pseudo

  13. 40th Annual GeoDaze March 29-31, 2012

    E-print Network

    Fay, Noah

    /Video Adam Hudson and Drew Laskowski Publications Sarah Dasher and Kate Metcalf Field Trip Matt Dettinger, Drew Laskowski and Kevin Ward #12;P a g e Huckleberry Richard D. Jones Susan Kidwell Charles Kluth Peter Kresan Robert B. Laughon

  14. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), south side. - Fitzsimons General Hospital, Tubercular Ward, Southwest Corner of East Bushnell Avenue & South Page Street, Aurora, Adams County, CO

  15. Photocopy of photograph from the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph from the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Semi-Infirmary Tubercular Ward, Southeast Corner of East Harlow Avenue & South Page Street, Aurora, Adams County, CO

  16. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Ambulent Tubercular Ward, Southeast Corner of East Bushnell Avenue & South Hickey Street, Aurora, Adams County, CO

  17. Photocopy of photograph in the Fitzsimons Army Medical Center real ...

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

    Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover). - Fitzsimons General Hospital, Semi-Infirmary Turbercular Ward, Northwest Corner of Charlie Kelly Boulevard & South Hickey Street, Aurora, Adams County, CO

  18. Epilepsy, Mental Retardation, and Anticonvulsant Therapy.

    ERIC Educational Resources Information Center

    Kaufman, Kenneth Roland; Katz-Garris, Lynda

    1979-01-01

    Inappropriate or inadequately documented medication for patients in mental retardation institutions is a major medical and economic problem. Within a 127-patient ward, 41 patients were treated with anticonvulsants. Of these patients, 24 had no documented indications for usage. (Author)

  19. US Army Corps of Engineers

    E-print Network

    US Army Corps of Engineers

    elements charged with addressing these types of questions. A major im- petus came during the droughts the RRDM: Dr. Frank Ward of New Mexico State University, Dr. John Loomis of the University of California

  20. 5 CFR 1690.13 - Guardianship and conservatorship orders.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...authorize an agent to conduct business with the TSP on behalf of an incapacitated participant or beneficiary. The agent is called a guardian or conservator and the incapacitated person is called a ward. The TSP must approve a court...