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Sample records for acuity-adaptable patient room

  1. [Emergency room management of contaminated patients].

    PubMed

    Strohm, P C; Hammer, T O; Kopp, K; Knobloch, V; Alawadi, K; Bannasch, H; Köstler, W; Zipfel, E; Südkamp, N P

    2008-06-01

    Accidents with the risk of exposure to hazardous nuclear, biological, or chemical materials are rare. Most emergency rooms are not familiar with the management of contaminated patients after this kind of incident. There are also ambiguous cases concerning the contamination status of the patient. The medical attendance should be performed carefully and under special security arrangements until a hazard for third persons can be excluded. The security arrangements should protect both (medical) personnel and third persons. Early medical treatment combined with decontamination should be the aim. Based on the case of a contaminated patient who was brought to our emergency department after an explosion of a fog grenade with red phosphorus, we discuss our management concept and the current literature. PMID:18066517

  2. Acoustical criteria for hospital patient rooms: Resolving competing requirements

    NASA Astrophysics Data System (ADS)

    Brooks, Bennett M.

    2003-10-01

    The acoustical criteria for patient rooms in hospitals, nursing homes, and rehabilitation facilities may be based on several needs. One important requirement is that noise levels in the room be conducive to restful sleep. Also, caregivers must have easy auditory and visual access to the patients, and be able to hear vital sign monitor alarms. This often means that patient rooms are located near central nurse stations and that patient room doors are left open. Further, the recently published federal privacy standards developed by the U.S. Department of Health and Human Services (HSS) under the Health Insurance Portability and Accountability Act (HIPAA) require that ``appropriate physical safeguards'' be put in place to protect the confidentiality of patient health information. The simultaneous and competing requirements for speech privacy, caregiver access, and good sleeping conditions present a serious acoustical challenge to health care facility designers. Specific facility design issues and potential solution strategies are presented.

  3. Quantification of Influenza Virus RNA in Aerosols in Patient Rooms

    PubMed Central

    Leung, Nancy H. L.; Zhou, Jie; Chu, Daniel K. W.; Yu, Han; Lindsley, William G.; Beezhold, Donald H.; Yen, Hui-Ling; Li, Yuguo; Seto, Wing-Hong; Peiris, Joseph S. M.; Cowling, Benjamin J.

    2016-01-01

    Background The potential for human influenza viruses to spread through fine particle aerosols remains controversial. The objective of our study was to determine whether influenza viruses could be detected in fine particles in hospital rooms. Methods and Findings We sampled the air in 2-bed patient isolation rooms for four hours, placing cyclone samplers at heights of 1.5m and 1.0m. We collected ten air samples each in the presence of at least one patient with confirmed influenza A virus infection, and tested the samples by reverse transcription polymerase chain reaction. We recovered influenza A virus RNA from 5/10 collections (50%); 4/5 were from particles>4 μm, 1/5 from 1–4 μm, and none in particles<1 μm. Conclusions Detection of influenza virus RNA in aerosols at low concentrations in patient rooms suggests that healthcare workers and visitors might have frequent exposure to airborne influenza virus in proximity to infected patients. A limitation of our study was the small sample size. Further studies should be done to quantify the concentration of viable influenza virus in healthcare settings, and factors affecting the detection of influenza viruses in fine particles in the air. PMID:26849130

  4. Suicide Mortality of Suicide Attempt Patients Discharged from Emergency Room, Nonsuicidal Psychiatric Patients Discharged from Emergency Room, Admitted Suicide Attempt Patients, and Admitted Nonsuicidal Psychiatric Patients

    ERIC Educational Resources Information Center

    Choi, Jae W.; Park, Subin; Yi, Ki K.; Hong, Jin P.

    2012-01-01

    The suicide mortality rate and risk factors for suicide completion of patients who presented to an emergency room (ER) for suicide attempt and were discharged without psychiatric admission, patients who presented to an ER for psychiatric problems other than suicide attempt and were discharged without psychiatric admission, psychiatric inpatients…

  5. Improving Patients Experience in Peadiatric Emergency Waiting Room.

    PubMed

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

    2016-01-01

    When visiting the emergency department, the perception of the time spent in the waiting room before the beginning of the care, may influence patients' experience. Based on models of service evaluation, highlighting the importance of informing people about their waiting process and their place in the queue, we have developed an innovative information screen aiming at improving perception of time by patients. Following an iterative process, a group of experts including computer scientists, ergonomists and caregivers designed a solution adapted to the pediatric context. The solution includes a screen displaying five lanes representing triage levels. Patients are represented by individual avatars, drawn sequentially in the appropriate line. The interface has been designed using gamification principle, aiming at increasing acceptance, lowering learning curve and improving satisfaction. Questionnaire based evaluation results revealed high satisfaction from the 278 respondents even if the informative content was not always completely clear. PMID:27332258

  6. [Clinical study of patients undergoing paperless electroencephalography in emergency room].

    PubMed

    Inoue, Takeshi; Kawawaki, Hisashi; Nukui, Megumi; Kuki, Ichiro; Okazaki, Shin; Tomiwa, Kiyotaka; Amo, Kiyoko; Togawa, Masao; Rinka, Hiroshi; Shiomi, Masashi

    2012-07-01

    Fifty-eight patients who visited the emergency room of our center with febrile convulsions and impaired consciousness, and underwent paperless electroencephalography soon after arrival. They consisted of 25 male and 33 female children, ranging in age from 5 months to 15 years and 4 months, with a mean age of 4 years and 10 months. The final diagnoses were poor responsiveness associated with fever and febrile delirium in 5 patients, febrile convulsions in 26, encephalitis/encephalopathy in 24, convulsions associated with mild gastroenteritis in 2, and aseptic meningitis in 1. The appearance of spindle wave within 24 hours after admission was considered to be a favorable prognostic factor, whereas generalized high-amplitude delta waves without fast-wave components and dysrhythmic flat basic waves were considered poor prognostic factors. We conclude that bed-side paperless electroencephalography is useful for the evaluation of changes in the brain function and course of treatment. PMID:22844762

  7. SU-E-T-387: Achieving Optimal Patient Setup Imaging and Treatment Workflow Configurations in Multi-Room Proton Centers

    SciTech Connect

    Zhang, H; Prado, K; Langen, K; Yi, B; Mehta, M; Regine, W; D'Souza, W

    2014-06-01

    Purpose: To simulate patient flow in proton treatment center under uncertainty and to explore the feasibility of treatment preparation rooms to improve patient throughput and cyclotron utilization. Methods: Three center layout scenarios were modeled: (S1: In-Tx room imaging) patient setup and imaging (planar/volumetric) performed in treatment room, (S2: Patient setup in preparation room) each treatment room was assigned with preparation room(s) that was equipped with lasers only for patient setup and gross patient alignment, and (S3: Patient setup and imaging in preparation room) preparation room(s) was equipped with laser and volumetric imaging for patient setup, gross and fine patient alignment. A 'snap' imaging was performed in treatment room. For each scenario, the number of treatment rooms and the number of preparation rooms serving each treatment room were varied. We examined our results (average of 100 16-hour (two shifts) working days) by evaluating patient throughput and cyclotron utilization. Results: When the number of treatment rooms increased ([from, to]) [1, 5], daily patient throughput increased [32, 161], [29, 184] and [27, 184] and cyclotron utilization increased [13%, 85%], [12%, 98%], and [11%, 98%] for scenarios S1, S2 and S3 respectively. However, both measures plateaued after 4 rooms. With the preparation rooms, the throughput and the cyclotron utilization increased by 14% and 15%, respectively. Three preparation rooms were optimal to serve 1-3 treatment rooms and two preparation rooms were optimal to serve 4 or 5 treatment rooms. Conclusion: Patient preparation rooms for patient setup may increase throughput and decrease the need for additional treatment rooms (cost effective). Optimal number of preparation rooms serving each gantry room varies as a function of treatment rooms and patient setup scenarios. A 5th treatment room may not be justified by throughput or utilization.

  8. The Impact of Patient-to-Patient Interaction in Health Facility Waiting Rooms on Their Perception of Health Professionals.

    PubMed

    Willis, William Kent; Ozturk, Ahmet Ozzie; Chandra, Ashish

    2015-01-01

    Patients have to wait in waiting rooms prior to seeing the physician. But there are few studies that demonstrate what they are actually doing in the waiting room. This exploratory study was designed to investigate the types of discussions that patients in the waiting room typically engage in with other patients and how the conversations affected their opinion on general reputation of the clinic, injections/blocks as treatment procedures, waiting time, time spent with the caregiver, overall patient satisfaction, and the pain medication usage policy. The study demonstrates that patient interaction in the waiting room has a positive effect on patient opinion of the pain clinic and the caregivers. PMID:25839351

  9. Suicide mortality of suicide attempt patients discharged from emergency room, nonsuicidal psychiatric patients discharged from emergency room, admitted suicide attempt patients, and admitted nonsuicidal psychiatric patients.

    PubMed

    Choi, Jae W; Park, Subin; Yi, Ki K; Hong, Jin P

    2012-06-01

    The suicide mortality rate and risk factors for suicide completion of patients who presented to an emergency room (ER) for suicide attempt and were discharged without psychiatric admission, patients who presented to an ER for psychiatric problems other than suicide attempt and were discharged without psychiatric admission, psychiatric inpatients admitted for suicide attempt, and psychiatric inpatients admitted for other reasons were examined. The records of 3,897 patients who were treated at a general hospital in Seoul, Korea, from July 2003 to December 2006 were reviewed. Forty-three of the 3,897 subjects died by suicide during the 2.5-year observation period. Compared to the general Korean population, the suicide mortality rate was 82-fold higher for suicide attempt patients, admitted; 54-fold higher for suicide attempt patients, discharged; 21-fold higher for nonsuicidal patients, admitted; and 11-fold higher for nonsuicidal patients, discharged. In all four groups, diagnosis of a depressive disorder and suicide attempt at presentation were each significant independent risk factors for suicide completion. These results highlight the need for suicide prevention strategies for depressed patients who present to the ER or are admitted to a psychiatric ward after a suicide attempt. PMID:22380459

  10. A system model of work flow in the patient room of hospital emergency department.

    PubMed

    Wang, Junwen; Li, Jingshan; Howard, Patricia K

    2013-12-01

    Modeling and analysis of patient flow in hospital emergency department (ED) is of significant importance. In a hospital ED, the patients spend most of their time in the patient room and most of the care delivery services are carried out during this time period. In this paper, we propose a system model to study patient (or work) flow in the patient room of an ED when the resources are partially available. A closed and re-entrant process model is developed to characterize the care service activities in the patient room with limited resources of doctors, nurses, and diagnosis tests. Analytical calculation of patient's length of stay in the patient room is derived, and monotonic properties with respect to care service parameters are investigated. PMID:23589322

  11. USE OF EMERGENCY ROOM PATIENT POPULATIONS IN AIR POLLUTION EPIDEMIOLOGY

    EPA Science Inventory

    The long-term objective of this project was the design and implementation of a particular epidemiological approach to investigation of ambient pollutant effects: the correlation of pollutant exposure with patterns of hospital emergency room utilization. The report covers the init...

  12. "Boarding" Psychiatric Patients in Emergency Rooms: One Court Says "No More".

    PubMed

    Appelbaum, Paul S

    2015-07-01

    "Boarding" involuntary psychiatric patients in medical emergency rooms is common in many parts of the United States. The practice, driven by a shortage of alternative resources, including limited inpatient capacity, can result in patients' being held for days without treatment or a hospital room, often in busy corridors or treatment rooms. A recent challenge to this practice led the Washington Supreme Court to declare it illegal and resulted in the appropriation of substantial funding to create new psychiatric beds. Centralized psychiatric crisis services, with appropriate payment models, may offer another approach to reducing the need for holding patients awaiting inpatient admission. PMID:26130151

  13. Patient health information materials in waiting rooms of family physicians: do patients care?

    PubMed Central

    Moerenhout, Tania; Borgermans, Liesbeth; Schol, Sandrina; Vansintejan, Johan; Van De Vijver, Erwin; Devroey, Dirk

    2013-01-01

    Background Patient health information materials (PHIMs), such as leaflets and posters are widely used by family physicians to reinforce or illustrate information, and to remind people of information received previously. This facilitates improved health-related knowledge and self-management by patients. Objective This study assesses the use of PHIMs by patient. It also addresses their perception of the quality and the impact of PHIMs on the interaction with their physician, along with changes in health-related knowledge and self-management. Methods Questionnaire survey among patients of family practices of one town in Belgium, assessing: (1) the extent to which patients read PHIMs in waiting rooms (leaflets and posters) and take them home, (2) the patients’ perception of the impact of PHIMs on interaction with their physician, their change in health-related knowledge and self-management, and (3) the patients judgment of the quality of PHIMs. Results We included 903 questionnaires taken from ten practices. Ninety-four percent of respondents stated they read PHIMs (leaflets), 45% took the leaflets home, and 78% indicated they understood the content of the leaflets. Nineteen percent of respondents reportedly discussed the content of the leaflets with their physician and 26% indicated that leaflets allowed them to ask fewer questions of their physician. Thirty-four percent indicated that leaflets had previously helped them to improve their health-related knowledge and self-management. Forty-two percent reportedly discussed the content of the leaflets with others. Patient characteristics are of significant influence on the perceived impact of PHIMS in physician interaction, health-related knowledge, and self-management. Conclusion This study suggests that patients value health information materials in the waiting rooms of family physicians and that they perceive such materials as being helpful in improving patient–physician interaction, health-related knowledge, and

  14. Emergency room thoracotomy for the resuscitation of patients with "fatal" penetrating injuries of the heart.

    PubMed

    Ivatury, R R; Shah, P M; Ito, K; Ramirez-Schon, G; Suarez, F; Rohman, M

    1981-10-01

    A total of 75 patients with penetrating cardiac injuries were treated at Lincoln Medical and Mental Health Center from January, 1974, to November, 1980. Twenty-two patients (29.3%) were unconscious on arrival and had no detectable vital signs, cardiac activity, or spontaneous respirations. Their last physical movement was observed in the ambulance. Immediate resuscitation of these patients employing intercostal or sternal splitting incisions in the emergency room revealed arrested hearts and permitted relief of tamponade, finger occlusion of the cardiac wound or wounds, and temporary suturing of the defect. Restoration of cardiac function was accomplished in 16 patients (72.7%). After transfer to the operating room for more definitive cardiorrhaphy and repair of other major wounds, 8 patients (36.4%) recovered without objective neurological disability. Our experience clearly supports the value of immediate emergency room thoracotomy in this group of patients. PMID:7305523

  15. Medical complications of intra-hospital patient transports: implications for architectural design and research.

    PubMed

    Ulrich, Roger S; Zhu, Xuemei

    2007-01-01

    Literature on healthcare architecture and evidence-based design has rarely considered explicitly that patient outcomes may be worsened by intra-hospital transport (IHT), which is defined as transport of patients within the hospital. The article focuses on the effects of IHTs on patient complications and outcomes, and the implications of such impacts for designing safer, better hospitals. A review of 22 scientific studies indicates that IHTs are subject to a wide range of complications, many of which occur frequently and have distinctly detrimental effects on patient stability and outcomes. The research suggests that higher patient acuity and longer transport durations are associated with more frequent and serious IHT-related complications and outcome effects. It appears no rigorous research has compared different hospital designs and layouts with respect to having possibly differential effects on transport-related complications and worsened outcomes. Nonetheless, certain design implications can be extracted from the existing research literature, including the importance of minimizing transport delays due to restricted space and congestion, and creating layouts that shorten IHT times for high-acuity patients. Limited evidence raises the possibility that elevator-dependent vertical building layouts may increase susceptibility to transport delays that worsen complications. The strong evidence indicating that IHTs trigger complications and worsen outcomes suggests a powerful justification for adopting acuity-adaptable rooms and care models that substantially reduce transports. A program of studies is outlined to address gaps in knowledge.Key WordsPatient transports, transports within hospitals, patient safety, evidence-based design, hospital design, healthcare architecture, intra-hospital transport complications, acuity-adaptable care, elevators, outcomes. PMID:21157716

  16. Ventilation Rates and Airflow Pathways in Patient Rooms: A Case Study of Bioaerosol Containment and Removal.

    PubMed

    Mousavi, Ehsan S; Grosskopf, Kevin R

    2015-11-01

    Most studies on the transmission of infectious airborne disease have focused on patient room air changes per hour (ACH) and how ACH provides pathogen dilution and removal. The logical but mostly unproven premise is that greater air change rates reduce the concentration of infectious particles and thus, the probability of airborne disease transmission. Recently, a growing body of research suggests pathways between pathogenic source (patient) and control (exhaust) may be the dominant environmental factor. While increases in airborne disease transmission have been associated with ventilation rates below 2 ACH, comparatively less data are available to quantify the benefits of higher air change rates in clinical spaces. As a result, a series of tests were conducted in an actual hospital to observe the containment and removal of respirable aerosols (0.5-10 µm) with respect to ventilation rate and directional airflow in a general patient room, and, an airborne infectious isolation room. Higher ventilation rates were not found to be proportionately effective in reducing aerosol concentrations. Specifically, increasing mechanical ventilation from 2.5 to 5.5 ACH reduced aerosol concentrations only 30% on average. However, particle concentrations were more than 40% higher in pathways between the source and exhaust as was the suspension and migration of larger particles (3-10 µm) throughout the patient room(s). Computational analyses were used to validate the experimental results, and, to further quantify the effect of ventilation rate on exhaust and deposition removal in patient rooms as well as other particle transport phenomena. PMID:26187326

  17. [Medical intervention for attempted suicide patients in emergency room].

    PubMed

    Hashimoto, Satoshi; Watanabe, Kenjiro; Takahashi, Takeshi

    2016-02-01

    Emergency department is an important location for suicide prevention activities. Past history of attempted suicides or deliberate self-harms is a predictable risk factor for future suicide completion. In Japan, most of the attempted suicide patients (ASP) are transported to the emergency hospitals. Therefore, the more improvement of intervention skills for ASP are needed. Emergency medical staffs are expected to communicate patients with warm and calm attitudes. To confirm the presence or absence of suicidal ideation, risk factors are important. If patients are suicidal, emergency physicians should not hesitate to consult to the psychiatrist. PMID:26915259

  18. Listening to "How the Patient Presents Herself": A Case Study of a Doctor-Patient Interaction in an Emergency Room

    ERIC Educational Resources Information Center

    Delbene, Roxana

    2015-01-01

    This is a case-study based on a micro-ethnography analyzing a doctor-patient interaction in an emergency room (ER) in New York City. Drawing on the framework of narrative medicine (Charon, 2006), the study examines how a phenomenological approach to listening to the patient facilitated the patient's narrative orientation not only to relevant…

  19. Group Therapy with Patients in the Waiting Room of an Oncology Clinic.

    ERIC Educational Resources Information Center

    Arnowitz, Edward; And Others

    1983-01-01

    Describes a therapy group for cancer patients, conducted by cotherapists in an oncology waiting room. Group members provided mutual support and shared concerns and coping methods. Medical staff members became more involved and were more able to address the affective needs of the patients and their families. (JAC)

  20. Detection of Common Respiratory Viruses and Mycoplasma pneumoniae in Patient-Occupied Rooms in Pediatric Wards.

    PubMed

    Wan, Gwo-Hwa; Huang, Chung-Guei; Chung, Fen-Fang; Lin, Tzou-Yien; Tsao, Kuo-Chien; Huang, Yhu-Chering

    2016-04-01

    Few studies have assessed viral contamination in the rooms of hospital wards. This cross-sectional study evaluated the air and objects in patient-occupied rooms in pediatric wards for the presence of common respiratory viruses and Mycoplasma pneumoniae.Air samplers were placed at a short (60-80 cm) and long (320 cm) distance from the head of the beds of 58 pediatric patients, who were subsequently confirmed to be infected with enterovirus (n = 17), respiratory syncytial virus (RSV) (n = 13), influenza A virus (n = 13), adenovirus (n = 9), or M pneumoniae (n = 6). Swab samples were collected from the surfaces of 5 different types of objects in the patients' rooms. All air and swab samples were analyzed via real-time quantitative polymerase chain reaction assay for the presence of the above pathogens.All pathogens except enterovirus were detected in the air, on the objects, or in both locations in the patients' rooms. The detection rates of influenza A virus, adenovirus, and M pneumoniae for the long distance air sampling were 15%, 67%, and 17%, respectively. Both adenovirus and M pneumoniae were detected at very high rates, with high concentrations, on all sampled objects.The respiratory pathogens RSV, influenza A virus, adenovirus, and M pneumoniae were detected in the air and/or on the objects in the pediatric ward rooms. Appropriate infection control measures should be strictly implemented when caring for such patients. PMID:27057827

  1. Patient safety in the operating room: an intervention study on latent risk factors

    PubMed Central

    2012-01-01

    Background Patient safety is one of the greatest challenges in healthcare. In the operating room errors are frequent and often consequential. This article describes an approach to a successful implementation of a patient safety program in the operating room, focussing on latent risk factors that influence patient safety. We performed an intervention to improve these latent risk factors (LRFs) and increase awareness of patient safety issues amongst OR staff. Methods Latent risk factors were studied using a validated questionnaire applied to the OR staff before and after an intervention. A pre-test/post-test control group design with repeated measures was used to evaluate the effects of the interventions. The staff from one operating room of an university hospital acted as the intervention group. Controls consisted of the staff of the operating room in another university hospital. The outcomes were the changes in LRF scores, perceived incident rate, and changes in incident reports between pre- and post-intervention. Results Based on pre-test scores and participants’ key concerns about organizational factors affecting patient safety in their department the intervention focused on the following LRFs: Material Resources, Training and Staffing Recourses. After the intervention, the intervention operating room - compared to the control operating room - reported significantly fewer problems on Material Resources and Staffing Resources and a significantly lower score on perceived incident rate. The contribution of technical factors to incident causation decreased significantly in the intervention group after the intervention. Conclusion The change of state of latent risk factors can be measured using a patient safety questionnaire aimed at these factors. The change of the relevant risk factors (Material and Staffing resources) concurred with a decrease in perceived and reported incident rates in the relevant categories. We conclude that interventions aimed at unfavourable

  2. Detection of Common Respiratory Viruses and Mycoplasma pneumoniae in Patient-Occupied Rooms in Pediatric Wards

    PubMed Central

    Wan, Gwo-Hwa; Huang, Chung-Guei; Chung, Fen-Fang; Lin, Tzou-Yien; Tsao, Kuo-Chien; Huang, Yhu-Chering

    2016-01-01

    Abstract Few studies have assessed viral contamination in the rooms of hospital wards. This cross-sectional study evaluated the air and objects in patient-occupied rooms in pediatric wards for the presence of common respiratory viruses and Mycoplasma pneumoniae. Air samplers were placed at a short (60–80 cm) and long (320 cm) distance from the head of the beds of 58 pediatric patients, who were subsequently confirmed to be infected with enterovirus (n = 17), respiratory syncytial virus (RSV) (n = 13), influenza A virus (n = 13), adenovirus (n = 9), or M pneumoniae (n = 6). Swab samples were collected from the surfaces of 5 different types of objects in the patients’ rooms. All air and swab samples were analyzed via real-time quantitative polymerase chain reaction assay for the presence of the above pathogens. All pathogens except enterovirus were detected in the air, on the objects, or in both locations in the patients’ rooms. The detection rates of influenza A virus, adenovirus, and M pneumoniae for the long distance air sampling were 15%, 67%, and 17%, respectively. Both adenovirus and M pneumoniae were detected at very high rates, with high concentrations, on all sampled objects. The respiratory pathogens RSV, influenza A virus, adenovirus, and M pneumoniae were detected in the air and/or on the objects in the pediatric ward rooms. Appropriate infection control measures should be strictly implemented when caring for such patients. PMID:27057827

  3. Use of Critical Access Hospital Emergency Rooms by Patients with Mental Health Symptoms

    ERIC Educational Resources Information Center

    Hartley, David; Ziller, Erika C.; Loux, Stephenie L.; Gale, John A.; Lambert, David; Yousefian, Anush E.

    2007-01-01

    Context: National data demonstrate that mental health (MH) visits to the emergency room (ER) comprise a small, but not inconsequential, proportion of all visits; however, we lack a rural picture of this issue. Purpose: This study investigates the use of critical access hospital (CAH) ERs by patients with MH problems to understand the role these…

  4. Evaluation of Access, a Primary Care Program for Indigent Patients: Inpatient and Emergency Room Utilization.

    ERIC Educational Resources Information Center

    Davidson, Richard A.; Giancola, Angela; Gast, Andrea; Ho, Janice; Waddell, Rhondda

    2003-01-01

    Evaluated the impact of Accessing Community Care through Eastside Social Services (ACCESS), a program that provided indigent patients with free primary care, on inpatient admissions, emergency room (ER) visits, and subsequent charges. Data on 19 people before and after program enrollment showed significant decreases in ER visits following…

  5. Non-operating Room Anesthesia: The Principles of Patient Assessment and Preparation.

    PubMed

    Chang, Beverly; Urman, Richard D

    2016-03-01

    A significant number of anesthetics are performed outside of the operating room (OR). Despite the increased requirement for anesthesia services, the framework to perform the necessary preprocedural anesthesia assessments to optimize patients has not been uniformly developed. Performing anesthesia in non-OR locations poses significant and distinct challenges compared with the procedures in the OR. Anesthesiologists are faced with patients with increasingly complicated comorbidities undergoing novel, complex interventional procedures. With unique training in preoperative triaging, and an expertise in intraoperative and postoperative management of complex patients, anesthesiologists can contribute to greater efficiency and patient safety in the non-OR setting. PMID:26927750

  6. Impact of healthcare design on patients' perception of a rheumatology outpatient infusion room: an interventional pilot study.

    PubMed

    Bukh, Gunhild; Tommerup, Anne Marie Munk; Madsen, Ole Rintek

    2015-07-01

    Evidence-based healthcare design is a concept aimed at reducing stress factors in the physical environment for the benefit of patients and the medical staff. The objective of this study was to examine the impact of room modifications on patients' perception of an outpatient infusion room used for treating rheumatologic diseases. Patient and nurse interviews, a staff workshop and field observations were performed to identify environmental room factors important for the patients, and the room was modified accordingly. The changes included the colours, atmosphere and functionality of the room. Artificial plants and a water bubble wall were added to the room. Forty-four patients receiving intravenous biologic therapy for inflammatory arthritis completed a questionnaire before and after the intervention. The agreement with 25 statements regarding the environmental room factors was scored (range 0-4). A total score was calculated as the sum of all 25 scores (range 0-100). The median (range) age was 55 (28-78) years. Seventeen out of 25 scores improved significantly (p < 0.000-0.050), none deteriorated. The amount of decorating and room colours, for example, was scored significantly higher after the intervention (p < 0.000), and the atmosphere was considered significantly more comfortable and "safe" (p < 0.005). The total score increased from 63.0 (34-88) to 81.0 (48-100) (p < 0.000). The study suggests that room modifications according to the principles of evidence-based healthcare design may have the potential to improve patients' perception of outpatient infusion rooms used for treating rheumatologic diseases. PMID:24705819

  7. Treatment of patients with immune thrombocytopenia admitted to the emergency room.

    PubMed

    Bavunoğlu, Işıl; Eşkazan, Ahmet Emre; Ar, Muhlis Cem; Cengiz, Mahir; Yavuzer, Serap; Salihoğlu, Ayşe; Öngören, Şeniz; Tunçkale, Aydın; Soysal, Teoman

    2016-08-01

    Immune thrombocytopenia (ITP) is the most frequent cause of acquired thrombocytopenia. In adult ITP patients, corticosteroids and intravenous immunoglobulin (IVIg) are used as first-line treatment. The aim of the present study was to investigate retrospectively the demographic and etiologic characteristics of patients with ITP admitted to the emergency room at our hospital. Seventy-five adult patients with ITP were included, and demographic data, bleeding characteristics, etiologic features and responses to treatments were evaluated retrospectively. Fifty-six patients (75 %) were female, and the median age was 43 years. Eighteen patients had a history of ITP, whereas in 57, thrombocytopenia was identified for the first time. During admission, the median platelet count was 5 × 10(9)/L. Cutaneous and/or mucosal bleeding was the most common clinical feature. High-dose dexamethasone was administered in 60 episodes, whereas IVIg and conventional-dose methylprednisolone were used in nine and six episodes, respectively. The overall response rate of the entire cohort following first-line treatments was 67 %, and complete remission was achieved in 31 patients, 19 patients achieved partial remission, and 25 patients were non-responders. In cases with life-threatening bleeding, concomitant infection, post-traumatic bleeding and need for emergency surgery, IVIg can be used as the first line of treatment option in addition to platelet transfusions. PMID:27129318

  8. Confidentiality and the physician-patient relationship -- ethical reflections from a surgical waiting room.

    PubMed

    Clark, Peter A

    2002-11-01

    The physician-patient relationship is the primary focus of ethics in medicine. It is both a personal and a professional relationship that is founded on trust, confidence, dignity and mutual respect. Trust is the bridge to the physician-patient relationship, and the burden is on the physician not only to expect the patient's trust but also to build a solid foundation upon which the patient can place his or her trust. Great strides have been made by physicians in refining the physician-patient relationship especially in understanding and respecting the patients' right of self-determination regarding medical decision-making and protecting their rights of privacy and confidentiality. However, further refinements are needed on both sides regarding this relationship. Breaches of confidentiality are occurring in places like surgical waiting rooms and as a result, the physician-patient relationship is being damaged. This article identifies some legitimate concerns and offers some concrete solutions so that the physician-patient relationship can be further refined and the virtues and rights that support it can be reinforced. PMID:12444393

  9. Norovirus GII.4 detection in environmental samples from patient rooms during nosocomial outbreaks.

    PubMed

    Nenonen, Nancy P; Hannoun, Charles; Svensson, Lennart; Torén, Kjell; Andersson, Lars-Magnus; Westin, Johan; Bergström, Tomas

    2014-07-01

    Norovirus (NoV) is an important cause of nosocomial gastroenteric outbreaks. This 5-month study was designed to characterize NoV contamination and airborne dispersal in patient rooms during hospital outbreaks. Air vents, overbed tables, washbasins, dust, and virus traps designed to collect charged particles from the air were swabbed to investigate the possibility of NoV contamination in patient rooms during outbreaks in seven wards and in an outbreak-free ward. Symptomatic inpatients were also sampled. Nucleic acid extracts of the samples were examined for NoV RNA using genogroup I (GI) and GII real-time reverse transcription-PCR (RT-PCR). The NoV strains were characterized by RT-PCR, sequencing, and phylogenetic analysis of the RNA-dependent RNA-polymerase-N/S capsid-coding region (1,040 nucleotides [nt]). Patient strains from two outbreaks in one ward were sequenced across the RNA-dependent-RNA-polymerase major capsid-coding region (2.5 kb), including the hypervariable P2 domain. In the outbreak wards, NoV GII was detected in 48 of 101 (47%) environmental swabs and 63 of 108 patients (58%); NoV genotype II.4 was sequenced from 18 environmental samples, dust (n = 8), virus traps (n = 4), surfaces (n = 6), and 56 patients. In contrast, NoV GII was detected in 2 (GII.4) of 28 (7%) environmental samples and in 2 (GII.6 and GII.4) of 17 patients in the outbreak-free ward. Sequence analyses revealed a high degree of similarity (>99.5%, 1,040 nt) between NoV GII.4 environmental and patient strains from a given ward at a given time. The strains clustered on 11 subbranches of the phylogenetic tree, with strong correlations to time and place. The high nucleotide similarity between the NoV GII.4 strains from patients and their hospital room environment provided molecular evidence of GII.4 dispersal in the air and dust; therefore, interventional cleaning studies are justified. PMID:24759712

  10. Norovirus GII.4 Detection in Environmental Samples from Patient Rooms during Nosocomial Outbreaks

    PubMed Central

    Hannoun, Charles; Svensson, Lennart; Torén, Kjell; Andersson, Lars-Magnus; Westin, Johan; Bergström, Tomas

    2014-01-01

    Norovirus (NoV) is an important cause of nosocomial gastroenteric outbreaks. This 5-month study was designed to characterize NoV contamination and airborne dispersal in patient rooms during hospital outbreaks. Air vents, overbed tables, washbasins, dust, and virus traps designed to collect charged particles from the air were swabbed to investigate the possibility of NoV contamination in patient rooms during outbreaks in seven wards and in an outbreak-free ward. Symptomatic inpatients were also sampled. Nucleic acid extracts of the samples were examined for NoV RNA using genogroup I (GI) and GII real-time reverse transcription-PCR (RT-PCR). The NoV strains were characterized by RT-PCR, sequencing, and phylogenetic analysis of the RNA-dependent RNA-polymerase-N/S capsid-coding region (1,040 nucleotides [nt]). Patient strains from two outbreaks in one ward were sequenced across the RNA-dependent-RNA-polymerase major capsid-coding region (2.5 kb), including the hypervariable P2 domain. In the outbreak wards, NoV GII was detected in 48 of 101 (47%) environmental swabs and 63 of 108 patients (58%); NoV genotype II.4 was sequenced from 18 environmental samples, dust (n = 8), virus traps (n = 4), surfaces (n = 6), and 56 patients. In contrast, NoV GII was detected in 2 (GII.4) of 28 (7%) environmental samples and in 2 (GII.6 and GII.4) of 17 patients in the outbreak-free ward. Sequence analyses revealed a high degree of similarity (>99.5%, 1,040 nt) between NoV GII.4 environmental and patient strains from a given ward at a given time. The strains clustered on 11 subbranches of the phylogenetic tree, with strong correlations to time and place. The high nucleotide similarity between the NoV GII.4 strains from patients and their hospital room environment provided molecular evidence of GII.4 dispersal in the air and dust; therefore, interventional cleaning studies are justified. PMID:24759712

  11. Evaluation of Injuries Caused by Penetrating Chest Traumas in Patients Referred to the Emergency Room.

    PubMed

    Aghaei Afshar, M; Mangeli, F; Nakhaei, A

    2015-06-01

    The aim of the study was to determine the frequency of different injuries caused by penetrating chest traumas, and also the cause and type of trauma and its accompanying injuries. This is a cross-sectional descriptive study, carried out on all patients referred to the emergency room of Shahid Bahonar Hospital, Kerman, from March 2000 to September 2008, due to penetrating chest trauma. The required information including age, sex, cause of trauma, type and site of injury, and accompanying injury was obtained and used to fill out a questionnaire and then was analyzed. 828 patients were included in the study; most of them were in the age range of 20-29. Of the patients, 97.6 % were males. The most frequent cause of trauma was stabbing, and the most frequent injuries following the trauma were pneumothorax and hemothorax. Orthopedic trauma was the most frequent accompanying injury. The most commonly used diagnostic method was plain chest radiography. In 93 % of the patients, the chest tube was placed and thoracotomy was performed for 97 % of the patients. Shahid Bahonar Hospital is a referral Trauma Centre and treats large number of chest trauma patients. Most patients need only chest tube placement as a definitive treatment. PMID:26246700

  12. Prehospital versus Emergency Room Intubation of Trauma Patients in Qatar: A-2-year Observational Study

    PubMed Central

    Al-Thani, Hassan; El-Menyar, Ayman; Latifi, Rifat

    2014-01-01

    Background: The impact of prehospital intubation (PHI) in improving outcome of trauma patients has not been adequately evaluated in the developing countries. Aims: The present study analyzed the outcome of PHI versus emergency room intubation (ERI) among trauma patients in Qatar. Materials and Methods: Data were retrospectively reviewed for all intubated trauma patients between 2010 and 2011. Patients were classified according to location of intubation (PHI: Group-1 versus ERI: Group-2). Data were analyzed and compared. Results: Out of 570 intubated patients; 482 patients (239 in group-1 and 243 in group-2) met the inclusion criteria with a mean age of 32 ΁ 14.6 years Head injury (P = 0.003) and multiple trauma (P = 0.004) were more prevalent in group-1, whereas solid organ injury predominated in group-2 (P = 0.02). Group-1 had significantly higher mean injury severity scoring (ISS), lower Glasgow coma scale (GCS), greater head abbreviated injury score and longer activation, response, scene and total emergency medical services times. The mortality was higher in group-1 (53% vs. 18.5%; P = 0.001). Multivariate analysis showed that GCS [odds ratio (OR) 0.78, P = 0.005) and ISS (OR 1.12, P = 0.001) were independent predictors of mortality. Conclusions: PHI is associated with high mortality when compared with ERI. However, selection bias cannot be ruled out and therefore, PHI needs further critical assessment in Qatar. PMID:24678471

  13. Music and ambient operating room noise in patients undergoing spinal anesthesia.

    PubMed

    Ayoub, Chakib M; Rizk, Laudi B; Yaacoub, Chadi I; Gaal, Dorothy; Kain, Zeev N

    2005-05-01

    Previous studies have indicated that music decreases intraoperative sedative requirements in patients undergoing surgical procedures under regional anesthesia. In this study we sought to determine whether this decrease in sedative requirements results from music or from eliminating operating room (OR) noise. A secondary aim of the study was to examine the relationship of response to intraoperative music and participants' culture (i.e., American versus Lebanese). Eighty adults (36 American and 54 Lebanese) undergoing urological procedures with spinal anesthesia and patient-controlled IV propofol sedation were randomly assigned to intraoperative music, white noise, or OR noise. We found that, controlling for ambient OR noise, intraoperative music decreases propofol requirements (0.004 +/- 0.002 mg . kg(-1) . min(-1) versus 0.014 +/- 0.004 mg . kg(-1) . min(-1) versus 0.012 +/- 0.002 mg . kg(-1) . min(-1); P = 0.026). We also found that, regardless of group assignment, Lebanese patients used less propofol as compared with American patients (0.005 +/- 0.001 mg . kg(-1) . min(-1) versus 0.017 +/- 0.003 mg . kg(-1) . min(-1); P = 0.001) and that, in both sites, patients in the music group required less propofol (P < 0.05). We conclude that when controlling for ambient OR noise, intraoperative music decreases propofol requirements of both Lebanese and American patients who undergo urological surgery under spinal anesthesia. PMID:15845676

  14. Time accuracy of a radio frequency identification patient tracking system for recording operating room timestamps.

    PubMed

    Marjamaa, Riitta A; Torkki, Paulus M; Torkki, Markus I; Kirvelä, Olli A

    2006-04-01

    A patient tracking system is a promising tool for managing patient flow and improving efficiency in the operating room. Wireless location systems, using infrared or radio frequency transmitters, can automatically timestamp key events, thereby decreasing the need for manual data input. In this study, we measured the accuracy and precision of automatically documented timestamps compared with manual recording. Each patient scheduled for urgent surgery was given an active radio frequency/infrared transmitter. The prototype software tracked the patient throughout the perioperative process, automatically documenting the timestamps. Both automatic and traditional data entry were compared with the reference data. The absolute value of median error was 64% smaller (P < 0.01), and the average quartile deviation of error was 69% smaller in automatic documentation. The average delay between an activity and the documentation was 80 seconds in automatic documentation and 735 seconds in manual documentation. Both the accuracy and the precision were better in automatic documentation and the data were immediately available. Automatic documentation with the Indoor Positioning System can help in managing patient flow and in increasing transparency with faster availability and better accuracy of data. PMID:16551921

  15. Emergency room resource utilization by patients with low-back pain.

    PubMed

    Drazin, Doniel; Nuño, Miriam; Patil, Chirag G; Yan, Kimberly; Liu, John C; Acosta, Frank L

    2016-05-01

    OBJECTIVE The objective of this study was to determine factors associated with admission to the hospital through the emergency room (ER) for patients with a primary diagnosis of low-back pain (LBP). The authors further evaluated the impact of ER admission and patient characteristics on mortality, discharge disposition, and hospital length of stay. METHODS The authors conducted a retrospective analysis of patients with LBP discharged from hospitals according to the Nationwide Inpatient Sample (NIS) between 1998 and 2007. Univariate comparisons of patient characteristics according to the type of admission (ER versus non-ER) were conducted. Multivariate analysis evaluated factors associated with an ER admission, risk of mortality, and nonroutine discharge. RESULTS According to the NIS, approximately 183,151 patients with a primary diagnosis of LBP were discharged from US hospitals between 1998 and 2007. During this period, an average of 65% of these patients were admitted through the ER, with a significant increase from 1998 (54%) to 2005 (71%). Multivariate analysis revealed that uninsured patients (OR 2.1, 95% CI 1.7-2.6, p < 0.0001) and African American patients (OR 1.5, 95% CI 1.2-1.7, p < 0.0001) were significantly more likely to be admitted through the ER than private insurance patients or Caucasian patients, respectively. Additionally, a moderate but statistically significant increase in the likelihood of ER admission was noted for patients with more preexisting comorbidities (OR 1.1, 95% CI 1.0-1.2, p < 0.001). An 11% incremental increase in the odds of admission through the ER was observed with each year increment (OR 1.1, 95% CI 1.0-1.2, p < 0.001). Highest income patients ($45,000+) were more likely to be admitted through the ER (OR 1.3, 95% CI 1.1-1.6, p = 0.007) than the lowest income cohort. While ER admission did not impact the risk of mortality (OR 0.95, 95% CI 0.60-1.51, p = 0.84), it increased the odds of a nonroutine discharge (OR 1.39, 95% CI 1

  16. Microbiological evaluation of wet and dry floor sanitization systems in hospital patient rooms.

    PubMed Central

    Vesley, D; Klapes, N A; Benzow, K; Le, C T

    1987-01-01

    A new system for sanitizing floors in hospital patient rooms has been developed. The method consists of dry dusting with a cotton-blend, chemically treated (10% by dry mop weight) dust mop. This method was compared with a conventional cleaning protocol consisting of an initial predusting with the same nongermicidal chemical (3% by dry mop weight) followed by wet mopping with a fresh solution of a quaternary ammonium disinfectant-detergent. Each of six rooms was sampled by using RODAC plates (Becton Dickinson Labware, Oxnard, Calif.) on 10 consecutive days for each of the two methods. The study was initially performed during the summer and then repeated during the winter. Results imply that there is no significant difference between the new dry method (81.9% CFU reduction) and the conventional method (83.1% CFU reduction). Furthermore, the initial dry dusting step in the conventional method accounted for virtually all of the reduction by that method. Thus, wet mopping with a germicidal chemical produced no additional significant reduction of natural microbial populations on environmental surfaces beyond that achieved by dry dusting with dust-suppressant chemicals. PMID:3606089

  17. The Impact of Emergency Room Utilization by Depression Patients on Medical Treatment Expense in Korea

    PubMed Central

    Lee, Hyun Sook

    2013-01-01

    Objectives To investigate the determinants of total medical expense for depression patients admitted through the emergency room (ER). Methods Data were selected from the Korean National Health Insurance sample data for 2009. SPSS version 18 was used for the statistical analysis such as descriptive analysis, correlation analysis, and multiple regression analysis. Data included 1203 cases admitted through the ER with ICD-10 codes (F31–F39). Results In the multiple regression analysis, significant variables affecting total payment were gender (p < 0.001), age (p < 0.001), main illness (p < 0.001), course of admission to the ER (p < 0.05), and length of stay (p < 0.001). Conclusion It is necessary to build a long-term program and system for high-risk depression groups. PMID:24298439

  18. Recruiting diverse patients to a breast cancer risk communication trial--waiting rooms can improve access.

    PubMed Central

    Bodurtha, Joann N.; Quillin, John M.; Tracy, Kelly A.; Borzelleca, Joseph; McClish, Donna; Wilson, Diane Baer; Jones, Resa M.; Quillin, Julie; Bowen, Deborah

    2007-01-01

    Low participation among underserved populations in health research constrains progress in public health practices. From 2003 to 2005, Women's Health Clinic patients at the VCU Health System were recruited to a trial investigating breast cancer risk communication. In secondary analyses, we examined dimensions of the recruitment of these diverse women. The sample characteristics (age, insurance, race and previous mammograms) were compared to the overall clinic. Of recruitment attempts for eligible women, 45% consented; of those who declined, the top cited reasons were lack of time (40%) and lack of interest (18%). Of 899 participants, 35% qualified for the indigent care program, compared to 31% of the overall clinic (P<0.001). Forty-five percent of participants were African American, compared to 54% of overall clinic patients (P<0.001). Participants were younger (50 vs. 53 years, P<0.001) than the overall clinic population. Nonrepresentative enrollment of patients in clinical trials is common and could lead to suboptimal applicability of findings. Although there were statistically significant race and age differences between the study sample and the overall population, we demonstrate that waiting room recruitment can engage diverse women in a clinical trial and cancer risk communication. PMID:17722671

  19. Potable water and nosocomial Legionnaires' disease--check water from all rooms in which patient has stayed.

    PubMed Central

    Marrie, T. J.; Johnson, W.; Tyler, S.; Bezanson, G.; Haldane, D.; Burbridge, S.; Joly, J.

    1995-01-01

    We studied 7 patients with nosocomial Legionnaires' disease to determine the relationship between isolates of Legionella pneumophila recovered from potable water and those recovered from patients. Potable water was cultured from all rooms in which patients had stayed prior to the diagnosis of Legionnaires' disease. The 38 isolates of L. pneumophila (31 environmental, 7 patient) were resolved into 9 distinct patterns by pulse-field gel electrophoresis (PFGE), 3 by plasmid content and 2 each with monoclonal antibodies and conventional agarose gel electrophoresis of small fragments of DNA. Using PFGE it was determined that 4 of the 7 patients were infected with L. pneumophila identical to an isolate recovered from the potable water supply in one of the rooms each had occupied prior to the diagnosis of Legionnaires' disease. Patients had resided in a mean of 3.57 rooms before a diagnosis of nosocomial Legionnaires' disease. We conclude that in the setting of contaminated potable water and nosocomial Legionnaires' disease water from all the rooms which the patient has occupied prior to this diagnosis should be cultured. PFGE of large DNA fragments discriminated best among the isolates of L. pneumophila. Images Fig. 1 PMID:7705490

  20. Hydrogen Peroxide Vapor Decontamination in a Patient Room Using Feline Calicivirus and Murine Norovirus as Surrogate Markers for Human Norovirus.

    PubMed

    Holmdahl, Torsten; Walder, Mats; Uzcátegui, Nathalie; Odenholt, Inga; Lanbeck, Peter; Medstrand, Patrik; Widell, Anders

    2016-05-01

    OBJECTIVE To determine whether hydrogen peroxide vapor (HPV) could be used to decontaminate caliciviruses from surfaces in a patient room. DESIGN Feline calicivirus (FCV) and murine norovirus (MNV) were used as surrogate viability markers to mimic the noncultivable human norovirus. Cell culture supernatants of FCV and MNV were dried in triplicate 35-mm wells of 6-well plastic plates. These plates were placed in various positions in a nonoccupied patient room that was subsequently exposed to HPV. Control plates were positioned in a similar room but were never exposed to HPV. METHODS Virucidal activity was measured in cell culture by reduction in 50% tissue culture infective dose titer for FCV and by both 50% tissue culture infective dose titer and plaque reduction for MNV. RESULTS Neither viable FCV nor viable MNV could be detected in the test room after HPV treatment. At least 3.65 log reduction for FCV and at least 3.67 log reduction for MNV were found by 50% tissue culture infective dose. With plaque assay, measurable reduction for MNV was at least 2.85 log units. CONCLUSIONS The successful inactivation of both surrogate viruses indicates that HPV could be a useful tool for surface decontamination of a patient room contaminated by norovirus. Hence nosocomial spread to subsequent patients can be avoided. Infect Control Hosp Epidemiol 2016;37:561-566. PMID:26861195

  1. Meanings of Being Critically Ill in a Sound-Intensive ICU Patient Room - A Phenomenological Hermeneutical Study

    PubMed Central

    Johansson, Lotta; Bergbom, Ingegerd; Lindahl, Berit

    2012-01-01

    The aim of this study was to illuminate the meanings of being critically ill in a sound-intensive ICU patient room, as disclosed through patients’ narratives. Patient rooms in ICUs are filled with loud activity and studies have revealed sound levels comparable to those of a busy road above the patient’s head. There is a risk that the sound or noise is disturbing and at worst a major problem for the patient, but there is a lack of knowledge concerning the patients’ own experiences. Thirteen patients were asked to narrate their experiences of the sound environment in ICU patient rooms. The interviews were analyzed using a phenomenological- hermeneutical method inspired by the philosophy of Ricoeur. Six themes emerged from the analysis. Conclusion: The meanings of being a patient in a sound- intensive environment were interpreted as never knowing what to expect next regarding noise, but also of being situated in the middle of an uncontrollable barrage of noise, unable to take cover or disappear. This condition is not to be seen as static; for some patients there is movement and change over time. The meanings indicate that the unpredictable shifts between silence and disturbing sounds stress the critically ill patient and impede sleep and recovery. Our findings indicate the need to reduce disturbing and unexpected sounds and noise around critically ill patients in high-tech environments in order to facilitate wellbeing, sleep and recovery. Nurses have a vital role in developing such an environment. PMID:22977654

  2. Identifying Patients with Bacteremia in Community-Hospital Emergency Rooms: A Retrospective Cohort Study

    PubMed Central

    Takeshima, Taro; Yamamoto, Yosuke; Noguchi, Yoshinori; Maki, Nobuyuki; Gibo, Koichiro; Tsugihashi, Yukio; Doi, Asako; Fukuma, Shingo; Yamazaki, Shin; Kajii, Eiji; Fukuhara, Shunichi

    2016-01-01

    Objectives (1) To develop a clinical prediction rule to identify patients with bacteremia, using only information that is readily available in the emergency room (ER) of community hospitals, and (2) to test the validity of that rule with a separate, independent set of data. Design Multicenter retrospective cohort study. Setting To derive the clinical prediction rule we used data from 3 community hospitals in Japan (derivation). We tested the rule using data from one other community hospital (validation), which was not among the three “derivation” hospitals. Participants Adults (age ≥ 16 years old) who had undergone blood-culture testing while in the ER between April 2011 and March 2012. For the derivation data, n = 1515 (randomly sampled from 7026 patients), and for the validation data n = 467 (from 823 patients). Analysis We analyzed 28 candidate predictors of bacteremia, including demographic data, signs and symptoms, comorbid conditions, and basic laboratory data. Chi-square tests and multiple logistic regression were used to derive an integer risk score (the “ID-BactER” score). Sensitivity, specificity, likelihood ratios, and the area under the receiver operating characteristic curve (i.e., the AUC) were computed. Results There were 241 cases of bacteremia in the derivation data. Eleven candidate predictors were used in the ID-BactER score: age, chills, vomiting, mental status, temperature, systolic blood pressure, abdominal sign, white blood-cell count, platelets, blood urea nitrogen, and C-reactive protein. The AUCs was 0.80 (derivation) and 0.74 (validation). For ID-BactER scores ≥ 2, the sensitivities for derivation and validation data were 98% and 97%, and specificities were 20% and 14%, respectively. Conclusions The ID-BactER score can be computed from information that is readily available in the ERs of community hospitals. Future studies should focus on developing a score with a higher specificity while maintaining the desired sensitivity

  3. Thinking in three's: changing surgical patient safety practices in the complex modern operating room.

    PubMed

    Gibbs, Verna C

    2012-12-14

    The three surgical patient safety events, wrong site surgery, retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study. The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined. Many providers may never have a personal experience with one of these events and training and education on these topics are sparse. These circumstances lead to faulty thinking that a provider won't ever have an event or if one does occur the provider will intuitively know what to do. Surgeons are not preoccupied with failure and tend to usually consider good outcomes, which leads them to ignore or diminish the importance of implementing and following simple safety practices. These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions. Individual facilities rarely have the time or talent to understand these events and develop lasting solutions. More often than not, even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate. This approach routinely fails and is another reason why these problems are so persistent. Vigilance actions alone have been unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stakeholders to optimize the OR environment. This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery, RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists, surgeons and nurses. A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to

  4. Self-Medication: Initial Treatments Used by Patients Seen in an Ophthalmologic Emergency Room

    PubMed Central

    Carvalho, Regina Souza; Kara-José, Newton; Temporini, Edméa Rita; Kara-Junior, Newton; Noma-Campos, Regina

    2009-01-01

    OJECTIVE This study seeks to identify practices of self-medication in the treatment of ocular emergencies. We examine patients’ use of both homemade preparations and manufactured products before seeking specialized care. MATERIALS AND METHODS We conducted a cross-sectional analytic survey of consecutive patients seen in the ophthalmology emergency room of a teaching hospital. RESULTS The sample included 561 subjects, 51.3% males and 48.7% females, with a mean age of 39.8 years. Prior to seeking emergency care, 40.5% reported self-medicating; 29.4% used a homemade preparation (13.9% referred to an industrialized product like boric acid as a homemade preparation), and 11.1% used a manufactured product. The most frequently used products included a boric acid solution (53.3%), a normal saline solution (35.7%), herbal infusions (6.1%) and breast milk (4.8%). Viral conjunctivitis was the most frequent diagnosis (24.4%), followed by the presence of a corneal foreign body (7.4%). No significant differences were found in the self-treatment of ocular injuries according to gender (p = 0.95), level of education (p = 0.21) or age (p = 0.14). In addition, self-medication practices were not related to the medically judged severity of the condition. CONCLUSION Patients often attempt to treat conditions that require ophthalmologic emergency care by self-medicating with homemade or manufactured products. The most widely used products include boric acid, normal saline, leaf infusions and breast milk. This behavior occurs independently of educational level, gender, age or the nature of the ocular condition. Self-medication is a culturally driven practice that is used even in cases of acute ocular injuries. PMID:19690656

  5. Thinking in three's: Changing surgical patient safety practices in the complex modern operating room

    PubMed Central

    Gibbs, Verna C

    2012-01-01

    The three surgical patient safety events, wrong site surgery, retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study. The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined. Many providers may never have a personal experience with one of these events and training and education on these topics are sparse. These circumstances lead to faulty thinking that a provider won’t ever have an event or if one does occur the provider will intuitively know what to do. Surgeons are not preoccupied with failure and tend to usually consider good outcomes, which leads them to ignore or diminish the importance of implementing and following simple safety practices. These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions. Individual facilities rarely have the time or talent to understand these events and develop lasting solutions. More often than not, even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate. This approach routinely fails and is another reason why these problems are so persistent. Vigilance actions alone have been unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stakeholders to optimize the OR environment. This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery, RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists, surgeons and nurses. A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to

  6. Antimicrobial Non-Susceptibility of Escherichia coli from Outpatients and Patients Visiting Emergency Rooms in Taiwan

    PubMed Central

    Wang, Jann-Tay; Chang, Shan-Chwen; Chang, Feng-Yee; Fung, Chang-Phone; Chuang, Yin-Ching; Chen, Yao-Shen; Shiau, Yih-Ru; Tan, Mei-Chen; Wang, Hui-Ying; Lai, Jui-Fen; Huang, I-Wen; Yang Lauderdale, Tsai-Ling

    2015-01-01

    Longitudinal nationwide surveillance data on antimicrobial non-susceptibility and prevalence of extended-spectrum β-lactamases (ESBLs) as well as AmpC β-lactamases producers among Escherichia coli from different sources in the community settings are limited. Such data may impact treatment practice. The present study investigated E. coli from outpatients and patients visiting emergency rooms collected by the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program. A total of 3481 E. coli isolates were studied, including 2153 (61.9%) from urine and 1125 (32.3%) from blood samples. These isolates were collected biennially between 2002 and 2012 from a total of 28 hospitals located in different geographic regions of Taiwan. Minimum inhibitory concentrations (MIC) were determined using methods recommended by the Clinical Laboratory Standards Institute (CLSI). The prevalence and factors associated with the presence of ESBL and AmpC β-lactamase-producers were determined. Significant increases in non-susceptibility to most β-lactams and ciprofloxacin occurred during the study period. By 2012, non-susceptibility to cefotaxime and ciprofloxacin reached 21.1% and 26.9%, respectively. The prevalence of ESBL- and AmpC- producers also increased from 4.0% and 5.3%, respectively, in 2002–2004, to 10.7% for both in 2010–2012 (P < 0.001). The predominant ESBL and AmpC β-lactamase genes were CTX-M and CMY-types, respectively. Non-susceptibility of urine isolates to nitrofurantoin remained at around 8% and to fosfomycin was low (0.7%) but to cefazolin (based on the 2014 CLSI urine criteria) increased from 11.5% in 2002–2004 to 23.9% in 2010–2012 (P <0.001). Non-susceptibility of isolates from different specimen types was generally similar, but isolates from elderly patients were significantly more resistant to most antimicrobial agents and associated with the presence of ESBL- and AmpC- β-lactamases. An additional concern is that decreased ciprofloxacin

  7. Antimicrobial Non-Susceptibility of Escherichia coli from Outpatients and Patients Visiting Emergency Rooms in Taiwan.

    PubMed

    Wang, Jann-Tay; Chang, Shan-Chwen; Chang, Feng-Yee; Fung, Chang-Phone; Chuang, Yin-Ching; Chen, Yao-Shen; Shiau, Yih-Ru; Tan, Mei-Chen; Wang, Hui-Ying; Lai, Jui-Fen; Huang, I-Wen; Yang Lauderdale, Tsai-Ling

    2015-01-01

    Longitudinal nationwide surveillance data on antimicrobial non-susceptibility and prevalence of extended-spectrum β-lactamases (ESBLs) as well as AmpC β-lactamases producers among Escherichia coli from different sources in the community settings are limited. Such data may impact treatment practice. The present study investigated E. coli from outpatients and patients visiting emergency rooms collected by the Taiwan Surveillance of Antimicrobial Resistance (TSAR) program. A total of 3481 E. coli isolates were studied, including 2153 (61.9%) from urine and 1125 (32.3%) from blood samples. These isolates were collected biennially between 2002 and 2012 from a total of 28 hospitals located in different geographic regions of Taiwan. Minimum inhibitory concentrations (MIC) were determined using methods recommended by the Clinical Laboratory Standards Institute (CLSI). The prevalence and factors associated with the presence of ESBL and AmpC β-lactamase-producers were determined. Significant increases in non-susceptibility to most β-lactams and ciprofloxacin occurred during the study period. By 2012, non-susceptibility to cefotaxime and ciprofloxacin reached 21.1% and 26.9%, respectively. The prevalence of ESBL- and AmpC- producers also increased from 4.0% and 5.3%, respectively, in 2002-2004, to 10.7% for both in 2010-2012 (P < 0.001). The predominant ESBL and AmpC β-lactamase genes were CTX-M and CMY-types, respectively. Non-susceptibility of urine isolates to nitrofurantoin remained at around 8% and to fosfomycin was low (0.7%) but to cefazolin (based on the 2014 CLSI urine criteria) increased from 11.5% in 2002-2004 to 23.9% in 2010-2012 (P <0.001). Non-susceptibility of isolates from different specimen types was generally similar, but isolates from elderly patients were significantly more resistant to most antimicrobial agents and associated with the presence of ESBL- and AmpC- β-lactamases. An additional concern is that decreased ciprofloxacin susceptibility (MIC

  8. One size fits all? Mixed methods evaluation of the impact of 100% single-room accommodation on staff and patient experience, safety and costs

    PubMed Central

    Maben, Jill; Penfold, Clarissa; Simon, Michael; Anderson, Janet E; Robert, Glenn; Pizzo, Elena; Hughes, Jane; Murrells, Trevor; Barlow, James

    2016-01-01

    Background and objectives There is little strong evidence relating to the impact of single-room accommodation on healthcare quality and safety. We explore the impact of all single rooms on staff and patient experience; safety outcomes; and costs. Methods Mixed methods pre/post ‘move’ comparison within four nested case study wards in a single acute hospital with 100% single rooms; quasi-experimental before-and-after study with two control hospitals; analysis of capital and operational costs associated with single rooms. Results Two-thirds of patients expressed a preference for single rooms with comfort and control outweighing any disadvantages (sense of isolation) felt by some. Patients appreciated privacy, confidentiality and flexibility for visitors afforded by single rooms. Staff perceived improvements (patient comfort and confidentiality), but single rooms were worse for visibility, surveillance, teamwork, monitoring and keeping patients safe. Staff walking distances increased significantly post move. A temporary increase of falls and medication errors in one ward was likely to be associated with the need to adjust work patterns rather than associated with single rooms per se. We found no evidence that single rooms reduced infection rates. Building an all single-room hospital can cost 5% more with higher housekeeping and cleaning costs but the difference is marginal over time. Conclusions Staff needed to adapt their working practices significantly and felt unprepared for new ways of working with potentially significant implications for the nature of teamwork in the longer term. Staff preference remained for a mix of single rooms and bays. Patients preferred single rooms. PMID:26408568

  9. Gender differences in the rate of restriction to room among Ontario forensic patients.

    PubMed

    Mathias, Krista; Hirdes, John P

    2015-07-01

    Gender can have separate and interacting effects on mental health. Gender-based analysis provides insight into these effects on mental health, and it can provide evidence to inform policy and practice to meet these gender-specific needs among persons in forensic mental health settings. Both individual and facility-level characteristics play a role in restriction to room as a form of control intervention in forensic mental health. Understanding the gender differences associated with the factors that increase a person's risk of restriction to room can allow for more targeted interventions and provide insight into policies that will help reduce these types of control interventions. PMID:26015491

  10. Modification of a motel-type room to accommodate patients receiving radioiodine therapy: reduction of environmental exposure.

    PubMed

    Pickering, Charles A; Dykes, James N; Domingo, Michelle T; Patricko, Joseph; Yamauchi, Dave M; Williams, Lawrence E

    2012-08-01

    Patients receiving ¹³¹I-based therapies are generally restricted in leaving the medical institution. In the U.S., the U.S. Nuclear Regulatory Commission (U.S. NRC) has developed the rule that a ≤ 7 mR h⁻¹ reading at 1 m from the patient (or 33 mCi) is sufficient to allow unrestricted release. Because of home situations and other constraints, it is preferable that a patient-specific release level be determined by the radiation safety staff. Locally, the City of Hope has instituted a general release criterion of ≤ 2 mR h⁻¹ at 1 m. While contributing to a reduction in public exposure, this as low as reasonably achievable (ALARA) approach is difficult to justify on a cost basis due to the expense of maintaining the radioactive individual in a hospital room. Instead, it was determined that a motel-type room already on the campus be modified to allow the patient to remain on-site until at or below a locally permitted release level. By adding lead to the bathroom area and sealing the tile surfaces, the room may be converted for less than $5,000. Daily cost for the patient is $65. In comparing the use of this facility for thyroid cancer patients from 2006 to 2010, it was found that the public exposure at 1 m was reduced by approximately 70% as compared to release at the 7 mR h level. In addition, controlling the release reduces the likelihood of a radiation incident in the public environment such as on public transportation or in a hotel. PMID:22739966

  11. An exploration of the basis for patient complaints about the oldness of magazines in practice waiting rooms: cohort study

    PubMed Central

    Alrutz, Stowe; Moyes, Simon

    2014-01-01

    Objective To explore the basis for patient complaints about the oldness of most magazines in practice waiting rooms. Design Cohort study. Setting Waiting room of a general practice in Auckland, New Zealand. Participants 87 magazines stacked into three mixed piles and placed in the waiting room: this included non-gossipy magazines (Time magazine, the Economist, Australian Women’s Weekly, National Geographic, BBC History) and gossipy ones (not identified for fear of litigation). Gossipy was defined as having five or more photographs of celebrities on the front cover and most gossipy as having up to 10 such images. Interventions The magazines were marked with a unique number on the back cover, placed in three piles in the waiting room, and monitored twice weekly. Main outcome measures Disappearance of magazines less than 2 months old versus magazines 3-12 months old, the overall rate of loss of magazines, and the rate of loss of gossipy versus non-gossipy magazines. Results 47 of the 82 magazines with a visible date on the front cover were aged less than 2 months. 28 of these 47 (60%) magazines and 10 of the 35 (29%) older magazines disappeared (P=0.002). After 31 days, 41 of the 87 (47%, 95% confidence interval 37% to 58%) magazines had disappeared. None of the 19 non-gossipy magazines (the Economist and Time magazine) had disappeared compared with 26 of the 27 (96%) gossipy magazines (P<0.001). All 15 of the most gossipy magazines and all 19 of the non-gossipy magazines had disappeared by 31 days. The study was terminated at this point. Conclusions General practice waiting rooms contain mainly old magazines. This phenomenon relates to the disappearance of the magazines rather than to the supply of old ones. Gossipy magazines were more likely to disappear than non-gossipy ones. On the grounds of cost we advise practices to supply old copies of non-gossipy magazines. A waiting room science curriculum is urgently needed. PMID:25500116

  12. The Plasma Level of Proprotein Convertase FURIN in Patients with Suspected Infection in the Emergency Room: A Prospective Cohort Study.

    PubMed

    Ranta, N; Turpeinen, H; Oksanen, A; Hämäläinen, S; Huttunen, R; Uusitalo-Seppälä, R; Rintala, E; Aittoniemi, J; Pesu, M

    2015-12-01

    There is an increasing need for novel biomarkers that enable better diagnostic and prognostic stratification of patients with suspected infection. A proprotein convertase enzyme FURIN is upregulated upon immune cell activation, and it promotes infectivity by cleaving and activating pathogens. In this study, we determined FURIN levels in plasma using ELISA from 537 patients that were admitted to emergency room with suspected infection. Patients were sorted to high- and low-level FURIN groups with a cut-off level of 370 pg/ml. The study cohort included five diagnostic groups: Group 1, no systemic inflammatory response syndrome (SIRS, n = 59 patients); Group 2, bacterial infection without SIRS (n = 67); Group 3, SIRS, but no bacterial infection (n = 308); Group 4, sepsis without organ failure (n = 308); and Group 5, severe sepsis (n = 49). Statistically significant associations were not found between the plasma level of FURIN and the prevalence of sepsis (P = 0.957), diagnostic group of a patient (P = 0.737) or the bacteria in blood culture (P = 0.499). Additionally, the concentration of FURIN did not predict the severity or case fatality of the infectious disease. However, statistically significant associations were found between high plasma level of FURIN and diagnosed rheumatic disease (P < 0.001) as well as with the prevalence of non-smokers (P = 0.034). Thus, albeit the plasma level of FURIN does not predict the severity of infectious disease, it may be of use in the diagnostics of autoimmune diseases. PMID:26346780

  13. [Shuttle Challenger disaster: what lessons can be learned for management of patients in the operating room?].

    PubMed

    Suva, Domizio; Poizat, Germain

    2015-02-01

    For many years hospitals have been implementing crew resource management (CRM) programs, inspired by the aviation industry, in order to improve patient safety. However, while contributing to improved patient care, CRM programs are controversial because of their limited impact, a decrease in effectiveness over time, and the underinvestment by some caregivers. By analyzing the space shuttle Challenger accident, the objective of this article is to show the potential impact of the professional culture in decision-making processes. In addition, to present an approach by cultural factors which are an essential complement to current CRM programs in order to enhance the safety of care. PMID:25854048

  14. RADIATION DOSIMETRY IN THE BNCT PATIENT TREATMENT ROOM AT THE BMRR.

    SciTech Connect

    HOLDEN, N.E.; RECINIELLO, R.N.; HU, J.-P.

    2005-05-08

    The Medical Research Reactor at the Brookhaven National Laboratory (BMRR) was a heterogeneous, tank type, light water cooled and moderated, graphite reflected reactor, which was operated on demand at a power level up to 3 mega-watts (MW) for medical and biological research [1]. The reactor first went critical on March 15, 1959, with 17 fresh fuel elements (2.52 kg uranium-235 in a total of 2.7 kg uranium) in the center core. The BMRR had two treatment rooms on opposite sides of the core. It had a predominately thermal neutron beam in the Thermal Neutron Irradiation Facility (TNE) on the west side of the core. By early 1990, a redesigned beam line had a predominately epithermal neutron beam in the Epithermal Neutron Irradiation Facility (ENIF) on the east side of the core [2]. The ENP was approximately 11 feet by 21 feet in size with its focal point consisting of a bismuth plate mounted in the wall adjacent to the reactor shield about 36 inches above the floor. The beam originated at a shutter constructed of 0.75 inch steel filled with concrete and weighing {approx}21 tons. Access to the ENIF was through a pair of hand operated steel shielding doors, each 42 inches wide, 84 inches high and 5 inches thick. The inner door had a 4-inch thick layer of paraffin on the side facing the reactor. The doors 5000 pounds weighed each. Additional shielding material had been added to the entire beam port at reactor wall within the ENIF. The shielding material consisted of 2-inch thick polyethylene sheets, which were impregnated with 95%-enriched {sup 6}Li in lithium carbonate (Li{sub 2}CO{sub 3}). The shielding sheets around the port face were designed to allow the insertion of a variety of different beam collimators.

  15. Proportional differences in emergency room adult patients with PTSD, mood disorders, and anxiety for a large ethnically diverse geographic sample.

    PubMed

    Onoye, Jane; Helm, Susana; Koyanagi, Chad; Fukuda, Michael; Hishinuma, Earl; Takeshita, Junji; Ona, Celia

    2013-05-01

    Underserved populations often utilize the emergency room in place of primary care, particularly for short term behavioral health services. This study examined emergency department (ED) utilization rates for rurality, insurance, sex, and ethnicity in a large sample of adult patients in Hawai'i hospitals from 2000-2010 with a diagnosis of post-traumatic stress disorder (PTSD), mood disorder, or other anxiety disorder. Findings showed a higher rate of use by rural and suburban residents with a diagnosis of PTSD or other anxiety than by urban residents. Utilization of EDs by African Americans and Other Pacific Islanders with PTSD was proportionally higher than for those with mood disorders or other anxiety disorders. Military ED visits were also proportionally higher for individuals with PTSD than for those with mood or other anxiety disorders. Limited economic resources and increasingly costly mental health disorders such as PTSD highlight the importance of better understanding the needs for behavioral health services for underserved populations. PMID:23728057

  16. Association between weather conditions and the number of patients at the emergency room in an Argentine hospital

    NASA Astrophysics Data System (ADS)

    Rusticucci, Matilde; Bettolli, Laura M.; de los Angeles Harris, M.

    2002-02-01

    The aim of this paper is to study the relationships between hospital emergencies and weather conditions by analysing summer and winter cases of patients requiring attention at the emergency room of a hospital in the city of Buenos Aires, Argentina. Hospital data have been sorted into seven different diagnostic groups as follows: (1) respiratory, cardiovascular and chest-pain complaints; (2) digestive, genitourinary and abdominal complaints; (3) neurological and psychopathological disorders; (4) infections; (5) contusion and crushing, bone and muscle complaints; (6) skin and allergies and (7) miscellaneous complaints. In general, there is an increase of 16.7% in winter while, for group 2 and group 6, there are more patients in summer, 54% and 75% respectively. In summer, the total number of patients for group 6 shows a significant positive correlation with temperature and dew-point temperature, and a negative correlation with the sea-level pressure for the same day. In winter, the same relationship exists, however its correlation is not as strong. The lags observed between these three variables: maximum dew-point temperature, maximum temperature, minimum air pressure and the peaks in admissions are 1, 2 and 4 days respectively. In winter, increases in temperature and dew point and decreases in pressure are followed by a peak in admissions for group 2. In winter, there are significantly more cases in group 5 on warm, dry days and on warm, wet days in the summer.

  17. The Effect of Continuity of Care on Emergency Room Use for Diabetic Patients Varies by Disease Severity

    PubMed Central

    Hsu, Chia-Hsiang; Chou, Yiing-Jenq; Pu, Christy

    2016-01-01

    Background Although many studies have reported that high-quality continuity of care (COC) is associated with improved patient outcomes for patients with diabetes, few studies have investigated whether this positive effect of COC depends on the level of diabetes severity. Methods A total of 3781 newly diagnosed diabetic patients selected from the 2005 National Health Insurance database were evaluated for the period 2005–2011. Generalized estimating equations combined with negative binomial estimation were used to determine the influence of COC on the overall emergency room (ER) use and diabetes mellitus (DM)-specific ER use. Analyses were stratified according to diabetes severity (measured using the Diabetes Complications Severity Index [DCSI]), comorbidities (measured using the Charlson comorbidity score), and age. Results COC effects varied according to diabetes severity. Stratified analysis showed that the positive effect of COC on DM-specific ER use was the highest for a DCSI of 0 (least severe), with an incidence rate ratio (IRR) of 0.49 (95% CI, 0.41–0.59) in the high-COC group (reference group: low-COC group). Compared with the low-COC group, high-quality COC had a significant beneficial effect on overall ER use in younger patients (IRR 0.51; 95% CI, 0.39–0.66 for the youngest [18–40 years] group, and IRR 0.67; 95% CI, 0.59–0.76 for the oldest [>65 years] group) and those with a high number of comorbidities. Conclusions The positive effects of high-quality COC on the treatment outcomes of patient with diabetes, based on the overall and DM-specific ER use, depends on the level of disease severity. Therefore, providing health education to enhance high-quality COC when the disease severity is low may be critical for ensuring optimal positive effects during diabetes disease progression. PMID:26902167

  18. A medical cost estimation with fuzzy neural network of acute hepatitis patients in emergency room.

    PubMed

    Kuo, R J; Cheng, W C; Lien, W C; Yang, T J

    2015-10-01

    Taiwan is an area where chronic hepatitis is endemic. Liver cancer is so common that it has been ranked first among cancer mortality rates since the early 1980s in Taiwan. Besides, liver cirrhosis and chronic liver diseases are the sixth or seventh in the causes of death. Therefore, as shown by the active research on hepatitis, it is not only a health threat, but also a huge medical cost for the government. The estimated total number of hepatitis B carriers in the general population aged more than 20 years old is 3,067,307. Thus, a case record review was conducted from all patients with diagnosis of acute hepatitis admitted to the Emergency Department (ED) of a well-known teaching-oriented hospital in Taipei. The cost of medical resource utilization is defined as the total medical fee. In this study, a fuzzy neural network is employed to develop the cost forecasting model. A total of 110 patients met the inclusion criteria. The computational results indicate that the FNN model can provide more accurate forecasts than the support vector regression (SVR) or artificial neural network (ANN). In addition, unlike SVR and ANN, FNN can also provide fuzzy IF-THEN rules for interpretation. PMID:26153643

  19. An Estimation for Availability of Battery less LF Band RFID Tag to Identify Patients in Operation Room from Viewpoint of Engineering

    NASA Astrophysics Data System (ADS)

    Hosaka, Ryosuke

    Nowadays, medical accidents increase in Japanese patient environment. Especially, misidentification of the patients occurred in operation room of higher level hospitals. It is considered that the great deals of accidents are due to mistakes by nurse. However, the accidents are prevented by management of patients. If a suitable patient identification system is developed, the accidents are prevented. In this study, new patient identification system using battery less LF band RFID(Radio Frequency Identification) is proposed. In the method, battery less RFID tag is attached to patient. In operation room, patient is identified before operation using the proposed system. However, identification distance of RFID is small. It is important that extension of the distance. In this study, antennas of RFID tag and sensor are designed. Two types of tag are proposed. One of them is set on wristband. An antenna for the tag is designed as a circular shape with 30mm in diameter. The other one is shaped like a necklace. The antenna is also designed 220mm, 240mm and 260mm in diameter. Using necklace type new antenna, sufficient identification distance for detection of the tag in the operation room is realized. The patient identification is realized using the proposed system

  20. Room Acoustics

    NASA Astrophysics Data System (ADS)

    Kuttruff, Heinrich; Mommertz, Eckard

    The traditional task of room acoustics is to create or formulate conditions which ensure the best possible propagation of sound in a room from a sound source to a listener. Thus, objects of room acoustics are in particular assembly halls of all kinds, such as auditoria and lecture halls, conference rooms, theaters, concert halls or churches. Already at this point, it has to be pointed out that these conditions essentially depend on the question if speech or music should be transmitted; in the first case, the criterion for transmission quality is good speech intelligibility, in the other case, however, the success of room-acoustical efforts depends on other factors that cannot be quantified that easily, not least it also depends on the hearing habits of the listeners. In any case, absolutely "good acoustics" of a room do not exist.

  1. Emergency room referral to internal medicine wards or to coronary care units of patients with first acute myocardial infarction. Israel Study Group on First Acute Myocardial Infarction.

    PubMed

    Drory, Y; Shapira, I; Goldbourt, U; Fisman, E Z; Villa, Y; Tenenbaum, A; Pines, A

    2000-01-01

    The objective of the study was to assess factors associated with ward assignment in the emergency room for patients < or = 65 years old with first acute myocardial infarction. We analysed uni- and multivariate predictors for ward assignment (coronary care unit versus internal ward). Eight major centrally located Israeli hospitals provided data during one year. The study population included 1252 patients, of whom 83% were men, 37% were hypertensives, 22% were diabetics, and 14% had previous anginal syndrome. Most patients (83%) were admitted to the coronary care unit. Internal medicine ward assignment was significantly associated with advanced age, history of hypertension or diabetes, a longer time from appearance of symptoms to arrival at the hospital, and myocardial infarction type (non-Q-wave or non-anterior). The likelihood of medical ward referral increased stepwise with the increasing number of a patient's predictive factors: those with > or = 4 factors had a > 30% chance of being assigned to a medical ward compared to a < 10% chance when there were 0-3 risk factors. Exclusion of patients with thrombolysis had no effect on the results. The shortage of cardiac care unit beds apparently leads to emergency room selection acting in detriment of patients with poorest prognoses. Clear guidelines for decision making in the emergency room are needed to resolve this paradoxical situation. PMID:10998758

  2. Genetic Similarity among One Aspergillus flavus Strain Isolated from a Patient Who Underwent Heart Surgery and Two Environmental Strains Obtained from the Operating Room

    PubMed Central

    Diaz-Guerra, Teresa M.; Mellado, Emilia; Cuenca-Estrella, Manuel; Gaztelurrutia, Lourdes; Navarro, Jose Ignacio Villate; Tudela, Juan L. Rodríguez

    2000-01-01

    We report the simultaneous isolation of one Aspergillus flavus strain from the aortic prosthesis of a heart surgery patient and another two isolates recovered from a dual-reservoir cooler-heater used in the operating room where this patient was operated on. Genetic typing of these three isolates by randomly amplified polymorphic DNA (RAPD) revealed identical genotypes. Eight unrelated control strains of A. flavus had eight different genotypes. These results clearly indicated the nosocomial origin of the A. flavus strain isolated from the patient. We suggest that the RAPD technique is a rapid and reliable tool to ascertain the epidemiology of infections caused by A. flavus. PMID:10835021

  3. Factors predicting a change in diagnosis in patients hospitalised through the emergency room: a prospective observational study

    PubMed Central

    Hautz, Stefanie C; Schuler, Luca; Kämmer, Juliane E; Schauber, Stefan K; Ricklin, Meret E; Sauter, Thomas C; Maier, Volker; Birrenbach, Tanja; Exadaktylos, Aristomenis

    2016-01-01

    Introduction Emergency rooms (ERs) generally assign a preliminary diagnosis to patients, who are then hospitalised and may subsequently experience a change in their lead diagnosis (cDx). In ERs, the cDx rate varies from around 15% to more than 50%. Among the most frequent reasons for diagnostic errors are cognitive slips, which mostly result from faulty data synthesis. Furthermore, physicians have been repeatedly found to be poor self-assessors and to be overconfident in the quality of their diagnosis, which limits their ability to improve. Therefore, some of the clinically most relevant research questions concern how diagnostic decisions are made, what determines their quality and what can be done to improve them. Research that addresses these questions is, however, still rare. In particular, field studies that allow for generalising findings from controlled experimental settings are lacking. The ER, with its high throughput and its many simultaneous visits, is perfectly suited for the study of factors contributing to diagnostic error. With this study, we aim to identify factors that allow prediction of an ER's diagnostic performance. Knowledge of these factors as well as of their relative importance allows for the development of organisational, medical and educational strategies to improve the diagnostic performance of ERs. Methods and analysis We will conduct a field study by collecting diagnostic decision data, physician confidence and a number of influencing factors in a real-world setting to model real-world diagnostic decisions and investigate the adequacy, validity and informativeness of physician confidence in these decisions. We will specifically collect data on patient, physician and encounter factors as predictors of the dependent variables. Statistical methods will include analysis of variance and a linear mixed-effects model. Ethics and dissemination The Bern ethics committee approved the study under KEK Number 197/15. Results will be published in

  4. Access to chronic disease care in general practice: the acceptability of implementing systematic waiting-room screening using computer-based patient-reported risk status

    PubMed Central

    Paul, Christine L; Carey, Mariko; Yoong, Sze Lin; D’Este, Catherine; Makeham, Meredith; Henskens, Frans

    2013-01-01

    Background Routine screening and advice regarding risky lifestyle behaviours is appropriate in the primary care setting, but often not implemented. Routine electronic collection of patients’ self-reported data may streamline the collection of such information. Aim To explore the perceptions of GPs and their attending patients regarding the acceptability of waiting-room touchscreen computers for the collection of health behaviour information. Uptake, ease of operation, and the perceived likelihood of future implementation were studied. Design and setting Cross-sectional health-risk survey. General practices in metropolitan areas in Australia. Method Practices were randomly selected by postcode. Consecutive patients who were eligible to take part in the study were approached in the waiting room and invited to do so. Participants completed the touchscreen health survey. A subsample of patients and GPs completed additional items regarding acceptability. Results Twelve general practices participated in the study, with 4058 patients (86%) and 51 of 68 (75%) GPs consenting to complete the health-risk survey, 596 patients and 30 GPs were selected to complete the acceptability survey. A majority of the 30 GPs indicated that the operation of the survey was not disruptive to practice and more than 90% of patients responded positively to all items regarding its operation. More than three-quarters of the patient sample were willing to consider allowing their responses to be kept on file and complete such surveys in the future. Conclusion As waiting-room-based collection of this information appears to be both feasible and acceptable, practitioners should consider collecting and incorporating routine patient-reported health behaviours for inclusion in the medical record. PMID:23998842

  5. Memory's Room.

    ERIC Educational Resources Information Center

    Carruthers, Mary

    1999-01-01

    Describes the Liberal Arts Studiolo from the Ducal Palace at Guibbio, Italy. Discusses how the room's design and decoration mirrors its educational uses. Notes that the object of education was to provide the young person with a kind of mental library of materials that could be drawn upon quickly. (RS)

  6. Acute myocardial imaging with TC-99m sestamibi identifies the culprit coronary artery in the emergency room assessment of patients with chest pain

    SciTech Connect

    Stowers, S.A.; Thompson, R.C.; Fulmer, H.

    1994-05-01

    Acute myocardial perfusion scintigraphy significantly increases diagnostic accuracy and provides independent predictive information in emergency room (ER) patients with typical angina and a normal or non-diagnostic ECG. We evaluated the correlation between location of perfusion defect on the acute nuclear perfusion scan and location of coronary arterial narrowing demonstrated by pre-hospital discharge coronary angiography. ER patients (n=150) with typical angina and a normal or non-diagnostic ECG had 10-30 mCi of Tc-99m Sestamibi injected while acutely symptomatic. 11 patients with a normal scan and 33 patients with an abnormal scan (total n=44) underwent pre-hospital discharge coronary angiography. Overall diagnostic accuracy in the detection of any significant ({ge}70%) angiographic stenosis was high (84%, p=.001). The diagnostic accuracy of anterior, lateral, and inferior perfusion abnormalities in the detection of significant stenosis of the left anterior descending (LAD), left circumflex (LCX), and right coronary artery (RCA), respectively was determined.

  7. Optimizing Operating Room Scheduling.

    PubMed

    Levine, Wilton C; Dunn, Peter F

    2015-12-01

    This article reviews the management of an operating room (OR) schedule and use of the schedule to add value to an organization. We review the methodology of an OR block schedule, daily OR schedule management, and post anesthesia care unit patient flow. We discuss the importance of a well-managed OR schedule to ensure smooth patient care, not only in the OR, but throughout the entire hospital. PMID:26610624

  8. Using Computer Vision and Depth Sensing to Measure Healthcare Worker-Patient Contacts and Personal Protective Equipment Adherence Within Hospital Rooms

    PubMed Central

    Chen, Junyang; Cremer, James F.; Zarei, Kasra; Segre, Alberto M.; Polgreen, Philip M.

    2016-01-01

    Background. We determined the feasibility of using computer vision and depth sensing to detect healthcare worker (HCW)-patient contacts to estimate both hand hygiene (HH) opportunities and personal protective equipment (PPE) adherence. Methods. We used multiple Microsoft Kinects to track the 3-dimensional movement of HCWs and their hands within hospital rooms. We applied computer vision techniques to recognize and determine the position of fiducial markers attached to the patient's bed to determine the location of the HCW's hands with respect to the bed. To measure our system's ability to detect HCW-patient contacts, we counted each time a HCW's hands entered a virtual rectangular box aligned with a patient bed. To measure PPE adherence, we identified the hands, torso, and face of each HCW on room entry, determined the color of each body area, and compared it with the color of gloves, gowns, and face masks. We independently examined a ground truth video recording and compared it with our system's results. Results. Overall, for touch detection, the sensitivity was 99.7%, with a positive predictive value of 98.7%. For gowned entrances, sensitivity was 100.0% and specificity was 98.15%. For masked entrances, sensitivity was 100.0% and specificity was 98.75%; for gloved entrances, the sensitivity was 86.21% and specificity was 98.28%. Conclusions. Using computer vision and depth sensing, we can estimate potential HH opportunities at the bedside and also estimate adherence to PPE. Our fine-grained estimates of how and how often HCWs interact directly with patients can inform a wide range of patient-safety research. PMID:26949712

  9. Using Computer Vision and Depth Sensing to Measure Healthcare Worker-Patient Contacts and Personal Protective Equipment Adherence Within Hospital Rooms.

    PubMed

    Chen, Junyang; Cremer, James F; Zarei, Kasra; Segre, Alberto M; Polgreen, Philip M

    2016-01-01

    Background.  We determined the feasibility of using computer vision and depth sensing to detect healthcare worker (HCW)-patient contacts to estimate both hand hygiene (HH) opportunities and personal protective equipment (PPE) adherence. Methods.  We used multiple Microsoft Kinects to track the 3-dimensional movement of HCWs and their hands within hospital rooms. We applied computer vision techniques to recognize and determine the position of fiducial markers attached to the patient's bed to determine the location of the HCW's hands with respect to the bed. To measure our system's ability to detect HCW-patient contacts, we counted each time a HCW's hands entered a virtual rectangular box aligned with a patient bed. To measure PPE adherence, we identified the hands, torso, and face of each HCW on room entry, determined the color of each body area, and compared it with the color of gloves, gowns, and face masks. We independently examined a ground truth video recording and compared it with our system's results. Results.  Overall, for touch detection, the sensitivity was 99.7%, with a positive predictive value of 98.7%. For gowned entrances, sensitivity was 100.0% and specificity was 98.15%. For masked entrances, sensitivity was 100.0% and specificity was 98.75%; for gloved entrances, the sensitivity was 86.21% and specificity was 98.28%. Conclusions.  Using computer vision and depth sensing, we can estimate potential HH opportunities at the bedside and also estimate adherence to PPE. Our fine-grained estimates of how and how often HCWs interact directly with patients can inform a wide range of patient-safety research. PMID:26949712

  10. Basement utility room (room 24; air handling room), near the ...

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

    Basement utility room (room 24; air handling room), near the west end of the combat operations center, looking southwest towards fan system one, air ducts, and walk-in filter rooms. The exterior equipment well is visible at the left - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  11. Assessing Patient Exposure to a Video-Based Intervention in STD Clinic Waiting Rooms: Findings From the Safe in the City Trial.

    PubMed

    Besera, Ghenet T; Cox, Shanna; Malotte, C Kevin; Rietmeijer, Cornelis A; Klausner, Jeffrey D; O'Donnell, Lydia; Margolis, Andrew D; Warner, Lee

    2016-09-01

    Safe in the City, a video intervention for clinic waiting rooms, was previously shown to reduce sexually transmitted disease (STD) incidence. However, little is known about patients' recall of exposure to the intervention. Using data from a nested study of patients attending clinics during the trial, we assessed whether participants recalled Safe in the City, and, if so, how the intervention affected subsequent attitudes and behaviors. Analyses were restricted to responses to a 3-month follow-up questionnaire among participants who were exposed to the video (n = 708). Impact was measured as participants' reports of the video's effect on behaviors and attitudes. Associations were evaluated using multivariable logistic regression. Of participants who were exposed, 685 (97%) recalled viewing the video, and 68% recalled all three vignettes. After watching the video, participants felt more positive about condoms (69%) and comfortable acquiring condoms (56%), were reminded of important information about STDs and condoms (90%), and tried to apply what they learned to their lives (59%). Compared with those who recalled viewing one or two vignettes, participants who recalled viewing all three vignettes reported more positive attitudes toward condoms and peer/provider communication. These findings demonstrate that a low-resource video intervention for waiting rooms can provide sufficient exposure to positively influence STD-related attitudes/behaviors. PMID:27091608

  12. A simplified way for the urgent treatment of somatic pain in patients admitted to the emergency room: the SUPER algorithm.

    PubMed

    Franceschi, Francesco; Marsiliani, Davide; Alesi, Andrea; Mancini, Maria Grazia; Ojetti, Veronica; Candelli, Marcello; Gabrielli, Maurizio; D'Aurizio, Gabriella; Gilardi, Emanuele; Adducci, Enrica; Proietti, Rodolfo; Buccelletti, Francesco

    2015-12-01

    Somatic pain is one of the most frequent symptoms reported by patients presenting to the emergency department (ED), but, in spite of this, it is very often underestimated and under-treated. Moreover, pain-killers prescriptions are usually related to the medical examination, leading to a delay in its administration, thus worsening the patient's quality of life. With our study, we want to define and validate a systematic and homogeneous approach to analgesic drugs administration, testing a new therapeutic algorithm in terms of earliness, safety, and efficacy. 442 consecutive patients who accessed our ED for any kind of somatic pain were enrolled, and then randomly divided into two groups: group A follow the normal process of access to pain-control drugs, and group B follow our SUPER algorithm for early administration of drugs to relieve pain directly from triage. We excluded from the study, patients with abdominal pain referred to the surgeon, patients with headache, recent history of trauma, history of drug allergies, and life-threatening conditions or lack of cooperation. Drugs used in the study were those available in our ED, such as paracetamol, paracetamol/codeine, ketorolac-tromethamine, and tramadol-hydrochloride. Pain level, risk factors, indication, and contraindication of each drug were taken into account in our SUPER algorithm for a rapid and safe administration of it. The Verbal Numeric Scale (VNS) and the Visual Analog Scale (VAS) were used to verify the patient's health and perception of it. Only 59 patient from group A (27.1 %) received analgesic therapy (at the time of the medical examination) compared to 181 patients (100 %) of group B (p < 0.001). Group B patients, received analgesic therapy 76 min before group A subjects (p < 0.01), resulting in a significant lower VNS (7.31 ± 1.68 vs 4.75 ± 2.3; p < 0.001), and a superior VAS after discharge (54.43 ± 22.16 vs 61.30 ± 19.13; p < 0.001) compared to group A subjects. No significant differences

  13. Assessment of DICOM Viewers Capable of Loading Patient-specific 3D Models Obtained by Different Segmentation Platforms in the Operating Room.

    PubMed

    Lo Presti, Giuseppe; Carbone, Marina; Ciriaci, Damiano; Aramini, Daniele; Ferrari, Mauro; Ferrari, Vincenzo

    2015-10-01

    Patient-specific 3D models obtained by the segmentation of volumetric diagnostic images play an increasingly important role in surgical planning. Surgeons use the virtual models reconstructed through segmentation to plan challenging surgeries. Many solutions exist for the different anatomical districts and surgical interventions. The possibility to bring the 3D virtual reconstructions with native radiological images in the operating room is essential for fostering the use of intraoperative planning. To the best of our knowledge, current DICOM viewers are not able to simultaneously connect to the picture archiving and communication system (PACS) and import 3D models generated by external platforms to allow a straight integration in the operating room. A total of 26 DICOM viewers were evaluated: 22 open source and four commercial. Two DICOM viewers can connect to PACS and import segmentations achieved by other applications: Synapse 3D® by Fujifilm and OsiriX by University of Geneva. We developed a software network that converts diffuse visual tool kit (VTK) format 3D model segmentations, obtained by any software platform, to a DICOM format that can be displayed using OsiriX or Synapse 3D. Both OsiriX and Synapse 3D were suitable for our purposes and had comparable performance. Although Synapse 3D loads native images and segmentations faster, the main benefits of OsiriX are its user-friendly loading of elaborated images and it being both free of charge and open source. PMID:25739346

  14. The person in the room: how relating holistically contributes to an effective patient-care provider alliance.

    PubMed

    Penner, Leslie A; Roger, Kerstin

    2012-01-01

    The purpose of this paper is to explore how relating to the 'whole' person--both the physical body and the invisible aspects of the 'self'--is essential in the establishment of a strong therapeutic alliance between patients and health care providers. Our work is based on interviews conducted with individuals affected by neurological illnesses (patients and family care providers). Hsieh and Shannon's (2005) conventional content analysis was used to analyze the data. Under the broad theme of 'maintaining a coherent sense of self' we identified four distinct sub-themes related to interactions with health care providers. The results elucidate the more complex and deep needs of patients who must access care on an ongoing basis, and highlight the important role that care providers play in supporting individuals who are experiencing physical, spiritual and social losses. Care must attend to the deep needs of these individuals by communicating in a style that addresses both emotional and cognitive needs of patients, by thorough and holistic assessment and by appropriate referrals. PMID:23763236

  15. Pharmacological primary and secondary cardiovascular prevention among diabetic patients in a multiethnic general practice population: still room for improvements

    PubMed Central

    2013-01-01

    Background Ethnic minority groups have higher prevalence of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). We assessed general practitioners’ (GPs’) performance with respect to the pharmacological prevention of CVD in patients with T2DM from different ethnic backgrounds in Oslo. Methods Of 1653 T2DM patients cared for by 49 GPs in 2005, 380 had a diagnosis of CVD. Ethnicity was categorized as Norwegian, South Asian and other. Risk factor levels, medication use, achievement of treatment targets (HbA1c ≤ 7.5%, systolic blood pressure (SBP) ≤ 140 mmHg, total cholesterol/HDL-cholesterol < 4) and therapeutic intensity (number of drugs targeting each risk factor) were recorded. Chi-square, Wald tests and multiple linear regression analyses were used. Results Of the 1273 patients receiving primary prevention, 1.5% had their Hb1Ac, 4.8% SBP and 12.7% lipids levels above treatment thresholds without relevant prescriptions. Among patients on pharmacological therapy, 66% reached the HbA1c, 62% SBP and 62% lipid target. Proportions not achieving the HbA1c target were 26% in Norwegians, 38% in South Asians and 29% in others (p = 0.008). Proportions not achieving the SBP target were 42% in Norwegians, 22% in South Asians and 25% in others (p ≤ 0.001). Of those not achieving the HbA1c and SBP targets, 43% and 35% respectively, used only one agent. In secondary prevention, 0.8% of the patients had their HbA1c, 0.5% SBP and 7.4% lipid levels above treatment thresholds without relevant prescriptions. Among patients on pharmacological therapy, 65% reached the HbA1c, 64% SBP and 66% lipid target. Proportions not achieving the HbA1c target were 26% in Norwegians, 47% in South Asians and 40% in others (p = 0.03). Proportions not achieving the SBP target were 36% in Norwegians, 22% in South Asians and 56% in others (p = 0.050). Of those not achieving HbA1c and SBP targets, 49% and 21% respectively, were on mono-therapy. Conclusions Norwegian GPs comply

  16. Mutagenicity of inhalation anaesthetics studied by the sister chromatid exchange test in lymphocytes of patients and operating room personnel.

    PubMed

    Husum, B

    1987-06-01

    Retrospective studies have indicated that operating room personnel may have increased risks of spontaneous abortion, congenital malformations in offspring, and cancer (Cohen et al 1980, Buring et al 1985). Occupational exposure to waste anaesthetic gases may be responsible for these possible adverse health effects, but a cause-effect relationship has never been proved. Induction of changes in the DNA in the chromosomes leading to mutations may play a role in teratogenicity and carcinogenicity. Along with an increasing concern in society regarding occupational diseases and working and living environment in general, cytogenetic methods have been developed for rapid detection of potential mutagenicity in vitro of chemical agents. One such method is the SCE test, which is based on examination of sister chromatid exchanges (SCEs), i.e. exchanges of chromatid-segments between the two chromatids in a chromosome, during cell replication. SCEs are not mutations, but an increased frequency of SCE is a sensitive indicator of exposure to agents that are capable of producing damage to the DNA and thus possibly mutations. In vitro tests like the SCE test are very useful for evaluation of specific chemical agents, which may be added to the culture in known concentrations. In studies of possible hazards from chemical agents in the working or living environment, the exposure is often poorly defined. Also, biotransformation may be different in different species, and the duration and the level of the exposure may play a role. Examination of SCEs is, therefore, increasingly performed directly on human lymphocytes from peripheral blood. Thus, although the examination of SCEs is still performed in vitro, the exposure has taken place in vivo. Increased SCE levels are then regarded as a non-specific indicator that the donor has been exposed to potentially mutagenic agents in the environment. The author and his associates used the SCE test to investigate the possible mutagenicity of

  17. [From a Service to a Brand: TUR-Room Inspection, Patient Journals, After-Sales Greetings in the Witten Marketing Concept].

    PubMed

    Wiedemann, A; Gellisch, O; Abrolat, J; Füsgen, I; Heppner, H J

    2015-05-01

    Marketing in economic systems means to create a brand in a competitive surrounding to serve customers as a target. Thereby, elements of marketing are product policy and pricing as well as distribution. Due to the fact that not only products and services are almost not modifiable at all and that price variation is impossible due to the DRG system but also common distribution channels, such as retail or wholesale, are prohibited, the fist mentioned marketing elements are of special importance. Primary customers are the referring physicians who are well served by medical education or presentations, which belong to the common facilities of a hospital department. Nowadays one can observe an increasing mobility of patients and an increasing willingness to inform themselves about medical topics and the service provider behind them. In conclusion, the maintenance of patients is a growing field for the economic success of a hospital or a hospital department. The marketing elements are ruled by the "Heilmittelwerbegesetz" and must fulfill the standards which are defined by this statute. Patient´s journals, a guided tour around the procedure rooms with technical equipment, an after-sales postcard and the participation in events not only with medical contents, such as fairs, can help to steadily establish an image, for example, as an ambitious and caring service provider. PMID:26077302

  18. Pharmacological Management of Elderly Patients with Asthma-Chronic Obstructive Pulmonary Disease Overlap Syndrome: Room for Speculation?

    PubMed

    Castiglia, Daniela; Battaglia, Salvatore; Benfante, Alida; Sorino, Claudio; Scichilone, Nicola

    2016-06-01

    Asthma and chronic obstructive pulmonary disease (COPD) are two distinct diseases that share a condition of chronic inflammation of the airways and bronchial obstruction. In clinical settings, it is not rare to come across patients who present with clinical and functional features of both diseases, posing a diagnostic dilemma. The overlap condition has been termed asthma-COPD overlap syndrome (ACOS), and mainly occurs in individuals with long-standing asthma, especially if they are also current or former smokers. Patients with ACOS have poorer health-related quality of life and a higher exacerbation rate than subjects with asthma or COPD alone. Whether ACOS is a distinct nosological entity with genetic variants or rather a condition of concomitant diseases that overlap is still a matter of debate. However, there is no doubt that extended life expectancy has increased the prevalence of asthma and COPD in older ages, and thus the probability that overlap conditions occur in clinical settings. In addition, age-associated changes of the lung create the basis for the two entities to converge on the same subject. ACOS patients may benefit from a stepwise treatment similar to that of asthma and COPD; however, the proposed therapeutic algorithms are only speculative and extrapolated from studies that are not representative of the ACOS population. Inhaled corticosteroids are the mainstay of therapy, and always in conjunction with long-acting bronchodilators. The potential heterogeneity of the overlap syndrome in terms of inflammatory features (T helper-1 vs. T helper-2 pathways) may be responsible for the different responses to treatments. The interaction between respiratory drugs and concomitant diseases should be carefully evaluated. Similarly, the effect of non-respiratory drugs, such as aspirin, statins, and β-blockers, on lung function needs to be properly assessed. PMID:27138954

  19. One-year follow-up of neurological status of patients after cardiac arrest seen at the emergency room of a teaching hospital

    PubMed Central

    Vancini-Campanharo, Cássia Regina; Vancini, Rodrigo Luiz; de Lira, Claudio Andre Barbosa; Lopes, Maria Carolina Barbosa Teixeira; Okuno, Meiry Fernanda Pinto; Batista, Ruth Ester Assayag; Atallah, Álvaro Nagib; de Góis, Aécio Flávio Teixeira

    2015-01-01

    ABSTRACT Objective: To describe neurological status and associated factors of survivors after cardiac arrest, upon discharge, and at 6 and 12 month follow-up. Methods: A cohort, prospective, descriptive study conducted in an emergency room. Patients who suffered cardiac arrest and survived were included. A one-year consecutive sample, comprising 285 patients and survivors (n=16) followed up for one year after discharge. Neurological status was assessed by the Cerebral Performance Category before the cardiac arrest, upon discharge, and at 6 and 12 months after discharge. The following factors were investigated: comorbidities, presence of consciousness upon admission, previous cardiac arrest, witnessed cardiac arrest, location, cause and initial rhythm of cardiac arrest, number of cardiac arrests, interval between collapse and start of cardiopulmonary resuscitation, and between collapse and end of cardiopulmonary resuscitation, and duration of cardiopulmonary resuscitation. Results: Of the patients treated, 4.5% (n=13) survived after 6 and 12 months follow-up. Upon discharge, 50% of patients remained with previous Cerebral Performance Category of the cardiac arrest and 50% had worsening of Cerebral Performance Category. After 6 months, 53.8% remained in the same Cerebral Performance Category and 46.2% improved as compared to discharge. After 12 months, all patients remained in the same Cerebral Performance Category of the previous 6 months. There was no statistically significant association between neurological outcome during follow-up and the variables assessed. Conclusion: There was neurological worsening at discharge but improvement or stabilization in the course of a year. There was no association between Cerebral Performance Category and the variables assessed. PMID:26154538

  20. Management Overview: Taking a Patient with Intracranial Hemorrhage Related to Direct Oral Anticoagulants to the Operating Room.

    PubMed

    Alturki, Abdulrahman; Alamri, Abdullah; Badawy, Mohamed; Teitelbaum, Jeanne

    2016-06-01

    Options for anticoagulation have been expanding constantly during the past few years, providing a greater number of agents for prevention and management of thromboembolic disease. Although heparins and vitamin K antagonists (VKAs) has been used extensively for many decades, their narrow therapeutic range, interactions with other medications and food, and the need for routine monitoring of blood levels have led to the search for less problematic alternatives. Direct oral anticoagulants represent an important advance in anticoagulation therapy, directly inhibiting thrombin (dabigatran) or factor Xa (rivaroxaban, apixaban) they represent an effective and safe alternatives to VKAs and heparins in the prevention and treatment of several thromboembolic disorders. DOCAs are associated with a low overall intracranial hemorrhage risk; however, life-threatening bleeding can occur. Reversal agents are approved for some and under development for others, concerns over the lack of antidotes or difficulty in obtaining them has tempered enthusiasm for their use because of the perception of better safety with heparins and VKAs as a result of the availability of effective reversal strategies. Appropriate use of these agents requires knowledge of their individual characteristics, mechanisms of action, pharmacokinetics, ways of monitoring, and when needed, manage patients in need of urgent surgery especially in life-threatening bleeds. This article provides a suggested comprehensive approach to manage patients with intracranial hemorrhage while on direct oral anticoagulants who require an urgent surgical intervention and who cannot wait for plasma concentration to decline. PMID:26960279

  1. Clinical Outcomes for Breast Cancer Patients Undergoing Mastectomy and Reconstruction with Use of DermACELL, a Sterile, Room Temperature Acellular Dermal Matrix

    PubMed Central

    Vashi, Christopher

    2014-01-01

    Background. Decellularized human skin has been used in a variety of medical applications, primarily involving soft tissue reconstruction, wound healing, and tendon augmentation. Theoretically, decellularization removes potentially immunogenic material and provides a clean scaffold for cellular and vascular in growth. The use of acellular dermal matrix in two-stage postmastectomy breast reconstruction is described. Methods. Ten consecutive breast cancer patients were treated with mastectomies and immediate reconstruction from August to November 2011. There were 8 bilateral and 1 unilateral mastectomies for a total of 17 breasts, with one exclusion for chronic tobacco use. Reconstruction included the use of a new 6 × 16 cm sterile, room temperature acellular dermal matrix patch (DermACELL) soaked in a cefazolin bath. Results. Of the 17 breasts, 15 reconstructions were completed; 14 of them with expander to implant sequence and acellular dermal matrix. Histological analysis of biopsies obtained during trimming of the matrix at the second stage appeared nonremarkable with evidence of normal healing, cellularity, and vascular infiltration. Conclusion. Postoperative observations showed that this cellular dermal matrix appears to be an appropriate adjunct to reconstruction with expanders. This acellular dermal matrix appeared to work well with all patients, even those receiving postoperative chemotherapy, postoperative radiation, prednisone, or warfarin sodium. PMID:24738030

  2. Pentraxin 3 (PTX3) Is Associated with Severe Sepsis and Fatal Disease in Emergency Room Patients with Suspected Infection: A Prospective Cohort Study

    PubMed Central

    Uusitalo-Seppälä, Raija; Huttunen, Reetta; Aittoniemi, Janne; Koskinen, Pertti; Leino, Aila; Vahlberg, Tero; Rintala, Esa M.

    2013-01-01

    Background Early diagnostic and prognostic stratification of patients with suspected infection is a difficult clinical challenge. We studied plasma pentraxin 3 (PTX3) upon admission to the emergency department in patients with suspected infection. Methods The study comprised 537 emergency room patients with suspected infection: 59 with no systemic inflammatory response syndrome (SIRS) and without bacterial infection (group 1), 67 with bacterial infection without SIRS (group 2), 54 with SIRS without bacterial infection (group 3), 308 with sepsis (SIRS and bacterial infection) without organ failure (group 4) and 49 with severe sepsis (group 5). Plasma PTX3 was measured on admission using a commercial solid-phase enzyme-linked immunosorbent assay (ELISA). Results The median PTX3 levels in groups 1–5 were 2.6 ng/ml, 4.4 ng/ml, 5.0 ng/ml, 6.1 ng/ml and 16.7 ng/ml, respectively (p<0.001). The median PTX3 concentration was higher in severe sepsis patients compared to others (16.7 vs. 4.9 ng/ml, p<0.001) and in non-survivors (day 28 case fatality) compared to survivors (14.1 vs. 5.1 ng/ml, p<0.001). A high PTX3 level predicted the need for ICU stay (p<0.001) and hypotension (p<0.001). AUCROC in the prediction of severe sepsis was 0.73 (95% CI 0.66–0.81, p<0.001) and 0.69 in case fatality (95% CI 0.58–0.79, p<0.001). PTX3 at a cut-off level for 14.1 ng/ml (optimal cut-off value for severe sepsis) showed 63% sensitivity and 80% specificity. At a cut-off level 7.7 ng/ml (optimal cut-off value for case fatality) showed 70% sensitivity and 63% specificity in predicting case fatality on day 28.In multivariate models, high PTX3 remained an independent predictor of severe sepsis and case fatality after adjusting for potential confounders. Conclusions A high PTX3 level on hospital admission predicts severe sepsis and case fatality in patients with suspected infection. PMID:23341967

  3. Smartphones in the Operating Room: Distraction or Diagnostic Aid? A Case of Newly Diagnosed Wolff-Parkinson White in a Pediatric Patient Having Bronchoscopy Under General Anesthesia.

    PubMed

    Esenther, Brandon; Ko, Riva

    2015-08-01

    A 4-year-old boy presented for elective bronchoscopy after years of pharmacologically unresponsive reactive airway disease that limited physical activity. After mask induction with nitrous oxide and sevoflurane, the patient was noted to be intermittently in a hemodynamically stable tachyarrhythmia. The anesthesia machine, though equipped with electrocardiogram (ECG) recording capabilities, malfunctioned during the case and was not able to print a rhythm strip. As a substitute, a smartphone picture and video were recorded. In the recovery room, initial 12-lead ECG showed sinus tachycardia. Shortly after, a presumptive diagnosis of Wolff-Parkinson White was given upon review of the smartphone recordings by the pediatric cardiologist on service. Twelve lead ECG was repeated which showed intermittent Wolff-Parkinson White. This case highlights 2 points. First, any prolonged or sustained pediatric dysrhythmia revealed during anesthesia warrants further investigation and should not be assumed secondary to an anesthetic drug. Second, ubiquitous smartphones are an excellent tool for capturing data that the monitor is unable to capture. PMID:26230306

  4. Does prewarming the i-gel supraglottic airway device fit the larynx better compared to keeping it at room temperature for non-paralysed, sedated patients: a randomised controlled trial

    PubMed Central

    Komasawa, Nobuyasu; Nishihara, Isao; Tatsumi, Shinichi; Minami, Toshiaki

    2015-01-01

    Objective This study aimed to test the hypothesis that the i-gel supraglottic airway device would fit the larynx and provide better sealing pressure if prewarmed to 42°C relative to the device kept at room temperature in non-paralysed, sedated patients. Methods A total of 74 adult patients were assigned to the warm (i-gel prewarmed to 42°C; W group; 37 patients) or the control (i-gel kept at room temperature; C group; 37 patients) groups. Anaesthesia was induced with propofol and fentanyl. The i-gel was prewarmed to 42°C for 30 min before insertion in the W group, but kept at room temperature (approximately 23°C) for the C group. The number of attempts made until successful insertion and sealing pressure were compared between the two groups. Results Insertion was successful with one attempt in 35 cases each for the W and C groups. Two attempts were needed in two cases for the W group and one case for the C group. There was one failed attempt in the C group, but none in the W group. None of the differences between the two groups were significant (p=0.51). Sealing pressure was slightly, but not significantly, higher in the W group than in the C group (W group 22.6±6.1 cm H2O; C group 20.7±6.1 cm H2O; p=0.15). Conclusions Prewarming of the i-gel to 42°C did not increase the success rate of insertion, nor did it significantly increase sealing pressure in anaesthetised, non-paralysed patients. Our data suggest that we can keep the i-gel at room temperature for emergency airway management for non-paralysed, sedated patients. Trial registration number University Medical Information Network, Japan 000012287. PMID:25586372

  5. The vascular hybrid room--operating room of the future.

    PubMed

    Hudorović, Narcis; Rogan, Suncica Andreja; Lovricević, Ivo; Zovak, Mario; Schmidt, Sasa

    2010-09-01

    The last two decades have seen a paradigm shift in the treatment of vascular related diseases from once traditional open surgical repairs to the entire vascular tree being amenable to percutaneous interventions. Neither the classic operating room nor the conventional angiography suite is optimal for both open surgery and endovascular procedures. Important issues for the vascular hybrid operating room include quality of the imaging equipment, radiation burden, ease of use of the equipment, need for specially trained personnel, ergonomics, ability to perform both open and percutaneous procedures, sterile environments, as well as quality and efficiency of patient care. The most important feature of working in a dedicated hybrid vascular suite should be the ability to attain best treatment of vascular patients. Whether the interventional radiologist or the vascular surgeon uses the facilities is of less importance. Establishment of an endovascular operating room suite has the benefit of a sterile environment, and the possibility of performing hybrid procedures and conversions when necessary. Moreover, angiography immediately before treatment gives contemporary anatomical information, and after treatment provides quality control. Consequently, better quality and service can be provided to the individual patient. These changes in the treatment of vascular disease require that a new type of vascular specialist, named 'vascular hybrid surgeon', trained to perform both endovascular and open surgical procedures in this highly complex patient group. PMID:21462818

  6. The virtual gamma camera room.

    PubMed

    Penrose, J M; Trowbridge, E A; Tindale, W B

    1996-05-01

    The installation of a gamma camera is time-consuming and costly and, once installed, the camera position is unlikely to be altered during its working life. Poor choice of camera position therefore has long-term consequences. Additional equipment such as collimators and carts, the operator's workstation and wall-mounted display monitors must also be situated to maximize access and ease of use. The layout of a gamma camera room can be optimized prior to installation by creating a virtual environment. Super-Scape VRT software running on an upgraded 486 PC microprocessor was used to create a 'virtual camera room'. The simulation included an operator's viewpoint and a controlled tour of the room. Equipment could be repositioned as required, allowing potential problems to be identified at the design stage. Access for bed-ridden patients, operator ergonomics, operator and patient visibility were addressed. The display can also be used for patient education. Creation of a virtual environment is a valuable tool which allows different camera systems to be compared interactively in terms of dimensions, extent of movement and use of a defined space. Such a system also has applications in radiopharmacy design and simulation. PMID:8736511

  7. The Upstairs Room - Room for Controversy?

    ERIC Educational Resources Information Center

    Poole, Mary F.

    1973-01-01

    Doubtless everyone is tired of the subject of censorship; but I do have to give vent to my feelings when they are as intense as they are over the selection of a book as full of profanity as a Newbery honor book ( The Upstairs Room''). (Author/SM)

  8. Clean room wiping liquids

    SciTech Connect

    Harding, W.B.

    1991-12-01

    A water-based liquid containing isopropyl alcohol, ammonium hydroxide, and surfactants was developed to replace 1,1,2-trichlorotrifluoroethane for the dampening of clean room wiping cloths used to wipe clean benches, clean room equipment, and latex finger cots and gloves.

  9. Unlocking the Locker Room.

    ERIC Educational Resources Information Center

    St. Clair, Dean

    1996-01-01

    Discusses locker-room design standards and common challenges when complying with the Americans with Disabilities Act. Accessibility and safety considerations for shower, toilet, and locker areas are addressed, as are entrance vestibules, drying and grooming areas, and private dressing rooms. (GR)

  10. Fludarabine, cyclophosphamide and horse antithymocyte globulin conditioning regimen for allogeneic peripheral blood stem cell transplantation performed in non-HEPA filter rooms for multiply transfused patients with severe aplastic anemia.

    PubMed

    Kumar, R; Prem, S; Mahapatra, M; Seth, T; Chowdhary, D R; Mishra, P; Pillai, L; Narendra, A M V R; Mehra, N K; Saxena, R; Choudhry, V P

    2006-04-01

    Multiply transfused patients of severe aplastic anemia are at increased risk of graft rejection. Five such patients underwent peripheral blood stem cell transplantation from HLA-identical siblings with a fludarabine-based protocol. The conditioning consisted of fludarabine 30 mg/m(2)/day x 6 days, cyclophosphamide 60 mg/kg/day x 2 days and horse antithymocyte globulin (ATG) x 4 days. Two different ATG preparations were used: ATGAM (dose 30 mg/kg/day x 4 days) or Thymogam (dose 40 mg/kg/day x 4 days). Engraftment: median time to absolute neutrophil count (ANC) >0.5 x 10(9)/l was 11 days (range: 8-17) and median time to platelet count >20 x 10(9)/l was 11 days (range: 9-17). At a median follow-up of 171 days (range: 47-389), there has been no graft rejection and all patients are in complete remission. Acute GVHD (grade 1) occurred in one patient only. Chronic GVHD developed in two patients (extensive in one and limited in another). The transplants were performed in non-HEPA filter rooms. In only one patient, systemic antifungal therapy (voriconazole) was used. The use of Thymogam brand of ATG for conditioning is being reported for the first time. Our experience suggests that this fludarabine-based protocol allows rapid sustained engraftment in high-risk patients without significant immediate toxicity. PMID:16518427

  11. Interior. Balance room for chemistry laboratory. Storage room for glassware ...

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

    Interior. Balance room for chemistry laboratory. Storage room for glassware and reference room with frequently used chemistry and chemical engineering texts. - Thomas A. Edison Laboratories, Building No. 2, Main Street & Lakeside Avenue, West Orange, Essex County, NJ

  12. Central room (delivery room on plan) between the east and ...

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

    Central room (delivery room on plan) between the east and west reading rooms, showing built-in card catalog drawers. View to south. - Sacramento Junior College, Library, 3835 Freeport Boulevard, Sacramento, Sacramento County, CA

  13. 15. Readiness Crew Building interior, Room 105, former briefing room, ...

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

    15. Readiness Crew Building interior, Room 105, former briefing room, looking northwest. Projection room in at the back wall. Thalheimer - Whiteman Air Force Base, Bomber Alert Facility S-6, 1300 Alert Road, Knob Noster, Johnson County, MO

  14. NCI Grant Resources Room

    Cancer.gov

    If you’re interested in information about NCI grants, visit the Grant Resources Room. You can talk to NCI staff about grant application and review processes, and even schedule a one-on-one consultation.

  15. The effects of warmed intravenous fluids, combined warming (warmed intravenous fluids with humid-warm oxygen), and pethidine on the severity of shivering in general anesthesia patients in the recovery room

    PubMed Central

    Nasiri, Ahmad; Akbari, Ayob; Sharifzade, GholamReza; Derakhshan, Pooya

    2015-01-01

    Background: Shivering is a common complication of general and epidural anesthesia. Warming methods and many drugs are used for control of shivering in the recovery room. The present study is a randomized clinical trial aimed to investigate the effects of two interventions in comparison with pethidine which is the routine treatment on shivering in patients undergoing abdominal surgery with general anesthesia. Materials and Methods: Eighty-seven patients undergoing abdominal surgery by general anesthesia were randomly assigned to three groups (two intervention groups in comparison with pethidine as routine). Patients in warmed intravenous fluids group received pre-warmed Ringer serum (38°C), patients in combined warming group received pre-warmed Ringer serum (38°C) accompanied by humid-warm oxygen, and patients in pethidine group received intravenous pethidine routinely. The elapsed time of shivering and some hemodynamic parameters of the participants were assessed for 20 min postoperatively in the recovery room. Then the collected data were analyzed by software SPSS (v. 16) with the significance level being P < 0.05. Results: The mean of elapsed time in the warmed intravenous serum group, the combined warming group, and the pethidine group were 7 (1.5) min, 6 (1.5) min, and 2.8 (0.7) min, respectively, which was statistically significant (P < 0.05). The body temperatures in both combined warming and pethidine groups were increased significantly (P < 0.05). Conclusions: Combined warming can be effective in controlling postoperative shivering and body temperature increase. PMID:26793258

  16. Wash room, bunkhouse, first floor interior. This room is a ...

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

    Wash room, bunkhouse, first floor interior. This room is a screened porch with the original sinks extant. Light and ventilation was borrowed from the wash room into the toilets and bathing rooms. - Sespe Ranch, Bunkhouse, 2896 Telegraph Road, Fillmore, Ventura County, CA

  17. Pharmacy practice in an operating room complex.

    PubMed

    Evans, D M; Guenther, A M; Keith, T D; Lazarus, H L

    1979-10-01

    The steps involved in establishing a comprehensive pharmaceutical service in an operating and recovery room complex is described. Objectives of the operating room pharmaceutical satellite were to: (1) improve control of distribution, storage and charging for all drugs, especially Schedule II controlled substances; (2) reduce inventory costs and loss of revenue; (3) improve compliance with the drug formulary; and (4) establish patient-oriented pharmaceutical services. The pharmacy satellite improved inventory control and patient charging, assured continual access to all drugs and appropriate security for controlled substances, and expanded the pharmacy department's clinical, drug information and research activities. PMID:507076

  18. Technology Equipment Rooms.

    ERIC Educational Resources Information Center

    Day, C. William

    2001-01-01

    Examines telecommunications equipment room design features that allow for growth and can accommodate numerous equipment replacements and upgrades with minimal service disruption and with minimal cost. Considerations involving the central hub, power and lighting needs, air conditioning, and fire protection are discussed. (GR)

  19. Visiting Room 501

    ERIC Educational Resources Information Center

    Curwen, Margaret Sauceda

    2009-01-01

    Students in Room 501 were exploring and negotiating their lives as transnational citizens. In a globalized world of instantaneous information and communication, Latino students are shaping, morphing, and evolving into a new generation. This study highlights one group of students who were aspiring toward middle class, which is not the typical…

  20. Rooms with a View

    ERIC Educational Resources Information Center

    Hourihan, Peter; Berry, Millard, III

    2006-01-01

    When well-designed and integrated into a campus living or learning space, an atrium can function as the heart and spirit of a building, connecting interior rooms and public spaces with the outside environment. However, schools and universities should seek technological and HVAC solutions that maximize energy efficiency. This article discusses how…

  1. Detention Room Counseling

    ERIC Educational Resources Information Center

    Salem, Terry

    1973-01-01

    This article describes how the detention room in one school system was changed in favor of group counseling sessions. In the counseling sessions, the counselors could aid students in identifying the problems which disturb them in order to improve self-understanding and status in school. (JC)

  2. Six-item self-administered questionnaires in the waiting room: an aid to explain uncontrolled hypertension in high-risk patients seen in general practice.

    PubMed

    Mulazzi, Isabelle; Cambou, Jean Pierre; Girerd, Xavier; Nicodeme, Robert; Chamontin, Bernard; Amar, Jacques

    2009-01-01

    We designed a cross-sectional study to determine whether 6-item self-administered questionnaires addressing difficulties in taking treatment provide independent and relevant information on uncontrolled hypertension in high-risk cardiovascular patients seen in general practice. Patients with both treated hypertension and a history of vascular diseases-myocardial infarction, stroke, or peripheral artery disease-were included. Risk factors, treatment, history of vascular diseases, blood pressure, and difficulties in taking treatment were assessed by 6-item self-administered questionnaires and recorded. Each positive response to the questions was weighted by 1 and each negative response by 0. Individual item scores were added together to produce 1 composite score for all 6 questions. A total of 11,096 patients were analyzed. Among them, 5,288 (51.4%) were controlled at 140/90 mm Hg threshold. In multivariate analysis, in addition to age, male gender, treated diabetes, peripheral artery disease, treatment, and alcohol consumption, the adherence score was negatively and independently associated with hypertension control (odds ratio score >/= 3, 0.73; [95% confidence interval, 0.65-0.81; P < .0001]. This study overwhelmingly confirms on a very large scale the effectiveness of this self-administered questionnaire in identifying difficulties in taking treatment in general practice. This questionnaire constitutes an inexpensive and timesaving tool capable of helping general practitioners to understand why hypertension is not controlled in patients at high cardiovascular risk. Whether the use of this questionnaire will improve hypertension control remains to be established. PMID:20409962

  3. Clean room wiping cloths

    SciTech Connect

    Harding, W.B.

    1981-01-01

    The suitability of various fabrics for use as clean room wiping cloths was investigated. These fabrics included knit polyester, knit nylon, urethane foam, woven cotton, nonwoven polyester, nonwoven rayon, nonwoven polyethylene and polypropylene, and woven nylon. These materials were tested for detachable lint and fibers, deterioration, and oil content which could leave contaminating films on wiped surfaces. Well-laundered nylon and polyester cloths knitted from filamentary yarn, with hems, were found to be suitable. (LCL)

  4. [Virtual room of gastroenterology].

    PubMed

    Spinelli, Osvaldo Mateo; Fittipaldi, Mónica Elsa; Henderson, Eduardo; Krabshuis, Justus Hendrik

    2010-12-01

    The amount of published information and its continuing growth can no longer be managed by an individual searcher. One of today's great challenges for the academic researcher and clinician is to find a relevant scientific article using bibliographic search strategies. We aimed to design and build a Virtual Room of Gastroenterology (VRG) generating real-time automated search strategies and producing bibliographic and full text search results. These results update and complement with the latest evidence the Clinical Guideline Program of the World Gastroenterology Organisation. The HTML driven interface provides a series of pre-formulated MeSH based search strategies for each Aula. For each topic between 10 and 20 specific terms, qualifiers and subheadings are identified. The functionality of the VRG is based on the PubMed's characteristic that allows a search strategy to be captured as a web address. The VRG is available in Spanish and English, and the access is free. There are 28 rooms currently available. All together these rooms provide an advanced bibliographic access using more than 900 pre-programmed MeSH driven strategies. In a further very recent development some of the topics of VRG now allow cascade based searches. These searches look at resource sensitive options and possible ethnic difference per topic. The VRG allows significant reductions in time required to design and carry out complex bibliographic searches in the areas of gastroenterology, hepatology and endoscopy. The system updates automatically in real-time thus ensuring the currency of the results. PMID:21381412

  5. 175. STORAGE ROOM, SOUTH WALL OF STORAGE ROOM, ADDED WITH ...

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

    175. STORAGE ROOM, SOUTH WALL OF STORAGE ROOM, ADDED WITH ELEVATOR ADDITION OF 1905. WALL IS EXTERIOR OF ORIGINAL WAGON WORKS OF 1883. - Gruber Wagon Works, Pennsylvania Route 183 & State Hill Road at Red Bridge Park, Bernville, Berks County, PA

  6. INTERIOR VIEW OF THE LIVING ROOM. DINING ROOM AND PANTRY ...

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

    INTERIOR VIEW OF THE LIVING ROOM. DINING ROOM AND PANTRY IN THE BACKGROUND. VIEW FACING NORTHEAST. - Hickam Field, Fort Kamehameha Officers' Housing Type Z, 19 Worchester Avenue, Honolulu, Honolulu County, HI

  7. 21. Perimeter acquisition radar building room #200, electrical equipment room ...

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

    21. Perimeter acquisition radar building room #200, electrical equipment room - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  8. Interior. Storage room for glassware and reference room with frequentlyused ...

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

    Interior. Storage room for glassware and reference room with frequently-used chemistry and chemical engineering texts. - Thomas A. Edison Laboratories, Building No. 2, Main Street & Lakeside Avenue, West Orange, Essex County, NJ

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

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

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

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

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

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

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

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

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

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

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

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

  13. Supreme Court Room (room 573), looking westsouthwest (bearing 250). Not ...

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

    Supreme Court Room (room 573), looking west-southwest (bearing 250). Not that missing scones are to be returned and presently obscured ceiling is proposed for restoration. - California State Library & Courts Building, 914 Capitol Mall, Sacramento, Sacramento County, CA

  14. 11. FIRST FLOOR, EAST ROOM, DOORWAY TO WEST ROOM ON ...

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

    11. FIRST FLOOR, EAST ROOM, DOORWAY TO WEST ROOM ON LEFT AND BOTTOM OF STAIRWAY ON RIGHT - Whitcomb Cabin, BZ Corners, Glenwood County Road (Conboy Lake National Wildlife Refuge), Glenwood, Klickitat County, WA

  15. 16. Readiness Crew Building interior, Room 105, former briefing room, ...

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

    16. Readiness Crew Building interior, Room 105, former briefing room, looking southeast. Thalheimer - Whiteman Air Force Base, Bomber Alert Facility S-6, 1300 Alert Road, Knob Noster, Johnson County, MO

  16. 24. Perimeter acquisition radar building room #203, communications room ...

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

    24. Perimeter acquisition radar building room #203, communications room - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  17. MACHINE ROOM FROM DOORWAY TO COMMUNICATIONS ROOM, VIEW FACING SOUTHWEST. ...

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

    MACHINE ROOM FROM DOORWAY TO COMMUNICATIONS ROOM, VIEW FACING SOUTHWEST. - Naval Air Station Barbers Point, World War II Command Center, Midway Street east of Lexington Avenue, Ewa, Honolulu County, HI

  18. View from window of southeast room (bed room no. 1), ...

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

    View from window of southeast room (bed room no. 1), second floor, commandant's house, looking east across parade ground. - Fort Simcoe, Commandant's House & Blockhouse, Fort Simcoe Road, White Swan, Yakima County, WA

  19. Entry area from living room with dining room beyond and ...

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

    Entry area from living room with dining room beyond and stairs to second floor through doorway to the right (southern unit) - Fitzsimons General Hospital, Officers' Quarters, West Charlie Kelly Boulevard & South Hutton Street, Southwest Corner, Aurora, Adams County, CO

  20. INTERIOR VIEW OF A TYPICAL ROOM (ROOM NO. 209), FACING ...

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

    INTERIOR VIEW OF A TYPICAL ROOM (ROOM NO. 209), FACING NORTH. THE SINK AND MIRROR MAY HAVE BEEN FROM THE ORIGINAL CONSTRUCTION. - U.S. Naval Base, Pearl Harbor, Bachelor Officer Quarters, Dealy Circle, Pearl City, Honolulu County, HI

  1. 8. VIEW OF ROOM 101 (ASSEMBLY ROOM) FROM NORTHEAST CORNER ...

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

    8. VIEW OF ROOM 101 (ASSEMBLY ROOM) FROM NORTHEAST CORNER SHOWING FLEXIBLE AIR-CONDITIONING DUCT - Vandenberg Air Force Base, Space Launch Complex 3, Vehicle Support Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  2. 14. Door leading from Boiler Room to Pattern Room. ...

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

    14. Door leading from Boiler Room to Pattern Room. - Central of Georgia Railway, Savannah Repair Shops & Terminal Facilities, Engine Boiler & Pattern Building, Bounded by West Broad, Jones, West Boundary & Hull Streets, Savannah, Chatham County, GA

  3. 13. Interior view of conference room looking into break room ...

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

    13. Interior view of conference room looking into break room beyond; along west side of upper level; view to southwest. - Ellsworth Air Force Base, Mess Hall & Administration Building, 1301 Ellsworth Street, Blackhawk, Meade County, SD

  4. Advance Directives and Operating: Room for Improvement?

    PubMed

    Hadler, Rachel A; Neuman, Mark D; Raper, Steven; Fleisher, Lee A

    2016-04-01

    Anesthesiologists and surgeons are frequently called on to perform procedures on critically ill patients with advanced directives. We assessed the attitudes of attending and resident surgeons and anesthesiologists at our institution regarding their understanding of and practice around the application of consenting critically ill patients with advance directives in the operating room. To do so, we deployed a survey after interdepartmental grand rounds, featuring a panel discussion of ethically complex cases featuring end-of-life issues. PMID:26599738

  5. Door Opening Affects Operating Room Pressure During Joint Arthroplasty.

    PubMed

    Mears, Simon C; Blanding, Renee; Belkoff, Stephen M

    2015-11-01

    Many resources are expended to ensure a sterile operating room environment. Efforts are made to prevent exposure of patients to personnel and to achieve positive room pressure to keep out airborne contaminants. Foot traffic into and out of the operating room during surgery can undermine these efforts. The authors investigated the number and duration of operating room door openings during hip and knee arthroplasty procedures and the effect of the door openings on room pressure. They tested the hypothesis that door openings defeat positive pressure, permitting air flow into the room. Room pressure and door status were monitored electronically during 191 hip and knee arthroplasty procedures. Operating room staff were unaware that data were being collected. The authors evaluated the data with regression analysis to determine whether the number and duration of door openings had an effect on room pressure. Significance was set at P<.05. Doors were open, on average, 9.5 minutes per case. In 77 of 191 cases, positive pressure was defeated, allowing air flow to reverse into the operating room. Total time with the door open significantly affected the minimum pressure recorded in the room (P<.02), but did not significantly affect average room pressure (P=.7). This finding suggested that the loss of positive pressure was a transient event from which the room recovered. The number and duration of door openings showed a significant association with length of surgery. Door openings threaten positive pressure, potentially jeopardizing operating room sterility. The causes of excessive operating room traffic must be evaluated to identify ways to reduce this traffic and the associated risks. PMID:26558679

  6. Room with a View: Ethical Encounters in Room 13

    ERIC Educational Resources Information Center

    Grube, Vicky

    2012-01-01

    In this article, the author describes ethical encounters in Room 13, a schoolroom where children made what they wanted, posed their own questions, and ran an art room like a small business. In Room 13 children had the responsibility to maintain all aspects of the art studio. Specific decisions fell to an annually elected management team, a small…

  7. 45. 1915 CLOTH ROOM ADJACENT TO PICKER ROOM, SECOND FLOOR, ...

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

    45. 1915 CLOTH ROOM ADJACENT TO PICKER ROOM, SECOND FLOOR, NORTH END OF MILL NO. 2, WALL ON LEFT DIVIDING CLOTH ROOM ADDED LATER (PROBABLY C. 1970s). - Prattville Manufacturing Company, Number One, 242 South Court Street, Prattville, Autauga County, AL

  8. Commander's conference room (room 202), closet and hallway to bathroom ...

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

    Commander's conference room (room 202), closet and hallway to bathroom and bedroom, leading to conference room 211. Viewing windows look down on the display area. View to north - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  9. One Room Schools in Iowa.

    ERIC Educational Resources Information Center

    Ruth, Amy, Ed.

    1994-01-01

    This issue focuses on one-room school houses in Iowa. At one time, almost 14,000 one-room schools dotted Iowa's rural landscape. Articles explore Native American schools of the past and present, segregation of black students, and Amish schools. An article remembering one-room schools describes the early schools from 1830 to 1858, township schools…

  10. CEBAF Control Room Renovation

    SciTech Connect

    Michael Spata; Thomas Oren

    2005-05-01

    The Machine Control Center (MCC) at Jefferson Lab's Continuous Electron Beam Accelerator Facility (CEBAF) was initially constructed in the early 1990s and based on proven technology of that era. Through our experience over the last 15 years and in our planning for the facility's 12 GeV upgrade we reevaluated the control room environment to capitalize on emerging visualization and display technologies and improve workflow processes and ergonomic attributes. This effort also sets the foundation for the redevelopment of the accelerator's control system to deliver high reliability performance with improvements in beam specifications management and information flow. The complete renovation was performed over a three-week maintenance period with no interruption to beam operations. We present the results of this effort.

  11. CEBAF Control Room Renovation

    SciTech Connect

    Michael Spata; Anthony Cuffe; Thomas Oren

    2005-03-22

    The Machine Control Center (MCC) at Jefferson Lab's Continuous Electron Beam Accelerator Facility (CEBAF) was constructed in the early 1990s and based on proven technology of that era. Through our experience over the last 15 years and in our planning for the facilities 12 GeV upgrade we reevaluated the control room environment to capitalize on emerging visualization and display technologies and improve on work-flow processes and ergonomic attributes. The renovation was performed in two phases during the summer of 2004, with one phase occurring during machine operations and the latter, more extensive phase, occurring during our semi-annual shutdown period. The new facility takes advantage of advances in display technology, analog and video signal management, server technology, ergonomic workspace design, lighting engineering, acoustic ceilings and raised flooring solutions to provide a marked improvement in the overall environment of machine operations.

  12. CEBAF Control Room Renovation

    SciTech Connect

    Michael Spata; Thomas Oren

    2005-05-01

    The Machine Control Center at Jefferson Lab's Continuous Electron Beam Accelerator Facility was initially constructed in the early 1990s and based on proven technology of that era. Through our experience over the last 15 years and in our planning for the facilities 12 GeV upgrade we reevaluated the control room environment to capitalize on emerging visualization and display technologies and improve on workflow processes and ergonomic attributes. This effort also sets the foundation for the redevelopment of the accelerator's control system to deliver high reliability performance with improvements in beam specifications management and information flow. The complete renovation was performed over a three-week period with no interruption to beam operations. We present the results of this effort.

  13. Binaural room simulation

    NASA Technical Reports Server (NTRS)

    Lehnert, H.; Blauert, Jens; Pompetzki, W.

    1991-01-01

    In every-day listening the auditory event perceived by a listener is determined not only by the sound signal that a sound emits but also by a variety of environmental parameters. These parameters are the position, orientation and directional characteristics of the sound source, the listener's position and orientation, the geometrical and acoustical properties of surfaces which affect the sound field and the sound propagation properties of the surrounding fluid. A complete set of these parameters can be called an Acoustic Environment. If the auditory event perceived by a listener is manipulated in such a way that the listener is shifted acoustically into a different acoustic environment without moving himself physically, a Virtual Acoustic Environment has been created. Here, we deal with a special technique to set up nearly arbitrary Virtual Acoustic Environments, the Binaural Room Simulation. The purpose of the Binaural Room Simulation is to compute the binaural impulse response related to a virtual acoustic environment taking into account all parameters mentioned above. One possible way to describe a Virtual Acoustic Environment is the concept of the virtual sound sources. Each of the virtual sources emits a certain signal which is correlated but not necessarily identical with the signal emitted by the direct sound source. If source and receiver are non moving, the acoustic environment becomes a linear time-invariant system. Then, the Binaural Impulse Response from the source to a listener' s eardrums contains all relevant auditory information related to the Virtual Acoustic Environment. Listening into the simulated environment can easily be achieved by convolving the Binaural Impulse Response with dry signals and representing the results via headphones.

  14. Anesthesia and sedation outside of the operating room

    PubMed Central

    Youn, Ann Misun; Kim, Yoon-Hee

    2015-01-01

    Due to rapid evolution and technological advancements, medical personnel now require special training outside of their safe zones. Anesthesiologists face challenges in practicing in locations beyond the operating room. New locations, inadequate monitoring devices, poor assisting staff, unfamiliarity of procedures, insufficient knowledge of basic standards, and lack of experience compromise the quality of patient care. Therefore, anesthesiologists must recognize possible risk factors during anesthesia in nonoperating rooms and familiarize themselves with standards to improve safe practice. This review article emphasizes the need for standardizing hospitals and facilities requiring nonoperating room anesthesia, and encourages anesthesiologists to take the lead in applying these practice guidelines to improve patient outcomes and reduce adverse events. PMID:26257843

  15. Acoustic echoes reveal room shape.

    PubMed

    Dokmanic, Ivan; Parhizkar, Reza; Walther, Andreas; Lu, Yue M; Vetterli, Martin

    2013-07-23

    Imagine that you are blindfolded inside an unknown room. You snap your fingers and listen to the room's response. Can you hear the shape of the room? Some people can do it naturally, but can we design computer algorithms that hear rooms? We show how to compute the shape of a convex polyhedral room from its response to a known sound, recorded by a few microphones. Geometric relationships between the arrival times of echoes enable us to "blindfoldedly" estimate the room geometry. This is achieved by exploiting the properties of Euclidean distance matrices. Furthermore, we show that under mild conditions, first-order echoes provide a unique description of convex polyhedral rooms. Our algorithm starts from the recorded impulse responses and proceeds by learning the correct assignment of echoes to walls. In contrast to earlier methods, the proposed algorithm reconstructs the full 3D geometry of the room from a single sound emission, and with an arbitrary geometry of the microphone array. As long as the microphones can hear the echoes, we can position them as we want. Besides answering a basic question about the inverse problem of room acoustics, our results find applications in areas such as architectural acoustics, indoor localization, virtual reality, and audio forensics. PMID:23776236

  16. 37. DINING ROOM FROM BALCONY. THE DINING ROOM ROOF IS ...

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

    37. DINING ROOM FROM BALCONY. THE DINING ROOM ROOF IS SUPPORTED BY A SCISSOR TRUSS SYSTEM REINFORCED WITH TURNBUCKLE IRON RODS AND GUSSET PLATES (NOTE: THIS SYSTEM DIFFERS FROM THE LOBBY). - Old Faithful Inn, 900' northeast of Snowlodge & 1050' west of Old Faithful Lodge, Lake, Teton County, WY

  17. 12. INTERIOR OF LIVING ROOM FROM DINING ROOM SHOWING OPEN ...

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

    12. INTERIOR OF LIVING ROOM FROM DINING ROOM SHOWING OPEN FRONT DOOR AT PHOTO CENTER AND OPEN DOOR TO BEDROOM NO. 1 AT PHOTO LEFT. VIEW TO NORTH. - Bishop Creek Hydroelectric System, Plant 4, Worker Cottage, Bishop Creek, Bishop, Inyo County, CA

  18. Looking west in the basement utility room, room 24, overview ...

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

    Looking west in the basement utility room, room 24, overview of air handling system, large walk-in filter, large ducts, pipes, and gauges - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  19. 2. ENGINE ROOM AND CHIPPY ENGINE ROOM OF THE DIAMOND ...

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

    2. ENGINE ROOM AND CHIPPY ENGINE ROOM OF THE DIAMOND MINE, LOOKING NORTH. THE MAIN HOIST USED A FLAT CABLE, WHICH WAS SCRAPPED IN THE 1950s. THE ORIGINAL DIXON CABLE STILL EXISTS IN THE CHIPPY HOIST HOUSE. - Butte Mineyards, Diamond Mine, Butte, Silver Bow County, MT

  20. 49. Machinery rooms on north tower. Facing north. Machinery rooms ...

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

    49. Machinery rooms on north tower. Facing north. Machinery rooms contain all motors, motor controllers, and gears for operating one span, in this case, the north span. Note bell with continuous operating clapper for use as fog signals. - Henry Ford Bridge, Spanning Cerritos Channel, Los Angeles-Long Beach Harbor, Los Angeles, Los Angeles County, CA

  1. 35. VIEW OF TELEMETRY ROOM (ROOM 106) FROM ITS NORTHWEST ...

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

    35. VIEW OF TELEMETRY ROOM (ROOM 106) FROM ITS NORTHWEST CORNER SHOWING TM-ISE-3 TELEMETRY CHECKOUT SYSTEM AND HONEYWELL TAPE RECORDER - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

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

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

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

  3. 10. CONTROL ROOM INTERIOR. Looking into southwest corner. CONTROL ROOM ...

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

    10. CONTROL ROOM INTERIOR. Looking into southwest corner. CONTROL ROOM INTERIOR, SHOWING ESCAPE HATCH. Looking north along east wall. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Instrumentation & Control Building, Test Area 1-115, northwest end of Saturn Boulevard, Boron, Kern County, CA

  4. LIVING ROOM WITH THE SLIDING DOORS TO DINING ROOM ON ...

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

    LIVING ROOM WITH THE SLIDING DOORS TO DINING ROOM ON THE LEFT. SHOWING THE WOOD GRILLE TO THE FOYER. VIEW FACING SOUTHEAST - Camp H.M. Smith and Navy Public Works Center Manana Title VII (Capehart) Housing, U-Shaped Two-Bedroom Duplex Type 1, Acacia Road, Birch Circle, and Cedar Drive, Pearl City, Honolulu County, HI

  5. 16. Perimeter acquisition radar building room #102, electrical equipment room; ...

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

    16. Perimeter acquisition radar building room #102, electrical equipment room; the prime power distribution system. Excellent example of endulum-types shock isolation. The grey cabinet and barrel assemble is part of the polychlorinated biphenyl (PCB) retrofill project - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  6. From living room through french doors toward room in southeast ...

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

    From living room through french doors toward room in southeast corner of south unit - Fitzsimons General Hospital, Civilian Employees' Quarters, North Hickey Street, West side, 150 feet North of intersection of North Hickey Street & West Loosley Avenue, Aurora, Adams County, CO

  7. 16. Bus Room (also known as Switch Gear Room), view ...

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

    16. Bus Room (also known as Switch Gear Room), view to the southeast. An air circuit breaker compressor (visible in photograph number 2) was once attached to the main bus relay visible in the background of the photograph. - Washington Water Power Clark Fork River Cabinet Gorge Hydroelectric Development, Powerhouse, North Bank of Clark Fork River at Cabinet Gorge, Cabinet, Bonner County, ID

  8. 38. NORTHEAST ROOM, SECOND FLOOR, SOUTH WALL. ROOM COMPLETELY WALLED ...

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

    38. NORTHEAST ROOM, SECOND FLOOR, SOUTH WALL. ROOM COMPLETELY WALLED WITH RANDOM WIDTH BOARDS WHICH WERE PAPERED OR PLASTERED OVER. THIS WAS TYPICAL THROUGHOUT HOUSE EXCEPT FOR WOOD PANELED WALLS - John Mark Verdier House, 801 Bay & Scott Streets, Beaufort, Beaufort County, SC

  9. Improving operating room schedules.

    PubMed

    Li, Fei; Gupta, Diwakar; Potthoff, Sandra

    2016-09-01

    Operating rooms (ORs) in US hospitals are costly to staff, generate about 70 % of a hospital's revenues, and operate at a staffed-capacity utilization of 60-70 %. Many hospitals allocate blocks of OR time to individual or groups of surgeons as guaranteed allocation, who book surgeries one at a time in their blocks. The booking procedure frequently results in unused time between surgeries. Realizing that this presents an opportunity to improve OR utilization, hospitals manually reschedule surgery start times one or two days before each day of surgical operations. The purpose of rescheduling is to decrease OR staffing costs, which are determined by the number of concurrently staffed ORs. We formulate the rescheduling problem as a variant of the bin-packing problem with interrelated items, which are the surgeries performed by the same surgeon. We develop a lower bound (LB) construction algorithm and prove that the LB is at least (2/3) of the optimal staffing cost. A key feature of our approach is that we allow hospitals to have two shift lengths. Our analytical results form the basis of a branch-and-bound algorithm, which we test on data obtained from three hospitals. Experiments show that rescheduling saves significant staffing costs. PMID:25687390

  10. SU-E-J-39: Comparison of PTV Margins Determined by In-Room Stereoscopic Image Guidance and by On-Board Cone Beam Computed Tomography Technique for Brain Radiotherapy Patients

    SciTech Connect

    Ganesh, T; Paul, S; Munshi, A; Sarkar, B; Krishnankutty, S; Sathya, J; George, S; Jassal, K; Roy, S; Mohanti, B

    2014-06-01

    Purpose: Stereoscopic in room kV image guidance is a faster tool in daily monitoring of patient positioning. Our centre, for the first time in the world, has integrated such a solution from BrainLAB (ExacTrac) with Elekta's volumetric cone beam computed tomography (XVI). Using van Herk's formula, we compared the planning target volume (PTV) margins calculated by both these systems for patients treated with brain radiotherapy. Methods: For a total of 24 patients who received partial or whole brain radiotherapy, verification images were acquired for 524 treatment sessions by XVI and for 334 sessions by ExacTrac out of the total 547 sessions. Systematic and random errors were calculated in cranio-caudal, lateral and antero-posterior directions for both techniques. PTV margins were then determined using van Herk formula. Results: In the cranio-caudal direction, systematic error, random error and the calculated PTV margin were found to be 0.13 cm, 0.12 cm and 0.41 cm with XVI and 0.14 cm, 0.13 cm and 0.44 cm with ExacTrac. The corresponding values in lateral direction were 0.13 cm 0.1 cm and 0.4 cm with XVI and 0.13 cm, 0.12 cm and 0.42 cm with ExacTrac imaging. The same parameters for antero-posterior were for 0.1 cm, 0.11 cm and 0.34 cm with XVI and 0.13 cm, 0.16 cm and 0.43 cm with ExacTrac imaging. The margins estimated with the two imaging modalities were comparable within ± 1 mm limit. Conclusion: Verification of setup errors in the major axes by two independent imaging systems showed the results are comparable and within ± 1 mm. This implies that planar imaging based ExacTrac can yield equal accuracy in setup error determination as the time consuming volumetric imaging which is considered as the gold standard. Accordingly PTV margins estimated by this faster imaging technique can be confidently used in clinical setup.

  11. Lean Strategies in the Operating Room.

    PubMed

    Robinson, Stephen T; Kirsch, Jeffrey R

    2015-12-01

    Lean strategies can be readily applied to health care in general and operating rooms specifically. The emphasis is on the patient as the customer, respect and engagement of all providers, and leadership from management. The strategy of lean is to use continuous improvement to eliminate waste from the care process, leaving only value-added activities. This iterative process progressively adds the steps of identifying the 7 common forms of waste (transportation, inventory, motion, waiting, overproduction, overprocessing, and defects), 5S (sort, simplify, sweep, standardize, sustain), visual controls, just-in-time processing, level-loaded work, and built-in quality to achieve the highest quality of patient care. PMID:26610625

  12. [Management for the operating room].

    PubMed

    Tschudi, O; Schüpfer, G

    2015-03-01

    Business companies, which in the current times also includes hospitals, must create customer benefits and as a prerequisite for this must sustainably generate profits. Management in the world of business means the formation and directing of a company or parts of a company on a permanent basis, whereby management in this context is not exercising power but function. This concept of management is exemplary developed in this article for the important services sector of the operating room (OR) and individual functions, such as resource control, capacity planning and materials administration are presented in detail. Some OR-specific management challenges are worked out. From this it becomes clear that the economic logic of the most efficient implementation possible is not a contradiction of medical ethics, enabling the most effective treatment possible for patients while safeguarding the highest possible levels of safety and quality. The article aims to build a bridge for medical specialists to the language and world of commerce, emphasizing the profession-based competence and hopefully to arouse interest to go into more detail. PMID:25782780

  13. [AT ROOM NUMBER 324].

    PubMed

    Grande Martínez, Rubén; Peña García, Ana; Alburquerque Medina, Eulalia

    2014-10-01

    Hello, my name is Rosa and I have breast cancer. My story begins at a general medical examination. I will remember for my whole life the exactly worlds that changed everything: "You have breast cancer". In relation to a case a description of the stages that patients who are suffering from a terminal illness use to go through. We try to go in depth into the feelings world, illness clinical details are leaving behind. PMID:26118012

  14. 33. ROOM A (WEST ROOM) LOOKING SOUTHWEST. The windows above ...

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

    33. ROOM A (WEST ROOM) LOOKING SOUTHWEST. The windows above the original Ministers' Gallery were raised in 1888 when inside toilet facilities were added on the other side of the west wall. Note the sloped window sills which provided more light. Also at the rear of the Meeting House a caretaker's apartment was added in 1908. - Twelfth Street Meeting House, 20 South Twelfth Street, Philadelphia, Philadelphia County, PA

  15. Improving on-time surgical starts in an operating room

    PubMed Central

    Wright, James G.; Roche, Ann; Khoury, Antoine E.

    2010-01-01

    Background Operating rooms are expensive to run, and hospitals strive to be efficient. The purpose of this study was to evaluate an initiative to improve starting on time in the operating room in an academic pediatric hospital. Methods We used an 8-step approach to transforming an organization. A multidisciplinary team defined on-time starts, identified reasons for delays and instituted changes, including improving the same-day admission process, instituting a huddle of operating room staff each morning and providing feedback about on-time starts to staff. Results The most common reasons for delay were surgeon and anesthesiologist unavailability and lack of preparedness of patients. The percentage of operations that began on time, defined as the patient being in the room, increased from about 6% to 60% over a 9-month period. Conclusion A targeted, multifaceted and multidisciplinary approach can increase the percentage of operations that begin on time in a pediatric hospital. PMID:20507788

  16. 32 CFR 518.9 - Reading room.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Reading room. 518.9 Section 518.9 National... RELATIONS THE FREEDOM OF INFORMATION ACT PROGRAM FOIA Reading Rooms § 518.9 Reading room. (a) Reading room... the records described, DA may elect to place other records in their reading room, and also make...

  17. Nuclear reactor control room construction

    DOEpatents

    Lamuro, Robert C.; Orr, Richard

    1993-01-01

    A control room 10 for a nuclear plant is disclosed. In the control room, objects 12, 20, 22, 26, 30 are no less than four inches from walls 10.2. A ceiling 32 contains cooling fins 35 that extend downwards toward the floor from metal plates 34. A concrete slab 33 is poured over the plates. Studs 36 are welded to the plates and are encased in the concrete.

  18. Nuclear reactor control room construction

    DOEpatents

    Lamuro, R.C.; Orr, R.

    1993-11-16

    A control room for a nuclear plant is disclosed. In the control room, objects labelled 12, 20, 22, 26, 30 in the drawing are no less than four inches from walls labelled 10.2. A ceiling contains cooling fins that extend downwards toward the floor from metal plates. A concrete slab is poured over the plates. Studs are welded to the plates and are encased in the concrete. 6 figures.

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

    SciTech Connect

    Tanner, Jennifer E.; Benz, Jacob M.; White, Helen; McOmish, Sarah; Allen, Keir; Tolk, Keith; Weeks, George E.

    2014-12-01

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

  20. Virus diffusion in isolation rooms.

    PubMed

    Kao, P H; Yang, R J

    2006-03-01

    In hospitals, the ventilation of isolation rooms operating under closed-door conditions is vital if the spread of viruses and infection is to be contained. Engineering simulation, which employs computational fluid dynamics, provides a convenient means of investigating airflow behaviour in isolation rooms for various ventilation arrangements. A cough model was constructed to permit the numerical simulation of virus diffusion inside an isolation room for different ventilation system configurations. An analysis of the region of droplet fallout and the dilution time of virus diffusion of coughed gas in the isolation room was also performed for each ventilation arrangement. The numerical results presented in this paper indicate that the parallel-directional airflow pattern is the most effective means of controlling flows containing virus droplets. Additionally, staggering the positions of the supply vents at the door end of the room relative to the exhaust vents on the wall behind the bed head provides effective infection control and containment. These results suggest that this particular ventilation arrangement enhances the safety of staff when performing medical treatments within isolation rooms. PMID:16359753

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

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

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

  2. [Cleanliness in the operating room].

    PubMed

    Suzuki, Toshiyasu

    2010-05-01

    With regard to recent findings in the cleanliness of the operating room, concerning handwashing and performing operations, the traditional method of excessive scrubbing using a brush is not effective, and handwashing using only an alcohol-containing antiseptic hand rub (rubbing method) has become common practice. Use of a brush has already been abolished in some medical institutions. In addition, sterilized water used for handwashing when performing operations has no scientific basis and use of tap water is considered sufficient. Furthermore, the concept of operating room zoning has also undergone a dramatic change. It was discovered that a layout focusing on work efficiency is more desirable than the one that follows an excessively rigid zoning pattern. One-footwear System not requiring change of shoes also has various advantages in improving the efficiency of the operation room, and this is thought to become commonplace in the future. PMID:20486565

  3. Corneal storage at room temperature.

    PubMed

    Sachs, U; Goldman, K; Valenti, J; Kaufman, H E

    1978-06-01

    Short-term eye banking is based mainly on moist chamber and McCarey-Kaufman medium (M-K medium) preservation. Both involve a controlled 4 C temperature for storage. Warming the cornea to room temperature, however, drastically affects the endothelial viability. On enzymatic staining and histological study, the M-K medium-stored rabbit corneas had more normal endothelium than did "moist chamber" eyes when storage was prolonged for seven days at room temperature. In human corneas that were kept at 4 C for 24 hours and then exposed to a temperature of 25 C, destruction of organelles had occurred by six hours and was increased by 12 hours. Corneas that were kept in M-K medium had relatively intact endothelium after four days, but cell disruption and vacuolation was present by the seventh day. The M-K medium, therefore, affords protection to tissue warmed to room temperature, where metabolic activity is resumed. PMID:350203

  4. Room temperature terahertz polariton emitter

    SciTech Connect

    Geiser, Markus; Scalari, Giacomo; Castellano, Fabrizio; Beck, Mattias; Faist, Jerome

    2012-10-01

    Terahertz (THz) range electroluminescence from intersubband polariton states is observed in the ultra strong coupling regime, where the interaction energy between the collective excitation of a dense electron gas and a photonic mode is a significant portion of the uncoupled excitation energy. The polariton's increased emission efficiency along with a parabolic electron confinement potential allows operation up to room temperature in a nonresonant pumping scheme. This observation of room temperature electroluminescence of an intersubband device in the THz range is a promising proof of concept for more powerful THz sources.

  5. 39 CFR 3004.12 - Reading room.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Reading room. 3004.12 Section 3004.12 Postal... Reading room. (a) The Commission maintains a public reading room at its offices (901 New York Avenue, NW., Suite 200, Washington, DC 20268-0001) and an electronic reading room at http://www.prc.gov. The...

  6. 32 CFR 296.6 - Reading room.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Reading room. 296.6 Section 296.6 National... Reading room. (a) The NRO shall provide a reading room equipped with hard copy and electronic records as required in the “Electronic Freedom of Information Act Amendments of 1996”. The NRO Reading Room is...

  7. 32 CFR 296.6 - Reading room.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Reading room. 296.6 Section 296.6 National... Reading room. (a) The NRO shall provide a reading room equipped with hard copy and electronic records as required in the “Electronic Freedom of Information Act Amendments of 1996”. The NRO Reading Room is...

  8. 39 CFR 3004.12 - Reading room.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Reading room. 3004.12 Section 3004.12 Postal... Reading room. (a) The Commission maintains a public reading room at its offices (901 New York Avenue, NW., Suite 200, Washington, DC 20268-0001) and an electronic reading room at http://www.prc.gov. The...

  9. Room-Maid in Hotel

    ERIC Educational Resources Information Center

    Hotel and Catering Industry Training Board, Wembley (England).

    This syllabus is intended for the use of training personnel in drawing up training programs for room-maids in hotels. Its main objective is to produce fully trained maids, thereby maintaining and raising standards. The syllabus is divided into three sections: Introducing to Housekeeping, Basic Tasks Performed by the Majority of Housekeeping…

  10. Locker Room Maintenance Made Easy.

    ERIC Educational Resources Information Center

    Theel, James

    1998-01-01

    Provides examples on ways to make locker room maintenance easier and their use more student-friendly. Improvements include use of indoor-outdoor carpeting with numerous floor drains to cut mildew buildup, adequate ventilation to reduce musty smells, better hot water management, ceramic tiles to reduce water-damage repair and painting needs, and…

  11. Hotels Make Room for Fitness.

    ERIC Educational Resources Information Center

    Koszuta, Laurie Einstein

    1986-01-01

    Hotels, in hopes of gaining a competitive edge, are offering workout rooms, exercise equipment, fitness trails, and jogging tracks, but no standards have been set for safety of the facilities or staff preparedness in exercise screening, equipment use, injury prevention, or first aid. (MT)

  12. Room Density and User Satisfaction

    ERIC Educational Resources Information Center

    Sommer, Robert; Becker, Franklin D.

    1971-01-01

    Over a four-year period, different sized classes were asked to rate the physical environment in a college classroom. Class size was found to be related to the proportion of complaints, satisfaction with ventilation, and room size for both students and faculty. It is necessary to develop theories of people-in-environments rather than of people and…

  13. Survey of psychiatric assessment rooms in UK emergency departments

    PubMed Central

    Bolton, Jim; Palmer, Lucy; Cawdron, Rohanna

    2016-01-01

    Aims and method We aimed to estimate the proportion of UK emergency departments with a psychiatric assessment room and to determine whether such rooms met criteria for conducting high-risk assessments. Liaison psychiatry services were asked whether their hospital had such a room, whether it met the criteria and whether respondents judged it to be sufficiently safe and private. Results Of the 60 emergency departments included in the survey, 23% had a psychiatric assessment room that met all the safety criteria and was judged to be safe and private. Barriers to the establishment of an appropriate facility included it being a low priority for hospital management, a room being used for other purposes, and balancing safety requirements with the creation of a calming environment. Clinical implications Mental illness is a common reason for presentation to emergency departments. Despite national recommendations, this survey indicates that many departments lack a sufficiently safe and private assessment room, which compromises the safety and privacy of patient care. PMID:27087987

  14. Small bowel wall thickening: MDCT evaluation in the emergency room.

    PubMed

    Akcalar, Seray; Turkbey, Baris; Karcaaltincaba, Musturay; Akpinar, Erhan; Akhan, Okan

    2011-10-01

    Small bowel wall thickening detected on computed tomography is a frequent finding in patients referring to emergency room with acute abdominal pain. In this pictorial review, we aim to discuss patterns of small bowel wall thickening and to explain hints for differential diagnosis with imaging findings. PMID:21681404

  15. Characteristics of Chinese Suicide Attempters: An Emergency Room Study

    ERIC Educational Resources Information Center

    Zhang, Jie; Jia, Shuhua; Jiang, Chao; Sun, Jie

    2006-01-01

    Studying the characteristics of attempted suicide is helpful in knowing the background of some completed suicides and improving prevention or intervention strategies. This current study analyzed data of 74 suicide attempters and 92 accident injured patients admitted to 6 hospital emergency rooms in an area of Northeastern China and found both…

  16. 'How To' Clean Room Video

    NASA Technical Reports Server (NTRS)

    McCarty, Kaley Corinne

    2013-01-01

    One of the projects that I am completing this summer is a Launch Services Program intern 'How to' set up a clean room informational video. The purpose of this video is to go along with a clean room kit that can be checked out by employees at the Kennedy Space Center and to be taken to classrooms to help educate students and intrigue them about NASA. The video will include 'how to' set up and operate a clean room at NASA. This is a group project so we will be acting as a team and contributing our own input and ideas. We will include various activities for children in classrooms to complete, while learning and having fun. Activities that we will explain and film include: helping children understand the proper way to wear a bunny suit, a brief background on cleanrooms, and the importance of maintaining the cleanliness of a space craft. This project will be shown to LSP management and co-workers; we will be presenting the video once it is completed.

  17. Effectiveness of ultraviolet devices and hydrogen peroxide systems for terminal room decontamination: Focus on clinical trials.

    PubMed

    Weber, David J; Rutala, William A; Anderson, Deverick J; Chen, Luke F; Sickbert-Bennett, Emily E; Boyce, John M

    2016-05-01

    Over the last decade, substantial scientific evidence has accumulated that indicates contamination of environmental surfaces in hospital rooms plays an important role in the transmission of key health care-associated pathogens (eg, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Clostridium difficile, Acinetobacter spp). For example, a patient admitted to a room previously occupied by a patient colonized or infected with one of these pathogens has a higher risk for acquiring one of these pathogens than a patient admitted to a room whose previous occupant was not colonized or infected. This risk is not surprising because multiple studies have demonstrated that surfaces in hospital rooms are poorly cleaned during terminal cleaning. To reduce surface contamination after terminal cleaning, no touch methods of room disinfection have been developed. This article will review the no touch methods, ultraviolet light devices, and hydrogen peroxide systems, with a focus on clinical trials which have used patient colonization or infection as an outcome. Multiple studies have demonstrated that ultraviolet light devices and hydrogen peroxide systems have been shown to inactivate microbes experimentally plated on carrier materials and placed in hospital rooms and to decontaminate surfaces in hospital rooms naturally contaminated with multidrug-resistant pathogens. A growing number of clinical studies have demonstrated that ultraviolet devices and hydrogen peroxide systems when used for terminal disinfection can reduce colonization or health care-associated infections in patients admitted to these hospital rooms. PMID:27131140

  18. Novel room temperature ferromagnetic semiconductors

    SciTech Connect

    Gupta, Amita

    2004-11-01

    Today's information world, bits of data are processed by semiconductor chips, and stored in the magnetic disk drives. But tomorrow's information technology may see magnetism (spin) and semiconductivity (charge) combined in one 'spintronic' device that exploits both charge and 'spin' to carry data (the best of two worlds). Spintronic devices such as spin valve transistors, spin light emitting diodes, non-volatile memory, logic devices, optical isolators and ultra-fast optical switches are some of the areas of interest for introducing the ferromagnetic properties at room temperature in a semiconductor to make it multifunctional. The potential advantages of such spintronic devices will be higher speed, greater efficiency, and better stability at a reduced power consumption. This Thesis contains two main topics: In-depth understanding of magnetism in Mn doped ZnO, and our search and identification of at least six new above room temperature ferromagnetic semiconductors. Both complex doped ZnO based new materials, as well as a number of nonoxides like phosphides, and sulfides suitably doped with Mn or Cu are shown to give rise to ferromagnetism above room temperature. Some of the highlights of this work are discovery of room temperature ferromagnetism in: (1) ZnO:Mn (paper in Nature Materials, Oct issue, 2003); (2) ZnO doped with Cu (containing no magnetic elements in it); (3) GaP doped with Cu (again containing no magnetic elements in it); (4) Enhancement of Magnetization by Cu co-doping in ZnO:Mn; (5) CdS doped with Mn, and a few others not reported in this thesis. We discuss in detail the first observation of ferromagnetism above room temperature in the form of powder, bulk pellets, in 2-3 mu-m thick transparent pulsed laser deposited films of the Mn (<4 at. percent) doped ZnO. High-resolution transmission electron microscopy (HRTEM) and electron energy loss spectroscopy (EELS) spectra recorded from 2 to 200nm areas showed homogeneous distribution of Mn substituting

  19. [When should the nephrologist be called in the emergency room?].

    PubMed

    Favre, Nathalie; Burnier, Michel; Kissling, Sébastien

    2016-02-24

    Nephrology emergencies are not the most frequent in the emergency room but they often generate some diagnostic and therapeutic problems. Most common renal emergencies are due most often to acute renal failure whatever the cause, electrolytes disturbances, hypertensive crisis and less frequently intoxications or acute decompensation of chronic kidney diseases. The goal of this paper is to review some of these clinical situations both in the diagnostic and therapeutic perspective but essentially to discuss when the nephrologist should be called in the emergency room so that the coordination of care is optimal for the patients. PMID:27039605

  20. 24 CFR 3280.109 - Room requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... gross floor area. (b) Rooms designed for sleeping purposes shall have a minimum gross square foot floor... of two. (c) Every room designed for sleeping purposes shall have accessible clothes hanging...

  1. 24 CFR 3280.109 - Room requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... gross floor area. (b) Rooms designed for sleeping purposes shall have a minimum gross square foot floor... of two. (c) Every room designed for sleeping purposes shall have accessible clothes hanging...

  2. 24 CFR 3280.109 - Room requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... gross floor area. (b) Rooms designed for sleeping purposes shall have a minimum gross square foot floor... of two. (c) Every room designed for sleeping purposes shall have accessible clothes hanging...

  3. 24 CFR 3280.109 - Room requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... gross floor area. (b) Rooms designed for sleeping purposes shall have a minimum gross square foot floor... of two. (c) Every room designed for sleeping purposes shall have accessible clothes hanging...

  4. 24 CFR 3280.109 - Room requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... gross floor area. (b) Rooms designed for sleeping purposes shall have a minimum gross square foot floor... of two. (c) Every room designed for sleeping purposes shall have accessible clothes hanging...

  5. Politics in the birthing room.

    PubMed

    Durain, Dawn

    2002-12-01

    Women have always braved their way through childbirth one way or another. The hands surrounding them as they make their journey have offered many things. For some it has been herbs or a totem to hold. For others, it has been a tether to a beeping machine or a drug to transform the experience. No one has yet found the method(s) that addresses every pregnant woman's fear or pain during labor and birth. And no one can truly guarantee that all will be okay. The contemporary medical profession offers to shoulder the burden for women by "taking care of it for them," The managed care industry assures the public that they will provide pregnant women with the highest quality of care and the greatest decision-making power. Elected officials promise that they will save women and newborns from unscrupulous legal practices and from the abuses of managed care. But these goals, for better or worse, have yet to be fully realized. No matter the circumstances, women will continue to have babies. Their labors will be short or long, will occur surrounded by flowered décor or in sterile wards, and will be attended by physicians who are overburdened by the demands of maintaining a practice or by a midwife who must battle with institutional protocols to care for her clients. The battle for the political victories in women's health care will undoubtedly continue for some time to come. The strength and resolve of women and their families will determine the outcome and give voice to the consumer and the midwife in the board-room, in the hearing room, and in the birthing room. PMID:12587376

  6. 7 CFR 58.409 - Drying room.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Drying room. 58.409 Section 58.409 Agriculture....409 Drying room. When applicable, a drying room of adequate size shall be provided to accommodate the... provided for proper drying. Temperature and humidity control facilities should be provided which...

  7. 7 CFR 58.409 - Drying room.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false Drying room. 58.409 Section 58.409 Agriculture....409 Drying room. When applicable, a drying room of adequate size shall be provided to accommodate the... provided for proper drying. Temperature and humidity control facilities should be provided which...

  8. 7 CFR 58.409 - Drying room.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 3 2014-01-01 2014-01-01 false Drying room. 58.409 Section 58.409 Agriculture....409 Drying room. When applicable, a drying room of adequate size shall be provided to accommodate the... provided for proper drying. Temperature and humidity control facilities should be provided which...

  9. 7 CFR 58.409 - Drying room.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Drying room. 58.409 Section 58.409 Agriculture....409 Drying room. When applicable, a drying room of adequate size shall be provided to accommodate the... provided for proper drying. Temperature and humidity control facilities should be provided which...

  10. 32 CFR 701.6 - Reading rooms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Reading rooms. 701.6 Section 701.6 National... Reading rooms. The FOIA requires that (a)(2) records created on or after 1 November 1996, be made available electronically (starting 1 November 1997) as well as in hard copy, in the FOIA reading room...

  11. 32 CFR 701.6 - Reading rooms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Reading rooms. 701.6 Section 701.6 National... Reading rooms. The FOIA requires that (a)(2) records created on or after 1 November 1996, be made available electronically (starting 1 November 1997) as well as in hard copy, in the FOIA reading room...

  12. Diagnostic Dilemmas and Cultural Diversity in Emergency Rooms

    PubMed Central

    Weaver, Charlotte; Sklar, David

    1980-01-01

    Language and cultural beliefs play an extremely important role in the interaction between patients from diverse cultural groups and physicians. Especially in emergency rooms, there are many dangers in missed communications. A patient from a foreign culture, especially one who does not speak English, often expresses symptoms in ways that are unfamiliar to many American physicians. Specific areas of cultural vulnerability can be identified for the major ethnic groups in the United States as they interact with the scientific medical system. A short review of folk medical beliefs and recommendations for improving diagnostic accuracy and treatment may assist emergency room staffs in offering care that is culturally acceptable to patients of diverse ethnic backgrounds. PMID:7347053

  13. Flow analysis of airborne particles in a hospital operating room

    NASA Astrophysics Data System (ADS)

    Faeghi, Shiva; Lennerts, Kunibert

    2016-06-01

    Preventing airborne infections during a surgery has been always an important issue to deliver effective and high quality medical care to the patient. One of the important sources of infection is particles that are distributed through airborne routes. Factors influencing infection rates caused by airborne particles, among others, are efficient ventilation and the arrangement of surgical facilities inside the operating room. The paper studies the ventilation airflow pattern in an operating room in a hospital located in Tehran, Iran, and seeks to find the efficient configurations with respect to the ventilation system and layout of facilities. This study uses computational fluid dynamics (CFD) and investigates the effects of different inflow velocities for inlets, two pressurization scenarios (equal and excess pressure) and two arrangements of surgical facilities in room while the door is completely open. The results show that system does not perform adequately when the door is open in the operating room under the current conditions, and excess pressure adjustments should be employed to achieve efficient results. The findings of this research can be discussed in the context of design and controlling of the ventilation facilities of operating rooms.

  14. Comparison of Rates of Coronary Angiography and Combined Testing Procedures in Patients Seen in the Emergency Room With Chest Pain (But No Objective Acute Coronary Syndrome Findings) Having Coronary Computed Tomography Versus Exercise Stress Testing.

    PubMed

    Grunau, Brian; Leipsic, Jonathon; Purssell, Elizabeth; Kasteel, Naomi; Nguyen, Kimchi; Kazem, Mikameh; Naoum, Christopher; Raju, Rekha; Blanke, Philipp; Heilbron, Brett; Taylor, Carolyn; Scheuermeyer, Frank X

    2016-07-15

    Coronary computed tomography angiography (CCTA) appears comparable to standard care, including exercise stress testing (EST), in diagnosing acute coronary syndrome in emergency department (ED) patients with chest pain but may increase downstream testing. The objective of this study was to investigate rates of post-CCTA versus post-EST testing for (1) invasive angiography and (2) all combined cardiac testing. This was a retrospective cohort study performed at 2 urban Canadian EDs involving patients aged up to 65 years with chest pain but no objective ACS findings that were evaluated with CCTA or EST at the physician's discretion. The primary outcome was the proportion of patients who had 30-day invasive angiography in each group; secondary outcomes included all subsequent 30-day cardiac testing, including nuclear medicine scanning. From July 1, 2012, to June 30, 2014, we collected 1,700 patients: 521 CCTA and 1,179 EST. Demographics and risk factors were similar in both cohorts. In the following 30 days, 30 CCTA (5.8%) and 297 EST (25.2%) patients underwent any type of additional cardiac testing (difference 19.4%, 95% CI 16.0 to 22.6), whereas 12 CCTA (2.3%) and 20 EST patients (1.7%) underwent angiography (difference 0.6%, 95% CI -0.8% to 2.6%). No patients in either group died or had a myocardial infarction within 30 days. For ED patients with chest pain who underwent brief observation, CCTA and EST had similar 30-day angiography rates, but CCTA patients underwent significantly less overall cardiac investigations. PMID:27236251

  15. True Cost of Amateur Clean rooms

    NASA Technical Reports Server (NTRS)

    Ramsey, W. Lawrence

    2005-01-01

    This viewgraph document reviews the cost factors for clean rooms that are not professionally built, monitored or maintained. These amateur clean rooms are built because scientist and engineers desire to create a clean room to build a part of an experiment that requires a clean room, and the program manager is looking to save money. However, in the long run these clean rooms may not save money, as the cost of maintenance may be higher due to the cost of transporting the crews, and if the materials were of lesser quality, the cost of modifications may diminish any savings, and the product may not be of the same quality. Several examples are shown of the clean rooms that show some of the problems that can arise from amateur clean rooms.

  16. Hospitalization in double-occupancy rooms and the risk of hospital-acquired influenza: a prospective cohort study.

    PubMed

    Munier-Marion, E; Bénet, T; Régis, C; Lina, B; Morfin, F; Vanhems, P

    2016-05-01

    Hospitalization in double-occupancy rooms and the risk of hospital-acquired influenza were assessed prospectively. The incidence was 2.0 for 100 patient-days in double- vs. 0.7 in single-occupancy rooms (p 0.028). The adjusted hazard ratio of hospital-acquired influenza was 2.67 (95% confidence interval 1.05-6.76) in patients hospitalized in double- compared to single-occupancy rooms. PMID:26806256

  17. Pre-admission NT-proBNP improves diagnostic yield and risk stratification – the NT-proBNP for EValuation of dyspnoeic patients in the Emergency Room and hospital (BNP4EVER) study

    PubMed Central

    Januzzi, James L; Medvedovski, Margarita; Sharist, Moshe; Shochat, Michael; Ashkar, Jalal; Peschansky, Pavel; Haim, Shmuel Bar; Blondheim, David S; Glikson, Michael; Shotan, Avraham

    2012-01-01

    Background: Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) level is useful to diagnose or exclude acutely decompensated heart failure (ADHF) in dyspnoeic patients presenting to the emergency department (ED). Aim: To evaluate the impact of ED NT-proBNP testing on admission, length of stay (LOS), discharge diagnosis and long-term outcome. Methods: Dyspnoeic patients were randomized in the ED to NT-proBNP testing. Admission and discharge diagnoses, and outcomes were examined. Results: During 17 months, 470 patients were enrolled and followed for 2.0±1.3 years. ADHF likelihood, determined at study conclusion by validated criteria, established ADHF diagnosis as unlikely in 86 (17%), possible in 120 (24%), and likely in 293 (59%) patients. The respective admission rates in these subgroups were 80, 91, and 96%, regardless of blinding, and 61.9% of blinded vs. 74.5% of unblinded ADHF-likely patients were correctly diagnosed at discharge (p=0.029), with similar LOS. 2-year mortality within subgroups was unaffected by test, but was lower in ADHF-likely patients with NT-proBNP levels below median (5000 pg/ml) compared with those above median (p=0.002). Incidence of recurrent cardiac events tracked NT-proBNP levels. Conclusion: ED NT-proBNP testing did not affect admission, LOS, 2-year survival, or recurrent cardiac events among study patients but improved diagnosis at discharge, and allowed risk stratification even within the ADHF-likely group. (ClinicalTrials.gov#NCT00271128) PMID:24062895

  18. Room acoustics for the aged.

    PubMed

    Plomp, R; Duquesnoy, A J

    1980-12-01

    This article deals with the combined effects of noise and reverberation on the speech-reception threshold for sentences. It is based on a series of current investigations on: (1) the modulation-transfer function as a measure of speech intelligibility in rooms, (2) the applicability of this concept to hearing-impaired persons, and (3) hearing loss for speech in quiet and in noise as a function of age. It is shown that, generally, in auditoria, classrooms, etc. the reverberation time T, acceptable for normal-hearing listeners, has to be reduced to (0.75)DT in order to be acceptable for elderly subjects with a hearing loss of D dB for speech in noise; for listening conditions as in lounges, restaurants, etc. the corresponding value is (0.82)DT. PMID:7462459

  19. Operating room of the future.

    PubMed

    Bharathan, Rasiah; Aggarwal, Rajesh; Darzi, Ara

    2013-06-01

    Development of surgical care in the 21st century is increasingly dependent on demonstrating safety, efficacy and cost effectiveness. Over the past 2 decades, the potential role of simulation in surgery has been explored with encouraging results; this can now be linked to direct improvement in the quality of care provision. Computer-assisted surgical platforms, such as robotic surgery, offer us the versatility to embrace a host of technical and technological developments. Rapid development in nanomedicine will expand the limits of operative performance through improved navigation and surgical precision. Integration of the multiple functions of the future operating room will be essential in optimising resource management. The key to bringing about the necessary paradigm shift in the design and delivery of modern surgical care is to appreciate that we now function in an information age, where the integrity of processes is driven by apt data management. PMID:23266083

  20. Apparel for Cleaner Clean Rooms

    NASA Technical Reports Server (NTRS)

    1983-01-01

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

  1. Experience using radio frequency laptops to access the electronic medical record in exam rooms.

    PubMed Central

    Dworkin, L. A.; Krall, M.; Chin, H.; Robertson, N.; Harris, J.; Hughes, J.

    1999-01-01

    Kaiser Permanente, Northwest, evaluated the use of laptop computers to access our existing comprehensive Electronic Medical Record in exam rooms via a wireless radiofrequency (RF) network. Eleven of 22 clinicians who were offered the laptops successfully adopted their use in the exam room. These clinicians were able to increase their exam room time with the patient by almost 4 minutes (25%), apparently without lengthening their overall work day. Patient response to exam room computing was overwhelmingly positive. The RF network response time was similar to the hardwired network. Problems cited by some laptop users and many of the eleven non-adopters included battery issues, different equipment layout and function, and inadequate training. IT support needs for the RF laptops were two to four times greater than for hardwired desktops. Addressing the reliability and training issues should increase clinician acceptance, making a successful general roll-out for exam room computing more likely. PMID:10566458

  2. The use of a novel technology to study dynamics of pathogen transmission in the operating room.

    PubMed

    Birnbach, David J; Rosen, Lisa F; Fitzpatrick, Maureen; Carling, Philip; Munoz-Price, L Silvia

    2015-04-01

    Pathogenic organisms have been found in the intraoperative environment, potentially posing a risk of infection that could cause morbidity and mortality. In an effort to understand how a patient's bacteria can be spread throughout the operating room with the anesthesia provider as a vector, we conducted a study using recently developed experimental technology in a simulated operating room environment with a high-fidelity human patient simulator. PMID:24810261

  3. Monitored anesthesia care in and outside the operating room

    PubMed Central

    Sohn, Hye-min

    2016-01-01

    Monitored anesthesia care (MAC) is an anesthesia technique combining local anesthesia with parenteral drugs for sedation and analgesia. The use of MAC is increasing for a variety of diagnostic and therapeutic procedures in and outside of the operating room due to the rapid postoperative recovery with the use of relatively small amounts of sedatives and analgesics compared to general anesthesia. The purposes of MAC are providing patients with safe sedation, comfort, pain control and satisfaction. Preoperative evaluation for patients with MAC is similar to those of general or regional anesthesia in that patients should be comprehensively assessed. Additionally, patient cooperation with comprehension of the procedure is an essential component during MAC. In addition to local anesthesia by operators or anesthesiologists, systemic sedatives and analgesics are administered to provide patients with comfort during procedures performed with MAC. The discretion and judgment of an experienced anesthesiologist are required for the safety and efficacy profiles because the airway of the patients is not secured. The infusion of sedatives and analgesics should be individualized during MAC. Many procedures in and outside of the operating room, including eye surgery, otolaryngologic surgery, cardiovascular procedures, pain procedures, and endoscopy are performed with MAC to increase patient and operator satisfaction. PMID:27482307

  4. From Baltic rooms to conference rooms: my jouney with data

    NASA Astrophysics Data System (ADS)

    Kozlowski, W. A.

    2015-12-01

    From time spent in murky, mosquito-filled mangrove swamps searching for fiddler crabs, to being transported off ships in webbed "man-baskets" on inky-black winter mornings to sample sea ice, to teaching rooms full of students the benefits of information organization, the wonders of science have long shaped my career path. Regardless of surroundings, the driving factor has always been a desire to learn new skills, then try to figure out how to use them to make work easier or more efficient for myself and hopefully others. Somewhere along the way, I've switched from doing it primarily for my "own" research projects, to a focus on helping others with theirs. Like many in this field, my route to a career in data science has influenced how I do my work. Along the way I've carried skills with me but also learned a few things that have made my journey both practical and fun. In this presentation, I'll discuss a few key factors that contribute to my current efforts as a data curation specialist in a research library, including communication (translation of "library" concepts to "science" concepts and vice versa), flexibility (ability to accomodate ideas, pace and values of those I'm working with), and prioritization (learning to balance what's valuable to researchers with principles important to libraries, curators, repositories, archives and other groups with which I interact).

  5. Snoezelen Room and Childbirth Outcome: A Randomized Clinical Trial

    PubMed Central

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

    2015-01-01

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

  6. Physician Activities During Time Out of the Examination Room

    PubMed Central

    Gilchrist, Valerie; McCord, Gary; Schrop, Susan Labuda; King, Bridget D.; McCormick, Kenelm F.; Oprandi, Allison M.; Selius, Brian A.; Cowher, Michael; Maheshwary, Rishi; Patel, Falguni; Shah, Ami; Tsai, Bonny; Zaharna, Mia

    2005-01-01

    PURPOSE Comprehensive medical care requires direct physician-patient contact, other office-based medical activities, and medical care outside of the office. This study was a systematic investigation of family physician office-based activities outside of the examination room. METHODS In the summer of 2000, 6 medical students directly observed and recorded the office-based activities of 27 northeastern Ohio community-based family physicians during 1 practice day. A checklist was used to record physician activity every 20 seconds outside of the examination room. Observation excluded medical care provided at other sites. Physicians were also asked to estimate how they spent their time on average and on the observed day. RESULTS The average office day was 8 hours 8 minutes. On average, 20.1 patients were seen and physicians spent 17.5 minutes per patient in direct contact time. Office-based time outside of the examination room averaged 3 hours 8 minutes or 39% of the office practice day; 61% of that time was spent in activities related to medical care. Charting (32.9 minutes per day) and dictating (23.4 minutes per day) were the most common medical activities. Physicians overestimated the time they spent in direct patient care and medical activities. None of the participating practices had electronic medical records. CONCLUSIONS If office-based, medically related activities were averaged over the number of patients seen in the office that day, the average office visit time per patient would increase by 7 minutes (40%). Care delivery extends beyond direct patient contact. Models of health care delivery need to recognize this component of care. PMID:16338912

  7. [Alcohol consumption in the emergency room].

    PubMed

    Alderete, Ethel; Bianchini, Pablo

    2008-01-01

    We examined patterns of alcohol consumption and blood alcohol levels in emergency room patients. The study was conducted in a public hospital of the province of Jujuy, Argentina. A survey was conducted among all patients during the 24 hours of 4 consecutive days (N = 500) using the Alcohol Use Disorders Identification Test, short version (AUDIT-C). Blood samples were collected in 84% of participants. Results showed that 37% were hazardous drinkers (men 50% vs. women 23%), 29% had symptoms of dependence (men 48% vs. women 11%); 17% of men and 3% of women had high blood alcohol levels, equal or greater than 50 mg/dl. In multivariate logistic regression models men had increased likelihood of hazardous drinking (Adjusted OR 3.2; 95% CI 2.1-5.0), symptoms of dependence (Adjusted OR 7.5; 95% CI 4.4-12.7) and increased blood alcohol levels (Adjusted OR 8.0; 95% CI 2.2-28.8), compared with women. Patients admitted due to accidents, violence, or drug use, had increased likelihood of hazardous drinking (Adjusted OR 2.4; 95% CI 1.5-3.9), dependence symptoms (Adjusted OR 2.0; 95% CI 1.2-3.3) and increased blood alcohol levels (Adjusted OR 7.7; 95% CI 3.0-19.8), compared with those admitted for other reasons. Alcoholism has a significant impact on the occurrence of injuries and on the demand imposed on health services. Prevention programs can potentially reduce the negative health and social impact of alcoholism. PMID:18416317

  8. Robin Room and cannabis policy: dangerous comparisons.

    PubMed

    Hall, Wayne

    2014-11-01

    This paper describes Robin Room's contribution to cannabis policy debates over the period 1993-2010. It focuses on a controversy that erupted over a review that Room and the author undertook for the World Health Organization in the mid-1990s on the comparative harms of cannabis, alcohol, opiates and tobacco. It also briefly describes Room's recent work on global cannabis policy and ends with a brief appreciation of the character of his scholarly contributions to this field. PMID:25395172

  9. Emergency room resuscitative thoracotomy: when is it indicated?

    PubMed

    Boyd, M; Vanek, V W; Bourguet, C C

    1992-11-01

    This study was designed to examine the results of emergency room resuscitative thoracotomy (ERRT) and to formulate cost-effective indications for this procedure. A retrospective study was performed of 28 patients who had ERRT at St. Elizabeth Hospital Medical Center, Youngstown, Ohio, during the 4 years from July 1985 through June 1989. The prognostic factors analyzed included mechanism and site of injury, signs of life (SOL), vital signs (VS), age, gender, and prehospital care. The overall survival rate of ERRT was 7% (2 of 28 patients). The survival rate was 18% (2 of 11 patients) with penetrating trauma, and 0% (none of 17 patients) with blunt trauma. The best survival rate was 66% in the subgroup of patients with penetrating trauma and SOL present at the scene and in the emergency room (ER), (two of three patients). Our observations were combined with those of 23 studies from the literature involving 2294 trauma patients who had ERRT. Using meta-analysis, the survival rate was 11% overall. Improved survival was noted for patients with penetrating trauma compared with patients with blunt trauma (14% vs. 2%, p < 0.01). There were no survivors in the group of patients with no SOL at the scene, and there were no neurologically intact survivors among blunt trauma patients with no SOL upon arrival at the ER. An algorithm based on mechanism of injury and presence or absence of SOL at the scene and in the ER is proposed. This algorithm would decrease the number of ERRTs performed by 41% without decreasing the number of neurologically intact survivors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1464921

  10. Prevalence of otorhinolaryngologic diagnoses in the pediatric emergency room

    PubMed Central

    Signorelli, Luiz Gabriel; Mendes, Elaine de Abreu

    2013-01-01

    Summary Introduction: Fever and pain, which are very common in ear, nose, and throat pathologies, are among the most frequent complaints recorded during emergency room pediatric patient treatment. Most of time, the pediatricians are called on to evaluate otorhinolaryngology disorders that requires specialist assessment. Aim: To determine the prevalence of otorhinolaryngologic diagnoses in a pediatric population in a reference hospital in the city of Itatiba, São Paulo. Methods: We evaluated 2,054 pediatric patients (age range, 0–12 years, 11 months) in this descriptive, transversal observational (survey) study. Data collection was performed by a single observer during 103 night shifts (07:00 p.m. to 07:00 a.m.) between January and December 2011, and included documentation of the main diagnosis, and patient age and sex. The ethics committee and research institution approved study. Patients were divided into 2 groups based on diagnosis: Group A otorhinolaryngology disease and Group B included diagnoses not contained in Group A. Results: Of the total enrolled patients, 52.2% corresponded to Group A and 47.8% to Group B; 51.9% were male and 48.1% were female. The average age was 4.5 years (Group A, 3.93 years; Group B, 5.03 years). We compared the prevalence of the diagnostic hypotheses of the 2 groups. Conclusion: A large number of patients sought treatment at pediatric emergency rooms for otorhinolaryngologic diagnoses. PMID:25991987

  11. Topological Insulators at Room Temperature

    SciTech Connect

    Zhang, Haijun; Liu, Chao-Xing; Qi, Xiao-Liang; Dai, Xi; Fang, Zhong; Zhang, Shou-Cheng; /Stanford U., Phys. Dept.

    2010-03-25

    Topological insulators are new states of quantum matter with surface states protected by the time-reversal symmetry. In this work, we perform first-principle electronic structure calculations for Sb{sub 2}Te{sub 3}, Sb{sub 2}Se{sub 3}, Bi{sub 2}Te{sub 3} and Bi{sub 2}Se{sub 3} crystals. Our calculations predict that Sb{sub 2}Te{sub 3}, Bi{sub 2}T e{sub 3} and Bi{sub 2}Se{sub 3} are topological insulators, while Sb{sub 2}Se{sub 3} is not. In particular, Bi{sub 2}Se{sub 3} has a topologically non-trivial energy gap of 0.3eV , suitable for room temperature applications. We present a simple and unified continuum model which captures the salient topological features of this class of materials. These topological insulators have robust surface states consisting of a single Dirac cone at the {Lambda} point.

  12. Xenon porometry at room temperature

    NASA Astrophysics Data System (ADS)

    Telkki, Ville-Veikko; Lounila, Juhani; Jokisaari, Jukka

    2006-01-01

    Xenon porometry is a method in which porous material is immersed in a medium and the properties of the material are studied by means of Xe129 nuclear magnetic resonance (NMR) of xenon gas dissolved in the medium. For instance, the chemical shift of a particular signal (referred to as signal D) arising from xenon inside small pockets formed in the pores during the freezing of the confined medium is highly sensitive to the pore size. In the present study, we show that when naphthalene is used as the medium the pore size distribution of the material can be determined by measuring a single one-dimensional spectrum near room temperature and converting the chemical shift scale of signal D to the pore radius scale by using an experimentally determined correlation. A model has been developed that explains the curious behavior of the chemical shift of signal D as a function of pore radius. The other signals of the spectra measured at different temperatures have also been identified, and the influence of xenon pressure on the spectra has been studied. For comparison, Xe129 NMR spectra of pure xenon gas adsorbed to porous materials have been measured and analyzed.

  13. Effect of Room Ventilation Rates in Rodent Rooms with Direct-Exhaust IVC Systems.

    PubMed

    Geertsema, Roger S; Lindsell, Claire E

    2015-09-01

    When IVC are directly exhausted from a rodent housing room, the air quality of the room can become independent of the intracage air quality and may reduce the need for high room ventilation rates. This study assessed the effect of decreasing the ventilation rate in rodent rooms using direct-exhaust IVC systems. The study was conducted over 16 wk and compared conditions in 8 rodent rooms that had ventilation rates of 5 to 6 air changes per hour (ACH) with those in rooms at 10 to 12 ACH. At the low ventilation rate, rooms had higher CO₂ concentrations, higher dew point temperature, and lower particulate levels and spent a greater percentage of time above the temperature set point than did rooms at the high rate. The levels of allergens and endotoxins in room air were the same regardless of the ventilation rate. Differences seen in parameters within cages at the 2 ventilation rates were operationally irrelevant. We detected no total volatile organic compounds in the room that were attributable to ammonia, regardless of the ventilation rate. Clearing the air of ethanol after a spill took longer at the low compared with high rate. However, ethanol clearance was faster at the low rate when the demand-control system was activated than at the high ventilation rate alone. Air quality in the room and in the cages were acceptable with room ventilation rates of 5 to 6 ACH in rodent rooms that use direct-exhaust IVC systems. PMID:26424250

  14. Effect of Room Ventilation Rates in Rodent Rooms with Direct-Exhaust IVC Systems

    PubMed Central

    Geertsema, Roger S; Lindsell, Claire E

    2015-01-01

    When IVC are directly exhausted from a rodent housing room, the air quality of the room can become independent of the intracage air quality and may reduce the need for high room ventilation rates. This study assessed the effect of decreasing the ventilation rate in rodent rooms using direct-exhaust IVC systems. The study was conducted over 16 wk and compared conditions in 8 rodent rooms that had ventilation rates of 5 to 6 air changes per hour (ACH) with those in rooms at 10 to 12 ACH. At the low ventilation rate, rooms had higher CO2 concentrations, higher dew point temperature, and lower particulate levels and spent a greater percentage of time above the temperature set point than did rooms at the high rate. The levels of allergens and endotoxins in room air were the same regardless of the ventilation rate. Differences seen in parameters within cages at the 2 ventilation rates were operationally irrelevant. We detected no total volatile organic compounds in the room that were attributable to ammonia, regardless of the ventilation rate. Clearing the air of ethanol after a spill took longer at the low compared with high rate. However, ethanol clearance was faster at the low rate when the demand-control system was activated than at the high ventilation rate alone. Air quality in the room and in the cages were acceptable with room ventilation rates of 5 to 6 ACH in rodent rooms that use direct-exhaust IVC systems. PMID:26424250

  15. Airflow analysis in mechanically ventilated obstructed rooms

    NASA Astrophysics Data System (ADS)

    Priest, John Brian

    1999-11-01

    Local and mean air velocities and standard deviations were measured in realistic rooms. Obstructions represented occupants and equipment in the rooms, internal heat loads varied and supply air temperature differed from room averages. Experimental setups differed for the isothermal and nonisothermal tests. Room dimensions for isothermal tests were 2.44 m high by 4.88 x 4.88 m. Ten different obstruction ratios using three different inlet types were analyzed. Obstructions covered 0 to 30% floor area and from 0 to 75% of room height. Air was supplied at ventilation rates ranging between 0.8 and 1.1 m 3/s. Room dimensions for the nonisothermal tests were 2.44 m high by 3.66 x 7.32 m. Obstruction differences between solid versus open partitions for farrowing crates were investigated for three commercially available inlets using two ventilation loads. Ventilation rates were 0.11 to 1.18 m 3/s, simulating cold and warm weather ventilation conditions, respectively. Based on these data and theoretical calculations, a kinetic energy model that predicts average room air velocity and energy level was developed as a practical room air flow design and analysis tool. It was recommended that designers interested in using CFD as a tool should use a three dimensional laminar model for acceptable qualitative flow results. It was concluded that for typical room flowrates and inlet types the room air distribution system is obstruction ratio independent. Local velocities and standard deviations varied with each obstruction setup and inlet combination. However, average air velocities and turbulence intensities were not influenced by obstruction setups or inlet configurations. The decay rate of mean velocity kinetic energy in the bulk flow region was independent of obstructions and inlets. Room average kinetic energy was a function of the supplied kinetic energy within the supply jet plus internal kinetic energy resulting from internal heat load (convective energy).

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

    PubMed

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

    2013-05-01

    OBJECTIVE. Effective disinfection of hospital rooms after discharge of patients with Clostridium difficile infection (CDI) is necessary to prevent transmission. We evaluated the impact of sequential cleaning and disinfection interventions by culturing high-touch surfaces in CDI rooms after cleaning. DESIGN. Prospective intervention. SETTING. A Veterans Affairs hospital. INTERVENTIONS. During a 21-month period, 3 sequential tiered interventions were implemented: (1) fluorescent markers to provide monitoring and feedback on thoroughness of cleaning facility-wide, (2) addition of an automated ultraviolet radiation device for adjunctive disinfection of CDI rooms, and (3) enhanced standard disinfection of CDI rooms, including a dedicated daily disinfection team and implementation of a process requiring supervisory assessment and clearance of terminally cleaned CDI rooms. To determine the impact of the interventions, cultures were obtained from CDI rooms after cleaning and disinfection. RESULTS. The fluorescent marker intervention improved the thoroughness of cleaning of high-touch surfaces (from 47% to 81% marker removal; P < .0001). Relative to the baseline period, the prevalence of positive cultures from CDI rooms was reduced by 14% (P=.024), 48% (P <.001), and 89% (P=.006) with interventions 1, 2, and 3, respectively. During the baseline period, 67% of CDI rooms had positive cultures after disinfection, whereas during interventions periods 1, 2, and 3 the percentages of CDI rooms with positive cultures after disinfection were reduced to 57%, 35%, and 7%, respectively. CONCLUSIONS. An intervention that included formation of a dedicated daily disinfection team and implementation of a standardized process for clearing CDI rooms achieved consistent CDI room disinfection. Culturing of CDI rooms provides a valuable tool to drive improvements in environmental disinfection. PMID:23571361

  17. Validation of the Excited Component of the Positive and Negative Syndrome Scale (PANSS-EC) in a naturalistic sample of 278 patients with acute psychosis and agitation in a psychiatric emergency room

    PubMed Central

    2011-01-01

    Background Despite the wide use of the Excited Component of the Positive and Negative Syndrome Scale (PANSS-EC) in a clinical setting to assess agitated patients, a validation study to evaluate its psychometric properties was missing. Methods Data from the observational NATURA study were used. This research describes trends in the use of treatments in patients with acute psychotic episodes and agitation seen in emergency departments. Exploratory principal component factor analysis was performed. Spearman's correlation and regression analyses (linear regression model) as well as equipercentile linking of Clinical Global Impression of Severity (CGI-S), Agitation and Calmness Evaluation Scale (ACES) and PANSS-EC items were conducted to examine the scale's diagnostic validity. Furthermore, reliability (Cronbach's alpha) and responsiveness were evaluated. Results Factor analysis resulted in one factor being retained according to eigenvalue ≥1. At admission, the PANSS-EC and CGI-S were found to be linearly related, with an average increase of 3.4 points (p < 0.001) on the PANSS-EC for each additional CGI-S point. The PANSS-EC and ACES were found to be linearly and inversely related, with an average decrease of 5.5 points (p < 0.001) on the PANSS-EC for each additional point. The equipercentile method shows the poor sensitivity of the ACES scale. Cronbach's alpha was 0.86 and effect size was 1.44. Conclusions The factorial analyses confirm the unifactorial structure of the PANSS-EC subscale. The PANSS-EC showed a strong linear correlation with rating scales such as CGI-S and ACES. PANSS-EC has also shown an excellent capacity to detect real changes in agitated patients. PMID:21447155

  18. Reappraisal of emergency room thoracotomy in a changing environment.

    PubMed

    Esposito, T J; Jurkovich, G J; Rice, C L; Maier, R V; Copass, M K; Ashbaugh, D G

    1991-07-01

    The efficacy of resuscitative emergency room thoracotomy (ERT), particularly in blunt injury, has been questioned. Wide application of the procedure may not be cost effective. The risk of exposure and lethal infection to medical personnel during ERT is considerable. For the past decade, the policy at this institution has been to perform ERT on all moribund patients sustaining penetrating torso injury and all patients sustaining blunt injury with any evidence of cardiac electrical activity. To evaluate whether such a liberal policy is currently justified, the charts of all patients undergoing ERT over a 4-year period were reviewed. One hundred twelve patients underwent ERT; 24 (21%) sustained penetrating injury, 88 (79%) blunt injury. The overall survival rate was 1.8%. Penetrating injury had a 4.2% survival and blunt injury 1.1%. No patients with CPR initiated at the scene and required throughout transport survived. In those patients with both blood pressure and spontaneous respirations present in the field, survival rate was 11.8%. Survival rate in patients manifesting sinus rhythm or ventricular fibrillation upon arrival at the ER was 6.4%. No survivors were noted among patients coming to the hospital with an idioventricular rhythm or asystole. The total hospital charges for patients undergoing ERT exceeded reimbursement by $59,565. Screening for HIV and hepatitis could be documented in only two patients; both were negative. Liberal performance of ERT has dismal results, incurs monetary loss, and affords a greater potential for exposure to lethal infection. Emergency room thoracotomy is justified only when vital signs or a resuscitatible cardiac rhythm are present in the field or ER and deteriorate shortly before thoracotomy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2072424

  19. 55. VIEW OF SLC3E CONTROL ROOM (ROOM 107) FROM ITS ...

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

    55. VIEW OF SLC-3E CONTROL ROOM (ROOM 107) FROM ITS NORTHEAST CORNER - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  20. FACILITY 810A, DINING ROOM IN FOREGROUND WITH LIVING ROOM AND ...

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

    FACILITY 810A, DINING ROOM IN FOREGROUND WITH LIVING ROOM AND ITS FIREPLACE IN BACKGROUND, VIEW FACING NORTH. - Schofield Barracks Military Reservation, Duplex Housing Type with Corner Entries, Between Hamilton & Tidball Streets near Williston Avenue, Wahiawa, Honolulu County, HI

  1. Field Test of Room-to-Room Uniformity of Ventilation Air Distribution in Two New Houses

    SciTech Connect

    Hendron, Robert; Anderson, Ren; Barley, Dennis; Rudd, Armin; Townsend, Aaron; Hancock, Ed

    2006-12-01

    This report describes a field test to characterize the uniformity of room-to-room ventilation air distribution under various operating conditions by examining multi-zone tracer gas decay curves and calculating local age-of-air.

  2. Interior building details of Building C, Room C203 to Room ...

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

    Interior building details of Building C, Room C-203 to Room C-204: historical partition track with folding doors, east painted wall; easterly view - San Quentin State Prison, Building 22, Point San Quentin, San Quentin, Marin County, CA

  3. Interior building details of Building D, Room D101 to Room ...

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

    Interior building details of Building D, Room D-101 to Room D-101c partition wall with multi-pane wood sash; westerly view - San Quentin State Prison, Building 22, Point San Quentin, San Quentin, Marin County, CA

  4. Non-Operating Room Anesthesia in the Endoscopy Unit.

    PubMed

    Bhavani, Sekar

    2016-07-01

    The term, non-operating room anesthesia, describes a location remote from the main operating suites and closer to the patient, including areas that offer specialized procedures, like endoscopy suites, cardiac catheterization laboratories, bronchoscopy suites, and invasive radiology suites. There has been an exponential growth in such procedures and they present challenges in both organizational aspects and administration of anesthesia. This article explores the requirements for the location, preoperative evaluation and patient selection, monitoring, anesthesia technique, and postoperative management at these sites. There is a need to better define the role of the anesthesia personnel at these remote sites. PMID:27372771

  5. On designing room sheilding for total-body irradiation

    SciTech Connect

    Barish, R.J.

    1996-05-01

    When designing shielding for total-body irradiation as an additional modality of treatment in an ordinary radiation therapy room, the extended treatment distance used for these patients greatly increases the workload because of the inverse-square factor. In a seeming contradiction to logic, for a facility with an exterior wall in the path of one lateral primary beam, and a restricted area behind the other primary wall, the overall shielding requirements are lower if the TBI patients are treated with the machine oriented toward the occupied interior. 4 refs.

  6. Instrumentation for measuring speech privacy in rooms

    NASA Astrophysics Data System (ADS)

    Horrall, Thomas; Pirn, Rein; Markham, Ben

    2003-10-01

    Federal legislation pertaining to oral privacy in healthcare and financial services industries has increased the need for a convenient and economical way to document speech privacy conditions in offices, medical examination rooms, and certain other workspaces. This legislation is embodied in the Health Insurance Portability and Accountability Act (HIPAA) and Gramm-Leach-Bliley Act (GLBA). Both laws require that reasonable measures be put in place to safeguard the oral privacy of patients and clients. While techniques for privacy documentation are known within the acoustical consulting community, it is unlikely that community alone has the capacity to provide the surveys needed to evaluate acoustical conditions and demonstrate compliance with the legislation. A portable computer with integrated soundboard and a suitable amplified loudspeaker and test microphone are all that are needed to perform in situ measurements of articulation index or other accepted indices of speech privacy. Along with modest training, such instrumentation allows technicians to survey a large number of sites economically. Cost-effective components are shown that can meet the requirements for testing in most common environments where oral privacy is likely to be required. Example cases are presented to demonstrate the feasibility of such instrumentation.

  7. High Efficiency Room Air Conditioner

    SciTech Connect

    Bansal, Pradeep

    2015-01-01

    This project was undertaken as a CRADA project between UT-Battelle and Geberal Electric Company and was funded by Department of Energy to design and develop of a high efficiency room air conditioner. A number of novel elements were investigated to improve the energy efficiency of a state-of-the-art WAC with base capacity of 10,000 BTU/h. One of the major modifications was made by downgrading its capacity from 10,000 BTU/hr to 8,000 BTU/hr by replacing the original compressor with a lower capacity (8,000 BTU/hr) but high efficiency compressor having an EER of 9.7 as compared with 9.3 of the original compressor. However, all heat exchangers from the original unit were retained to provide higher EER. The other subsequent major modifications included- (i) the AC fan motor was replaced by a brushless high efficiency ECM motor along with its fan housing, (ii) the capillary tube was replaced with a needle valve to better control the refrigerant flow and refrigerant set points, and (iii) the unit was tested with a drop-in environmentally friendly binary mixture of R32 (90% molar concentration)/R125 (10% molar concentration). The WAC was tested in the environmental chambers at ORNL as per the design rating conditions of AHAM/ASHRAE (Outdoor- 95F and 40%RH, Indoor- 80F, 51.5%RH). All these modifications resulted in enhancing the EER of the WAC by up to 25%.

  8. Operating Room Technology. Post Secondary Curriculum Guide.

    ERIC Educational Resources Information Center

    Simpson, Bruce; And Others

    This curriculum guide was designed for use in postsecondary operating room technology education programs in Georgia. Its purpose is to provide for development of entry level skills in operating room technology in the areas of knowledge, theoretical structure, tool usage, diagnostic ability, related supportive skills, and occupational survival…

  9. Room 13: The Movement and International Network

    ERIC Educational Resources Information Center

    Gibb, Claire

    2012-01-01

    Room 13 is a global uprising of creative and entrepreneurial children who are responsible for a growing international network of student-organised art studios. Each Room 13 studio facilitates the work of young artists alongside a professional adult artist in residence, providing an exchange of ideas, skills and experience across the ages. The…

  10. The Mini Dark Room from Holywell High

    ERIC Educational Resources Information Center

    Lane, Frank

    2011-01-01

    The mini dark room from Holywell High School costs nothing to make and has a construction time of 10 min. In spite of progress, or perhaps because of it, light experiments often have to be performed without blackout. Put this idea into practice and each pupil can have a dark room--and best of all, it's free. In this article, the author describes…

  11. PASSWORD: Organizing Exits from the Resource Room.

    ERIC Educational Resources Information Center

    Johnson, Linda K.

    1990-01-01

    The article offers a classroom management technique, PASSWORD, that facilitates the smooth transition of handicapped students from the resource room to the regular class. Students are each asked a "code question," usually a review question, the answer to which is the password for leaving the resource room. (DB)

  12. 32 CFR 701.35 - Reading room.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Reading room. 701.35 Section 701.35 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND... DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.35 Reading room. Location where...

  13. 32 CFR 701.35 - Reading room.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Reading room. 701.35 Section 701.35 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY UNITED STATES NAVY REGULATIONS AND... DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.35 Reading room. Location where...

  14. New thinking for the boiler room.

    PubMed

    Rose, Wayne

    2008-09-01

    Wayne Rose, marketing manager at integrated plant room manufacturer Armstrong Integrated Systems, explains how increasing use of off-site manufacture, the latest 3D modelling technology, and advances in control technology, are revolutionising boiler room design and construction. PMID:18822819

  15. Perceptual effects in auralization of virtual rooms

    NASA Astrophysics Data System (ADS)

    Kleiner, Mendel; Larsson, Pontus; Vastfjall, Daniel; Torres, Rendell R.

    2002-05-01

    By using various types of binaural simulation (or ``auralization'') of physical environments, it is now possible to study basic perceptual issues relevant to room acoustics, as well to simulate the acoustic conditions found in concert halls and other auditoria. Binaural simulation of physical spaces in general is also important to virtual reality systems. This presentation will begin with an overview of the issues encountered in the auralization of room and other environments. We will then discuss the influence of various approximations in room modeling, in particular, edge- and surface scattering, on the perceived room response. Finally, we will discuss cross-modal effects, such as the influence of visual cues on the perception of auditory cues, and the influence of cross-modal effects on the judgement of ``perceived presence'' and the rating of room acoustic quality.

  16. 8. VIEW OF SLC3W CONTROL ROOM (ROOM 105) FROM ITS ...

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

    8. VIEW OF SLC-3W CONTROL ROOM (ROOM 105) FROM ITS NORTHEAST CORNER. TELEMETRY ROOM VISIBLE THROUGH WINDOWS IN SOUTH WALL. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  17. The Most Difficult Transition in Child Care: From the Infant Room into the Toddler Room.

    ERIC Educational Resources Information Center

    Miller, Karen

    1998-01-01

    Examines the transition in child care from the infant room into the toddler room from the perspectives of the parents, the child, and the caregiver. Suggests strategies for easing the transition by moving the caregivers with the children, moving one caregiver to the toddler room, making transition gradual, and retaining the positive aspects of the…

  18. 146. View of oil filter room in basement (Room B1) ...

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

    146. View of oil filter room in basement (Room B-1) where oil used in lubrication in generator room is cleaned and recycled. The two tanks in the foreground each have capacities of 2,100 gallons. Photo by Jet Lowe, HAER, 1989. - Puget Sound Power & Light Company, White River Hydroelectric Project, 600 North River Avenue, Dieringer, Pierce County, WA

  19. Automated Primary Care Screening in Pediatric Waiting Rooms

    PubMed Central

    Carroll, Aaron E.; Downs, Stephen M.

    2012-01-01

    BACKGROUND AND OBJECTIVE: Implementing US Preventive Services Task Force and American Academy of Pediatrics preventive service guidelines within the short duration of a visit is difficult because identifying which of a large number of guidelines apply to a particular patient is impractical. Clinical decision support system integrated with electronic medical records offer a good strategy for implementing screening in waiting rooms. Our objective was to determine rates of positive risk screens during typical well-care visits among children and adolescents in a primary care setting. METHODS: Child Health Improvement through Computer Automation (CHICA) is a pediatric clinical decision support system developed by our research group. CHICA encodes clinical guidelines as medical logic modules to generate scanable paper forms: the patient screening form to collect structured data from patient families in the waiting room and the physician worksheet to provide physician assessments at each visit. By using visit as a unit of analysis from CHICA’s database, we have determined positive risk screen rates in our population. RESULTS: From a cohort of 16 963 patients, 408 601 questions were asked in 31 843 visits. Of the questions asked, 362 363 (89%) had a response. Of those, 39 176 (11%) identified positive risk screens in both the younger children and the adolescent age groups. CONCLUSIONS: By automating the process of screening and alerting the physician to those who screened positive, we have significantly decreased the burden of identifying relevant guidelines and screening of patient families in our clinics. PMID:22508925

  20. Three-dimensional conformal setup (3D-CSU) of patients using the coordinate system provided by three internal fiducial markers and two orthogonal diagnostic X-ray systems in the treatment room

    SciTech Connect

    Shirato, Hiroki . E-mail: hshirato@radi.med.hokudai.ac.jp; Oita, Masataka; Fujita, Katsuhisa; Shimizu, Shinichi; Onimaru, Rikiya; Uegaki, Shinji; Watanabe, Yoshiharu; Kato, Norio; Miyasaka, Kazuo

    2004-10-01

    Purpose: To test the accuracy of a system for correcting for the rotational error of the clinical target volume (CTV) without having to reposition the patient using three fiducial markers and two orthogonal fluoroscopic images. We call this system 'three-dimensional conformal setup' (3D-CSU). Methods and materials: Three 2.0-mm gold markers are inserted into or adjacent to the CTV. On the treatment couch, the actual positions of the three markers are calculated based on two orthogonal fluoroscopies crossing at the isocenter of the linear accelerator. Discrepancy of the actual coordinates of gravity center of three markers from its planned coordinates is calculated. Translational setup error is corrected by adjustment of the treatment couch. The rotation angles ({alpha}, {beta}, {gamma}) of the coordinates of the actual CTV relative to the planned CTV are calculated around the lateral (x), craniocaudal (y), and anteroposterior (z) axes of the planned CTV. The angles of the gantry head, collimator, and treatment couch of the linear accelerator are adjusted according to the rotation of the actual coordinates of the tumor in relation to the planned coordinates. We have measured the accuracy of 3D-CSU using a static cubic phantom. Results: The gravity center of the phantom was corrected within 0.9 {+-} 0.3 mm (mean {+-} SD), 0.4 {+-} 0.2 mm, and 0.6 {+-} 0.2 mm for the rotation of the phantom from 0-30 degrees around the x, y, and z axes, respectively, every 5 degrees. Dose distribution was shown to be consistent with the planned dose distribution every 10 degrees of the rotation from 0-30 degrees. The mean rotational error after 3D-CSU was -0.4 {+-} 0.4 (mean {+-} SD), -0.2 {+-} 0.4, and 0.0 {+-} 0.5 degrees around the x, y, and z axis, respectively, for the rotation from 0-90 degrees. Conclusions: Phantom studies showed that 3D-CSU is useful for performing rotational correction of the target volume without correcting the position of the patient on the treatment couch

  1. Stability of blood gases in ice and at room temperature.

    PubMed

    Liss, H P; Payne, C P

    1993-04-01

    Arterial blood samples from 75 patients were analyzed for PO2, PCO2, and pH at 0, 15, and 30 min. After the baseline analysis, 60 samples were kept in ice while 59 samples were left at room temperature. There was a statistically significant increase in the PO2 at 15 min and again at 30 min in both groups. There was a statistically significant decrease in the PCO2 at 15 min in both groups. There were no further changes in the PCO2 at 30 min in either group. There was a statistically significant decrease in the pH at 15 min in both groups. There was a further statistically significant decrease in the pH at 30 min in the group of blood samples left at room temperature but not in those in ice. There is no reason to keep arterial blood in ice if blood gas analysis is done within 30 min. PMID:8131450

  2. Stability of disposal rooms during waste retrieval

    SciTech Connect

    Brandshaug, T.

    1989-03-01

    This report presents the results of a numerical analysis to determine the stability of waste disposal rooms for vertical and horizontal emplacement during the period of waste retrieval. It is assumed that waste retrieval starts 50 years after the initial emplacement of the waste, and that access to and retrieval of the waste containers take place through the disposal rooms. It is further assumed that the disposal rooms are not back-filled. Convective cooling of the disposal rooms in preparation for waste retrieval is included in the analysis. Conditions and parameters used were taken from the Nevada Nuclear Waste Storage Investigation (NNWSI) Project Site Characterization Plan Conceptual Design Report (MacDougall et al., 1987). Thermal results are presented which illustrate the heat transfer response of the rock adjacent to the disposal rooms. Mechanical results are presented which illustrate the predicted distribution of stress, joint slip, and room deformations for the period of time investigated. Under the assumption that the host rock can be classified as ``fair to good`` using the Geomechanics Classification System (Bieniawski, 1974), only light ground support would appear to be necessary for the disposal rooms to remain stable. 23 refs., 28 figs., 2 tabs.

  3. Some folded issues related to over-shielded and unplanned rooms for medical linear accelerators - A case study

    NASA Astrophysics Data System (ADS)

    Muhammad, Wazir; Ullah, Asad; Hussain, Amjad; Ali, Nawab; Alam, Khan; Khan, Gulzar; Matiullah; Maeng, Seongjin; Lee, Sang Hoon

    2015-08-01

    A medical linear accelerator (LINAC) room must be properly shielded to limit the outside radiation exposure to an acceptable safe level defined by individual state and international regulations. However, along with this prime objective, some additional issues are also important. The current case-study was designed to unfold the issues related to over-shielded and unplanned treatment rooms for LINACs. In this connection, an apparently unplanned and over-shielded treatment room of 610 × 610 cm2 in size was compared with a properly designed treatment room of 762 × 762 cm2 in size ( i.e., by following the procedures and recommendations of the IAEA Safety Reports Series No. 47 and NCRP 151). Evaluation of the unplanned room indicated that it was over-shielded and that its size was not suitable for total body irradiation (TBI), although the license for such a treatment facility had been acquired for the installed machine. An overall 14.96% reduction in the total shielding volume ( i.e., concrete) for an optimally planned room as compared to a non-planned room was estimated. Furthermore, the inner room's dimensions were increased by 25%, in order to accommodate TBI patients. These results show that planning and design of the treatment rooms are imperative to avoid extra financial burden to the hospitals and to provide enough space for easy and safe handling of the patients. A spacious room is ideal for storing treatment accessories and facilitates TBI treatment.

  4. Operating room metrics score card-creating a prototype for individualized feedback.

    PubMed

    Gabriel, Rodney A; Gimlich, Robert; Ehrenfeld, Jesse M; Urman, Richard D

    2014-11-01

    The balance between reducing costs and inefficiencies with that of patient safety is a challenging problem faced in the operating room suite. An ongoing challenge is the creation of effective strategies that reduce these inefficiencies and provide real-time personalized metrics and electronic feedback to anesthesia practitioners. We created a sample report card structure, utilizing existing informatics systems. This system allows to gather and analyze operating room metrics for each anesthesia provider and offer personalized feedback. To accomplish this task, we identified key metrics that represented time and quality parameters. We collected these data for individual anesthesiologists and compared performance to the overall group average. Data were presented as an electronic score card and made available to individual clinicians on a real-time basis in an effort to provide effective feedback. These metrics included number of cancelled cases, average turnover time, average time to operating room ready and patient in room, number of delayed first case starts, average induction time, average extubation time, average time to recovery room arrival to discharge, performance feedback from other providers, compliance to various protocols, and total anesthetic costs. The concept we propose can easily be generalized to a variety of operating room settings, types of facilities and OR health care professionals. Such a scorecard can be created using content that is important for operating room efficiency, research, and practice improvement for anesthesia providers. PMID:25315824

  5. Key facilitators and best practices of hotel-style room service in hospitals.

    PubMed

    Sheehan-Smith, Lisa

    2006-04-01

    This qualitative study sought to identify the features, advantages, and disadvantages of hotel-style room service; the barriers to, and facilitators for, implementing the process; and "best practices." The study took place in four heterogeneous hospitals. Participants included hospital administrators, managers, and room-service employees. Data-collection methods included semi-structured interviews, observations, and document analysis. Common features of hotel-style room service were meal delivery within 30 to 45 minutes, a restaurant-style menu, procedures to feed ineligible patients, tray assembly on demand, scripting, and waitstaff uniforms for room-service employees. The major barrier to implementing room service was obtaining nursing support. The key facilitators were the hospital's service-oriented culture, using a multidisciplinary planning team, engaging nursing departments early in the planning stages, and intense customer-service training of room-service employees. The overwhelming advantage was patients' control over their food choices. The main disadvantage was cost. Initial best practices in hotel-style room service include: (a) taking a multidisciplinary team approach for developing and implementing the process, (b) customer-service training, (c) using a customer-driven menu, (d) wearing waitstaff uniforms, and (e) using carts with airpots for dispensing hot beverages. PMID:16567154

  6. Factors determining the smooth flow and the non-operative time in a one-induction room to one-operating room setting

    PubMed Central

    Mulier, Jan P; De Boeck, Liesje; Meulders, Michel; Beliën, Jeroen; Colpaert, Jan; Sels, Annabel

    2015-01-01

    Rationale, aims and objectives What factors determine the use of an anaesthesia preparation room and shorten non-operative time? Methods A logistic regression is applied to 18 751 surgery records from AZ Sint-Jan Brugge AV, Belgium, where each operating room has its own anaesthesia preparation room. Surgeries, in which the patient's induction has already started when the preceding patient's surgery has ended, belong to a first group where the preparation room is used as an induction room. Surgeries not fulfilling this property belong to a second group. A logistic regression model tries to predict the probability that a surgery will be classified into a specific group. Non-operative time is calculated as the time between end of the previous surgery and incision of the next surgery. A log-linear regression of this non-operative time is performed. Results It was found that switches in surgeons, being a non-elective surgery as well as the previous surgery being non-elective, increase the probability of being classified into the second group. Only a few surgery types, anaesthesiologists and operating rooms can be found exclusively in one of the two groups. Analysis of variance demonstrates that the first group has significantly lower non-operative times. Switches in surgeons, anaesthesiologists and longer scheduled durations of the previous surgery increases the non-operative time. A switch in both surgeon and anaesthesiologist strengthens this negative effect. Only a few operating rooms and surgery types influence the non-operative time. Conclusion The use of the anaesthesia preparation room shortens the non-operative time and is determined by several human and structural factors. PMID:25496600

  7. Principles of operating room organization.

    PubMed

    Watkins, W D

    1997-01-01

    The importance of the changing health care climate has triggered important changes in the management of high-cost components of acute care facilities. By integrating and better managing various elements of the surgical process, health care institutions are able to rationally trim costs while maintaining high-quality services. The leadership that physicians can provide is crucial to the success of this undertaking (1). The importance of the use of primary data related to patient throughput and related resources should be strongly emphasized, for only when such data are converted to INFORMATION of functional value can participating healthcare personnel be reasonably expected to anticipate and respond to varying clinical demands with ever-limited resources. Despite the claims of specific commercial vendors, no single product will likely be sufficient to significantly change the perioperative process to the degree or for the duration demanded by healthcare reform. The most effective approach to achieving safety, cost-effectiveness, and predictable process in the realm of Surgical Services will occur by appropriate application of the "best of breed" contributions of: (a) medical/patient safety practice/oversight; (b) information technology; (c) contemporary management; and (d) innovative and functional cost-accounting methodology. S "modified activity-based cost accounting method" can serve as the basis for acquiring true direct-cost information related to the perioperative process. The proposed overall management strategy emphasizes process and feedback, rather than specific product, and although imposing initial demands and change on the traditional hospital setting, can advance the strongest competitive position in perioperative services. This comprehensive approach comprises a functional basis for important bench-marking activities among multiple surgical services. An active, comparative process of this type is of paramount importance in emphasizing patient care and

  8. 7 CFR 58.211 - Packaging room for bulk products.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Packaging room for bulk products. 58.211 Section 58... Service 1 Rooms and Compartments § 58.211 Packaging room for bulk products. A separate room or area shall... dust within the packaging room and where needed, a dust collector shall be provided and...

  9. Room temperature creep in metals and alloys

    SciTech Connect

    Deibler, Lisa Anne

    2014-09-01

    Time dependent deformation in the form of creep and stress relaxation is not often considered a factor when designing structural alloy parts for use at room temperature. However, creep and stress relaxation do occur at room temperature (0.09-0.21 Tm for alloys in this report) in structural alloys. This report will summarize the available literature on room temperature creep, present creep data collected on various structural alloys, and finally compare the acquired data to equations used in the literature to model creep behavior. Based on evidence from the literature and fitting of various equations, the mechanism which causes room temperature creep is found to include dislocation generation as well as exhaustion.

  10. High Fidelity Simulation of a Computer Room

    NASA Technical Reports Server (NTRS)

    Ahmad, Jasim; Chan, William; Chaderjian, Neal; Pandya, Shishir

    2005-01-01

    This viewgraph presentation reviews NASA's Columbia supercomputer and the mesh technology used to test the adequacy of the fluid and cooling of a computer room. A technical description of the Columbia supercomputer is also presented along with its performance capability.

  11. The Whys and Hows of Training Rooms.

    ERIC Educational Resources Information Center

    Sturgeon, Julie

    2000-01-01

    Offers advice on building and equipping a college athletic training room that can serve in preventing and treating athletic injuries. Issues concerning space utilization, protecting confidentiality, and making accommodations for amenities such as hydrotherapy pools are addressed. (GR)

  12. What Happens in the Emergency Room?

    MedlinePlus

    ... Quizzes Kids' Dictionary of Medical Words En Español What Other Kids Are Reading Back-to-School Butterflies? ... Got Homework? Here's Help White House Lunch Recipes What Happens in the Emergency Room? KidsHealth > For Kids > ...

  13. What Happens in the Operating Room?

    MedlinePlus

    ... Quizzes Kids' Dictionary of Medical Words En Español What Other Kids Are Reading Back-to-School Butterflies? ... Got Homework? Here's Help White House Lunch Recipes What Happens in the Operating Room? KidsHealth > For Kids > ...

  14. The Portable War Room Research Project

    NASA Technical Reports Server (NTRS)

    Govers, Francis X., III; Fry, Mark

    1997-01-01

    The Portable War Room is an internal TASC project to research and develop a visualization and simulation environment to provide for decision makers the power to review the past, understand the present, and peer into the future.

  15. 7 CFR 58.312 - Churn rooms.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION... Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments §...

  16. 7 CFR 58.312 - Churn rooms.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION... Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments §...

  17. 7 CFR 58.312 - Churn rooms.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION... Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments §...

  18. 7 CFR 58.312 - Churn rooms.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION... Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments §...

  19. 7 CFR 58.312 - Churn rooms.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION... Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments §...

  20. A Music House in the Music Room

    ERIC Educational Resources Information Center

    Cameron, William F.

    1972-01-01

    Describes a house'' within a music room where children come to listen to and read some of their favorite songs, listen to musical stories, play with musical games, or practice their chorus parts with a tape recorder. (Author/CB)

  1. Determining Camera Gain in Room Temperature Cameras

    SciTech Connect

    Joshua Cogliati

    2010-12-01

    James R. Janesick provides a method for determining the amplification of a CCD or CMOS camera when only access to the raw images is provided. However, the equation that is provided ignores the contribution of dark current. For CCD or CMOS cameras that are cooled well below room temperature, this is not a problem, however, the technique needs adjustment for use with room temperature cameras. This article describes the adjustment made to the equation, and a test of this method.

  2. Radiation transport in a radiotherapy room

    SciTech Connect

    Agosteo, S.; Para, A.F.; Maggioni, B.

    1995-01-01

    The photoneutron dose equivalent in a linac radio-therapy room and its entrance maze was investigated by means of Monte Carlo simulations under different conditions. Particularly, the effect of neutron absorbers and moderator layers placed on the maze walls was considered. The contribution of prompt gamma rays emitted in absorption reactions of thermal neutrons was also taken into account. The simulation results are compared with some experimental measurements in the therapy room and in the maze. 13 refs., 5 figs., 5 tabs.

  3. RLA room 20 cleanout and stabilization

    SciTech Connect

    Ham, J.E.

    1997-06-01

    This engineering report documents the decontamination and stabilization of the Rupture Loop Annex located in room 20 of the 309 building`s Plutonium Recycle Test Reactor. Low level, mixed, and recyclable waste was removed from the room. Smearable contamination was removed and/or fixed in place with paint. The RLA was cleaned out and stabilized to meet the Environmental Restoration Contractor`s turnover criteria.

  4. The effect of increasing operating room capacity on day-of-surgery cancellation.

    PubMed

    Yoon, S-Z; Lee, S I; Lee, H W; Lim, H J; Yoon, S M; Chang, S H

    2009-03-01

    Several studies have been conducted to evaluate the utilisation of the operating room, a fixed resource, in terms of conditions that prevent day-of-surgery cancellation due to deficient operative capacity. In this study, we surveyed the causes and overall rates of elective surgery cancellation and then compared the number of cancellations that occurred before and after the installation of additional operating rooms. We surveyed all patients undergoing elective surgery for 100 days prior to and after the installation of additional operating rooms. The causes for cancellations were divided into six categories: departmental issues, abnormal laboratory results, patient denial, inadequate preparation, over-booking and other issues. The departmental causes were further divided into four categories: ward overflow, scheduling date errors, unavailable surgeons and other issues. The number of overall cancelled cases and scheduled cases increased following the increase in operating room capacity, although this increase was not statistically significant. However; the cancellation ratio rose significantly after the operating room capacity was increased. The primary reasons for cancellation prior to the increase in operating room capacity were departmental issues, over-booking and abnormal laboratory data, in that order. After the operating room capacity was increased, the primary reasons for cancellation were departmental issues, abnormal laboratory data and over-booking, in that order Taken together the results of this study indicate that increased operating room capacity can prevent cancellation due to over-booking. However; the numbers of cancellations due to ward overflow exceeded the numbers of cancellations that occurred as a result of over-booking. In conclusion, increasing the operating room capacity is not an appropriate option for preventing the cancellation of operations. PMID:19400490

  5. 29. FIRST FLOOR, SOUTHWEST ROOM: DOUBLE DOOR CASE LOOKING EAST ...

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

    29. FIRST FLOOR, SOUTHWEST ROOM: DOUBLE DOOR CASE LOOKING EAST INTO SOUTHEAST ROOM. This case is typical for all double doors and triple windows in southeast and southwest rooms - Robinson-Aiken House, 48 Elizabeth Street, Charleston, Charleston County, SC

  6. TRACES OF ORIGINAL PARTITIONS AT JUNCTURE OF FRONT ROOM, REAR ...

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

    TRACES OF ORIGINAL PARTITIONS AT JUNCTURE OF FRONT ROOM, REAR ROOM AND HALL, SECOND FLOOR. ALSO SHOWS ORIGINAL STUCCO CORNICE OF FRONT AND REAR ROOMS (LEFT) AND HALL (RIGHT) - Kid-Chandler House, 323 Walnut Street, Philadelphia, Philadelphia County, PA

  7. Biopsychosocial Health Care Needs at the Emergency Room: Challenge of Complexity

    PubMed Central

    Matzer, Franziska; Wisiak, Ursula V.; Graninger, Monika; Söllner, Wolfgang; Stilling, Hans Peter; Glawischnig-Goschnik, Monika; Lueger, Andreas; Fazekas, Christian

    2012-01-01

    Background In an emergency room of internal medicine, triage and treatment of patients deserve first priority. However, biopsychosocial case complexity may also affect patient health outcome but has not yet been explored in this setting. Therefore, the aims of the study are (1) to estimate prevalence rates of complex patients in the emergency room (ER), (2) to describe biopsychosocial complexity in this population and (3) to evaluate possible correlations between patient profiles regarding case complexity and further clinical treatment. Methods During a study period of one week, all patients of an emergency room of internal medicine who were triaged to Manchester levels three to five were invited to participate in the study. Biopsychosocial case complexity was assessed by the INTERMED method. Psychosocial interventions were evaluated based on all documented interventions and recommendations given at the emergency room and during inpatient treatment. Results Study participants consisted of 167 patients with a subgroup of 19% (n = 32) receiving subsequent inpatient-treatment at the department. High biopsychosocial case complexity was found in 12% (n = 20) of the total sample (INTERMED score >20). This finding was paralleled by a cluster analysis suggesting three clusters with one highly complex patient group of 14%. These highly complex patients differed significantly from the other clusters as they had visited the emergency room more often within the last year and lived alone more frequently. In addition, admission rates were highest in this group. During ER treatment and subsequent inpatient treatment, 21% of highly complex patients received interventions addressing psychosocial factors as compared to 6% and 7%, respectively, in the other clusters. Conclusions A standardized screening of biopsychosocial case complexity among ‘frequent utilizers’ of the ER would be helpful to detect specific multidisciplinary health care needs among this particularly

  8. Medical robotics and the operating room of the future.

    PubMed

    Cleary, Kevin

    2005-01-01

    Medical robotics is an evolving field with a relatively short history and limited market penetration, although some recent systems have shown some commercial success. Nevertheless, medical robotics shows great promise for improving patient care and may become a key component in the Operating Room of the Future (ORF), where high technology equipment will be integrated with medical imaging. This paper gives an overview of the medical robotics field and summarizes a recent ORF workshop in which participants concluded that standards are critical for an integrated approach. PMID:17281953

  9. Neutron distribution and induced activity inside a Linac treatment room.

    PubMed

    Juste, B; Miró, R; Verdú, G; Díez, S; Campayo, J M

    2015-08-01

    Induced radioactivity and photoneutron contamination inside a radiation therapy bunker of a medical linear accelerator (Linac) is investigated in this work. The Linac studied is an Elekta Precise electron accelerator which maximum treatment photon energy is 15 MeV. This energy exceeds the photonuclear reaction threshold (around 7 MeV for high atomic number metals). The Monte Carlo code MCNP6 has been used for quantifying the neutron contamination inside the treatment room for different gantry rotation configuration. Walls activation processes have also been simulated. The approach described in this paper is useful to prevent the overexposure of patients and medical staff. PMID:26737878

  10. Transport of airborne particles within a room.

    PubMed

    Richmond-Bryant, J; Eisner, A D; Brixey, L A; Wiener, R W

    2006-02-01

    The objective of this study is to test a technique used to analyze contaminant transport in the wake of a bluff body under controlled experimental conditions for application to aerosol transport in a complex furnished room. Specifically, the hypothesis tested by our work is that the dispersion of contaminants in a room is related to the turbulence kinetic energy and length scale. This turbulence is, in turn, determined by the size and shape of furnishings within the room and by the ventilation characteristics. This approach was tested for indoor dispersion through computational fluid dynamics simulations and laboratory experiments. In each, 3 mum aerosols were released in a furnished room with varied contaminant release locations (at the inlet vent or under a desk). The realizable k approximately epsilon model was employed in the simulations, followed by a Lagrangian particle trajectory simulation used as input for an in-house FORTRAN code to compute aerosol concentration. For the experiments, concentrations were measured simultaneously at seven locations by laser photometry, and air velocity was measured using laser Doppler velocimetry. The results suggest that turbulent diffusion is a significant factor in contaminant residence time in a furnished room. This procedure was then expanded to develop a simplified correlation between contaminant residence time and the number of enclosing surfaces around a point containing the contaminant. Practical Implications The work presented here provides a methodology for relating local aerosol residence time to properties of room ventilation and furniture arrangement. This technique may be used to assess probable locations of high concentration by knowing only the particle release location, furniture configuration, inlet and outlet locations, and air speeds, which are all observable features. Applications of this method include development of 'rules of thumb' for first responders entering a room where an agent has been released

  11. Xenon spill distribution and room clearance.

    PubMed

    Kelsey, C A; Telepak, R J

    1999-11-01

    The purpose of these studies was to investigate actual xenon gas clearance times under different exhaust conditions, to compare them with the calculated clearance times, to observe the distribution of the xenon gas while it was being exhausted from the room, and to determine the cause of a stationary xenon cloud that appeared on some clinical images. Clearance times with and without a flexible exhaust hose placed next to a simulated 133Xe gas spill were compared with clearance times measured in a room with all exhaust closed off. Two gamma cameras were used to observe the transport and exhaust of xenon following a simulated spill. Clearance times with the flexible exhaust hose were less than one minute because the xenon gas was removed before it had a chance to disperse into the room. Conventional room clearance calculations based on uniform mixing and measured exhaust rates yielded a clearance time of 22 min. The source of an artifactual stationary cloud image was discovered to be a small amount of xenon trapped between the collimator and camera face. A negative pressure and dedicated exhaust can be even more effective in exhausting spilled xenon from a room than air transfer calculations predict. The authors believe the flexible hose should always be used. PMID:10524516

  12. Software Support during a Control Room Upgrade

    SciTech Connect

    Michele Joyce; Michael Spata; Thomas Oren; Anthony Cuffe; Theo McGuckin; Isadoro Carlino; C. Higgins; Harry Fanning; Matthew Bickley; Brian Bevins

    2005-09-21

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

  13. The operating room as a clinical learning environment: An exploratory study.

    PubMed

    Meyer, Rhoda; Van Schalkwyk, Susan C; Prakaschandra, Rosaley

    2016-05-01

    Students undertake their clinical placement in various clinical settings for the exposure to and acquisition of skills related to that particular context. The operating room is a context that offers the opportunity to develop critical skills related to the perioperative care of the patient. Despite numerous studies that have been undertaken in this field, few have investigated the operating room as a clinical learning environment in the South African private healthcare context. The aim of this study was to determine nursing students' perceptions of the operating room as a clinical learning environment. An exploratory, interpretive and descriptive design generating qualitative data was utilized. Eight nursing students completed an open-ended questionnaire, and twelve nursing students participated in the focus group discussion. Four themes emerged, namely, 'interpersonal factors', 'educational factors', 'private operating room context', and 'recommendations'. The opinion that the operating room offers an opportunity to gain skills unique to this context was expressed. However, despite the potential learning opportunities, the key findings of this study reveal negative perceptions of nursing students regarding learning experiences in the operating room. Exploration into the preparatory needs of students specific to learning outcomes before operating room placement should be considered. It will also be necessary to improve collaboration between lecturers, mentors and theatre managers. PMID:27235567

  14. Persons with Mild or Moderate Alzheimer's Disease Use a Basic Orientation Technology to Travel to Different Rooms within a Day Center

    ERIC Educational Resources Information Center

    Lancioni, Giulio E.; Perilli, Viviana; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Bosco, Andrea; De Caro, Maria Fara; Cassano, Germana; Pinto, Katia; Minervini, Mauro

    2011-01-01

    This study assessed whether three patients with Alzheimer's disease could learn to use a basic orientation technology to reach different rooms within a day center. At each travel instance, the technology provided verbal messages (cues) from the room to reach. For the first two patients, the messages were presented at intervals of about 15 s. For…

  15. Nurses' perception of single-occupancy versus multioccupancy rooms in acute care environments: an exploratory comparative assessment.

    PubMed

    Chaudhury, Habib; Mahmood, Atiya; Valente, Maria

    2006-08-01

    Health care design professionals, planners, and administrators cite the advantages of private patient rooms, including reduction of hospital-acquired infections, reduction of patient stress levels, and facilitation of nurses' and health care workers' efficiency [e.g., Ulrich, R. (2003). Creating a healing environment with evidence-based design. Paper presented at the American Institute of Architects, Academy of Architecture for Health virtual seminar-Healing environments; Ulrich, R., Quan, X., Zimring, C., Joseph, A., & Choudhary, R. (2004). The role of the physical environment in the hospital of the 21st century: A once-in-a-lifetime-opportunity. ]. A review of the literature revealed that operating costs are reduced in single-patient rooms compared with multioccupancy rooms due to reduction in transfer cost, higher bed occupancy rates, and reduction in labor cost. In addition, single rooms can positively impact patients' hospital experience through increased privacy, better interaction between family and staff, and reduced noise and anxiety. This pilot study focused on nurses' perception of the advantages and disadvantages of single-occupancy versus multioccupancy patient rooms in medical-surgical units in four hospitals in the northwest. A majority of respondents in the four hospitals favored single rooms over double-occupancy rooms for the majority of the 15 categories, including the following: appropriateness for patient examination, interaction with or accommodation of family members, and lower probability of dietary mix-ups. Future studies need to carefully examine the objective measures of patient care variables (e.g., incidents of medication errors, opportunities for surveillance), patient outcomes (e.g., recovery rate, falls), and implications of room occupancy on operating costs. PMID:16877190

  16. An informationally structured room for robotic assistance.

    PubMed

    Tsuji, Tokuo; Mozos, Oscar Martinez; Chae, Hyunuk; Pyo, Yoonseok; Kusaka, Kazuya; Hasegawa, Tsutomu; Morooka, Ken'ichi; Kurazume, Ryo

    2015-01-01

    The application of assistive technologies for elderly people is one of the most promising and interesting scenarios for intelligent technologies in the present and near future. Moreover, the improvement of the quality of life for the elderly is one of the first priorities in modern countries and societies. In this work, we present an informationally structured room that is aimed at supporting the daily life activities of elderly people. This room integrates different sensor modalities in a natural and non-invasive way inside the environment. The information gathered by the sensors is processed and sent to a centralized management system, which makes it available to a service robot assisting the people. One important restriction of our intelligent room is reducing as much as possible any interference with daily activities. Finally, this paper presents several experiments and situations using our intelligent environment in cooperation with our service robot. PMID:25912347

  17. Electric control of magnetism at room temperature

    PubMed Central

    Wang, Liaoyu; Wang, Dunhui; Cao, Qingqi; Zheng, Yuanxia; Xuan, Haicheng; Gao, Jinlong; Du, Youwei

    2012-01-01

    In the single-phase multiferroics, the coupling between electric polarization (P) and magnetization (M) would enable the magnetoelectric (ME) effect, namely M induced and modulated by E, and conversely P by H. Especially, the manipulation of magnetization by an electric field at room-temperature is of great importance in technological applications, such as new information storage technology, four-state logic device, magnetoelectric sensors, low-power magnetoelectric device and so on. Furthermore, it can reduce power consumption and realize device miniaturization, which is very useful for the practical applications. In an M-type hexaferrite SrCo2Ti2Fe8O19, large magnetization and electric polarization were observed simultaneously at room-temperature. Moreover, large effect of electric field-controlled magnetization was observed even without magnetic bias field. These results illuminate a promising potential to apply in magnetoelectric devices at room temperature and imply plentiful physics behind them. PMID:22355737

  18. Artificial life and the Chinese room argument.

    PubMed

    Anderson, David; Copeland, B Jack

    2002-01-01

    "Strong artificial life" refers to the thesis that a sufficiently sophisticated computer simulation of a life form is a life form in its own right. Can John Searle's Chinese room argument [12]-originally intended by him to show that the thesis he dubs "strong AI" is false-be deployed against strong ALife? We have often encountered the suggestion that it can be (even in print; see Harnad [8]). We do our best to transfer the argument from the domain of AI to that of ALife. We do so in order to show once and for all that the Chinese room argument proves nothing about ALife. There may indeed be powerful philosophical objections to the thesis of strong ALife, but the Chinese room argument is not among them. PMID:12650646

  19. Method of Remotely Constructing a Room

    DOEpatents

    Michie, J. D.; De Hart, R. C.

    1971-10-05

    The testing of nuclear devices of high explosive yield has required that cavities of relatively large size be provided at considerable distances below the surface of the earth for the pre-detonation emplacement of the device. The construction of an essentially watertight chamber or room in the cavity is generally required for the actual emplacement of the device. A method is described of constructing such a room deep within the earth by personnel at the surface. A dual wall bladder of a watertight, pliable fabric material is lowered down a shaft into a selected position. The bladder is filled with a concrete grout while a heavy fluid having essentially the same density as the grout is maintained on both sides of the bladder, to facilitate complete deployment of the bladder by the grout to form a room of desired configuration. (10 claims)

  20. Method of remotely constructing a room

    DOEpatents

    Michie, J.D.; De Hart, R.C.

    1971-10-05

    The testing of nuclear devices of high explosive yield has required that cavities of relatively large size be provided at considerable distances below the surface of the earth for the pre-detonation emplacement of the device. The construction of an essentially watertight chamber or room in the cavity is generally required for the actual emplacement of the device. A method is described of constructing such a room deep within the earth by personnel at the surface. A dual wall bladder of a watertight, pliable fabric material is lowered down a shaft into a selected position. The bladder is filled with a concrete grout while a heavy fluid having essentially the same density as the grout is maintained on both sides of the bladder, to facilitate complete deployment of the bladder by the grout to form a room of desired configuration. (10 claims)

  1. A New Control Room for SLAC Accelerators

    SciTech Connect

    Erickson, Roger; Guerra, E.; Stanek, M.; Hoover, Z.Van; Warren, J.; /SLAC

    2012-06-04

    We are planning to construct a new control room at SLAC to unify and improve the operation of the LCLS, SPEAR3, and FACET accelerator facilities, and to provide the space and flexibility needed to support the LCLS-II and proposed new test beam facilities. The existing control rooms for the linac and SPEAR3 have been upgraded in various ways over the last decade, but their basic features have remained unchanged. We propose to build a larger modern Accelerator Control Room (ACR) in the new Research Support Building (RSB) which is currently under construction at SLAC. Shifting the center of control for the accelerator facilities entails both technical and administrative challenges. In this paper, we describe the history, concept, and status of this project.

  2. Interior building details of Building C, Room C003 and Room ...

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

    Interior building details of Building C, Room C-003 and Room C-002 catwalk above false ceiling, east brick retaining wall, brick north wall, 1930 retrofit pillars, wood floor joints; northeasterly view - San Quentin State Prison, Building 22, Point San Quentin, San Quentin, Marin County, CA

  3. Case reports: response to a partial power failure in the operating room.

    PubMed

    Carpenter, Tammy; Robinson, Stephen T

    2010-06-01

    Failure of the power supply to the operating suites is a rare event. When it happens, it is critical that the care team responds in a way that optimizes patient safety. In the event we describe in this case report, only the emergency (red) power outlets failed. The anesthesia care team and other staff in the 8 affected rooms with anesthetized patients generally responded appropriately. The optimal response to these events is not necessarily intuitive. It is important to have advanced planning both within the immediate work area and beyond the operating room all the way into the hospital infrastructure. PMID:20008912

  4. Entangling Macroscopic Diamonds at Room Temperature

    NASA Astrophysics Data System (ADS)

    Lee, K. C.; Sprague, M. R.; Sussman, B. J.; Nunn, J.; Langford, N. K.; Jin, X.-M.; Champion, T.; Michelberger, P.; Reim, K. F.; England, D.; Jaksch, D.; Walmsley, I. A.

    2011-12-01

    Quantum entanglement in the motion of macroscopic solid bodies has implications both for quantum technologies and foundational studies of the boundary between the quantum and classical worlds. Entanglement is usually fragile in room-temperature solids, owing to strong interactions both internally and with the noisy environment. We generated motional entanglement between vibrational states of two spatially separated, millimeter-sized diamonds at room temperature. By measuring strong nonclassical correlations between Raman-scattered photons, we showed that the quantum state of the diamonds has positive concurrence with 98% probability. Our results show that entanglement can persist in the classical context of moving macroscopic solids in ambient conditions.

  5. Overview of geometrical room acoustic modeling techniques.

    PubMed

    Savioja, Lauri; Svensson, U Peter

    2015-08-01

    Computerized room acoustics modeling has been practiced for almost 50 years up to date. These modeling techniques play an important role in room acoustic design nowadays, often including auralization, but can also help in the construction of virtual environments for such applications as computer games, cognitive research, and training. This overview describes the main principles, landmarks in the development, and state-of-the-art for techniques that are based on geometrical acoustics principles. A focus is given to their capabilities to model the different aspects of sound propagation: specular vs diffuse reflections, and diffraction. PMID:26328688

  6. Dynamics of Glass Relaxation at Room Temperature

    NASA Astrophysics Data System (ADS)

    Welch, Roger C.; Smith, John R.; Potuzak, Marcel; Guo, Xiaoju; Bowden, Bradley F.; Kiczenski, T. J.; Allan, Douglas C.; King, Ellyn A.; Ellison, Adam J.; Mauro, John C.

    2013-06-01

    The problem of glass relaxation under ambient conditions has intrigued scientists and the general public for centuries, most notably in the legend of flowing cathedral glass windows. Here we report quantitative measurement of glass relaxation at room temperature. We find that Corning® Gorilla® Glass shows measurable and reproducible relaxation at room temperature. Remarkably, this relaxation follows a stretched exponential decay rather than simple exponential relaxation, and the value of the stretching exponent (β=3/7) follows a theoretical prediction made by Phillips for homogeneous glasses.

  7. Control room habitability system review models

    SciTech Connect

    Gilpin, H. )

    1990-12-01

    This report provides a method of calculating control room operator doses from postulated reactor accidents and chemical spills as part of the resolution of TMI Action Plan III.D.3.4. The computer codes contained in this report use source concentrations calculated by either TACT5, FPFP, or EXTRAN, and transport them via user-defined flow rates to the control room envelope. The codes compute doses to six organs from up to 150 radionuclides (or 1 toxic chemical) for time steps as short as one second. Supporting codes written in Clipper assist in data entry and manipulation, and graphically display the results of the FORTRAN calculations. 7 refs., 22 figs.

  8. Computer vision based room interior design

    NASA Astrophysics Data System (ADS)

    Ahmad, Nasir; Hussain, Saddam; Ahmad, Kashif; Conci, Nicola

    2015-12-01

    This paper introduces a new application of computer vision. To the best of the author's knowledge, it is the first attempt to incorporate computer vision techniques into room interior designing. The computer vision based interior designing is achieved in two steps: object identification and color assignment. The image segmentation approach is used for the identification of the objects in the room and different color schemes are used for color assignment to these objects. The proposed approach is applied to simple as well as complex images from online sources. The proposed approach not only accelerated the process of interior designing but also made it very efficient by giving multiple alternatives.

  9. Lightning Effects in the Payload Changeout Room

    NASA Technical Reports Server (NTRS)

    Thomas, Garland L.; Fisher, Franklin A.; Collier, Richard S.; Medelius, Pedro J.

    1997-01-01

    Analytical and empirical studies have been performed to provide better understanding of the electromagnetic environment inside the Payload Changeout Room and Orbiter payload bay resulting from lightning strikes to the launch pad lightning protection system. The analytical studies consisted of physical and mathematical modeling of the pad structure and the Payload Changeout Room. Empirical testing was performed using a lightning simulator to simulate controlled (8 kA) lightning strikes to the catenary wire lightning protection system. In addition to the analyses and testing listed above, an analysis of the configuration with the vehicle present was conducted, in lieu of testing, by the Finite Difference, Time Domain method.

  10. Room Temperature Multiferroicity of Charge Transfer Crystals.

    PubMed

    Qin, Wei; Chen, Xiaomin; Li, Huashan; Gong, Maogang; Yuan, Guoliang; Grossman, Jeffrey C; Wuttig, Manfred; Ren, Shenqiang

    2015-09-22

    Room temperature multiferroics has been a frontier research field by manipulating spin-driven ferroelectricity or charge-order-driven magnetism. Charge-transfer crystals based on electron donor and acceptor assembly, exhibiting simultaneous spin ordering, are drawing significant interests for the development of all-organic magnetoelectric multiferroics. Here, we report that a remarkable anisotropic magnetization and room temperature multiferroicity can be achieved through assembly of thiophene donor and fullerene acceptor. The crystal motif directs the dimensional and compositional control of charge-transfer networks that could switch magnetization under external stimuli, thereby opening up an attractive class of all-organic nanoferronics. PMID:26257033

  11. Widely tunable room temperature semiconductor terahertz source

    SciTech Connect

    Lu, Q. Y.; Slivken, S.; Bandyopadhyay, N.; Bai, Y.; Razeghi, M.

    2014-11-17

    We present a widely tunable, monolithic terahertz source based on intracavity difference frequency generation within a mid-infrared quantum cascade laser at room temperature. A three-section ridge waveguide laser design with two sampled grating sections and a distributed-Bragg section is used to achieve the terahertz (THz) frequency tuning. Room temperature single mode THz emission with a wide tunable frequency range of 2.6–4.2 THz (∼47% of the central frequency) and THz power up to 0.1 mW is demonstrated, making such device an ideal candidate for THz spectroscopy and sensing.

  12. 30 CFR 57.4262 - Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... liquid storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. 57.4262 Section 57... storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. Transformer stations, storage and dispensing areas for combustible liquids, pump rooms, compressor rooms, and hoist rooms shall...

  13. 30 CFR 57.4262 - Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... liquid storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. 57.4262 Section 57... storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. Transformer stations, storage and dispensing areas for combustible liquids, pump rooms, compressor rooms, and hoist rooms shall...

  14. 30 CFR 57.4262 - Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... liquid storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. 57.4262 Section 57... storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. Transformer stations, storage and dispensing areas for combustible liquids, pump rooms, compressor rooms, and hoist rooms shall...

  15. 30 CFR 57.4262 - Underground transformer stations, combustible liquid storage and dispensing areas, pump rooms...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... liquid storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. 57.4262 Section 57... storage and dispensing areas, pump rooms, compressor rooms, and hoist rooms. Transformer stations, storage and dispensing areas for combustible liquids, pump rooms, compressor rooms, and hoist rooms shall...

  16. Individual room temperature control: A peaceful solution to thermostat wars

    SciTech Connect

    Pieper, C.A. )

    1994-01-01

    This article addresses the problem of maintaining thermal comfort in individual rooms using an individual room temperature control concept to provide greater occupant comfort and potentially reduce energy consumption. The topics of the article include occupant temperature control methods, multi-room zone control, HVAC system operation, computer simulation, and the results of using individual room temperature control.

  17. Interior of the shipping room with doorway leading to processing ...

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

    Interior of the shipping room with doorway leading to processing room. A pass-through window with conveyor allowed the fresh packed oysters to be sent from the processing room into the shipping room. - J.C. Lore Oyster House, 14430 Solomons Island Road, Solomons, Calvert County, MD

  18. 32 CFR 806.11 - FOIA reading rooms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 6 2012-07-01 2012-07-01 false FOIA reading rooms. 806.11 Section 806.11... FREEDOM OF INFORMATION ACT PROGRAM § 806.11 FOIA reading rooms. Each FOIA office will arrange for a... room with the FOIA office. The FOIA does not require creation of a reading room dedicated...

  19. 32 CFR 806.11 - FOIA reading rooms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 6 2011-07-01 2011-07-01 false FOIA reading rooms. 806.11 Section 806.11... FREEDOM OF INFORMATION ACT PROGRAM § 806.11 FOIA reading rooms. Each FOIA office will arrange for a... room with the FOIA office. The FOIA does not require creation of a reading room dedicated...

  20. 32 CFR 806.11 - FOIA reading rooms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 6 2013-07-01 2013-07-01 false FOIA reading rooms. 806.11 Section 806.11... FREEDOM OF INFORMATION ACT PROGRAM § 806.11 FOIA reading rooms. Each FOIA office will arrange for a... room with the FOIA office. The FOIA does not require creation of a reading room dedicated...

  1. 32 CFR 806.11 - FOIA reading rooms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 6 2014-07-01 2014-07-01 false FOIA reading rooms. 806.11 Section 806.11... FREEDOM OF INFORMATION ACT PROGRAM § 806.11 FOIA reading rooms. Each FOIA office will arrange for a... room with the FOIA office. The FOIA does not require creation of a reading room dedicated...

  2. 30 CFR 42.50 - Charges for room and board.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Charges for room and board. 42.50 Section 42.50... ADMINISTRATIVE REQUIREMENTS NATIONAL MINE HEALTH AND SAFETY ACADEMY Room and Board § 42.50 Charges for room and board. The Academy will charge room and board to all persons staying at the Academy, except...

  3. 11. BUILDING 324, INTERIOR, DINING ROOM, FROM WEST SIDE OF ...

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

    11. BUILDING 324, INTERIOR, DINING ROOM, FROM WEST SIDE OF ROOM, LOOKING EAST, WITH ENTRY, LIVING ROOM AND SUN ROOM THROUGH SEQUENTIAL DOORWAYS. - Oakland Naval Supply Center, Commanding Officers Residences, Between E & F Streets, West of Fourth Street, Oakland, Alameda County, CA

  4. 13 CFR 102.2 - Public reading rooms.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Public reading rooms. 102.2... Disclosure of Information § 102.2 Public reading rooms. (a) SBA maintains a public reading room in the... described in paragraph (a) of this section are available in the SBA Online Reading Room at...

  5. 22 CFR 303.5 - Public reading room.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Public reading room. 303.5 Section 303.5 Foreign... Public reading room. (a) The Peace Corps will maintain a public reading room at its headquarters at 1111... records will be made available in the public reading room: (1) All final public opinions,...

  6. 22 CFR 171.3 - Public reading room.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Public reading room. 171.3 Section 171.3... PUBLIC General Policy and Procedures § 171.3 Public reading room. A reading room providing public access..., NW., Washington, DC. The reading room contains material pertaining to access to information under...

  7. 19 CFR 103.1 - Public reading rooms.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false Public reading rooms. 103.1 Section 103.1 Customs... reading rooms. Each office listed below will maintain a public reading room or public reading area where... Angeles Street, Los Angeles, California 90012. The reading rooms are open to the public during...

  8. 13 CFR 102.2 - Public reading rooms.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Public reading rooms. 102.2... Disclosure of Information § 102.2 Public reading rooms. (a) SBA maintains a public reading room in the... described in paragraph (a) of this section are available in the SBA Online Reading Room at...

  9. 19 CFR 103.1 - Public reading rooms.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Public reading rooms. 103.1 Section 103.1 Customs... reading rooms. Each office listed below will maintain a public reading room or public reading area where... Angeles Street, Los Angeles, California 90012. The reading rooms are open to the public during...

  10. 22 CFR 303.5 - Public reading room.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Public reading room. 303.5 Section 303.5 Foreign... Public reading room. (a) The Peace Corps will maintain a public reading room at its headquarters at 1111... records will be made available in the public reading room: (1) All final public opinions,...

  11. 22 CFR 171.3 - Public reading room.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Public reading room. 171.3 Section 171.3... PUBLIC General Policy and Procedures § 171.3 Public reading room. A reading room providing public access..., NW., Washington, DC. The reading room contains material pertaining to access to information under...

  12. 18 CFR 1301.2 - Public reading rooms.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Public reading rooms... Freedom of Information Act § 1301.2 Public reading rooms. TVA maintains a public electronic reading room through its Web site at http://www.tva.gov. This electronic reading room contains the records that...

  13. 22 CFR 171.3 - Public reading room.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... PUBLIC General Policy and Procedures § 171.3 Public reading room. A reading room providing public access.... There are no fees for access by the public to this room or the material contained therein, but fees... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Public reading room. 171.3 Section...

  14. 22 CFR 171.3 - Public reading room.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... PUBLIC General Policy and Procedures § 171.3 Public reading room. A reading room providing public access.... There are no fees for access by the public to this room or the material contained therein, but fees... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Public reading room. 171.3 Section...

  15. 7 CFR 58.413 - Cutting and packaging rooms.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Cutting and packaging rooms. 58.413 Section 58.413....413 Cutting and packaging rooms. When small packages of cheese are cut and wrapped, separate rooms... outward to minimize the entrance of unfiltered air into the cutting and packaging room. The...

  16. Measurement Adherence in the Blood Pressure Self-Measurement Room

    PubMed Central

    Buus, Niels Henrik; Jespersen, Bente; Ahrendt, Peter; Bertelsen, Olav W.; Toftegaard, Thomas S.

    2013-01-01

    Abstract Background: Patients with hypertension or receiving blood pressure (BP)-lowering treatment are often required to self-measure their BP in a dedicated self-measurement room before consultation. Current praxis does not guarantee valid measurements, possibly leading to misdiagnoses or inappropriate antihypertensive medication. The aim of this study was to investigate patients' ability to correctly self-report and follow recommendations. Patients and Methods: We used a context-aware system to gather information on BP measurements and relevant context parameters. Patients were not informed that the system automatically collected behavior data and were instructed to self-report their measurements on a paper sheet as usual. We then compared the automatically recorded data with the self-reported data in order to detect any nonadherent reporting behavior. Also, we investigated the patients' ability to adhere to the measurement recommendations. Results: We found that (1) a third of all 113 participating patients failed to self-report measured BP data correctly and (2) none of the 642 measurements obtained adhered fully to the recommendations. Conclusions: Results indicate that context-aware technology may be useful for accurately modeling aspects of nonadherent patient behavior. This may be used to inform staff of the validity of the measurement and pinpoint patients in need of additional training or to design better aids to assist the patients. The developed system is generally applicable to other self-measurement environments, including the home setting and remote outpatient clinics, as it is built using telemedicine technology and thus well suited for remote monitoring and diagnosis. PMID:23631589

  17. Recognizing/accepting futility: prehospital, emergency center, operating room, and intensive care unit.

    PubMed

    Coimbra, Raul; Lee, Jeanne; Bansal, Vishal; Hollingsworth-Fridlund, Peggy

    2007-01-01

    Trauma has been perceived by the public as occurring as an isolated event, always resulting in favorable outcomes. There has therefore been a lack of discussion of futility of care and termination of care when dealing with the sick trauma patient. Several stages exist where issues of futility and early termination of care must be considered. These include the prehospital setting and involve the emergency medical service system in recognizing those patients who are nonsurvivors. Next is in the emergency room, where heroic measures may not benefit the very sick patient. In the operating room, the surgeon must always reassess and recognize when massive resuscitation will not benefit a particular trauma patient. Lastly, the intensivist must recognize those patients who may or may not benefit from continued efforts to sustain life. PMID:17579324

  18. A smart room for hospitalised elderly people: essay of modelling and first steps of an experiment.

    PubMed

    Rialle, V; Lauvernay, N; Franco, A; Piquard, J F; Couturier, P

    1999-01-01

    We present a study of modelling and the first steps of an experiment of a smart room for hospitalised elderly people. The system aims at detecting falls and sicknesses, and implements four main functions: perception of patient and environment through sensors, reasoning from perceived events and patient clinical findings, action by way of alarm triggering and message passing to medical staff, and adaptation to various patient profiles, sensor layouts, house fixtures and architecture. It includes a physical multisensory device located in the patient's room, and a multi-agent system for fall detection and alarm triggering. This system encompasses a perception agent, and a reasoning agent. The latter has two complementary capacities implemented by sub-agents: deduction of type of alarm from incoming events, and knowledge induction from recorded events. The system has been tested with a few patients in real clinical situation, and the first experiment provides encouraging results which are described in a precise manner. PMID:10543419

  19. Room-temperature antiferromagnetic memory resistor.

    PubMed

    Marti, X; Fina, I; Frontera, C; Liu, Jian; Wadley, P; He, Q; Paull, R J; Clarkson, J D; Kudrnovský, J; Turek, I; Kuneš, J; Yi, D; Chu, J-H; Nelson, C T; You, L; Arenholz, E; Salahuddin, S; Fontcuberta, J; Jungwirth, T; Ramesh, R

    2014-04-01

    The bistability of ordered spin states in ferromagnets provides the basis for magnetic memory functionality. The latest generation of magnetic random access memories rely on an efficient approach in which magnetic fields are replaced by electrical means for writing and reading the information in ferromagnets. This concept may eventually reduce the sensitivity of ferromagnets to magnetic field perturbations to being a weakness for data retention and the ferromagnetic stray fields to an obstacle for high-density memory integration. Here we report a room-temperature bistable antiferromagnetic (AFM) memory that produces negligible stray fields and is insensitive to strong magnetic fields. We use a resistor made of a FeRh AFM, which orders ferromagnetically roughly 100 K above room temperature, and therefore allows us to set different collective directions for the Fe moments by applied magnetic field. On cooling to room temperature, AFM order sets in with the direction of the AFM moments predetermined by the field and moment direction in the high-temperature ferromagnetic state. For electrical reading, we use an AFM analogue of the anisotropic magnetoresistance. Our microscopic theory modelling confirms that this archetypical spintronic effect, discovered more than 150 years ago in ferromagnets, is also present in AFMs. Our work demonstrates the feasibility of fabricating room-temperature spintronic memories with AFMs, which in turn expands the base of available magnetic materials for devices with properties that cannot be achieved with ferromagnets. PMID:24464243

  20. Integrating robotic technology into the operating room.

    PubMed

    Coon, Thomas M

    2009-02-01

    Integration of any highly complex technology into the operating room is challenging but can be accomplished with dedicated engineers, trained surgical team members, a streamlined surgical setup, and efficient surgical technique. Early results suggest a short learning curve and excellent radiographic outcomes (2.5 times improvement in tibial alignment, lower SD). The robotic arm is a valuable tool in modern orthopedics. PMID:19340376

  1. Room-temperature antiferromagnetic memory resistor

    NASA Astrophysics Data System (ADS)

    Marti, X.; Fina, I.; Frontera, C.; Liu, Jian; Wadley, P.; He, Q.; Paull, R. J.; Clarkson, J. D.; Kudrnovský, J.; Turek, I.; Kuneš, J.; Yi, D.; Chu, J.-H.; Nelson, C. T.; You, L.; Arenholz, E.; Salahuddin, S.; Fontcuberta, J.; Jungwirth, T.; Ramesh, R.

    2014-04-01

    The bistability of ordered spin states in ferromagnets provides the basis for magnetic memory functionality. The latest generation of magnetic random access memories rely on an efficient approach in which magnetic fields are replaced by electrical means for writing and reading the information in ferromagnets. This concept may eventually reduce the sensitivity of ferromagnets to magnetic field perturbations to being a weakness for data retention and the ferromagnetic stray fields to an obstacle for high-density memory integration. Here we report a room-temperature bistable antiferromagnetic (AFM) memory that produces negligible stray fields and is insensitive to strong magnetic fields. We use a resistor made of a FeRh AFM, which orders ferromagnetically roughly 100 K above room temperature, and therefore allows us to set different collective directions for the Fe moments by applied magnetic field. On cooling to room temperature, AFM order sets in with the direction of the AFM moments predetermined by the field and moment direction in the high-temperature ferromagnetic state. For electrical reading, we use an AFM analogue of the anisotropic magnetoresistance. Our microscopic theory modelling confirms that this archetypical spintronic effect, discovered more than 150 years ago in ferromagnets, is also present in AFMs. Our work demonstrates the feasibility of fabricating room-temperature spintronic memories with AFMs, which in turn expands the base of available magnetic materials for devices with properties that cannot be achieved with ferromagnets.

  2. One-Room Schools: Myth and Reality

    ERIC Educational Resources Information Center

    Stortz, Paul; Panayotidis, E. Lisa

    2004-01-01

    This article discusses the myth and reality of the ubiquitous one-room school in Canada. A marker of civilization, it bespoke a desire to spread the merits of education to the rugged laborers and their families in even the most remote areas of rural Canada. This historical vestige, particularly in the early-to-mid 20th century, painted a…

  3. The Living Room School Cognitive Assessment Inventory.

    ERIC Educational Resources Information Center

    Time Frame, 1973

    1973-01-01

    The inventory is an individually administered procedure designed to assess the cognitive skills of preschool children enrolled in the Living Room School (LRS) program. It was developed to measure change in the cognitive behavior of the 2- to 5-year-old child as well as to diagnose his performance patterns in order to formulate an individualized…

  4. Virtual Project Rooms for Education in Engineering

    ERIC Educational Resources Information Center

    van Vliet, Rudolf G.; Roeling, Monika M.; de Graaff, Rick; Pilot, Albert

    2004-01-01

    Virtual project rooms (VPRs) may support collaborative project-based learning groups by facilitating project management, documentation and communication. In this study a set of experiments was carried out at Eindhoven University of Technology using the MS Outlook/Exchange software as a groupware platform for design-oriented group projects. The…

  5. A Tribute to Waiting Room Moms Everywhere

    ERIC Educational Resources Information Center

    Ansfield, Mara

    2008-01-01

    Waiting rooms are oases for mothers of children with special needs. They congregate in these small holding areas, sitting on musty couches, while their children receive the latest therapeutic interventions. Sometimes they sit quietly, sneaking glances at each other while pretending to read year-old "People" magazines. Sometimes they crawl under a…

  6. Using Computers in the Interrelated Resource Room

    ERIC Educational Resources Information Center

    Bowles, Steffanie

    2006-01-01

    This article explores ways computers can be used in special education resource rooms. Discusses management of computer access, integration of computer into curriculum, software selection, and negative computer practices. Models of computer use, including use of computer as individual learning center and use of computer as a cognitive "tool kit" …

  7. The Resource Concept: Bigger than a Room!

    ERIC Educational Resources Information Center

    Adelman, Howard S.

    1972-01-01

    The resource room concept need not be considered as merely an alternative learning environment for handicapped children but can aid in the improvement of general education so that fewer children need specialized services and in the provision of services for children who still require specialized instruction. (DB)

  8. Guidelines on ergonomic aspects of control rooms

    NASA Technical Reports Server (NTRS)

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

    1983-01-01

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

  9. Making a room-sized camera obscura

    NASA Astrophysics Data System (ADS)

    Flynt, Halima; Ruiz, Michael J.

    2015-01-01

    We describe how to convert a room into a camera obscura as a project for introductory geometrical optics. The view for our camera obscura is a busy street scene set against a beautiful mountain skyline. We include a short video with project instructions, ray diagrams and delightful moving images of cars driving on the road outside.

  10. The Art of Graffiti and Room 161

    ERIC Educational Resources Information Center

    Forseth, Sonia

    1972-01-01

    Covering the walls of the art room with white paper and sealing off all the open edges with masking tape, students proceeded to do their thing'' by using tempera, oil crayons and India ink to create an environment that was completely their own. (Author/CB)

  11. Steps for Washroom and Locker Room Sustainability.

    ERIC Educational Resources Information Center

    Wiens, Janet

    2003-01-01

    Administrators and design teams can use proven approaches to create sustainable washrooms and locker rooms. Presents design strategies related to lighting, flooring, and water conservation that contribute to sustainability, then describes one college's experiences developing sustainable architecture, explaining how the building takes full…

  12. The One-Room School in Canada.

    ERIC Educational Resources Information Center

    Cochrane, Jean

    A unique collection of photographs and personal letters, journals and diaries, newspaper clippings, official reports, readers and textbooks, mail-order catalogues, architectural plans and diagrams recreate the flavor of the Canadian one-room school and the rural communities it served from the 1840's to 1960's. The emphasis is on the human…

  13. Tales from a One-Room Schoolhouse

    ERIC Educational Resources Information Center

    Kaesshaefer, Megan

    2011-01-01

    This article presents an interview with Lyn Huston, who teaches in a one-room schoolhouse--Duckwater School--in Duckwater, Nevada. The school, which has a class of only 15 students, is set on a plot of land between alfalfa farms, an Indian reservation, and a 20,500-acre wilderness area. Huston discusses the challenges that exist when teaching in a…

  14. 7 CFR 58.407 - Make room.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Make room. 58.407 Section 58.407 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) REGULATIONS AND STANDARDS UNDER THE AGRICULTURAL MARKETING ACT OF 1946 AND THE...

  15. Advanced nuclear plant control room complex

    DOEpatents

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

    1993-01-01

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

  16. [Computerized barcode operational system for package of surgical instruments in operating room].

    PubMed

    Wu, Su-Lan; Liu, Yu-Chu; Shih, Whie-Mei; Wu, Shu-Chu; Lee, Hsiu-Fang; Lin, Chau-Tzu

    2008-10-01

    About 8,000 people die every year in Taiwan as a result of nosocomial infection. Clinically, there is a high possibility for patients to contract nosocomial infection if medical equipment is not completely sterilized. In order to provide care and safety to patients in the operating room, increase management effectiveness and efficiency, and to reduce equipment operating costs, a project was developed to improve operating room management through data collection and analysis. A computerized barcode operational system for packages of surgical instruments was developed and executed throughout an entire operating room. The results showed that average time spent searching for surgical instruments decreased by 2,872 minutes (47.8hrs/month), 150% of the target figure; computerized monitoring of equipment expiration dates reduced total cost by 29.2% abnormal recognition of equipment tags was reduced to 0%. This project is the first one of its kind in the world. PMID:18836975

  17. Out-of-hospital cardiopulmonary arrest due to penetrating cardiac injury treated by percutaneous cardiopulmonary support in the emergency room: report of a case.

    PubMed

    Kurimoto, Yoshihiko; Kano, Hitoshi; Yama, Naoya; Nara, Satoshi; Hase, Mamoru; Asai, Yasufumi

    2007-01-01

    Penetrating cardiac injury tends to generally be repaired without cardiopulmonary bypass in the operating room. We herein report the case of penetrating cardiac injury repaired using percutaneous cardiopulmonary support in an emergency room. A 57-year-old man attempted suicide by stabbing himself in the left anterior chest with a knife. Although the patient suffered cardiopulmonary arrest for 7 min in the ambulance, spontaneous circulation was restored following pericardiotomy through emergency left thoracotomy in the emergency room. To prevent coronary artery injury and control the massive bleeding, percutaneous cardiopulmonary support was instituted without systemic heparinization and the cardiac injury was repaired in the emergency room. The patient was then transferred to another hospital on day 46 for further rehabilitation. Percutaneous cardiopulmonary support might be helpful for treating critical patients in an emergency room, even in the case of trauma patients. PMID:17342366

  18. Virtual reality in the operating room of the future.

    PubMed

    Müller, W; Grosskopf, S; Hildebrand, A; Malkewitz, R; Ziegler, R

    1997-01-01

    In cooperation with the Max-Delbrück-Centrum/Robert-Rössle-Klinik (MDC/RRK) in Berlin, the Fraunhofer Institute for Computer Graphics is currently designing and developing a scenario for the operating room of the future. The goal of this project is to integrate new analysis, visualization and interaction tools in order to optimize and refine tumor diagnostics and therapy in combination with laser technology and remote stereoscopic video transfer. Hence, a human 3-D reference model is reconstructed using CT, MR, and anatomical cryosection images from the National Library of Medicine's Visible Human Project. Applying segmentation algorithms and surface-polygonization methods a 3-D representation is obtained. In addition, a "fly-through" the virtual patient is realized using 3-D input devices (data glove, tracking system, 6-DOF mouse). In this way, the surgeon can experience really new perspectives of the human anatomy. Moreover, using a virtual cutting plane any cut of the CT volume can be interactively placed and visualized in realtime. In conclusion, this project delivers visions for the application of effective visualization and VR systems. Commonly known as Virtual Prototyping and applied by the automotive industry long ago, this project shows, that the use of VR techniques can also prototype an operating room. After evaluating design and functionality of the virtual operating room, MDC plans to build real ORs in the near future. The use of VR techniques provides a more natural interface for the surgeon in the OR (e.g., controlling interactions by voice input). Besides preoperative planning future work will focus on supporting the surgeon in performing surgical interventions. An optimal synthesis of real and synthetic data, and the inclusion of visual, aural, and tactile senses in virtual environments can meet these requirements. This Augmented Reality could represent the environment for the surgeons of tomorrow. PMID:10173059

  19. Family-Based Crisis Intervention with Suicidal Adolescents in the Emergency Room: A Pilot Study

    ERIC Educational Resources Information Center

    Wharff, Elizabeth A.; Ginnis, Katherine M.; Ross, Abigail M.

    2012-01-01

    The prevailing model of care for psychiatric patients in the emergency room (ER) is evaluation and disposition, with little or no treatment provided. This article describes the results of a pilot study of a family-based crisis intervention (FBCI) for suicidal adolescents and their families in a large, urban pediatric ER. FBCI is an intervention…

  20. Increase in voice level and speaker comfort in lecture rooms.

    PubMed

    Brunskog, Jonas; Gade, Anders Christian; Bellester, Gaspar Payá; Calbo, Lilian Reig

    2009-04-01

    Teachers often suffer from health problems related to their voice. These problems are related to their working environment, including the acoustics of the lecture rooms. However, there is a lack of studies linking the room acoustic parameters to the voice produced by the speaker. In this pilot study, the main goals are to investigate whether objectively measurable parameters of the rooms can be related to an increase in the voice sound power produced by speakers and to the speakers' subjective judgments about the rooms. In six different rooms with different sizes, reverberation times, and other physical attributes, the sound power level produced by six speakers was measured. Objective room acoustic parameters were measured in the same rooms, including reverberation time and room gain, and questionnaires were handed out to people who had experience talking in the rooms. It is found that in different rooms significant changes in the sound power produced by the speaker can be found. It is also found that these changes mainly have to do with the size of the room and to the gain produced by the room. To describe this quality, a new room acoustic quantity called "room gain" is proposed. PMID:19354383

  1. Computational study of room scattering influence in the THOR BNCT treatment room.

    PubMed

    Hsiao, Ming-Chen; Liu, Yuan-Hao; Jiang, Shiang-Huei

    2014-06-01

    BNCT dosimetry has often employed heavy Monte Carlo calculations for the beam characterization and the dose determination. However, these calculations commonly ignored the scattering influence between the radiations and the room structure materials in order to facilitate the calculation speed. The aim of this article attempts to explore how the room scattering affects the physical quantities such as the capture reaction rate and the gamma-ray dose rate under in-phantom and free-air conditions in the THOR BNCT treatment room. The geometry and structure materials of the treatment room were simulated in detail. The capture reaction rates per atom, as well as the gamma-ray dose rate were calculated in various sizes of phantoms and in the free-air condition. Results of this study showed that the room scattering has significant influence on the physical quantities, whether in small phantoms or in the free-air condition. This paper may be of importance in explaining the discrepancies between measurements and calculations in the BNCT dosimetry using small phantoms, in addition to provide a useful consideration with a better understanding of how the room scattering influence acts in a BNCT facility. PMID:24365466

  2. Damage control resuscitation: from emergency department to the operating room.

    PubMed

    Duchesne, Juan C; Barbeau, James M; Islam, Tareq M; Wahl, Georgia; Greiffenstein, Patrick; McSwain, Norman E

    2011-02-01

    Damage control surgery emphasizes limited operations with control of bleeding and contamination. Traditional management centered upon correction of acidosis and hypotension with crystalloids. Damage control resuscitation (DCR) is permissive hypotension and early hemostatic resuscitation combined identified and corrects coagulopathy with fresh-frozen plasma (FFP), restricting use of crystalloids. We hypothesize a survival advantage in patients managed with DCR when compared with a historical cohort of patients. During the 2-year retrospective review, a 1-year period after institution of DCR was compared with a historical control. Resuscitation strategies were analyzed and stratified into emergency department (ED) resuscitation and intraoperative resuscitation. Univariate analysis of continuous data was done with Student's t test followed by multiple logistic regression. Fifty-seven and 61 patients were managed during the NonDCR and DCR periods respectively. Baseline demographic patient characteristics and physiologic variables were similar between groups. ED DCR patients received less crystalloids: 1.1 versus 4.7 liters (P = 0.0001), more FFP: 1.8 versus 0.5 (P = 0.001). NonDCR had a lower initial systolic pressure in the operating room when compared with DCR: 81 mm Hg versus 95 mm Hg (P = 0.03). DCR patients received less intraoperative crystalloids: 5.7 versus 15.8 liters (P = 0.0001) and more FFP: 15.1 versus 6.2 (P = 0.0001). DCR conveyed a survival benefit (Odds Ratio; 95% confidence interval: 0.40 (0.18-0.90), P = 0.024). NonDCR group had 13.2 days longer hospital length of stay. Damage control resuscitation, beginning in the ED, used more packed red blood cells and FFP minimizing crystalloids. DCR was associated with a survival advantage and shorter length of stay in patients with severe hemorrhage. PMID:21337881

  3. Local public document room directory. Revision 7

    SciTech Connect

    1998-04-01

    This directory (NUREG/BR-0088, Revision 7) lists local public document rooms (LPDRs) for commercial nuclear power plants with operating or possession-only licenses or under construction, plus the LPDRs for potential high-level radioactive waste repository sites, gaseous diffusion plants, certain fuel cycle facilities, certain low-level waste disposal facilities, and any temporary LPDRs established for the duration of licensing proceedings. In some instances, the LPDR libraries maintain document collections for more than one licensed facility. The library staff members listed are the persons most familiar with the LPDR collections. Reference librarians in the NRC Headquarters Public Document Room (PDR) are also available to assist the public in locating NRC documents.

  4. Imprinting bulk amorphous alloy at room temperature

    SciTech Connect

    Kim, Song-Yi; Park, Eun-Soo; Ott, Ryan T.; Lograsso, Thomas A.; Huh, Moo-Young; Kim, Do-Hyang; Eckert, Jürgen; Lee, Min-Ha

    2015-11-13

    We present investigations on the plastic deformation behavior of a brittle bulk amorphous alloy by simple uniaxial compressive loading at room temperature. A patterning is possible by cold-plastic forming of the typically brittle Hf-based bulk amorphous alloy through controlling homogenous flow without the need for thermal energy or shaping at elevated temperatures. The experimental evidence suggests that there is an inconsistency between macroscopic plasticity and deformability of an amorphous alloy. Moreover, imprinting of specific geometrical features on Cu foil and Zr-based metallic glass is represented by using the patterned bulk amorphous alloy as a die. These results demonstrate the ability of amorphous alloys or metallic glasses to precisely replicate patterning features onto both conventional metals and the other amorphous alloys. In conclusion, our work presents an avenue for avoiding the embrittlement of amorphous alloys associated with thermoplastic forming and yields new insight the forming application of bulk amorphous alloys at room temperature without using heat treatment.

  5. Imprinting bulk amorphous alloy at room temperature

    PubMed Central

    Kim, Song-Yi; Park, Eun-Soo; Ott, Ryan T.; Lograsso, Thomas A.; Huh, Moo-Young; Kim, Do-Hyang; Eckert, Jürgen; Lee, Min-Ha

    2015-01-01

    We present investigations on the plastic deformation behavior of a brittle bulk amorphous alloy by simple uniaxial compressive loading at room temperature. A patterning is possible by cold-plastic forming of the typically brittle Hf-based bulk amorphous alloy through controlling homogenous flow without the need for thermal energy or shaping at elevated temperatures. The experimental evidence suggests that there is an inconsistency between macroscopic plasticity and deformability of an amorphous alloy. Moreover, imprinting of specific geometrical features on Cu foil and Zr-based metallic glass is represented by using the patterned bulk amorphous alloy as a die. These results demonstrate the ability of amorphous alloys or metallic glasses to precisely replicate patterning features onto both conventional metals and the other amorphous alloys. Our work presents an avenue for avoiding the embrittlement of amorphous alloys associated with thermoplastic forming and yields new insight the forming application of bulk amorphous alloys at room temperature without using heat treatment. PMID:26563908

  6. Imprinting bulk amorphous alloy at room temperature.

    PubMed

    Kim, Song-Yi; Park, Eun-Soo; Ott, Ryan T; Lograsso, Thomas A; Huh, Moo-Young; Kim, Do-Hyang; Eckert, Jürgen; Lee, Min-Ha

    2015-01-01

    We present investigations on the plastic deformation behavior of a brittle bulk amorphous alloy by simple uniaxial compressive loading at room temperature. A patterning is possible by cold-plastic forming of the typically brittle Hf-based bulk amorphous alloy through controlling homogenous flow without the need for thermal energy or shaping at elevated temperatures. The experimental evidence suggests that there is an inconsistency between macroscopic plasticity and deformability of an amorphous alloy. Moreover, imprinting of specific geometrical features on Cu foil and Zr-based metallic glass is represented by using the patterned bulk amorphous alloy as a die. These results demonstrate the ability of amorphous alloys or metallic glasses to precisely replicate patterning features onto both conventional metals and the other amorphous alloys. Our work presents an avenue for avoiding the embrittlement of amorphous alloys associated with thermoplastic forming and yields new insight the forming application of bulk amorphous alloys at room temperature without using heat treatment. PMID:26563908

  7. Effect of Ventilation on Occupational Exposure to Airborne Biological Contaminants in an Isolation Room

    PubMed Central

    Jafari, Mohammad Javad; Omidi, Leila; Jafari, Mina; Tabarsi, Payam; Salehpour, Soussan; Amiri, Zohre

    2015-01-01

    Background: Airborne pathogens play an important role in a hospital air quality. Respiratory infections are the most common occupational disease among the health care staff. The aim of this study was to determine the effect of ventilation system parameters and patient bed arrangements on concentration of airborne pathogens in indoor air of an isolation room. Materials and Methods: A single-bed room was considered in which a patient diagnosed with tuberculosis had been admitted. Five different ventilation types, each at four different capacities were installed in the room while two different locations for the patient’s bed were assessed. A direct-impact sampling method (blood agar plate) was used in order to determine the intensity of the bio-aerosols in indoor air of the isolation room. Results: The results showed that when the air was supplied through a circular vent located on the northern wall and the vented air was exhausted via a linear vent located on the southern wall, the average concentration of the bio-aerosols in the air, (with 12 air changes per hour) was reduced to 25 colonies per cubic meter (cfu/m3) (in the range of 25–88 cfu/m3 and a 95 percent confidence interval). In accordance with the analysis applied upon the two different locations of the bed, no significant difference was observed (P>0.05). Conclusion: Installation of ventilation systems as determined by the study is recommended for tuberculosis isolation rooms. PMID:26528369

  8. Do-not-resuscitate orders in the operating room: required reconsideration.

    PubMed

    Smith, K A

    2000-07-01

    Advances in medical technology are giving health care providers the tools with which to keep patients alive for longer and longer periods of time. However, in our struggle to keep patients alive, we must not forget that the patient is the one who controls his or her own destiny. Advance directives and do-not-resuscitate orders are becoming more commonplace as patients strive to make their wishes known to all who care for them. The use of such orders in the operating room has historically been a hotbed of controversy because it appears contrary to the necessity of surgery in the first place. Surgeons, anesthetists, operating room nurses, and others all have concerns regarding this issue, and they will be discussed here. The answer to the dilemma lies in a policy of "required reconsideration" to examine all factors of the do-not-resuscitate order and its applicability to the situation at hand. PMID:10920651

  9. [Hemorrhoidal thrombosis: treatment at the consulting room].

    PubMed

    Nyst, J-F

    2015-09-01

    The hemorrhoidal thrombosis is an acute complication with no gravity but an emergency because of the severe pain. Oral or local medical treatments are rarely effective; they poorly relieve the pain. The realization of an incision with removal of the blood clot or of an excision is an easy procedure to perform in the consultation room. She brings an almost immediate pain relief. It only takes a few minutes and requires minimal equipment. PMID:26591313

  10. Final disposal room structural response calculations

    SciTech Connect

    Stone, C.M.

    1997-08-01

    Finite element calculations have been performed to determine the structural response of waste-filled disposal rooms at the WIPP for a period of 10,000 years after emplacement of the waste. The calculations were performed to generate the porosity surface data for the final set of compliance calculations. The most recent reference data for the stratigraphy, waste characterization, gas generation potential, and nonlinear material response have been brought together for this final set of calculations.

  11. White Paper for Virtual Control Room

    NASA Technical Reports Server (NTRS)

    Little, William; Tully-Hanson, Benjamin

    2015-01-01

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

  12. Fighting drug abuse in operating rooms.

    PubMed

    Nemes, J

    1991-07-29

    A growing problem of drug addicts working in operating rooms is mobilizing hospitals to make it more difficult for staff members to steal drugs for their own use or for sale to others. Monitoring devices and tighter drug distribution security are among measures being used to deter theft by anesthesiologists, technicians or nurses who are addicted to one of many potent narcotics readily available to them. PMID:10170762

  13. Simplified models for heat transfer in rooms

    NASA Astrophysics Data System (ADS)

    Graca, Guilherme C. C. Carrilho Da

    Buildings protect their occupants from the outside environment. As a semi-enclosed environment, buildings tend to contain the internally generated heat and air pollutants, as well as the solar and conductive heat gains that can occur in the facade. In the warmer months of the year this generally leads to overheating, creating a need for a cooling system. Ventilation air replaces contaminated air in the building and is often used as the dominant medium for heat transfer between indoor and outdoor environments. The goal of the research presented in this thesis is to develop a better understanding of the important parameters in the performance of ventilation systems and to develop simplified convective heat transfer models. The general approach used in this study seeks to capture the dominant physical processes for these problems with first order accuracy, and develop simple models that show the correct system behavior trends. Dimensional analysis, in conjunction with simple momentum and energy conservation, scaled model experiments and numerical simulations, is used to improve airflow and heat transfer rate predictions in both single and multi room ventilation systems. This study includes the three commonly used room ventilation modes: mixing, displacement and cross-ventilation. A new modeling approach to convective heat transfer between the building and the outside is presented: the concept of equivalent room heat transfer coefficient. The new model quantifies the reduction in heat transfer between ventilation air and internal room surfaces caused by limited thermal capacity and temperature variation of the air for the three modes studied. Particular emphasis is placed on cross-ventilation, and on the development of a simple model to characterize the airflow patterns that occur in this case. The implementation of the models in a building thermal simulation software tool is presented as well as comparisons between model predictions, experimental results and complex

  14. Colossal magnetocapacitance effect at room temperature

    NASA Astrophysics Data System (ADS)

    Bishchaniuk, T. M.; Grygorchak, I. I.

    2014-05-01

    First nano-hybridized clathrate/cavitant structure of hierarchical architecture was synthesized. The results of investigations of the properties of initial nanoporous silica matrices MCM-41, with encapsulated in its pores of β-cyclodextrin in cavitand and cavitat (with FeSO4) states and change at room temperature in a constant magnetic field intensity of 2.75 kOe, have been presented. Phenomenon of enormous magnetocapacitance and giant negative variable-current magnetoresistance has been discovered.

  15. Virtual acoustics for music practice rooms

    NASA Astrophysics Data System (ADS)

    Freiheit, Ron

    2003-04-01

    The use of virtual acoustics has provided a new level of practice experience for the musician. By integrating the sound isolation of music practice rooms with the signal processing of an active acoustic system (with time variant-gain before feedback) musicians can now benefit from the experience of practicing in multiple acoustic environments. Musicians select from various acoustics environments from a typical small practice room to that of a large space such as a sports arena. The variability of the acoustic environment allows the musician to hear clearly their intonation and articulation, which may be difficult to discern in a small practice room. To effectively communicate the various acoustics environments, the musicians must be immersed in the sound field of the active acoustics without being able to discern source locations of the speakers. The system must also be able to support the dynamic range of the musicians without presenting artifacts of its own such as system noise or audible distortion. This paper deals with the design constraints needed to meet these requirements as well the antidotal responses from musicians who have used these environments for practice.

  16. Gastrointestinal Emergency Room Admissions and Florida Red Tide Blooms

    PubMed Central

    Kirkpatrick, Barbara; Bean, Judy A; Fleming, Lora E; Kirkpatrick, Gary; Grief, Lynne; Nierenberg, Kate; Reich, Andrew; Watkins, Sharon; Naar, Jerome

    2009-01-01

    Human exposure to brevetoxins during Florida red tide blooms formed by Karenia brevis has been documented to cause acute gastrointestinal, neurologic, and respiratory health effects.. Traditionally, the routes of brevetoxin exposure have been through the consumption of contaminated bivalve shellfish and the inhalation of contaminated aerosols. However, recent studies using more sensitive methods have demonstrated the presence of brevetoxins in many components of the aquatic food web which may indicate potential alternative routes for human exposure. This study examined whether the presence of a Florida red tide bloom affected the rates of admission for a gastrointestinal diagnosis to a hospital emergency room in Sarasota, FL. The rates of gastrointestinal diagnoses admissions were compared for a 3-month time period in 2001 when Florida red tide bloom was present onshore to the same 3-month period in 2002 when no Florida red tide bloom occurred. A significant 40% increase in the total number of gastrointestinal emergency room admissions for the Florida red tide bloom period was found compared to the non red tide period. These results suggest that the healthcare community may experience a significant and unrecognized impact from patients needing emergency medical care for gastrointestinal illnesses during Florida red tide blooms. Thus, additional studies characterizing the potential sources of exposure to the toxins, as well as the dose/effect relationship of brevetoxin exposure, should be undertaken. PMID:20161425

  17. Monitoring operating room turnaround time: a retrospective analysis.

    PubMed

    Scagliarini, Michele; Apreda, Mariarosaria; Wienand, Ulrich; Valpiani, Giorgia

    2016-04-18

    Purpose - Operating room (OR) turnaround time is a key process indicator for hospital business management: delays lead to a reduced surgical interventions per day with a consequent increase in costs and decrease in efficiency. The purpose of this paper is to increase understanding by assessing the process' steady-state behaviour and identifying changes that indicate either improvement or deterioration in quality. Design/methodology/approach - With this purpose, the authors retrospectively applied Shewhart control charts and exponentially weighted moving average control charts to data extracted from an hospital information system. Findings - The results showed that statistical process control is able to identify steady-state behaviour process and to detect positive or negative changes in process performance. In particular the authors detected a deterioration in the process performance coinciding with the change in the operating room patient transfer staff. Practical implications - This study showed that statistical quality control is a valuable tool for monitoring performance indicators. Currently, hospital managers are designing an OR dashboard which also includes the control charts. Originality/value - The paper highlights the control chart application to organizational indicators allowing an objective OR system performance assessment. PMID:27120511

  18. Gastrointestinal Emergency Room Admissions and Florida Red Tide Blooms.

    PubMed

    Kirkpatrick, Barbara; Bean, Judy A; Fleming, Lora E; Kirkpatrick, Gary; Grief, Lynne; Nierenberg, Kate; Reich, Andrew; Watkins, Sharon; Naar, Jerome

    2010-01-01

    Human exposure to brevetoxins during Florida red tide blooms formed by Karenia brevis has been documented to cause acute gastrointestinal, neurologic, and respiratory health effects.. Traditionally, the routes of brevetoxin exposure have been through the consumption of contaminated bivalve shellfish and the inhalation of contaminated aerosols. However, recent studies using more sensitive methods have demonstrated the presence of brevetoxins in many components of the aquatic food web which may indicate potential alternative routes for human exposure.This study examined whether the presence of a Florida red tide bloom affected the rates of admission for a gastrointestinal diagnosis to a hospital emergency room in Sarasota, FL. The rates of gastrointestinal diagnoses admissions were compared for a 3-month time period in 2001 when Florida red tide bloom was present onshore to the same 3-month period in 2002 when no Florida red tide bloom occurred. A significant 40% increase in the total number of gastrointestinal emergency room admissions for the Florida red tide bloom period was found compared to the non red tide period.These results suggest that the healthcare community may experience a significant and unrecognized impact from patients needing emergency medical care for gastrointestinal illnesses during Florida red tide blooms. Thus, additional studies characterizing the potential sources of exposure to the toxins, as well as the dose/effect relationship of brevetoxin exposure, should be undertaken. PMID:20161425

  19. Surgical attire and the operating room: role in infection prevention.

    PubMed

    Salassa, Tiare E; Swiontkowski, Marc F

    2014-09-01

    ➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear. PMID:25187588

  20. Protective lung ventilation in operating room: a systematic review.

    PubMed

    Futier, E; Constantin, J M; Jaber, S

    2014-06-01

    Postoperative pulmonary and extrapulmonary complications adversely affect clinical outcomes and healthcare utilization, so that prevention has become a measure of the quality of perioperative care. Mechanical ventilation is an essential support therapy to maintain adequate gas exchange during general anesthesia for surgery. Mechanical ventilation using high tidal volume (VT) (between 10 and 15 mL/kg) has been historically encouraged to prevent hypoxemia and atelectasis formation in anesthetized patients undergoing abdominal and thoracic surgery. However, there is accumulating evidence from both experimental and clinical studies that mechanical ventilation, especially the use of high VT and plateau pressure, may potentially aggravate or even initiate lung injury. Ventilator-associated lung injury can result from cyclic alveolar overdistension of non-dependent lung tissue, and repetitive opening and closing of dependent lung tissue resulting in ultrastructural damage at the junction of closed and open alveoli. Lung-protective ventilation, which refers to the use of lower VT and limited plateau pressure to minimize overdistension, and positive end-expiratory pressure to prevent alveolar collapse at end-expiration, was shown to improve outcome in critically ill patients with acute respiratory distress syndrome (ARDS). It has been recently suggested that this approach might also be beneficial in a broader population, especially in critically ill patients without ARDS at the onset of mechanical ventilation. There is, however, little evidence regarding a potential beneficial effect of lung protective ventilation during surgery, especially in patients with healthy lungs. Although surgical patients are frequently exposed to much shorter periods of mechanical ventilation, this is an important gap in knowledge given the number of patients receiving mechanical ventilation in the operating room. This review developed the benefits of lung protective ventilation during surgery

  1. CONVENIENT SAMPLING OF AIR BACTERIA IN OPERATING ROOMS.

    PubMed

    WARNER, P; GLASSCO, A; KROEKER, J

    1964-02-22

    A convenient arrangement for sampling air bacteria in operating rooms with a slit sampler (the Fort Detrick sampler) is described. Its purpose is to contribute as far as possible to the convenience of the surgical staff and thereby to the safety of the patient. It has the advantages of recording minute-to-minute changes in bacterial air count; it is unobtrusive and yet can be continually observed by a technician; it is not noisy and avoids the dangers of explosion and static electricity; it is inexpensive, and parts are easily replaced; and finally it provides a means of keeping permanent photographic records of bacterial counts. Results of a preliminary trial of this method appeared to be satisfactory. PMID:14118695

  2. Operating room fire: Should we mistrust alcoholic antiseptics?

    PubMed

    Bonnet, A; Devienne, M; De Broucker, V; Duquennoy-Martinot, V; Guerreschi, P

    2015-08-01

    Surgical site infections are a challenge for public health. One of the keystones of prevention is the skin preparation of the patient. Alcoholic antiseptics are presented as the best solution. But the adverse effects attributed to them must not be overshadowed by the exclusive benefit of their microbiological performance. The authors report four cases of severe burn having occurred in the operating room after skin antisepsis performed with an alcoholic antiseptic. The mechanisms of these accidents and preventive measures are reviewed. It concerns the restriction of ignition factors during use and the strict conformity to drying time. These potentially dramatic complications can and should be avoided. Probably underestimated, burns due to ignition of alcoholic antiseptics should appear more clearly in the evaluation of the risk-benefit balance. PMID:26066854

  3. Quality of emergency rooms and urgent care services: user satisfaction

    PubMed Central

    Lima, Cássio de Almeida; dos Santos, Bruna Tatiane Prates; Andrade, Dina Luciana Batista; Barbosa, Francielle Alves; da Costa, Fernanda Marques; Carneiro, Jair Almeida

    2015-01-01

    Objective To evaluate the quality of emergency rooms and urgent care services according to the satisfaction of their users. Methods A cross-sectional descriptive study with a quantitative approach. The sample comprised 136 users and was drawn at random. Data collection took place between October and November 2012 using a structured questionnaire. Results Participants were mostly male (64.7%) aged less than 30 years (55.8%), and the predominant level of education was high school (54.4%). Among the items evaluated, those that were statistically associated with levels of satisfaction with care were waiting time, confidence in the service, model of care, and the reason for seeking care related to acute complaints, cleanliness, and comfortable environment. Conclusion Accessibility, hospitality, and infrastructure were considered more relevant factors for patient satisfaction than the cure itself. PMID:26313440

  4. Music in the operating room: is it a safety hazard?

    PubMed

    Shambo, Lyda; Umadhay, Tony; Pedoto, Alessia

    2015-02-01

    Noise is a health hazard and a source of stress, and it impairs concentration and communication. Since 1960, hospital noise levels have risen around the world. Nowhere in the healthcare setting is noise more prevalent than in the operating room (OR). The genetic makeup of humans does not evolve at the rate of technology. Noise exposure, sensory overload, and the capacity to adapt without physical and psychological consequences are absent from the human condition. The World Health Organization has recognized environmental noise as harmful pollution that causesadverse effects on health. Although noise in the OR is unavoidable, music is a choice. The purpose of this literature review is to provide further insight into the ramifications of the presence of music in the OR, evaluate its appropriateness in relation to care and safety for the patient and staff, and provide information for future research. PMID:25842633

  5. Emergency Room Crowding: A Marker of Hospital Health

    PubMed Central

    Barish, Robert A.; Mcgauly, Patrick L.; Arnold, Thomas C.

    2012-01-01

    Emergency room (ER) crowding has become a widespread problem in hospitals across the United States. Two main reasons can be cited. First, emergency medicine is the only specialty in the “House of Medicine” that has a federal mandate to provide care to any patients requesting treatment. Second, primary care providers are in short supply, forcing sick people to seek medical care in ERs. Once seen as an “ER problem,” crowding has become more appropriately recognized as a “hospital problem,” related to factors beyond the doors of the ER. This realization has led many regulating agencies to launch corrective attempts, some of which have actually been effective. Now, the lack of ER crowding is considered a measure of the success of a hospital or system. This review considers the complex causative factors that contribute to ER crowding and explores corrective measures that may prove helpful in alleviating this paralyzing condition. PMID:23303998

  6. Racism in the consulting room: myth or reality?

    PubMed

    Msebele, Naison; Brown, Hilary

    2011-08-01

    This paper explores ways in which issues of race might impact on, and/or be ignored within, the practice of psychotherapy. Racial difference, that is being white as well as being black, taps into ingrained patterns of binary thinking that create hierarchies of "otherness." This generates anxiety which leads some therapists to avoid seeing race or naming its resonance in the therapeutic alliance. The origins of this splitting may lie in the unconscious, from whence it can be subtly nudged into more conscious awareness, as a seminal paper by Andrew Curry, published in this journal, suggested some forty-five years ago. Other modalities bring these dynamics more directly into the therapeutic space by exploring the patient's familial history or their daily lived experiences of racial (dis)advantage from an explicitly empowering standpoint. But whatever route is taken, racism is not an animal that can, or should, be left sleeping in the corner of the consulting room. PMID:21864143

  7. [Acute dyspnea in the emergency room: from pathophysiology to ultrasonography].

    PubMed

    Rosset-Zufferey, Sarah; Ramlawi, Majd

    2015-08-12

    Acute dyspnea is one of the leading clinical symptoms encountered in the emergency room. Its differential diagnosis is wide, ranging from noisy panic attacks to threatening acute heart failure. History taking and physical examination, even when exhaustive are of limited diagnostic value. Patient reported descriptions are fairly correlated to pathophysiology. Vital signs such as the respiratory rate and pulse oximetry carry prognostic significance. Ancillary tests like the chest x-ray lack sensitivity and specificity. The most astonishing adjunct to testing is the chest ultrasound. Its integration into the emergency physician's armamentarium considerably changed clinical management. Fast and accurate, ultrasonography has become the modern era stethoscope. This review discusses acute dyspnea through the main elements useful to diagnosis. PMID:26449099

  8. Use of a portable air disinfecting system to remove seeded coliphage in hospital rooms.

    PubMed

    Verhougstraete, Marc; Reynolds, Kelly

    2016-06-01

    Health care-associated infections are a major problem worldwide, and the airborne route is believed to be a contributory source of secondary health care-associated infections. This study examined the efficacy of a portable air disinfecting system to remove seeded coliphage virus from the air in hospitals rooms. Aerosolized coliphage concentrations were not statistically different between treatment and no treatment measurements. However, future research should focus on additional investigations in the patient rooms that incorporate fomite and air testing alongside portable air filtration devices. PMID:26905789

  9. A Neurologist’s Guide to Acute Migraine Therapy in the Emergency Room

    PubMed Central

    Gelfand, Amy A.; Goadsby, Peter J.

    2012-01-01

    Migraine is a common reason for visits to the emergency room. Attacks that lead patients to come to the emergency room are often more severe, refractory to home rescue medication, and have been going on for longer. All of these features make these attacks more challenging to treat. The purpose of this article is to review available evidence pertinent to the treatment of acute migraine in adults in the emergency department setting in order to provide neurologists with a rational approach to management. Drug classes and agents reviewed include opioids, dopamine receptor antagonists, triptans, nonsteroidal anti-inflammatory drugs, corticosteroids, and sodium valproate. PMID:23936605

  10. 16. POWERHOUSE FOREMAN'S BUNGALOW. DETAIL OF COLONNADE BETWEEN LIVING ROOM ...

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

    16. POWERHOUSE FOREMAN'S BUNGALOW. DETAIL OF COLONNADE BETWEEN LIVING ROOM AND DINING ROOM. VIEW TO NORTHEAST. - Thompson Falls Hydroelectric Project, Power Foreman's Bungalow, On island between Forebay Channel & ClarkFord River, Thompson Falls, Sanders County, MT

  11. 15. POWERHOUSE FOREMAN'S BUNGALOW. VIEW FROM LIVING ROOM TO DINING ...

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

    15. POWERHOUSE FOREMAN'S BUNGALOW. VIEW FROM LIVING ROOM TO DINING ROOM SHOWING WINDOWS, DOOR, AND COLONNADE. VIEW TO NORTH. - Thompson Falls Hydroelectric Project, Power Foreman's Bungalow, On island between Forebay Channel & ClarkFord River, Thompson Falls, Sanders County, MT

  12. 13. VIEW LOOKING NORTHEAST, SHOWING SHIPPING ROOMS AND VENEER MILL ...

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

    13. VIEW LOOKING NORTHEAST, SHOWING SHIPPING ROOMS AND VENEER MILL (AT RIGHT), AND ENGINE ROOM (AT LEFT) - Ichabod T. Williams & Sons Sawmill & Veneer Plant, Roosevelt Avenue at Carteret Avenue, Carteret, Middlesex County, NJ

  13. 16. INTERIOR VIEW TO THE SOUTHWEST OF ROOM 5, OFFICE ...

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

    16. INTERIOR VIEW TO THE SOUTHWEST OF ROOM 5, OFFICE AND STORAGE ROOM. - Nevada Test Site, Test Cell A Facility, Test Cell A Building & Addition, Area 25, Jackass Flats, Road F, Mercury, Nye County, NV

  14. 6. VIEW OF CONNECTING WALL BETWEEN FRONT AND REAR ROOMS ...

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

    6. VIEW OF CONNECTING WALL BETWEEN FRONT AND REAR ROOMS ON FIRST FLOOR, SHOWING ODDLY PROPORTIONED CLASSIC REVIVAL MANTLE IN FRONT ROOM; LOOKING WEST. - Manlius Thomas House, 125 North Mulberry Street, Georgetown, Scott County, KY

  15. 16. DINING ROOM INTERIOR SHOWING DOUBLE DOOR ARCHWAY INTO LIVING ...

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

    16. DINING ROOM INTERIOR SHOWING DOUBLE DOOR ARCHWAY INTO LIVING ROOM AND DOUBLE FRENCH DOORS INTO SOUTH END SCREENED PORCH. VIEW TO SOUTHWEST. - Big Creek Hydroelectric System, Powerhouse 8, Operator Cottage, Big Creek, Big Creek, Fresno County, CA

  16. 49. INTERIOR OF GILLEY ROOM: Interior view towards southeast of ...

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

    49. INTERIOR OF GILLEY ROOM: Interior view towards southeast of the Gilley Room on the second floor of the powerhouse and ear barn. - San Francisco Cable Railway, Washington & Mason Streets, San Francisco, San Francisco County, CA

  17. Visitor center flight room, detail of twin structural piers at ...

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

    Visitor center flight room, detail of twin structural piers at northeast corner supporting flight room dome - Wright Brothers National Memorial Visitor Center, Highway 158, Kill Devil Hills, Dare County, NC

  18. INTERIOR VIEW SHOWING THE THREE OPENINGS BETWEEN THE FAMILY ROOM ...

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

    INTERIOR VIEW SHOWING THE THREE OPENINGS BETWEEN THE FAMILY ROOM AND THE LANAI. NOTE THE ORIGINAL VENTED EAVES AT THE FAMILY ROOM. VIEW FACING WEST. - Hickam Field, Officers' Housing Type F, 602 Beard Avenue, Honolulu, Honolulu County, HI

  19. 121. VIEW OF SOUTH SIDE OF TRANSFORMER ROOM (112), LSB ...

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

    121. VIEW OF SOUTH SIDE OF TRANSFORMER ROOM (112), LSB (BLDG. 770), FROM MECHANICAL AND ELECTRICAL ROOM (110) - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  20. 48. GENERAL VIEW OF SOUTHWEST, FIRST FLOOR ROOM, EAST WALL, ...

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

    48. GENERAL VIEW OF SOUTHWEST, FIRST FLOOR ROOM, EAST WALL, WITH SECRET DOOR TO BOXED STAIRWAY TO ROOM ABOVE OPEN IN PANELLED WALL - Montpelier, Montpelier Drive & State Route 197, Laurel, Prince George's County, MD

  1. 97. NORTHWEST CORNER OF BOILER ROOM. EQUIPMENT HAS BEEN REMOVED ...

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

    97. NORTHWEST CORNER OF BOILER ROOM. EQUIPMENT HAS BEEN REMOVED AND ROOM IS NOW USED FOR STORAGE. - Gruber Wagon Works, Pennsylvania Route 183 & State Hill Road at Red Bridge Park, Bernville, Berks County, PA

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

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

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

  3. 7. VIEW OF CONNECTING WALL BETWEEN FRONT AND REAR ROOMS ...

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

    7. VIEW OF CONNECTING WALL BETWEEN FRONT AND REAR ROOMS OF SECOND FLOOR, SHOWING SIMPLE GREEK REVIVAL MANTLE. LOOKING WEST; TAKEN FROM FRONT ROOM. - Manlius Thomas House, 125 North Mulberry Street, Georgetown, Scott County, KY

  4. INTERIOR VIEW OF THE LIVING ROOM. SHOWING THE STEPS UP ...

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

    INTERIOR VIEW OF THE LIVING ROOM. SHOWING THE STEPS UP TO THE DINING ROOM WITH IRON RAILING. VIEW FACING NORTHEAST. - Hickam Field, Officers' Housing Type F, 602 Beard Avenue, Honolulu, Honolulu County, HI

  5. INTERIOR VIEW OF THE DINING ROOM. SHOWING THE BUILTIN CHINA ...

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

    INTERIOR VIEW OF THE DINING ROOM. SHOWING THE BUILT-IN CHINA CABINETS IN THE CORNERS OF THE ROOM. VIEW FACING NORTH. - Hickam Field, Officers' Housing Type D, 111 Beard Avenue, Honolulu, Honolulu County, HI

  6. 1. INTERIOR VIEW OF MOLDING ROOM, NO. 2 WORKS, SHOWING ...

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

    1. INTERIOR VIEW OF MOLDING ROOM, NO. 2 WORKS, SHOWING BUCKET LINE FEEDING MOLDING MACHINES - Harbison-Walker Refractories Company, Molding Room, West end of Shirley Street, Mount Union, Huntingdon County, PA

  7. Room 113, chemistry laboratory with benches perpendicular to the long ...

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

    Room 113, chemistry laboratory with benches perpendicular to the long axis of the room. A view to the southwest. - San Bernardino Valley College, Life Science Building, 701 South Mount Vernon Avenue, San Bernardino, San Bernardino County, CA

  8. 14. Interior view of vestibule separating rehabilitation space, testing room, ...

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

    14. Interior view of vestibule separating rehabilitation space, testing room, and corridor to workout room looking into corridor; near center of occupied portion; view to southeast. - Ellsworth Air Force Base, Mess & Administration Building, 2279 Risner Drive, Blackhawk, Meade County, SD

  9. 12. Interior view of workout room in rehabilitation and testing ...

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

    12. Interior view of workout room in rehabilitation and testing facilities; showing break/dressing rooms beyond; near southeast corner of occupied portion; view to southwest. - Ellsworth Air Force Base, Mess & Administration Building, 2279 Risner Drive, Blackhawk, Meade County, SD

  10. 8. INTERIOR: FRONT HALL VIEWED FROM LIVING ROOM, SHOWING LIVINGROOM ...

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

    8. INTERIOR: FRONT HALL VIEWED FROM LIVING ROOM, SHOWING LIVING-ROOM COLUMNS, STAIRCASE RAILING AND PANELED SPANDREL, AND NICHE BELOW STAIRCASE, VIEW WEST - Dr. William M. Curtis House, 23-25 High Street, Bristol, Hartford County, CT

  11. Stair and entry room, bunkhouse, first floor interior. Door from ...

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

    Stair and entry room, bunkhouse, first floor interior. Door from entry hall leads to toilets and bathing rooms. A coat and hat rack is on each side of the door. - Sespe Ranch, Bunkhouse, 2896 Telegraph Road, Fillmore, Ventura County, CA

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

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

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

  13. OVERVIEW OF GENERATOR ROOM FOR #1 AND #2 GENERATORS, LOOKING ...

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

    OVER-VIEW OF GENERATOR ROOM FOR #1 AND #2 GENERATORS, LOOKING WEST FROM STAIRWAY LEAVING CONTROL ROOM. PHOTO BY JET LOWE, HAER, 1995. - Elwha River Hydroelectric System, Elwha Hydroelectric Dam & Plant, Port Angeles, Clallam County, WA

  14. VIEW OF GENERATOR ROOM FOR #1 AND #2 GENERATORS, LOOKING ...

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

    VIEW OF GENERATOR ROOM FOR #1 AND #2 GENERATORS, LOOKING EAST TOWARD STAIRWAY TO CONTROL ROOM. PHOTO BY JET LOWE, HAER, 1995. - Elwha River Hydroelectric System, Elwha Hydroelectric Dam & Plant, Port Angeles, Clallam County, WA

  15. INTERIOR, ROOF, A view looking southwest through Room 205 at ...

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

    INTERIOR, ROOF, A view looking southwest through Room 205 at the doorway that leads to Room 206P, a shower and clean area in the penthouse - Department of Energy, Mound Facility, B Building, One Mound Road, Miamisburg, Montgomery County, OH

  16. Central firstfloor room of northwest wing, looking through entry to ...

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

    Central first-floor room of northwest wing, looking through entry to northwestern room. note crack in ceiling showing location of summer beam. - Scheetz Farm, House, 7161 Camp Hill Road, Fort Washington, Montgomery County, PA

  17. 106. INTERIOR, FIFTH FLOOR, WING 5100 WEST, ROOM 5160, SECRETARY'S ...

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

    106. INTERIOR, FIFTH FLOOR, WING 5100 WEST, ROOM 5160, SECRETARY'S CONFERENCE ROOM (AFTER REMODELING) - U.S. Department of the Interior, Eighteenth & C Streets Northwest, Washington, District of Columbia, DC

  18. 108. INTERIOR, FIFTH FLOOR, WING 5100 WEST, ROOM 5160, SECRETARY'S ...

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

    108. INTERIOR, FIFTH FLOOR, WING 5100 WEST, ROOM 5160, SECRETARY'S CONFERENCE ROOM (AFTER REMODELING), DETAIL OF CEILING DECORATION - U.S. Department of the Interior, Eighteenth & C Streets Northwest, Washington, District of Columbia, DC

  19. 107. INTERIOR, FIFTH FLOOR, WING 5100 WEST, ROOM 5160, SECRETARY'S ...

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

    107. INTERIOR, FIFTH FLOOR, WING 5100 WEST, ROOM 5160, SECRETARY'S CONFERENCE ROOM (AFTER REMODELING), DETAIL OF PANELING - U.S. Department of the Interior, Eighteenth & C Streets Northwest, Washington, District of Columbia, DC

  20. 107. UMBILICAL MAST HYDRAULIC CONTROL PANEL IN CENTER OF ROOM ...

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

    107. UMBILICAL MAST HYDRAULIC CONTROL PANEL IN CENTER OF ROOM UMBILICAL MAST PUMP ROOM (109), LSB (BDLG. 770), FACING WEST - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  1. TENANT HOUSE INTERIOR, LIVING ROOM, SOUTH AND EAST WALLS, LOOKING ...

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

    TENANT HOUSE INTERIOR, LIVING ROOM, SOUTH AND EAST WALLS, LOOKING SOUTHEAST FROM CENTER OF ROOM - Irvine Ranch Agricultural Headquarters, Carillo Tenant House, Southwest of Intersection of San Diego & Santa Ana Freeways, Irvine, Orange County, CA

  2. TENANT HOUSE INTERIOR, LIVING ROOM, NORTH AND EAST WALLS, LOOKING ...

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

    TENANT HOUSE INTERIOR, LIVING ROOM, NORTH AND EAST WALLS, LOOKING NORTH FROM CENTER OF ROOM - Irvine Ranch Agricultural Headquarters, Carillo Tenant House, Southwest of Intersection of San Diego & Santa Ana Freeways, Irvine, Orange County, CA

  3. Southeast Elevation, Attic Stair Nosing, Day Room Fireplace Details, Day ...

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

    Southeast Elevation, Attic Stair Nosing, Day Room Fireplace Details, Day Room Mantel Shelf, Northeast Elevation - National Home for Disabled Volunteer Soldiers - Battle Mountain Sanitarium, Ward 4, 500 North Fifth Street, Hot Springs, Fall River County, SD

  4. INTERIOR VIEW OF THE LIVING ROOM. NOTE THE SINGLEPANEL SLIDING ...

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

    INTERIOR VIEW OF THE LIVING ROOM. NOTE THE SINGLE-PANEL SLIDING DOORS TO THE FAMILY ROOM IN THE BACKGROUND. VIEW FACING NORTH. - Hickam Field, Officers' Housing Type K, 304 Sixth Street, Honolulu, Honolulu County, HI

  5. 46 CFR 92.20-25 - Washrooms and toilet rooms.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... attached. (b) The toilet rooms and washrooms must be located convenient to the sleeping quarters of the... private or semi-private facilities are provided and washbasins are installed in the sleeping rooms....

  6. 46 CFR 92.20-25 - Washrooms and toilet rooms.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... attached. (b) The toilet rooms and washrooms must be located convenient to the sleeping quarters of the... private or semi-private facilities are provided and washbasins are installed in the sleeping rooms....

  7. 46 CFR 92.20-25 - Washrooms and toilet rooms.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... attached. (b) The toilet rooms and washrooms must be located convenient to the sleeping quarters of the... private or semi-private facilities are provided and washbasins are installed in the sleeping rooms....

  8. 4. VIEW OF SHIPPING AND RECEIVING ROOM (109) FROM NORTHEAST ...

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

    4. VIEW OF SHIPPING AND RECEIVING ROOM (109) FROM NORTHEAST CORNER SHOWING INTERIOR DOORS TO ASSEMBLY ROOM (101) IN SOUTH WALL - Vandenberg Air Force Base, Space Launch Complex 3, Vehicle Support Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  9. 82. REGENTS' ROOM WEST WALL, WITH ORIGINAL CHAIRS BY JAMES ...

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

    82. REGENTS' ROOM WEST WALL, WITH ORIGINAL CHAIRS BY JAMES RENWICK, JR. MANTELPIECE AND MIRROR ARE NOT ORIGINAL TO THE ROOM. - Smithsonian Institution Building, 1000 Jefferson Drive, between Ninth & Twelfth Streets, Southwest, Washington, District of Columbia, DC

  10. 28. Perimeter acquisition radar building room #302, signal process and ...

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

    28. Perimeter acquisition radar building room #302, signal process and analog receiver room - Stanley R. Mickelsen Safeguard Complex, Perimeter Acquisition Radar Building, Limited Access Area, between Limited Access Patrol Road & Service Road A, Nekoma, Cavalier County, ND

  11. 1. View south, metal shed (at left) and tool room ...

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

    1. View south, metal shed (at left) and tool room shed (WV-268-C)) (at right), in front of wash house (WV-268-D) - 3240 Cyrus Road, Tool Room Shed, About 25 feet directly behind house, Cyrus, Wayne County, WV

  12. North rear, east part. Ramp leads to basement utility rooms ...

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

    North rear, east part. Ramp leads to basement utility rooms and specimen preparation rooms. - San Bernardino Valley College, Life Science Building, 701 South Mount Vernon Avenue, San Bernardino, San Bernardino County, CA

  13. 4. INTERIOR, CENTRAL BOILER ROOM, LOWER LEVEL, BOILERS, FROM SOUTHWEST ...

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

    4. INTERIOR, CENTRAL BOILER ROOM, LOWER LEVEL, BOILERS, FROM SOUTHWEST CORNER OF ROOM, LOOKING SOUTHEAST. - Oakland Naval Supply Center, Heating Plant, North of B Street & West of Third Street, Oakland, Alameda County, CA

  14. 12. Forward end of Boiler Room showing open firing doors ...

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

    12. Forward end of Boiler Room showing open firing doors for boilers. Note ladderway retracted overhead by which firemen entered and left Boiler Room. Coal ejectors shown at extreme left of view. - Ferry TICONDEROGA, Route 7, Shelburne, Chittenden County, VT

  15. 6. View along E wall of Engine Room, Boiler House ...

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

    6. View along E wall of Engine Room, Boiler House and Pattern Room. - Central of Georgia Railway, Savannah Repair Shops & Terminal Facilities, Engine Boiler & Pattern Building, Bounded by West Broad, Jones, West Boundary & Hull Streets, Savannah, Chatham County, GA

  16. 5. N elevation of Engine Room, Boiler House and Pattern ...

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

    5. N elevation of Engine Room, Boiler House and Pattern Room. - Central of Georgia Railway, Savannah Repair Shops & Terminal Facilities, Engine Boiler & Pattern Building, Bounded by West Broad, Jones, West Boundary & Hull Streets, Savannah, Chatham County, GA

  17. 2. S. elevation of Engine Room, Boiler House and Pattern ...

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

    2. S. elevation of Engine Room, Boiler House and Pattern Room. - Central of Georgia Railway, Savannah Repair Shops & Terminal Facilities, Engine Boiler & Pattern Building, Bounded by West Broad, Jones, West Boundary & Hull Streets, Savannah, Chatham County, GA

  18. 16. INTERIOR VIEW TO THE NORTHEAST OF ROOM 107, THE ...

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

    16. INTERIOR VIEW TO THE NORTHEAST OF ROOM 107, THE HOT STORAGE AND PACKAGING ROOM. - Nevada Test Site, Pluto Facility, Disassembly Building, Area 26, Wahmonie Flats, Cane Spring Road, Mercury, Nye County, NV

  19. 25. INTERIOR VIEW TO THE SOUTHWEST OF ROOM 109, THE ...

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

    25. INTERIOR VIEW TO THE SOUTHWEST OF ROOM 109, THE WARM AND COLD STORAGE ROOM. - Nevada Test Site, Pluto Facility, Disassembly Building, Area 26, Wahmonie Flats, Cane Spring Road, Mercury, Nye County, NV

  20. 15. INTERIOR VIEW TO THE WEST OF ROOM 107, THE ...

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

    15. INTERIOR VIEW TO THE WEST OF ROOM 107, THE HOT STORAGE AND PACKAGING ROOM. - Nevada Test Site, Pluto Facility, Disassembly Building, Area 26, Wahmonie Flats, Cane Spring Road, Mercury, Nye County, NV

  1. 20. INTERIOR OF SOUTHERN ROOM. VIEW LOOKING NORTHWEST TOWARD HALL ...

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

    20. INTERIOR OF SOUTHERN ROOM. VIEW LOOKING NORTHWEST TOWARD HALL CONNECTING WITH CENTRAL ROOM. - Chollas Heights Naval Radio Transmitting Facility, Transmitter Building, 6410 Zero Road, San Diego, San Diego County, CA

  2. 3. GENERAL VIEW OF BOILER ROOM, LOOKING NORTH; CONTROL PANEL ...

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

    3. GENERAL VIEW OF BOILER ROOM, LOOKING NORTH; CONTROL PANEL AT CENTER; BOXLIKE, RIVETED HOUSING AT TOP CENTER CONTAINED AUGER FOR COAL DISTRIBUTION SYSTEM - Rath Packing Company, Boiler Room, Sycamore Street between Elm & Eighteenth Streets, Waterloo, Black Hawk County, IA

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

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

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

  4. 10. INTERIOR OF NORTH MAIN BUILDING ROOM, SOUTH WALL CABINETS ...

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

    10. INTERIOR OF NORTH MAIN BUILDING ROOM, SOUTH WALL CABINETS AND DOOR TO SOUTH MAIN BUILDING ROOM. VIEW TO SOUTH. - Bishop Creek Hydroelectric System, Control Station, Hydrographer's Office, Bishop Creek, Bishop, Inyo County, CA

  5. 13. BUILDING 106. PACKAGING UNIT. DETAILS OF HOT ROOM AND ...

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

    13. BUILDING 106. PACKAGING UNIT. DETAILS OF HOT ROOM AND RELATIVE HUMIDITY ROOM. June 5, 1944 - Frankford Arsenal, Building No. 106, South of Tacony Street between Bridge Street & tracks of former Pennsylvania Railroad, Philadelphia, Philadelphia County, PA

  6. 15. ROOMS 48 AND 49, LOOKING SOUTH FROM ENTRANCE TO ...

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

    15. ROOMS 48 AND 49, LOOKING SOUTH FROM ENTRANCE TO ROOM 47. THE OAK CABINETS ARE USED TO STORE ROCK CORE SAMPLES. - U.S. Geological Survey, Rock Magnetics Laboratory, 345 Middlefield Road, Menlo Park, San Mateo County, CA

  7. 46 CFR 92.20-25 - Washrooms and toilet rooms.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... attached. (b) The toilet rooms and washrooms must be located convenient to the sleeping quarters of the... private or semi-private facilities are provided and washbasins are installed in the sleeping rooms....

  8. 13. INTERIOR VIEW TO THE WEST OF EQUIPMENT IN ROOM ...

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

    13. INTERIOR VIEW TO THE WEST OF EQUIPMENT IN ROOM 2, RADIATION EFFECTS ROOM. - Nevada Test Site, Test Cell A Facility, Test Cell A Building & Addition, Area 25, Jackass Flats, Road F, Mercury, Nye County, NV

  9. Stroke Education in an Emergency Department Waiting Room: A Comparison of Methods

    PubMed Central

    Chan, Yu-Feng Yvonne; Richardson, Lynne D.; Nagurka, Roxanne; Hao, Ke; Zaets, Sergey B.; Brimacombe, Michael B.; Bentley, Susanne; Levine, Steven R.

    2015-01-01

    Background: Since the emergency department (ED) waiting room hosts a large, captive audience of patients and visitors, it may be an ideal location for conducting focused stroke education. The aim of this study was to assess the effectiveness of various stroke education methods. Methods: Patients and visitors of an urban ED waiting room were randomized into one of the following groups: video, brochure, one-to-one teaching, combination of these three methods, or control group. We administered a 13-question multiple-choice test to assess stroke knowledge prior to, immediately after, and at 1 month post-education to patients and visitors in the ED waiting room. Results: Of 4 groups receiving education, all significantly improved their test scores immediately post intervention (test scores 9.4±2.5-10.3±2.0, P<0.01). At 1 month, the combination group retained the most knowledge (9.4±2.4) exceeding pre-intervention and control scores (both 6.7±2.6, P<0.01). Conclusion: Among the various stroke education methods delivered in the ED waiting room, the combination method resulted in the highest knowledge retention at 1-month post intervention. PMID:26000244

  10. 22. (Credit JTL) Detail, south elevation of boiler room; view ...

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

    22. (Credit JTL) Detail, south elevation of boiler room; view looking NNW at Adolphous Custodis stack base (1900), boiler room doors, boiler backheads and edge of old high service pump room. Note joint in bricks to right of Poller room doors showing extent of wall replacement when doors were installed. - McNeil Street Pumping Station, McNeil Street & Cross Bayou, Shreveport, Caddo Parish, LA

  11. 31. VIEW OF ROOM 212 LOOKING NORTHWEST TOWARDS EXPOSED STUD ...

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

    31. VIEW OF ROOM 212 LOOKING NORTHWEST TOWARDS EXPOSED STUD WALL THAT SERVES AS DIVIDER TO ROOM 211. EXPOSED TRUSSWORK VISIBLE THROUGH TO NEXT ROOM. WOOD PANELED WALLS ARE PAINTED; FLOORS ARE WOOD. - Presidio of San Francisco, Cavalry Stables, Cowles Street, between Lincoln Boulevard & McDowell Street, San Francisco, San Francisco County, CA

  12. 5 CFR 9800.5 - Public reading room.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Public reading room. 9800.5 Section 9800.5 Administrative Personnel COUNCIL OF THE INSPECTORS GENERAL ON INTEGRITY AND EFFICIENCY FREEDOM OF INFORMATION ACT REGULATIONS § 9800.5 Public reading room. CIGIE maintains an electronic public reading room...

  13. 10 CFR 429.15 - Room air conditioners.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 3 2014-01-01 2014-01-01 false Room air conditioners. 429.15 Section 429.15 Energy... COMMERCIAL AND INDUSTRIAL EQUIPMENT Certification § 429.15 Room air conditioners. (a) Sampling plan for selection of units for testing. (1) The requirements of § 429.11 are applicable to room air...

  14. 29 CFR 779.113 - Warehouse and stock room employees.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Warehouse and stock room employees. 779.113 Section 779.113 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS....113 Warehouse and stock room employees. Warehouse and stock room employees of retail businesses...

  15. 112. VIEW OF SOUTH SIDE OF MECHANICAL AND ELECTRICAL ROOM ...

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

    112. VIEW OF SOUTH SIDE OF MECHANICAL AND ELECTRICAL ROOM (110), LSB (BLDG. 770). VEHICLE MECHANICAL SYSTEMS ROOM (111) AND PNEUMATIC SUPPLY PANEL VISIBLE AT SOUTH END OF MECHANICAL AND ELECTRICAL ROOM (110). PAYLOAD CABLE DISTRIBUTION BOX ON LEFT OF PHOTO, FACING WEST. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  16. 7 CFR 58.622 - Hardening and storage rooms.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Hardening and storage rooms. 58.622 Section 58.622 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....622 Hardening and storage rooms. Hardening and storage rooms for frozen desserts shall be...

  17. 7 CFR 58.622 - Hardening and storage rooms.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false Hardening and storage rooms. 58.622 Section 58.622 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....622 Hardening and storage rooms. Hardening and storage rooms for frozen desserts shall be...

  18. 7 CFR 58.622 - Hardening and storage rooms.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 3 2014-01-01 2014-01-01 false Hardening and storage rooms. 58.622 Section 58.622 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....622 Hardening and storage rooms. Hardening and storage rooms for frozen desserts shall be...

  19. 7 CFR 58.622 - Hardening and storage rooms.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Hardening and storage rooms. 58.622 Section 58.622 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....622 Hardening and storage rooms. Hardening and storage rooms for frozen desserts shall be...

  20. 7 CFR 58.622 - Hardening and storage rooms.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Hardening and storage rooms. 58.622 Section 58.622 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....622 Hardening and storage rooms. Hardening and storage rooms for frozen desserts shall be...

  1. 22 CFR 303.5 - Public reading room.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Public reading room. 303.5 Section 303.5 Foreign Relations PEACE CORPS PROCEDURES FOR DISCLOSURE OF INFORMATION UNDER THE FREEDOM OF INFORMATION ACT § 303.5 Public reading room. (a) The Peace Corps will maintain a public reading room at...

  2. 22 CFR 303.5 - Public reading room.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Public reading room. 303.5 Section 303.5 Foreign Relations PEACE CORPS PROCEDURES FOR DISCLOSURE OF INFORMATION UNDER THE FREEDOM OF INFORMATION ACT § 303.5 Public reading room. (a) The Peace Corps will maintain a public reading room at its headquarters at...

  3. 5 CFR 9800.5 - Public reading room.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Public reading room. 9800.5 Section 9800.5 Administrative Personnel COUNCIL OF THE INSPECTORS GENERAL ON INTEGRITY AND EFFICIENCY FREEDOM OF INFORMATION ACT REGULATIONS § 9800.5 Public reading room. CIGIE maintains an electronic public reading room...

  4. 10. INTERIOR, FIRST FLOOR, GENERAL VIEW FROM WEST ROOM TO ...

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

    10. INTERIOR, FIRST FLOOR, GENERAL VIEW FROM WEST ROOM TO EAST ROOM. NORTH SIDE OF ROOM SOUTHWEST TO NORTHEAST SHOWS FIREPLACE, DOUBLE DOORS (SLIDING) AND WINDOW TO PORCH. - P. A. Bowen House, 15701 Dr. Bowen Road, Aquasco, Prince George's County, MD

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

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

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

  6. 45 CFR 612.2 - Public reading room.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 3 2012-10-01 2012-10-01 false Public reading room. 612.2 Section 612.2 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION AVAILABILITY OF RECORDS AND INFORMATION § 612.2 Public reading room. (a) The Foundation maintains a public reading room located in the NSF Library at 4201...

  7. 6 CFR 5.2 - Public reading rooms.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ..., Washington, DC 20229-0001 (for a list of field office reading room locations please consult 19 CFR 103.1... the Department in a public reading room will be made available electronically at www.dhs.gov/foia... public reading room are available electronically at http://www.bis.doc.gov/FOIA/Default.htm; (4)...

  8. 45 CFR 612.2 - Public reading room.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 3 2011-10-01 2011-10-01 false Public reading room. 612.2 Section 612.2 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION AVAILABILITY OF RECORDS AND INFORMATION § 612.2 Public reading room. (a) The Foundation maintains a public reading room located in the NSF Library at 4201...

  9. 45 CFR 612.2 - Public reading room.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false Public reading room. 612.2 Section 612.2 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION AVAILABILITY OF RECORDS AND INFORMATION § 612.2 Public reading room. (a) The Foundation maintains a public reading room located in the NSF Library at 4201...

  10. 15. INTERIOR OF DINING ROOM SHOWING RECESSED TELEPHONE ALCOVE IN ...

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

    15. INTERIOR OF DINING ROOM SHOWING RECESSED TELEPHONE ALCOVE IN PARTION WALL BETWEEN LIVING ROOM AND DINING ROOM AT PHOTO RIGHT CENTER. OPEN DOOR AT PHOTO LEFT CENTER LEADS TO BEDROOM NO.2. VIEW TO NORTH. - Bishop Creek Hydroelectric System, Plant 4, Worker Cottage, Bishop Creek, Bishop, Inyo County, CA

  11. 113. VIEW OF NORTH SIDE OF MECHANICAL AND ELECTRICAL ROOM ...

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

    113. VIEW OF NORTH SIDE OF MECHANICAL AND ELECTRICAL ROOM (110), LSB (BLDG. 770). QUALITY ASSURANCE ROOM (106A) ON RIGHT SIDE OF PHOTO; CABLE TRAYS OVERHEAD AT TOP; STAIRS TO LSB (BLDG. 770) ADDITION (ROOMS 117 THROUGH 120) IN CENTER OF PHOTO. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  12. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... must be reported pursuant to 49 CFR part 191 to determine if control room actions contributed to the... 49 Transportation 3 2013-10-01 2013-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management....

  13. 49 CFR 195.446 - Control room management.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Control room management. 195.446 Section 195.446... PIPELINE Operation and Maintenance § 195.446 Control room management. (a) General. This section applies to... written control room management procedures that implement the requirements of this section. The...

  14. 49 CFR 195.446 - Control room management.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Control room management. 195.446 Section 195.446... PIPELINE Operation and Maintenance § 195.446 Control room management. (a) General. This section applies to... written control room management procedures that implement the requirements of this section. The...

  15. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... must be reported pursuant to 49 CFR part 191 to determine if control room actions contributed to the... 49 Transportation 3 2011-10-01 2011-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management....

  16. 49 CFR 192.631 - Control room management.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... must be reported pursuant to 49 CFR part 191 to determine if control room actions contributed to the... 49 Transportation 3 2012-10-01 2012-10-01 false Control room management. 192.631 Section 192.631... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.631 Control room management....

  17. 49 CFR 195.446 - Control room management.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Control room management. 195.446 Section 195.446... PIPELINE Operation and Maintenance § 195.446 Control room management. (a) General. This section applies to... written control room management procedures that implement the requirements of this section. The...

  18. INTERIOR VIEW OF THE DINING ROOM DOORWAYS TO THE KITCHEN ...

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

    INTERIOR VIEW OF THE DINING ROOM DOORWAYS TO THE KITCHEN (RIGHT) AND LIVING ROOM (LEFT). NOTE THE TELEPHONE NICHE IN THE DINING ROOM AND THE FIVE-PANEL DOOR TO THE HALL IN THE BACKGROUND. VIEW FACING SOUTH. - Hickam Field, NCO Housing Type 2, 301 Eleventh Street, Honolulu, Honolulu County, HI

  19. 7 CFR 58.313 - Print and bulk packaging rooms.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 3 2014-01-01 2014-01-01 false Print and bulk packaging rooms. 58.313 Section 58.313....313 Print and bulk packaging rooms. Rooms used for packaging print or bulk butter and related products should, in addition to proper construction and sanitation, provide an atmosphere relatively free...

  20. 7 CFR 58.313 - Print and bulk packaging rooms.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false Print and bulk packaging rooms. 58.313 Section 58.313....313 Print and bulk packaging rooms. Rooms used for packaging print or bulk butter and related products should, in addition to proper construction and sanitation, provide an atmosphere relatively free...

  1. 36 CFR 1600.2 - Public reading room.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Public reading room. 1600.2... Records Under the Freedom of Information Act § 1600.2 Public reading room. (a) The Foundation maintains a public reading room that contains the records that the FOIA requires to be made regularly available...

  2. 39 CFR 265.5 - Public reading rooms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Public reading rooms. 265.5 Section 265.5 Postal... reading rooms. The Library of the Postal Service Headquarters, 475 L'Enfant Plaza SW, Washington, DC 20260-1641, serves as public reading room for the materials which are listed in paragraphs (a)(2), (3),...

  3. 46 CFR 69.121 - Engine room deduction.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Engine room deduction. 69.121 Section 69.121 Shipping... MEASUREMENT OF VESSELS Standard Measurement System § 69.121 Engine room deduction. (a) General. The engine...) Space below the crown. The crown is the top of the main space of the engine room to which the heights...

  4. 46 CFR 69.121 - Engine room deduction.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Engine room deduction. 69.121 Section 69.121 Shipping... MEASUREMENT OF VESSELS Standard Measurement System § 69.121 Engine room deduction. (a) General. The engine...) Space below the crown. The crown is the top of the main space of the engine room to which the heights...

  5. 1. Distant view shows Engine Room Building behind cranes. Retort ...

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

    1. Distant view shows Engine Room Building behind cranes. Retort rings in foreground were once located in Engine Room Building. See photo WA-131-A-2. Building on left is Machine Shop. Boiler Building is in front of stack. - Pacific Creosoting Plant, Engine Room Building, 5350 Creosote Place, Northeast, Bremerton, Kitsap County, WA

  6. 46 CFR 69.121 - Engine room deduction.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Engine room deduction. 69.121 Section 69.121 Shipping... MEASUREMENT OF VESSELS Standard Measurement System § 69.121 Engine room deduction. (a) General. The engine...) Space below the crown. The crown is the top of the main space of the engine room to which the heights...

  7. 27 CFR 24.166 - Buildings or rooms.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Buildings or rooms. 24.166... OF THE TREASURY ALCOHOL WINE Construction and Equipment § 24.166 Buildings or rooms. All buildings or... afford adequate protection to the revenue. Each building or room will be constructed of...

  8. 27 CFR 24.166 - Buildings or rooms.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Buildings or rooms. 24.166... OF THE TREASURY ALCOHOL WINE Construction and Equipment § 24.166 Buildings or rooms. All buildings or... afford adequate protection to the revenue. Each building or room will be constructed of...

  9. 27 CFR 24.166 - Buildings or rooms.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Buildings or rooms. 24.166... OF THE TREASURY LIQUORS WINE Construction and Equipment § 24.166 Buildings or rooms. All buildings or... afford adequate protection to the revenue. Each building or room will be constructed of...

  10. 27 CFR 24.166 - Buildings or rooms.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Buildings or rooms. 24.166... OF THE TREASURY LIQUORS WINE Construction and Equipment § 24.166 Buildings or rooms. All buildings or... afford adequate protection to the revenue. Each building or room will be constructed of...

  11. 27 CFR 24.166 - Buildings or rooms.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Buildings or rooms. 24.166... OF THE TREASURY LIQUORS WINE Construction and Equipment § 24.166 Buildings or rooms. All buildings or... afford adequate protection to the revenue. Each building or room will be constructed of...

  12. 1. TERMINAL ROOM, INTERIOR, SHOP LEVEL, SHOWING FIRE EXTINGUISHING SYSTEM ...

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

    1. TERMINAL ROOM, INTERIOR, SHOP LEVEL, SHOWING FIRE EXTINGUISHING SYSTEM PIPES AND VALVES AT LEFT. Looking southeast from entrance to terminal room. - Edwards Air Force Base, Air Force Rocket Propulsion Laboratory, Test Stand 1-A Terminal Room, Test Area 1-120, north end of Jupiter Boulevard, Boron, Kern County, CA

  13. 28 CFR 16.2 - Public reading rooms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Public reading rooms. 16.2 Section 16.2... Procedures for Disclosure of Records Under the Freedom of Information Act § 16.2 Public reading rooms. (a) The Department maintains public reading rooms that contain the records that the FOIA requires to...

  14. 29 CFR 70.4 - Public reading rooms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Public reading rooms. 70.4 Section 70.4 Labor Office of the Secretary of Labor PRODUCTION OR DISCLOSURE OF INFORMATION OR MATERIALS General § 70.4 Public reading rooms... this section are available through public reading rooms, and, to the extent indicated in this...

  15. 36 CFR 1600.2 - Public reading room.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Public reading room. 1600.2... Records Under the Freedom of Information Act § 1600.2 Public reading room. (a) The Foundation maintains a public reading room that contains the records that the FOIA requires to be made regularly available...

  16. 40 CFR 1601.12 - Public reading room.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Public reading room. 1601.12 Section... DISCLOSURE OF RECORDS UNDER THE FREEDOM OF INFORMATION ACT Administration § 1601.12 Public reading room. (a) The CSB maintains a public reading room that contains the records that the FOIA requires to be...

  17. 32 CFR 806.11 - FOIA reading rooms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false FOIA reading rooms. 806.11 Section 806.11... FREEDOM OF INFORMATION ACT PROGRAM § 806.11 FOIA reading rooms. Each FOIA office will arrange for a reading room where the public may inspect releasable records. You do not need to co-locate the...

  18. 39 CFR 265.5 - Public reading rooms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Public reading rooms. 265.5 Section 265.5 Postal... reading rooms. The Library of the Postal Service Headquarters, 475 L'Enfant Plaza SW, Washington, DC 20260-1641, serves as public reading room for the materials which are listed in paragraphs (a)(2), (3),...

  19. 12 CFR 505.2 - Public Reading Room.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Public Reading Room. 505.2 Section 505.2 Banks....2 Public Reading Room. OTS will make materials available for review on an ad hoc basis when..., or you may visit the Public Reading Room at 1700 G Street, NW., by appointment only. (Please...

  20. 7 CFR 58.620 - Freezing and packaging rooms.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Freezing and packaging rooms. 58.620 Section 58.620 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....620 Freezing and packaging rooms. The rooms used for freezing and packaging frozen desserts shall...

  1. 7 CFR 58.313 - Print and bulk packaging rooms.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 false Print and bulk packaging rooms. 58.313 Section 58.313 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....313 Print and bulk packaging rooms. Rooms used for packaging print or bulk butter and related...

  2. 22 CFR 171.3 - Public reading room.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Public reading room. 171.3 Section 171.3 Foreign Relations DEPARTMENT OF STATE ACCESS TO INFORMATION AVAILABILITY OF INFORMATION AND RECORDS TO THE PUBLIC General Policy and Procedures § 171.3 Public reading room. A reading room providing public access to certain Department of State material...

  3. 7 CFR 58.620 - Freezing and packaging rooms.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Freezing and packaging rooms. 58.620 Section 58.620 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....620 Freezing and packaging rooms. The rooms used for freezing and packaging frozen desserts shall...

  4. 7 CFR 58.620 - Freezing and packaging rooms.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 3 2014-01-01 2014-01-01 false Freezing and packaging rooms. 58.620 Section 58.620 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....620 Freezing and packaging rooms. The rooms used for freezing and packaging frozen desserts shall...

  5. 7 CFR 58.620 - Freezing and packaging rooms.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 3 2013-01-01 2013-01-01 false Freezing and packaging rooms. 58.620 Section 58.620 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....620 Freezing and packaging rooms. The rooms used for freezing and packaging frozen desserts shall...

  6. 7 CFR 58.313 - Print and bulk packaging rooms.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 3 2012-01-01 2012-01-01 false Print and bulk packaging rooms. 58.313 Section 58.313 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....313 Print and bulk packaging rooms. Rooms used for packaging print or bulk butter and related...

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

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

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

  8. 7 CFR 58.620 - Freezing and packaging rooms.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Freezing and packaging rooms. 58.620 Section 58.620 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....620 Freezing and packaging rooms. The rooms used for freezing and packaging frozen desserts shall...

  9. 7 CFR 58.313 - Print and bulk packaging rooms.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Print and bulk packaging rooms. 58.313 Section 58.313 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....313 Print and bulk packaging rooms. Rooms used for packaging print or bulk butter and related...

  10. 40 CFR 1601.12 - Public reading room.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Public reading room. 1601.12 Section 1601.12 Protection of Environment CHEMICAL SAFETY AND HAZARD INVESTIGATION BOARD PROCEDURES FOR DISCLOSURE OF RECORDS UNDER THE FREEDOM OF INFORMATION ACT Administration § 1601.12 Public reading room. (a) The CSB maintains a public reading room...

  11. Telco maintenance (room 228) looking south into the telephone equipment ...

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

    Telco maintenance (room 228) looking south into the telephone equipment room (room 227). Note workbench in left corner, lighting fixtures, and air handling ducts - March Air Force Base, Strategic Air Command, Combat Operations Center, 5220 Riverside Drive, Moreno Valley, Riverside County, CA

  12. 46 CFR 111.105-41 - Battery rooms.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... REQUIREMENTS Hazardous Locations § 111.105-41 Battery rooms. Each electrical installation in a battery room must meet 46 CFR subpart 111.15 and IEEE 45-1998 (incorporated by reference; see 46 CFR 110.10-1). ... 46 Shipping 4 2014-10-01 2014-10-01 false Battery rooms. 111.105-41 Section 111.105-41...

  13. 46 CFR 111.105-41 - Battery rooms.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... REQUIREMENTS Hazardous Locations § 111.105-41 Battery rooms. Each electrical installation in a battery room must meet 46 CFR subpart 111.15 and IEEE 45-1998 (incorporated by reference; see 46 CFR 110.10-1). ... 46 Shipping 4 2013-10-01 2013-10-01 false Battery rooms. 111.105-41 Section 111.105-41...

  14. 46 CFR 111.105-41 - Battery rooms.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... REQUIREMENTS Hazardous Locations § 111.105-41 Battery rooms. Each electrical installation in a battery room must meet 46 CFR subpart 111.15 and IEEE 45-1998 (incorporated by reference; see 46 CFR 110.10-1). ... 46 Shipping 4 2012-10-01 2012-10-01 false Battery rooms. 111.105-41 Section 111.105-41...

  15. 46 CFR 111.105-41 - Battery rooms.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... REQUIREMENTS Hazardous Locations § 111.105-41 Battery rooms. Each electrical installation in a battery room must meet 46 CFR subpart 111.15 and IEEE 45-1998 (incorporated by reference; see 46 CFR 110.10-1). ... 46 Shipping 4 2010-10-01 2010-10-01 false Battery rooms. 111.105-41 Section 111.105-41...

  16. 46 CFR 111.105-41 - Battery rooms.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... REQUIREMENTS Hazardous Locations § 111.105-41 Battery rooms. Each electrical installation in a battery room must meet 46 CFR subpart 111.15 and IEEE 45-1998 (incorporated by reference; see 46 CFR 110.10-1). ... 46 Shipping 4 2011-10-01 2011-10-01 false Battery rooms. 111.105-41 Section 111.105-41...

  17. 7 CFR 58.412 - Coolers or curing rooms.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Coolers or curing rooms. 58.412 Section 58.412 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards....412 Coolers or curing rooms. Coolers or curing rooms where cheese is held for curing or storage...

  18. 122. SOUTH SIDE OF TRANSFORMER ROOM (112), LSB (BLDG. 770), ...

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

    122. SOUTH SIDE OF TRANSFORMER ROOM (112), LSB (BLDG. 770), WITH MECHANICAL AND ELECTRICAL ROOM (110) AND LANDLINE INSTRUMENTATION ROOM (106) VISIBLE THROUGH OPEN DOORS. POWER PANEL 2A AT LEFT EDGE OF PHOTO. FIRE SUPPRESSION DELUGE PANEL ON RIGHT EDGE OF PHOTO. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  19. 133. SOUTH SIDE OF TRANSFORMER ROOM (212), LSB (BLDG. 751), ...

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

    133. SOUTH SIDE OF TRANSFORMER ROOM (212), LSB (BLDG. 751), WITH MECHANICAL AND ELECTRICAL ROOM (210) AND LANDLINE INSTRUMENTATION ROOM (206) VISIBLE THROUGH OPEN DOORS. POWER PANEL A, FACING WEST, AT LEFT EDGE OF PHOTOGRAPH. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 East, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  20. 46 CFR 69.121 - Engine room deduction.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Engine room deduction. 69.121 Section 69.121 Shipping... MEASUREMENT OF VESSELS Standard Measurement System § 69.121 Engine room deduction. (a) General. The engine...) Space below the crown. The crown is the top of the main space of the engine room to which the heights...