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Sample records for acuity-adaptable patient room

  1. Acuity-adaptable patient room improves length of stay and cost of patients undergoing renal transplant: a pilot study.

    PubMed

    Bonuel, Nena; Degracia, Alma; Cesario, Sandra

    2013-01-01

    The acuity-adaptable patient room concept is an emerging care model where patient is cared for in the same room from admission through discharge regardless of the patient level of acuity. After implementation of the care cluster strategy to support the implementation of an acuity-adaptable patient room, a descriptive study was conducted looking at so whether there will be a decreased length of stay and cost on patient cared for in the acuity-adaptable patient room compared to patients cared for in a transitional care process. Result of the study showed decreased length of stay of kidney transplant patients from 9.6 (11.0) days (before acuity-adaptable patient room) to 4.1 (1.3) days (acuity-adaptable patient room). Not only that the acuity-adaptable patient room improves patient outcome and cost but with the nursing competency preparation to support the implementation of the acuity-adaptable patient room, a hybrid nurse was created who possessed both critical care and medical-surgical skills. This can be a potential trend in the professional nurse model to address the health care challenges we face today in terms of nursing shortage, abbreviated plan of care, and facility operation efficiency. PMID:23470704

  2. Acuity-adaptable patient room improves length of stay and cost of patients undergoing renal transplant: a pilot study.

    PubMed

    Bonuel, Nena; Degracia, Alma; Cesario, Sandra

    2013-01-01

    The acuity-adaptable patient room concept is an emerging care model where patient is cared for in the same room from admission through discharge regardless of the patient level of acuity. After implementation of the care cluster strategy to support the implementation of an acuity-adaptable patient room, a descriptive study was conducted looking at so whether there will be a decreased length of stay and cost on patient cared for in the acuity-adaptable patient room compared to patients cared for in a transitional care process. Result of the study showed decreased length of stay of kidney transplant patients from 9.6 (11.0) days (before acuity-adaptable patient room) to 4.1 (1.3) days (acuity-adaptable patient room). Not only that the acuity-adaptable patient room improves patient outcome and cost but with the nursing competency preparation to support the implementation of the acuity-adaptable patient room, a hybrid nurse was created who possessed both critical care and medical-surgical skills. This can be a potential trend in the professional nurse model to address the health care challenges we face today in terms of nursing shortage, abbreviated plan of care, and facility operation efficiency.

  3. Impacting patient outcomes through design: acuity adaptable care/universal room design.

    PubMed

    Brown, Katherine Kay; Gallant, Dennis

    2006-01-01

    To succeed in today's challenging healthcare environment, hospitals must examine their impact on customers--patients and families--staff and physicians. By using competitive facility design and incorporating evidence-based concepts such as the acuity adaptable care delivery model and the universal room, the hospital will realize an impact on patient satisfaction that will enhance market share, on physician satisfaction that will foster loyalty, and on staff satisfaction that will decrease turnover. At the same time, clinical outcomes such as a reduction in mortality and complications and efficiencies such as a reduction in length of stay and minimization of hospital costs through the elimination of transfers can be gained. The results achieved are dependent on the principles used in designing the patient room that should focus on maximizing patient safety and improving healing. This article will review key design elements that support the success of an acuity adaptable unit such as the use of a private room with zones dedicated to patients, families, and staff, healing environment, technology, and decentralized nursing stations that support the success of the acuity adaptable unit. Outcomes of institutions currently utilizing the acuity adaptable concept will be reviewed.

  4. Asymptomatic blood methanol in emergency room patients.

    PubMed

    Wargotz, E S; Werner, M

    1987-06-01

    Over a four-month period, methanol was found in the blood of 18 patients among 687 sequential emergency room admissions screened for alcohols by gas chromatography. In the patients with positive results, blood ethanol ranged from 6 to 570 mg/dL (1.3-123.7 mmol/L), blood methanol from 2.3 to 4.0 mg/dL (0.72-1.25 mmol/L). Methanol exposure during preparation of the sampling site or in the course of specimen handling, ingestion of denatured alcohol, as well as methanol production from the metabolism of aspartame are ruled out as causes for these findings. The authors conclude that endogenous methanol production is the probable major cause, while methanol as a fermentation congener may be a contributory minor cause.

  5. Arterial oxygen saturation in anaesthetised patients during transfer from induction room to operating room.

    PubMed

    Riley, R H; Davis, N J; Finucane, K E; Christmas, P

    1988-05-01

    There is no published study that examines oxygenation of anaesthetised patients during transport from anaesthesia induction room to operating room. Arterial oxygen saturation (SaO2) was measured in twenty-five anaesthetised patients before and during transfer to an adjacent operating room and continuously recorded on a calibrated chart recorder. A telemetry ECG recorder was used to detect cardiac dysrhythmias. All anaesthetists followed their usual anaesthetic practice. Patients ventilated via face-mask and via endotracheal tube were studied. During transfer patients were either apnoeic (n = 8) or breathing room air spontaneously (n = 17). Mean SaO2 before induction was 95.4 (SD 2.5)%, was higher after induction of anaesthesia, 98.5 (SD 1.4)% and fell after transfer, 95.7 (SD 2.6)%. A fall in SaO2 was recorded for 21 patients. No SaO2 value below 90% was seen. The decrease in SaO2 was related to the time taken to transfer the patients and spontaneous ventilation (Multiple regression analysis); it was not related to the body mass index although two of the greatest decreases were seen in obese patients. Transfer time averaged 51 seconds (range: 24-97 s). No changes in cardiac rhythm were seen. Transfer of anaesthetised patients was accompanied by variable falls in SaO2 which related to duration of transfer and spontaneous breathing of room air and which were not associated with new dysrhythmias.

  6. 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.

  7. 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

  8. 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…

  9. 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

  10. Outpatient education reduces emergency room use by patients with epilepsy.

    PubMed

    Pascual, Franchette T; Hoang, Kathy; Hollen, Christopher; Swearingen, Richard; Hakimi, Andrea S; King, Jeanne Ann; Thompson, David

    2015-01-01

    Epilepsy is a costly diagnosis, with emergency room (ER) visits and hospital admissions comprising a large portion of total direct cost. An educational intervention to decrease the number of ER visits was implemented on outpatients with epilepsy, using educational handouts and DVD. The number of ER visits declined significantly in the four months following intervention compared with the preceding four months. This finding supports patient education as a valuable tool to reduce ER use, which may, in turn, cut down on health-care cost. PMID:25499153

  11. Islam and the healthcare environment: designing patient rooms.

    PubMed

    Kopec, D A K; Han, Li

    2008-01-01

    Islam and the Muslim population are often the source of much misunderstanding and media-influenced misconceptions. Muslim patients who enter the healthcare environment are often weak and likely to experience feelings of vulnerability. Because of the complex and interwoven nature of culture and religion in a person's identity, it is important to consider patient belief systems and values when designing a patient's immediate environment. Through an exploration of literature related to culture and diversity and the beliefs and value system of the Muslim population, the authors were able to identify flexible design initiatives that could accommodate an array of cultural and spiritual practices. Islam and the Muslim population were chosen as the points of reference for this study because of the strong influence of the religion on the culture, and because of the many nuances that differ from the dominant culture within the United States. From these points of reference, a hypothetical design was developed for a patient room that considers differing notions of privacy, alternatives for cultural and religious practices, and ways to include symbolic meaning derived from attributes such as color.

  12. 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.

  13. 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.

  14. Acinetobacter baumannii: association between environmental contamination of patient rooms and occupant status.

    PubMed

    Munoz-Price, L Silvia; Namias, Nicholas; Cleary, Timothy; Fajardo-Aquino, Yovanit; Depascale, Dennise; Arheart, Kristopher L; Rivera, Jesabel I; Doi, Yohei

    2013-05-01

    We aimed to determine the association between the presence of Acinetobacter baumannii in patient rooms and the carrier status of the occupants. Fifty-six (39%) of 143 rooms with A. baumannii-positive patients had results positive for A. baumannii. Only 49 (10%) of 485 rooms with A. baumannii-negative patients were positive (odds ratio, 5.72 [95% confidence interval, 3.66-8.96]; [Formula: see text]). Clinical and environmental isolates shared pulsed-field gel electrophoresis patterns.

  15. 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.

  16. Comparison of Environmental MRSA Levels on High-Touch Surfaces in Contact Isolation and Noncontact Isolation Patient Rooms.

    PubMed

    Villamaria, Frank C; Berlanga, Gemma; Liao, I-Chia; Ganachari-Mallappa, Nagaraja; Stock, Eileen M; Zeber, John E; Jinadatha, Chetan

    2015-12-01

    Environmental samples were collected from 100 hospital rooms, 32 noncontact rooms, and 68 contact isolation rooms. We isolated 202 and 1,830 MRSA colonies in noncontact and contact isolation rooms, respectively. The study identified MRSA isolates in hospital rooms of patients without colonization or infection with MRSA. Infect. Control Hosp. Epidemiol. 2015;36(12):1472-1475.

  17. "Unless you went in with your head under your arm": patient perceptions of emergency room visits.

    PubMed

    Wellstood, Katie; Wilson, Kathi; Eyles, John

    2005-12-01

    There is increasing concern in Canada regarding growing pressures on emergency room care. Frequent media reports call attention to overcrowding, lengthy waiting times and the re-routing of ambulances due to the closure of emergency rooms during periods of overcrowding. Much of this information, however, is anecdotal. As such, little is known about patients' experiences in emergency rooms in Canada. The purpose of this study is to explore patients' perceptions of their most recent emergency room visit. Semi-structured, in-depth interviews were conducted with 41 men and women from two socially distinct neighbourhoods in Hamilton, Ontario, Canada. Much of the previous work on experiences in emergency room care is international in scope and uses quantitative methods to examine patient satisfaction with emergency care. This study considers patient experiences more broadly and looks beyond satisfaction to examine reasons for seeking emergency room care and the factors that shape experiences. The findings show that most patients describe their experiences in negative terms. The aspects of emergency room care that were most often linked with negative experiences were waiting times, patient perceptions of the quality of care received and staff-patient interactions. The findings are discussed in the context of recent health care reforms in Canada, which we argue have not addressed adequately the 'crisis' in emergency rooms.

  18. Do patients in hospitals benefit from single rooms? A literature review.

    PubMed

    van de Glind, Irene; de Roode, Stanny; Goossensen, Anne

    2007-12-01

    In the context of growing attention for 'healing environments' and 'evidence based design' an increasing number of hospitals have decided to provide single-bedded rooms. However it remains unclear to what extent these policy decisions are based on scientific evidence. The aim of this study is to review the literature on benefits of single patient rooms for patients. The following outcome measures were used: privacy and dignity, patient satisfaction with care, noise and quality of sleep, hospital infection rates, recovery rates, and patient safety issues. We selected 25 studies for review. Randomized controlled trials on this subject were scarce, but other empirical studies have been found. We found that single rooms have a moderate effect on patient satisfaction with care, noise and quality of sleep, and the experience of privacy and dignity. Conflicting results have been found on hospital infection rates. Some studies did not show significant differences, while others concluded that single rooms decrease the risk of hospital infections. Evidence on recovery rates and patient safety was lacking. Too few sound studies were found to evaluate the effects of single patient rooms thoroughly. Future research should build the body of knowledge on single-bedded rooms in order to explore their impact on well-being and healing on both patients and staff. Also consequences of single rooms to management of care should be explored. Research should support policy making by exploring, indicating and initiating improvements in patient housing and quality of care.

  19. 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

  20. 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.

  1. Decontamination of targeted pathogens from patient rooms using an automated ultraviolet-C-emitting device.

    PubMed

    Anderson, Deverick J; Gergen, Maria F; Smathers, Emily; Sexton, Daniel J; Chen, Luke F; Weber, David J; Rutala, William A

    2013-05-01

    OBJECTIVE. To determine the effectiveness of an automated ultraviolet-C (UV-C) emitter against vancomycin-resistant enterococci (VRE), Clostridium difficile, and Acinetobacter spp. in patient rooms. DESIGN. Prospective cohort study. SETTING. Two tertiary care hospitals. PARTICIPANTS. Convenience sample of 39 patient rooms from which a patient infected or colonized with 1 of the 3 targeted pathogens had been discharged. INTERVENTION. Environmental sites were cultured before and after use of an automated UV-C-emitting device in targeted rooms but before standard terminal room disinfection by environmental services. RESULTS. In total, 142 samples were obtained from 27 rooms of patients who were colonized or infected with VRE, 77 samples were obtained from 10 rooms of patients with C. difficile infection, and 10 samples were obtained from 2 rooms of patients with infections due to Acinetobacter. Use of an automated UV-C-emitting device led to a significant decrease in the total number of colony-forming units (CFUs) of any type of organism (1.07 log10 reduction; P < .0001), CFUs of target pathogens (1.35 log10 reduction; P < .0001), VRE CFUs (1.68 log10 reduction; P < .0001), and C. difficile CFUs (1.16 log10 reduction; P < .0001). CFUs of Acinetobacter also decreased (1.71 log10 reduction), but the trend was not statistically significant (P = .25). CFUs were reduced at all 9 of the environmental sites tested. Reductions similarly occurred in direct and indirect line of sight. CONCLUSIONS. Our data confirm that automated UV-C-emitting devices can decrease the bioburden of important pathogens in real-world settings such as hospital rooms.

  2. Compliance with antihypertensive treatment in consultation rooms for hypertensive patients.

    PubMed

    Balazovjech, I; Hnilica, P

    1993-12-01

    Compliance with antihypertensive therapy was examined by a questionnaire in 124 essential hypertension patients in an outpatient hypertension clinic. It was found that antihypertensive drugs were used regularly by only 62% of patients, with forgetting and feeling of well-being without therapy the principal reasons given for irregular drug taking. Treatment of hypertension is reported to have a deleterious effect on physical and mental activity, routine activities, sexual activity, memory, athletics and family life in only 2% of patients. Patients who were aware that increased BP reduces life span used the prescribed drugs more regularly and came regularly for checkups compared with patients lacking the relevant information. Patients over 60 years of age and smokers exhibited the worst compliance. No significant differences were found for sex or duration of treatment. With regard to nonpharmacological measures, most patients were willing to begin a programme of regular physical exercise, reduce weight, learn relaxation techniques and reduce alcohol intake: smokers, however were unable to stop the habit.

  3. 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…

  4. Diagnostic errors in emergency room medicine: physical illness in patients labeled "psychiatric" and vice versa.

    PubMed

    Leeman, C P

    1975-01-01

    Patients coming to general hospital emergency rooms often present mixed physical and psychological problems. An unfortunate tendency of physicians caring for these patients to "label" them as either "organic" or "psychiatric," based on initial impressions, may lead to inadequate diagnosis and improper treatment. Four case examples are discussed, in which diagnostic errors resulted either from ignoring psychological and social factors, or by focusing on emotional factors to the exclusion of organic disease. The provision of quality medical care in a hospital emergency room requires that attention be directed coordinately to both physical and emotional factors in each patient's illness.

  5. 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)

  6. 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.

  7. 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

  8. 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

  9. Radiation Dosimetry in the BNCT Patient Treatment Room at the Brookhaven Medical Research Reactor

    SciTech Connect

    Holden,N.; Reciniello, R.; Hu, J.

    2006-01-01

    The BMRR was a 3 MW light water reactor that had an epithermal neutron beam that was used to perform clinical trials on patients with malignant brain tumors. A series of measurements and calculations had been performed in the treatment room both prior to the trials and during the trials. The details of the measurements and the Monte Carlo calculations are presented and compared.

  10. 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…

  11. 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…

  12. Emergency room assessment and adrenaline treatment of patients with acute asthma of different severity.

    PubMed

    Limthongkul, S

    1989-06-01

    The adequacy of emergency room assessment and treatment of patients with acute severe asthmatic attacks was evaluated by analyzing the course of 451 visits of 348 patients to Chulalongkorn hospital's Emergency Room. Eighty-five per cent of the patients had an initial index score of greater than or equal to 4 and an average peak expiratory flow rate of 92.16 +/- 46.3 L/min. The discharge index score was 85 per cent with a score of less than or equal to 3 and an average peak expiratory flow rate of 192 +/- 40.3 L/min. Our study indicated that the predictive index proposed by Fischl et al correlated with the severity of airway obstruction; however, the initial index did not help with emergency room decision-making in predicting which patients might be hospitalized, have a relapse or be discharged. In fact, in our emergency room department, the index score to determine airway obstruction and the pattern of response to treatment were better predictors of the outcome, which was classified into three categories: non-responsive or minimally responsive, responsive, and partially responsive. By using conventional clinical criteria (i.e. recumbent position with elimination of laboured breathing, disappearance of dyspnea and reduction of wheezing), there was a 93 per cent accurate determination in the episodes of patients who responded sufficiently to the emergency room treatment to allow their discharge. The remaining 7 per cent of those seeking emergency treatment were hospitalized, which is a lower incidence than that of others series.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Does privacy matter? Former patients discuss their perceptions of privacy in shared hospital rooms.

    PubMed

    Malcolm, Helen A

    2005-03-01

    As a relative concept, privacy is difficult to define in universal terms. In the New Zealand setting recent legislation aims to protect patients' privacy but anecdotal evidence suggests that these policies are not well understood by some providers and recipients of health care. This qualitative study set out to identify some of the issues by exploring former patients' perceptions of privacy in shared hospital rooms. The findings suggest a conditional acceptance of a loss of privacy in an environment dictated by architectural structure and by fiscal and time constraints. Participants indicated an awareness that personal information could be overheard and that their preference for a choice of setting for serious discussions was desirable. Some enjoyed the support offered in shared rooms, while, for others, overhearing another person's health issues caused unnecessary distress. The participants suggested that knowing they could be overheard constrained information disclosure. This withholding of information has implications for health professionals' ability to diagnose and treat patients appropriately.

  14. The multifunctional therapy room of the future: image guidance, interdisciplinarity, integration and impact on patient pathways.

    PubMed

    Jacob, A L; Regazzoni, P; Steinbrich, W; Messmer, P

    2000-01-01

    With few exceptions the interventional rooms of the present are either imaging suites or sterile operating rooms. Their users are restricted to either percutaneous procedures or to two-staged image-guided surgery without intra-operative imaging control. Since interventional therapy of the future will be minimally invasive and since minimally invasive therapy is essentially image-guided therapy, a new physical place for these activities has to be devised: the multifunctional therapy room of the future integrates sophisticated imaging and image guidance modalities together with advanced surgical and life-support equipment in a sterile environment [1, 2, 3]. Even given a high degree of integration, this will be a complex and costly piece of medical technology. These two factors--complexity and cost-- require interdisciplinary technological and medical collaboration to bring it into existence, distribute its cost and maximize usage and medical benefit. Yet another dimension of multifunctionality will be introduced and a significant impact on the care of vitally threatened patients will be exerted by using this room not only for elective image-guided therapy but also for emergent one-stop diagnosis and treatment. Motivation, technology, implementation strategies and funding of this image-guided, integrated and interdisciplinary therapy room, as well as a comprehensive approach combining emergency care and elective computer-assisted therapy (CAT), are discussed in this paper.

  15. Early prediction of poor outcome in patients with acute asthma in the emergency room.

    PubMed

    Mallmann, F; Fernandes, A K; Avila, E M; Nogueira, F L; Steinhorst, A M P; Saucedo, D Z; Machado, F J; Raymundi, M G; Dalcin, P T R; Menna Barreto, S S

    2002-01-01

    Early identification of patients who need hospitalization or patients who should be discharged would be helpful for the management of acute asthma in the emergency room. The objective of the present study was to examine the clinical and pulmonary functional measures used during the first hour of assessment of acute asthma in the emergency room in order to predict the outcome. We evaluated 88 patients. The inclusion criteria were age between 12 and 55 years, forced expiratory volume in the first second below 50% of predicted value, and no history of chronic disease or pregnancy. After baseline evaluation, all patients were treated with 2.5 mg albuterol delivered by nebulization every 20 min in the first hour and 60 mg of intravenous methylprednisolone. Patients were reevaluated after 60 min of treatment. Sixty-five patients (73.9%) were successfully treated and discharged from the emergency room (good responders), and 23 (26.1%) were hospitalized or were treated and discharged with relapse within 10 days (poor responders). A predictive index was developed: peak expiratory flow rates after 1 h < or =0% of predicted values and accessory muscle use after 1 h. The index ranged from 0 to 2. An index of 1 or higher presented a sensitivity of 74.0, a specificity of 69.0, a positive predictive value of 46.0, and a negative predictive value of 88.0. It was possible to predict outcome in the first hour of management of acute asthma in the emergency room when the index score was 0 or 2.

  16. An automated information system for families of patients in the operation room based on EMR data.

    PubMed

    Jo, Eun-mi

    2013-01-01

    When children undergo surgery, the parents waiting for them outside the room feel extreme anxiety. SNUH was a full EMR hospital. But nurses had to manually operate an electronic display board which provided information regarding the progresses of the operations. The parents had to be located in front of the board. It was a unilateral and passive system. Therefore, we were about to improve the system to provide efficient information satisfying both parents and nurses. This service, which connected to the EMR system to provide real time location of patients undergoing operations, provide information through an electronic display board outside the operating room and SMS messages. We could reduce uneasiness of patients' families, increase satisfactions, and further, not only contribute to establishing the improved service of SNUH but also lessening unnecessary duties of nurses.

  17. Insufflation using carbon dioxide versus room air during colonoscopy: comparison of patient comfort, recovery time, and nursing resources.

    PubMed

    Lynch, Isabelle; Hayes, Ann; Buffum, Martha D; Conners, Erin E

    2015-01-01

    The standard of practice for colonoscopy is room air insufflation. Recent research demonstrates safety and significant decrease in postcolonoscopy discomfort from distention when carbon dioxide (CO2) is used during insufflation. Reducing abdominal pain after colonoscopy may lead to increased acceptance of colonoscopy screening for colorectal cancer. This study aims to compare patient comfort intra- and postprocedure, length of recovery, and nursing time in patients undergoing colonoscopy using room air vs. CO2 insufflation. This study uses an experimental design with patients randomly assigned to either room air or CO2 during colonoscopy. Physician endoscopists, postprocedure nurses, and patients were blinded to assignment. Prior bowel surgery, inflammatory bowel disease, or inability to consent excluded participants. Outcome measures included discomfort assessment, nursing tasks, and recovery time.Of 191 participants, 177 were men and 14 were women; 94 received room air; 97 received CO2. Patients insufflated with room air reported higher levels of some measures of discomfort: (a) during colonoscopy (p = .02), (b) on admission to recovery (p = .001), and (c) on discharge from recovery (p = .001). Patients receiving room air required more nursing tasks in recovery (p = .001) and more total nursing time (p = .001).Compared with room air, CO2 insufflation increases patient comfort and decreases nursing tasks and time.

  18. Telesurveillance of elderly patients by use of passive infra-red sensors in a 'smart' room.

    PubMed

    Banerjee, S; Steenkeste, F; Couturier, P; Debray, M; Franco, A

    2003-01-01

    We have developed an automated surveillance system based on passive infra-red sensors. Eight sensors were installed in a hospital room. A computer automatically captured data from the sensors every night from 21:00 until 06:00 the following morning. The sensors were polled twice per second and when a sensor was activated by movement, the event and time were recorded in a data file. At the end of the surveillance period the program analysed the data and generated a report showing the activities taking place in the room and their times. Four elderly patients were observed for a total of 97 nights. A total of 1637 possible sequences of movements by the patient and the hospital staff were detected. The computer was able to identify 1450 sequences (89%) correctly, in comparison with manual analysis. Only 10 movements (0.6%) were undetected by the system; all were very short sequences (five or six activations of the sensors). The system was generally capable of detecting and classifying all major movements in the room.

  19. Two loose screws: near-miss fall of a morbidly obese patient after an operating room table failure.

    PubMed

    McAllister, Russell K; Booth, Robert T; Bittenbinder, Timothy M

    2016-09-01

    Operating room surgical table failure is a rare event but can lead to a dangerous situation when it does occur. The dangers can be compounded in the presence of obesity, especially in the anesthetized or sedated patient. We present a case of a near-miss fall of a morbidly obese patient while turning the patient in preparation to transfer from the operating room table to the hospital bed when 2 fractured bolts in the tilt cylinder mechanism led to an operating room table failure.

  20. 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

  1. 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.

  2. Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis.

    PubMed

    Kadry, Bassam; Press, Christopher D; Alosh, Hassan; Opper, Isaac M; Orsini, Joe; Popov, Igor A; Brodsky, Jay B; Macario, Alex

    2014-01-01

    Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI) in patients undergoing total hip arthroplasty (THA) with different components of operating room (OR) time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE) was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P < 0.001) for morbidly obese patients. At a BMI > 35 kg/m(2) each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization.

  3. Obesity increases operating room times in patients undergoing primary hip arthroplasty: a retrospective cohort analysis

    PubMed Central

    Kadry, Bassam; Press, Christopher D.; Alosh, Hassan; Opper, Isaac M.; Orsini, Joe; Popov, Igor A.; Macario, Alex

    2014-01-01

    Background. Obesity impacts utilization of healthcare resources. The goal of this study was to measure the relationship between increasing body mass index (BMI) in patients undergoing total hip arthroplasty (THA) with different components of operating room (OR) time. Methods. The Stanford Translational Research Integrated Database Environment (STRIDE) was utilized to identify all ASA PS 2 or 3 patients who underwent primary THA at Stanford Medical Center from February 1, 2008 through January 1, 2013. Patients were divided into five groups based on the BMI weight classification. Regression analysis was used to quantify relationships between BMI and the different components of total OR time. Results. 1,332 patients were included in the study. There were no statistically significant differences in age, gender, height, and ASA PS classification between the BMI groups. Normal-weight patients had a total OR time of 138.9 min compared 167.9 min (P < 0.001) for morbidly obese patients. At a BMI > 35 kg/m2 each incremental BMI unit increase was associated with greater incremental total OR time increases. Conclusion. Morbidly obese patients required significantly more total OR time than normal-weight patients undergoing a THA procedure. This increase in time is relevant when scheduling obese patients for surgery and has an important impact on health resource utilization. PMID:25210656

  4. Understanding the effects of nurses, patients' hospital rooms, and patients' perception of control on the perceived quality of a hospital.

    PubMed

    Gotlieb, J B

    2000-01-01

    Service marketing researchers suggest that the physical environment, the people, and the process strongly affect consumers' judgements when they evaluate services. Previous research has rarely applied this general framework to help identify specific hospital variables that affect the perceived quality of a hospital. This article presents a proposed model and empirical evidence that is based upon this general framework. That is, this article reports the results of a study which found that the physical environment (i.e., patients' perception of their hospital rooms) and people (i.e., patients' perception of nurses) affected patients' perception of hospital quality. The process (i.e., patients' perception of control over the process) did not directly affect their perception of hospital quality. However, patients' perception of control over the process and their perception of their hospital rooms affected their perception of their nurses. Consequently, this research suggests that the general framework identified by service marketing researchers can be applied to help understand how patients develop their perception of hospital quality. PMID:11184431

  5. Understanding the effects of nurses, patients' hospital rooms, and patients' perception of control on the perceived quality of a hospital.

    PubMed

    Gotlieb, J B

    2000-01-01

    Service marketing researchers suggest that the physical environment, the people, and the process strongly affect consumers' judgements when they evaluate services. Previous research has rarely applied this general framework to help identify specific hospital variables that affect the perceived quality of a hospital. This article presents a proposed model and empirical evidence that is based upon this general framework. That is, this article reports the results of a study which found that the physical environment (i.e., patients' perception of their hospital rooms) and people (i.e., patients' perception of nurses) affected patients' perception of hospital quality. The process (i.e., patients' perception of control over the process) did not directly affect their perception of hospital quality. However, patients' perception of control over the process and their perception of their hospital rooms affected their perception of their nurses. Consequently, this research suggests that the general framework identified by service marketing researchers can be applied to help understand how patients develop their perception of hospital quality.

  6. 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

  7. 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.

  8. Noise in hospital rooms and sleep disturbance in hospitalized medical patients

    PubMed Central

    Park, Marn Joon; Yoo, Jee Hee; Cho, Byung Wook; Kim, Ki Tae; Jeong, Woo-Chul; Ha, Mina

    2014-01-01

    Objectives Hospitalized patients are vulnerable to sleep disturbances because of environmental stresses including noise. While most previous studies on hospital noise and sleep have been performed for medical machines in intensive care units, there is a limited data for patients hospitalized in medical wardrooms. The purpose of present study was to measure noise level of medical wardrooms, identify patient-perceived sources of noise, and to examine the association between noise levels and sleep disturbances in hospitalized patients. Methods Noise dosimeters were used to measure noise level in 29 inpatient wardrooms at a university hospital. Sleep pattern and disturbance were assessed in 103 hospitalized patients, using the Pittsburgh Sleep Quality Index (PSQI) and Leeds Sleep Evaluation Questionnaire. Results The mean equivalent continuous noise level for 24 hours was 63.5 decibel A (dBA), which was far higher than 30 dBA recommended by the World Health Organization for hospital wardrooms. Other patients sharing a room were perceived as the most common source of noise by the patients, which was usually preventable. Of the patients in the study, 86% had bad sleep as assessed by the PSQI. The sleep disturbance was significantly correlated with increasing noise levels in a dose response manner. Conclusions Systemic organizational interventions are needed to keep wardrooms private and quiet to reduce sleep disturbance. PMID:25163680

  9. Patient Monitoring in the Operating Room: Validation of Instrument Readings by Artificial Intelligence Methods

    PubMed Central

    Garfinkel, D.; Matsiras, P.V.; Mavrides, T.; McAdams, J.; Aukburg, S.J.

    1989-01-01

    Physiological monitoring in the operating room is needed to follow the patient's state of ventilation, circulation, etc. Parameters such as heart rate, blood pressure, and respiratory gas content are observed with devices of uncertain reliability. These provide speedy information in the form of cautions and alarms, which may indicate that corrective action is needed. In practice the large number of alarms when there is no hazard to the patient (false alarms) is a considerable problem. We describe a method of comparing and validating instrument readings in this situation involving a knowledge base whose core is a set of 36 rules. This was applied to 7803 warnings (6287 cautions and 1516 alarms) from 68 day surgery patients undergoing 115 hours of surgery. Most of the cautions were validated by our analysis, but 734 of the 1516 alarms were invalidated while 419 were validated and 363 left indeterminate. This translates to a potential reduction from one alarm every 4 minutes to one every 16 minutes.

  10. 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

  11. Room-temperature susceptometry predicts biopsy-determined hepatic iron in patients with elevated serum ferritin

    PubMed Central

    Maliken, Bryan D.; Avrin, William F.; Nelson, James E.; Mooney, Jody; Kumar, Sankaran; Kowdley, Kris V.

    2012-01-01

    Background There is an ongoing clinical need for novel methods to measure hepatic iron content (HIC) noninvasively. Both magnetic resonance imaging (MRI) and superconducting quantum interference device (SQUID) methods have previously shown promise for estimation of HIC, but these methods can be expensive and are not widely available. Room-temperature susceptometry (RTS) represents an inexpensive alternative and was previously found to be strongly correlated with HIC estimated by SQUID measurements among patients with transfusional iron overload related to thalassemia. Aim The goal of the current study was to examine the relationship between RTS and biochemical HIC measured in liver biopsy specimens in a more varied patient cohort. Methods Susceptometry was performed in a diverse group of patients with hyperferritinemia due to hereditary hemochromatosis (HHC) (n=2), secondary iron overload (n=3), nonalcoholic fatty liver disease (NAFLD) (n=2), and chronic viral hepatitis (n=3) within one month of liver biopsy in the absence of iron depletion therapy. Results The correlation coefficient between HIC estimated by susceptometry and by biochemical iron measurement in liver tissue was 0.71 (p=0.022). Variance between liver iron measurement and susceptometry measurement was primarily related to reliance on the patient’s body-mass index (BMI) to estimate the magnetic susceptibility of tissue overlying the liver. Conclusions In conclusion, we believe RTS holds promise for noninvasive measurement of HIC. Improved measurement techniques, including more accurate overlayer correction, may further improve the accuracy of liver susceptometry in patients with liver disease. PMID:22166564

  12. 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

  13. 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

  14. 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

  15. Evaluation of two organosilane products for sustained antimicrobial activity on high-touch surfaces in patient rooms.

    PubMed

    Boyce, John M; Havill, Nancy L; Guercia, Kerri A; Schweon, Steven J; Moore, Brent A

    2014-03-01

    A controlled trial of applying 2 organosilane-based products with antimicrobial properties to high-touch surfaces was conducted in 9 patient rooms. Cultures of surfaces obtained before daily cleaning with a quaternary ammonium disinfectant showed no significant residual antimicrobial activity of the organosilane products, although a modest reduction could not be excluded.

  16. Operating Room to Intensive Care Unit Handoffs and the Risks of Patient Harm

    PubMed Central

    McElroy, Lisa M.; Collins, Kelly M.; Koller, Felicitas L.; Khorzad, Rebeca; Abecassis, Michael M.; Holl, Jane L.; Ladner, Daniela P.

    2015-01-01

    Background The goal of this study was to assess systems and processes involved in the operating room (OR) to intensive care unit (ICU) handoff in an attempt to understand the criticality of specific steps of the handoff. Methods We performed a failure modes, effects and criticality analysis (FMECA) of the OR to ICU handoff of deceased donor liver transplant recipients using in-person observations and descriptions of the handoff process from a multidisciplinary group of clinicians. For each step in the process, failures were identified along with frequency of occurrence, causes, potential effects and safeguards. A risk priority number (RPN) was calculated for each failure (Frequency x Potential effect x Safeguard; range 1-least risk to 1000-most risk). Results The FMECA identified 37 individual steps in the OR to ICU handoff process. In total, 81 process failures were identified, 22 of which were determined to be critical and 36 of which relied on weak safeguards such as informal human verification. Process failures with the highest risk of harm were lack of preliminary OR to ICU communication (RPN 504), team member absence during handoff communication (RPN 480) and transport equipment malfunction (RPN 448). Conclusions Based on the analysis, recommendations were made to reduce potential for patient harm during OR to ICU handoffs. These included automated transfer of OR data to ICU clinicians, enhanced ICU team member notification processes and revision of the postoperative order sets. The FMECA revealed steps in the OR to ICU handoff that are high risk for patient harm and are currently being targeted for process improvement. PMID:26067459

  17. 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

  18. 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

  19. 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

  20. 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

  1. Initial presentation in psychiatry emergency room led to diagnosis of many urinary bladder stones in a male patient.

    PubMed

    El-Hennawy, Adel S; Nagaraja, Aarathi; Mahmood, Aza K

    2013-01-01

    The first case of man who presented to psychiatry emergency room for evaluation of abnormal behavior because of urinary stones was reported. Careful evaluation of patient led to a diagnosis of 37 urinary bladder stones in an Egyptian man with obstructive uropathy and metabolic defects in the form of hyperoxaluria and hypocitraturia. Knowledge of the differential diagnosis of metabolic defects can lead to successful outcome in preventing reformation of urinary tract stones after surgery. A 61-year-old Egyptian man presented to psychiatry emergency room because he was found lying on floor in bathroom to urinate by his wife who thought her husband needed psychiatric evaluation. Patient gave history of frequent urination and dysuria on and off for 3 years. In the last 3 months before his presentation to emergency room, he got into a habit of lying down on his left side when he went to bathroom to urinate because it was easier for him to pass urine. Renal consultation requested because of presence of red blood cells in urinalysis. Computed tomography of the abdomen and pelvis showed bilateral hydronephrosis and multiple bladder stones. Twenty-four-hour urine collection showed low urinary citrate and high oxalate. Patient underwent open vesicolithotomy and removal of 36 stones. Stone analysis showed 75% uric acid and 25% calcium oxalate. Patient did very well after surgery, and 1 month later, he underwent transuretheral resection of prostate without any complications. Now patient has no difficulty passing urine and he has no recent attack of urinary tract infection. Knowledge of the differential diagnosis of metabolic defects in men with urinary bladder stones would hopefully provide clinicians with the proper diagnostic tools to more specifically treat such patients with improved success in preventing reformation of urinary tract stones after surgery.

  2. Role of the trauma-room chest x-ray film in assessing the patient with severe blunt traumatic injury

    PubMed Central

    McLellan, Barry A.; Ali, Jameel; Towers, Mark J.; Sharkey, P. William

    1996-01-01

    Objectives To examine the accuracy of standard trauma-room chest x-ray films in assessing blunt abdominal trauma and to determine the significance of missed injuries under these circumstances. Design A retrospective review. Setting A regional trauma unit in a tertiary-care institution. Patients Multiply injured trauma patients admitted between January 1988 and December 1990 who died within 24 hours of injury and in whom an autopsy was done. Intervention Standard radiography of the chest. Main Outcome Measures Chest injuries diagnosed and recorded by the trauma room team from standard anteroposterior x-ray films compared with the findings at autopsy and with review of the films by a staff radiologist initially having no knowledge of the injuries and later, if injuries remained undetected, having knowledge of the autopsy findings. Results Thirty-seven patients met the study criteria, and their cases were reviewed. In 11 cases, significant injuries were noted at autopsy and not by the trauma-room team, and in 7 cases these injuries were also missed by the reviewing radiologist. Injuries missed by the team were: multiple rib fractures (11 cases), sternal fractures (3 cases), diaphragmatic tear (2 cases) and intimal aortic tear (1 case). In five cases, chest tubes were not inserted despite the presence (undiagnosed) of multiple rib fractures and need for intubation and positive-pressure ventilation. Conclusions Significant blunt abdominal trauma, potentially requiring operative management or chest-tube insertion, may be missed on the initial anteroposterior chest x-ray film. Caution must therefore be exercised in interpreting these films in the trauma resuscitation room. PMID:8599789

  3. Clinician Perceptions of Operating Room to Intensive Care Unit Handoffs and Implications for Patient Safety: A Qualitative Study

    PubMed Central

    McElroy, Lisa M.; Macapagal, Kathryn R.; Collins, Kelly M.; Abecassis, Michael M.; Holl, Jane L.; Ladner, Daniela P.; Gordon, Elisa J.

    2015-01-01

    Background Operating room (OR) to the intensive care unit (ICU) handoffs are known sources of medical error, yet little is known about the relationship between process failures and patient harm. Materials and Methods Interviews were conducted with clinicians involved in the OR-to-ICU handoff to characterize the relationship between handoff process failures and patient harm. Thematic analysis was used to inductively identify key themes. Results A total of 38 interviews were conducted. Dominant themes included early communication from the OR to the ICU, team member participation in the handoff, and relationships between clinicians; clinician perspectives varied depending substantially on role within the team. Conclusions The findings suggest that ambiguous roles and conflicting expectations of team members during the OR-to-ICU handoff can increase risk of patient harm. Future studies should investigate early postoperative ICU care as outcome markers of handoff quality and the effect of inter-professional education on clinician adherence to interventions. PMID:26198333

  4. Study of emergency room health care providers and the fixed facility physical capabilities to manage the presenting radiologically injured patient. Study report, July 1984-July 1985

    SciTech Connect

    Not Available

    1985-07-01

    This study examined emergency room health care providers to determine if their knowledge and clinical expertise is sufficient to appropriately manage radiologically injured patient. This study posed an unannounced disaster preparedness drill to measure the ability of the emergency room staff to care for radiologically injured patients. This study produced a checklist for measurement of the care. The clinical expertise and performance were satisfactory. The instrument for measuring the abilities of the clinical staff provided useful, but required some modification.

  5. TREC-Rio trial: a randomised controlled trial for rapid tranquillisation for agitated patients in emergency psychiatric rooms [ISRCTN44153243

    PubMed Central

    Huf, Gisele; Coutinho, Evandro SF; Adams, Clive E

    2002-01-01

    Background Agitated or violent patients constitute 10% of all emergency psychiatric treatment. Management guidelines, the preferred treatment of clinicians and clinical practice all differ. Systematic reviews show that all relevant studies are small and none are likely to have adequate power to show true differences between treatments. Worldwide, current treatment is not based on evidence from randomised trials. In Brazil, the combination haloperidol-promethazine is frequently used, but no studies involving this mix exist. Methods TREC-Rio (Tranquilização Rápida-Ensaio Clínico [Translation: Rapid Tranquillisation-Clinical Trial]) will compare midazolam with haloperidol-promethazine mix for treatment of agitated patients in emergency psychiatric rooms of Rio de Janeiro, Brazil. TREC-Rio is a randomised, controlled, pragmatic and open study. Primary measure of outcome is tranquillisation at 20 minutes but effects on other measures of morbidity will also be assessed. TREC-Rio will involve the collaboration of as many health care professionals based in four psychiatric emergency rooms of Rio as possible. Because the design of this trial does not substantially complicate clinical management, and in several aspects simplifies it, the study can be large, and treatments used in everyday practice can be evaluated. PMID:12383353

  6. Length of stay, wait time to surgery and 30-day mortality for patients with hip fractures after the opening of a dedicated orthopedic weekend trauma room

    PubMed Central

    Taylor, Michel; Hopman, Wilma; Yach, Jeff

    2016-01-01

    Background In September 2011, Kingston General Hospital (KGH) opened a dedicated orthopedic weekend trauma room. Previously, 1 weekend operating room (OR) was used by all surgical services. We assessed the impact this dedicated weekend trauma room had on hospital length of stay (LOS), time to surgery and 30-day mortality for patients with hip fractures. Methods Patients admitted between Oct. 1, 2009, and Sept. 30, 2012, were identified through our trauma registry, representing the 2 years before and 1 year after the opening of the orthopedic weekend trauma room. We documented type of fracture, mode of fixation, age, sex, American Society of Anesthesiologists (ASA) score, time to OR, LOS, discharge disposition and 30-day mortality. We excluded patients with multiple fractures, open fractures and those requiring trauma team activation. Results Our study included 609 patients (405 pre- and 204 post–trauma room opening). Mean LOS decreased from 11.6 to 9.4 days (p = 0.005) and there was a decreasing trend in mean time to OR from 31.5 to 28.5 hours (p = 0.16). There was no difference in 30-day mortality (p = 0.24). The LOS decreased by an average of 2 days following opening of the weekend trauma room (p = 0.031) and by an average of 2.2 additional days if the patient was admitted on the weekend versus during the week (p = 0.024). Conclusion The weekend trauma OR at KGH significantly decreased the LOS and appears to have decreased wait times to surgery. Further analysis is needed to assess the cost-effectiveness of the current strategy, the long-term outcome of this patient population and the impact the additional orthopedic weekend trauma room has had on other surgical services (i.e., general surgery) and their patients. PMID:27668332

  7. ALCOHOL AND VIOLENCE-RELATED INJURIES AMONG EMERGENCY ROOM PATIENTS IN AN INTERNATIONAL PERSPECTIVE

    PubMed Central

    Cherpitel, Cheryl J.; Ye, Yu

    2010-01-01

    While alcohol has been found to be more closely associated with violence-related injury than with injury from other causes, little data is available which documents heterogeneity in this association across countries or cultures, taking into consideration usual drinking patterns and other socio-cultural variables. Data are reported from 15 countries comprising the Emergency Room Collaborative Alcohol Analysis Project and the WHO Collaborative Study on Alcohol and Injury. Case-crossover analysis was used to analyze the risk of injury (among current drinkers) from drinking six hours prior to the event, based on frequency of usual drinking, for violence-related injuries and separately for non-violence related injuries. Relative risk (RR) for a violence-related injury was significantly greater than for injuries from other causes across all countries (pooled RR=22.22 vs. 4.33), but the magnitude of risk varied considerably (ranging from 4.68 in Spain to 942 in Canada). Pooled effect size was found to be heterogeneous across countries, and was explained, in part, by the level of detrimental drinking pattern in a country. Risk for a violence-related injury was not significantly different by age (<30 and 30+), reporting 5 or more drinks on at least one occasion during the last year, or reporting symptoms of alcohol dependence. A number of methodological concerns suggest that risk of a violence-related injury compared to injuries from other causes may be inflated, and such variables as context of drinking should be taken into consideration in establishing relative risk and alcohol attributable fraction of violence-related injury across countries and cultures. PMID:20824198

  8. 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.

  9. [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.

  10. [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

  11. A nosocomial epidemic model with infection of patients due to contaminated rooms.

    PubMed

    Browne, Cameron; Webb, Glenn F

    2015-08-01

    A model of epidemic bacterial infections in hospitals is developed. The model incorporates the infection of patients and the contamination of healthcare workers due to environmental causes. The model is analyzed with respect to the asymptotic behavior of solutions. The model is interpreted to provide insight for controlling these nosocomial epidemics.

  12. [Nuclear magnetic resonance based metabolic phenotyping for patient evaluations in operating rooms and intensive care units].

    PubMed

    Blaise, B J; Gouel-Chéron, A; Floccard, B; Monneret, G; Plaisant, F; Chassard, D; Javouhey, E; Claris, O; Allaouchiche, B

    2014-03-01

    Metabolic phenotyping consists in the identification of subtle and coordinated metabolic variations associated with various pathophysiological stimuli. Different analytical methods, such as nuclear magnetic resonance, allow the simultaneous quantification of a large number of metabolites. Statistical analyses of these spectra thus lead to the discrimination between samples and the identification of a metabolic phenotype corresponding to the effect under study. This approach allows the extraction of candidate biomarkers and the recovery of perturbed metabolic networks, driving to the generation of biochemical hypotheses (pathophysiological mechanisms, diagnostic tests, therapeutic targets…). Metabolic phenotyping could be useful in anaesthesiology and intensive care medicine for the evaluation, monitoring or diagnosis of life-threatening situations, to optimise patient managements. This review introduces the physical and statistical fundamentals of NMR-based metabolic phenotyping, describes the work already achieved by this approach in anaesthesiology and intensive care medicine. Finally, potential areas of interest are discussed for the perioperative and intensive management of patients, from newborns to adults.

  13. 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.

  14. 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

  15. 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.

  16. Drinking patterns and problems and drinking in the injury event: an analysis of emergency room patients by ethnicity.

    PubMed

    Cherpitel, C J

    1998-12-01

    While a substantial literature exists on the association of alcohol consumption and injury, less is known about the context in which drinking occurs within specific ethnic groups in the United States. This paper analyzes drinking patterns, alcohol-related problems and drinking-in-the-event variables among a probability sample of 359 black, 528 Hispanic and 458 white patients who were breathalyzed and interviewed after admission to the emergency room. Injured patients among both Hispanics and whites were more likely to be positive on the breathalyzer and to report heavy drinking and more frequent drunkenness during the preceding year than their non-injured counterparts. Blacks were less likely than either Hispanics or whites to report a larger number of drinks prior to injury, feeling drunk at the time, or a causal association of alcohol and the injury event. These data suggest a differential role of alcohol in injury occurrence within ethnic groups, with alcohol possibly playing less of a role in the injury event for blacks than for Hispanics or whites. PMID:16203509

  17. 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

  18. Nursing the patient, the room and the doctor: Assessing New Zealand nurses' practical capability, 1900-1945.

    PubMed

    Wood, Pamela J

    2011-02-01

    Assessing nurses' practical capability was a challenge in the past as it is today. In 1901 New Zealand established state registration of nurses, with a standardised three-year hospital-based training system and state final examinations. Nurses' practical capability was assessed in an oral and practical examination and in general nursing questions in written medical and surgical nursing papers. This historical research identifies the practical component of nursing assessed in these examinations, categorising it as nursing the patient, the room and the doctor. It considers changes in the nursing profession's view, 1900-1945, of the best way to assess nurses' practical capability. This shifted from the artificial setting of the oral and practical examination held by doctors and matrons, to a process of senior nurses assessing candidates in the more realistic setting of a ward. The research also considers whether the nursing or medical profession defined nursing practice. By the end of the time period, the nursing profession was claiming for itself the right to both determine and assess the practical component of nursing.

  19. 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

  20. R. D. Laing and long-stay patients: discrepant accounts of the refractory ward and 'rumpus room' at Gartnavel Royal Hospital.

    PubMed

    Abrahamson, David

    2007-06-01

    R. D. Laing's mental hospital experience has been considered a formative influence on his controversial views. This paper addresses a number of discrepancies in the existing accounts: important aspects of the refractory ward and 'rumpus room' were underestimated; all the 'rumpus room' patients were not discharged and readmitted as repeatedly stated; his interactions with the patients were very limited and the viewpoints of most remain unknown; and the introduction of Largactil (chlorpromazine) was not mentioned. The Kingsley Hall residential project, Laing's first book The Divided Self, and his influence on psychiatrists' attitudes are considered in the light of these findings. Pessimism about long-stay patients may have influenced the acceptance of inaccurate information. PMID:18589930

  1. [Patient positioning using in-room kV CT for image-guided radiotherapy (IGRT) of prostate cancer].

    PubMed

    Kliton, Jorgo; Agoston, Péter; Major, Tibor; Polgár, Csaba

    2012-09-01

    automatic and manual image registrations were 0.31 cm and 0.26 cm in LAT, 0.27 cm and 0.27 cm in LONG and 0.24 cm and 0.33 cm in VERT directions, respectively. In case of manual image co-registration, the required PTV to CTV margins to cover at least 95% of the CTVs with at least 95% percent of the prescribed dose were calculated to 0.93 cm in LAT, 0.65 cm in LONG, and 0.89 cm in VERT directions. Patients set up can be verified with manual image co-registration based on soft tissues around the prostate using a kV CT-on-rails system installed in the treatment room. The difference between automatic and manual image co-registration was significant in LAT direction. A PTV to CTV margin <1 cm seems to be appropriate to cover the CTVs in image-guided prostate radiotherapy. These findings support our recent clinical protocol.

  2. 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

  3. User-Centered Design of a Tablet Waiting Room Tool for Complex Patients to Prioritize Discussion Topics for Primary Care Visits

    PubMed Central

    Altschuler, Andrea; Chawla, Neetu; Kowalski, Christine; McQuillan, Deanna; Bayliss, Elizabeth; Heisler, Michele; Grant, Richard W

    2016-01-01

    Background Complex patients with multiple chronic conditions often face significant challenges communicating and coordinating with their primary care physicians. These challenges are exacerbated by the limited time allotted to primary care visits. Objective Our aim was to employ a user-centered design process to create a tablet tool for use by patients for visit discussion prioritization. Methods We employed user-centered design methods to create a tablet-based waiting room tool that enables complex patients to identify and set discussion topic priorities for their primary care visit. In an iterative design process, we completed one-on-one interviews with 40 patients and their 17 primary care providers, followed by three design sessions with a 12-patient group. We audiorecorded and transcribed all discussions and categorized major themes. In addition, we met with 15 key health communication, education, and technology leaders within our health system to further review the design and plan for broader implementation of the tool. In this paper, we present the significant changes made to the tablet tool at each phase of this design work. Results Patient feedback emphasized the need to make the tablet tool accessible for patients who lacked technical proficiency and to reduce the quantity and complexity of text presentation. Both patients and their providers identified specific content choices based on their personal experiences (eg, the ability to raise private or sensitive concerns) and recommended targeting new patients. Stakeholder groups provided essential input on the need to augment text with video and to create different versions of the videos to match sex and race/ethnicity of the actors with patients. Conclusions User-centered design in collaboration with patients, providers, and key health stakeholders led to marked evolution in the initial content, layout, and target audience for a tablet waiting room tool intended to assist complex patients with setting

  4. 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)

  5. Alcoholics and drug addicts at the emergency room of the hospital. Analysis of the staff behavior and patients' progressions.

    PubMed

    Corten, P; Pelc, I

    1986-01-01

    The statistical analysis of a large sample (1.707 cases) was carried out using objective variables. These variables consist of the key points in the progression of alcoholics and drug addicts within two emergency departments situated in general hospitals. This study pinpoints a lack of therapeutic work at the emergency room where neither medical diagnoses nor psychopathological analyses seem to be done.

  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. Direct feedback with the ATP luminometer as a process improvement tool for terminal cleaning of patient rooms.

    PubMed

    Branch-Elliman, Westyn; Robillard, Ernie; McCarthy, Gary; Gupta, Kalpana

    2014-02-01

    We assessed the adenosine triphosphate luminometer as a tool for point-of-cleaning education. Following a terminal cleaning, infection preventionists met with cleaning staff and used the luminometer to evaluate multiple surfaces; 820 surfaces in 210 rooms were sampled. The mean proportion of clean surfaces improved significantly over the study period, P = .012. These findings suggest that direct measurement and education at the point of cleaning with an objective tool is useful for improving terminal cleaning.

  8. 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

  9. 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

  10. 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.

  11. The new standard: single family room design.

    PubMed

    Stichler, Jaynelle F

    2012-10-01

    Nurse leaders influence decisions related to single patient rooms or multioccupancy room designs. The purpose of this facility design article is to expand nurse leaders' knowledge and competency in health facility design enabling them to lead design efforts and the transition to new facilities and models of care. This article describes the new standard of all-private rooms for adult and neonatal ICU care and defines the benefits of the single family room design on patients, families, and providers.

  12. 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.

  13. Prognostic accuracy of cerebral blood flow measurement by perfusion computed tomography, at the time of emergency room admission, in acute stroke patients.

    PubMed

    Wintermark, Max; Reichhart, Marc; Thiran, Jean-Philippe; Maeder, Philippe; Chalaron, Marc; Schnyder, Pierre; Bogousslavsky, Julien; Meuli, Reto

    2002-04-01

    The purpose of this study was to determine the prognostic accuracy of perfusion computed tomography (CT), performed at the time of emergency room admission, in acute stroke patients. Accuracy was determined by comparison of perfusion CT with delayed magnetic resonance (MR) and by monitoring the evolution of each patient's clinical condition. Twenty-two acute stroke patients underwent perfusion CT covering four contiguous 10mm slices on admission, as well as delayed MR, performed after a median interval of 3 days after emergency room admission. Eight were treated with thrombolytic agents. Infarct size on the admission perfusion CT was compared with that on the delayed diffusion-weighted (DWI)-MR, chosen as the gold standard. Delayed magnetic resonance angiography and perfusion-weighted MR were used to detect recanalization. A potential recuperation ratio, defined as PRR = penumbra size/(penumbra size + infarct size) on the admission perfusion CT, was compared with the evolution in each patient's clinical condition, defined by the National Institutes of Health Stroke Scale (NIHSS). In the 8 cases with arterial recanalization, the size of the cerebral infarct on the delayed DWI-MR was larger than or equal to that of the infarct on the admission perfusion CT, but smaller than or equal to that of the ischemic lesion on the admission perfusion CT; and the observed improvement in the NIHSS correlated with the PRR (correlation coefficient = 0.833). In the 14 cases with persistent arterial occlusion, infarct size on the delayed DWI-MR correlated with ischemic lesion size on the admission perfusion CT (r = 0.958). In all 22 patients, the admission NIHSS correlated with the size of the ischemic area on the admission perfusion CT (r = 0.627). Based on these findings, we conclude that perfusion CT allows the accurate prediction of the final infarct size and the evaluation of clinical prognosis for acute stroke patients at the time of emergency evaluation. It may also provide

  14. Briefing and debriefing in the cardiac operating room. Analysis of impact on theatre team attitude and patient safety.

    PubMed

    Papaspyros, Sotiris C; Javangula, Kalyana C; Adluri, Rajeshwara Krishna Prasad; O'Regan, David J

    2010-01-01

    Error in health services delivery has long been recognised as a significant cause of inpatient morbidity and mortality. Root-cause analyses have cited communication failure as one of the contributing factors in adverse events. The formalised fighter pilot mission brief and debrief formed the basis of the National Aeronautics and Space Administration (NASA) crew resource management (CRM) concept produced in 1979. This is a qualitative analysis of our experience with the briefing-debriefing process applied to cardiac theatres. We instituted a policy of formal operating room (OR) briefing and debriefing in all cardiac theatre sessions. The first 118 cases were reviewed. A trouble-free operation was noted in only 28 (23.7%) cases. We experienced multiple problems in 38 (32.2%) cases. A gap was identified in the second order problem solving in relation to instrument repair and maintenance. Theatre team members were interviewed and their comments were subjected to qualitative analysis. The collaborative feeling is that communication has improved. The health industry may benefit from embracing the briefing-debriefing technique as an adjunct to continuous improvement through reflective learning, deliberate practice and immediate feedback. This may be the initial step toward a substantive and sustainable organizational transformation.

  15. 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.

  16. [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

  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.

  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. 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

  1. Locker Room Design Trends.

    ERIC Educational Resources Information Center

    Wiens, Janet

    2001-01-01

    Examines how today's college and university athletic locker rooms have become sophisticated recruiting tools that rival many professional facilities. Locker room design and location and their level of furniture, finishes, and equipment are discussed as is the trend for more environmentally friendly locker rooms. (GR)

  2. 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)

  3. 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)

  4. 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.

  5. Music practice rooms

    NASA Astrophysics Data System (ADS)

    Lamberty, D. C.

    1980-03-01

    A study of users, requirements and preferences for music practice rooms is described. Analysis of the subjective and objective information obtained provides guide lines for the design of such rooms. The study has shown that, ideally, the requirements for different users and different instruments vary, but there are broad areas of agreement so that satisfactory designs are often possible.

  6. [Interdisciplinary emergency room - key to success?].

    PubMed

    Kirsch, M; Zahn, P; Happel, D; Gries, A

    2014-09-01

    In Germany, which is also faced with a scarcity of resources, the concept of central, interdisciplinary emergency rooms ("Zentrale Notfallaufnahme", ZNA) is being developed as an answer to the complex demands of modern emergency medicine with increasing numbers of patients and complexity of the medical conditions. This autonomous institution is the first point of contact for all emergency patients. The central tasks of the ZNA are triage and the interdisciplinary primary treatment of patients. The establishment of the ZNA includes specific facilities (treatment rooms, short stay units, resuscitation rooms, triage and management areas, integration of the premises on site) as well as specific processes (triage systems, specific standard operating procedures) and training for the staff (European Curriculum for Emergency Medicine). It could be shown that by establishing a ZNA along with all its structures the satisfaction of the patients (including shorter waiting times), resource management (intensive care capacity), and patient outcome could be significantly improved.

  7. 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

  8. 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

  9. Men's toilet (room 207, representing rooms 306, 406, and 506; ...

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

    Men's toilet (room 207, representing rooms 306, 406, and 506; also women's toilets, rooms 102, 104, 204, 204A, 303, 403, and 503), looking north. - California State Office Building No. 1, 915 Capitol Mall, Sacramento, Sacramento County, CA

  10. Secondary entrance corridor (room 120, representing room 121), looking west ...

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

    Secondary entrance corridor (room 120, representing room 121), looking west (bearing 270) from elevator lobby - California State Office Building No. 1, 915 Capitol Mall, Sacramento, Sacramento County, CA

  11. 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

  12. Test Room Stability Plan

    SciTech Connect

    Not Available

    1993-01-01

    This plan documents the combination of designs, installations, programs, and activities that ensures that the underground excavations at the Waste Isolation Pilot Plant (WIPP), in which transuranic (TRU) waste may be emplaced during the Test Phase, will remain sufficiently stable and safe during that time. The current ground support systems installed at the WIPP are the result of over ten years of data collection from hundreds of geomechanical instruments and thousands of hours of direct observation of the changing conditions of the openings. In addition, some of the world's most respected experts on salt rock mechanics have provided input in the design process and concurrence on the suitability of the final design. The general mine rockbolt pattern and the ground support system for the test rooms are designed to specifically address the fracture and deformation geometries observed today at the WIPP. After an introductory chapter, this plan describes the general underground design, then proceeds to an account of general ground support performance, and finally focuses on the details of the special test room ground support systems. One such system already installed in Room 1, Panel 1, is described in comprehensive detail. Other test rooms in Panel 1, whether full-size or smaller, will be equipped with systems that ensure stability to the same or equivalent extent. They will benefit from the experience gained in the first test room, which in turn benefitted from the data and knowledge accumulated during previous stages (e.g., the Site and Preliminary Design Validation program) of the project.

  13. Staff corridor (room 206, representing rooms 301, 305, 401, 405, ...

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

    Staff corridor (room 206, representing rooms 301, 305, 401, 405, 501, and 505), looking south towards the staff corridor vestibule (room 206A, representing rooms 305A, 405A, and 505A). - California State Office Building No. 1, 915 Capitol Mall, Sacramento, Sacramento County, CA

  14. 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

  15. 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

  16. 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)

  17. 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…

  18. Locker-Room Talk.

    ERIC Educational Resources Information Center

    Lowe, Jason; Noyes, Brad

    1999-01-01

    Explains how proper athletic facility locker-room design can save time and money. Design factors that address who will be using the facility are discussed as are user requirements, such as preparation areas, total storage area per user, grooming area, and security areas. Final comments address maintenance and operations issues. (GR)

  19. Making Room for One

    ERIC Educational Resources Information Center

    Silva, Peggy

    2006-01-01

    In this article, the author shares the lesson she learned from her young friend, Mirabel, whose mother was dying. By following the daily path of support taken by Mirabel, she learned that it does not matter whether schools have a hundred kids, a thousand kids, or several thousand kids. Teachers must make sure that they can make room for each one.…

  20. Test Room Stability Plan

    SciTech Connect

    Not Available

    1993-03-01

    This plan documents the combination of designs, installations, programs, and activities that ensures that the underground excavations at the Waste Isolation Pilot Plant (WIPP), in which transuranic (TRU) waste may be emplaced during the Test Phase, will remain sufficiently stable and safe during that time. The current ground support systems installed at the WIPP are the result of over ten years of data collection from hundreds of geomechanical instruments and thousands of hours of direct observation of the changing conditions of the openings. In addition, some of the world`s most respected experts on salt rock mechanics have provided input in the design process and concurrence on the suitability of the final design. The general mine rockbolt pattern and the ground support system for the test rooms are designed to specifically address the fracture and deformation geometries observed today at the WIPP. After an introductory chapter, this plan describes the general underground design, then proceeds to an account of general ground support performance, and finally focuses on the details of the special test room ground support systems. One such system already installed in Room 1, Panel 1, is described in comprehensive detail. Other test rooms in Panel 1, whether full-size or smaller, will be equipped with systems that ensure stability to the same or equivalent extent. They will benefit from the experience gained in the first test room, which in turn benefitted from the data and knowledge accumulated during previous stages (e.g., the Site and Preliminary Design Validation program) of the project.

  1. Sensory rooms in psychiatric inpatient care: Staff experiences.

    PubMed

    Björkdahl, Anna; Perseius, Kent-Inge; Samuelsson, Mats; Lindberg, Mathilde Hedlund

    2016-10-01

    There is an increased interest in exploring the use of sensory rooms in psychiatric inpatient care. Sensory rooms can provide stimulation via sight, smell, hearing, touch and taste in a demand-free environment that is controlled by the patient. The rooms may reduce patients' distress and agitation, as well as rates of seclusion and restraint. Successful implementation of sensory rooms is influenced by the attitudes and approach of staff. This paper presents a study of the experiences of 126 staff members who worked with sensory rooms in a Swedish inpatient psychiatry setting. A cross-sectional descriptive survey design was used. Data were collected by a web based self-report 12-item questionnaire that included both open- and closed-ended questions. Our findings strengthen the results of previous research in this area in many ways. Content analyses revealed three main categories: hopes and concerns, focusing on patients' self-care, and the room as a sanctuary. Although staff initially described both negative and positive expectations of sensory rooms, after working with the rooms, there was a strong emphasis on more positive experiences, such as letting go of control and observing an increase in patients' self-confidence, emotional self-care and well-being. Our findings support the important principals of person-centred nursing and recovery-oriented mental health and the ability of staff to implement these principles by working with sensory rooms.

  2. 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)

  3. 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

  4. 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

  5. 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

  6. 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

  7. 23. Perimeter acquisition radar building room #202, mechanical equipment room ...

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

    23. Perimeter acquisition radar building room #202, mechanical equipment room no. 2 - 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. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. Console Room, looking southwesterly into Highbay Generator Room Beale ...

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

    Console Room, looking southwesterly into Highbay Generator Room - Beale Air Force Base, Perimeter Acquisition Vehicle Entry Phased-Array Warning System, Power Plant, End of Spencer Paul Road, north of Warren Shingle Road (14th Street), Marysville, Yuba County, CA

  14. 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

  15. 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

  16. LOOKING NORTHWEST FROM LIVING ROOM TOWARD DINING ROOM AT LEFT ...

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

    LOOKING NORTHWEST FROM LIVING ROOM TOWARD DINING ROOM AT LEFT AND FOYER AT RIGHT - Hamilton Field, Double Non-Commmissioned Officers' Quarters Type C, San Jose & Crescent Drives, Novato, Marin County, CA

  17. FACILITY 809, DINING ROOM WITH LIVING ROOM ON RIGHT, VIEW ...

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

    FACILITY 809, DINING ROOM WITH LIVING ROOM ON RIGHT, VIEW FACING NORTH-NORTHWEST. - Schofield Barracks Military Reservation, Corner-Entry Single-Family Housing Type, Between Hamilton & Tidball Streets, & between Williston & Ayres Avenues, Wahiawa, Honolulu County, HI

  18. FACILITY 713, DINING ROOM WITH LIVING ROOM IN LEFT BACKGROUND, ...

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

    FACILITY 713, DINING ROOM WITH LIVING ROOM IN LEFT BACKGROUND, VIEW FACING EAST. - Schofield Barracks Military Reservation, Central-Entry Single-Family Housing Type, Between Bragg & Grime Streets near Ayres Avenue, Wahiawa, Honolulu County, HI

  19. FACILITY 728, LIVING ROOM FROM DINING ROOM, OBLIQUE VIEW FACING ...

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

    FACILITY 728, LIVING ROOM FROM DINING ROOM, OBLIQUE VIEW FACING SOUTH. - Schofield Barracks Military Reservation, Corner-Entry Single-Family Housing Type, Between Bragg & Grime Streets near Williston Avenue, Wahiawa, Honolulu County, HI

  20. 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

  1. 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

  2. Living room toward dining room, bath, and bedroom of south ...

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

    Living room toward dining room, bath, and bedroom 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

  3. 7. October 1969 SOUTHWEST ROOM, FIRST FLOOR, 'CAPTAINS' ROOM' (Note: ...

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

    7. October 1969 SOUTHWEST ROOM, FIRST FLOOR, 'CAPTAINS' ROOM' (Note: Furnace has replaced pot-bellied stove, cribbage board on table) - William Rotch Warehouse, Main & South Water Streets, Nantucket, Nantucket County, MA

  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. [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.

  6. 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.

  7. 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…

  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. Patterns and injuries associated with orbital wall fractures in elderly patients who visited the emergency room: a retrospective case–control study

    PubMed Central

    Kim, Youn-Jung; Ahn, Shin; Seo, Dong-Woo; Sohn, Chang Hwan; Lee, Hyung-Joo; Park, In-June; Yang, Dong-Jin; Ryoo, Seung Mok; Kim, Won Young; Lim, Kyung Soo

    2016-01-01

    Objectives This study aimed to determine orbital wall fracture (OWF) patterns and associated facial injuries in elderly patients and compare them with those in their younger adult counterparts. Design A retrospective case–control study. Setting An emergency department of a university-affiliated hospital located in an urban area. Participants A total of 1378 adult patients with OWF diagnosed by CT from 1 January 2004 through 31 March 2014 were enrolled. Patients were categorised into elderly (≥65 years) and non-elderly (<65 years) groups. Results The elderly group (n=146) had a mean age of 74.0 years compared with 37.5 years in the non-elderly group (n=1232). Slipping was the most common cause of OWF in the elderly group (43.8%, p<0.001), whereas violence was the most common cause in the non-elderly group (37.3%, p<0.001). The lateral orbital wall was the more common site of fracture in the elderly group, and their injuries were more often associated with concurrent facial bone fractures, including the mandible, maxilla and zygoma, compared with the non-elderly group. After adjusting for sex and the mechanism of injury, inclusion in the elderly group was a significant risk factor for fracture of the lateral wall (OR 1.658; 95% CI 1.074 to 2.560) and concomitant facial bone fractures of the maxilla (OR 1.625; 95% CI 1.111 to 2.377) and zygoma (OR 1.670; 95% CI 1.126 to 2.475). Conclusions Elderly patients were vulnerable to facial trauma, and concurrent facial bone fracture associated with OWF was more commonly observed in this age group. Therefore, a high index of suspicion and thorough investigation, including CT, for OWF-associated facial bone fractures are important. PMID:27645553

  10. 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…

  11. Disinfectants used for environmental disinfection and new room decontamination technology.

    PubMed

    Rutala, William A; Weber, David J

    2013-05-01

    Environmental contamination plays an important role in the transmission of several key health care-associated pathogens. Effective and thorough cleaning/disinfecting of the patient environment is essential. Room decontamination units (such as ultraviolet-C and hydrogen peroxide systems) aid in reducing environmental contamination after terminal room cleaning and disinfection.

  12. "Noninvasive" oral treatment of asthma in the emergency room.

    PubMed

    Aelony, Y

    1985-06-01

    One hundred forty consecutive patients with acute asthmatic episodes presenting to the emergency room were studied prospectively to assess the efficacy of oral therapy. After the emergency room staff was oriented to the pharmacologic action of hydroalcoholic elixir of theophylline, oral terbutaline, and a metered-dose hand-held nebulizer (metaproterenol), use of oral therapy as initial therapy rose from 12 percent to 76 percent (p = 0.005). More than half of these patients were discharged without receiving any of the traditional more invasive therapies of subcutaneous epinephrine, intravenous hydrating fluids with aminophylline, and machine-delivered sympathomimetic aerosols. Oral therapy did not substantially alter the total time spent in the emergency room. Only 4 percent treated with oral therapy required further treatment in the emergency room within 48 hours; 2 percent vomited after treatment. Oral therapy is safe and effective for most asthmatic patients presenting to the emergency room, as they generally are undermedicated with regard to theophyllines and sympathomimetic drugs. Use of oral therapy in the emergency room is a potent tool for educating asthmatic patients in the use of medication available for home use. The patients who require emergency room treatment despite being well-medicated at home (a small minority) need a higher level of care including intermittent positive-pressure breathing, corticosteroids, and often hospitalization.

  13. 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.

  14. 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.

  15. 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.

  16. [Pollution of room air].

    PubMed

    Schlatter, J

    1986-01-01

    In the last decade the significance of indoor air pollution to human health has increased because of improved thermal insulation of buildings to save energy: air turnover is reduced and air quality is impaired. The most frequent air pollutants are tobacco smoke, radioactive radon gas emanating from the soil, formaldehyde from furniture and insulation material, nitrogen oxides from gas stoves, as well as solvents from cleaning agents. The most important pollutants leading to health hazards are tobacco smoke and air pollutants which are emitted continuously from building materials and furniture. Such pollutants have to be eliminated by reducing the emission rate. A fresh air supply is necessary to reduce the pollutants resulting from the inhabitants and their activities, the amount depending on the number of inhabitants and the usage of the room. The carbon dioxide level should not exceed 1500 ppm.

  17. 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.

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. Room temperature polyesterification

    SciTech Connect

    Moore, J.S.; Stupp, S.I. . Dept. of Materials Science and Engineering)

    1990-01-01

    A new room temperature polymerization method has been developed for the synthesis of high molecular weight polyesters directly from carboxylic acids and phenols. The solution polymerization reaction proceeds under mild conditions, near neutral pH, and also avoids the use of preactivated acid derivatives for esterification. The reaction is useful in the preparation of isoregic ordered chains with translational polar symmetry and also in the polymerization of functionalized or chiral monomers. The conditions required for polymerization in the carbodiimide-based reaction included catalysis by the 1:1 molecular complex formed by 4-(dimethylamino)pyridine and p-toluenesulfonic acid. These conditions were established through studies on a model system involving esterification of p-toluic acid and p-cresol. Self-condensation of several hydroxy acid monomers by this reaction has produced routinely good yields of polyesters with molecular weights greater than 15,000. It is believed that the high extents of reaction required for significant degrees of polymerization result from suppression of the side reaction leading to N-acylurea. The utility of this reaction in the formation of polar chains from sensitive monomers is demonstrated hereby the polycondensation of a chiral hydroxy acid.

  10. [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

  11. [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.

  12. 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

  13. Making room for alternatives.

    PubMed

    Edelberg, D

    1994-07-01

    Alternative healing is an idea whose time has come, and 1993 was the critical year for that recognition. So believes internist David Edelberg, founder of the Chicago Holistic Center. There patients can see one of four allopathic physicians as well as practitioners in 37 additional therapies, including acupuncture, infant massage, homeopathy, nutrition counseling, and Ayurvedic medicine. PMID:10136509

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

    PubMed

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

    2006-06-01

    One of the major challenges for day-of-surgery operating room coordination is accurate and timely situation awareness. Distributed and secure real-time status information is key to addressing these challenges. This article reports on the design and implementation of a passive status monitoring system in a 19-room surgical suite of a major academic medical center. Key design requirements considered included integrated real-time operating room status display, access control, security, and network impact. The system used live operating room video images and patient vital signs obtained through monitors to automatically update events and operating room status. Images were presented on a "need-to-know" basis, and access was controlled by identification badge authorization. The system delivered reliable real-time operating room images and status with acceptable network impact. Operating room status was visualized at 4 separate locations and was used continuously by clinicians and operating room service providers to coordinate operating room activities. PMID:17012154

  15. 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.

  16. [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

  17. 32 CFR 518.9 - Reading room.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 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...

  18. 32 CFR 518.9 - Reading room.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false 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...

  19. 32 CFR 518.9 - Reading room.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 3 2013-07-01 2013-07-01 false 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...

  20. 32 CFR 518.9 - Reading room.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 2009-07-01 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...

  1. Pediatric emergency room visits: a risk factor for acquiring measles.

    PubMed

    Farizo, K M; Stehr-Green, P A; Simpson, D M; Markowitz, L E

    1991-01-01

    In recent years, measles outbreaks have occurred among unimmunized children in inner cities in the United States. From May 1988 through June 1989, 1214 measles cases were reported in Los Angeles, and from October 1988 through June 1989, 1730 cases were reported in Houston. More than half of cases were in children younger than 5 years of age, most of whom were unvaccinated. Of cases of measles in preschool-aged children, nearly one fourth in Los Angeles and more than one third in Houston were reported by one inner-city emergency room. To evaluate whether emergency room visits were a risk factor for acquiring measles, in Los Angeles, 35 measles patients and 109 control patients with illnesses other than measles, and in Houston, 49 measles patients and 128 control patients, who visited these emergency rooms, were enrolled in case-control studies. Control patients were matched to case patients for ethnicity, age, and week of visit. Records were reviewed to determine whether case patients had visited the emergency room during the period of potential measles exposure, which was defined as 10 to 18 days before rash onset, and whether control patients had visited 10 to 18 days before their enrollment visit. In Los Angeles, 23% of case patients and 5% of control patients (odds ratio = 5.2, 95% confidence interval = 1.7, 15.9; P less than .01), and in Houston, 41% of case patients and 6% of control patients (odds ratio = 8.4, 95% confidence interval = 3.3, 21.2; P less than .01), visited the emergency room during these periods.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. 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.

  3. 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.

  4. 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

  5. Visual acuity-adaptive detail enhancement and shadow noise reduction for iCAM06-based HDR imaging

    NASA Astrophysics Data System (ADS)

    Lee, Geun-Young; Lee, Sung-Hak; Kwon, Hyuk-Ju; Sohng, Kyu-Ik

    2015-04-01

    An image appearance model is extremely useful for high-dynamic-range image (HDRI) rendering. However, the base-detail separation and the tone compression process for tonal control cause degradations in image quality. This study focuses on the de-saturation, reduced contrast, and noise problems in dark regions that occur through HDRI-rendering. First, we discuss de-saturation compensation using a bilateral filter that is based on the visual acuity characteristics of various illuminant levels. The edge stop function of the bilateral filter in iCAM06 is adaptively modified according to the illuminant information. Second, to reduce the magnified noise in the dark regions caused by tone mapping, the shadow regions are detected by an object's intensity and illuminant level, and then the noise of the detected regions is reduced using a luminance-adaptive coring function. Finally, we confirmed the enhanced color saturation, image contrast, and reduced noise in shadow regions through the application of the proposed methods.

  6. Getting into the System: The Physician's Staff and Waiting Room

    PubMed Central

    1976-01-01

    This article represents a panel discussion with the staff of the Family Practice Unit at the Plains Health Centre, Regina, Sask. It outlines those things found helpful in presenting a positive image to the patient by a physician and his staff - telephone contacts, waiting rooms, patient flow, and common complaints. PMID:21308056

  7. High-tech tools transform the operating room.

    PubMed

    Haugh, Richard

    2005-01-01

    This installment of our quarterly Clinical Management series examines how the hospital operating room is becoming a safer place for patients. Thanks to such technological breakthroughs as 3-D images, virtual patients and robots, surgeons can operate with more accuracy and efficiency.

  8. No room at the inn: a snapshot of an American emergency room.

    PubMed

    Olson, E J

    1994-01-01

    The emergency rooms of American hospitals have frequently become the principal suppliers of nonurgent primary care to the under- and uninsured. Canvassing published reports and using original data obtained from a representative urban hospital, Erik Olson examines the demographics of the American emergency room and analyzes its finances. The costs of providing primary care are shifted, to the extent possible, to those who can pay. The result is escalating health care costs and a deterioration of quality of care due to overcrowding, leading some hospitals to close their emergency rooms and others to turn away ambulances or "dump" patients who still require critical care. Mr. Olson explains that state antidumping laws and the federal COBRA statute have been ineffective at stemming these practices in the face of severe economic pressure to continue them. Pointing out that emergency rooms are an excessively expensive method of treating uninsured nonemergency patients, he proposes a system of primary care clinics created through a public/private partnership between municipalities and existing private health care providers. The partnership is designed to maintain a high standard of care at the clinics. As an incentive to stimulate the appearance of such clinics, a tax would be imposed on private health care providers; the tax on a given provider would be reduced to the extent that provider subsidizes a local primary care clinic that offers universal coverage, regardless of insurance status. Because the existence of such clinics would reduce inefficient use of hospital emergency rooms, in the long run hospitals should find it less expensive to finance local primary care clinics than to continue to sustain unreimbursed expenses due to improper use of their emergency departments.

  9. The emergency room in systemic rheumatic diseases

    PubMed Central

    Slobodin, G; Hussein, A; Rozenbaum, M; Rosner, I

    2006-01-01

    Complications of systemic rheumatic diseases frequently have protean manifestations and may present a diagnostic problem. Patients with connective tissue diseases and vasculitides may have dangerous or life threatening conditions, which must be recognised and treated promptly to prevent rapidly evolving morbidity and mortality. Knowledge of possible emergencies in the context of a defined rheumatic disease may aid in promoting a high index of suspicion and contribute significantly to the timely diagnosis of many potentially dangerous conditions. This review is written for the emergency room physician and discusses the early recognition of selected emergencies in the context of a defined rheumatic disease. PMID:16921075

  10. 31. ROOM A (WEST ROOM), SOUTH SIDE, LOOKING EAST. The ...

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

    31. ROOM A (WEST ROOM), SOUTH SIDE, LOOKING EAST. The two benches in the foreground were constructed with rose head hand wrought nails and are therefore likely to have come from the 1755 Greater Meeting House, which stood at Second and Market Streets until 1812. Similar benches are to be found at the Arch Street Meeting House. The light buff brick fireplace at left was added in 1892 along with the overdoor paneling - Twelfth Street Meeting House, 20 South Twelfth Street, Philadelphia, Philadelphia County, PA

  11. 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

  12. 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

  13. 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.

  14. Complex soundproofing of industrial rooms

    NASA Technical Reports Server (NTRS)

    Pocsa, V.; Veres, A.; Biborosch, L.

    1974-01-01

    Some structures treated for sound absorption are described that are used to soundproof industrial rooms with a very high noise level. Soundproofing treatments for the walls and coilings or only for the ceilings are considered. In the case of relatively small rooms having a noise source with a high level, complex treatments involve, in addition to soundproofing of the walls and ceiling, suspended panels specially oriented with respect to the noise source. The efficiency of the adopted solutions is compared with calculated damping values.

  15. 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...

  16. 32 CFR 296.6 - Reading room.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 2 2013-07-01 2013-07-01 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...

  17. 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...

  18. 32 CFR 296.6 - Reading room.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 2 2014-07-01 2014-07-01 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...

  19. 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...

  20. 32 CFR 296.6 - Reading room.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 2 2012-07-01 2012-07-01 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...

  1. 39 CFR 3004.12 - Reading room.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 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...

  2. 39 CFR 3004.12 - Reading room.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 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...

  3. 39 CFR 3004.12 - Reading room.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 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...

  4. 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...

  5. Transport of surgically produced aerosols in an operating room.

    PubMed

    Buchanan, C R; Dunn-Rankin, D

    1998-06-01

    The particle transport characteristics of two ventilation configurations commonly used in hospital operating rooms (ORs), cross-flow and impinging-flow ventilation, were investigated. The computational fluid dynamics software FLUENT was used to simulate turbulent airflow with mixed convection in a three-dimensional, rectangular OR. Two OR personnel, a patient, OR spotlights, an anesthetics cart, and an operating table were represented in the room. Heat loads from the personnel, patient, and lights affected the airflow through buoyancy. Particles produced at the operation site with various sizes and initial conditions were tracked through the room. A stochastic model was used to include the random effects of turbulence on particle trajectories. Simulation results show that heat loads from the personnel, patient, and OR spotlights had an important effect on the airflow through natural convection. Particle trajectories were influenced greatly by the flow field structure, particle launch position, and turbulence in the flow, and somewhat by particle size. However, particle paths were insensitive to the launch velocity. Virtually identical trajectories were obtained for particles with launch velocities ranging from 0 to 1 m/sec in magnitude. Changes in ventilation configuration dramatically affected particle transport. The cross-flow ventilation configuration performed better, based on the criteria of removing particles from the breathing zone of room occupants. Proper flow field design and contaminant source placement can be used to control particle transport. Numerical simulations allow quick and inexpensive comparisons between room designs and provide details about airflow and contaminant transport.

  6. Locker Rooms: The Durable Design.

    ERIC Educational Resources Information Center

    Viklund, Roy; Coons, John

    1997-01-01

    Offers advice on heavy-use locker-room design that provides easier maintenance and vandal resistance. Design features and materials used for flooring, ceilings, and walls are addressed as are built-in systems and equipment, toilet and shower fixtures and partitions, lockers, and mechanical and electrical systems. (GR)

  7. Transition Room Program, 1967 Report.

    ERIC Educational Resources Information Center

    Glassner, Leonard E.

    The Transition Room Program of the Pittsburgh Schools was defined and evaluated by the staff, the administration, and a program evaluator from the Office of Research. The definition included general objectives, anticipated outcomes, student criteria and characteristics, staff qualifications and functions, media, student activities, and staff…

  8. 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)

  9. 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…

  10. 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

  11. Survey of psychiatric assessment rooms in UK emergency departments.

    PubMed

    Bolton, Jim; Palmer, Lucy; Cawdron, Rohanna

    2016-04-01

    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.

  12. 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…

  13. Polariton condensates at room temperature

    NASA Astrophysics Data System (ADS)

    Guillet, Thierry; Brimont, Christelle

    2016-10-01

    We review the recent developments of the polariton physics in microcavities featuring the exciton-photon strong coupling at room temperature, and leading to the achievement of room-temperature polariton condensates. Such cavities embed active layers with robust excitons that present a large binding energy and a large oscillator strength, i.e. wide bandgap inorganic or organic semiconductors, or organic molecules. These various systems are compared, in terms of figures of merit and of common features related to their strong oscillator strength. The various demonstrations of polariton laser are compared, as well as their condensation phase diagrams. The room-temperature operation indeed allows a detailed investigation of the thermodynamic and out-of-equilibrium regimes of the condensation process. The crucial role of the spatial dynamics of the condensate formation is discussed, as well as the debated issue of the mechanism of stimulated relaxation from the reservoir to the condensate under non-resonant excitation. Finally the prospects of polariton devices are presented.

  14. '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.

  15. 7. VIEW OF SLC3W CONTROL ROOM (ROOM 105) FROM ITS ...

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

    7. VIEW OF SLC-3W CONTROL ROOM (ROOM 105) FROM ITS SOUTHWEST CORNER. NOTE RAISED FLATFORM IN CENTER OF ROOM. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  16. [Occupational accidents treated in an emergency room].

    PubMed

    Conceição, Paulo Sérgio de Andrade; Nascimento, Itatyane Bispo de Oliveira; Oliveira, Patrícia Silva; Cerqueira, Maria Ruth Moreira

    2003-01-01

    In Brazil, work-related injuries are only reported to the National Social Security data system. Therefore, records are limited to formally hired workers, who represent less than half of the active work force. In this cross-sectional study, cases of work-related injuries were identified and interviewed in an emergency room in the city of Salvador, capital of Bahia State, Brazil, to estimate their frequency and characteristics. Work-related injuries accounted for 31.6% of all injuries from external causes (n = 215). Only 36.8% of these patients reported having a formal job contract, and of these, fewer than half (45.5%) had their injuries reported to the Social Security data system, which indicates extensive underreporting of such important work-related health events, even in the formal sector of the economy. Medical records from emergency rooms can be an important source of information on work-related accidents, and health surveillance needs to be enforced in such health care services. This can also be an important step in obtaining a more complete picture of the occurrence of work-related accidents in Brazil.

  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

    2004-06-01

    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. [Teamwork and leadership in the trauma room. Trauma room management from a psychological perspective].

    PubMed

    Passauer-Baierl, S; Hofinger, G

    2011-09-01

    The treatment of patients in the trauma room places extraordinary demands on the multidisciplinary and multiprofessional team with regard to expert qualifications and teamwork. The present study triangulates data extracted from observation, interviews and questionnaires. In general, team climate and teamwork are good, yet some problems could be identified. Not all team members-especially younger physicians and nurses-feel free to express their doubts and uncertainties. Furthermore, the treatment plan is not always clear for all team members. Absent or unclear leadership is seen as a main problem when a treatment proceeds negatively. The establishment of a team leader is therefore recommended. PMID:21870134

  20. [Teamwork and leadership in the trauma room. Trauma room management from a psychological perspective].

    PubMed

    Passauer-Baierl, S; Hofinger, G

    2011-09-01

    The treatment of patients in the trauma room places extraordinary demands on the multidisciplinary and multiprofessional team with regard to expert qualifications and teamwork. The present study triangulates data extracted from observation, interviews and questionnaires. In general, team climate and teamwork are good, yet some problems could be identified. Not all team members-especially younger physicians and nurses-feel free to express their doubts and uncertainties. Furthermore, the treatment plan is not always clear for all team members. Absent or unclear leadership is seen as a main problem when a treatment proceeds negatively. The establishment of a team leader is therefore recommended.

  1. [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.

  2. [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

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 32 CFR 701.6 - Reading rooms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 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...

  8. 7 CFR 58.409 - Drying room.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 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. 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...

  11. 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...

  12. 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...

  13. 32 CFR 701.6 - Reading rooms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 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...

  14. 32 CFR 701.6 - Reading rooms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 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...

  15. 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

  16. 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.

  17. 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.

  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.

  20. Oxygen in the delivery room.

    PubMed

    Cernada, María; Cubells, Elena; Torres-Cuevas, Isabel; Kuligowski, Julia; Escobar, Javier; Aguar, Marta; Escrig, Raquel; Vento, Maximo

    2013-06-01

    Immediately after birth the newly born infant aerates the lungs, diminishes pulmonary vascular resistance, and initiates gas exchange. However, under certain circumstances this process will not be adequately accomplished. Asphyxia is characterized by periods of hypoxia and ischemia leading frequently to hypoxic ischemic encephalopathy. The mainstay of newborn resuscitation resides in the establishment of a functional residual capacity and an adequate oxygenation. Recent guidelines have established guidelines which provide counsel on the use of oxygen in term infants. However, preterm oxygenation in the delivery room (DR) has only been defined very vaguely. Herewith, we will address available information regarding the use of oxygen supplementation in the DR both in term and preterm babies for a satisfactory postnatal adaptation. PMID:23809339

  1. 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.

  2. 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

  3. 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

  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. 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

  7. 9 CFR 354.241 - Cleaning of rooms and compartments.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Sanitary Conditions and Precautions Against Contamination of Products § 354.241 Cleaning of rooms and..., water, and dirt. (i) All equipment in the toilet room and locker room, as well as the room itself,...

  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.

  9. 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

  10. Light propagation in a Penrose unilluminable room.

    PubMed

    Fukushima, Takehiro; Sakaguchi, Koichiro; Tokuda, Yasunori

    2015-06-29

    Using the finite-difference time-domain method, propagation of light waves is studied in a Penrose unilluminable room. Such a room always has dark (unilluminated) regions, regardless of the position of a point source in it. However, in contrast to the predictions of ray dynamical simulations, a small amount of light propagates into the unilluminated regions via diffraction. We conjecture that this diffraction effect becomes more prominent as the size of the room decreases.

  11. Impulsive nonconformity in female chat room users.

    PubMed

    Fullwood, Chris; Galbraith, Niall; Morris, Neil

    2006-10-01

    Heavy chat room use has been associated with social isolation, introversion, impulse control problems, and risk taking. Such characteristics form part of the cluster of traits associated with schizotypy. This study used multiple regression to examine the relationship between age, sex, four dimensions of schizotypy, and frequency of reported chat room use. The only significant association with schizotypy was between frequency of chat room use and impulsive nonconformity (IN) in females. These findings may be explained by the increased risk associated with female chat room use.

  12. Nonoperating room anesthesia for the gastrointestinal endoscopy suite.

    PubMed

    Tetzlaff, John E; Vargo, John J; Maurer, Walter

    2014-06-01

    Anesthesia services are increasingly being requested for gastrointestinal (GI) endoscopy procedures. The preparation of the patients is different from the traditional operating room practice. The responsibility to optimize comorbid conditions is also unclear. The anesthetic techniques are unique to the procedures, as are the likely events that require intervention by the anesthesia team. The postprocedure care is also unique. The future needs for anesthesia services in GI endoscopy suite are likely to expand with further developments of the technology.

  13. 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

  14. 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.

  15. 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

  16. 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)

  17. 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

  18. 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.

  19. 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

  20. 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

  1. VIEW OF ICE/INSP TEAM ROOM, FIRING ROOM NO. 2, FACING ...

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

    VIEW OF ICE/INSP TEAM ROOM, FIRING ROOM NO. 2, 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

  2. 6. VIEW OF SLC3W CONTROL ROOM (ROOM 105) FROM ITS ...

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

    6. VIEW OF SLC-3W CONTROL ROOM (ROOM 105) FROM ITS SOUTHEAST CORNER - Vandenberg Air Force Base, Space Launch Complex 3, Launch Operations Building, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

  3. 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

  4. 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

  5. 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.

  6. Comparison of Microbial Contamination Levels Among Hospital Operating Rooms and Industrial Clean Rooms

    PubMed Central

    Favero, Martin S.; Puleo, John R.; Marshall, James H.; Oxborrow, Gordon S.

    1968-01-01

    Microbial contamination in industrial clean rooms was compared quantitatively and qualitatively with that of hospital operating rooms. The number of aerobic mesophilic microorganisms which accumulated on stainless-steel strips exposed for periods up to 21 weeks to the intramural air of four operating rooms was at least 1 log higher than the accumulation on strips exposed in four clean rooms, and was essentially the same as that found in two factory areas. Volumetric air samplings showed that there were significantly higher numbers of airborne viable particles per cubic foot of air in operating rooms than in industrial clean rooms. In contrast to clean rooms, where most of the airborne contaminants were those associated with human hair, skin, and respiratory tract, the hospital operating rooms showed a very high level of microorganisms associated with dust and soil. Images Fig. 4 PMID:5649862

  7. Utilizing Health Analytics in Improving Emergency Room Performance.

    PubMed

    Khalifa, Mohamed

    2016-01-01

    Emergency room performance improvement has been a major concern for healthcare professionals and researchers. ER patients' length of stay and percentage of patients leaving without treatment are two of the most important indicators for performance monitoring and improvement. The main objective of this study is to utilize health analytics methods in identifying areas of deficiency, potential improvements and recommending effective solutions to enhance ER performance. ER data of 2014 were retrospectively retrieved in January 2015 and analyzed for significant variables affecting inpatient admission rates. Patient Acuity Level was the significant variable on which the recommendations were based. A Fast-Track area was redesigned and dedicated for managing lower acuity level patients; CTAS levels 4 and 5. The performance of the ER has been monitored for the first six months of 2015 and compared to 2014. 29% improvement was achieved on shortening the total ER LOS and 30% improvement was achieved on the percentage of patients leaving ER without treatment.

  8. 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

  9. 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…

  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. 32 CFR 701.35 - Reading room.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 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...

  12. 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...

  13. 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...

  14. 32 CFR 701.35 - Reading room.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 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...

  15. 32 CFR 701.35 - Reading room.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 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...

  16. 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…

  17. 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.

  18. 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%.

  19. 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

  20. 149. Interior of Room B3, Air Compressor Room, showing a ...

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

    149. Interior of Room B-3, Air Compressor Room, showing a ca. 1960s Worthington air compressor used to provide compressed air for powerhouse; air compressor powered by an electric motor; stairway (far left) leads to the generator room. Looking south. Photo by Jet Lowe, HAER, 1989. - Puget Sound Power & Light Company, White River Hydroelectric Project, 600 North River Avenue, Dieringer, Pierce County, WA

  1. 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

  2. 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.

  3. 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

  4. Noninvasive liver iron measurements with a room-temperature susceptometer

    PubMed Central

    Avrin, W F; Kumar, S

    2011-01-01

    Magnetic susceptibility measurements on the liver can quantify iron overload accurately and noninvasively. However, established susceptometer designs, using Superconducting QUantum Interference Devices (SQUIDs) that work in liquid helium, have been too expensive for widespread use. This paper presents a less expensive liver susceptometer that works at room temperature. This system uses oscillating magnetic fields, which are produced and detected by copper coils. The coil design cancels the signal from the applied field, eliminating noise from fluctuations of the source-coil current and sensor gain. The coil unit moves toward and away from the patient at 1 Hz, cancelling drifts due to thermal expansion of the coils. Measurements on a water phantom indicated instrumental errors less than 30 μg of iron per gram of wet liver tissue, which is small compared with other errors due to the response of the patient’s body. Liver iron measurements on eight thalassemia patients yielded a correlation coefficient r=0.98 between the room-temperature susceptometer and an existing SQUID. These results indicate that the fundamental accuracy limits of the room-temperature susceptometer are similar to those of the SQUID. PMID:17395991

  5. Misidentification of English Language Proficiency in Triage: Impact on Satisfaction and Door-to-Room Time.

    PubMed

    Balakrishnan, Vamsi; Roper, Jamie; Cossey, Kori; Roman, Crystal; Jeanmonod, Rebecca

    2016-04-01

    We examined triage nurses' assessment of patients' language proficiency compared to patients' self-reported proficiency and the impact of language discordance on door-to-room time and patient satisfaction. This was a prospective study of emergency department walk-in patients. Patients completed a survey in which they identified their language proficiency. On a Likert scale, patients ranked how well they felt they were understood and how satisfied they were with the triage process. Nurses completed surveys identifying the patient's primary language and how well they felt they understood the patient. Door-to-room times were obtained from medical records. 163 patients were enrolled. 66% of patients identified themselves as having good English proficiency, while 34% of patients had limited English proficiency. Nurses misclassified 27% of self-identified Spanish-speaking patients as being English proficient. Spanish-speakers felt less satisfied with triage than English-speakers (p < 0.01). There were no differences in door-to-room time. Triage nurses overestimate patient language skills. Spanish-speaking patients feel less satisfied with triage than English-speakers.

  6. 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.

  7. 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.

  8. Should relatives be denied access to the resuscitation room?

    PubMed

    Ardley, Christine

    2003-02-01

    Within a health care system that promotes choice and autonomy, it no longer seems appropriate to exclude relatives from the resuscitation room. There is a growing body of research that suggests there are indeed many long-term benefits to be gained from witnessing the resuscitation of a loved one. There seems no doubt that relatives would like the opportunity to spend the last few valuable minutes with their loved one to say goodbye. However, it is the views of many staff working in the critical care setting that appear to be preventing witnessed resuscitation from becoming normal practice. This paper considers the staffs', the relatives' and the patients' perspectives on witnessed resuscitation and concludes that the majority of relatives should not be denied access to the resuscitation room.

  9. 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

  10. 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.

  11. Microbial surface contamination after standard operating room cleaning practices following surgical treatment of infection.

    PubMed

    Balkissoon, Rishi; Nayfeh, Tariq; Adams, Kerri L; Belkoff, Stephen M; Riedel, Stefan; Mears, Simon C

    2014-04-01

    At the authors' institution, some joint arthroplasty surgeons require the operating room to be terminally cleaned before using the room after infected cases, in theory to decrease exposure to excessive microbial contamination for the subsequent patient. The authors found no guidance in the literature to support this practice. To test this theory, the authors measured microbial surface contamination from 9 surfaces in operating rooms after standard operating room turnover following 14 infected cases vs 16 noninfected cases. A check was made for an association between organisms isolated intraoperatively from infected surgical patients immediately preceding standard cleaning and organisms isolated from common operating room surfaces. Colony counts were made at 24 and 48 hours, and organisms were identified. No significant difference was noted in colony counts between infected and noninfected cases, and no relationship was found between organisms isolated from infected cases and those from operating room surfaces. Furthermore, the largest colony count from both groups (0.08 cfu/cm(2)) was an order of magnitude less than the recently proposed 5 cfu/cm(2) threshold for surface hygiene in hospitals. This finding indicates that standard operating room turnover results in minimal surface contamination, regardless of the previous case's infection status, and that there is no need for a more extensive terminal cleaning after an infected case.

  12. 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

  13. 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

  14. 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

  15. [Assessment of traumatic tooth injuries in the emergency room].

    PubMed

    Risheim, Helge

    2006-04-27

    Many patients with facial injuries are first seen by doctors in the emergency room. Injuries affecting teeth and alveolar process are common in children; approximately half of all children have sustained such an injury before adulthood. Dentoalveolar trauma does not pose a significant morbid risk for the trauma patient. However, failure to recognise or obtain appropriate consultation can result in premature tooth or alveolar bone loss, resulting in problematic prosthetic rehabilitation. Emergency room doctors should know the initial treatment guidelines for traumatic dental injuries to provide optimal treatment before the patient can seen by a dentist. An avulsed tooth should be replanted immediately, or kept moist until it can be replanted. Prognosis is related to storage media and the length of the extra-alveolar period. Teeth replanted within 5 minutes have the best prognosis. If the primary consultation is by phone the patient, or the parent, should be informed to replant the avulsed tooth. If this is not feasible the tooth should be stored in milk, saliva (oral cavity) or physiologic saline until replanted. Primary teeth are not replanted.

  16. 7 CFR 58.211 - Packaging room for bulk products.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 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...

  17. Conflict in the operating room: fight and flight or growth and communication.

    PubMed

    Stella, Cheryl

    2010-06-01

    Conflict is partial to no one. It ranges from within an individual and spirals in a ripple effect to others. Conflict among Registered Nurses (RNs) and Operating Room Technicians (ORTs) and between fellow RNs is prevalent in the operation room. The OR environment is filled with a number of personalities, each possessing varying methods for the implementation of patient care. Effective communication is key to preventing, and resolving, conflict situations.

  18. 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

  19. Smokey Visits Station Flight Control Room

    NASA Video Gallery

    Smokey Bear celebrated his 68th birthday with a special visit to the International Space Station Flight Control Room at Johnson Space Center in Houston. On May 14, Smokey went where no bear had gon...

  20. 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.

  1. 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 > ...

  2. 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 > ...

  3. 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.

  4. 7 CFR 58.213 - Repackaging room.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., GENERAL SPECIFICATIONS FOR APPROVED PLANTS AND STANDARDS FOR GRADES OF DAIRY PRODUCTS 1 General Specifications for Dairy Plants Approved for USDA Inspection and Grading Service 1 Rooms and Compartments §...

  5. IMPROVED SYNTHESIS OF ROOM TEMPERATURE IONIC LIQUIDS

    EPA Science Inventory

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

  6. 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)

  7. 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.

  8. Real-time virtual room acoustic simulation

    NASA Astrophysics Data System (ADS)

    Carneal, James P.; Johnson, Jan; Johnson, Troge; Johnson, Marty

    2003-10-01

    A realistic virtual room acoustic simulation has been implemented on a PC-based computer in near real-time. Room acoustics are calculated by the image source method using realistic absorption coefficients for a variety of realistic surfaces and programmed in MATLAB. The resulting impulse response filters are then applied in near real-time using fast convolution DSP techniques using data being read from a CD-ROM. The system was implemented in a virtual acoustic room facility. Optimizations have been performed to retain the realistic virtual room effect while minimizing computations through limited psycho-acoustic testing. In general, realistic anechoic to reverberant virtual rooms have been re-created with six 8192 coefficient filters. To provide realistic simulations, special care must be taken to accurately reproduce the low frequency acoustics. Since the virtual room acoustic facility was not totally anechoic (as are most anechoic chambers), inverse filters were applied to compensate for over-amplified acoustics at frequencies below 350 Hz.

  9. Using acoustic information to perceive room size: effects of blindness, room reverberation time, and stimulus.

    PubMed

    Kolarik, Andrew J; Pardhan, Shahina; Cirstea, Silvia; Moore, Brian C J

    2013-01-01

    Blind participants greatly rely on sound for spatial information regarding the surrounding environment. It is not yet established whether lack of vision to calibrate audition in far space affects blind participants' internal spatial representation of acoustic room size. Furthermore, blind participants may rely more on farthest distance estimates to sound sources compared with sighted participants when perceiving room size. Here we show that judgments of apparent room size and sound distance are correlated, more so for blind than for sighted participants. Sighted participants judged a reverberant virtual room to be larger for speech than for music or noise stimuli, whereas blind participants did not. The results suggest that blindness affects the use of room reverberation for distance and room-size judgments. PMID:24386717

  10. 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

  11. INTERIOR VIEW OF THE LANAI AND FAMILY ROOM FROM THE ...

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

    INTERIOR VIEW OF THE LANAI AND FAMILY ROOM FROM THE DINING ROOM. SHOWING THE TONGUE-AND-GROOVE WOOD FLOORING IN THE DINING ROOM. VIEW FACING NORTHEAST. - Hickam Field, Officers' Housing Type L, 702 Julian Avenue, Honolulu, Honolulu County, HI

  12. Acute asthma in emergency room.

    PubMed

    Chugh, Krishan

    2003-03-01

    Acute asthmatic exacerbation is one of the commonest emergencies seen in the pediatric age group. Viral infections are the most important triggers which set up the inflammatory reaction in the bronchial mucosa. GINA 2002 guidelines for assessing the severity and management are very useful for day to day practice. There is evidence to support the view that metered dose inhaler alongwith spaceor with or without mask is as effective as the standard doses of beta-2 agonists given by nebulizer. Ipratrpium bromide adds to the benefits of short acting beta-2 agonists. Systemic steroids should be started early. Early introduction of l/v beta-2 agonists and trial of l/v magnesium sulfate in non-responders have been recently recommended. Intravenous aminophylline can be tried in addition to full dose beta-2 agonists in those who reach the PICU. A close watch on the patient by monitoring clinical parameters, pulse oximeter, arterial blood gases and peak flow rate help in deciding whether there is need to further step up the therapy. Non-conventional measures like ketamine should be tried only under constant monitoring.

  13. Common questions about herpes: analysis of chat-room transcripts.

    PubMed

    Gilbert, Lisa K; Omisore, Folashade

    2009-01-01

    Patients diagnosed with genital herpes typically undergo a period of psychological adjustment. Although healthcare providers can play a key role in this adjustment, in several patient surveys patients have expressed dissatisfaction with the information and counselling offered by professionals. To address this gap, providers must first identify the common questions and myths that are not addressed, or are addressed inadequately. This article is that first step. Through a content analysis of herpes chat-room transcripts captured on their website from autumn 2001 to spring 2006, researchers from the American Social Health Association identified common herpes questions and myths. The 1968 chat passages were coded into 12 themes and 50 sub-themes. Frequently, visitors' questions concerned transmission, symptoms and diagnosis followed by natural history, psychosocial issues and treatment options. The results of this analysis will aid in the creation of tailored messages to address common factual questions and provide psychosocial support.

  14. Dedicated operating room for emergency surgery improves access and efficiency

    PubMed Central

    Heng, Marilyn; Wright, James G.

    2013-01-01

    Background Scheduling emergency cases among elective surgeries often results in prolonged waits for emergency surgery and delays or cancellation of elective cases. We evaluated the benefits of a dedicated operating room (OR) for emergency procedures available to all surgical services at a large children’s hospital. Methods We compared a 6-month period (January 2009 to June 2009) preimplementation with a 6-month period (January 2010 to June 2010) postimplementation of a dedicated OR. We evaluated OR use, wait times, percentage of cases done within and outside of access targets, off-hours surgery, cancellations, overruns and length of stay. Results Preimplementation, 1069 of the 5500 surgeries performed were emergency cases. Postimplementation, 1084 of the 5358 surgeries performed were emergency cases. Overall use of the dedicated OR was 53% (standard deviation 25%) postimplementation. Excluding outliers, the average wait time for priority 3 emergency patients decreased from 11 hours 8 minutes to 10 hours 5 minutes (p = 0.004). An increased proportion of priority 3 patients, from 52% to 58%, received surgery within 12 hours (p = 0.020). There was a 9% decrease in the proportion of priority 3 cases completed during the evening and night (p < 0.001). The elective surgical schedule benefited from the dedicated OR, with a significant decrease in cancellations (1.5% v. 0.7%, p < 0.001) and an accumulated decrease of 5211 minutes in overrun minutes in elective rooms. The average hospital stay after emergency surgery decreased from 16.0 days to 14.7 days (p = 0.12) following implementation of the dedicated OR. Conclusion A dedicated OR for emergency cases improved quality of care by decreasing cancellations and overruns in elective rooms and increasing the proportion of priority 3 patients who accessed care within the targeted time. PMID:23706847

  15. [Occupational exposure to enflurane and laughing gas in operating rooms].

    PubMed

    Hoerauf, K; Mayer, T; Hobbhahn, J

    1996-02-01

    Current scientific evidence suggests that chronic exposure to trace concentrations of anaesthetic gases may result in various forms of untoward health responses in operating room personnel. Although there are no clear dose-effect-relationships, in Germany threshold values (MAK-values) exist for nitrous oxide of 100 ppm and for enflurane of 20 ppm. Aim of this investigation was, to determine the exposure of the operating room personnel under modern working conditions using a standardized anaesthetic procedure. By means of a direct-reading, high sensitive gas monitor trace concentrations of nitrous oxide and enflurane were measured at three personnel-related (surgeon, anaesthetist, auxiliary nurse) and a potential leakage source (patient's mouth). The calculation and assessment of the measured concentrations followed the prescriptions of the technical rules for hazardous substances 402 and 403 (TRGS 402 and 403). The personnel-related concentrations were clearly under the MAK-values of 100 ppm nitrous oxide and/or 20 ppm enflurane. The time weighted averages were for the personnel-related measurement points, indicated in ppm for nitrous oxide and enflurane, respectively: "surgeon" 28.3/0.25, "anaesthetist" 39.3/0.34 and "auxiliary nurse" 64.6/0.57. At the leakage source "patient's mouth" time weighted averages of 317 ppm nitrous oxide and 3.79 ppm enflurane were measured. Under air-conditioning with a high air change rate, a central scavenging system and low leakage anaesthesia machine low trace concentrations of anaesthetic gases were measured. Despite an average contamination of approx. 300 ppm nitrous oxide at the "patient's mouth" personnel-related values remained clearly under the MAK-values. Outside the mainstream of the air-conditioning system the group "auxiliary nurse" had an approximately 30% higher exposure than the other groups. Under the described conditions, the working environment "operating room" can be classified as a low exposure working area. PMID

  16. 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

  17. Dyspnea in acute bronchial asthma in an emergency room.

    PubMed

    Kunitoh, H; Watanabe, K; Sajima, Y

    1994-03-01

    Pulmonary function, arterial blood gases, and pulse rate were prospectively compared with dyspnea perceived by patients before and after emergency room treatment for acute asthma in 83 episodes. Subjective degree of dyspnea was rated on a modified Borg scale. Before treatment, all spirometry (FVC, FEV1, and peak expiratory flow rate) and arterial blood gas (PaO2, PaCO2, and bicarbonate) data as well as pulse rate were significantly correlated with modified Borg scale, but only PaCO2 showed significant correlation (P < .001) in a multivariate analysis. After treatment, only PaO2 was significantly correlated with modified Borg scale (P = .008) in a multivariate analysis, and pulse rate showed correlation of borderline significance (P = .06). In another 37 episodes of relapsed acute asthma, the correlations between laboratory data and modified Borg scale were very weak, especially after treatment. We conclude that dyspnea expressed by asthmatic patients in an emergency room might be reflecting different mechanisms as treatment is performed. Although it should be one useful guide in emergency evaluation, it must be recognized that dyspnea in the same patient could mean different abnormalities.

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

    PubMed

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

    2015-01-01

    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

  19. 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.

  20. Exposure to Room Light before Bedtime Suppresses Melatonin Onset and Shortens Melatonin Duration in Humans

    PubMed Central

    Chamberlain, Kyle; Smith, Kurt A.; Khalsa, Sat Bir S.; Rajaratnam, Shantha M. W.; Van Reen, Eliza; Zeitzer, Jamie M.; Czeisler, Charles A.; Lockley, Steven W.

    2011-01-01

    Context: Millions of individuals habitually expose themselves to room light in the hours before bedtime, yet the effects of this behavior on melatonin signaling are not well recognized. Objective: We tested the hypothesis that exposure to room light in the late evening suppresses the onset of melatonin synthesis and shortens the duration of melatonin production. Design: In a retrospective analysis, we compared daily melatonin profiles in individuals living in room light (<200 lux) vs. dim light (<3 lux). Patients: Healthy volunteers (n = 116, 18–30 yr) were recruited from the general population to participate in one of two studies. Setting: Participants lived in a General Clinical Research Center for at least five consecutive days. Intervention: Individuals were exposed to room light or dim light in the 8 h preceding bedtime. Outcome Measures: Melatonin duration, onset and offset, suppression, and phase angle of entrainment were determined. Results: Compared with dim light, exposure to room light before bedtime suppressed melatonin, resulting in a later melatonin onset in 99.0% of individuals and shortening melatonin duration by about 90 min. Also, exposure to room light during the usual hours of sleep suppressed melatonin by greater than 50% in most (85%) trials. Conclusions: These findings indicate that room light exerts a profound suppressive effect on melatonin levels and shortens the body's internal representation of night duration. Hence, chronically exposing oneself to electrical lighting in the late evening disrupts melatonin signaling and could therefore potentially impact sleep, thermoregulation, blood pressure, and glucose homeostasis. PMID:21193540

  1. 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.

  2. 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)

  3. 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)

  4. 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.

  5. 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

  6. 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

  7. 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…

  8. 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

  9. ADM. Administration Building (TAN602). Early room layout, door and room ...

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

    ADM. Administration Building (TAN-602). Early room layout, door and room schedules. Ralph M. Parsons 902-2-ANP-602-A 31. Date: December 1952. Approved by INEEL Classification Office for public release. INEEL index code no. 033-0602-00-693-106710 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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...

  17. 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...

  18. Fire growth experiments: toward a standard room fire test

    SciTech Connect

    Williamson, R.B.; Fisher, F.L.

    1980-05-01

    The use of full-scale room fire experiments and the development of a standard room fire test are discussed. A series of room fire experiments with a gas burner ignition source, and gypsum wallboard, glass fiber insulation and plywood linings are described in detail. The results of the experiments are discussed in the context of a standard room fire test.

  19. 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...

  20. 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.

  1. 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

  2. 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....313 Print and bulk packaging rooms. Rooms used for packaging print or bulk butter and related products... contamination and maintain a reasonable room temperature in accordance with good commercial practices....

  3. 22 CFR 303.5 - Public reading room.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... records will be made available in the public reading room: (1) All final public opinions, including... 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...

  4. 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

  5. 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...

  6. 19 CFR 103.1 - Public reading rooms.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 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...

  7. 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... 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,...

  8. 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... 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...

  9. 13 CFR 102.2 - Public reading rooms.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 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...

  10. 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,...

  11. 18 CFR 1301.2 - Public reading rooms.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 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...

  12. 22 CFR 171.3 - Public reading room.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 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...

  13. 13 CFR 102.2 - Public reading rooms.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 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...

  14. 22 CFR 171.3 - Public reading room.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 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...

  15. 18 CFR 1301.2 - Public reading rooms.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true 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...

  16. 19 CFR 103.1 - Public reading rooms.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 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...

  17. 22 CFR 303.5 - Public reading room.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 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,...

  18. 19 CFR 103.1 - Public reading rooms.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 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...

  19. 18 CFR 1301.2 - Public reading rooms.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 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...

  20. 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... ACT § 303.5 Public reading room. (a) The Peace Corps will maintain a public reading room at its... following records will be made available in the public reading room: (1) All final public...

  1. 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...

  2. 13 CFR 102.2 - Public reading rooms.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 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...

  3. 18 CFR 1301.2 - Public reading rooms.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 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...

  4. 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...

  5. 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...

  6. 7 CFR 58.413 - Cutting and packaging rooms.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 3 2011-01-01 2011-01-01 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...

  7. 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…

  8. 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…

  9. 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.

  10. The Technique of the Film Cutting Room.

    ERIC Educational Resources Information Center

    Walter, Ernest

    This book is more concerned with the "physical" in contrast to the "artistic" problems of the editing process. The functions of the editor and his assistants in relation to each stage in the production of a large-scale film are described in detail. All the routine operations of the editing room are discussed, from the receipt and documentation of…

  11. 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.

  12. Tritium behavior intentionally released in the room

    SciTech Connect

    Kobayashi, K.; Hayashi, T.; Iwai, Y.; Yamanishi, T.; Willms, R. S.; Carlson, R. V.

    2008-07-15

    To construct a fusion reactor with high safety and acceptability, it is necessary to establish and to ensure tritium safe handling technology. Tritium should be well-controlled not to be released to the environment excessively and to prevent workers from excess exposure. It is especially important to grasp tritium behavior in the final confinement area, such as the room and/or building. In order to obtain data for actual tritium behavior in a room and/or building, a series of intentional Tritium Release Experiments (TREs) were planned and carried out within a radiologically controlled area (main cell) at Tritium System Test Assembly (TSTA) in Los Alamos National Laboratory (LANL) under US-JAPAN collaboration program. These experiments were carried out three times. In these experiments, influence of a difference in the tritium release point and the amount of hydrogen isotope for the initial tritium behavior in the room were suggested. Tritium was released into the main cell at TSTA/LANL. The released tritium reached a uniform concentration about 30 - 40 minutes in all the experiments. The influence of the release point and the amount of hydrogen isotope were not found to be important in these experiments. The experimental results for the initial tritium behavior in the room were also simulated well by the modified three-dimensional eddy flow analysis code FLOW-3D. (authors)

  13. 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)

  14. 32 CFR 701.6 - Reading rooms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... available electronically (starting 1 November 1997) as well as in hard copy, in the FOIA reading room for...) records shall be made available to the public, both in hard copy and electronically by 31 December 1999... inspection and copying, and by electronic means. Examples of “(a)(1)” materials are: descriptions of...

  15. 32 CFR 701.6 - Reading rooms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., online documents, and Navy electronic reading rooms maintained by SECNAV/CNO, CMC, OGC, JAG and Echelon 2... servers, the Navy FOIA website provides a common gateway for all Navy online resources. To this end, DON... clearly unwarranted invasions of privacy, or competitive harm to business submitters. In appropriate...

  16. 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.

  17. 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…

  18. 24 CFR 3285.502 - Expanding rooms.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 5 2014-04-01 2014-04-01 false Expanding rooms. 3285.502 Section 3285.502 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND......

  19. 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…

  20. 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.

  1. General Semantics in the Labor Room.

    ERIC Educational Resources Information Center

    Keller, Jo

    This paper provides a review of some basic general semantic principles and then applies them to the area of prenatal classes and labor room practices. It first presents an overview of the principle that language is not a neutral factor in human perceptions but an active, reactive force. Next, it looks at the relationship between language and…

  2. 7 CFR 58.408 - Brine room.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... AGRICULTURAL MARKETING ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) GRADING AND INSPECTION... readily cleanable. The brine room equipment shall be maintained in good repair and corrosion kept at...

  3. Followup Behavioral Research in Resource Rooms

    ERIC Educational Resources Information Center

    Glavin, John P.

    1973-01-01

    Five groups of approximately 50 children, grades 2 through 6, from each of five schools (four in low socioeconomic mostly black areas), originally referred for 1 or 2 years' support in a behaviorally oriented resource room, were followed up after regular class placement for 2 or 3 years. (MC)

  4. 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…

  5. 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" …

  6. 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.

  7. 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

  8. 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

  9. Strategies to maintain operating room functionality following the complete loss of the recovery room due to an internal disaster.

    PubMed

    Metzler, Elise C; Kodali, Bhavani S; Urman, Richard D; Flanagan, Hugh L; Rego, Monica Sa; Vacanti, Joshua C

    2015-01-01

    The post-anesthesia care unit (PACU) is a major contributor to the operating room (OR) process flow and efficiency. A sudden failure of hospital facility infrastructure due to a burst pipe resulted in the complete loss of a 66-bed combined preoperative and PACU facility of a major academic medical center. The OR suites were undamaged. The clinical and administrative challenges of caring for surgical patients without the usual preoperative and postoperative care areas are discussed. Our strategy for maintaining OR functions and management of patient flow, OR personnel, case prioritization, and equipment needs are detailed from the time of initial crisis until restoration of these clinical care areas. Utilization of the hospital disaster Incident Command Structure and the activation and decision support provided by the hospital Emergency Operations Center (EOC) for the week immediately following the crisis, helped maintain OR functionality.

  10. Strategies to maintain operating room functionality following the complete loss of the recovery room due to an internal disaster.

    PubMed

    Metzler, Elise C; Kodali, Bhavani S; Urman, Richard D; Flanagan, Hugh L; Rego, Monica Sa; Vacanti, Joshua C

    2015-01-01

    The post-anesthesia care unit (PACU) is a major contributor to the operating room (OR) process flow and efficiency. A sudden failure of hospital facility infrastructure due to a burst pipe resulted in the complete loss of a 66-bed combined preoperative and PACU facility of a major academic medical center. The OR suites were undamaged. The clinical and administrative challenges of caring for surgical patients without the usual preoperative and postoperative care areas are discussed. Our strategy for maintaining OR functions and management of patient flow, OR personnel, case prioritization, and equipment needs are detailed from the time of initial crisis until restoration of these clinical care areas. Utilization of the hospital disaster Incident Command Structure and the activation and decision support provided by the hospital Emergency Operations Center (EOC) for the week immediately following the crisis, helped maintain OR functionality. PMID:26102040

  11. [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

  12. [Interface interconnection and data integration in implementing of digital operating room].

    PubMed

    Feng, Jingyi; Chen, Hua; Liu, Jiquan

    2011-10-01

    The digital operating-room, with highly integrated clinical information, is very important for rescuing lives of patients and improving quality of operations. Since equipments in domestic operating-rooms have diversified interface and nonstandard communication protocols, designing and implementing an integrated data sharing program for different kinds of diagnosing, monitoring, and treatment equipments become a key point in construction of digital operating room. This paper addresses interface interconnection and data integration for commonly used clinical equipments from aspects of hardware interface, interface connection and communication protocol, and offers a solution for interconnection and integration of clinical equipments in heterogeneous environment. Based on the solution, a case of an optimal digital operating-room is presented in this paper. Comparing with the international solution for digital operating-room, the solution proposed in this paper is more economical and effective. And finally, this paper provides a proposal for the platform construction of digital perating-room as well as a viewpoint for standardization of domestic clinical equipments.

  13. 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

  14. 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.

  15. 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

  16. 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

  17. Imprinting bulk amorphous alloy at room temperature

    NASA Astrophysics Data System (ADS)

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

    2015-11-01

    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.

  18. 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.

  19. 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.

  20. Commander Collins in the White Room

    NASA Technical Reports Server (NTRS)

    1999-01-01

    STS-93 Commander Eileen M. Collins is checked out by white room closeout crew members before entering the orbiter Columbia. The white room is an environmental chamber at the end of the orbiter access arm that provides entry to the orbiter crew compartment. STS-93 is a five-day mission primarily to release the Chandra X- ray Observatory, which will allow scientists from around the world to study some of the most distant, powerful and dynamic objects in the universe. After Space Shuttle Columbia's July 20 and 22 launch attempts were scrubbed, the launch was again rescheduled for Friday, July 23, at 12:24 a.m. EDT. The target landing date is July 27 at 11:20 p.m. EDT.

  1. 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…

  2. Are emergency room physicians always employees?

    PubMed

    Tesdahl, D B

    1994-05-01

    The Internal Revenue Service (IRS) has recently increased its scrutiny of the worker classifications used by hospitals in arrangements with physicians for the provision of services (see "Reclassifying physicians as employees for Federal tax purposes," HEALTHCARE FINANCIAL MANAGEMENT, February 1994, pp. 38-44). In particular, emergency room physicians have been singled out by the IRS as a category of physicians who are often treated as independent contractors by hospitals but should, in the view of the IRS, be characterized as employees.

  3. 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.

  4. Teaching physics in the weight room

    NASA Astrophysics Data System (ADS)

    Barr, Alex

    2010-03-01

    Activities that take place outside the classroom can help keep students engaged by offering an unexpected experience while illustrating the physics involved in everyday phenomena. I will outline three lab activities from an Introduction to Physical Science class, two semi-quantitative activities on Newton's laws and a quantitative activity on the efficiency of the human body. Each of these activities takes place outside the classroom and involves equipment that available in many high school and university weight rooms.

  5. 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

  6. Priority coding for control room alarms

    DOEpatents

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

    1994-01-01

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

  7. 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.

  8. 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

  9. 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.

  10. Display Developer for Firing Room Applications

    NASA Technical Reports Server (NTRS)

    Bowman, Elizabeth A.

    2013-01-01

    The firing room at Kennedy Space Center (KSC) is responsible for all NASA human spaceflight launch operations, therefore it is vital that all displays within the firing room be properly tested, up-to-date, and user-friendly during a launch. The Ground Main Propulsion System (GMPS) requires a number of remote displays for Vehicle Integration and Launch (VIL) Operations at KSC. My project is to develop remote displays for the GMPS using the Display Services and Framework (DSF) editor. These remote displays will be based on model images provided by GMPS through PowerPoint. Using the DSF editor, the PowerPoint images can be recreated with active buttons associated with the correct Compact Unique Identifiers (CUIs). These displays will be documented in the Software Requirements and Design Specifications (SRDS) at the 90% GMPS Design Review. In the future, these remote displays will be available for other developers to improve, edit, or add on to so that the display may be incorporated into the firing room to be used for launches.

  11. 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.

  12. 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

  13. 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.

  14. Impact of terminal cleaning and disinfection on isolation of Acinetobacter baumannii complex from inanimate surfaces of hospital rooms by quantitative and qualitative methods.

    PubMed

    Manian, Farrin A; Griesnauer, Sandra; Senkel, Diane

    2013-04-01

    Quantitative broth cultures were obtained from hospital rooms newly vacated by patients positive for multidrug-resistant Acinetobacter baumannii complex (ABC) before and after terminal cleaning and disinfection. Of 10 ABC-positive precleaned room surfaces, 6 (60%) remained culture-positive after terminal cleaning and disinfection. Of a total of 16 room surfaces with detectable ABC by the quantitative method, 5 (31.2%; 95% confidence interval, 13.9%-55.8%) were also culture-positive by the qualitative technique.

  15. 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.

  16. The fluorescence camera: how to use fluorescein dye in a normally illuminated room.

    PubMed

    Myers, B; Guber, M; Donovan, W

    1983-03-01

    The Polaroid SX 70 Sonar camera has been modified so that it will produce instant photographs of the fluorescence of fluorescein in illuminated rooms. The camera was used to record the dye pattern in 40 rats and 65 patients. The photographic method proved to be as good as--but no better than--the visual one in predicting the viability of skin flaps. The camera eliminates the need to totally darken the room and use an ultraviolet lamp; it provides useful information to the surgeon and a permanent record for the chart.

  17. 28. VIEW OF FLAMMABLE TEST ROOM, LOCATED IN THE NORTHEAST ...

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

    28. VIEW OF FLAMMABLE TEST ROOM, LOCATED IN THE NORTHEAST CORNER OF SHIPPING AND STORAGE ROOM, 1923 ADDITION, FIRST FLOOR - Underwriters' Laboratories, 207-231 East Ohio Street, Chicago, Cook County, IL

  18. 26. GENERAL VIEW OF SHIPPING AND RECEIVING ROOM, 1923 ADDITION, ...

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

    26. GENERAL VIEW OF SHIPPING AND RECEIVING ROOM, 1923 ADDITION, FIRST FLOOR, LOOKING NORTHWEST. FLAMMABLE TEST ROOM IS ON EXTREME RIGHT - Underwriters' Laboratories, 207-231 East Ohio Street, Chicago, Cook County, IL

  19. 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

  20. 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

  1. 46 CFR 92.20-25 - Washrooms and toilet rooms.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 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....

  2. 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....

  3. 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....

  4. 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....

  5. 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....

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 9. INTERIOR, TOOL ROOM IN NORTHWEST CORNER OF 'CENTRAL NORTH ...

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

    9. INTERIOR, TOOL ROOM IN NORTHWEST CORNER OF 'CENTRAL NORTH WING,' FROM SOUTHEAST CORNER OF ROOM, LOOKING NORTHWEST. - Oakland Naval Supply Center, Lumber Storage & Box Factory, East of Fifth Street, between H & I Streets, Oakland, Alameda County, CA

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  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. 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

  2. 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

  3. 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

  4. 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

  5. DETAIL VIEW OF CUTTING ROOMS SHOWING CULLETT CHUTES FOR WASTE ...

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

    DETAIL VIEW OF CUTTING ROOMS SHOWING CULLETT CHUTES FOR WASTE GLASS, LOOKING EAST - Chambers Window Glass Company, Cutting Room, North of Drey (Nineteenth) Street, West of Constitution Boulevard, Arnold, Westmoreland County, PA

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 7. INTERIOR, CONFERENCE ROOM ON SOUTHWEST SIDE OF BUILDING, FROM ...

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

    7. INTERIOR, CONFERENCE ROOM ON SOUTHWEST SIDE OF BUILDING, FROM NEAR ENTRY TO ROOM, LOOKING NORTHWEST. - Oakland Naval Supply Center, Administrative Offices, On Seventh Street East of Maritime Street, Oakland, Alameda County, CA

  12. 39. VAL, DETAIL OF INTERIOR ROOM OF CONCRETE 'A' FRAME ...

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

    39. VAL, DETAIL OF INTERIOR ROOM OF CONCRETE 'A' FRAME STRUCTURE SHOWING NATURAL ROCK PROTRUDING THROUGH SLAB AT STORAGE ROOM. - Variable Angle Launcher Complex, Variable Angle Launcher, CA State Highway 39 at Morris Reservior, Azusa, Los Angeles County, CA

  13. 15. View of Ford Mansion's living room looking towards rear ...

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

    15. View of Ford Mansion's living room looking towards rear of house; scale is in back of room - Richmond Hill Plantation, Ford Mansion, East of Richmond Hill on Ford Neck Road, Richmond Hill, Bryan County, GA

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. 124. INTERIOR, SIXTH FLOOR, WING 6100 WEST, SUITE 6000, ROOM ...

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

    124. INTERIOR, SIXTH FLOOR, WING 6100 WEST, SUITE 6000, ROOM 6154, SUPPORT STAFF ROOM (FORMERLY STUDY) (4' x 5' negative; 8' x 10' print) - U.S. Department of the Interior, Eighteenth & C Streets Northwest, Washington, District of Columbia, DC

  20. 18. Process area room. Incinerator to the left. Filter boxes ...

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

    18. Process area room. Incinerator to the left. Filter boxes on the right. Looking north towards change room. - Plutonium Finishing Plant, Waste Incinerator Facility, 200 West Area, Richland, Benton County, WA

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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.

  7. Inactivation of poxviruses by upper-room UVC light in a simulated hospital room environment.

    PubMed

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

    2008-09-10

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

  8. 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

  9. In-room CT techniques for image-guided radiation therapy

    SciTech Connect

    Ma, C.-M. Charlie . E-mail: charlie.ma@fccc.edu; Paskalev, Kamen M.S.

    2006-04-01

    Accurate patient setup and target localization are essential to advanced radiation therapy treatment. Significant improvement has been made recently with the development of image-guided radiation therapy, in which image guidance facilitates short treatment course and high dose per fraction radiotherapy, aiming at improving tumor control and quality of life. Many imaging modalities are being investigated, including x-ray computed tomography (CT), ultrasound imaging, positron emission tomography, magnetic resonant imaging, magnetic resonant spectroscopic imaging, and kV/MV imaging with flat panel detectors. These developments provide unique imaging techniques and methods for patient setup and target localization. Some of them are different; some are complementary. This paper reviews the currently available kV x-ray CT systems used in the radiation treatment room, with a focus on the CT-on-rails systems, which are diagnostic CT scanners moving on rails installed in the treatment room. We will describe the system hardware including configurations, specifications, operation principles, and functionality. We will review software development for image fusion, structure recognition, deformation correction, target localization, and alignment. Issues related to the clinical implementation of in-room CT techniques in routine procedures are discussed, including acceptance testing and quality assurance. Clinical applications of the in-room CT systems for patient setup, target localization, and adaptive therapy are also reviewed for advanced radiotherapy treatments.

  10. 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

  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. The Influence of Room Design on Small Group Communication.

    ERIC Educational Resources Information Center

    Pendell, Sue Davis

    This study assessed the effect of room design on small-group communication patterns. Twenty-seven groups of three subjects each were assigned to nine types of rooms that differed with respect to shape, interior decoration, and other environmental elements. Subjects discussed a standard group-discussion topic. Data indicated that room design had no…

  13. 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

  14. 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

  15. 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

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 49 CFR Appendix D to Part 227 - Audiometric Test Rooms

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Test Rooms This appendix is mandatory. A. Rooms used for audiometric testing shall not have background...) and S.1.11-2004 in this section in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. You may obtain a... 49 Transportation 4 2014-10-01 2014-10-01 false Audiometric Test Rooms D Appendix D to Part...

  3. 49 CFR Appendix D to Part 227 - Audiometric Test Rooms

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Test Rooms This appendix is mandatory. A. Rooms used for audiometric testing shall not have background...) and S.1.11-2004 in this section in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. You may obtain a... 49 Transportation 4 2013-10-01 2013-10-01 false Audiometric Test Rooms D Appendix D to Part...

  4. 49 CFR Appendix D to Part 227 - Audiometric Test Rooms

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Test Rooms This appendix is mandatory. A. Rooms used for audiometric testing shall not have background...) and S.1.11-2004 in this section in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. You may obtain a... 49 Transportation 4 2012-10-01 2012-10-01 false Audiometric Test Rooms D Appendix D to Part...

  5. 46 CFR 69.121 - Engine room deduction.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 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...

  6. 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...

  7. 10 CFR 429.15 - Room air conditioners.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 3 2013-01-01 2013-01-01 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...

  8. 10 CFR 429.15 - Room air conditioners.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 3 2012-01-01 2012-01-01 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...

  9. 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...

  10. 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...

  11. 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

  12. 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

  13. 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

  14. 9 CFR 354.241 - Cleaning of rooms and compartments.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... skinning room shall be kept clean and free from offensive odors at all times. (g) The walls, floors, and all equipment and utensils used in the killing and skinning room shall be thoroughly washed and cleaned after each day's operation. (h) The floor in the killing and skinning rooms shall be...

  15. 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

  16. 29 CFR 779.113 - Warehouse and stock room employees.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 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...

  17. 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

  18. 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...

  19. 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

  20. 49 CFR 195.446 - Control room management.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 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...