An observational study of the temporal and spatial patterns of Marek's-disease-associated leukosis condemnation of young chickens in the United States of America

USDA-ARS?s Scientific Manuscript database

Marek's disease, a disease primarily affecting immature chickens, is a worldwide problem that has on at least three occasions threatened the poultry industry in the United States. A rich dataset to study the epidemiology of this disease is available because the United States Department of Agricultu...

Understanding Behavior Disorders: Their Perception, Acceptance, and Treatment--A Cross-Cultural Comparison between India and the United States

ERIC Educational Resources Information Center

Chakraborti-Ghosh, Sumita

2008-01-01

The purpose of this study was to explore the perceptions, identification and treatment of students with behavior problems or disorders in India and the United States. Participants in the study were students and teachers in the United States and India. A qualitative approach included in-depth interviews and participant observations. These were…

Innervation zones of fasciculating motor units: observations by a linear electrode array

PubMed Central

Jahanmiri-Nezhad, Faezeh; Barkhaus, Paul E.; Rymer, William Z.; Zhou, Ping

2015-01-01

This study examines the innervation zone (IZ) in the biceps brachii muscle in healthy subjects and those with amyotrophic lateral sclerosis (ALS) using a 20-channel linear electromyogram (EMG) electrode array. Raster plots of individual waveform potentials were studied to estimate the motor unit IZ. While this work mainly focused on fasciculation potentials (FPs), a limited number of motor unit potentials (MUPs) from voluntary activity of 12 healthy and seven ALS subjects were also examined. Abnormal propagation of MUPs and scattered IZs were observed in fasciculating units, compared with voluntarily activated MUPs in healthy and ALS subjects. These findings can be related to muscle fiber reinnervation following motor neuron degeneration in ALS and the different origin sites of FPs compared with voluntary MUPs. PMID:26029076

Time use and physical activity in a specialised brain injury rehabilitation unit: an observational study.

PubMed

Hassett, Leanne; Wong, Siobhan; Sheaves, Emma; Daher, Maysaa; Grady, Andrew; Egan, Cara; Seeto, Carol; Hosking, Talia; Moseley, Anne

2018-04-18

To determine what is the use of time and physical activity in people undertaking inpatient rehabilitation in a specialised brain injury unit. To determine participants' level of independence related to the use of time and physical activity. Design: Cross-sectional observation study. Fourteen people [mean (SD) age 40 (15) years] with brain injuries undertaking inpatient rehabilitation. Participants were observed every 12 minutes over 5 days (Monday to Friday from 7:30 am until 7:30 pm) using a behaviour mapping tool. Observation of location, people present, body position and activity engaged in (both therapeutic and nontherapeutic). Functional Independence Measure (FIM) scores were determined for each participant. Participants spent a large part of their time alone (34%) in sedentary positions (83%) and in their bedrooms (48%) doing non-therapeutic activities (78%). There was a positive relationship between a higher level of independence (higher FIM score) and being observed in active body positions (r=0.60; p=0.03) and participating in physically active therapeutic activities (r=0.53; p=0.05). Similar to stroke units, inpatients in a specialised brain injury unit spend large parts of the day sedentary, alone and doing non-therapeutic activities. Strategies need to be evaluated to address this problem, particularly for people with greater physical dependence.

Vastus Lateralis Motor Unit Firing Rate Is Higher in Women With Patellofemoral Pain.

PubMed

Gallina, Alessio; Hunt, Michael A; Hodges, Paul W; Garland, S Jayne

2018-05-01

To compare neural drive, determined from motor unit firing rate, in the vastus medialis and lateralis in women with and without patellofemoral pain. Cross-sectional study. University research laboratory. Women (N=56) 19 to 35 years of age, including 36 with patellofemoral pain and 20 controls. Not applicable. Participants sustained an isometric knee extension contraction at 10% of their maximal voluntary effort for 70 seconds. Motor units (N=414) were identified using high-density surface electromyography. Average firing rate was calculated between 5 and 35 seconds after recruitment for each motor unit. Initial firing rate was the inverse of the first 3 motor unit interspike intervals. In control participants, vastus medialis motor units discharged at higher rates than vastus lateralis motor units (P=.001). This was not observed in women with patellofemoral pain (P=.78) because of a higher discharge rate of vastus lateralis compared with control participants (P=.002). No between-group differences were observed for vastus medialis (P=.93). Similar results were obtained for the initial motor unit firing rate. These findings suggest that women with patellofemoral pain have a higher neural drive to vastus lateralis but not vastus medialis, which may be a contributor of the altered patellar kinematics observed in some studies. The different neural drive may be an adaptation to patellofemoral pain, possibly to compensate for decreased quadriceps force production, or a precursor of patellofemoral pain. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Physical Activity Patterns of Acute Stroke Patients Managed in a Rehabilitation Focused Stroke Unit

PubMed Central

2013-01-01

Background. Comprehensive stroke unit care, incorporating acute care and rehabilitation, may promote early physical activity after stroke. However, previous information regarding physical activity specific to the acute phase of stroke and the comprehensive stroke unit setting is limited to one stroke unit. This study describes the physical activity undertaken by patients within 14 days after stroke admitted to a comprehensive stroke unit. Methods. This study was a prospective observational study. Behavioural mapping was used to determine the proportion of the day spent in different activities. Therapist reports were used to determine the amount of formal therapy received on the day of observation. The timing of commencement of activity out of bed was obtained from the medical records. Results. On average, patients spent 45% (SD 25) of the day in some form of physical activity and received 58 (SD 34) minutes per day of physiotherapy and occupational therapy combined. Mean time to first mobilisation out of bed was 46 (SD 32) hours post-stroke. Conclusions. This study suggests that commencement of physical activity occurs earlier and physical activity is at a higher level early after stroke in this comprehensive stroke unit, when compared to studies of other acute stroke models of care. PMID:24024192

Washington's "free" 300-station microscale weather network

Treesearch

Thomas Blackburn

1977-01-01

This article is intended to encourage those planning to conduct meso- or microscale weather studies to supplement their sophisticated observing techniques and equipment- with low-cost observations taken by volunteers. Such observations can often show high benefits per unit costs in expanding the geographical area of study, increasing the density of observations, or in...

Observational Learning among Older Adults Living in Nursing Homes

ERIC Educational Resources Information Center

Story, Colleen D.

2010-01-01

The purpose of this study was to evaluate learning by older adults living in nursing homes through observational learning based on Bandura's (1977) social learning theory. This quantitative study investigated if older adults could learn through observation. The nursing homes in the study were located in the midwestern United States. The…

Training adaptations in the behavior of human motor units.

PubMed

Duchateau, Jacques; Semmler, John G; Enoka, Roger M

2006-12-01

The purpose of this brief review is to examine the neural adaptations associated with training, by focusing on the behavior of single motor units. The review synthesizes current understanding on motor unit recruitment and rate coding during voluntary contractions, briefly describes the techniques used to record motor unit activity, and then evaluates the adaptations that have been observed in motor unit activity during maximal and submaximal contractions. Relatively few studies have directly compared motor unit behavior before and after training. Although some studies suggest that the voluntary activation of muscle can increase slightly with strength training, it is not known how the discharge of motor units changes to produce this increase in activation. The evidence indicates that the increase is not attributable to changes in motor unit synchronization. It has been demonstrated, however, that training can increase both the rate of torque development and the discharge rate of motor units. Furthermore, both strength training and practice of a force-matching task can evoke adaptations in the discharge characteristics of motor units. Because the variability in discharge rate has a significant influence on the fluctuations in force during submaximal contractions, the changes produced with training can influence motor performance during activities of daily living. Little is known, however, about the relative contributions of the descending drive, afferent feedback, spinal circuitry, and motor neuron properties to the observed adaptations in motor unit activity.

To What Behaviors Do Attending Adults Respond? A Replication.

ERIC Educational Resources Information Center

Felce, David; And Others

1987-01-01

In a replication of a study by Warren and Mondy (1971), staff responses to severely mentally retarded adults (N=90) in institutional units, large community units, and small community houses in the United Kingdom were observed. Staff in small community houses showed a greater level of encouragement of appropriate behavior. (Author/JW)

Finding a Middle Ground: Exploring the Impact of Patient- and Family-Centered Design on Nurse-Family Interactions in the Neuro ICU.

PubMed

Rippin, Allyn S; Zimring, Craig; Samuels, Owen; Denham, Megan E

2015-01-01

This comparative study of two adult neuro critical care units examined the impact of patient- and family-centered design on nurse-family interactions in a unit designed to increase family involvement. A growing evidence base suggests that the built environment can facilitate the delivery of patient- and family-centered care (PFCC). However, few studies examine how the PFCC model impacts the delivery of care, specifically the role of design in nurse-family interactions in the adult intensive care unit (ICU) from the perspective of the bedside nurse. Two neuro ICUs with the same patient population and staff, but with different layouts, were compared. Structured observations were conducted to assess changes in the frequency, location, and content of interactions between the two units. Discussions with staff provided additional insights into nurse attitudes, perceptions, and experiences caring for families. Nurses reported challenges balancing the needs of many stakeholders in a complex clinical environment, regardless of unit layout. However, differences in communication patterns between the clinician- and family-centered units were observed. More interactions were observed in nurse workstations in the PFCC unit, with most initiated by family. While the new unit was seen as more conducive to the delivery of PFCC, some nurses reported a loss of workspace control. Patient- and family-centered design created new spatial and temporal opportunities for nurse-family interactions in the adult ICU, thus supporting PFCC goals. However, greater exposure to unplanned family encounters may increase nurse stress without adequate spatial and organizational support. © The Author(s) 2015.

A portable digital microphotography unit for rapid documentation of periungual nailfold capillary changes in autoimmune connective tissue diseases.

PubMed

Sontheimer, Richard D

2004-03-01

While employing a DermLite dermoscopy unit to assess pigment pattern networks in melanocytic skin lesions, it was observed that this compact, portable dermoscopy unit can also be used to quickly detect nailfold capillary changes when entertaining a diagnosis of autoimmune connective tissue diseases (CTD) such as dermatomyositis (DM), scleroderma/systemic sclerosis (SSc), or systemic lupus erythematosus. Aware that the suppliers of the DermLite dermoscopy unit also market a portable digital microphotography unit based on the DermLite optical principles for efficiently documenting cutaneous pigment network patterns, we investigated whether this unit (DermLite Foto flash unit attached to a Nikon Coolpix digital camera) might be used to photographically document nailfold capillary changes in patients with autoimmune CTD. A DermLite Foto flash unit attached to a Nikon Coolpix digital camera was used in a controlled observational study to obtain digital photographs of nailfold capillaries in a small sequential sample of patients with autoimmune CTD attending a rheumatic skin disease subspecialty clinic in an academic department of dermatology. The digital microphotography system proved to be highly useful in documenting the nailfold vascular changes observed in a small sample of patients with DM. We observed that the nailfold capillary changes seen in patients with clinically amyopathic DM were qualitatively and quantitatively similar to those seen in patients with classical DM. Digital microphotography systems designed for examining pigmented skin lesions can be used easily to document nailfold capillary changes often observed in DM and SSc. Nailfold capillary changes documented in this manner appear to be indistinguishable in clinically amyopathic DM and classical DM.

The effect of hospital unit layout on nurse walking behavior.

PubMed

Yi, Lu; Seo, Hyun-Bo

2012-01-01

To confirm a new method for the research question, "How do different hospital unit layouts affect nurses' walking behavior and distance?" Concern is renewed regarding nurses' long walking distances because of the trend toward larger patient rooms with family areas inside, resulting in a larger overall unit size. Studies have found unit design characteristics that support nurses' efficient walking, but few have done it in units designed for patient- and family-centered care. To examine the effect of unit design on nurses' walking behavior, the authors propose a new method of observing a specific task. The authors observed nurses during the task of medication administration. Contrary to their hypotheses, results showed: (1) Experienced nurses had more unnecessary stops and longer walking distances than new nurses because of interactions; and (2) nurses in the smaller wing of the unit walked more than those in the larger wing of the same unit. The authors posit that the closeness between the nurses' path to the medication supply room and the central nurses' station affected the frequency of interactions and prompted a deviation from the shortest and most efficient path during medication administration. Observing a specific task to identify the effect of unit layout was effective, determining that overall unit shape or unit layout type might not be a good predictor of nurses' walking behavior; instead the characteristics of the path that connects functional spaces such as patient room and medication area might better predict nurses' walking behavior.

Searching the Sinus Amoris: Using profiles of geological units, impact and volcanic features to characterize a major terrane interface on the Moon

NASA Technical Reports Server (NTRS)

Clark, P.; Joerg, S.; Dehon, R.

1994-01-01

Geochemical profiles of surface units, impact, and volcanic features are studied in detail to determine the underlying structure in an area of extensive mare/highland interface, Sinus Amoris. This study region includes and surrounds the northeastern embayment of Mare Tranquillitatis. The concentrations of two major rock-forming elements (Mg and Al), which were derived from the Apollo 15 orbital geochemical measurements, were used in this study. Mapped units and deposits associated with craters in the northwestern part of the region tend to have correlated low Mg and Al concentrations, indicating the presence of Potassium (K)-Rare Earth Elements (REE)-Phosphorus (P) (KREEP)-enriched basalt. Found along the northeastern rim of Tranquillitatis were areas with correlated high Mg and Al concentration, indicating the presence of troctolite. Distinctive west/east and north/south trends were observed in the concentrations of Mg and Al, and, by implication, in the distribution of major rock components on the surface. Evidence for a systematic geochemical transition in highland or basin-forming units may be observed here in the form of distinctive differences in chemistry in otherwise similar units in the western and eastern portions of the study region.

The role of photogeologic mapping in traverse planning: Lessons from DRATS 2010 activities

USGS Publications Warehouse

Skinner, James A.; Fortezzo, Corey M.

2013-01-01

We produced a 1:24,000 scale photogeologic map of the Desert Research and Technology Studies (DRATS) 2010 simulated lunar mission traverse area and surrounding environments located within the northeastern part of the San Francisco Volcanic Field (SFVF), north-central Arizona. To mimic an exploratory mission, we approached the region “blindly” by rejecting prior knowledge or preconceived notions of the regional geologic setting and focused instead only on image and topographic base maps that were intended to be equivalent to pre-cursor mission “orbital returns”. We used photogeologic mapping techniques equivalent to those employed during the construction of modern planetary geologic maps. Based on image and topographic base maps, we identified 4 surficial units (talus, channel, dissected, and plains units), 5 volcanic units (older cone, younger cone, older flow, younger flow, and block field units), and 5 basement units (grey-toned mottled, red-toned platy, red-toned layered, light-toned slabby, and light-toned layered units). Comparison of our remote-based map units with published field-based map units indicates that the two techniques yield pervasively similar results of contrasting detail, with higher accuracies linked to remote-based units that have high topographic relief and tonal contrast relative to adjacent units. We list key scientific questions that remained after photogeologic mapping and prior to DRATS activities and identify 13 specific observations that the crew and science team would need to make in order to address those questions and refine the interpreted geologic context. We translated potential observations into 62 recommended sites for visitation and observation during the mission traverse. The production and use of a mission-specific photogeologic map for DRATS 2010 activities resulted in strategic and tactical recommendations regarding observational context and hypothesis tracking over the course of an exploratory mission.

Effect of advanced age and vital signs on admission from an ED observation unit.

PubMed

Caterino, Jeffrey M; Hoover, Emily M; Moseley, Mark G

2013-01-01

The primary objective was to determine the relationship between advanced age and need for admission from an emergency department (ED) observation unit. The secondary objective was to determine the relationship between initial ED vital signs and admission. We conducted a prospective, observational cohort study of ED patients placed in an ED-based observation unit. Multivariable penalized maximum likelihood logistic regression was used to identify independent predictors of need for hospital admission. Age was examined continuously and at a cutoff of 65 years or more. Vital signs were examined continuously and at commonly accepted cutoffs.We additionally controlled for demographics, comorbid conditions, laboratory values, and observation protocol. Three hundred patients were enrolled, 12% (n = 35) were 65 years or older, and 11% (n = 33) required admission. Admission rates were 2.9% (95% confidence interval [CI], 0.07%-14.9%) in older adults and 12.1% (95% CI, 8.4%-16.6%) in younger adults. In multivariable analysis, age was not associated with admission (odds ratio [OR], 0.30; 95% CI, 0.05-1.67). Predictors of admission included systolic pressure 180 mm Hg or greater (OR, 4.19; 95% CI, 1.08-16.30), log Charlson comorbidity score (OR, 2.93; 95% CI, 1.57-5.46), and white blood cell count 14,000/mm(3) or greater (OR, 11.35; 95% CI, 3.42-37.72). Among patients placed in an ED observation unit, age 65 years or more is not associated with need for admission. Older adults can successfully be discharged from these units. Systolic pressure 180 mm Hg or greater was the only predictive vital sign. In determining appropriateness of patients selected for an ED observation unit, advanced age should not be an automatic disqualifying criterion. Copyright © 2013 Elsevier Inc. All rights reserved.

Effect of advanced age and vital signs on admission from an emergency department observation unit

PubMed Central

Caterino, Jeffrey M.; Hoover, Emily; Moseley, Mark G.

2012-01-01

Objectives The primary objective was to determine the relationship between advanced age and need for admission from an emergency department (ED) observation unit. The secondary objective was to determine the relationship between initial ED vital signs and admission. Methods We conducted a prospective, observational cohort study of ED patients placed in an ED-based observation unit. Multivariable penalized maximum likelihood logistic regression was used to identify independent predictors of need for hospital admission. Age was examined continuously and at a cutoff of ≥65 years. Vital signs were examined continuously and at commonly accepted cutoffs. We additionally controlled for demographics, co-morbid conditions, laboratory values, and observation protocol. Results Three hundred patients were enrolled, 12% (n=35) ≥65 years old and 11% (n=33) requiring admission. Admission rates were 2.9% (95% confidence interval [CI], 0.07-14.9%) in older adults and 12.1% (95% CI, 8.4-16.6%) in younger adults. In multivariable analysis, age was not associated with admission (odds ratio [OR] 0.30, 95% CI 0.05-1.67). Predictors of admission included: systolic pressure ≥180 mmHg (OR 4.19, 95% CI 1.08-16.30), log Charlson co-morbidity score (OR 2.93, 95% CI 1.57-5.46), and white blood cell count ≥14,000/mm3 (OR11.35, 95% CI 3.42-37.72). Conclusions Among patients placed in an ED observation unit, age ≥65 years is not associated with need for admission. Older adults can successfully be discharged from these units. Systolic pressure≥180 mmHg was the only predictive vital sign. In determining appropriateness of patients selected for an ED observation unit, advanced age should not be an automatic disqualifying criterion. PMID:22386358

A multilevel study on the association of observer-assessed working conditions with depressive symptoms among female eldercare workers from 56 work units in 10 care homes in Denmark

PubMed Central

Jakobsen, Louise M; Jorgensen, Anette F B; Thomsen, Birthe L; Greiner, Birgit A; Rugulies, Reiner

2015-01-01

Objectives Eldercare workers in Denmark have a higher prevalence of poor psychological health than other occupational groups. We examined the association between working conditions assessed by trained observers and depressive symptoms assessed by self-report in a study of female Danish eldercare workers. Methods Working conditions were observed based on action regulation theory and defined as (1) regulation requirements, a workplace resource providing opportunity for decision-making and skill development and (2) barriers for task completion. We examined the associations of individual and work unit averaged working conditions with depressive symptoms in a sample of 95 individually observed eldercare workers. Further, we examined the association of work unit averaged working conditions with depressive symptoms in a sample of 205 care workers, including both observed and non-observed individuals. We used regression models that allowed for correlations within work units and care homes and adjusted these models for demographics, job characteristics and stressful life events. Results Higher levels of regulation requirements were associated with lower depressive symptoms at the individual level (p=0.04), but not at the workplace level. Barriers were not associated with depressive symptoms at the individual level. At the workplace level, a higher number of qualitatively different barriers (p=0.04) and a higher number of barriers for equipment use (p=0.03) were associated with lower levels of depressive symptoms in the age and cohabitation adjusted model, however statistical significance was lost in the fully adjusted model. Conclusions Low level of regulation requirements was associated with a high level of depressive symptoms. The study highlights the importance of examining both individual and workplace levels of working conditions. PMID:26560058

Hydrolyzable tannins with the hexahydroxydiphenoyl unit and the m-depsidic link: HPLC-DAD-MS identification and model synthesis.

PubMed

Arapitsas, Panagiotis; Menichetti, Stefano; Vincieri, Franco F; Romani, Annalisa

2007-01-10

This study was designed to develop efficient analytical tools for the difficult HPLC-DAD-MS identification of hydrolyzable tannins in natural tissue extracts. Throughout the study of the spectroscopic characteristics of properly synthesized stereodefined standards, it was observed that the UV-vis spectra of compounds with the m-depsidic link showed a characteristic shoulder at 300 nm, consistent with the simple glucogalloyl esters, whereas compounds with the hexahydroxydiphenoyl (HHDP) unit gave a diagnostic fragmentation pattern, caused by a spontaneous lactonization in the mass spectrometer. These observations were confirmed by HPLC-DAD-MS analyses of tannic acid and raspberry extracts, which are rich in hydrolyzable tannins with the m-depsidic link and the HHDP unit, respectively.

Transformational leadership training programme for charge nurses.

PubMed

Duygulu, Sergul; Kublay, Gulumser

2011-03-01

This paper is a report of an evaluation of the effects of a transformational leadership training programme on Unit Charge Nurses' leadership practices. Current healthcare regulations in the European Union and accreditation efforts of hospitals for their services mandate transformation in healthcare services in Turkey. Therefore, the transformational leadership role of nurse managers is vital in determining and achieving long-term goals in this process. The sample consisted of 30 Unit Charge Nurses with a baccalaureate degree and 151 observers at two university hospitals in Turkey. Data were collected using the Leadership Practices Inventory-Self and Observer (applied four times during a 14-month study process from December 2005 to January 2007). The transformational leadership training programme had theoretical (14 hours) and individual study (14 hours) in five sections. Means, standard deviations and percentages, repeated measure tests and two-way factor analysis were used for analysis. According the Leadership Practices Inventory-Self and Observer ratings, leadership practices increased statistically significantly with the implementation of the programme. There were no significant differences between groups in age, length of time in current job and current position. The Unit Charge Nurses Leadership Practices Inventory self-ratings were significantly higher than those of the observers. There is a need to develop similar programmes to improve the leadership skills of Unit Charge Nurses, and to make it mandatory for nurses assigned to positions of Unit Charge Nurse to attend this kind of leadership programme. © 2010 Blackwell Publishing Ltd.

Waterworks: A K-3 Integrated Unit on Water and the Community.

ERIC Educational Resources Information Center

Caldwell, John R.

1991-01-01

An integrated unit that combines the areas of science, social studies, and art is described. Water and land environment, the community, and folk arts are reflected in the unit. Activities include measuring water and air parameters, netting and seining, observation of a stream and the land around it, writing and picture journals, and media…

Effect of inhomogeneity of light from light curing units on the surface hardness of composite resin.

PubMed

Arikawa, Hiroyuki; Kanie, Takahito; Fujii, Koichi; Takahashi, Hideo; Ban, Seiji

2008-01-01

This study investigated the characteristics of output light from different types of light curing units, and their effects on polymerization of light-activated composite resin. Three quartz-tungsten-halogen lamps, one plasma arc lamp, and one LED light curing unit were used. Intensity distribution of light emitted from the light guide tip was measured at 1.0-mm intervals across the guide tip. Distribution of Knoop hardness number on the surface of resin irradiated with the light curing units was also measured. For all units, inhomogeneous distribution of light intensity across the guide tip was observed. Minimum light intensity values were 19-80% of the maximum values. In terms of surface hardness, inhomogeneous distribution was also observed for the materials irradiated with the tested units. Minimum values were 53-92% of the maximum values. Our results indicated that markedly inhomogeneous light emitted from light curing unit could result in inhomogeneous polymerization in some areas of the restoration below the light guide tip.

Health beliefs toward cardiovascular risk reduction in patients admitted to chest pain observation units.

PubMed

Katz, David A; Graber, Mark; Birrer, Emily; Lounsbury, Patricia; Baldwin, Austin; Hillis, Stephen L; Christensen, Alan J

2009-05-01

Even after acute coronary syndrome (ACS) is ruled out, observational studies have suggested that many patients with nonspecific chest pain have a high burden of cardiovascular risk factors (CRFs) and are at increased long-term risk of ischemic heart disease (IHD)-related mortality. The aim of this study was to evaluate the premise that evaluation in an observation unit for symptoms of possible ACS is a "teachable moment" with regard to modification of CRFs. The authors conducted a baseline face-to-face interview and a 3-month telephone interview of 83 adult patients with at least one modifiable CRF who presented with symptoms of possible ACS to an academic medical center. Existing questionnaires were adapted to measure Health Belief Model (HBM) constructs for IHD. Stage of change and self-reported CRF-related behaviors (diet, exercise, and smoking) were assessed using previously validated measures. The paired t-test or signed rank test was used to compare baseline and 3-month measures of health behavior within the analysis sample. Of the 83 study patients, 45 and 40% reported having received clinician advice regarding diet and physical activity during the observation unit encounter, respectively; 69% of current smokers received advice to quit smoking. Patients reported lower susceptibility to IHD (13.3 vs. 14.0, p = 0.06) and greater perceived benefit of healthy lifestyles (27.5 vs. 26.4, p = 0.0003) at 3-month follow-up compared to baseline. Patients also reported greater readiness to change and improved self-reported behaviors at follow-up (vs. baseline): decreased intake of saturated fat (10.1% vs. 10.5% of total calories, p = 0.005), increased fruit and vegetable intake (4.0 servings/day vs. 3.6 servings/day, p = 0.01), and fewer cigarettes (13 vs. 18, p = 0.002). Observed changes in IHD health beliefs and CRF-related behaviors during follow-up support the idea that observation unit admission is a teachable moment. Patients with modifiable risk factors may benefit from systematic interventions to deliver CRF-related counseling during observation unit evaluation.

The compensatory interaction between motor unit firing behavior and muscle force during fatigue

PubMed Central

De Luca, Carlo J.; Kline, Joshua C.

2016-01-01

Throughout the literature, different observations of motor unit firing behavior during muscle fatigue have been reported and explained with varieties of conjectures. The disagreement amongst previous studies has resulted, in part, from the limited number of available motor units and from the misleading practice of grouping motor unit data across different subjects, contractions, and force levels. To establish a more clear understanding of motor unit control during fatigue, we investigated the firing behavior of motor units from the vastus lateralis muscle of individual subjects during a fatigue protocol of repeated voluntary constant force isometric contractions. Surface electromyographic decomposition technology provided the firings of 1,890 motor unit firing trains. These data revealed that to sustain the contraction force as the muscle fatigued, the following occurred: 1) motor unit firing rates increased; 2) new motor units were recruited; and 3) motor unit recruitment thresholds decreased. Although the degree of these adaptations was subject specific, the behavior was consistent in all subjects. When we compared our empirical observations with those obtained from simulation, we found that the fatigue-induced changes in motor unit firing behavior can be explained by increasing excitation to the motoneuron pool that compensates for the fatigue-induced decrease in muscle force twitch reported in empirical studies. Yet, the fundamental motor unit control scheme remains invariant throughout the development of fatigue. These findings indicate that the central nervous system regulates motor unit firing behavior by adjusting the operating point of the excitation to the motoneuron pool to sustain the contraction force as the muscle fatigues. PMID:27385798

The compensatory interaction between motor unit firing behavior and muscle force during fatigue.

PubMed

Contessa, Paola; De Luca, Carlo J; Kline, Joshua C

2016-10-01

Throughout the literature, different observations of motor unit firing behavior during muscle fatigue have been reported and explained with varieties of conjectures. The disagreement amongst previous studies has resulted, in part, from the limited number of available motor units and from the misleading practice of grouping motor unit data across different subjects, contractions, and force levels. To establish a more clear understanding of motor unit control during fatigue, we investigated the firing behavior of motor units from the vastus lateralis muscle of individual subjects during a fatigue protocol of repeated voluntary constant force isometric contractions. Surface electromyographic decomposition technology provided the firings of 1,890 motor unit firing trains. These data revealed that to sustain the contraction force as the muscle fatigued, the following occurred: 1) motor unit firing rates increased; 2) new motor units were recruited; and 3) motor unit recruitment thresholds decreased. Although the degree of these adaptations was subject specific, the behavior was consistent in all subjects. When we compared our empirical observations with those obtained from simulation, we found that the fatigue-induced changes in motor unit firing behavior can be explained by increasing excitation to the motoneuron pool that compensates for the fatigue-induced decrease in muscle force twitch reported in empirical studies. Yet, the fundamental motor unit control scheme remains invariant throughout the development of fatigue. These findings indicate that the central nervous system regulates motor unit firing behavior by adjusting the operating point of the excitation to the motoneuron pool to sustain the contraction force as the muscle fatigues. Copyright © 2016 the American Physiological Society.

Elements of Leading Collegiate Choral Programs in the United States

ERIC Educational Resources Information Center

Garrett, Jennifer M.

2010-01-01

This study explored the attributes of three leading choral programs in the United States using interview and observation data. It extrapolated attributes from case studies of highly respected programs located at St. Olaf College, the University of Southern California (USC), and Florida State University (FSU). The first attribute identified at each…

A longitudinal ecological study of seasonal influenza deaths in relation to climate conditions in the United States from 1999 through 2011.

PubMed

Geier, David A; Kern, Janet K; Geier, Mark R

2018-01-01

Introduction: Influenza is an acute respiratory disease with significant annual global morbidity/mortality. Influenza transmission occurs in distinct seasonal patterns suggesting an importance of climate conditions on disease pathogenesis. This hypothesis-testing study evaluated microenvironment conditions within different demographic/geographical groups on seasonal influenza deaths in the United States. Materials and methods: The United States Centers for Disease Control and Prevention (CDC) Wonder online computer interface was utilized to integrate and analyze potential correlations in data generated from 1999 through 2011 for climate conditions of mean daily sunlight (KJ/m 2 ), mean daily maximum air temperature ( o C), mean daily minimum air temperature ( o C), and mean daily precipitation (mm) from the North America Land Data Assimilation System (NLDAS) database and on influenza mortality (ICD-10 codes:J09, J10, or J11) from the Underlying Cause of Death database. Results and discussion: Significant inverse correlations between the climate conditions of temperature, sunlight, and precipitation and seasonal influenza death rate were observed. Similar effects were observed among males and females, but when the data were separated by race and urbanization status significant differences were observed. Conclusion: This study highlights key factors that can help shape public health policy to deal with seasonal influenza in the United States and beyond.

The Origin of Ina: Evidence for Inflated Lava Flows on the Moon

NASA Technical Reports Server (NTRS)

Garry, W. B.; Robinson, M. S.; Zimbelman, J. R.; Bleacher, J. E.; Hawke, B. R.; Crumpler, L. S.; Braden, S. E.; Sato, H.

2012-01-01

Ina is an enigmatic volcanic feature on the Moon known for its irregularly shaped mounds, the origin of which has been debated since the Apollo Missions. Three main units are observed on the floor of the depression (2.9 km across, < or =64 m deep) located at the summit of a low-shield volcano: irregularly shaped mounds up to 20 m tall, a lower unit 1 to 5 m in relief that surrounds the mounds, and blocky material. Analyses of Lunar Reconnaissance Orbiter Camera images and topography show that features in Ina are morphologically similar to terrestrial inflated lava flows. Comparison of these unusual lunar mounds and possible terrestrial analogs leads us to hypothesize that features in Ina were formed through lava flow inflation processes. While the source of the lava remains unclear, this new model suggests that as the mounds inflated, breakouts along their margins served as sources for surface flows that created the lower morphologic unit. Over time, mass wasting of both morphologic units has exposed fresh surfaces observed in the blocky unit. Ina is different than the terrestrial analogs presented in this study in that the lunar features formed within a depression, no vent sources are observed, and no cracks are observed on the mounds. However, lava flow inflation processes explain many of the morphologic relationships observed in Ina and are proposed to be analogous with inflated lava flows on Earth.

Potential Observing Systems for Tropical Cyclone Motion Studies.

DTIC Science & Technology

1987-05-01

Relatively good coverage exists along the island chain between Taiwan and Japan. Although a number of stations occur along 10N east of the Philippines...shipboard CLASS units for use in GALE. A shipboard CLASS unit will be taking observations during the Taiwan Mesoscale Experiment (TAMEX) in May 1987. f...experiment. Another wind profiler (50 Mhz) is permanently located on the northern tip of Taiwan . Personnel of the Center for Space and Remote Sensing

Analysis of long-term trends (1950–2009) in precipitation, runoff and runoff coefficient in major urban watersheds in the United States

USGS Publications Warehouse

Velpuri, N.M.; Senay, G.B.

2013-01-01

This study investigates the long-term trends in precipitation, runoff and runoff coefficient in major urban watersheds in the United States. The seasonal Mann–Kendall trend test was performed on monthly precipitation, runoff and runoff coefficient data from 1950 to 2009 obtained from 62 urban watersheds covering 21 major urban centers in the United States. The results indicate that only five out of 21 urban centers in the United States showed an uptrend in precipitation. Twelve urban centers showed an uptrend in runoff coefficient. However, six urban centers did not show any trend in runoff coefficient, and three urban centers showed a significant downtrend. The highest rate of change in precipitation, runoff and runoff coefficient was observed in the Houston urban watershed. Based on the results obtained, we also attributed plausible causes for the trends. Our analysis indicated that while a human only influence is observed in most of the urban watersheds, a combined climate and human influence is observed in the central United States.

Sample size considerations for paired experimental design with incomplete observations of continuous outcomes.

PubMed

Zhu, Hong; Xu, Xiaohan; Ahn, Chul

2017-01-01

Paired experimental design is widely used in clinical and health behavioral studies, where each study unit contributes a pair of observations. Investigators often encounter incomplete observations of paired outcomes in the data collected. Some study units contribute complete pairs of observations, while the others contribute either pre- or post-intervention observations. Statistical inference for paired experimental design with incomplete observations of continuous outcomes has been extensively studied in literature. However, sample size method for such study design is sparsely available. We derive a closed-form sample size formula based on the generalized estimating equation approach by treating the incomplete observations as missing data in a linear model. The proposed method properly accounts for the impact of mixed structure of observed data: a combination of paired and unpaired outcomes. The sample size formula is flexible to accommodate different missing patterns, magnitude of missingness, and correlation parameter values. We demonstrate that under complete observations, the proposed generalized estimating equation sample size estimate is the same as that based on the paired t-test. In the presence of missing data, the proposed method would lead to a more accurate sample size estimate comparing with the crude adjustment. Simulation studies are conducted to evaluate the finite-sample performance of the generalized estimating equation sample size formula. A real application example is presented for illustration.

Piloting violence and incident reporting measures on one acute mental health inpatient unit.

PubMed

Woods, Phil; Ashley, Carolyn; Kayto, Denise; Heusdens, Carol

2008-05-01

During May, 2006, on one acute mental health inpatient unit, nursing staff evaluated each patient three times a day (i.e., once each nursing shift) using the Broset Violence Checklist (BVC). Associated data were collected using the Staff Observation and Aggression Scale-Revised (SOAS-R) if an adverse incident occurred. At the end of the data collection period, the nursing staff were asked to complete a short questionnaire anonymously to evaluate how useful they had found the instruments. N = 93 patients were admitted to the unit during the month of study. Seven incidents were reported using the SOAS-R. A slight trend was noted for higher BVC score in aggressive patients. A potential high occurrence of underreporting on incidents was observed. There was limited feedback data from nursing staff at the end of the study, but the responses received were encouraging for continued use of the instruments in practice. The pilot study fulfilled its purpose in two ways. First, it allowed staff on the unit to experience using structured instruments to support their practice. Second, it allowed an opportunity to raise awareness of potential underreporting and tolerance of aggression on the unit.

Design to Improve Visibility: Impact of Corridor Width and Unit Shape.

PubMed

Hadi, Khatereh; Zimring, Craig

2016-07-01

This study analyzes 10 intensive care units (ICUs) to understand the associations between design features of space layout and nurse-to-patient visibility parameters. Previous studies have explored how different hospital units vary in their visibility relations and how such varied visibility relations result in different nurse behaviors toward patients. However, more limited research has examined the specific design attributes of the layouts that determine the varied visibility relations in the unit. Changes in size, geometry, or other attributes of design elements in nursing units, which might affect patient observation opportunities, require more research. This article reviews the literature to indicate evidence for the impact of hospital unit design on nurse/patient visibility relations and to identify design parameters shown to affect visibility. It further focuses on 10 ICUs to investigate how different layouts diverge regarding their visibility relations using a set of metrics developed by other researchers. Shape geometry and corridor width, as two selected design features, are compared. Corridor width and shape characteristics of ICUs are positively correlated with visibility. Results suggest that floor plans, which are repeatedly broken down into smaller convex (higher convex fragmentation values), or units, which have longer distances between their rooms or between their two opposite ends (longer relative grid distances), might have lower visibility levels across the unit. The findings of this study also suggest that wider corridors positively affect visibility of patient rooms. Changes in overall shape configuration and corridor width of nursing units may have important effects on patient observation and monitoring opportunities. © The Author(s) 2016.

Contribution from motor unit firing adaptations and muscle co-activation during fatigue.

PubMed

Contessa, Paola; Letizi, John; De Luca, Gianluca; Kline, Joshua C

2018-03-14

The control of motor unit firing behavior during fatigue is still debated in the literature. Most studies agree that the central nervous system increases the excitation to the motoneuron pool to compensate for decreased force contributions of individual motor units and sustain muscle force output during fatigue. However, some studies claim that motor units may decrease their firing rates despite increased excitation, contradicting the direct relationship between firing rates and excitation that governs the voluntary control of motor units. To investigate whether the control of motor units in fact changes with fatigue, we measured motor unit firing behavior during repeated contractions of the first dorsal interosseous (FDI) muscle while concurrently monitoring the activation of surrounding muscles - including the flexor carpi radialis, extensor carpi radialis, and pronator teres. Across all subjects, we observed an overall increase in FDI activation and motor unit firing rates by the end of the fatigue task. However, in some subjects we observed increases in FDI activation and motor unit firing rates only during the initial phase of the fatigue task, followed by subsequent decreases during the late phase of the fatigue task while the co-activation of surrounding muscles increased. These findings indicate that the strategy for sustaining force output may occasionally change leading to increases in the relative activation of surrounding muscles while the excitation to the fatiguing muscle decreases. Importantly, irrespective of changes in the strategy for sustaining force output, the control properties regulating motor unit firing behavior remain unchanged during fatigue.

Impact of water quality on the bacterial populations and off-flavours in recirculating aquaculture systems.

PubMed

Auffret, Marc; Yergeau, Étienne; Pilote, Alexandre; Proulx, Émilie; Proulx, Daniel; Greer, Charles W; Vandenberg, Grant; Villemur, Richard

2013-05-01

A variety of factors affecting water quality in recirculating aquaculture systems (RAS) are associated with the occurrence of off-flavours. In this study, we report the impact of water quality on the bacterial diversity and the occurrence of the geosmin-synthesis gene (geoA) in two RAS units operated for 252 days. Unit 2 displayed a higher level of turbidity and phosphate, which affected the fresh water quality compared with unit 1. In the biofilter, nitrification is one of the major processes by which high water quality is maintained. The bacterial population observed in the unit 1 biofilter was more stable throughout the experiment, with a higher level of nitrifying bacteria compared with the unit 2 biofilter. Geosmin appeared in fish flesh after 84 days in unit 2, whereas it appeared in unit 1 after 168 days, but at a much lower level. The geoA gene was detected in both units, 28 days prior to the detection of geosmin in fish flesh. In addition, we detected sequences associated with Sorangium and Nannocystis (Myxococcales): members of these genera are known to produce geosmin. These sequences were observed at an earlier time in unit 2 and at a higher level than in unit 1. This study confirms the advantages of new molecular methods to understand the occurrence of geosmin production in RAS. © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

Aggression on haemodialysis units: a mixed method study.

PubMed

Jones, Julia; Nijman, Henk; Ross, Jamie; Ashman, Neil; Callaghan, Patrick

2014-09-01

Aggression on haemodialysis units is a growing problem internationally that has received little research attention to date. Aggressive behaviour by patients or their relatives can compromise the safety and well-being of staff and other patients sharing a haemodialysis session. The objectives of the study were twofold: First, to identify the prevalance and nature of aggression on haemodialysis units; and second, to investigate factors that contribute to aggressive behaviour on haemodialysis units. A cross-sectional, sequential mixed method research design was adopted, with two research methods utilised. Incidents of aggressive behaviour were recorded over a 12-month period, using a renal version of the Staff Observation Aggression Scale. Six months after the incident data collection had commenced, semi-structured qualitative interviews were conducted with 29 multidisciplinary members of staff. Over 12 months, 74 aggressive incidents were recorded. The majority of incidents involved verbal aggression, and the perpetrators were a minority of patients, relatives and staff. Two patients were responsible for 38% of all incidents; both patients had mental health problems. Distinct temporal patterns to the aggressive behaviour were observed according to the day of the week and time of day. This study demonstrates that aggression is a significant problem on haemodialysis units, with verbal aggression most prevalent. The temporal patterns to aggression observed are related to the uniqueness of the haemodialysis setting, with a distinctly different treatment environment compared with other healthcare settings. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Paleoclimatic investigations during the late Quaternary using gravity core sediments of Lake Hovsgol in Mongolia

NASA Astrophysics Data System (ADS)

Cheong, Daekyo; Shin, Seungwon; Park, Yong-Hee; Nam, Seung Il

2010-05-01

The Lake Hovsgol is located in northeast Eurasia which is a tectonic lake formed by rifting, and its thick bottom sediments record climatic change of the past. The lake is a suitable site to study a rapid Quaternary climate change. This study includes analysis of smear slides, particle size analysis, data of spectrophotometer and magnetic susceptibility, trace element analysis using XRF core scanner for HS-3, 5 gravity core sediments from the middle southern Lake Hovsgol. HS-3 core sediments were measured for TOC, and HS-5 core was scrutinized for species analysis of ostracods. HS-3 core was obtained at 160 m water depth, and is divided into three sedimentary units. Unit A of HS-3 is characterized by distinct lamination, high sand contents considerably decreasing towards the upper part, and the ostracods are rarely discovered at the upper part of Unit A. Unit B is characterized by weakly lamination, and some ostracods are observed in the lower part, but diatoms are observed in the upper part of Unit B. Also grain size is getting smaller toward the upper part. Unit C consists of fine diatomaceous ooze and contains abundant diatoms. Overall organic contents are high, and lamination with black-colored organic layer is observed in the lower part of Unit C. HS-5 core was obtained at 210 m water depth and is divided into two sedimentary units with faint boundary. Unit A of HS-5 is characterized by lamination and contains abundant diatoms and ostracods. At Unit B, grain size is getting smaller toward the upper part, and occurrence change of ostracods is observed in the upper part. Framboidal pyrite were formed during the diagenesis. Four species of ostracods are observed in the core sediments, i.e. Cytherissa lacustris, Limnocythere inopinate dominate in the lower part, and Candona lepnevae, Leucocythere sp dominates in the upper part. Carbon age dating results show that sediment unit B of HS-5 and unit C of HS-3 containing rare ostracods are similar in age. The reason of low occurrence of ostracods fossils and high content of sand is consistent with that ostracods disappeared as temperature rise or inhabitant change since late LGM. An age of sediment unit B of HS-3 is the Last Deglacial period when organic contents increased obviously and contents of sand decreased as the lake level rose. The change of magnetic susceptibility and Fe/Al, Ca/Al and Si/Al ratio values are observed at 90 cm depth section of HS-3, which indicates that input sediments changed as the lake level fell due to a temporal cooling at Younger Dryas during the Last Deglacial. The age of the sediment unit C of HS-3 is Holocene. At this period, high contents of organic materials were caused by increase of nutrition input because of a thick vegetation cover as temperature rose, and thus diatom blooming. The organic strata containing mica minerals at early Holocene have been formed during fall or stagnation periods of the lake level. We interpreted that those are closely related to the global environmental change.

Nurses' understanding influences comprehension of patients admitted in the observation unit.

PubMed

Desme, Aline; Mendes, Nathalie; Perruche, Franck; Veillard, Elsa; Elie, Caroline; Moulinet, Françoise; Sanson, Fabienne; Georget, Jean-Michel; Tissier, Anne; Pourriat, Jean-Louis; Claessens, Yann-Erick

2013-01-01

Comprehension is poor in patients admitted in the emergency observation unit. Teamwork communication gaps could contribute to patients' misunderstanding of their health condition. To determine in patients admitted in the emergency observation unit whether comprehension of diagnosis, prognosis, and management depended on nurses' comprehension, the authors conducted a prospective observational study in a busy adult emergency department of a tertiary teaching hospital in Paris over 2 months. Consecutive patients admitted in the emergency observation unit were included. Patients' and nurses' comprehension of diagnosis, prognosis, and management was compared with the statements of the emergency department attending physicians for these items. The authors observed whether patients' misunderstanding was associated with nurses' misunderstanding. A total of 544 patients were evaluated. For each patient, nurses' and patients' comprehension was available. Patients understood severity in 40%, organ involved in 69%, medical wording in 57%, reason for admission in 48%, and discharge instruction in 67%. In comparison with patients, nurses better understood each item except for discharge instruction. The authors observed that patients' comprehension was better when nurses understood diagnosis (p <.0001), reasons for admission (p =.032) and discharge instructions (p =.002). Nurses' understanding of severity did not modify patients' comprehension. These results support the conclusions that communication gaps in teamwork alter patients' comprehension and that nurses' and patients' misunderstandings are associated. Therefore, improving communication by nurses and physicians to patients may improve patients' understanding.

Engaging Primary Students in Learning about New Zealand Birds: A Socially Relevant Context

ERIC Educational Resources Information Center

Chen, Junjun; Cowie, Bronwen

2013-01-01

This article reports on a classroom study of a unit on New Zealand birds that focused on adaptation and conservation in a Year 7 class. The unit used a "context as social circumstances" model. The researchers observed the nine lessons and interviewed students, the classroom teacher, and three other teachers who had taught the same unit.…

Inclusive Prekindergarten Classrooms in a New Era: Exploring the Perspectives of Teachers in the United States

ERIC Educational Resources Information Center

Anderson, Elizabeth McKendry; Lindeman, Karen Wise

2017-01-01

The purpose of this article is to share the results of a qualitative research study designed to shed light on the perspectives of inclusive prekindergarten classroom teachers in the United States. This study used surveys, interviews, and classroom observations to explore understandings of recently adopted learning standards and accountability…

Interaural delay sensitivity and the classification of low best-frequency binaural responses in the inferior colliculus of the guinea pig.

PubMed

McAlpine, D; Jiang, D; Palmer, A R

1996-08-01

Monaural and binaural response properties of single units in the inferior colliculus (IC) of the guinea pig were investigated. Neurones were classified according to the effect of monaural stimulation of either ear alone and the effect of binaural stimulation. The majority (309/334) of IC units were excited (E) by stimulation of the contralateral ear, of which 41% (127/309) were also excited by monaural ipsilateral stimulation (EE), and the remainder (182/309) were unresponsive to monaural ipsilateral stimulation (EO). For units with best frequencies (BF) up to 3 kHz, similar proportions of EE and EO units were observed. Above 3 kHz, however, significantly more EO than EE units were observed. Units were also classified as either facilitated (F), suppressed (S), or unaffected (O) by binaural stimulation. More EO than EE units were suppressed or unaffected by binaural stimulation, and more EE than EO units were facilitated. There were more EO/S units above 1.5 kHz than below. Binaural beats were used to examine the interaural delay sensitivity of low-BF (BF < 1.5 kHz) units. The distributions of preferred interaural phases and, by extension, interaural delays, resembled those seen in other species, and those obtained using static interaural delays in the IC of the guinea pig. Units with best phase (BP) angles closer to zero generally showed binaural facilitation, whilst those with larger BPs generally showed binaural suppression. The classification of units based upon binaural stimulation with BF tones was consistent with their interaural-delay sensitivity. Characteristic delays (CD) were examined for 96 low-BF units. A clear relationship between BF and CD was observed. CDs of units with very low BFs (< 200 Hz) were long and positive, becoming progressively shorter as BF increased until, for units with BFs between 400 and 800 Hz, the majority of CDs were negative. Above 800 Hz, both positive and negative CDs were observed. A relationship between CD and characteristic phase (CP) was also observed, with CPs increasing in value as CDs became more negative. These results demonstrate that binaural processing in the guinea pig at low frequencies is similar to that reported in all other species studied. However, the dependence of CD on BF would suggest that the delay line system that sets up the interaural-delay sensitivity in the lower brainstem varies across frequency as well as within each frequency band.

International Perceptions of Cyberbullying within Higher Education

ERIC Educational Resources Information Center

Luker, Julie Marie; Curchack, Barbara C.

2017-01-01

In this study, we investigated perceptions of cyberbullying within higher education among 1,587 professionals from Australia, Canada, the United Kingdom, and the United States. Regardless of country or professional role, participants presented essentially the same bleak picture. Almost half of all participants observed cyberbullying between…

Mineral Trends in Early Hesperian Lacustrine Mudstone at Gale Crater, Mars

NASA Technical Reports Server (NTRS)

Rampe, E. B.; Ming, D. W.; Grotzinger, J. P.; Morris, R. V.; Blake, D. F.; Vaniman, D. T.; Bristow, T. F.; Morrison, S. M.; Yen, A. S.; Chipera, S. J.;

[Observational study of outpatient unit duration of stay depending on the route of administration (intravenous vs subcutaneous) for a targeted therapy].

PubMed

Despiau, Frédéric; Zagala, Yann; Delord, Jean-Pierre; Montastruc, Marion; Lacaze, Jean-Louis; Ferrand, Régis; Bombail, Marie

2017-10-01

New routes of administration available for some targeted therapies, especially subcutaneous injections, have an impact not only on the patients' daycare experience, but also on the unit's organization. This observational study conducted on 48 voluntary patients at the Institut universitaire du cancer Toulouse-Oncopole shows that the mean duration of the outpatient unit stay is diminished by one hour when a subcutaneous injection is used instead of an intravenous route. This duration decrease is mainly caused by an 82% average reduction in treatment duration. However, the waiting times before and after the treatment itself are not significantly impacted. Organizational methods related to the treatment prescription and preparation remain indeed the same. Anticipated prescription is not noticeably impacted either. This reduction of the duration of stay will truly be obtained if the whole unit's organization is adapted. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Acculturation Strategy, Integration Paradoxes and Educational Adaptation--A Case Study of Chinese Visiting Scholar's Family in the United States

ERIC Educational Resources Information Center

Weidong, Li; Chen, Sisi

2017-01-01

In this case study, we developed a theoretical framework for examining the relationship between acculturation strategy and educational adaptation. By interviews and observations of one Chinese visiting scholar's family in the United States, we found that the family utilized "integration" as the acculturation strategy to adapt to the US…

Populations, Teacher's Guide.

ERIC Educational Resources Information Center

Conard, David; Lawson, Chester A.

This Teacher's Guide is designed for use with the Science Curriculum Improvement Study's (SCIS) unit Population. Populations is the third of a six-unit sequence of SCIS's Life Science Program for grades K-6. The Populations guide consists of activity outlines along with suggestions for guiding children's observation and manipulations of living…

Intermediate SCDC Spanish Curricula Units. Science/Health, Unit 1, Kits 1-4, Teacher's Guide.

ERIC Educational Resources Information Center

Spanish Curricula Development Center, Miami Beach, FL.

Unified by the theme "our community", this unit, part of nine basic instructional units for intermediate level, reflects the observations of Mexican Americans, Puerto Ricans, and Cubans in various regions of the United States. Comprised of Kits 1-4, the unit extends the following basic and interpreted science processes: observing, communicating,…

Patient aggression towards different professional groups of healthcare workers.

PubMed

Kowalczuk, Krystyna; Krajewska-Kułak, Elżbieta

2017-03-31

Patient aggression affects healthcare quality and, in extreme situations, may even lead to medical malpractice. Little is known, however, about the specific distribution of health care professionals' exposure to patient aggression in various countries. The aim of this study was to assess the exposure of various professional groups of healthcare personnel to patient aggression, and to identify potential determinants (medical profession, age, gender, professional experience and employment at outpatient/inpatient healthcare units) of this exposure. The study was performed between January 2008 - December 2009 in northeastern Poland, and included 1,624 healthcare workers (493 nurses, 504 midwives, 501 physicians and 126 medical rescue workers). Exposure to eight forms of patient aggression was assessed using the MDM Mobbing Questionnaire. Using a raised voice was the most frequently observed form of aggression in all groups, whereas the least frequent form of aggression encountered was the use of direct physical violence. In inpatient healthcare units, the intensity of patient aggression was encountered most by nurses and medical rescue workers, followed by physicians and midwives. In outpatient healthcare units, medical rescue workers experienced significantly higher levels of aggression when compared to other professional groups. Significant differences in mean aggression intensity experienced in inpatient and outpatient healthcare units were observed only in nurses and physicians. Furthermore, no significant effects of gender were observed on the intensity of patient aggression. Nurses are most exposed to different forms of patient aggression, with verbal attacks being most prevalent. Nurses employed at inpatient healthcare units experienced aggression more frequently than those working in outpatient healthcare units.

Aggregation and the Measurement of Health Care Costs

PubMed Central

Getzen, Thomas E

2006-01-01

Objective This study evaluated the extent to which the causes of variation in health care costs differ by the level at which observations are made. Methods More than 40 U.S. and international studies providing empirical estimates of the sources of variation in health care costs were reviewed and arrayed by size of observational units. A simplified graphical analysis demonstrating how estimated correlation coefficients change with the level and type of aggregation is presented. Results As the unit of observation becomes larger, association between health care costs and health status/morbidity becomes weaker and smaller in magnitude, while correlation with income (per capita GDP) becomes stronger and larger. Individual expenditure variation within a particular health care system is largely due to differences in health status, but across systems, morbidity has almost no effect on costs. For nations, differences in per capita income explain over 90 percent of the variation in both time series and cross section. Conclusions Units of observation used for analysis of health care costs must be matched to the units at which decision making occurs. The observed pattern of empirical results is consistent with a multilevel allocative model incorporating aggregate capacity constraints. To the extent that macro constraints determine total budgets at the national level, policy interventions at the micro level (substitution of generic pharmaceuticals, use of CEA for allocation of treatments, controls on construction and technology, etc.) can act to improve efficiency, equity and average health status, but will not usually reduce aggregate average per capita costs of medical care. PMID:16987309

A multilevel study on the association of observer-assessed working conditions with depressive symptoms among female eldercare workers from 56 work units in 10 care homes in Denmark.

PubMed

Jakobsen, Louise M; Jorgensen, Anette F B; Thomsen, Birthe L; Greiner, Birgit A; Rugulies, Reiner

2015-11-11

Eldercare workers in Denmark have a higher prevalence of poor psychological health than other occupational groups. We examined the association between working conditions assessed by trained observers and depressive symptoms assessed by self-report in a study of female Danish eldercare workers. Working conditions were observed based on action regulation theory and defined as (1) regulation requirements, a workplace resource providing opportunity for decision-making and skill development and (2) barriers for task completion. We examined the associations of individual and work unit averaged working conditions with depressive symptoms in a sample of 95 individually observed eldercare workers. Further, we examined the association of work unit averaged working conditions with depressive symptoms in a sample of 205 care workers, including both observed and non-observed individuals. We used regression models that allowed for correlations within work units and care homes and adjusted these models for demographics, job characteristics and stressful life events. Higher levels of regulation requirements were associated with lower depressive symptoms at the individual level (p=0.04), but not at the workplace level. Barriers were not associated with depressive symptoms at the individual level. At the workplace level, a higher number of qualitatively different barriers (p=0.04) and a higher number of barriers for equipment use (p=0.03) were associated with lower levels of depressive symptoms in the age and cohabitation adjusted model, however statistical significance was lost in the fully adjusted model. Low level of regulation requirements was associated with a high level of depressive symptoms. The study highlights the importance of examining both individual and workplace levels of working conditions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Determining the Molecular Growth Mechanisms of Protein Crystal Faces by Atomic Force Microscopy

NASA Technical Reports Server (NTRS)

Nadarajah, Arunan; Li, Huayu; Pusey, Marc L.

1999-01-01

A high resolution atomic force microscopy (AFM) study had shown that the molecular packing on the tetragonal lysozyme (110) face corresponded to only one of two possible packing arrangements, suggesting that growth layers on this face were of bimolecular height. Theoretical analyses of the packing also indicated that growth of this face should proceed by the addition of growth units of at least tetramer size corresponding to the 43 helices in the crystal. In this study an AFM linescan technique was devised to measure the dimensions of individual growth units on protein crystal faces as they were being incorporated into the lattice. Images of individual growth events on the (110) face of tetragonal lysozyme crystals were observed, shown by jump discontinuities in the growth step in the linescan images as shown in the figure. The growth unit dimension in the scanned direction was obtained from these images. A large number of scans in two directions on the (110) face were performed and the distribution of lysozyme growth unit sizes were obtained. A variety of unit sizes corresponding to 43 helices, were shown to participate in the growth process, with the 43 tetramer being the minimum observed size. This technique represents a new application for AFM allowing time resolved studies of molecular process to be carried out.

Factors contributing to the process of intensive care patient discharge: an ethnographic study informed by activity theory.

PubMed

Lin, Frances; Chaboyer, Wendy; Wallis, Marianne; Miller, Anne

2013-08-01

Patient flow from intensive care to acute care units is often problematic and many discharges from intensive care to acute care are unsuccessful on the first attempt. The aim of this study was to explore the factors that influence intensive care patient discharge. This ethnographic study was undertaken in an Australian metropolitan tertiary hospital that had a 14-bed level 3 intensive care unit. Intensive care and acute care unit medical and nursing staff, and other hospital staff who were involved in the intensive care patient discharge process participated in this study. A total of 28 discharges were observed, and 56 one on one interviews were conducted. Data collection techniques including direct observations, semi-structured interviews, and collection of existing documents were used. Activity theory was the theoretical framework that underpinned this study. Three patient activity systems were identified: intensive care patient discharge activity, acute care unit accepting patient activity, and hospital bed management activity. Analysis of the interactions among these activity systems revealed conflicting objects (goals), communication breakdowns, and teamwork issues. Discharge delay was found to be a significant problem, which was associated with limited acute care unit bed availability. Strategies to improve acute care unit bed availability are needed. Routine after-hours ICU discharge could raise patient safety concerns which need to be considered. All team members' input in discharge decision making should be encouraged. Problems identified in clinical handover call for actions to change the handover practice. Activity theory successfully guided the study by providing a practical and descriptive framework for the study, facilitating the understanding of the interrelationships among the activity systems. Copyright © 2012 Elsevier Ltd. All rights reserved.

A Study of Mesoscale Gravity Waves over the North Atlantic with Satellite Observations and a Mesoscale Model

NASA Technical Reports Server (NTRS)

Wu, Dong L.; Zhang, Fuqing

2004-01-01

Satellite microwave data are used to study gravity wave properties and variabilities over the northeastern United States and the North Atlantic in the December-January periods. The gravity waves in this region, found in many winters, can reach the stratopause with growing amplitude. The Advanced Microwave Sounding Unit-A (AMSU-A) observations show that the wave occurrences are correlated well with the intensity and location of the tropospheric baroclinic jet front systems. To further investigate the cause(s) and properties of the North Atlantic gravity waves, we focus on a series of wave events during 19-21 January 2003 and compare AMSU-A observations to simulations from a mesoscale model (MM5). The simulated gravity waves compare qualitatively well with the satellite observations in terms of wave structures, timing, and overall morphology. Excitation mechanisms of these large-amplitude waves in the troposphere are complex and subject to further investigations.

Winning Insurgent War: Back to Basics

DTIC Science & Technology

2011-01-01

to the government of Ecuador , spurred on by Hugo Chavez, dictator of Venezuela, to call the incident an international invasion of Ecuador by...ii Geoff Demarest The Foreign Military Studies Office Ft. Leavenworth, Kansas This publication is a work of the United States Government ...lone. They are not the opinions, observations, advice or practice of the United States Arn1y or any other part of the United States Government and

Unit: Rocks from Sediments, Inspection Pack, National Trial Print.

ERIC Educational Resources Information Center

Australian Science Education Project, Toorak, Victoria.

Four compulsory introductory activities, involving learning to use a stream tray, observing the relationship between water speed and entraining, transporting and depositing sediments, studying the formation of sedimentary rocks, and examining several types of sedimentary rocks, are completed by all students using the unit prepared for Australian…

Unit: Rocks from Sediments, Inspection Set, First Trial Materials.

ERIC Educational Resources Information Center

Australian Science Education Project, Toorak, Victoria.

Four compulsory introductory activities involving learning to use a stream tray, observing the relationship between water speed and entraining, transporting and depositing sediments, studying the formation of sedimentary rocks, and examining several types of sedimentary rocks are completed by all students using the unit prepared for Australian…

Historical gaseous and primary aerosol emissions in the United States from 1990-2010

EPA Science Inventory

An accurate description of emissions is crucial for model simulations to reproduce and interpret observed phenomena over extended time periods. In this study, we used an approach based on activity data to develop a consistent series of spatially resolved emissions in the United S...

Leading Professional Learning to Develop Professional Capital: The Saskatchewan Professional Development Unit's Facilitator Community

ERIC Educational Resources Information Center

Osmond-Johnson, Pamela

2017-01-01

Drawing on data from a mixed methods study of the Saskatchewan Professional Development Unit's (SPDU) Facilitator Community, this paper highlights the potential of teacher-led professional learning in developing professional capital through engagement in teacher leadership. Analysis of survey, interview, and observational data revealed the…

Effects of single-family rooms on nurse-parent and nurse-infant interaction in neonatal intensive care unit.

PubMed

Toivonen, Mirka; Lehtonen, Liisa; Löyttyniemi, Eliisa; Axelin, Anna

Single-family rooms in neonatal intensive care unit can provide longer interaction between family and staff. On the other hand, separation in private rooms has been shown detrimental to child development if parents are not present. To examine the effects of single-family rooms on nurse-family, nurse-parent and nurse-infant interaction time in neonatal intensive care unit. A quantitative, comparative, observational study was conducted before and after a move to a neonatal intensive care unit with single-family rooms. A total of 194 observation hours were conducted before the move and 194h after the move. The differences were analyzed using a hierarchical linear mixed model. Nurses working in one neonatal intensive care unit were recruited to study. The duration and number of nurse-parent and nurse-infant interaction episodes were recorded. The nurse-family and the nurse-parent interaction were longer in the unit with single-family rooms compared with the unit before the move (mean 261 vs. 138min per shift, p<0.0001 and 117 vs. 35, p=0.001, respectively). The duration of the nurse-infant interaction did not change after the move. The frequency of the nurse-parent or the nurse-infant interactions did not change between the time periods. Neonatal intensive care unit with single-family rooms supported an increase in nurse-parent interaction time. Importantly, nurse-infant interaction time did not decrease. Copyright © 2017 Elsevier B.V. All rights reserved.

Dynamic action units slip in speech production errors ☆

PubMed Central

Goldstein, Louis; Pouplier, Marianne; Chen, Larissa; Saltzman, Elliot; Byrd, Dani

2008-01-01

In the past, the nature of the compositional units proposed for spoken language has largely diverged from the types of control units pursued in the domains of other skilled motor tasks. A classic source of evidence as to the units structuring speech has been patterns observed in speech errors – “slips of the tongue”. The present study reports, for the first time, on kinematic data from tongue and lip movements during speech errors elicited in the laboratory using a repetition task. Our data are consistent with the hypothesis that speech production results from the assembly of dynamically defined action units – gestures – in a linguistically structured environment. The experimental results support both the presence of gestural units and the dynamical properties of these units and their coordination. This study of speech articulation shows that it is possible to develop a principled account of spoken language within a more general theory of action. PMID:16822494

Incidence and Outcomes of Cardiopulmonary Resuscitation in Pediatric Intensive Care Units

PubMed Central

Berg, Robert A.; Nadkarni, Vinay M.; Clark, Amy E.; Moler, Frank; Meert, Kathleen; Harrison, Rick E.; Newth, Christopher J. L.; Sutton, Robert M.; Wessel, David L.; Berger, John T.; Carcillo, Joseph; Dalton, Heidi; Heidemann, Sabrina; Shanley, Thomas P.; Zuppa, Athena F.; Doctor, Allan; Tamburro, Robert F.; Jenkins, Tammara L.; Dean, J. Michael; Holubkov, Richard; Pollack, Murray M.

2015-01-01

Objective To determine the incidence of cardiopulmonary resuscitation (CPR) in pediatric intensive care units (PICU) and subsequent outcomes. Design, Setting, and Patients Multi-center prospective observational study of children 30 minutes, p30 minutes of CPR. Conclusions These data establish that contemporary PICU CPR, including long durations of CPR, results in high rates of survival to hospital discharge (45%) and favorable neurologic outcomes among survivors (89%). Rates of survival with favorable neurologic outcomes were similar among cardiac and non-cardiac patients. The rigorous prospective, observational study design avoided the limitations of missing data and potential selection biases inherent in registry and administrative data. PMID:26646466

The Effects of a Content Knowledge Workshop on Teachers' Pedagogical Content Knowledge and Student Learning in a Soccer Unit in Middle School Physical Education

ERIC Educational Resources Information Center

Lee, Yun Soo

2011-01-01

There is an assumption that pedagogical content knowledge (PCK) is observable and measurable. Yet, in many studies referencing PCK, the construct of PCK remains both undefined operationally and poorly described. In physical education, although one study has measured teachers' PCK using teachers' weak and strong units of instruction (Ayvazo, 2007),…

Interventions to Improve Safe Sleep Among Hospitalized Infants at Eight Children's Hospitals.

PubMed

Kuhlmann, Stephanie; Ahlers-Schmidt, Carolyn R; Lukasiewicz, Gloria; Truong, Therese Macasiray

2016-02-01

Within hospital pediatric units, there is a lack of consistent application or modeling of the American Academy of Pediatrics recommendations for safe infant sleep. The purpose of this study was to improve safe sleep practices for infants in nonneonatal pediatric units with implementation of specific interventions. This multi-institutional study was conducted by using baseline observations collected for sleep location, position, and environment (collectively, "safe sleep") of infants admitted to pediatric units. Interventions consisted of: (1) staff education, including a commitment to promote safe sleep; (2) implementing site-generated safe sleep policies; (3) designating supply storage in patient rooms; and/or (4) caregiver education. Postintervention observations of safe sleep were collected. Eight hospitals participated from the Inpatient FOCUS Group of the Children's Hospital Association. Each site received institutional review board approval/exemption. Safe sleep was observed for 4.9% of 264 infants at baseline and 31.2% of 234 infants postintervention (P<.001). Extra blankets, the most common of unsafe items, were present in 77% of cribs at baseline and 44% postintervention. However, the mean number of unsafe items observed in each sleeping environment was reduced by >50% (P=.001). Implementation of site-specific interventions seems to improve overall safe sleep in inpatient pediatric units, although continued improvement is needed. Specifically, extra items are persistently left in the sleeping environment. Moving forward, hospitals should evaluate their compliance with American Academy of Pediatrics recommendations and embrace initiatives to improve modeling of safe sleep. Copyright © 2016 by the American Academy of Pediatrics.

Systematic Review of Economic Evaluations of Units Dedicated to Acute Coronary Syndromes.

PubMed

Azeredo-Da-Silva, André Luis Ferreira; Perini, Silvana; Rigotti Soares, Pedro Henrique; Polaczyk, Carisi Anne

2016-01-01

Dedicated units for the care of acute coronary syndrome (ACS) have been submitted to economic evaluations; however, the results have not been systematically presented. To identify and summarize economic outcomes of studies on hospital units dedicated to the initial care of patients with suspected or confirmed ACS. A systematic review of literature to identify economic evaluations of chest pain unit (CPU), coronary care unit (CCU), or equivalent units was done. Two search strategies were used: the first one to identify economic evaluations irrespective of study design, and the second one to identify randomized clinical trials that reported economic outcomes. The following databases were searched: MEDLINE, EMBASE, CENTRAL, and National Health Service (NHS)Economic Evaluation Database. Data extraction was performed by two independent reviewers. Costs were inflated to 2012 values. Search strategies retrieved five partial economic evaluations based on observational studies, six randomized clinical trials that reported economic outcomes, and five model-based economic evaluations. Overall, cost estimates based on observational studies and randomized clinical trials reported statistically significant cost savings of more than 50% with the adoption of CPU care instead of routine hospitalization or CCU care for suspected low-to-intermediate risk patients with ACS (median per-patient cost US $1,969.89; range US $1,002.12-13,799.15). Model-based economic evaluations reported incremental cost-effectiveness ratios below US $ 50,000/quality-adjusted life-year for all comparisons between intermediate care unit, CPU, or CCU with routine hospital admissions. This finding was sensible to myocardial infarction probability. Published economic evaluations indicate that more intensive care is likely to be cost-effective in comparison to routine hospital admission for patients with suspected ACS. Copyright © 2016. Published by Elsevier Inc.

A sensitivity analysis for missing outcomes due to truncation by death under the matched-pairs design.

PubMed

Imai, Kosuke; Jiang, Zhichao

2018-04-29

The matched-pairs design enables researchers to efficiently infer causal effects from randomized experiments. In this paper, we exploit the key feature of the matched-pairs design and develop a sensitivity analysis for missing outcomes due to truncation by death, in which the outcomes of interest (e.g., quality of life measures) are not even well defined for some units (e.g., deceased patients). Our key idea is that if 2 nearly identical observations are paired prior to the randomization of the treatment, the missingness of one unit's outcome is informative about the potential missingness of the other unit's outcome under an alternative treatment condition. We consider the average treatment effect among always-observed pairs (ATOP) whose units exhibit no missing outcome regardless of their treatment status. The naive estimator based on available pairs is unbiased for the ATOP if 2 units of the same pair are identical in terms of their missingness patterns. The proposed sensitivity analysis characterizes how the bounds of the ATOP widen as the degree of the within-pair similarity decreases. We further extend the methodology to the matched-pairs design in observational studies. Our simulation studies show that informative bounds can be obtained under some scenarios when the proportion of missing data is not too large. The proposed methodology is also applied to the randomized evaluation of the Mexican universal health insurance program. An open-source software package is available for implementing the proposed research. Copyright © 2018 John Wiley & Sons, Ltd.

Association of Resident Coverage with Cost, Length of Stay, and Profitability at a Community Hospital

PubMed Central

Shine, Daniel; Beg, Sumbul; Jaeger, Joseph; Pencak, Dorothy; Panush, Richard

2001-01-01

OBJECTIVE The effect of care by medical residents on hospital length of stay (LOS), indirect costs, and reimbursement was last examined across a range of illnesses in 1981; the issue has never been examined at a community hospital. We studied resource utilization and reimbursement at a community hospital in relation to the involvement of medical residents. DESIGN This nonrandomized observational study compared patients discharged from a general medicine teaching unit with those discharged from nonteaching general medical/surgical units. SETTING A 620-bed community teaching hospital with a general medicine teaching unit (resident care) and several general medicine nonteaching units (no resident care). PATIENTS All medical discharges between July 1998 and February 1999, excluding those from designated subspecialty and critical care units. MEASUREMENTS AND MAIN RESULTS Endpoints included mean LOS in excess of expected LOS, mean cost in excess of expected mean payments, and mean profitability (payments minus total costs). Observed values were obtained from the hospital's database and expected values from a proprietary risk–cost adjustment program. No significant difference in LOS between 917 teaching-unit patients and 697 nonteaching patients was demonstrated. Costs averaged $3,178 (95% confidencence interval (CI) ± $489) less than expected among teaching-unit patients and $4,153 (95% CI ± $422) less than expected among nonteaching-unit patients. Payments were significantly higher per patient on the teaching unit than on the nonteaching units, and as a result mean, profitability was higher: $848 (95% CI ± $307) per hospitalization for teaching-unit patients and $451 (95% CI ± $327) for patients on the nonteaching units. Teaching-unit patients of attendings who rarely admitted to the teaching unit (nonteaching attendings) generated an average profit of $1,299 (95% CI ± $613), while nonteaching patients of nonteaching attendings generated an average profit of $208 (95% CI ± $437). CONCLUSIONS Resident care at our community teaching hospital was associated with significantly higher costs but also with higher payments and greater profitability. PMID:11251744

Activity and social factors affect cohesion among individuals in female Japanese macaques: A simultaneous focal-follow study.

PubMed

Nishikawa, Mari; Suzuki, Mariko; Sprague, David S

2014-07-01

Understanding cohesion among individuals within a group is necessary to reveal the social system of group-living primates. Japanese macaques (Macaca fuscata) are female-philopatric primates that reside in social groups. We investigated whether individual activity and social factors can affect spatio-temporal cohesion in wild female Japanese macaques. We conducted behavioral observation on a group, which contained 38 individuals and ranged over ca. 60 ha during the study period. Two observers carried out simultaneous focal-animal sampling of adult female pairs during full-day follows using global positioning system which enabled us to quantify interindividual distances (IIDs), group members within visual range (i.e., visual unit), and separation duration beyond visual range as indicators of cohesion among individuals. We found considerable variation in spatio-temporal group cohesion. The overall mean IID was 99.9 m (range = 0-618.2 m). The percentage of IIDs within visual range was 23.1%, within auditory range was 59.8%, and beyond auditory range was 17.1%. IIDs varied with activity; they were shorter during grooming and resting, and longer during foraging and traveling. Low-ranking females showed less cohesion than high-ranking ones. Kin females stayed nearly always within audible range. The macaques were weakly cohesive with small mean visual unit size (3.15 counting only adults, 5.99 counting all individuals). Both-sex units were the most frequently observed visual unit type when they were grooming/resting. Conversely, female units were the most frequently observed visual unit type when they were foraging. The overall mean visual separation duration was 25.7 min (range = 3-513 min). Separation duration was associated with dominance rank. These results suggest that Japanese macaques regulate cohesion among individuals depending on their activity and on social relationships; they were separated to adapt food distribution and aggregated to maintain social interactions. © 2014 Wiley Periodicals, Inc.

Human leukocyte antigen-A, -B, and -DRB1 haplotypes of cord blood units in the Tzu Chi Taiwan Cord Blood Bank.

PubMed

Wen, Shu-Hui; Lai, Meng-Jiun; Yang, Kuo-Liang

2008-07-01

Cord blood (CB) is considered an alternative resource to bone marrow and peripheral blood stem cells (PBSC) for allogeneic stem cell transplantation. In this study, human leukocyte antigen (HLA)-A, -B, and -DRB1 high-resolution allele types were analyzed from a total of 710 CB units in the Tzu Chi Taiwan Cord Blood Bank. We observed 21 HLA-A alleles, 59 HLA-B alleles, and 28 HLA-DRB1 alleles, whereas 19 unique alleles were present in the CB units of 2,023 individuals selected for confirmatory testing in the Tzu Chi Taiwan Marrow Donor Registry (TCTMDR). The allelic associations between the HLA-A and -B locus were stronger than that of either the HLA-B and -DRB1 loci or the HLA-A and -DRB1 loci. The most common haplotype of CB units in the general Taiwanese population was A*3303-B*5801-DRB1*0301 (6.59%), followed by A*0207-B*4601-DRB1*0901 (3.47%) and then A*1101-B*4001-DRB1*0901 (2.11%). Moreover, two haplotypes, A*2402-B*5201-DRB1*1502 and A*0201-B*1301-DRB1*1202, existed uniquely in the CB units but were not observed in the data of TCTMDR. Although the number of CB units studied for high-resolution of HLA typing in the current study is small, we believe our data should provide useful information to increase the chances of obtaining acceptable HLA-A-, -B-, and -DRB1-matched CB units for patients.

Study on observation planning of LAMOST focal plane positioning system and its simulation

NASA Astrophysics Data System (ADS)

Zhai, Chao; Jin, Yi; Peng, Xiaobo; Xing, Xiaozheng

2006-06-01

Fiber Positioning System of LAMOST focal plane based on subarea thinking, adopts a parallel controllable positioning plan, the structure is designed as a round area and overlapped each other in order to eliminate the un-observation region. But it also makes the observation efficiency of the system become an important problem. In this paper According to the system, the model of LAMOST focal plane Observation Planning including 4000 fiber positioning units is built, Stars are allocated using netflow algorithm and mechanical collisions are diminished through the retreat algorithm, then the simulation of the system's observation efficiency is carried out. The problem of observation efficiency of LAMOST focal plane is analysed systemic and all-sided from the aspect of overlapped region, fiber positioning units, observation radius, collisions and so on. The observation efficiency of the system in theory is describes and the simulation indicates that the system's observation efficiency is acceptable. The analyses play an indicative role on the design of the LAMOST focal plane structure.

Multi-scale strain localization within orthogneiss during subduction and exhumation (Tenda unit, Alpine Corsica)

NASA Astrophysics Data System (ADS)

Beaudoin, Alexandre; Augier, Romain; Jolivet, Laurent; Raimbourg, Hugues; Jourdon, Anthony; Scaillet, Stéphane; Cardello, Giovanni Luca

2016-04-01

Strain localization depends upon scale-related factors resulting in a gap between small-scale studies of deformation mechanisms and large-scale numerical and tectonic models. The former often ignore the variations in composition and water content across tectonic units, while the latter oversimplify the role of the deformation mechanisms. This study aims to heal this gap, by considering microstructures and strain localization not only at a single shear zone-scale but across a 40km-wide tectonic unit and throughout its complex polyphased evolution. The Tenda unit (Alpine Corsica) is an external continental unit mainly composed of granites, bounded by the East Tenda Shear Zone (ETSZ) that separates it from the overlying oceanic-derived HP tectonic units. Previous studies substantially agreed on (1) the burial of the Tenda unit down to blueschist-facies conditions associated with top-to-the-west shearing (D1) and (2) subsequent exhumation accommodated by a localized top-to-the-east shear zone (D2). Reaction-softening is the main localizing mechanism proposed in the literature, being associated with the transformation of K-feldspar into white-mica. In this work, the Tenda unit is reviewed through (1) the construction of a new field-based strain map accompanied by cross-sections representing volumes of rock deformed at different grades related to large-scale factors of strain localization and (2) the structural study of hand-specimens and thin-sections coupled with EBSD analysis in order to target the deformation processes. We aim to find how softening and localization are in relation to the map-scale distribution of strain. The large-scale study shows that the whole Tenda unit is affected by the two successive stages of deformation. However, a more intense deformation is observed along the eastern margin, which originally led to the definition of the ETSZ, with a present-day anastomosed geometry of deformation. Strain localization is clearly linked to rheological/lithological contrasts as it concentrates either along preexisting intrusive and tectonic contacts. As K-feldspar-poor granites remain relatively undeformed, reaction-softening seems to be a major mechanism during D1. However, evidences suggest that this mechanism is in competition with dynamic recrystallization: at outcrop and hand-specimen scale, the correlation between localized structures such as C-planes and phengite-rich zones is not always observed. This same competition remains active during D2 where top-to-the-east C-planes are common in phengite-rich layers, but an overall grain-size reduction is also observed across the different strain grades, suggesting that dynamic recrystallization remains active during the whole story. Final localization is sometimes observed in phengite-poor aplitic ultramylonites characterized by a very fine quartz-albite matrix suggesting that grain-size sensitive flow would be the major mechanism involved in the final rheology of the ETSZ.

Similar alteration of motor unit recruitment strategies during the anticipation and experience of pain.

PubMed

Tucker, Kylie; Larsson, Anna-Karin; Oknelid, Stina; Hodges, Paul

2012-03-01

A motor unit consists of a motoneurone and the multiple muscle fibres that it innervates, and forms the final neural pathway that influences movement. Discharge of motor units is altered (decreased discharge rate and/or cessation of firing; and increased discharge rate and/or recruitment of new units) during matched-force contractions with pain. This is thought to be mediated by nociceptive (pain) input on motoneurones, as demonstrated in animal studies. It is also possible that motoneurone excitability is altered by pain related descending inputs, that these changes persist after noxious stimuli cease, and that direct nociceptive input is not necessary to induce pain related changes in movement. We aimed to determine whether anticipation of pain (descending pain related inputs without nociceptor discharge) alters motor unit discharge, and to observe motor unit discharge recovery after pain has ceased. Motor unit discharge was recorded with fine-wire electrodes in the quadriceps of 9 volunteers. Subjects matched isometric knee-extension force during anticipation of pain (anticipation: electrical shocks randomly applied over the infrapatellar fat-pad); pain (hypertonic saline injected into the fat-pad); and 3 intervening control conditions. Discharge rate of motor units decreased during pain (P<.001) and anticipation (P<.01) compared with control contractions. De-recruitment of 1 population of units and new recruitment of another population were observed during both anticipation and pain; some changes in motor unit recruitment persisted after pain ceased. This challenges the fundamental theory that pain-related changes in muscle activity result from direct nociceptor discharge, and provides a mechanism that may underlie long-term changes in movement/chronicity in some musculoskeletal conditions. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Pathology Observed on Cone Beam Computed Tomographic Scans: A Comparison of Prevalence and Type of Incidental Findings for Child/Adolescents and Adults

DTIC Science & Technology

2013-04-13

the radiation passed through the subject. For conventional CT, this value is called a Hounsfield unit (HU), named in the honor of Godfrey Hounsfield ...concretions and tonsilloliths. Otolaryngol Clin North Am. 1987 May;20(2):305-9. 39. Reeves TE, Mah P, McDavid WD. Deriving Hounsfield units using grey...study are those of the authors and do not reflect the official policy of the United States Air Force, the Department of Defense, or the United States

[Changing medical practices and nosocomial infection rates in French maternity units from 1997 to 2000].

PubMed

Vincent-Boulétreau, A; Caillat-Vallet, E; Dumas, A M; Ayzac, L; Chapuis, C; Emery, M N; Girard, R; Haond, C; Lafarge-Leboucher, J; Tissot-Guerraz, F; Fabry, J

2005-04-01

In this study we describe the changes in medical practices and nosocomial infection rates in obstetrics observed through a surveillance network in the South East of France. The maternity units which belong to this network participated in voluntary surveillance using the network's methodology. The criteria for the diagnosis of nosocomial infections were in accordance with the methods described by the Centers for Disease Control and Prevention. 101240 pregnancies including 18503 caesareans (18.3%) were included in the network from 1997 to 2000. During the study period, nosocomial infection rates following caesarean section and vaginal delivery decreased respectively from 7.8% to 4.3% (p < 0.001) and from 2.2% to 0.9% (p < 0.001). This evolution was compared with the evolution of collected risk factors. In spite of the methodology limits, general value of surveillance and infection control programs in maternity units has been confirmed by the results of this surveillance network. During the study period, both obstetrics-related risk factors for nosocomial infection and observed hospital-acquired infection rates were dramatically reduced, what prove an improvement of quality of care in maternity units.

Century Scale Evaporation Trend: An Observational Study

NASA Technical Reports Server (NTRS)

Bounoui, Lahouari

2012-01-01

Several climate models with different complexity indicate that under increased CO2 forcing, runoff would increase faster than precipitation overland. However, observations over large U.S watersheds indicate otherwise. This inconsistency between models and observations suggests that there may be important feedbacks between climate and land surface unaccounted for in the present generation of models. We have analyzed century-scale observed annual runoff and precipitation time-series over several United States Geological Survey hydrological units covering large forested regions of the Eastern United States not affected by irrigation. Both time-series exhibit a positive long-term trend; however, in contrast to model results, these historic data records show that the rate of precipitation increases at roughly double the rate of runoff increase. We considered several hydrological processes to close the water budget and found that none of these processes acting alone could account for the total water excess generated by the observed difference between precipitation and runoff. We conclude that evaporation has increased over the period of observations and show that the increasing trend in precipitation minus runoff is correlated to observed increase in vegetation density based on the longest available global satellite record. The increase in vegetation density has important implications for climate; it slows but does not alleviate the projected warming associated with greenhouse gases emission.

Is smoking heaviness causally associated with alcohol use? A Mendelian randomization study in four European cohorts.

PubMed

Taylor, Michelle; Rode, Line; Bjørngaard, Johan; Taylor, Amy E; Bojesen, Stig E; Åsvold, Bjørn O; Gabrielsen, Maiken E; Lewis, Glyn; Nordestgaard, Børge G; Romundstad, Pål R; Hickman, Matthew; Munafò, Marcus R

2018-03-02

Observational studies have shown that tobacco and alcohol use co-occur, but it is not clear whether this relationship is causal. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) and UK Biobank, we used observational methods to test the hypothesis that smoking heaviness increases alcohol consumption. Mendelian randomization (MR) analyses were then used to test the causal relationship between smoking heaviness and alcohol consumption using 55 967 smokers from four European studies [ALSPAC, The Nord-Trøndelag Health Study (HUNT), the Copenhagen General Population Study (CGPS) and UK Biobank]. MR analyses used rs1051730/rs16969968 as a genetic proxy for smoking heaviness. Observational results provided evidence of an association between cigarettes per day and weekly alcohol consumption (increase in units of alcohol per additional cigarette smoked per day = 0.10, 95% confidence interval (CI) 0.05 to 0.15, P ≤ 0.001 in ALSPAC; and 0.48, 95% CI 0.45 to 0.52, P ≤ 0.001 in UK Biobank). However, there was little evidence for an association between rs1051730/rs16969968 and units of alcohol consumed per week across ALSPAC, HUNT, CGPS and UK Biobank (standard deviation increase in units of alcohol per additional copy of the risk allele = -0.004, 95% CI -0.023 to 0.016, P=0.708, I2 = 51.9%). We had 99% and 88% power to detect a change of 0.03 and 0.02 standard deviation units of alcohol per additional copy of the risk allele, respectively. Previously reported associations between smoking and alcohol are unlikely to be causal, and may be the result of confounding and/or reverse causation. This has implications for public health research and intervention research.

Self-administered Versus Directly Observed Once-Weekly Isoniazid and Rifapentine Treatment of Latent Tuberculosis Infection

PubMed Central

Belknap, Robert; Holland, David; Feng, Pei-Jean; Millet, Joan-Pau; Caylà, Joan A.; Martinson, Neil A.; Wright, Alicia; Chen, Michael P.; Moro, Ruth N.; Scott, Nigel A.; Arevalo, Bert; Miró, José M.; Villarino, Margarita E.; Weiner, Marc; Borisov, Andrey S.

2017-01-01

Background Expanding latent tuberculosis treatment is important to decrease active disease globally. Once-weekly isoniazid and rifapentine for 12 doses is effective but limited by requiring direct observation. Objective To compare treatment completion and safety of once-weekly isoniazid and rifapentine by self-administration versus direct observation. Design An open-label, phase 4 randomized clinical trial designed as a noninferiority study with a 15% margin. Seventy-five percent or more of study patients were enrolled from the United States for a prespecified subgroup analysis. (ClinicalTrials.gov: NCT01582711) Setting Outpatient tuberculosis clinics in the United States, Spain, Hong Kong, and South Africa. Participants 1002 adults (aged ≥18 years) recommended for treatment of latent tuberculosis infection. Intervention Participants received once-weekly isoniazid and rifapentine by direct observation, self-administration with monthly monitoring, or self-administration with weekly text message reminders and monthly monitoring. Measurements The primary outcome was treatment completion, defined as 11 or more doses within 16 weeks and measured using clinical documentation and pill counts for direct observation, and self-reports, pill counts, and medication event–monitoring devices for self-administration. The main secondary outcome was adverse events. Results Median age was 36 years, 48% of participants were women, and 77% were enrolled at the U.S. sites. Treatment completion was 87.2% (95% CI, 83.1% to 90.5%) in the direct-observation group, 74.0% (CI, 68.9% to 78.6%) in the self-administration group, and 76.4% (CI, 71.3% to 80.8%) in the self-administration–with–reminders group. In the United States, treatment completion was 85.4% (CI, 80.4% to 89.4%), 77.9% (CI, 72.7% to 82.6%), and 76.7% (CI, 70.9% to 81.7%), respectively. Self-administered therapy without reminders was noninferior to direct observation in the United States; no other comparisons met noninferiority criteria. A few drug-related adverse events occurred and were similar across groups. Limitation Persons with latent tuberculosis infection enrolled in South Africa would not routinely be treated programmatically. Conclusion These results support using self-administered, once-weekly isoniazid and rifapentine to treat latent tuberculosis infection in the United States, and such treatment could be considered in similar settings when direct observation is not feasible. Primary Funding Source Centers for Disease Control and Prevention. PMID:29114781

[Nursing care time in a teaching hospital].

PubMed

Rogenski, Karin Emília; Fugulin, Fernanda Maria Togeiro; Gaidzinski, Raquel Rapone; Rogenski, Noemi Marisa Brunet

2011-03-01

This is a quantitative exploratory, descriptive study performed with the objective to identify and analyze the performance of the average time of nursing care delivered to patients of the Inpatient Units of the University Hospital at University of São Paulo (UH-USP), from 2001 to 2005. The average nursing care time delivered to patients of the referred units was identified by applying of a mathematical equation proposed in the literature, after surveying data from the Medical and Statistical Service and based on the monthly working shifts of the nursing professionals. Data analysis was performed using descriptive statistics. The average nursing care time observed in most units, despite some variations, remained stable during the analyzed period. Based on this observed stability, it is concluded that the nursing staff in the referred HU-USP units has been continuously evaluated with the purposes of maintaining the average time of assistance and, thus, the quality of the care being delivered.

Students' Illustrations of the Human Nervous System as a Formative Assessment Tool

ERIC Educational Resources Information Center

Ranaweera, Sisika Priyani Nelum; Montplaisir, Lisa Marie

2010-01-01

The purpose of this study was to explore students' knowledge and learning of the human nervous system (HNS) in an introductory undergraduate Human Anatomy and Physiology course. Classroom observations, demographic data, a preinstructional unit test with drawings, and a postinstructional unit test with drawings were used to identify students'…

What Science Teaching Looks Like: An International Perspective

ERIC Educational Resources Information Center

Roth, Kathleen; Garnier, Helen

2007-01-01

Using the Trends in International Mathematics and Science (TIMSS) video study, the authors compare science teaching practices in the United States and in four other countries that outperformed the United States: Australia, the Czech Republic, Japan, and the Netherlands. Their observations of videotapes from 100 8th-grade science lessons in each…

Detection and attribution of streamflow timing changes to climate change in the Western United States

USGS Publications Warehouse

Hidalgo, H.G.; Das, T.; Dettinger, M.D.; Cayan, D.R.; Pierce, D.W.; Barnett, T.P.; Bala, G.; Mirin, A.; Wood, A.W.; Bonfils, Celine; Santer, B.D.; Nozawa, T.

2009-01-01

This article applies formal detection and attribution techniques to investigate the nature of observed shifts in the timing of streamflow in the western United States. Previous studies have shown that the snow hydrology of the western United States has changed in the second half of the twentieth century. Such changes manifest themselves in the form of more rain and less snow, in reductions in the snow water contents, and in earlier snowmelt and associated advances in streamflow "center" timing (the day in the "water-year" on average when half the water-year flow at a point has passed). However, with one exception over a more limited domain, no other study has attempted to formally attribute these changes to anthropogenic increases of greenhouse gases in the atmosphere. Using the observations together with a set of global climate model simulations and a hydrologic model (applied to three major hydrological regions of the western United States_the California region, the upper Colorado River basin, and the Columbia River basin), it is found that the observed trends toward earlier "center" timing of snowmelt-driven streamflows in the western United States since 1950 are detectably different from natural variability (significant at the p < 0.05 level). Furthermore, the nonnatural parts of these changes can be attributed confidently to climate changes induced by anthropogenic greenhouse gases, aerosols, ozone, and land use. The signal from the Columbia dominates the analysis, and it is the only basin that showed a detectable signal when the analysis was performed on individual basins. It should be noted that although climate change is an important signal, other climatic processes have also contributed to the hydrologic variability of large basins in the western United States. ?? 2009 American Meteorological Society.

Development of a Model of Interprofessional Shared Clinical Decision Making in the ICU: A Mixed-Methods Study.

PubMed

DeKeyser Ganz, Freda; Engelberg, Ruth; Torres, Nicole; Curtis, Jared Randall

2016-04-01

To develop a model to describe ICU interprofessional shared clinical decision making and the factors associated with its implementation. Ethnographic (observations and interviews) and survey designs. Three ICUs (two in Israel and one in the United States). A convenience sample of nurses and physicians. None. Observations and interviews were analyzed using ethnographic and grounded theory methodologies. Questionnaires included a demographic information sheet and the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration. From observations and interviews, we developed a conceptual model of the process of shared clinical decision making that involves four stepped levels, proceeding from the lowest to the highest levels of collaboration: individual decision, information exchange, deliberation, and shared decision. This process is influenced by individual, dyadic, and system factors. Most decisions were made at the lower two levels. Levels of perceived collaboration were moderate with no statistically significant differences between physicians and nurses or between units. Both qualitative and quantitative data corroborated that physicians and nurses from all units were similarly and moderately satisfied with their level of collaboration and shared decision making. However, most ICU clinical decision making continues to take place independently, where there is some sharing of information but rarely are decisions made collectively. System factors, such as interdisciplinary rounds and unit culture, seem to have a strong impact on this process. This study provides a model for further study and improvement of interprofessional shared decision making.

The Intelligence of Observation: Improving High School Students' Spatial Ability by Means of Intervention Unit

ERIC Educational Resources Information Center

Patkin, Dorit; Dayan, Ester

2013-01-01

This case study of one class versus a control group focused on the impact of an intervention unit, which is not part of the regular curriculum, on the improvement of spatial ability of high school students (forty-six 12th-graders, aged 17-18, both boys and girls) in general as well as from a gender perspective. The study explored three…

Magellan: Preliminary description of Venus surface geologic units

NASA Technical Reports Server (NTRS)

Saunders, R. S.; Arvidson, R.; Head, J. W., III; Schaber, G. G.; Solomon, S. C.; Stofan, E. R.; Basilevsky, Alexander T.; Guest, J. E.; Mcgill, G. E.; Moore, H. J.

1991-01-01

Observations from approximately one-half of the Magellan nominal eight-month mission to map Venus are summarized. Preliminary compilation of initial geologic observations of the planet reveals a surface dominated by plains that are characterized by extensive and intensive volcanism and tectonic deformation. Four broad categories of units have been identified: plains units, linear belts, surficial units, and terrain units.

Crystalline structures of particles interacting through the harmonic-repulsive pair potential

NASA Astrophysics Data System (ADS)

Levashov, V. A.

2017-09-01

The behavior of identical particles interacting through the harmonic-repulsive pair potential has been studied in 3D using molecular dynamics simulations at a number of different densities. We found that at many densities, as the temperature of the systems decreases, the particles crystallize into complex structures whose formation has not been anticipated in previous studies on the harmonic-repulsive pair potential. In particular, at certain densities, crystallization into the structure I a 3 ¯ d (space group #230) with 16 particles in the unit cell occupying Wyckoff special positions (16b) was observed. This crystal structure has not been observed previously in experiments or in computer simulations of single component atomic or soft matter systems. At another density, we observed a liquid which is rather stable against crystallization. Yet, we observed crystallization of this liquid into the monoclinic C2/c (space group #15) structure with 32 particles in the unit cell occupying four different non-special Wyckoff (8f) sites. In this structure particles located at different Wyckoff sites have different energies. From the perspective of the local atomic environment, the organization of particles in this structure resembles the structure of some columnar quasicrystals. At a different value of the density, we did not observe crystallization at all despite rather long molecular dynamics runs. At two other densities, we observed the formation of the β S n distorted diamond structures instead of the expected diamond structure. Possibly, we also observed the formation of the R 3 ¯ c hexagonal lattice with 24 particles per unit cell occupying non-equivalent positions.

Identifying strengths and weaknesses of Quality Management Unit University of Sumatera Utara software using SCAMPI C

NASA Astrophysics Data System (ADS)

Gunawan, D.; Amalia, A.; Rahmat, R. F.; Muchtar, M. A.; Siregar, I.

2018-02-01

Identification of software maturity level is a technique to determine the quality of the software. By identifying the software maturity level, the weaknesses of the software can be observed. As a result, the recommendations might be a reference for future software maintenance and development. This paper discusses the software Capability Level (CL) with case studies on Quality Management Unit (Unit Manajemen Mutu) University of Sumatera Utara (UMM-USU). This research utilized Standard CMMI Appraisal Method for Process Improvement class C (SCAMPI C) model with continuous representation. This model focuses on activities for developing quality products and services. The observation is done in three process areas, such as Project Planning (PP), Project Monitoring and Control (PMC), and Requirements Management (REQM). According to the measurement of software capability level for UMM-USU software, turns out that the capability level for the observed process area is in the range of CL1 and CL2. Planning Project (PP) is the only process area which reaches capability level 2, meanwhile, PMC and REQM are still in CL 1 or in performed level. This research reveals several weaknesses of existing UMM-USU software. Therefore, this study proposes several recommendations for UMM-USU to improve capability level for observed process areas.

A Raman spectroscopic study of the uranyl sulphate mineral johannite.

PubMed

Frost, Ray L; Erickson, Kristy L; Cejka, Jirí; Reddy, B Jagannadha

2005-09-01

Raman spectroscopy at 298 and 77K has been used to study the secondary uranyl mineral johannite of formula (Cu(UO2)2(SO4)2(OH)2 x 8H2O). Four Raman bands are observed at 3593, 3523, 3387 and 3234cm(-1) and four infrared bands at 3589, 3518, 3389 and 3205cm(-1). The first two bands are assigned to OH- units (hydroxyls) and the second two bands to water units. Estimations of the hydrogen bond distances for these four bands are 3.35, 2.92, 2.79 and 2.70 A. A sharp intense band at 1042 cm(-1) is attributed to the (SO4)2- symmetric stretching vibration and the three Raman bands at 1147, 1100 and 1090cm(-1) to the (SO4)2- anti-symmetric stretching vibrations. The nu2 bending modes were at 469, 425 and 388 cm(-1) at 77K confirming the reduction in symmetry of the (SO4)2- units. At 77K two bands at 811 and 786 cm(-1) are attributed to the nu1 symmetric stretching modes of the (UO2)2+ units suggesting the non-equivalence of the UO bonds in the (UO2)2+ units. The band at 786cm(-1), however, may be related to water molecules libration modes. In the 77K Raman spectrum, bands are observed at 306, 282, 231 and 210cm(-1) with other low intensity bands found at 191, 170 and 149cm(-1). The two bands at 282 and 210 cm(-1) are attributed to the doubly degenerate nu2 bending vibration of the (UO2)2+ units. Raman spectroscopy can contribute significant knowledge in the study of uranyl minerals because of better band separation with significantly narrower bands, avoiding the complex spectral profiles as observed with infrared spectroscopy.

Nutritional status among older residents with dementia in open versus special care units in municipal nursing homes: an observational study

PubMed Central

2013-01-01

Background Undernutrition is widespread among institutionalised elderly, and people suffering from dementia are at particularly high risk. Many elderly with dementia live in open units or in special care units in nursing homes. It is not known whether special care units have an effect on the nutritional status of the residents. The aim of this study was therefore to examine the nutritional status of residents with dementia in both open units and in special care units. Methods Among Oslo’s 29 municipal nursing homes, 21 participated with 358 residents with dementia or cognitive impairment, of which 46% lived in special care units. Nutritional status was assessed using the Malnutrition Universal Screening Tool and anthropometry. Results We found no differences (p > 0.05) in risk of undernutrition, body mass index, mid-upper arm muscle circumference or triceps skinfold thickness between residents in open units and those in special care units. Residents in special care units were significantly younger and stronger when measured with a hand-grip test. Conclusions We found no difference in nutritional status between nursing home residents with dementia/cognitive impairment in open units versus in special care units. PMID:23496975

Dairy calf rearing unit and infectious diseases: diarrhea outbreak by bovine coronavirus as a model for the dispersion of pathogenic microorganisms.

PubMed

Alfieri, Amauri Alcindo; Ribeiro, Juliane; de Carvalho Balbo, Luciana; Lorenzetti, Elis; Alfieri, Alice Fernandes

2018-04-18

Dairy calf rearing unit is a management system that is only recently being implemented by some milk producer's cooperatives in southern Brazil. However, aspects related to the health profile of the heifer calves that arrive in the rearing unit as well as about biosecurity practices and microbiological challenges have not yet been evaluated in this rearing system in a tropical country. Diarrhea is the main and most frequent consequence of enteric infections in newborn calves. This study, through some etiological and epidemiological characteristics of an outbreak of neonatal diarrhea, has the aim to alert to the possibility of pathogenic microorganism spread in a dairy heifer calf rearing unit. The diarrhea outbreak presented some non-regular characteristics observed in bovine coronavirus (BCoV) enteric infections in dairy calves. The spread of infection was extremely rapid (1 week); the attack rate (> 50%) was much higher than that observed in calves subjected to conventional rearing; and the age range (5 to 90 days) of the affected heifer calves was much broader than that often observed in the BCoV diarrhea worldwide. These unusual epidemiological characteristics observed in this BCoV diarrhea outbreak raise awareness of the health threat present in calf rearing units as well as of the easy and rapid viral spread in a population of young animals from different dairy herds and, therefore, with very distinct immunological status.

Human motor unit recordings: origins and insight into the integrated motor system.

PubMed

Duchateau, Jacques; Enoka, Roger M

2011-08-29

Soon after Edward Liddell [1895-1981] and Charles Sherrington [1857-1952] introduced the concept of a motor unit in 1925 and the necessary technology was developed, the recording of single motor unit activity became feasible in humans. It was quickly discovered by Edgar Adrian [1889-1977] and Detlev Bronk [1897-1975] that the force exerted by muscle during voluntary contractions was the result of the concurrent recruitment of motor units and modulation of the rate at which they discharged action potentials. Subsequent studies found that the relation between discharge frequency and motor unit force was characterized by a sigmoidal function. Based on observations on experimental animals, Elwood Henneman [1915-1996] proposed a "size principle" in 1957 and most studies in humans focussed on validating this concept during various types of muscle contractions. By the end of the 20th C, the experimental evidence indicated that the recruitment order of human motor units was determined primarily by motoneuron size and that the occasional changes in recruitment order were not an intended strategy of the central nervous system. Fundamental knowledge on the function of Sherrington's "common final pathway" was expanded with observations on motor unit rotation, minimal and maximal discharge rates, discharge variability, and self-sustained firing. Despite the great amount of work on characterizing motor unit activity during the first century of inquiry, however, many basic questions remain unanswered and these limit the extent to which findings on humans and experimental animals can be integrated and generalized to all movements. 2011 Elsevier B.V. All rights reserved.

Teaching the Teachers: Peer Observations in Elementary Classrooms

ERIC Educational Resources Information Center

Schenk, Matthew D.

2016-01-01

The United States is facing an unprecedented teacher shortage. With many studies estimating that 17-33% of teachers leave the profession within their first five years of starting a career, something needs to change to keep new teachers in the classroom. This study evaluates the effectiveness of peer observation as a learning tool to supplement the…

Follicular Lymphoma in the United States: First Report of the National LymphoCare Study

PubMed Central

Friedberg, Jonathan W.; Taylor, Michael D.; Cerhan, James R.; Flowers, Christopher R.; Dillon, Hildy; Farber, Charles M.; Rogers, Eric S.; Hainsworth, John D.; Wong, Elaine K.; Vose, Julie M.; Zelenetz, Andrew D.; Link, Brian K.

2009-01-01

Purpose Optimal therapy of follicular lymphoma (FL) is not defined. We analyzed a large prospective cohort study to identify current demographics and patterns of care of FL in the United States. Patients and Methods The National LymphoCare Study is a multicenter, longitudinal, observational study designed to collect information on treatment regimens and outcomes for patients with newly diagnosed FL in the United States. Patients were enrolled between 2004 and 2007. There is no study-specific prescribed treatment regimen or intervention. Results Two thousand seven hundred twenty-eight subjects were enrolled at 265 sites, including the 80% of patients enrolled from nonacademic sites. Using the Follicular Lymphoma International Prognostic Index (FLIPI), three distinct groups independent of histologic grade could be defined. Initial therapeutic strategy was: observation, 17.7%; rituximab monotherapy, 13.9%; clinical trial 6.1%; radiation therapy, 5.6%; chemotherapy only, 3.2%; chemotherapy plus rituximab, 51.9%. Chemotherapy plus rituximab regimens were: rituximab plus cyclophosphamide, doxorubicin, vincristine, prednisone, 55.0%; rituximab plus cyclophosphamide, vincristine, and prednisone, 23.1%; rituximab plus fludarabine based, 15.5%; other, 6.4%. The choice to initiate therapy rather than observe was associated with age, FLIPI, stage, and grade (P < .01). Significant differences in treatment (P < .01) across regions of the United States were noted. Contrary to practice guidelines, treatment of stage I FL frequently omits radiation therapy. Conclusion Widely disparate therapeutic approaches are utilized for FL. Initial therapy is deferred in a small subset of patients. There is no single standard of care for the treatment of de novo FL, although antibody use is ubiquitous when therapy is initiated. These disparate approaches to the initial care of patients with FL render a heterogeneous group of patients at relapse. PMID:19204203

Establishment of a medium-scale mosquito facility: optimization of the larval mass-rearing unit for Aedes albopictus (Diptera: Culicidae).

PubMed

Zhang, Dongjing; Zhang, Meichun; Wu, Yu; Gilles, Jeremie R L; Yamada, Hanano; Wu, Zhongdao; Xi, Zhiyong; Zheng, Xiaoying

2017-11-13

Standardized larval rearing units for mosquito production are essential for the establishment of a mass-rearing facility. Two larval rearing units, developed respectively by the Guangzhou Wolbaki Biotech Co. Ltd. (Wolbaki) and Insect Pest Control Laboratory, Joint FAO/IAEA Division of Nuclear Techniques in Food and Agriculture (FAO/IAEA-IPCL), are tested to assess their potential uses to mass-rear the larval stages of Aedes albopictus in support of the establishment of a medium-scale mosquito facility for the application of mosquito genetic control strategies. The triple Wolbachia-infected Ae. albopictus strain (HC strain) was used in this study. The effects of larval densities of two larval rearing trays (corresponding to 2.4, 3.0 and 3.6 larvae/cm 2 ) and tray size/position (top, middle and bottom layers) on the pupae production and larval survival were assessed when trays were stacked within the larval rearing units. The male pupae production, female pupae contamination after sex separation, and male mating competitiveness were also studied by using both larval rearing units in their entirety. The optimal larval rearing density for Wolbaki-tray (Wol-tray) was 6,600 larvae (equal to 3.0 larvae/cm 2 ) and 18,000 larvae (3.6 larvae/cm 2 ) for the FAO/IAEA-IPCL tray (IAEA-tray). No significant difference in pupae production was observed when trays were stacked within top, middle or bottom layers for both units. At thirty-four hours after the first pupation, the average male pupae production was (0.89 × 10 5 ) for the Wol-unit and (3.16 × 10 5 ) for the IAEA-unit. No significant difference was observed in female pupae contamination between these two units. The HC males showed equal male mating competitiveness to wild type males for mating with wild type females in large cages, regardless of whether they were reared in the Wol-unit or IAEA-unit. The current study has indicated that both the Wol-unit and IAEA-unit are suitable for larvae mass-rearing for Ae. albopictus. However, the IAEA-unit, with higher male production and less space required compared to the Wol-unit, is recommended to be used in support of the establishment of a medium-sized mosquito facility.

Influence of using a single facial vein as outflow in full-face transplantation: A three-dimensional computed tomographic study.

PubMed

Rodriguez-Lorenzo, Andres; Audolfsson, Thorir; Wong, Corrine; Cheng, Angela; Arbique, Gary; Nowinski, Daniel; Rozen, Shai

2015-10-01

The aim of this study was to evaluate the contribution of a single unilateral facial vein in the venous outflow of total-face allograft using three-dimensional computed tomographic imaging techniques to further elucidate the mechanisms of venous complications following total-face transplant. Full-face soft-tissue flaps were harvested from fresh adult human cadavers. A single facial vein was identified and injected distally to the submandibular gland with a radiopaque contrast (barium sulfate/gelatin mixture) in every specimen. Following vascular injections, three-dimensional computed tomographic venographies of the faces were performed. Images were viewed using TeraRecon Software (Teracon, Inc., San Mateo, CA, USA) allowing analysis of the venous anatomy and perfusion in different facial subunits by observing radiopaque filling venous patterns. Three-dimensional computed tomographic venographies demonstrated a venous network with different degrees of perfusion in subunits of the face in relation to the facial vein injection side: 100% of ipsilateral and contralateral forehead units, 100% of ipsilateral and 75% of contralateral periorbital units, 100% of ipsilateral and 25% of contralateral cheek units, 100% of ipsilateral and 75% of contralateral nose units, 100% of ipsilateral and 75% of contralateral upper lip units, 100% of ipsilateral and 25% of contralateral lower lip units, and 50% of ipsilateral and 25% of contralateral chin units. Venographies of the full-face grafts revealed better perfusion in the ipsilateral hemifaces from the facial vein in comparison with the contralateral hemifaces. Reduced perfusion was observed mostly in the contralateral cheek unit and contralateral lower face including the lower lip and chin units. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Motor units in vastus lateralis and in different vastus medialis regions show different firing properties during low-level, isometric knee extension contraction.

PubMed

de Souza, Leonardo Mendes Leal; Cabral, Hélio Veiga; de Oliveira, Liliam Fernandes; Vieira, Taian Martins

2018-04-01

Architectural differences along vastus medialis (VM) and between VM and vastus lateralis (VL) are considered functionally important for the patellar tracking, knee joint stability and knee joint extension. Whether these functional differences are associated with a differential activity of motor units between VM and VL is however unknown. In the present study, we, therefore, investigate neuroanatomical differences in the activity of motor units detected proximo-distally from VM and from the VL muscle. Nine healthy volunteers performed low-level isometric knee extension contractions (20% of their maximum voluntary contraction) following a trapezoidal trajectory. Surface electromyograms (EMGs) were recorded from VM proximal and distal regions and from VL using three linear adhesive arrays of eight electrodes. The firing rate and recruitment threshold of motor units decomposed from EMGs were then compared among muscle regions. Results show that VL motor units reached lower mean firing rates in comparison with VM motor units, regardless of their position within VM (P < .040). No significant differences in firing rate were found between proximal and distal, VM motor units (P = .997). Furthermore, no significant differences in the recruitment threshold were observed for all motor units analysed (P = .108). Our findings possibly suggest the greater potential of VL to generate force, due to its fibres arrangement, may account for the lower discharge rate observed for VL then either proximally or distally detected motor units in VM. Additionally, the present study opens new perspectives on the importance of considering muscle architecture in investigations of the neural aspects of motor behaviour. Copyright © 2017 Elsevier B.V. All rights reserved.

The effect of inter-unit HLA matching in double umbilical cord blood transplantation for acute leukemia

PubMed Central

Brunstein, Claudio; Zhang, Mei-Jie; Barker, Juliet; St. Martin, Andrew; Bashey, Asad; de Lima, Marcos; Dehn, Jason; Hematti, Peiman; Perales, Miguel-Angel; Rocha, Vanderson; Territo, Mary; Weisdorf, Daniel; Eapen, Mary

2017-01-01

The effects of inter-unit HLA-match on early outcomes with regards to double cord blood transplantation have not been established. Therefore, we studied the effect of inter-unit HLA-mismatching on the outcomes of 449 patients with acute leukemia after double cord blood transplantation. Patients were divided into two groups: one group that included transplantations with inter-unit mismatch at 2 or less HLA-loci (n=381) and the other group with inter-unit mismatch at 3 or 4 HLA-loci (n=68). HLA-match considered low resolution matching at HLA-A and -B loci and allele-level at HLA-DRB1, the accepted standard for selecting units for double cord blood transplants. Patients’, disease, and transplant characteristics were similar in the two groups. We observed no effect of the degree of inter-unit HLA-mismatch on neutrophil (Hazard Ratio 1.27, P=0.11) or platelet (Hazard Ratio 0.1.13, P=0.42) recovery, acute graft-versus-host disease (Hazard Ratio 1.17, P=0.36), treatment-related mortality (Hazard Ratio 0.92, P=0.75), relapse (Hazard Ratio 1.18, P=0.49), treatment failure (Hazard Ratio 0.99, P=0.98), or overall survival (Hazard Ratio 0.98, P=0.91). There were no differences in the proportion of transplants with engraftment of both units by three months (5% after transplantation of units with inter-unit mismatch at ≤2 HLA-loci and 4% after transplantation of units with inter-unit mismatch at 3 or 4 HLA-loci). Our observations support the elimination of inter-unit HLA-mismatch criterion when selecting cord blood units in favor of optimizing selection based on individual unit characteristics. PMID:28126967

Regional stratigraphy of the south polar layered deposits (Promethei Lingula, Mars): "Discontinuity-bounded" units in images and radargrams

NASA Astrophysics Data System (ADS)

Guallini, Luca; Rossi, Angelo Pio; Forget, François; Marinangeli, Lucia; Lauro, Sebastian Emanuel; Pettinelli, Elena; Seu, Roberto; Thomas, Nicolas

2018-07-01

The Mars South Polar Layered Deposits (SPLD) are the result of depositional and erosional events, which are marked by different stratigraphic sequences and erosional surfaces. To unambiguously define the stratigraphic units at regional scale, we mapped the SPLD on the basis of observed discontinuities (i.e., unconformities, correlative discontinuities and conformities), as commonly done in terrestrial modern stratigraphy. This methodology is defined as "Discontinuity-Bounded Units" or allostratigraphy, and is complemented by geomorphological mapping. Our study focuses on Promethei Lingula (PL) and uses both high-resolution images (CTX, HiRISE) and radargrams (SHARAD) to combine surface and sub-surface observations and obtain a 3D geological reconstruction of the SPLD. One regional discontinuity (named AUR1) was defined within the studied stratigraphic succession and is exposed in several non-contiguous outcrops around PL as well as observed at depth within the ice sheet. This is the primary contact between two major depositional sequences, showing a different texture at CTX resolution. The lower sequence is characterized mainly by a "ridge and trough" morphology (Ridge and Trough Sequence; RTS) and the upper sequence shows mainly by a "stair-stepped" morphology (Stair-Stepped Sequence; SSS). On the basis of the observations, we defined two regional "discontinuity-bounded" units in PL, respectively coinciding with RTS and SSS sequences. Our stratigraphic reconstruction provides new hints on the major scale events that shaped this region. Oscillations in Martian axial obliquity could have controlled local climate conditions in the past, affecting the PL geological record.

Early rehabilitation for severe acquired brain injury in intensive care unit: multicenter observational study.

PubMed

Bartolo, Michelangelo; Bargellesi, Stefano; Castioni, Carlo A; Bonaiuti, Donatella; Antenucci, Roberto; Benedetti, Angelo; Capuzzo, Valeria; Gamna, Federica; Radeschi, Giulio; Citerio, Giuseppe; Colombo, Carolina; Del Casale, Laura; Recubini, Elena; Toska, Saimir; Zanello, Marco; D'Aurizio, Carlo; Spina, Tullio; Del Gaudio, Alredo; Di Rienzo, Filomena; Intiso, Domenico; Dallocchio, Giulia; Felisatti, Giovanna; Lavezzi, Susanna; Zoppellari, Roberto; Gariboldi, Valentina; Lorini, Luca; Melizza, Giovanni; Molinero, Guido; Mandalà, Giorgio; Pignataro, Amedeo; Montis, Andrea; Napoleone, Alessandro; Pilia, Felicita; Pisu, Marina; Semerjian, Monica; Pagliaro, Giuseppina; Nardin, Lorella; Scarponi, Federico; Zampolini, Mauro; Zava, Raffaele; Massetti, Maria A; Piccolini, Carlo; Aloj, Fulvio; Antonelli, Sergio; Zucchella, Chiara

2016-02-01

The increased survival after a severe acquired brain injury (sABI) raise the problem of making most effective the treatments in Intensive Care Unit (ICU)/Neurointensive Care Unit (NICU), also integrating rehabilitation care. Despite previous studies reported that early mobilization in ICU was effective in preventing complications and reducing hospital stay, few studies addressed the rehabilitative management of sABI patients in ICU/NICU. To collect clinical and functional data about the early rehabilitative management of sABI patients during ICU/NICU stay. Prospective, observational, multicenter study. Fourteen facilities supplied by intensive neurorehabilitation units and ICU/NICUs. Consecutive sABI patients admitted to ICU/NICU. Patients were evaluated at admission and then every 3-5 days. Clinical, functional and rehabilitative data, including Glasgow Coma Scale (GCS), Disability Rating Scale (DRS), The Rancho Los Amigos Levels of Cognitive Functioning Scale (LCF), Early Rehabilitation Barthel Index (ERBI), Glasgow Outcome scale (GOS) and Functional Independence Measure (FIM) were collected. One hundred and two patients (F/M 44/58) were enrolled. The mean duration of ICU stay was 24.7±13.9 days and the first rehabilitative evaluation occurred after 8.7±8.8 days. Regular postural changes and multijoint mobilization were prescribed in 63.7% and 64.7% cases, respectively. The mean session duration was 38±11.5 minutes. Swallowing evaluation was performed in 14.7% patients, psychological support was provided to 12.7% of patients' caregivers, while 17.6% received a psycho-educational intervention, and 28.4% were involved in interdisciplinary team meetings. The main discharge destinations were Severe Acquired Brain Injury rehabilitation units for 43.7%, intensive neurorehabilitation units for 20.7%. Data showed that early rehabilitation was not diffusely performed in sABI subjects in ICU/NICU and rehabilitative interventions were variable; one-third of subjects were not referred to dedicated rehabilitation unit at discharge. The study stresses the need to spread and implement a rehabilitative culture also for critical ill patients due to neurological diseases.

An audit of behavioral indicators of poor welfare in kenneled dogs in the United Kingdom.

PubMed

Stephen, Jacqueline M; Ledger, Rebecca A

2005-01-01

This survey-based study describes the prevalence and onset of behavioral indicators of poor welfare in dogs kenneled at United Kingdom rescue shelters. It describes key factors contributing to individual variation in behaviors. At 8 rescue shelters, staff trained in the care of nonhuman animals recorded daily whether dogs in their care displayed each of 15 behaviors. The study originally involved 302 dogs; for the first 14 days, it monitored only 148 dogs daily. The study observed dogs for a maximum of 6 weeks from admittance, observing all 15 behaviors at least once during the first 2 weeks (n = 148). The proportion of dogs observed to perform each behavior differed within the sample. The most commonly observed behavior (24.3% of dogs) was excessive barking. The remaining 14 behaviors ranged from listlessness (20.3%) to repetitive tail-chasing (1.3%). Over the 6 weeks, the proportion observed to pace repetitively and wall bounce increased. The proportion who lacked appetite and displayed fear-associated behavior decreased. Breed differences, gender, and age partially explained variability in the onset and prevalence of behavioral indicators of poor welfare in kenneled dogs.

Data assimilation to extract soil moisture information from SMAP observations

USDA-ARS?s Scientific Manuscript database

This study compares different methods to extract soil moisture information through the assimilation of Soil Moisture Active Passive (SMAP) observations. Neural Network(NN) and physically-based SMAP soil moisture retrievals were assimilated into the NASA Catchment model over the contiguous United Sta...

Communities. Community Study Unit, Grade 1. Teacher Edition, Field Trip Guide for Teachers, and Student Book.

ERIC Educational Resources Information Center

Lee County School District, Ft. Myers, FL. Dept. of Environmental Education and Instructional Development Services.

This unit is designed to help first grade students understand the broad concept of community. The students experience a variety of in-class and field trip activities that will expose them to communities. The students observe and compare both natural and human-designed communities. Learning activities include pantomimes, listening activities,…

Unit Plants, First Trial Materials, Inspection Set.

ERIC Educational Resources Information Center

Australian Science Education Project, Toorak, Victoria.

The Australian Science Education Project is producing materials designed for use in grades 7-10 of Australian schools. This is the first trial version of a unit introducing the study of plants. The section to be completed by all pupils, contained in the first of the student workbooks, emphasizes observation of specimens on school grounds and on…

Mid- and Late-Career Teachers Struggle with Paltry Incomes

ERIC Educational Resources Information Center

Boser, Ulrich; Straus, Chelsea

2014-01-01

Low teacher pay is not news. Over the years, all sorts of observers have argued that skimpy teacher salaries keep highly qualified individuals out of the profession. One recent study found that a major difference between the education system in the United States and those in other nations with high-performing students is that the United States…

Many participants in inpatient rehabilitation can quantify their exercise dosage accurately: an observational study.

PubMed

Scrivener, Katharine; Sherrington, Catherine; Schurr, Karl; Treacy, Daniel

2011-01-01

Are inpatients undergoing rehabilitation who appear able to count exercises able to quantify accurately the amount of exercise they undertake? Observational study. Inpatients in an aged care rehabilitation unit and a neurological rehabilitation unit, who appeared able to count their exercises during a 1-2 min observation by their treating physiotherapist. Participants were observed for 30 min by an external observer while they exercised in the physiotherapy gymnasium. Both the participants and the observer counted exercise repetitions with a hand-held tally counter and the two tallies were compared. Of the 60 people admitted for aged care rehabilitation during the study period, 49 (82%) were judged by their treating therapist to be able to count their own exercise repetitions accurately. Of the 30 people admitted for neurological rehabilitation during the study period, 20 (67%) were judged by their treating therapist to be able to count their repetitions accurately. Of the 69 people judged to be accurate, 40 underwent observation while exercising. There was excellent agreement between these participants' counts of their exercise repetitions and the observers' counts, ICC (3,1) of 0.99 (95% CI 0.98 to 0.99). Eleven participants (28%) were in complete agreement with the observer. A further 19 participants (48%) varied from the observer by less than 10%. Therapists were able to identify a group of rehabilitation participants who were accurate in counting their exercise repetitions. Counting of exercise repetitions by therapist-selected patients is a valid means of quantifying exercise dosage during inpatient rehabilitation. Copyright © 2011 Australian Physiotherapy Association. Published by .. All rights reserved.

Apollo 16 landing site: Summary of earth based remote sensing data, part W

NASA Technical Reports Server (NTRS)

Zisk, S. H.; Masursky, H.; Milton, D. J.; Schaber, G. G.; Shorthill, R. W.; Thompson, T. W.

1972-01-01

Infrared and radar studies of the Apollo 16 landing site are summarized. Correlations and comparisons between earth based remote sensing data, IR observations, and other data are discussed in detail. Remote sensing studies were devoted to solving two problems: (1) determining the physical difference between Cayley and Descartes geologic units near the landing site; and (2) determining the nature of the bright unit of Descartes mountain material.

The Milieu Manager: A Nursing Staffing Strategy to Reduce Observer Use in the Acute Psychiatric Inpatient Setting.

PubMed

Triplett, Patrick; Dearholt, Sandra; Cooper, Mary; Herzke, John; Johnson, Erin; Parks, Joyce; Sullivan, Patricia; Taylor, Karin F; Rohde, Judith

Rising acuity levels in inpatient settings have led to growing reliance on observers and increased the cost of care. Minimizing use of observers, maintaining quality and safety of care, and improving bed access, without increasing cost. Nursing staff on two inpatient psychiatric units at an academic medical center pilot-tested the use of a "milieu manager" to address rising patient acuity and growing reliance on observers. Nursing cost, occupancy, discharge volume, unit closures, observer expense, and incremental nursing costs were tracked. Staff satisfaction and reported patient behavioral/safety events were assessed. The pilot initiatives ran for 8 months. Unit/bed closures fell to zero on both units. Occupancy, patient days, and discharges increased. Incremental nursing cost was offset by reduction in observer expense and by revenue from increases in occupancy and patient days. Staff work satisfaction improved and measures of patient safety were unchanged. The intervention was effective in reducing observation expense and improved occupancy and patient days while maintaining patient safety, representing a cost-effective and safe approach for management of acuity on inpatient psychiatric units.

Unit Costs of Interlibrary Loans and Photocopies at a Regional Medical Library: Preliminary Report *

PubMed Central

Spencer, Carol C.

1970-01-01

Unit costs of providing interlibrary loans and photocopies were determined by a method not previously used for library cost studies: random time sampling with self-observation. The working time of all appropriate personnel was sampled using Random Alarm Mechanisms and a structured checklist of tasks. The total lender's unit cost per request received, including direct labor, materials, fringe benefits, and overhead, was $1.526 for originals mailed postpaid by lender, and $1.534 for photocopies mailed. Corresponding unit costs per request filled were: originals, $1.932, and photocopies, $1.763. PMID:5439910

Ubiquitous strong electron–phonon coupling at the interface of FeSe/SrTiO3

PubMed Central

Zhang, Chaofan; Liu, Zhongkai; Chen, Zhuoyu; Xie, Yanwu; He, Ruihua; Tang, Shujie; He, Junfeng; Li, Wei; Jia, Tao; Rebec, Slavko N.; Ma, Eric Yue; Yan, Hao; Hashimoto, Makoto; Lu, Donghui; Mo, Sung-Kwan; Hikita, Yasuyuki; Moore, Robert G.; Hwang, Harold Y.; Lee, Dunghai; Shen, Zhixun

2017-01-01

The observation of replica bands in single-unit-cell FeSe on SrTiO3 (STO)(001) by angle-resolved photoemission spectroscopy (ARPES) has led to the conjecture that the coupling between FeSe electrons and the STO phonons are responsible for the enhancement of Tc over other FeSe-based superconductors. However the recent observation of a similar superconducting gap in single-unit-cell FeSe/STO(110) raised the question of whether a similar mechanism applies. Here we report the ARPES study of the electronic structure of FeSe/STO(110). Similar to the results in FeSe/STO(001), clear replica bands are observed. We also present a comparative study of STO(001) and STO(110) bare surfaces, and observe similar replica bands separated by approximately the same energy, indicating this coupling is a generic feature of the STO surfaces and interfaces. Our findings suggest that the large superconducting gaps observed in FeSe films grown on different STO surface terminations are likely enhanced by a common mechanism. PMID:28186084

Ubiquitous strong electron–phonon coupling at the interface of FeSe/SrTiO 3

DOE PAGES

Zhang, Chaofan; Liu, Zhongkai; Chen, Zhuoyu; ...

2017-02-10

The observation of replica bands in single-unit-cell FeSe on SrTiO 3 (STO)(001) by angle-resolved photoemission spectroscopy (ARPES) has led to the conjecture that the coupling between FeSe electrons and the STO phonons are responsible for the enhancement of T c over other FeSe-based superconductors. However the recent observation of a similar superconducting gap in single-unit-cell FeSe/STO(110) raised the question of whether a similar mechanism applies. Here we report the ARPES study of the electronic structure of FeSe/STO(110). Similar to the results in FeSe/STO(001), clear replica bands are observed. We also present a comparative study of STO(001) and STO(110) bare surfaces,more » and observe similar replica bands separated by approximately the same energy, indicating this coupling is a generic feature of the STO surfaces and interfaces. Lastly, our findings suggest that the large superconducting gaps observed in FeSe films grown on different STO surface terminations are likely enhanced by a common mechanism.« less

As CMS makes another policy change, policy makers distinguish between different forms of care.

PubMed

2013-10-01

As observation care continues to draw fire from critics who charge that the designation ends up costing hospitals money while also sticking patients with exorbitant fees, the medical directors of dedicated observation units counter that the kind of care delivered by their specialized units actually saves money and gets patients out of the hospital sooner. They note that the problem is that only about one-third of hospitals actually have dedicated observation units, so patients placed on observation typically wind up in inpatient beds, where they may only be evaluated once a day. CMS has just released a new policy rule on observation that should help patients avoid excessive charges, but many experts would like to see the agency take steps to incentivize the kind of quality care that is delivered in dedicated units. The new CMS rule for 2014 caps observation stays at 48 hours. Patients who remain in the hospital beyond this point become inpatients, as long as they meet inpatient criteria. Proponents of observation care contend that the average length-of-stay in a dedicated observation unit is just 15 hours--typically much shorter than the LOS of patients who are placed on observation in inpatient beds. Care in a dedicated observation unit is generally driven by protocol in an emergency medicine environment where there is continuous rounding. Discharges can occur at any time of the day or night. Experts note that observation patients account for the largest portion of both misdiagnoses and malpractice lawsuits stemming from emergency settings.

Patterns and causes of observed piñon pine mortality in the southwestern United States

USGS Publications Warehouse

Meddens, Arjan J.H.; Hicke, Jeff H.; Macalady, Alison K.; Buotte, P.C.; Cowles, T.R.; Allen, Craig D.

2015-01-01

Recently, widespread piñon pine die-off occurred in the southwestern United States. Here we synthesize observational studies of this event and compare findings to expected relationships with biotic and abiotic factors. Agreement exists on the occurrence of drought, presence of bark beetles and increased mortality of larger trees. However, studies disagree about the influences of stem density, elevation and other factors, perhaps related to study design, location and impact of extreme drought. Detailed information about bark beetles is seldom reported and their role is poorly understood. Our analysis reveals substantial limits to our knowledge regarding the processes that produce mortality patterns across space and time, indicating a poor ability to forecast mortality in response to expected increases in future droughts.

The Effects of Observing Others versus Self-Observation on Teacher Accuracy in Presenting Learn Unit Instruction

ERIC Educational Resources Information Center

Sarto, Elizabeth

2017-01-01

In Experiment I, I tested whether training teacher trainers to conduct TPRA observations to a calibrated standard by teaching them to 1) measure the accuracy of other individuals presenting learn unit instruction, then 2) measure their own accuracy in presenting learn unit instruction, would influence the accuracy of the teacher trainer's…

The Design of Adult Acute Care Units in U.S. Hospitals

PubMed Central

Catrambone, Cathy; Johnson, Mary E.; Mion, Lorraine C.; Minnick, Ann F.

2010-01-01

Purpose To describe the current state of design characteristics determined to be desirable by the Agency for Health Research and Quality (AHRQ) in U.S. adult medical, surgical, and intensive care units (ICUs). Design Descriptive study of patient visibility; distance to hygiene, toileting, charting, and supplies; unit configuration; percentage of private rooms; and presence or absence of carpeting in 56 ICUs and 81 medical-surgical units in six metropolitan areas. Methods Data were collected via observation, measurement, and interviews. Unit configurations were classified via an iterative process. Descriptive data were analyzed according to ICU and non-ICU status using SPSS (Version 15). Findings Analysis of unit configurations indicated eight unit designs. Statistical analysis showed inter- and intrahospital variation in unit configurations, percentage private rooms, carpeting, visibility, and distance to supplies and charting. Few units met the AHRQ designated design elements studied. Conclusions A wide gap exists between desirable characteristics in ICUs and medical-surgical units. Future research is needed to explore operationalization of unit design elements as risk adjustments, how design elements contribute to patient outcomes, and how design elements influence one another. Clinical Relevance There is room for improvement on almost every design variable, particularly on medical-surgical units. Future planning should take into consideration the interaction of bed capacity and unit configuration. PMID:19335681

Water characteristics associated with the occurrence of Legionella pneumophila in dental units.

PubMed

Zanetti, F; Stampi, S; De Luca, G; Fateh-Moghadam, P; Antonietta, M; Sabattini, B; Checchi, L

2000-02-01

This study evaluated the incidence of Legionella pneumophila in dental unit water samples and investigated how the occurrence of these bacteria may be related to some physical, chemical and bacteriological characteristics of the water. The samples were taken from the incoming tap water, oral rinsing cup, air-water syringe, ultrasonic scaler, and the turbine of 23 dental units of private and public institutions. Apart from L. pneumophila (serogroup 1 and 3) isolated in 22 out of the 101 (21.8%) water samples tested, two other species were found: L. bozemanii and L. dumoffii. The highest densities and frequency of L. pneumophila were observed in the water coming into the units and in the dental units of public institutions. A negative association between L. pneumophila and 36 degrees C and 22 degrees C heterotrophic total plate counts and other gram-negative bacteria was found. An inverse association between the concentration of L. pneumophila and water temperature was also observed. The values of pH and total hardness did not show any significant difference in the L. pneumophila-positive and -negative dental unit waters. Finally, the chemical oxygen demand (COD) and residual chlorine were found to correlate positively with L. pneumophila.

Candidemia in the intensive care unit: A 12-year retrospective cohort study in Reunion Island.

PubMed

Hoarau, G; Picot, S; Lemant, J; Peytral, J; Poubeau, P; Zunic, P; Mohr, C; Coueffe, X; Gerardin, P; Antok, E

2018-05-09

We aimed to describe the epidemiology of Candida bloodstream infection in an intensive care unit (ICU) in Reunion Island. We performed a retrospective cohort study and evaluated 63 candidemia episodes, which occurred between January 2004 and December 2015 in the ICU of a University Hospital in St-Pierre. The incidence rate of candidemia in the ICU was estimated at 7.6%. Candida albicans was the most common yeast pathogen species recovered (54%), followed by Candida glabrata (17%), Candida tropicalis (12%) and Candida parapsilosis (10%). Between 2012 and 2015, we also observed a modification of antifungal use. The epidemiology of candidemia in Reunion Island is characterized by the predominance of Candida albicans and by the relative importance of Candida tropicalis. This pattern corresponds to a model of epidemiological transition between the one usually observed in tropical areas and the one observed in temperate countries. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

What Happens When Parents and Children Go Grocery Shopping? An Observational Study of Latino Dyads in Southern California, USA

ERIC Educational Resources Information Center

Calderon, Joanna; Ayala, Guadalupe X.; Elder, John P.; Belch, George E.; Castro, Iana A.; Weibel, Nadir; Pickrel, Julie

2017-01-01

The objective of this study was to observe parent-child interactions in "tiendas," limited assortment food stores catering to Latinos in the United States, and to examine the extent to which child involvement influenced these interactions and their purchase outcomes. Two confederates, one posing as a "tienda" employee and one…

Trends in seasonal warm anomalies across the contiguous United States: Contributions from natural climate variability

Treesearch

Lejiang Yu; Shiyuan Zhong; Warren E. Heilman; Xindi Bian

2018-01-01

Many studies have shown the importance of anthropogenic greenhouse gas emissions in contributing to observed upward trends in the occurrences of temperature extremes over the U.S. However, few studies have investigated the contributions of internal variability in the climate system to these observed trends. Here we use daily maximum temperature time series from the...

Frequency-dependent seismic attenuation in the eastern United States as observed from the 2011 central Virginia earthquake and aftershock sequence

USGS Publications Warehouse

McNamara, Daniel E.; Gee, Lind; Benz, Harley M.; Chapman, Martin

2014-01-01

Ground shaking due to earthquakes in the eastern United States (EUS) is felt at significantly greater distances than in the western United States (WUS) and for some earthquakes it has been shown to display a strong preferential direction. Shaking intensity variation can be due to propagation path effects, source directivity, and/or site amplification. In this paper, we use S and Lg waves recorded from the 2011 central Virginia earthquake and aftershock sequence, in the Central Virginia Seismic Zone, to quantify attenuation as frequency‐dependent Q(f). In support of observations based on shaking intensity, we observe high Q values in the EUS relative to previous studies in the WUS with especially efficient propagation along the structural trend of the Appalachian mountains. Our analysis of Q(f) quantifies the path effects of the northeast‐trending felt distribution previously inferred from the U.S. Geological Survey (USGS) “Did You Feel It” data, historic intensity data, and the asymmetrical distribution of rockfalls and landslides.

An intervention to improve the catheter associated urinary tract infection rate in a medical intensive care unit: Direct observation of catheter insertion procedure.

PubMed

Galiczewski, Janet M; Shurpin, Kathleen M

2017-06-01

Healthcare associated infections from indwelling urinary catheters lead to increased patient morbidity and mortality. The purpose of this study was to determine if direct observation of the urinary catheter insertion procedure, as compared to the standard process, decreased catheter utilization and urinary tract infection rates. This case control study was conducted in a medical intensive care unit. During phase I, a retrospective data review was conducted on utilsiation and urinary catheter infection rates when practitioners followed the institution's standard insertion algorithm. During phase II, an intervention of direct observation was added to the standard insertion procedure. The results demonstrated no change in utilization rates, however, CAUTI rates decreased from 2.24 to 0 per 1000 catheter days. The findings from this study may promote changes in clinical practice guidelines leading to a reduction in urinary catheter utilization and infection rates and improved patient outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Extensive Middle Amazonian mantling of debris aprons and plains in Deuteronilus Mensae, Mars: Implications for the record of mid-latitude glaciation

NASA Astrophysics Data System (ADS)

Baker, David M. H.; Head, James W.

2015-11-01

The mid-latitudes of Mars are host to a record of recent episodes of accumulations of ice-rich materials. The record includes debris aprons, interpreted to be debris-covered glaciers, that may represent the preserved remnants of a much more extensive ice sheet. We assessed the possibility of former glacial extents by examining debris aprons and the surrounding plains in Deuteronilus Mensae. Geomorphic units and stratigraphic relationships were mapped and documented from Mars Reconnaissance Orbiter (MRO) Context (CTX) and High Resolution Imaging Science Experiment (HiRISE) camera images, and crater retention ages were estimated from crater size-frequency distributions. Three major units are observed within the study area: debris aprons, lower plains, and upper plains. Debris aprons exhibit characteristics typical for these features documented elsewhere and in previous studies, including integrated flow lineations and patterns, convex-upward profiles, and knobby and brain terrain surface textures. A lower bound on the age for debris aprons is estimated to be 0.9 Ga. Debris aprons are superposed on a lower plains unit having a lower bound age of 3.3-3.5 Ga. A 50-100 m thick upper plains unit superposes both debris apron landforms and lower plains units and has a best-fit minimum age of 0.6 Ga. The upper plains unit exhibits characteristics of atmospherically-emplaced mantle material, including fine-grained nature, sublimation textures, cyclic layering, draping character, and widespread spatial distribution. Fracturing and subsequent sublimation/erosion of upper plains on debris aprons has contributed to many of the surface textures on debris aprons. The upper plains unit has also been eroded from the lower plains and plateaus, evidenced by isolated blocks of upper plains in the interiors of craters and on the walls and tops of plateaus. While no conclusive evidence diagnostic of former cold-based ice sheets are observed in the plains within the study region, such landforms and units may have been poorly developed or absent, as is often the case on Earth, and would have been covered and reworked by later mantling episodes. These observations suggest that emplacement of thick ice-rich mantle deposits extended at least to near the Early/Middle Amazonian boundary and overlapped with the waning stages of glaciation in Deuteronilus Mensae.

Examining Time Use of Dutch Nursing Staff in Long-Term Institutional Care: A Time-Motion Study.

PubMed

Tuinman, Astrid; de Greef, Mathieu H G; Krijnen, Wim P; Nieweg, Roos M B; Roodbol, Petrie F

2016-02-01

Increasing residents' acuity levels and available resources in long-term institutional care requires insight into the care provided by nursing staff so as to guide task allocation and optimal use of resources, and enhance quality of care. The purpose of this study was to examine the relationship between time use and type of nursing staff, residents' acuity levels, and unit type by using a standardized nursing intervention classification. A multicenter cross-sectional observational study was performed using time-motion technique. Five Dutch long-term institutional care facilities participated. In total, 4 residential care units, 3 somatic units, and 6 psycho-geriatric units were included. Data were collected from 136 nursing staff members: 19 registered nurses, 89 nursing assistants, 9 primary caregivers, and 19 health care assistants. A structured observation list was used based on the Nursing Interventions Classification (NIC). Residents' acuity levels, representing residents' needs, were based on the Dutch Care Severity Index. Medians and interquartile ranges were calculated for time spent on interventions per type of nursing staff and units. Linear mixed models were used to examine the relationship between time spent on nursing interventions and the type of nursing staff, residents' acuity levels, and unit type. Observations resulted in 52,628 registered minutes for 102 nursing interventions categorized into 6 NIC domains for 335 residents. Nursing staff spent the most time on direct care interventions, particularly in the domain of basic physiological care. Variances in time spent on interventions between types of nursing staff were minimal. Unit type was more significantly (P < .05) associated with time spent on interventions in domains than the type of nursing staff. Residents' acuity levels did not affect time spent by nursing staff (P > .05). The current study found limited evidence for task allocation between the types of nursing staff, which may suggest a blurring of role differentiation. Also, findings suggest that residents received similar care regardless of their needs, implying that care is predominantly task-oriented instead of person-centered. Managers may reconsider whether the needs of residents are adequately met by qualified nursing staff, considering the differences in education and taking into account increasing acuity levels of residents and available resources. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Quality of shallow ground water in alluvial aquifers of the Willamette Basin, Oregon, 1993-95

USGS Publications Warehouse

Hinkle, Stephen R.

1997-01-01

The current (1993?95) quality of shallow ground water (generally, <25 meters below land surface) in Willamette Basin alluvium is described using results from two studies. A Study-Unit Survey, or regional assessment of shallow groundwater quality in alluvium, was done from June through August 1993. During the Study-Unit Survey, data were collected from 70 domestic wells chosen using a random-selection process and located mostly in areas of agricultural land use. An urban Land-Use Study, which was a reconnaissance of shallow urban ground-water quality from 10 monitoring wells installed in areas of residential land use, was done in July 1995. Concentrations of nitrite plus nitrate (henceforth, nitrate, because nitrite concentrations were low) ranged from <0.05 to 26 mg N/L (milligrams nitrogen per liter) in ground water from 70 Study-Unit-Survey wells; concentrations exceeded the U.S. Environmental Protection Agency (USEPA) Maximum Contaminant Level (MCL) of 10 mg N/L in 9 percent of Study-Unit-Survey samples. Relationships were observed between nitrate concentrations and dissolved-oxygen concentrations, the amount of clay present within and overlying aquifers, overlying geology, and upgradient land use. Tritium (3H) data indicate that 21 percent of Study-Unit-Survey samples represented water recharged prior to 1953. Nitrogen-fertilizer application rates in the basin have increased greatly over the past several decades. Thus, some observed nitrate concentrations may reflect nitrogen loading rates that were smaller than those presently applied in the basin. Concentrations of phosphorus ranged from <0.01 to 2.2 mg/L in 70 Study-Unit-Survey wells and exceeded 0.10 mg/L in 60 percent of the samples. Phosphorus and nitrate concentrations were inversely correlated. From 1 to 5 pesticides and pesticide degradation products (henceforth, pesticides) were detected in ground water from each of 23 Study-Unit-Survey wells (33 percent of 69 wells sampled for pesticides) for a total of 51 pesticide detections. Thirteen different pesticides were detected; atrazine was the most frequently encountered pesticide. Although detections were widespread, concentrations were low (generally <1,000 ng/L [nanograms per liter]). (One ng/L is equal to 0.001 mg/L [micrograms per liter].) One detection (dinoseb, at 7,900 ng/L) exceeded a USEPA MCL. Relationships were observed between the occurrence of pesticides and the amount of clay present within and overlying aquifers, overlying geology, and land use. Between 1 and 5 volatile organic compounds (VOCs) were detected at each of 7 Study-Unit-Survey sites (11 percent of 65 sites evaluated), for a total of 14 VOC detections. One detection (tetrachloroethylene, at 29 mg/L) exceeded a USEPA MCL. Other detections were at low concentrations (0.2 to 2.0 mg/L). VOC detections generally were from sites associated with urban land use. Concentrations of arsenic ranged from <1 to 13 mg/L in 70 Study-Unit-Survey wells. Concentrations in 16 percent of samples exceeded the USEPA Risk-Specific-Dose Health Advisory of 2 mg/L. Radon concentrations ranged from 200 to 1,200 pCi/L (picocuries per liter) in 51 Study-Unit-Survey wells. All samples exceeded the USEPA Risk-Specific-Dose Health Advisory of 150 pCi/L. All urban Land-Use-Study samples were well oxygenated; thus, nitrate reduction probably did not affect these samples. Urban Land-Use-Study nitrate concentrations were similar to those of the well oxygenated, agricultural subset of Study-Unit-Survey samples. Pesticides were detected in samples from three urban Land-Use-Study sites, but concentrations were low (1 to 5 ng/L). In contrast, VOCs were detected in ground water from 80 percent of urban Land-Use-Study wells; concentrations ranged up to 7.6 mg/L. Trace-element concentrations in the urban Land-Use Study samples were low. Median concentrations consistently were <10 mg/L and frequently were <1 mg/L

An Observational Cohort Study Examining the Effect of the Duration of Skin-to-Skin Contact on the Physiological Parameters of the Neonate in a Neonatal Intensive Special Care Unit.

PubMed

Jones, Hannah; Santamaria, Nick

2018-06-01

Focus on skin-to-skin contact (SSC) as a family-centered care intervention in Neonatal Intensive Special Care (NISC) Units continues to increase. Previously, SSC has been shown to improve neonatal physiological stability, support brain development, and promote bonding and attachment. Limited research exists investigating SSC duration and neonatal physiological responses. This study examined the relationship between SSC duration and the neonate's oxygen saturation, heart rate (HR), respiratory rate (RR), and temperature. An observational cohort study was conducted at The Royal Women's Hospital NISC Unit in Melbourne, Australia. For each neonate participant, 1 SSC with their parent was studied (parent convenience) and neonatal physiological parameters recorded, with a bivariate correlation used to explore the relationship between the duration of SSC and the percentage of time during SSC that the neonate's physiological variables remained within a target range. No correlation existed between the duration of SSC and the neonatal physiological variables of oxygen saturation, HR, RR, and temperature. However, neonatal oxygen requirement was more often reduced across the duration of SSC. Due to previously documented benefits to neonates physiologically from SSC, and our supportive finding that SSC reduces neonatal oxygen requirement, we believe that this study adds to the evidence to support promotion of SSC in NISC Units. The duration of SSC does not appear to negatively impact the physiological effects to the neonate. Thus, SSC should be encouraged in all NISC Units to be conducted for the length of time the parent is able. This study should be repeated with a larger sample size.

Pilot study evaluating the effect of massage therapy on stress, anxiety and aggression in a young adult psychiatric inpatient unit.

PubMed

Garner, Belinda; Phillips, Lisa J; Schmidt, Hans-Martin; Markulev, Connie; O'Connor, Jenny; Wood, Stephen J; Berger, Gregor E; Burnett, Peter; McGorry, Patrick D

2008-05-01

The aim of the present pilot study was to examine the effectiveness of a relaxation massage therapy programme in reducing stress, anxiety and aggression on a young adult psychiatric inpatient unit. This was a prospective, non-randomized intervention study comparing treatment as usual (TAU) with TAU plus massage therapy intervention (MT) over consecutive 7 week blocks (May-August 2006). MT consisted of a 20 min massage therapy session offered daily to patients during their period of hospitalization. The Kennedy Nurses' Observational Scale for Inpatient Evaluation (NOSIE), the Symptom Checklist-90-Revised (SCL-90-R), the State-Trait Anxiety Inventory (STAI) and stress hormone (saliva cortisol) levels were used to measure patient outcomes at admission and discharge from the unit. The Staff Observation Aggression Scale-Revised (SOAS-R) was used to monitor the frequency and severity of aggressive incidents on the unit. There was a significant reduction in self-reported anxiety (p < 0.001), resting heart rate (p < 0.05) and cortisol levels (p < 0.05) immediately following the initial and final massage therapy sessions. Significant improvements in hostility (p = 0.007) and depression scores (p < 0.001) on the SCL-90-R were observed in both treatment groups. There was no group x time interaction on any of the measures. Poor reliability of staff-reported incidents on the SOAS-R limited the validity of results in this domain. Massage therapy had immediate beneficial effects on anxiety-related measures and may be a useful de-escalating tool for reducing stress and anxiety in acutely hospitalized psychiatric patients. Study limitations preclude any definite conclusions on the effect of massage therapy on aggressive incidents in an acute psychiatric setting. Randomized controlled trials are warranted.

Experience with intubated patients does not affect the accidental extubation rate in pediatric intensive care units and intensive care nurseries.

PubMed

Frank, B S; Lewis, R J

1997-06-01

Accidental extubation is a potentially serious event for pediatric or neonatal patients with respiratory failure, especially in clinical settings in which personnel capable of performing reintubation may not be readily available. Thus the rate of accidental extubation in small intensive care units that operate without 24-hour in-house physician availability may be an important quality assurance indicator. The objective of this study were to determine the accidental extubation rate at a single small pediatric intensive care unit (PICU) and compare it with published reports. This study was carried out in a six-bed PICU at Washoe Medical Center in Reno, Nevada, with a relatively low level of patient acuity, as measured by PRISM score and the frequency of intubation, and without 24-hour in-house physician availability. All intubated patients admitted during the 5-year period from January 1, 1989 to December 31, 1993 were included. The primary outcome measure was the occurrence of accidental extubation. We observed only two accidental extubations in 1,749 intubated-patient-days (IPD) (0.114 accidental extubations/100 IPD [95% confidence interval 0.014-0.413 accidental extubations/ 100 IPD]). This rate of accidental extubation was compared with data in published reports from neonatal intensive care units (NICUs) and PICUs, which ranged from 0.14 accidental extubations/100 IPD to 4.36 accidental extubations/100 IPD. The dependence of the observed accidental extubation rate on unit size and institutional experience with intubated patients, as measured by the average number of intubated patients, was examined. We found no evidence that the accidental extubation rate is higher in smaller units or units with less institutional experience. Low rates can be achieved in small units with low acuity.

[Environmental noise levels in 2 intensive care units in a tertiary care centre].

PubMed

Ornelas-Aguirre, José Manuel; Zárate-Coronado, Olivia; Gaxiola-González, Fabiola; Neyoy-Sombra, Venigna

2017-04-03

The World Health Organisation (WHO) has established a maximum noise level of 40 decibels (dB) for an intensive care unit. The aim of this study was to compare the noise levels in 2 different intensive care units at a tertiary care centre. Using a cross-sectional design study, an analysis was made of the maximum noise level was within the intensive coronary care unit and intensive care unit using a digital meter. A measurement was made in 4 different points of each room, with 5minute intervals, for a period of 60minutes 7:30, 14:30, and 20:30. The means of the observations were compared with descriptive statistics and Mann-Whitney U. An analysis with Kruskal-Wallis test was performed to the mean noise level. The noise observed in the intensive care unit had a mean of 64.77±3.33dB (P=.08), which was similar to that in the intensive coronary care unit, with a mean of 60.20±1.58dB (P=.129). Around 25% or more of the measurements exceeded the level recommended by the WHO by up to 20 points. Noise levels measured in intensive care wards exceed the maximum recommended level for a hospital. It is necessary to design and implement actions for greater participation of health personnel in the reduction of environmental noise. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

The distribution of meteoric 36Cl/Cl in the United States: A comparison of models

USGS Publications Warehouse

Moysey, S.; Davis, S.N.; Zreda, M.; Cecil, L.D.

2003-01-01

The natural distribution of 36Cl/Cl in groundwater across the continental United States has recently been reported by Davis et al. (2003). In this paper, the large-scale processes and atmospheric sources of 36Cl and chloride responsible for controlling the observed 36Cl/Cl distribution are discussed. The dominant process that affects 36Cl/Cl in meteoric groundwater at the continental scale is the fallout of stable chloride from the atmosphere, which is mainly derived from oceanic sources. Atmospheric circulation transports marine chloride to the continental interior, where distance from the coast, topography, and wind patterns define the chloride distribution. The only major deviation from this pattern is observed in northern Utah and southern Idaho where it is inferred that a continental source of chloride exists in the Bonneville Salt Flats, Utah. In contrast to previous studies, the atmospheric flux of 36Cl to the land surface was found to be approximately constant over the United States, without a strong correlation between local 36Cl fallout and annual precipitation. However, the correlation between these variables was significantly improved (R 2=0.15 to R 2=0.55) when data from the southeastern USA, which presumably have lower than average atmospheric 36Cl concentrations, were excluded. The total mean flux of 36Cl over the continental United States and total global mean flux of 36Cl are calculated to be 30.5??7.0 and 19.6??4.5 atoms m-2 s-1, respectively. The 36Cl/Cl distribution calculated by Bentley et al. (1996) underestimates the magnitude and variability observed for the measured 36Cl/Cl distribution across the continental United States. The model proposed by Hainsworth (1994) provides the best overall fit to the observed 36Cl/Cl distribution in this study. A process-oriented model by Phillips (2000) generally overestimates 36Cl/Cl in most parts of the country and has several significant local departures from the empirical data.

Curve numbers for nine mountainous eastern United States watersheds: seasonal variation and forest cutting

Treesearch

Negussie H. Tedela; Steven C. McCutcheon; John L. Campbell; Wayne T. Swank; Mary Beth Adams; Todd C. Rasmussen

2012-01-01

Many engineers and hydrologists use the curve number method to estimate runoff from ungaged watersheds; however, the method does not explicitly account for the influence of season or forest cutting on runoff. This study of observed rainfall and runoff for small, forested watersheds that span the Appalachian Mountains of the eastern United States showed that curve...

Migrating from Mexico and Sharing Pretend with Peers in the United States

ERIC Educational Resources Information Center

Howes, Carollee; Wishard Guerra, Alison G.; Zucker, Eleanor

2008-01-01

The intent of this study was to examine the development of peer interaction in low-income Mexican-heritage families in the United States. Eighty-eight children (44 girls) were observed and mothers interviewed when children were 14, 24, 36, and 54 months old. We used the Attachment Q-Set (Waters, 1990), the Peer Play Scale (Howes & Matheson, 1992),…

Navigating the Structures of Elementary School in the United States and Japan: An Ethnography of the Particular

ERIC Educational Resources Information Center

Damrow, Amy

2014-01-01

This study uses an ecological framework to map one Japanese child's transition between elementary school life in the United States and Japan. I privilege the child's perspective while weaving in parent and teacher views, as well as observation and document data. Implicit and explicit expectations in the focal student's classrooms and schools are…

Reading Practices of Pre-Service Teachers in the United States

ERIC Educational Resources Information Center

Huang, SuHua

2017-01-01

The purpose of this mixed method study was to investigate the reading practices of pre-service teachers in the United States. A total of 395 (38 male and 357 female) pre-service teachers completed a self-reported survey. In addition, 45 (10 males and 35 females) of the 395 voluntarily agreed to participate in interviews and classroom observations.…

Empirical study of alginate impression materials by customized proportioning system

PubMed Central

2016-01-01

PURPOSE Alginate mixers available in the market do not have the automatic proportioning unit. In this study, an automatic proportioning unit for the alginate mixer and controller software were designed and produced for a new automatic proportioning unit. With this device, it was ensured that proportioning operation could arrange weight-based alginate impression materials. MATERIALS AND METHODS The variation of coefficient in the tested groups was compared with the manual proportioning. Compression tension and tear tests were conducted to determine the mechanical properties of alginate impression materials. The experimental data were statistically analyzed using one way ANOVA and Tukey test at the 0.05 level of significance. RESULTS No statistically significant differences in modulus of elastisity (P>0.3), tensional/compresional strength (P>0.3), resilience (P>0.2), strain in failure (P>0.4), and tear energy (P>0.7) of alginate impression materials were seen. However, a decrease in the standard deviation of tested groups was observed when the customized machine was used. To verify the efficiency of the system, powder and powder/water mixing were weighed and significant decrease was observed. CONCLUSION It was possible to obtain more mechanically stable alginate impression materials by using the custom-made proportioning unit. PMID:27826387

The association between measurements of antimicrobial use and resistance in the faeces microbiota of finisher batches.

PubMed

Andersen, V D; DE Knegt, L V; Munk, P; Jensen, M S; Agersø, Y; Aarestrup, F M; Vigre, H

2017-10-01

The objectives were to present three approaches for calculating antimicrobial (AM) use in pigs that take into account the rearing period and rearing site, and to study the association between these measurements and phenotypical resistance and abundance of resistance genes in faeces samples from 10 finisher batches. The AM use was calculated relative to the rearing period of the batches as (i) 'Finisher Unit Exposure' at unit level, (ii) 'Lifetime Exposure' at batch level and (iii) 'Herd Exposure' at herd level. A significant effect on the occurrence of tetracycline resistance measured by cultivation was identified for Lifetime Exposure for the AM class: tetracycline. Furthermore, for Lifetime Exposure for the AM classes: macrolide, broad-spectrum penicillin, sulfonamide and tetracycline use as well as Herd Unit Exposure for the AM classes: aminoglycoside, lincosamide and tetracycline use, a significant effect was observed on the occurrence of genes coding for the AM resistance classes: aminoglycoside, lincosamide, macrolide, β-lactam, sulfonamide and tetracycline. No effect was observed for Finisher Unit Exposure. Overall, the study shows that Lifetime Exposure is an efficient measurement of AM use in finisher batches, and has a significant effect on the occurrence of resistance, measured either by cultivation or metagenomics.

School District Inputs and Biased Estimation of Educational Production Functions.

ERIC Educational Resources Information Center

Watts, Michael

1985-01-01

In 1979, Eric Hanushek pointed out a potential problem in estimating educational production functions, particularly at the precollege level. He observed that it is frequently inappropriate to include school-system variables in equations using the individual student as the unit of observation. This study offers limited evidence supporting this…

A Constructivist Study of Middle School Students' Narratives and Ecological Illustrations

ERIC Educational Resources Information Center

Stokrocki, Mary L.; Flatt, Barbara; York, Emily

2010-01-01

Using participant observation, we describe/interpret the results of teaching a constructivist unit that empowered students in narrative writing and illustration. Participant observation methods included daily note taking, pre-post questioning, and photographing artworks. We analyzed students' stories and illustrations with borrowed and emerging…

Within-Cluster and Across-Cluster Matching with Observational Multilevel Data

ERIC Educational Resources Information Center

Kim, Jee-Seon; Steiner, Peter M.; Hall, Courtney; Thoemmes, Felix

2013-01-01

When randomized experiments cannot be conducted in practice, propensity score (PS) techniques for matching treated and control units are frequently used for estimating causal treatment effects from observational data. Despite the popularity of PS techniques, they are not yet well studied for matching multilevel data where selection into treatment…

Young Children's Block Play and Mathematical Learning

ERIC Educational Resources Information Center

Park, Boyoung; Chae, Jeong-Lim; Boyd, Barbara Foulks

2008-01-01

This qualitative study investigated young children's mathematical engagement in play with wooden unit blocks. Two boys, ages 6 and 7, were independently observed completing the task of filling outlined regions with the various sets of blocks. Three major mathematical actions were observed: categorizing geometric shapes, composing a larger shape…

[Prevalence of nosocomial infections in two hospitals in Conakry (Guinea)].

PubMed

Keita, Alpha Kabinet; Doumbouya, Naman; Sow, Mamadou Saliou; Konaté, Bintou; Dabo, Yacouba; Panzo, Daniel Agbo; Keita, Mamady

2016-01-01

Nosocomial infections can be prevented by applying simple hygiene rules. However, they have not been sufficiently studied in the Republic of Guinea. For this purpose, we conducted a one-day study in the Conakry University Hospital surgery wards and intensive care units. Fourteen units (12 surgical wards and 2 intensive care units) participated in the study. A total of 310 patients were included. A nosocomial infection was observed in 62 patients, [20%, 95%CI 15.9-24.8%]. Surgical site infections were significantly more frequent with 42/62 cases [67.7%, 95%CI 55.3-78.1%, p = 0.0001] than other types of infections (urinary tract, skin and digestive) with 20/62 cases [32.3% 95%CI 21.9-44.6%]. The average hospital stay of 29.1 ± 23.4 days [95%CI, 23.2 ± 35.04] for patients with nosocomial infection was significantly different (p = 0.0001) from that observed in patients without nosocomial infection: 15.9 ± 16.3 days [95%CI, 13.8 ± 17.9]. Staphylococcus aureus was the pathogen most commonly isolated: 32/62 (51.6%; 95%CI 39.5-63.6%). Escherichia coli infection was identified in the bladder catheters of 13 patients [20.9%, 95%CI 12.7-32.6%]. Finally, five deaths were observed among the 62 patients with nosocomial infection. This study shows that nosocomial infections are common in Conakry University Hospital. Further studies must be conducted to identify the risk factors for nosocomial infections and to propose solutions.

Association between length of storage of red blood cell units and outcome of critically ill children: a prospective observational study

PubMed Central

2010-01-01

Introduction Transfusion is a common treatment in pediatric intensive care units (PICUs). Studies in adults suggest that prolonged storage of red blood cell units is associated with worse clinical outcome. No prospective study has been conducted in children. Our objectives were to assess the clinical impact of the length of storage of red blood cell units on clinical outcome of critically ill children. Methods Prospective, observational study conducted in 30 North American centers, in consecutive patients aged <18 years with a stay ≥ 48 hours in a PICU. The primary outcome measure was the incidence of multiple organ dysfunction syndrome after transfusion. The secondary outcomes were 28-day mortality and PICU length of stay. Odds ratios were adjusted for gender, age, number of organ dysfunctions at admission, total number of transfusions, and total dose of transfusion, using a multiple logistic regression model. Results The median length of storage was 14 days in 296 patients with documented length of storage. For patients receiving blood stored ≥ 14 days, the adjusted odds ratio for an increased incidence of multiple organ dysfunction syndrome was 1.87 (95% CI 1.04;3.27, P = 0.03). There was also a significant difference in the total PICU length of stay (adjusted median difference +3.7 days, P < 0.001) and no significant change in mortality. Conclusions In critically ill children, transfusion of red blood cell units stored for ≥ 14 days is independently associated with an increased occurrence of multiple organ dysfunction syndrome and prolonged PICU stay. PMID:20377853

Effect of the one‑carbon unit cycle on overall DNA methylation in children with Down's syndrome.

PubMed

Song, Cui; He, Jingyi; Chen, Jie; Liu, Youxue; Xiong, Feng; Wang, Yutian; Li, Tingyu

2015-12-01

DNA methylation is a major epigenetic mechanism regulating gene expression. In order to analyze the impact of the one‑carbon unit cycle on the overall level of DNA methylation in children with Down's syndrome (DS), the levels of indicators associated with the one‑carbon unit cycle, including folic acid (FA), vitamin B12 (VB12) and homocysteine (Hcy), and the overall DNA methylation level of DS and healthy controls (HCs) were determined in the present study. A total of 36 DS children and 40 age‑ and gender‑matched HCs were included in the present study to determine the levels of FA, VB12, Hcy and overall DNA methylation. The effect of the one‑carbon unit cycle on the overall level of DNA methylation within the DS group was analyzed. The results demonstrated that the level of VB12 was decreased (P=0.008), while the Hcy level was increased (P=0.000) in DS patients compared with the HCs. FA and VB12 levels decreased with increasing age in DS patients (P<0.05). DNA hypermethylation and hypomethylation were observed in DS patients with VB12 deficiency and hyperhomocysteinemia, respectively (P=0.031, P=0.021). Abnormalities in the one‑carbon unit cycle tend to worsen with increasing age in DS children. Thus, one‑carbon unit cycle‑associated alterations in DNA methylation may be important in the neuropathological alterations observed in DS.

Resurgence of Integrated Behavioral Units

PubMed Central

Bachá-Méndez, Gustavo; Reid, Alliston K; Mendoza-Soylovna, Adela

2007-01-01

Two experiments with rats examined the dynamics of well-learned response sequences when reinforcement contingencies were changed. Both experiments contained four phases, each of which reinforced a 2-response sequence of lever presses until responding was stable. The contingencies then were shifted to a new reinforced sequence until responding was again stable. Extinction-induced resurgence of previously reinforced, and then extinguished, heterogeneous response sequences was observed in all subjects in both experiments. These sequences were demonstrated to be integrated behavioral units, controlled by processes acting at the level of the entire sequence. Response-level processes were also simultaneously operative. Errors in sequence production were strongly influenced by the terminal, not the initial, response in the currently reinforced sequence, but not by the previously reinforced sequence. These studies demonstrate that sequence-level and response-level processes can operate simultaneously in integrated behavioral units. Resurgence and the development of integrated behavioral units may be dissociated; thus the observation of one does not necessarily imply the other. PMID:17345948

Clinical Alarms in intensive care: implications of alarm fatigue for the safety of patients1

PubMed Central

Bridi, Adriana Carla; Louro, Thiago Quinellato; da Silva, Roberto Carlos Lyra

2014-01-01

OBJECTIVES: to identify the number of electro-medical pieces of equipment in a coronary care unit, characterize their types, and analyze implications for the safety of patients from the perspective of alarm fatigue. METHOD: this quantitative, observational, descriptive, non-participatory study was conducted in a coronary care unit of a cardiology hospital with 170 beds. RESULTS: a total of 426 alarms were recorded in 40 hours of observation: 227 were triggered by multi-parametric monitors and 199 were triggered by other equipment (infusion pumps, dialysis pumps, mechanical ventilators, and intra-aortic balloons); that is an average of 10.6 alarms per hour. CONCLUSION: the results reinforce the importance of properly configuring physiological variables, the volume and parameters of alarms of multi-parametric monitors within the routine of intensive care units. The alarms of equipment intended to protect patients have increased noise within the unit, the level of distraction and interruptions in the workflow, leading to a false sense of security. PMID:25591100

Exploring the Influence of Environment on the Spatial Behavior of Older Adults in a Purpose-Built Acute Care Dementia Unit.

PubMed

Mazzei, Francesco; Gillan, Roslyn; Cloutier, Denise

2014-06-01

Limited research explores the experience of individuals with dementia in acute care geriatric psychiatry units. This observational case study examines the influence of the physical environment on behavior (wandering, pacing, door testing, congregation and seclusions) among residents in a traditional geriatric psychiatry unit who were then relocated to a purpose-built acute care unit. Purpose-built environments should be well suited to the needs of residents with dementia. Observed trends revealed differences in spatial behaviors in the pre- and post- environments attributable to the physical environment. Person-centred modifications to the current environment including concerted efforts to know residents are meaningful in fostering quality of life. Color coded environments (rooms vs dining areas etc.) to improve wayfinding and opportunities to personalize rooms that address the `hominess' of the setting also have potential. Future research could also seek the opinions of staff about the impact of the environment on them as well as residents. © The Author(s) 2013.

Site-specific Installation and Study of Electroactive Units in Every Layer of Dendrons

PubMed Central

Azagarsamy, Malar A.; Krishnamoorthy, Kothandam; Sivanandan, Kulandaivelu; Thayumanavan, S.

2009-01-01

While encapsulation of functional groups at the core of dendrimers is well-understood, very little is known about their intermediate layers or even the periphery. Here we report on a systematic investigation of every layer of dendrimers by incorporating a single ferrocene unit in well-defined locations in dendrons. Site-specific incorporation of the ferrocene unit was achieved utilizing the dendrimer sequencing methodology. We show here that the redox potential values of ferrocene at intermediate layers were remarkably different from that at the core and the periphery. While redox potential values were location-dependent, no significant change in the rate of heterogeneous electron transfer (k0) was observed with respect to locations. This was attributed to the possibility that free rotation of dendrimer nullifies the distance between the electrode and ferrocene unit. Finally, we also show that no Faradaic current was observed for the amphiphilic assemblies of these dendrons, while the same dendron did exhibit significant Faradaic current in non-assembling solvent environments. PMID:19905006

Cost-effectiveness of a new short-stay unit to "rule out" acute myocardial infarction in low risk patients.

PubMed

Gaspoz, J M; Lee, T H; Weinstein, M C; Cook, E F; Goldman, P; Komaroff, A L; Goldman, L

1994-11-01

This study attempted to determine the safety and costs of a new short-stay unit for low risk patients who may be admitted to a hospital to rule out myocardial infarction or ischemia. One strategy to reduce the costs of ruling out acute myocardial infarction in low risk patients is to develop alternatives to coronary care units. The short-term and 6-month clinical outcomes and costs for 592 patients admitted to a short-stay coronary observation unit at Brigham and Women's Hospital with a low (< or = 10%) probability of acute myocardial infarction were compared with those for 924 consecutive comparison patients who were eligible for the same unit but were admitted to other hospital settings or discharged home. Actual costs were calculated using detailed cost-accounting methods that incorporated nursing intensity weights. The rate of major complications, recurrent myocardial infarction or cardiac death during 6 months after the initial presentation of the 592 patients admitted to the coronary observation unit was similar to that of the 924 comparison patients before and after adjustment for clinical factors influencing triage and initial diagnoses (adjusted relative risk 0.86, 95% confidence interval 0.49 to 1.53). Their median total costs (25th, 75th percentile) at 6 months ($1,927; 1,455, 3,650) were significantly lower than for comparison patients admitted to the wards $4,712; 1,868, 11,187), to stepdown or intermediate care units ($4,031; 2,069, 9,169) or to the coronary care unit ($9,201; 3,171, 20,011) but were higher than for comparison patients discharged home from the emergency department ($403; 403,927) before and after the same adjustments (all adjusted p < 0.0001). These data suggest that the coronary observation unit may be a safe and cost-saving alternative to current triage strategies for patients with a low risk of acute myocardial infarction admitted from the emergency department. Its replication in other hospitals should be tested.

Exploring the decision-making process in the delivery of physiotherapy in a stroke unit.

PubMed

McGlinchey, Mark P; Davenport, Sally

2015-01-01

The aim of this study was to explore the decision-making process in the delivery of physiotherapy in a stroke unit. A focused ethnographical approach involving semi-structured interviews and observations of clinical practice was used. A purposive sample of seven neurophysiotherapists and four patients participated in semi-structured interviews. From this group, three neurophysiotherapists and four patients were involved in observation of practice. Data from interviews and observations were analysed to generate themes. Three themes were identified: planning the ideal physiotherapy delivery, the reality of physiotherapy delivery and involvement in the decision-making process. Physiotherapists used a variety of clinical reasoning strategies and considered many factors to influence their decision-making in the planning and delivery of physiotherapy post-stroke. These factors included the therapist's clinical experience, patient's presentation and response to therapy, prioritisation, organisational constraints and compliance with organisational practice. All physiotherapists highlighted the importance to involve patients in planning and delivering their physiotherapy. However, there were varying levels of patient involvement observed in this process. The study has generated insight into the reality of decision-making in the planning and delivery of physiotherapy post-stroke. Further research involving other stroke units is required to gain a greater understanding of this aspect of physiotherapy. Implications for Rehabilitation Physiotherapists need to consider multiple patient, therapist and organisational factors when planning and delivering physiotherapy in a stroke unit. Physiotherapists should continually reflect upon how they provide physiotherapy, with respect to the duration, frequency and time of day sessions are delivered, in order to guide current and future physiotherapy delivery. As patients may demonstrate varying levels of participation in deciding and understanding how physiotherapy is delivered, physiotherapists need to adjust how they engage patients in the decision-making process and manage patient expectations accordingly.

Substantivity of hypochlorous acid-based disinfectant against biofilm formation in the dental unit waterlines

PubMed Central

Shajahan, Irfana Fathima; Kandaswamy, Deivanayagam; Lakshminarayanan, L.; Selvarajan, R.

2017-01-01

Objective: The purpose of the study was to examine the substantivity of a new disinfectant against biofilm formation in the dental unit waterlines. Materials and Methods: Twenty dental units were selected for the study and divided into two groups: Group A (dental unit waterlines treated with the disinfectant) and Group B (untreated dental unit waterlines). Biofilm formation was monitored in both groups by removing the one dental unit waterline from each group for the period of 10 days. One inch of the dental unit waterline tube was cut at random site, and the inner lumen of the cut sections was analyzed using the scanning electron microscope (SEM) (TESCAN VEGA3 SBU). Results: On examination, SEM images showed that there was no slime layer or bacterial cells seen in cut section for the period of 7 days in the treated dental waterlines, which means that there is no evident of biofilm formation. In the untreated dental unit waterline cut section, slime layer was observed from day 1. Conclusion: Disinfectant solution was proved to be effective for 7 days against biofilm formation. This technique could be used as a valid method for disinfection of dental unit waterlines. PMID:28761244

Patient's dignity in intensive care unit: A critical ethnography.

PubMed

Bidabadi, Farimah Shirani; Yazdannik, Ahmadreza; Zargham-Boroujeni, Ali

2017-01-01

Maintaining patient's dignity in intensive care units is difficult because of the unique conditions of both critically-ill patients and intensive care units. The aim of this study was to uncover the cultural factors that impeded maintaining patients' dignity in the cardiac surgery intensive care unit. The study was conducted using a critical ethnographic method proposed by Carspecken. Participants and research context: Participants included all physicians, nurses and staffs working in the study setting (two cardiac surgery intensive care units). Data collection methods included participant observations, formal and informal interviews, and documents assessment. In total, 200 hours of observation and 30 interviews were performed. Data were analyzed to uncover tacit cultural knowledge and to help healthcare providers to reconstruct the culture of their workplace. Ethical Consideration: Ethical approval for the study from Ethics committee of Isfahan University of Medical Sciences was obtained. The findings of the study fell into the following main themes: "Presence: the guarantee for giving enough attention to patients' self-esteem", "Instrumental and objectified attitudes", "Adherence to the human equality principle: value-action gap", "Paternalistic conduct", "Improper language", and "Non-interactive communication". The final assertion was "Reductionism as a major barrier to the maintaining of patient's dignity". The prevailing atmosphere in subculture of the CSICU was reductionism and paternalism. This key finding is part of the biomedical discourse. As a matter of fact, it is in contrast with dignified care because the latter necessitate holistic attitudes and approaches. Changing an ICU culture is not easy; but through increasing awareness and critical self-reflections, the nurses, physicians and other healthcare providers, may be able to reaffirm dignified care and cure in their therapeutic relationships.

Effect of vegetation management for reducing damage to lodgepole pine seedlings from northern pocket gophers

USGS Publications Warehouse

Engeman, Richard M.; Barnes, Victor G.; Anthony, Richard M.; Krupa, Heather W.

1997-01-01

The effects of vegetation management on northern pocket gopher (Thomomys talpoides) activity and damage to lodgepole pine (Pinus contorta) seedlings were studied using 2,4-D herbicide to alter the habitat. Treatments were applied to a large (8.1 ha) treatment unit and observed effects were compared with an untreated control unit of the same size. The greatly reduced forb and grass cover on the treated unit was associated with a corresponding decrease in pocket gopher activity that persisted for 6 years after initial treatment. Times until seedlings first incurred gopher damage and overall survival of seedlings were greatly increased on the treated unit.

The effects of cognitive intervention on cognitive impairments after intensive care unit admission.

PubMed

Zhao, Jingjing; Yao, Li; Wang, Changqing; Sun, Yun; Sun, Zhongwu

2017-04-01

Patients who survive critical illness commonly suffer cognitive impairments. We aimed to study the effects of cognitive intervention to treat the long-term impairments observed among different populations of intensive care unit (ICU) survivors. The results showed that the intervention significantly suppressed the deterioration of cognitive function in these patients. Medical and neurological ICU survivors were more susceptible than post-anaesthesia ICU patients to severe cognitive damage. In the former, the deterioration of impairments can be slowed by cognitive intervention. In comparison, intervention exerted significantly positive effects on the recovery of the cognitive functions of post-anaesthesia care unit patients. Furthermore, young populations were more likely than older populations to recover from acute cognitive impairments, and the impairment observed among the older population seemed to be multi-factorial and irreversible.

Phenology satellite experiment. [detection of brown wave and green wave in north-south corridors of United States

NASA Technical Reports Server (NTRS)

Dethier, B. E.; Ashley, M. D.; Blair, B. O.; Caprio, J. M.; Hopp, R. J.; Rouse, J., Jr. (Principal Investigator)

1973-01-01

The author has identified the following significant results. The 1972 Brown Wave and 1973 Green Wave were detected at 24 sites located in four north-south corridors across the United States through analysis of ERTS-1 imagery and multispectral scanner digital tapes. Ground observations from these sites were correlated with ERTS data. These two phenological events were documented by observations from more than 3200 sites across the United States. The problem of changing atmospheric and illumination conditions were studied and corrections to ERTS data suggested. Band-to-band ratios were developed and correlated with the fall and spring phenological changes in field crops and forests. The results to date show the feasibility of developing and refining phenoclimatic models for use in characterizing crop status and as an aid to yield prediction.

Physical and Visual Accessibilities in Intensive Care Units: A Comparative Study of Open-Plan and Racetrack Units.

PubMed

Rashid, Mahbub; Khan, Nayma; Jones, Belinda

2016-01-01

This study compared physical and visual accessibilities and their associations with staff perception and interaction behaviors in 2 intensive care units (ICUs) with open-plan and racetrack layouts. For the study, physical and visual accessibilities were measured using the spatial analysis techniques of Space Syntax. Data on staff perception were collected from 81 clinicians using a questionnaire survey. The locations of 2233 interactions, and the location and length of another 339 interactions in these units were collected using systematic field observation techniques. According to the study, physical and visual accessibilities were different in the 2 ICUs, and clinicians' primary workspaces were physically and visually more accessible in the open-plan ICU. Physical and visual accessibilities affected how well clinicians' knew their peers and where their peers were located in these units. Physical and visual accessibilities also affected clinicians' perception of interaction and communication and of teamwork and collaboration in these units. Additionally, physical and visual accessibilities showed significant positive associations with interaction behaviors in these units, with the open-plan ICU showing stronger associations. However, physical accessibilities were less important than visual accessibilities in relation to interaction behaviors in these ICUs. The implications of these findings for ICU design are discussed.

In vitro and in vivo Safety Evaluation of NephureTM

PubMed Central

Cowley, Helena; Yan, Qin; Koetzner, Lee; Dolan, Laurie; Nordwald, Erik; Cowley, Aaron B.

2017-01-01

NephureTM is a proprietary oxalate decarboxylase (OxDC) enzyme being developed as a food ingredient. In this study, the safety of NephureTM was evaluated in a bacterial mutagenicity assay and in a sub-chronic (13-week) oral toxicity study in rats. NephureTM did not show any mutagenic properties in the mutagenicity assay. In the 13-week sub-chronic oral toxicity study in which 10 Sprague Dawley rats per sex were administered 0, 118, 235 and 475 mg/kg bw/day (8260, 16450 and 33,250 Units/kg bw/day, respectively) of NephureTM by gavage, male and female rats did not show any test article-related clinical observations or effects on body weight, body weight gain, food consumption, food efficiency, ophthalmology, functional observational battery parameters or motor activity. Furthermore, there were no changes in coagulation, clinical chemistry, urinalysis or hematology parameters, macroscopic/microscopic findings or organ weights that could be attributed to the test article. Based on these results, NephureTM was not mutagenic and the no-adverse-effect level (NOAEL) in the 13-week study was determined to be 475 mg/kg bw/day (33,250 Units/kg bw/day). Evaluation of the estimated consumption of NephureTM, generation of the metabolite formate, and the current safety studies resulted in a conclusion of a tolerable upper limit of 3450 Units of OxDC activity/day (57.5 Units activity/kg bw/day), when NephureTM is added to food to decrease dietary oxalate. PMID:28322893

TiO2 induced structural modifications in Cs containing borosilicate glasses: Raman and infrared studies

NASA Astrophysics Data System (ADS)

Pandey, M.; Banerjee, D.; Sudarsan, V.; Kshirsagar, R. J.

2018-04-01

Effect of TiO2 addition in Cs containing Sodium-borosilicate glasses is studied using Raman and infrared spectroscopic techniques. As revealed from infrared and Raman studies, TiO2 does not form segregated phase, but instead enters into the borosilicate network. It is further observed that TiO2 addition results in modifications of the borate and silicate structural units by transforming into tetraborates and metasilicate structural units. These structural modifications are responsible for Cs immobilization, leach rate and chemical durability of these glasses.

United States Army Research Institute of Environmental Medicine: Warfighter Research Focusing on the Past 25 Years

DTIC Science & Technology

2011-12-01

effect today. Additional military nutrition issues were also investigated in the mid-1990s. Observational studies assessed dietary intake, nutritional...soldiers regularly consumed countless dietary supplements, observations of continued concern, even today. Also in 1991, investigations on nutritional...commercial food product containing supplemental energy, structured lipids, and micronutrients normalized im- mune function, an observation confirmed in a

Tectonic signatures on active margins

NASA Astrophysics Data System (ADS)

Hogarth, Leah Jolynn

High-resolution Compressed High-Intensity Radar Pulse (CHIRP) surveys offshore of La Jolla in southern California and the Eel River in northern California provide the opportunity to investigate the role of tectonics in the formation of stratigraphic architecture and margin morphology. Both study sites are characterized by shore-parallel tectonic deformation, which is largely observed in the structure of the prominent angular unconformity interpreted as the transgressive surface. Based on stratal geometry and acoustic character, we identify three sedimentary sequences offshore of La Jolla: an acoustically laminated estuarine unit deposited during early transgression, an infilling or "healing-phase" unit formed during the transgression, and an upper transparent unit. The estuarine unit is confined to the canyon edges in what may have been embayments during the last sea-level rise. The healing-phase unit appears to infill rough areas on the transgressive surface that may be related to relict fault structures. The upper transparent unit is largely controlled by long-wavelength tectonic deformation due to the Rose Canyon Fault. This unit is also characterized by a mid-shelf (˜40 m water depth) thickness high, which is likely a result of hydrodynamic forces and sediment grain size. On the Eel margin, we observe three distinct facies: a seaward-thinning unit truncated by the transgressive surface, a healing-phase unit confined to the edges of a broad structural high, and a highly laminated upper unit. The seaward-thinning wedge of sediment below the transgressive surface is marked by a number of channels that we interpret as distributary channels based on their morphology. Regional divergence of the sequence boundary and transgressive surface with up to ˜8 m of sediment preserved across the interfluves suggests the formation of subaerial accommodation during the lowstand. The healing-phase, much like that in southern California, appears to infill rough areas in the transgressive surface. Reflectors within the laminated upper unit exhibit divergence towards the Eel River Syncline, which suggests that deposition in the syncline is syntectonic. The transgressive surface is offset across the Eureka Anticline indicating deformation has occurred since ˜10 ka. The relief observed along the transgressive surface is consistent with deformation rates measured onshore.

Does resolution of flow field observation influence apparent habitat use and energy expenditure in juvenile coho salmon?

NASA Astrophysics Data System (ADS)

Tullos, D. D.; Walter, C.; Dunham, J.

2016-12-01

This study investigated how the resolution of observation influences interpretation of how fish, juvenile Coho Salmon (Oncorhynchus kisutch), exploit the hydraulic environment in streams. Our objectives were to evaluate how spatial resolution of the flow field observation influenced: 1) the velocities considered to be representative of habitat units; 2) patterns of use of the hydraulic environment by fish; and 3) estimates of energy expenditure. We addressed these objectives using observations within a 1:1 scale physical model of a full-channel log jam in an outdoor experimental stream. Velocities were measured with Acoustic Doppler Velocimetry at a 10 cm grid spacing, whereas fish locations and tailbeat frequencies were documented over time using underwater videogrammetry. Results highlighted that resolution of observation did impact perceived habitat use and energy expenditure, as did the location of measurement within habitat units and the use of averaging to summarize velocities within a habitat unit. In this experiment, the range of velocities and energy expenditure estimates increased with coarsening resolution, reducing the likelihood of measuring the velocities locally experienced by fish. In addition, the coarser resolutions contributed to fish appearing to select velocities that were higher than what was measured at finer resolutions. These findings indicate the need for careful attention to and communication of resolution of observation in investigating the hydraulic environment and in determining the habitat needs and bioenergetics of aquatic biota.

Average activity of excitatory and inhibitory neural populations

NASA Astrophysics Data System (ADS)

Roulet, Javier; Mindlin, Gabriel B.

2016-09-01

We develop an extension of the Ott-Antonsen method [E. Ott and T. M. Antonsen, Chaos 18(3), 037113 (2008)] that allows obtaining the mean activity (spiking rate) of a population of excitable units. By means of the Ott-Antonsen method, equations for the dynamics of the order parameters of coupled excitatory and inhibitory populations of excitable units are obtained, and their mean activities are computed. Two different excitable systems are studied: Adler units and theta neurons. The resulting bifurcation diagrams are compared with those obtained from studying the phenomenological Wilson-Cowan model in some regions of the parameter space. Compatible behaviors, as well as higher dimensional chaotic solutions, are observed. We study numerical simulations to further validate the equations.

Study of positive and negative plasma catalytic oxidation of ethylene.

PubMed

Van Wesenbeeck, K; Hauchecorne, B; Lenaerts, S

2017-06-01

The effect of introducing a photocatalytically active coating inside a plasma unit is investigated. This technique combines the advantages of high product selectivity from catalysis and the fast start-up from plasma technology. In this study, a preselected TiO 2 coating is applied on the collector electrode of a DC corona discharge unit as non-thermal plasma reactor, in order to study the oxidation of ethylene. For both positive and negative polarities an enhanced mineralization is observed while the formation of by-products drastically decreases. The plasma catalytic unit gave the best results when using negative polarity at a voltage of 15 kV. This shows the potential of plasma catalysis as indoor air purification technology.

Average activity of excitatory and inhibitory neural populations

PubMed Central

Mindlin, Gabriel B.

2016-01-01

We develop an extension of the Ott-Antonsen method [E. Ott and T. M. Antonsen, Chaos 18(3), 037113 (2008)] that allows obtaining the mean activity (spiking rate) of a population of excitable units. By means of the Ott-Antonsen method, equations for the dynamics of the order parameters of coupled excitatory and inhibitory populations of excitable units are obtained, and their mean activities are computed. Two different excitable systems are studied: Adler units and theta neurons. The resulting bifurcation diagrams are compared with those obtained from studying the phenomenological Wilson-Cowan model in some regions of the parameter space. Compatible behaviors, as well as higher dimensional chaotic solutions, are observed. We study numerical simulations to further validate the equations. PMID:27781447

Elder Abuse in Nursing Homes: Do Special Care Units Make a Difference? A Secondary Data Analysis of the Swiss Nursing Homes Human Resources Project.

PubMed

Blumenfeld Arens, Olivia; Fierz, Katharina; Zúñiga, Franziska

2017-01-01

In special care units (SCUs) for residents with advanced dementia, both personnel and organizations are adapted to the needs of residents. However, whether these adaptations have a preventive effect on elder abuse has not yet been explored. To describe the prevalence of observed emotional abuse, neglect, and physical abuse in Swiss nursing homes, to compare SCUs with non-SCUs concerning the frequency of observed emotional abuse, neglect, and physical abuse, and to explore how resident-related characteristics, staff outcomes/characteristics, and organizational/environmental factors relate to observed elder abuse. This is a secondary data analysis of the Swiss Nursing Homes Human Resources Project (SHURP), a cross-sectional multicenter study. Data were collected from 2012 to 2013 and are based on observed rather than perpetrated elder abuse. We performed multilevel mixed-effects logistic regressions taking into account the hierarchical structure of the data with personnel nested within units and facilities. Of 4,599 care workers in 400 units and 156 facilities, 50.8% observed emotional abuse, 23.7% neglect, and 1.4% physical abuse. There was no significant difference between SCUs and non-SCUs regarding observed emotional abuse and neglect. Higher scores for 'workload' and sexual aggression towards care workers were associated with higher rates of emotional abuse and neglect. Verbal and physical resident aggression, however, were only associated with higher rates of emotional abuse. Negative associations were found between 'teamwork and resident safety climate' and both forms of abuse. Improving teamwork and the safety climate and reducing work stressors might be promising points of intervention to reduce elder abuse. More specific research about elder abuse in SCUs and the interaction between work climate and elder abuse is required. © 2016 S. Karger AG, Basel.

Estimating Time Physicians and Other Health Care Workers Spend with Patients in an Intensive Care Unit Using a Sensor Network.

PubMed

Butler, Rachel; Monsalve, Mauricio; Thomas, Geb W; Herman, Ted; Segre, Alberto M; Polgreen, Philip M; Suneja, Manish

2018-04-09

Time and motion studies have been used to investigate how much time various health care professionals spend with patients as opposed to performing other tasks. However, the majority of such studies are done in outpatient settings, and rely on surveys (which are subject to recall bias) or human observers (which are subject to observation bias). Our goal was to accurately measure the time physicians, nurses, and critical support staff in a medical intensive care unit spend in direct patient contact, using a novel method that does not rely on self-report or human observers. We used a network of stationary and wearable mote-based sensors to electronically record location and contacts among health care workers and patients under their care in a 20-bed intensive care unit for a 10-day period covering both day and night shifts. Location and contact data were used to classify the type of task being performed by health care workers. For physicians, 14.73% (17.96%) of their time in the unit during the day shift (night shift) was spent in patient rooms, compared with 40.63% (30.09%) spent in the physician work room; the remaining 44.64% (51.95%) of their time was spent elsewhere. For nurses, 32.97% (32.85%) of their time on unit was spent in patient rooms, with an additional 11.34% (11.79%) spent just outside patient rooms. They spent 11.58% (13.16%) of their time at the nurses' station and 23.89% (24.34%) elsewhere in the unit. From a patient's perspective, we found that care times, defined as time with at least one health care worker of a designated type in their intensive care unit room, were distributed as follows: 13.11% (9.90%) with physicians, 86.14% (88.15%) with nurses, and 8.14% (7.52%) with critical support staff (eg, respiratory therapists, pharmacists). Physicians, nurses, and critical support staff spend very little of their time in direct patient contact in an intensive care unit setting, similar to reported observations in both outpatient and inpatient settings. Not surprisingly, nurses spend far more time with patients than physicians. Additionally, physicians spend more than twice as much time in the physician work room (where electronic medical record review and documentation occurs) than the time they spend with all of their patients combined. Copyright © 2018 Elsevier Inc. All rights reserved.

Effect of various surface treatment methods on the bond strength of the heat-pressed ceramic samples.

PubMed

Saraçoğlu, A; Cura, C; Cötert, H S

2004-08-01

This in vitro study was conducted to evaluate the interaction between the shear bond strength and the surface treatment method for a commercial dental ceramic. Ninety bonded ceramic units were manufactured for this study. Each unit was made by luting two cylinder-shaped ceramic samples to each other with a resin-composite luting agent. The units were then divided into nine groups, containing 10 units in each group. Samples from each group were treated with one of the following: etching with 4.9% hydrofluoric acid for 10, 20 and 40 s, 9.5% hydrofluoric acid for 10, 20 and 40 s, 40% orthophosphoric acid for 40 s, air abrasion with alumina in 50-microm particles, and grinding with a high-speed diamond bur. The treated samples were then silanated and luted with a resin-composite luting agent. The luted units were then loaded to failure. Two samples from each group were neither silanated nor luted after the surface treatment procedure, and morphological changes obtained by various surface treatment regimens were investigated by scanning electron microscopy. A statistically significant difference was observed among the mean shear bond strengths of the groups prepared with different surface treatment techniques (P = 0.00). Hydrofluoric acid appeared to be the most suitable chemical medium to produce a reliable ceramic bond. Etching time and concentration of the acidic medium were also observed as important prognostic variates. Orthophosphoric acid treatment was observed to be the least effective surface treatment method on the heat-pressed ceramic samples. Physical applications such as bur grinding and air blasting maintained stronger bonds than the orthophosphoric acid, while producing weaker bonds than surfaces treated with hydrofluoric acid in all concentrations and etching periods. The effect of the silane priming agent was not considered in this study. Copyright 2004 Blackwell Publishing Ltd.

The great red flashlight

NASA Astrophysics Data System (ADS)

Halbach, Edward A.

After fifty years of fighting with flashlights which persisted in rolling to the ground, being mislaid, or stashed in a pocket, the author designed a unit which was always on hand and needed no search for the switch. A normally closed switch, internal to the bottom of the flashlight case, is opened by the weight of the unit suspended on a cord about the neck. Lifting the unit with two fingers turns on the red light, while releasing the unit automatically turns it off. A felt covering around the flashlight provides comfort on cold nights. Because this red light would be a welcome tool for other variable star observers, more units were assembled and brought to the AAVSO meeting in Houston for distribution to observers who agreed to give each unit a workout and report on its performance. The author is waiting to hear from these observers.

The Incidence and Wage Consequences of Home-Based Work in the United States, 1980-2000

ERIC Educational Resources Information Center

Oettinger, Gerald S.

2011-01-01

This study documents the rapid growth in home-based wage and salary employment and the sharp decline in the home-based wage penalty in the United States between 1980 and 2000. These twin patterns, observed for both men and women in most occupation groups, suggest that employer costs of providing home-based work arrangements have decreased.…

Course-Taking Patterns of Latino ESL Students: Mobility and Mainstreaming in Urban Community Colleges in the United States

ERIC Educational Resources Information Center

Razfar, Aria; Simon, Jenny

2011-01-01

In most Western countries where English is the medium of instruction, there is a substantial gap in student success between immigrant English as a second language (ESL) students and non-ESL students. In the United States, this situation has been observed in particular with Latino ESL students. This article describes a longitudinal study of two…

MANGO Imager Network Observations of Geomagnetic Storm Impact on Midlatitude 630 nm Airglow Emissions

NASA Astrophysics Data System (ADS)

Kendall, E. A.; Bhatt, A.

2017-12-01

The Midlatitude Allsky-imaging Network for GeoSpace Observations (MANGO) is a network of imagers filtered at 630 nm spread across the continental United States. MANGO is used to image large-scale airglow and aurora features and observes the generation, propagation, and dissipation of medium and large-scale wave activity in the subauroral, mid and low-latitude thermosphere. This network consists of seven all-sky imagers providing continuous coverage over the United States and extending south into Mexico. This network sees high levels of medium and large scale wave activity due to both neutral and geomagnetic storm forcing. The geomagnetic storm observations largely fall into two categories: Stable Auroral Red (SAR) arcs and Large-scale traveling ionospheric disturbances (LSTIDs). In addition, less-often observed effects include anomalous airglow brightening, bright swirls, and frozen-in traveling structures. We will present an analysis of multiple events observed over four years of MANGO network operation. We will provide both statistics on the cumulative observations and a case study of the "Memorial Day Storm" on May 27, 2017.

The molecular structure of the phosphate mineral chalcosiderite - A vibrational spectroscopic study

NASA Astrophysics Data System (ADS)

Frost, Ray L.; Xi, Yunfei; Scholz, Ricardo; Ribeiro, Carlos Augusto de Brito

2013-07-01

The mineral chalcosiderite with formula CuFe6(PO4)4(OH)8ṡ4H2O has been studied by Raman spectroscopy and by infrared spectroscopy. A comparison of the chalcosiderite spectra is made with the spectra of turquoise. The spectra of the mineral samples are very similar in the 1200-900 cm-1 region but strong differences are observed in the 900-100 cm-1 region. The effect of substitution of Fe for Al in chalcosiderite shifts the bands to lower wavenumbers. Factor group analysis (FGA) implies four OH stretching vibrations for both the water and hydroxyl units. Two bands ascribed to water are observed at 3276 and 3072 cm-1. Three hydroxyl stretching vibrations are observed. Calculations using a Libowitzky type formula show that the hydrogen bond distances of the water molecules are 2.745 and 2.812 Å which are considerably shorter than the values for the hydroxyl units 2.896, 2.917 and 2.978 Å. Two phosphate stretching vibrations at 1042 and 1062 cm-1 in line with the two independent phosphate units in the structure of chalcosiderite. Three bands are observed at 1102, 1159 and 1194 cm-1 assigned to the phosphate antisymmetric stretching vibrations. FGA predicts six bands but only three are observed due to accidental degeneracy. Both the ν2 and ν4 bending regions are complex. Four Raman bands observed at 536, 580, 598 and 636 cm-1 are assigned to the ν4 bending modes. Raman bands at 415, 420, 475 and 484 cm-1are assigned to the phosphate ν2 bending modes. Vibrational spectroscopy enables aspects of the molecular structure of chalcosiderite to be assessed.

A comparative study of patients' activities and interactions in a stroke unit before and after reconstruction-The significance of the built environment.

PubMed

Anåker, Anna; von Koch, Lena; Sjöstrand, Christina; Bernhardt, Julie; Elf, Marie

2017-01-01

Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients' activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole. The data were collected using a behavioral mapping technique at three different time points: in the original unit, in the temporary unit and in the new unit. A total of 59 patients were included. The analysis included field notes from observations of the physical environment and examples from planning and design documents. The findings indicated that in the new unit, the patients spent more time in their rooms, were less active, and had fewer interactions with staff and family than the patients in the original unit. The reconstruction involved a change from a primarily multi-bed room design to single-room accommodations. In the new unit, the patients' lounge was located in a far corner of the unit with a smaller entrance than the patients' lounge in the old unit, which was located at the end of a corridor with a noticeable entrance. Changes in the design of the stroke unit may have influenced the patients' activities and interactions. This study raises the question of how the physical environment should be designed in the future to facilitate the delivery of health care and improve outcomes for stroke patients. This research is based on a case study, and although the results should be interpreted with caution, we strongly recommend that environmental considerations be included in future stroke guidelines.

Does neonatal pain management in intensive care units differ between night and day? An observational study.

PubMed

Guedj, Romain; Danan, Claude; Daoud, Patrick; Zupan, Véronique; Renolleau, Sylvain; Zana, Elodie; Aizenfisz, Sophie; Lapillonne, Alexandre; de Saint Blanquat, Laure; Granier, Michèle; Durand, Philippe; Castela, Florence; Coursol, Anne; Hubert, Philippe; Cimerman, Patricia; Anand, K J S; Khoshnood, Babak; Carbajal, Ricardo

2014-02-20

To determine whether analgesic use for painful procedures performed in neonates in the neonatal intensive care unit (NICU) differs during nights and days and during each of the 6 h period of the day. Conducted as part of the prospective observational Epidemiology of Painful Procedures in Neonates study which was designed to collect in real time and around-the-clock bedside data on all painful or stressful procedures. 13 NICUs and paediatric intensive care units in the Paris Region, France. All 430 neonates admitted to the participating units during a 6-week period between September 2005 and January 2006. During the first 14 days of admission, data were collected on all painful procedures and analgesic therapy. The five most frequent procedures representing 38 012 of all 42 413 (90%) painful procedures were analysed. Observational study. We compared the use of specific analgesic for procedures performed during each of the 6 h period of a day: morning (7:00 to 12:59), afternoon, early night and late night and during daytime (morning+afternoon) and night-time (early night+late night). 7724 of 38 012 (20.3%) painful procedures were carried out with a specific analgesic treatment. For morning, afternoon, early night and late night, respectively, the use of analgesic was 25.8%, 18.9%, 18.3% and 18%. The relative reduction of analgesia was 18.3%, p<0.01, between daytime and night-time and 28.8%, p<0.001, between morning and the rest of the day. Parental presence, nurses on 8 h shifts and written protocols for analgesia were associated with a decrease in this difference. The substantial differences in the use of analgesics around-the-clock may be questioned on quality of care grounds.

Submarine hydrothermal processes, mirroring the geotectonic evolution of the NE Hungarian Jurassic Szarvaskő Unit

NASA Astrophysics Data System (ADS)

Kiss, Gabriella B.; Zagyva, Tamás; Pásztor, Domokos; Zaccarini, Federica

2018-05-01

The Jurassic pillow basalt of the NE Hungarian Szarvaskő Unit is part of an incomplete ophiolitic sequence, formed in a back-arc- or marginal basin of Neotethyan origin. Different, often superimposing hydrothermal processes were studied aiming to characterise them and to discover their relationship with the geotectonic evolution of the region. Closely packed pillow, pillow-fragmented hyaloclastite breccia and transition to peperitic facies of a submarine lava flow were observed. The rocks underwent primary and cooling-related local submarine hydrothermal processes immediately after eruption at ridge setting. Physico-chemical data of this process and volcanic facies analyses revealed distal formation in the submarine lava flow. A superimposing, more extensive fluid circulation system resulted in intense alteration of basalt and in the formation of mostly sulphide-filled cavities. This lower temperature, but larger-scale process was similar to VMS systems and was related to ridge setting. As a peculiarity of the Szarvaskő Unit, locally basalt may be completely altered to a grossular-bearing mineral assemblage formed by rodingitisation s.l. This unique process observed in basalt happened in ridge setting/during spreading, in the absence of known large ultramafic blocks. Epigenetic veins formed also during Alpine regional metamorphism, related to subduction/obduction. The observed hydrothermal minerals represent different steps of the geotectonic evolution of the Szarvaskő Unit, from the ridge setting and spreading till the subduction/obduction. Hence, studying the superimposing alteration mineral assemblages can be a useful tool for reconstructing the tectonic history of an ophiolitic complex. Though the found mineral parageneses are often similar, careful study can help in distinguishing the processes and characterising their P, T, and X conditions.

Use of physical restraints in adult critical care: a bicultural study.

PubMed

Martin, Beth; Mathisen, Lars

2005-03-01

Although controversial, physical restraints are commonly used in adult critical care units in the United States to prevent treatment interference and self-inflicted harm. Use of physical restraints in Norwegian hospitals is very limited. In the United States, an experimental design for research on use of restraints has not seemed feasible. However, international research provides an opportunity to compare and contrast practices. To describe the relationship between patients' characteristics, environment, and use of physical restraints in the United States and Norway. Observations of patients and chart data were collected from 2 intensive care units (n = 50 patients) in Norway and 3 (n = 50 patients) in the United States. Sedation was measured by using the Sedation-Agitation Scale. The Nine Equivalents of Nursing Manpower Use Score was used to indicate patients' acuity level. Restraints were in use in 39 of 100 observations in the United States and not at all in Norway (P = .001). Categories of patients were balanced. In the Norwegian sample, the median Nine Equivalents of Nursing Manpower Use Score was higher (37 vs 27 points, P < .001), patients were more sedated (P < .001), and nurse-to-patient ratios were higher (1.05:1 vs 0.65:1, P < .001). Seven incidents of unplanned device removal were reported in the US sample. Critical care units with similar technology and characteristics of patients vary between nations in restraint practices, levels of sedation, and nurse-to-patient ratios. Restraint-free care was, in this sample, safe in terms of treatment interference.

Effect on mental health of a participatory intervention to improve psychosocial work environment: a cluster randomized controlled trial among nurses.

PubMed

Uchiyama, Ayako; Odagiri, Yuko; Ohya, Yumiko; Takamiya, Tomoko; Inoue, Shigeru; Shimomitsu, Teruichi

2013-01-01

Improvement of psychosocial work environment has proved to be valuable for workers' mental health. However, limited evidence is available for the effectiveness of participatory interventions. The purpose of this study was to investigate the effect on mental health among nurses of a participatory intervention to improve the psychosocial work environment. A cluster randomized controlled trial was conducted in hospital settings. A total of 434 nurses in 24 units were randomly allocated to 11 intervention units (n=183) and 13 control units (n=218). A participatory program was provided to the intervention units for 6 months. Depressive symptoms as mental health status and psychosocial work environment, assessed by the Job Content Questionnaire, the Effort-Reward Imbalance Questionnaire, and the Quality Work Competence questionnaire, were measured before and immediately after the 6-month intervention by a self-administered questionnaire. No significant intervention effect was observed for mental health status. However, significant intervention effects were observed in psychosocial work environment aspects, such as Coworker Support (p<0.01) and Goals (p<0.01), and borderline significance was observed for Job Control (p<0.10). It is suggested that a 6-month participatory intervention is effective in improving psychosocial work environment, but not mental health, among Japanese nurses.

Shear bond strength evaluation of chemically-cured and light-cured orthodontic adhesives after enamel deproteinization with 5.25% sodium hypochlorite

NASA Astrophysics Data System (ADS)

Salim, J. C.; Krisnawati; Purbiati, M.

2017-08-01

This study aimed to assess the effect of enamel deproteinization with 5.25% sodium hypochlorite (NaOCl) before etching on the shear bond strength (SBS) of Unite (UN; 3M Unitek) and Xihu-BIOM adhesive (XB). Fifty-two maxillary first premolars were divided into four groups: (1) UN and (2) XB according to manufacturer’s recommendation and (3) UN and (4) XB deproteinized with 5.25% NaOCl. Brackets were bonded, and a mechanical test was performed using a universal testing machine. The mean SBS value for groups A1, A2, B1, and B2 was 13.51 ± 2.552, 14.36 ± 2.902, 16.43 ± 2.615, and 13.05 ± 2.348 MPa, respectively. A statistically significant difference in SBSs was observed between chemically cured groups and between group B (p < 0.05). No statistically significant difference in SBSs was observed between light-cured adhesive groups and between group A (p > 0.05). NaOCl enamel deproteinization before acid etching has a significant effect on the SBS of Unite adhesive, but not on that of the Xihu-BIOM adhesive. Furthermore, a significant difference in the SBS of Unite and Xihu-BIOM adhesives within the enamel deproteinization group was observed in this study.

SEM, EDX and Raman and infrared spectroscopic study of brianyoungite Zn3(CO3,SO4)(OH)4 from Esperanza Mine, Laurion District, Greece

NASA Astrophysics Data System (ADS)

Frost, Ray L.; López, Andrés; Wang, Lina; Scholz, Ricardo; Sampaio, Ney Pinheiro

2015-10-01

The mineral brianyoungite, a carbonate-sulphate of zinc, has been studied by scanning electron microscopy (SEM) with chemical analysis using energy dispersive spectroscopy (EDX) and Raman and infrared spectroscopy. Multiple carbonate stretching modes are observed and support the concept of non-equivalent carbonate units in the brianyoungite structure. Intense Raman band at 1056 cm-1 with shoulder band at 1038 cm-1 is assigned to the CO32- ν1 symmetric stretching mode. Two intense Raman bands at 973 and 984 cm-1 are assigned to the symmetric stretching modes of the SO42- anion. The observation of two bands supports the concept of the non-equivalence of sulphate units in the brianyoungite structure. Raman bands at 704 and 736 cm-1 are assigned to the CO32- ν4 bending modes and Raman bands at 507, 528, 609 and 638 cm-1 are assigned to the CO32- ν2 bending modes. Multiple Raman and infrared bands in the OH stretching region are observed, proving the existence of water and hydroxyl units in different molecular environments in the structure of brianyoungite. Vibrational spectroscopy enhances our knowledge of the molecular structure of brianyoungite.

Lava flow field emplacement studies of Manua Ulu (Kilauea Volcano, Hawai'i, United States) and Venus, using field and remote sensing analyses

NASA Astrophysics Data System (ADS)

Byrnes, Jeffrey Myer

2002-04-01

This work examines lava emplacement processes by characterizing surface units using field and remote sensing analyses in order to understand the development of lava flow fields. Specific study areas are the 1969--1974 Mauna Ulu compound flow field, (Kilauea Volcano, Hawai'i, USA), and five lava flow fields on Venus: Turgmam Fluctus, Zipaltonal Fluctus, the Tuli Mons/Uilata Fluctus flow complex, the Var Mons flow field, and Mylitta Fluctus. Lava surface units have been examined in the field and with visible-, thermal-, and radar-wavelength remote sensing datasets for Mauna Ulu, and with radar data for the Venusian study areas. For the Mauna Ulu flow field, visible characteristics are related to color, glass abundance, and dm- to m-scale surface irregularities, which reflect the lava flow regime, cooling, and modification due to processes such as coalescence and inflation. Thermal characteristics are primarily affected by the abundance of glass and small-scale roughness elements (such as vesicles), and reflect the history of cooling, vesiculation and degassing, and crystallization of the lava. Radar characteristics are primarily affected by unit topography and fracturing, which are related to flow inflation, remobilization, and collapse, and reflect the local supply of lava during and after unit emplacement. Mauna Ulu surface units are correlated with pre-eruption topography, lack a simple relationship to the main feeder lava tubes, and are distributed with respect to their position within compound flow lobes and with distance from the vent. The Venusian lava flow fields appear to have developed through emplacement of numerous, thin, simple and compound flows, presumably over extended periods of time, and show a wider range of radar roughness than is observed at Mauna Ulu. A potential correlation is suggested between flow rheology and surface roughness. Distributary flow morphologies may result from tube-fed flows, and flow inflation is consistent with observed surface characteristics. Furthermore, the significance of inflation at Mauna Ulu and comparison of radar characteristics indicates that inflation may, in fact, be more prevalent on Venus than at Mauna Ulu. Although the Venusian flow fields display morphologies similar to those observed within terrestrial flow fields, the Venusian flow units are significantly larger.

Thermophysical Properties of the Phoenix Mars Landing Site Study Regions

NASA Astrophysics Data System (ADS)

Putzig, N. E.; Mellon, M. T.; Golombek, M. P.; Arvidson, R. E.

2006-03-01

Analysis of Phoenix Mars study regions places 4 of 5 in a previously-identified duricrust-dominated thermophysical unit which also contains the Viking and Spirit landing sites. Extrapolation of lander-observed properties to the study regions may be complicated by surface heterogeneity.

From orogenic buildup to extensional unroofing: the evolution of the Adria - Europe collisional zone in the Medvednica Mountains of Croatia

NASA Astrophysics Data System (ADS)

Beniest, Anouk; van Gelder, Inge; Matenco, Liviu; Willingshofer, Ernst; Gruic, Andrea; Tomljenovic, Bruno

2013-04-01

Quantifying the kinematics of the Miocene extension in the Pannonian Basin is of critical importance for understanding the evolution of Adria-Europe collision in particular in the transitional zone from the Alps (Adria the upper plate) to the Dinarides (Adria the lower plate). Recent studies have demonstrated that large-scale extensional unroofing and core-complex formation affected the Europe-Adria contact in the Dinarides during Miocene times. The relationship between this extensional exhumation of Adriatic units and the roughly coeval Miocene extension affecting the Alpine-derived units during their E-ward extrusion into the intra-Carpathians ALCAPA block and the formation of the Pannonian basin is still unknown. One key area situated in the transitional zone is the Medvednica Mountains of Croatia, an area that benefits from already existing and extensive petrological and structural studies. The area of the Medvednica Mountains has been targeted by the means of a field kinematic analysis complemented by low-temperature thermochronology, metamorphic petrology and sedimentological observations. The results demonstrate that two units, reflecting distinct Adriatic paleogeographical positions, make up the structural geometry of the mountains. The upper unit contains Paleozoic mostly fine clastic sequence metamorphosed in sub-greenschist facies, overlain by a proximal Adriatic facies consisting of Triassic shallow water carbonates. The lower unit is made up by a volcanic sequence overlain by gradual deepening Triassic carbonates metamorphosed in greenschist facies that bears a strong resemblance to the Triassic break-up volcanism and subsequent sedimentation affecting the distal Adriatic units observed elsewhere in the Jadar-Kopaonik unit of the Dinarides. The strong contrast between the Middle-Upper Triassic facies suggests large scale thrusting during Cretaceous nappe stacking. Subsequently, the studied area has been affected by significant extensional deformation creating the present-day turtleback geometry. This resulted in the formation of brittle normal faults in both units, locally tilted by the uplift of the mountain core, which indicate mostly NE-SW extension. The lower unit is affected by a pervasive deformation characterized by a wide mylonitic shear zone with stretching lineations indicating consistently top-NE to E sense of shear. The present-day structural geometry of the mountains was established during the Pliocene-Quaternary inversion. The exact ages of nappe-stacking and subsequent extensional exhumation will be clarified by the upcoming low-temperature thermochronology and absolute age dating study. However, available results demonstrate that the extensional geometry and sense of shear is typical for the Miocene extensional exhumation and basin formation that affected the Adria-Europe contact elsewhere in the Dinarids, e.g. Kozara-Prosara-Motajica and Fruska Gora extensional structures. By comparing similar extensional features observed in for instance the Rechnitz and Pohorje extensional structures, the combined study potentially demonstrates that the Miocene mechanism of extension and sense of shear is structurally coherent at the scale of the entire Dinaridic and Alpine margins.

Determining the Molecular Growth Mechanisms of Protein Crystal faces by Atomic Force Microscopy

NASA Technical Reports Server (NTRS)

Li, Huayu; Nadarajah, Arunan; Pusey, Marc L.

1998-01-01

A high resolution atomic force microscopy (AFM) study had shown that the molecular packing on the tetragonal lysozyme (110) face corresponded to only one of two possible packing arrangements, suggesting that growth layers on this face were of bimolecular height (Li et al., 1998). Theoretical analyses of the packing had also indicated that growth of this face should proceed by the addition of growth units of at least tetramer size corresponding to the 43 helices in the crystal. In this study an AFM linescan technique was devised to measure the dimensions of individual growth units on protein crystal faces. The growth process of tetragonal lysozyme crystals was slowed down by employing very low supersaturations. As a result images of individual growth events on the (110) face were observed, shown by jump discontinuities in the growth step in the linescan images. The growth unit dimension in the scanned direction was obtained by suitably averaging these images. A large number of scans in two directions on the (110) face were performed and the distribution of lysozyme aggregate sizes were obtained. A variety of growth units, all of which were 43 helical lysozyme aggregates, were shown to participate in the growth process with a 43 tetramer being the minimum observed size. This technique represents a new application for AFM allowing time resolved studies of molecular process to be carried out.

Outbreaks of Pox Disease Due to Canarypox-Like and Fowlpox-Like Viruses in Large-Scale Houbara Bustard Captive-Breeding Programmes, in Morocco and the United Arab Emirates.

PubMed

Le Loc'h, G; Paul, M C; Camus-Bouclainville, C; Bertagnoli, S

2016-12-01

Infectious diseases can be serious threats for the success of reinforcement programmes of endangered species. Houbara Bustard species (Chlamydotis undulata and Chlamydotis macqueenii), whose populations declined in the last decades, have been captive-bred for conservation purposes for more than 15 years in North Africa and the Middle East. Field observations show that pox disease, caused by avipoxviruses (APV), regularly emerges in conservation projects of Houbara Bustard, despite a very strict implementation of both vaccination and biosecurity. Data collected from captive flocks of Houbara Bustard in Morocco from 2006 through 2013 and in the United Arab Emirates from 2011 through 2013 were analysed, and molecular investigations were carried out to define the virus strains involved. Pox cases (n = 2311) were observed during more than half of the year (88% of the months in Morocco, 54% in the United Arab Emirates). Monthly morbidity rates showed strong variations across the time periods considered, species and study sites: Four outbreaks were described during the study period on both sites. Molecular typing revealed that infections were mostly due to canarypox-like viruses in Morocco while fowlpox-like viruses were predominant in the United Arab Emirates. This study highlights that APV remain a major threat to consider in bird conservation initiatives. © 2015 Blackwell Verlag GmbH.

The organization and administration of community college non-credit workforce education and training cuts

NASA Astrophysics Data System (ADS)

Kozachyn, Karen P.

Community colleges are struggling financially due to underfunding. Recent state budget cuts coupled with the elimination of federal stimulus money has exacerbated the issue as these funding streams had contributed to operating costs (Moltz, 2011). In response to these budget cuts, community colleges are challenged to improve, increase, and develop revenue producing programs. These factors heighten the need for community colleges to examine their non-credit workforce organizations. The community college units charged with delivering non-credit workforce education and training programs are historically ancillary to the academic divisions that deliver certificate, technical degree, and transfer degree programs. The perceptions of these units are that they are the community college's 'step child' (Grubb, Bradway, and Bell, 2002). This case study examined the organization and administration of community college non-credit workforce education and training units, utilizing observation, interviews, and document analysis. Observational data focused on the physical campus and the unit. Interviews were conducted onsite with decision-making personnel of the division units that deliver non-credit workforce education and training within each community college. Document analysis included college catalogues, program guides, marketing material, and website information. The study was grounded in the review of literature associated with the evolution of the community college, as well as the development of workforce education and training including funding, organizational structure and models, management philosophies, and effectiveness. The findings of the study report that all five units were self-contained and were organized and operated uniquely within the organization. Effectiveness was measured differently by each institution. However, two common benchmarks were revenue and student evaluations. Another outcome of this study is the perceived lack of college-wide alignment between the non-credit workforce education and training unit and the college community. With more than 54 million working adults enrolling in non-credit education through an institution of higher education (American Association of Community Colleges, 2012) the findings of this study could increase the community college's awareness of the potential in non-credit workforce education and training and thus strengthen confidence to invest more college funds and resources to increase non-credit workforce education and training.

Observing the work of the Clinical Nurse Specialist: a pilot study.

PubMed

Darmody, Julie V

2005-01-01

The Clinical Nurse Specialist (CNS) is an advanced practice nurse (APN) with graduate preparation as a clinical expert within a specialty area of nursing practice. There is a need for information about the work of the CNS in order to link CNS activities to outcomes and costs of care. To describe the work of the CNS in the acute care setting using the National Association of Clinical Nurse Specialists (NACNS) model as an organizing framework. Descriptive pilot study of the work of the CNS in acute care. A 500-bed academic medical center located in the Midwestern United States. Five masters-prepared APNs in a unit-based CNS role. Direct observation and time study were used to record activities and time for 4 hours with each CNS (n = 5) for a total of 20 hours of observation. CNS activity and time within each practice domain included patient/client (30%), nursing (44%), organization/system (10%), and other activities (16%). Specific activities observed were linked to possible outcomes in the NACNS framework. The NACNS model provided a useful framework for developing a data collection tool that can be used in a larger study that analyzes the work of the acute care CNS. Describing the work of the CNS is an important preliminary step to measuring outcomes and costs of care.

Effect of transient warming of red blood cells for up to 24 h: in vitro characteristics in CPD/saline-adenine-glucose-mannitol environment.

PubMed

Gulliksson, H; Nordahl-Källman, A-S

2014-01-01

There are few studies on transient warming of red blood cells (RBCs). Occasional storage outside restricted temperature range often results in destroying of the RBC unit, even after a short period of time due to national guidelines. This study evaluates the in vitro effects associated with such accidental warming on RBCs stored in saline-adenine-glucose-mannitol (SAGM) and prepared within 8 h after blood collection. This study includes both repeated short-term exposure of RBCs to room temperature for 6 h as wells as warming for either 6, 12, 18 or 24 h after 1 week or after 3 weeks of storage in two separate studies. RBCs were stored for 42 days. We weekly measured pH, K(+) , glucose, lactate, haemolysis, red cell ATP and 2,3-diphosphoglycerate. The lowest individual ATP value observed in any of the groups of warmed units was 2·6 μmol/g haemoglobin. Increased haemolysis in warmed units was noted in two of the studies. None of the individual units exceeded the European maximum limit of 0·8% haemolysis. Our results suggest that quality of RBCs after transient warming will be maintained at acceptable levels specified in standards and in previous studies. However, increased haemolysis was observed when transient warming occurred during the second part of the storage period of 6 weeks suggesting that RBCs are more vulnerable to warming by the end of storage. © 2013 International Society of Blood Transfusion.

Newborn physiological responses to noise in the neonatal unit.

PubMed

Cardoso, Sandra Maria Schefer; Kozlowski, Lorena de Cássia; Lacerda, Adriana Bender Moreira de; Marques, Jair Mendes; Ribas, Angela

2015-01-01

The incorporation of technologies in the care of infants has contributed to increased survival; however, this has turned neonatal unit into a noisy environment. To evaluate the physiological and functional effects resulting from the exposure to noise on low-weight newborns in incubators in a neonatal unit. Prospective, observational, quantitative, exploratory, descriptive study. The adopted statistical method included tables of frequency, descriptive statistics, and Student's t-test, with a 0.05 level of significance. As data collection tools, the environmental noise and the noise inside of the incubator were evaluated, and the Assessment of Preterm Infant Behavior scale was used to assess premature newborn behavior and projected specifically to document the neurobehavioral functioning of preterm infants. The data collection occurred from September of 2012 to April of 2013; 61 low-weight newborns admitted in the neonatal unit and in incubators were observed. Significant differences in the variables heart rate and oxygen saturation were noted when newborns were exposed to noise. Low-weight neonates in incubators present physiological alterations when facing discomfort caused by environmental noise in neonatal units. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

The Diffuse Radiation Field at High Galactic Latitudes

NASA Astrophysics Data System (ADS)

Akshaya, M. S.; Murthy, Jayant; Ravichandran, S.; Henry, R. C.; Overduin, James

2018-05-01

We have used GALEX observations of the north and south Galactic poles to study the diffuse ultraviolet background at locations where the Galactic light is expected to be at a minimum. We find offsets of 230–290 photon units in the far-UV (1531 Å) and 480–580 photon units in the near-UV (2361 Å). Of this, approximately 120 photon units can be ascribed to dust-scattered light and another 110 photon units (190 in the near-UV) to extragalactic radiation. The remaining radiation is, as yet, unidentified and amounts to 120–180 photon units in the far-UV and 300–400 photon units in the near-UV. We find that molecular hydrogen fluorescence contributes to the far-UV when the 100 μm surface brightness is greater than 1.08 MJy sr‑1.

Transitional neonatal hydronephrosis: fact or fantasy

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

Homsy, Y.L.; Williot, P.; Danais, S.

1986-07-01

Hydronephrosis secondary to an anomalous ureteropelvic junction was detected antenatally in more than 60 neonatal renal units Those 21 units that exhibited partial obstruction or dilatation without obstruction were selected for this study. They were assessed and followed by serial diuretic isotope renography (99mtechnetium-diethylenetriaminepentaacetic acid augmented with furosemide) and ultrasonography. Excretory urography was used selectively. Of the 17 renal units that could be assessed 88 per cent demonstrated labile ureteropelvic junctions. Indeed, in 3 to 6 months, when the definitive status seemed to be attained, 41 per cent (7 units) had deteriorated, 12 per cent (2 units) remained stable andmore » 47 per cent (8 units) underwent spontaneous improvement. We recommend a 3 to 6-month observation period for patients with hydronephrosis secondary to ureteropelvic junction anomalies when definite obstruction cannot be confirmed by isotope renography.« less

HEMP (high-altitude electromagnetic pulse) test and analysis of selected recloser-control units

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

Liu, T.K.; Sands, S.H.; Tesche, F.M.

A simulated HEMP test was performed on power line recloser-control units in the ARES facility during the month of October 1988. Two types of recloser-control units were tested: an electronic control unit presently in wide use in electric power distribution systems and a new microprocessor based unit presently being introduced to electric utilities. It was found that the ARES fields did not cause reproducible disruptive failure of the equipment. Minor upsets, which were considered to be non-disruptive to the recloser operation, were observed. The test results were compared to the results of an analysis from a previous study and itmore » is concluded that the probability of disruptive failure of field operating recloser-control units subjected to a nominal unclassified HEMP environment is small. 3 refs., 30 figs., 1 tab.« less

Consumer food handling in the home: a review of food safety studies.

PubMed

Redmond, Elizabeth C; Griffith, Christopher J

2003-01-01

Epidemiological data from Europe, North America, Australia, and New Zealand indicate that a substantial proportion of foodborne disease is attributable to improper food preparation practices in consumers' homes. International concern about consumer food safety has prompted considerable research to evaluate domestic food-handling practices. The majority of consumer food safety studies in the last decade have been conducted in the United Kingdom and Northern Ireland (48%) and in the United States (42%). Surveys (questionnaires and interviews), the most frequent means of data collection, were used in 75% of the reviewed studies. Focus groups and observational studies have also been used. One consumer food safety study examined the relationship between pathogenic microbial contamination from raw chicken and observed food-handling behaviors, and the results of this study indicated extensive Campylobacter cross-contamination during food preparation sessions. Limited information about consumers' attitudes and intentions with regard to safe food-handling behaviors has been obtained, although a substantial amount of information about consumer knowledge and self-reported practices is available. Observation studies suggest that substantial numbers of consumers frequently implement unsafe food-handling practices. Knowledge, attitudes, intentions, and self-reported practices did not correspond to observed behaviors, suggesting that observational studies provide a more realistic indication of the food hygiene actions actually used in domestic food preparation. An improvement in consumer food-handling behavior is likely to reduce the risk and incidence of foodborne disease. The need for the development and implementation of food safety education strategies to improve specific food safety behaviors is reviewed in this paper.

Impact of organizational policies and practices on workplace injuries in a hospital setting.

PubMed

Tveito, T H; Sembajwe, G; Boden, L I; Dennerlein, J T; Wagner, G R; Kenwood, C; Stoddard, A M; Reme, S E; Hopcia, K; Hashimoto, D; Shaw, W S; Sorensen, G

2014-08-01

This study aimed to assess relationships between perceptions of organizational practices and policies (OPP), social support, and injury rates among workers in hospital units. A total of 1230 hospital workers provided survey data on OPP, job flexibility, and social support. Demographic data and unit injury rates were collected from the hospitals' administrative databases. Injury rates were lower in units where workers reported higher OPP scores and high social support. These relationships were mainly observed among registered nurses. Registered nurses perceived coworker support and OPP as less satisfactory than patient care associates (PCAs). Nevertheless, because of the low number of PCAs at each unit, results for the PCAs are preliminary and should be further researched in future studies with larger sample sizes. Employers aiming to reduce injuries in hospitals could focus on good OPP and supportive work environment.

From spouse to caregiver and back: a grounded theory study of post-intensive care unit spousal caregiving.

PubMed

Ågård, Anne Sophie; Egerod, Ingrid; Tønnesen, Else; Lomborg, Kirsten

2015-08-01

To explore the challenges and caring activities of spouses of intensive care unit survivors during the first year of patient recovery. Every year, millions of people globally are discharged from an intensive care unit after critical illness to continue treatment, care and rehabilitation in general hospital wards, rehabilitation facilities and at home. Consequently, millions of spouses become informal caregivers. Little is known, however, about the concrete challenges spouses face in post-intensive care unit everyday life. Explorative, qualitative grounded theory study. Participants were spouses of intensive care unit survivors. The study was undertaken in Denmark in 2009-2010. Data consisted of 35 semi-structured dyad interviews at 3 and 12 months post-intensive care unit discharge, two group interviews with patients and two with spouses. 'Shifting their role from spouse to caregiver and back' was identified as the core category of the study. The role shifts progressed in a dynamic process involving four elements: (1) committing to caregiving; (2) acquiring caregiving skills; (3) negotiating level of caregiving and (4) gradually leaving the caregiver role. Post-ICU caregiving comprised five patient dimensions: observing, assisting, coaching, advocating and managing activities. Spouses play a vital and multifaceted role in post-intensive care unit recovery. The findings can inform healthcare professionals in their efforts to prepare intensive care unit patients' families for the time following intensive care unit and hospital discharge. Hospital staff, rehabilitation experts and primary care professionals must acknowledge spouses' important contribution from intensive care unit admission throughout recovery. © 2015 John Wiley & Sons Ltd.

Platelet transfusion therapy in sub-Saharan Africa: bacterial contamination, recipient characteristics and acute transfusion reactions

PubMed Central

Hume, Heather A.; Ddungu, Henry; Angom, Racheal; Baluku, Hannington; Kajumbula, Henry; Kyeyune-Byabazaire, Dorothy; Orem, Jackson; Ramirez-Arcos, Sandra; Tobian, Aaron A.R.

2017-01-01

Background Little data are available on bacterial contamination (BC) of platelet units or acute transfusion reactions to platelet transfusions (PT) in sub-Saharan Africa (SSA). Methods This prospective observational study evaluated the rate of BC of whole blood derived platelet units (WB-PU), the utility of performing Gram stains (GS) to prevent septic reactions, characteristics of patients receiving PT and the rate of acute reactions associated with PT at the Uganda Cancer Institute in Kampala, Uganda. An aliquot of each WB-PU studied was taken to perform GS and culture using the Bactec™ 9120 instrument. Study participants were monitored for reactions. Results 337 WB-PU were evaluated for BC, of which 323 units were transfused in 151 transfusion episodes to 50 patients. The frequency of BC ranged from 0.3%–2.1% (according to criteria used to define BC). The GS had high specificity (99.1%), but low sensitivity to detect units with BC. The median platelet count prior to PT was 10,900 (IQR 6,000–18,900) cells/μL. 78% of PT were given to patients with no bleeding. Acute reactions occurred in 11 transfusion episodes, involving 13 WB-PU, for a rate of 7.3% (95%CI=3.7–12.7%) per transfusion episode. All recipients of units with positive bacterial cultures were receiving antibiotics at the time of transfusion; none experienced a reaction. Conclusions The rate of BC observed in this study is lower than previously reported in SSA, but still remains a safety issue. As GS appears to be an ineffective screening tool, alternate methods should be explored to prevent transfusing bacterially-contaminated platelets in SSA. PMID:27079627

Mineralogy of Mare Serenitatis on the near side of the Moon based on Chandrayaan-1 Moon Mineralogy Mapper (M3) observations

NASA Astrophysics Data System (ADS)

Kaur, Prabhjot; Bhattacharya, Satadru; Chauhan, Prakash; Ajai; Kiran Kumar, A. S.

2013-01-01

Spectral analysis of Mare Serenitatis has been carried out using Chandrayaan-1 Moon Mineralogy Mapper (M3) data in order to map the compositional diversity of the basaltic units that exist in the basin. Mare Serenitatis is characterized by multiple basaltic flows of different ages indicating a prolonged volcanism subsequent to the basin formation event. Reflectance spectra of fresh craters from the Mare Serenitatis have been analyzed to study the nature and location of the spectral absorption features around 1- and 2-μm respectively, arising due to the electronic charge transition of Fe2+ in the crystal lattice of pyroxenes and/or olivine. Chandrayaan-1 M3 data have been utilized to obtain an Integrated Band Depth (IBD) mosaic of the Serenitatis basin. Based on the spectral variations observed in the IBD mosaic, 13 spectral units have been mapped in the Mare Serenitatis. In the present study, we have also derived spectral band parameters, namely, band center, band strength, band area and band area ratio from the M3 data to study the mineralogical and compositional variations amongst the basaltic units of the studied basin. On the basis of spectral band parameter analysis, the pyroxene compositions of the basaltic units have been determined, which vary from low to intermediate end of the high-Ca pyroxene and probably represent a sub-calcic to calcic augite compositional range. Detailed spectral analyses reveal little variations in the mafic mineralogy of the mare basalts in terms of pyroxene chemistry. The uniformity in pyroxene composition across the basaltic units of Mare Serenitatis, therefore, suggest a probably stable basaltic source region, which might not have experienced large-scale fractionation during the prolonged volcanism that resulted in filling of the large Serenitatis basin.

Seasonal and geographic variations in the incidence of asthma exacerbations in the United States.

PubMed

Gerhardsson de Verdier, M; Gustafson, Per; McCrae, Christopher; Edsbäcker, Staffan; Johnston, Neil

2017-10-01

Exacerbations drive the burden of asthma and lead to significant morbidity and consumption of health care resources. Many prior studies of the epidemiology of asthma exacerbations have relied upon data from hospital care. The objective of this study was to determine US patterns of geographic and seasonal variations of asthma exacerbations being defined as asthma episodes requiring hospital care and/or a prescription for oral steroid. The study was a retrospective observational cohort study using administrative claims data for insured individuals from the HealthCore Integrated Research Database, including around 43 million members in the United States. Analyses examined 3 age groups, 6-17, 18-64, and ≥65 years and four US regions, Northeast, Southeast, Central, and Western. Monthly rates of asthma exacerbations showed the greatest variation over the year in children, less so in adults and in the elderly. Clinically important differences in rates of asthma exacerbation were observed between regions with the Western Region having the lowest in all three age groups followed by the Northeast, Central, and Southeast regions. Peaks in children occurred in the early fall following troughs in the summer months, and peaks at year-end occurred in adults, particularly in those over 65 years. There is a striking seasonal variation in asthma exacerbations in the United States. Substantial differences between regions of the United States in asthma exacerbation rates cannot readily be explained and invite further investigation.

ITE Trip Generation Modification Factors for Louisiana : Research Project Capsule

DOT National Transportation Integrated Search

2017-12-01

Using data from studies conducted in the United States over the last 50-60 years, the Institute of Transportation Engineers (ITE) has published trip generation rates for different land uses. Over time, observations from new studies have been incorpor...

Protocols and Hospital Mortality in Critically ill Patients: The United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study

PubMed Central

Sevransky, Jonathan E.; Checkley, William; Herrera, Phabiola; Pickering, Brian W.; Barr, Juliana; Brown, Samuel M; Chang, Steven Y; Chong, David; Kaufman, David; Fremont, Richard D; Girard, Timothy D; Hoag, Jeffrey; Johnson, Steven B; Kerlin, Mehta P; Liebler, Janice; O'Brien, James; O'Keefe, Terence; Park, Pauline K; Pastores, Stephen M; Patil, Namrata; Pietropaoli, Anthony P; Putman, Maryann; Rice, Todd W.; Rotello, Leo; Siner, Jonathan; Sajid, Sahul; Murphy, David J; Martin, Greg S

2015-01-01

Objective Clinical protocols may decrease unnecessary variation in care and improve compliance with desirable therapies. We evaluated whether highly protocolized intensive care units have superior patient outcomes compared with less highly protocolized intensive care units. Design Observational study in which participating intensive care units completed a general assessment and enrolled new patients one day each week. Setting and Patients 6179 critically ill patients across 59 intensive care units in the United States Critical Illness and Injury Trials Group Critical Illness Outcomes Study Interventions: None Measurements and Main Results The primary exposure was the number of intensive care unit protocols; the primary outcome was hospital mortality. 5809 participants were followed prospectively and 5454 patients in 57 intensive care units had complete outcome data. The median number of protocols per intensive care unit was 19 (IQR 15 to 21.5). In single variable analyses, there were no differences in intensive care unit and hospital mortality, length of stay, use of mechanical ventilation, vasopressors, or continuous sedation among individuals in intensive care units with a high vs. low number of protocols. The lack of association was confirmed in adjusted multivariable analysis (p=0.70). Protocol compliance with two ventilator management protocols was moderate and did not differ between intensive care units with high vs. low numbers of protocols for lung protective ventilation in ARDS (47% vs. 52%; p=0.28) and for spontaneous breathing trials (55% vs. 51%; p=0.27). Conclusions Clinical protocols are highly prevalent in United States intensive care units. The presence of a greater number of protocols was not associated with protocol compliance or patient mortality. PMID:26110488

Hand hygiene compliance before and after wearing gloves among intensive care unit nurses in Iran.

PubMed

Ghorbani, Azam; Sadeghi, Leila; Shahrokhi, Akram; Mohammadpour, Asghar; Addo, Mary; Khodadadi, Esmail

2016-11-01

Nosocomial infections are considered a major risk factor in hospital wards, and hand hygiene is the first step in their control. An observational study was conducted in 2015 with 200 nurses working in intensive care units in teaching hospitals of Tabriz, Iran. Data were collected by using the Hand Hygiene Observation Tool questionnaire. The researchers monitored nurses' opportunities for hand hygiene during the 8-week period from February 3-April 4, 2015. A total of 1,067 opportunities occurred for hand hygiene before and after wearing gloves. The results show that hand hygiene compliance before wearing gloves is poor among nurses who work in intensive care units (14.8%). Therefore it is necessary to conduct effective interventions through continuing education programs to improve hand hygiene compliance. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Estimating the Impact of the 2004 Alaskan Forest Fires on Episodic Particulate Matter Pollution over the Eastern United States through Assimilation of Satellite Derived Aerosol Optical Depths in a Regional Air Quality Model

EPA Science Inventory

During the summer of 2004, extensive wildfires burned in Alaska and western Canada; the fires were the largest on record for Alaska. Smoke from these fires was observed over the continental United States in satellite images. Recent studies have quantified the impacts of the long-...

Corima: A Bilingual Experiment in the Tarahumara Region in the State of Chihuahua, Mexico. How Does It Measure against Transitional Bilingual Programs in the United States?

ERIC Educational Resources Information Center

Nunez, Mario A.

This report explores two bilingual educational approaches currently in use in Mexico and the United States. The study pursues a limited comparison between two modalities of bilingual instruction, as observed and reported in the consulted literature. The U.S. model featured is known as the two-way bilingual model, an additive approach to…

Soil resources and potential for agricultural development in Bahr El Jebel in southern Sudan, Jonglei Canal project area

NASA Technical Reports Server (NTRS)

Myers, V. I.; Moore, D. G.; Abdel-Hady, M. A.; Abdel-Samie, A. G.; Elshazly, E. M. (Principal Investigator); Youvis, H.; Worcester, B. K.; Klingebiel, A. A.; Elshazly, M. M.; Hamad, M. A.

1978-01-01

The author has identified the following significant results. Fourteen LANDSAT scenes were used to produce mosaics of the 167, 474 sq km study area. These were black and white MSS 7 images and false color composite images. Five major soil-landscape units were delineated on the mosaics, and these were subdivided into a total of 40 soil mapping units. Aerial reconnaissance was useful in defining boundaries between mapping units and in estimating the proportion of the various soils which composed each mapping unit. Ground surveying permitted first-hand observation of major soils and sampling for quantitative laboratory analysis. Soil interpretations were made, including properties, potentials, and limitations.

HMSIW-based switchable units using super compact loaded shunt stubs and its applications on SIW/HMSIW switches

NASA Astrophysics Data System (ADS)

Chen, Haidong; Che, Wenquan; Zhang, Tianyu; Cao, Yue; Feng, Wenjie

2018-06-01

Half-mode substrate integrated waveguide (HMSIW) switchable unit, built by HMSIW section with loaded single or multi-microstrip shunt stub(s), was proposed in this work. Both shorted and opened stubs were studied, investigated and compared, bandwidth enhancement method for proposed switchable units was proposed and demonstrated. Based on these switchable units, narrowband and broadband HMSIW single-pole-single-through (SPST) switches, SIW SPST switch and SIW/HMSIW-based single-pole-double-through (SPDT) switch were designed, fabricated and measured. Good performances were observed experimentally for these proposed circuits, showing the advantages of proposed concept and an excellent candidate for switchable or reconfigurable SIW/HMSIW circuits or systems.

A qualitative, exploratory study of nurses' decision-making when interrupted during medication administration within the Paediatric Intensive Care Unit.

PubMed

Bower, Rachel A; Coad, Jane E; Manning, Joseph C; Pengelly, Theresa A

2018-02-01

In the paediatric intensive care unit (PICU), medication administration is challenging. Empirical studies demonstrate that interruptions occur frequently and that nurses are fundamental in the delivery of medication. However, little is known about nurse's decision making when interrupted during medication administration. Therefore, the objective is to understand decision making when interrupted during medication administration within the PICU. A qualitative study incorporating non-participant observation and audio recorded semi-structured interviews. A convenience sample of ten PICU nurses were interviewed. Each interview schedule was informed by two hours of observation which involved a further 29 PICU nurses. Data was analysed using Framework Analysis. A regional PICU located in a university teaching hospital in the United Kingdom. Analysis resulted in four overarching themes: (1) Guiding the medication process, (2) Concentration, focus and awareness, (3) Influences on interruptions (4) Impact and recovery CONCLUSION: Medication administration within the PICU is an essential but complex activity. Interruptions can impact on focus and concentration which can contribute to patient harm. Decision making by PICU nurses is influenced by interruption awareness, fluctuating levels of concentration, and responding to critically ill patient and families' needs. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Hierarchical Framework for State-Space Matrix Inference and Clustering.

PubMed

Zuo, Chandler; Chen, Kailei; Hewitt, Kyle J; Bresnick, Emery H; Keleş, Sündüz

2016-09-01

In recent years, a large number of genomic and epigenomic studies have been focusing on the integrative analysis of multiple experimental datasets measured over a large number of observational units. The objectives of such studies include not only inferring a hidden state of activity for each unit over individual experiments, but also detecting highly associated clusters of units based on their inferred states. Although there are a number of methods tailored for specific datasets, there is currently no state-of-the-art modeling framework for this general class of problems. In this paper, we develop the MBASIC ( M atrix B ased A nalysis for S tate-space I nference and C lustering) framework. MBASIC consists of two parts: state-space mapping and state-space clustering. In state-space mapping, it maps observations onto a finite state-space, representing the activation states of units across conditions. In state-space clustering, MBASIC incorporates a finite mixture model to cluster the units based on their inferred state-space profiles across all conditions. Both the state-space mapping and clustering can be simultaneously estimated through an Expectation-Maximization algorithm. MBASIC flexibly adapts to a large number of parametric distributions for the observed data, as well as the heterogeneity in replicate experiments. It allows for imposing structural assumptions on each cluster, and enables model selection using information criterion. In our data-driven simulation studies, MBASIC showed significant accuracy in recovering both the underlying state-space variables and clustering structures. We applied MBASIC to two genome research problems using large numbers of datasets from the ENCODE project. The first application grouped genes based on transcription factor occupancy profiles of their promoter regions in two different cell types. The second application focused on identifying groups of loci that are similar to a GATA2 binding site that is functional at its endogenous locus by utilizing transcription factor occupancy data and illustrated applicability of MBASIC in a wide variety of problems. In both studies, MBASIC showed higher levels of raw data fidelity than analyzing these data with a two-step approach using ENCODE results on transcription factor occupancy data.

Spaced planar laminations formed by repetitive basal erosion and resurgence to high-sedimentation-rate regime: new insight from a bedform-like structures and laterally continuous exposures

NASA Astrophysics Data System (ADS)

Ishihara, Yoshiro; Yuri, Onishi; Tsuda, Keisuke; Yokokawa, Miwa

2017-04-01

Spaced planar laminations (SPL), or so-called traction carpet deposits, are frequently observed in deposits of sediment gravity flows. Several sedimentation models for a succession of inversely graded units have been suggested from field observations and flume experiments. The formation of the inversely graded unit could be summarized as follows: (1) abrupt sedimentation on freezing of an inversely graded layer, or (2) interruptions in flow causing a freezing of an inversely graded layer at the most basal part of flow. In either case, traction carpets as a bed load overlying the erosive boundary at the base of flow are required. Although some descriptions have reported SPLs forming antidune bedform-like structures and the association of SPLs with structureless massive deposits have not been clearly explained. In this study, we suggest a novel model of SPL formation by repetition of basal erosion and resurgence to high-sedimentation rates, based on detail examinations of SPLs both showing bedform-like structures and lateral extents of hundreds of meters. SPLs were investigated in the Mio-Pliocene Kiyosumi Formation in central Japan and the Miocene Aoshima Formation in southwest Japan. In a turbidite in the Kiyosumi Formation, SPLs show three mound-like structures, suggesting antidune bedforms with wavelengths of about 6 to 7 m. On the upcurrent flanks, SPLs show lenticular cross laminations or pinching out of units; those units do not show clear inverse grading. Rip-up mud clasts and relatively high-angle imbrications are also observed. On the other hand, SPLs on the downcurrent flanks show relatively clear inverse grading and transition downcurrent into a massive structureless bed. In the Aoshima Formation, SPLs with ca. 1 cm unit thickness continue approximately 50 m along a palaeocurrent direction without changes in thickness. These SPLs gradually transition upward into a massive structureless unit. From the observations described above, in addition to descriptions from previous studies, it is suggested that SPLs comprising mound-like bedforms exhibit erosive conditions in the upcurrent flanks and depositional conditions in the downcurrent flanks, whereas SPLs on flat sea-floor extensively maintain their structure. Also, massive structureless beds are observed when erosion did not occur. These facts indicate that SPLs are strongly associated with an erosional process at the base of sediment gravity flows under a supercritical flow condition. The formation of SPLs does not necessary require a traction carpet and they may reflect basal erosion with a lag deposit of fine-grained particles, followed by resurgence to conditions of high sedimentation rates and massive structureless bed deposition. Repetitions of inversely graded units could occur when basal shear stresses are changed by fluctuations of flow depth, such as internal waves in a sediment gravity flow. This model can explain the concurrence of massive structureless beds with SPLs and examples of bedform-like structures without a unit thickness control.

Anticipatory Posturing of the Vocal Tract Reveals Dissociation of Speech Movement Plans from Linguistic Units

PubMed Central

Tilsen, Sam; Spincemaille, Pascal; Xu, Bo; Doerschuk, Peter; Luh, Wen-Ming; Feldman, Elana; Wang, Yi

2016-01-01

Models of speech production typically assume that control over the timing of speech movements is governed by the selection of higher-level linguistic units, such as segments or syllables. This study used real-time magnetic resonance imaging of the vocal tract to investigate the anticipatory movements speakers make prior to producing a vocal response. Two factors were varied: preparation (whether or not speakers had foreknowledge of the target response) and pre-response constraint (whether or not speakers were required to maintain a specific vocal tract posture prior to the response). In prepared responses, many speakers were observed to produce pre-response anticipatory movements with a variety of articulators, showing that that speech movements can be readily dissociated from higher-level linguistic units. Substantial variation was observed across speakers with regard to the articulators used for anticipatory posturing and the contexts in which anticipatory movements occurred. The findings of this study have important consequences for models of speech production and for our understanding of the normal range of variation in anticipatory speech behaviors. PMID:26760511

Anticipatory Posturing of the Vocal Tract Reveals Dissociation of Speech Movement Plans from Linguistic Units.

PubMed

Tilsen, Sam; Spincemaille, Pascal; Xu, Bo; Doerschuk, Peter; Luh, Wen-Ming; Feldman, Elana; Wang, Yi

2016-01-01

Models of speech production typically assume that control over the timing of speech movements is governed by the selection of higher-level linguistic units, such as segments or syllables. This study used real-time magnetic resonance imaging of the vocal tract to investigate the anticipatory movements speakers make prior to producing a vocal response. Two factors were varied: preparation (whether or not speakers had foreknowledge of the target response) and pre-response constraint (whether or not speakers were required to maintain a specific vocal tract posture prior to the response). In prepared responses, many speakers were observed to produce pre-response anticipatory movements with a variety of articulators, showing that that speech movements can be readily dissociated from higher-level linguistic units. Substantial variation was observed across speakers with regard to the articulators used for anticipatory posturing and the contexts in which anticipatory movements occurred. The findings of this study have important consequences for models of speech production and for our understanding of the normal range of variation in anticipatory speech behaviors.

Vibrational spectroscopic study of poldervaartite CaCa[SiO3(OH)(OH)

NASA Astrophysics Data System (ADS)

Frost, Ray L.; López, Andrés; Scholz, Ricardo; Lima, Rosa Malena Fernandes

2015-02-01

We have studied the mineral poldervaartite CaCa[SiO3(OH)(OH)] which forms a series with its manganese analogue olmiite CaMn[SiO3(OH)](OH) using a range of techniques including scanning electron microscopy, thermogravimetric analysis, Raman and infrared spectroscopy. Chemical analysis shows the mineral is reasonably pure and contains only calcium and manganese with low amounts of Al and F. Thermogravimetric analysis proves the mineral decomposes at 485 °C with a mass loss of 7.6% compared with the theoretical mass loss of 7.7%. A strong Raman band at 852 cm-1 is assigned to the SiO stretching vibration of the SiO3(OH) units. Two Raman bands at 914 and 953 cm-1 are attributed to the antisymmetric vibrations. Intense prominent peaks observed at 3487, 3502, 3509, 3521 and 3547 cm-1 are assigned to the OH stretching vibration of the SiO3(OH) units. The observation of multiple OH bands supports the concept of the non-equivalence of the OH units. Vibrational spectroscopy enables a detailed assessment of the molecular structure of poldervaartite.

Mitochondrial DNA diversity of honey bees (Apis mellifera) from unmanaged colonies and swarms in the United States.

PubMed

Magnus, Roxane M; Tripodi, Amber D; Szalanski, Allen L

2014-06-01

To study the genetic diversity of honey bees (Apis mellifera L.) from unmanaged colonies in the United States, we sequenced a portion of the mitochondrial DNA COI-COII region. From the 530 to 1,230 bp amplicon, we observed 23 haplotypes from 247 samples collected from 12 states, representing three of the four A. mellifera lineages known to have been imported into the United States (C, M, and O). Six of the 13 C lineage haplotypes were not found in previous queen breeder studies in the United States. The O lineage accounted for 9% of unmanaged colonies which have not yet been reported in queen breeder studies. The M lineage accounted for a larger portion of unmanaged samples (7%) than queen breeder samples (3%). Based on our mitochondrial DNA data, the genetic diversity of unmanaged honey bees in the United States differs significantly from that of queen breeder populations (p < 0.00001). The detection of genetically distinct maternal lineages of unmanaged honey bees suggests that these haplotypes may have existed outside the managed honey bee population for a long period.

Administrators' Descriptions of Their Leadership Roles in a Precollege Program

ERIC Educational Resources Information Center

Owens, Michael A.

2010-01-01

The purpose of this work is to describe how leaders of the Upward Bound (UB) program at a university in the western United States described their leadership roles in the program. It is a qualitative study based on data drawn from interviews, observations, written material, and field observations conducted over two years. Participants described…

The Effects of E-Training versus Traditional Training Delivery Methods on Professional Students in Contemporary Organizations

ERIC Educational Resources Information Center

Seda, Albert

2016-01-01

This research investigated the limitations of Albert Bandura's theory of observational training (also known as observational learning) when applied to e-learning. The study focused on professional employees in different industries around the United States. These professionals engaged in continuous training either in the classroom or on in an…

Greater Perceived Age Discrimination in England than the United States: Results from HRS and ELSA

PubMed Central

Zaninotto, Paola; Steptoe, Andrew

2015-01-01

Objectives. We examined cross-national differences in perceptions of age discrimination in England and the United States. Under the premise that the United States has had age discrimination legislation in place for considerably longer than England, we hypothesized that perceptions of age discrimination would be lower in the United States. Methods. We analyzed data from two nationally representative studies of aging, the U.S. Health and Retirement Study (n = 4,818) and the English Longitudinal Study of Ageing (n = 7,478). Respondents aged 52 years and older who attributed any experiences of discrimination to their age were treated as cases of perceived age discrimination. We used multivariable logistic regression to estimate the odds ratios of experiencing perceived age discrimination in relation to selected sociodemographic factors. Results. Perceptions of age discrimination were significantly higher in England than the United States, with 34.8% of men and women in England reporting age discrimination compared with 29.1% in the United States. Associations between perceived age discrimination and older age and lower levels of household wealth were observed in both countries, but we found differences between England and the United States in the relationship between perceived age discrimination and education. Discussion. Our study revealed that levels of perceived age discrimination are lower in the United States than England and are less socially patterned. This suggests that differing social and political circumstances in the two countries may have an important role to play. PMID:26224759

The effect of increased mobility on morbidity in the neurointensive care unit.

PubMed

Titsworth, W Lee; Hester, Jeannette; Correia, Tom; Reed, Richard; Guin, Peggy; Archibald, Lennox; Layon, A Joseph; Mocco, J

2012-06-01

The detrimental effects of immobility on intensive care unit (ICU) patients are well established. Limited studies involving medical ICUs have demonstrated the safety and benefit of mobility protocols. Currently no study has investigated the role of increased mobility in the neurointensive care unit population. This study was a single-institution prospective intervention trial to investigate the effectiveness of increased mobility among neurointensive care unit patients. All patients admitted to the neurointensive care unit of a tertiary care center over a 16-month period (April 2010 through July 2011) were evaluated. The study consisted of a 10-month (8025 patient days) preintervention observation period followed by a 6-month (4455 patient days) postintervention period. The intervention was a comprehensive mobility initiative utilizing the Progressive Upright Mobility Protocol (PUMP) Plus. Implementation of the PUMP Plus increased mobility among neurointensive care unit patients by 300% (p < 0.0001). Initiation of this protocol also correlated with a reduction in neurointensive care unit length of stay (LOS; p < 0.004), hospital LOS (p < 0.004), hospital-acquired infections (p < 0.05), and ventilator-associated pneumonias (p < 0.001), and decreased the number of patient days in restraints (p < 0.05). Additionally, increased mobility did not lead to increases in adverse events as measured by falls or inadvertent line disconnections. Among neurointensive care unit patients, increased mobility can be achieved quickly and safely with associated reductions in LOS and hospital-acquired infections using the PUMP Plus program.

Does resolution of flow field observation influence apparent habitat use and energy expenditure in juvenile coho salmon?

USGS Publications Warehouse

Tullos, Desiree D.; Walter, Cara; Dunham, Jason B.

2016-01-01

This study investigated how the resolution of observation influences interpretation of how fish, juvenile Coho Salmon (Oncorhynchus kisutch), exploit the hydraulic environment in streams. Our objectives were to evaluate how spatial resolution of the flow field observation influenced: (1) the velocities considered to be representative of habitat units; (2) patterns of use of the hydraulic environment by fish; and (3) estimates of energy expenditure. We addressed these objectives using observations within a 1:1 scale physical model of a full-channel log jam in an outdoor experimental stream. Velocities were measured with Acoustic Doppler Velocimetry at a 10 cm grid spacing, whereas fish locations and tailbeat frequencies were documented over time using underwater videogrammetry. Results highlighted that resolution of observation did impact perceived habitat use and energy expenditure, as did the location of measurement within habitat units and the use of averaging to summarize velocities within a habitat unit. In this experiment, the range of velocities and energy expenditure estimates increased with coarsening resolution (grid spacing from 10 to 100 cm), reducing the likelihood of measuring the velocities locally experienced by fish. In addition, the coarser resolutions contributed to fish appearing to select velocities that were higher than what was measured at finer resolutions. These findings indicate the need for careful attention to and communication of resolution of observation in investigating the hydraulic environment and in determining the habitat needs and bioenergetics of aquatic biota.

The geological history of Northeast Syrtis Major, Mars

NASA Astrophysics Data System (ADS)

Bramble, Michael S.; Mustard, John F.; Salvatore, Mark R.

2017-09-01

As inferred from orbital spectroscopic data, Northeast Syrtis Major bears considerable mineral diversity that spans the Noachian-Hesperian boundary despite its small geographic area. In this study we use observations from the High Resolution Imaging Science Experiment, supplemented with Context Camera imagery, to characterize and map the lateral extent of geomorphic units in Northeast Syrtis Major, and constrain the geomorphic context of the orbital-identified mineral signatures. Using recent observations, we confirm previous mineralogy identified with the Compact Reconnaissance Imaging Spectrometer for Mars, and greatly extend the lateral extent of visible to near-infrared investigation utilizing the greater coverage. Analysis of Thermal Emission Imaging System observations reveals further physical properties and distribution of the geomorphic units. The stratigraphy, which spans the Noachian-Hesperian boundary, displays significant morphological heterogeneity at the decameter scale, but it is unifiable under five distinct geomorphic units. Our paired morphological and mineralogical analysis allows us to construct a detailed geological history of Northeast Syrtis Major. Several geological events that occurred in Northeast Syrtis Major-including the formation of the post-Isidis crust, the emplacement of an olivine-rich unit, the formation of sulfate minerals, and the emplacement of the Syrtis Major Volcanics-can be related to regional and global processes constraining the local chronology. Other mineralogical indicators, particularly the formation of Al-phyllosilicates, are difficult to place in the temporal sequence. They are observed in isolated patches on the post-Isidis crust, not as a distinct stratigraphic unit as observed elsewhere in Nili Fossae, suggesting their formation via isolated leaching or through alteration of initial compositional heterogeneities within the crust. Exposures of an olivine-rich unit are intermittently observed to form quasi-circular landforms, suggestive of emplacement in circular depressions, which may indicate a period of cratering between the formation of the Isidis basin and the deposition of the olivine-rich unit. We identify and discuss intriguing large linear features of the olivine-rich unit, reminiscent of dyke-fed volcanism, that have raised bounding ridges suggestive of contact metamorphism with the crust. We compile, review, and discuss many of the outstanding questions and running hypotheses relevant to our mapping area. A synthesis of our geomorphic mapping with recent literature reveals a well-defined geological history with extensive aqueous activity at Northeast Syrtis Major that is amassed in a stratigraphic sequence spanning a time likely greater than 250 million years of geological history. Our geomorphic and spectral analyses confirm that Northeast Syrtis Major exhibits considerable geomorphic and mineralogic diversity within a relatively small geographic area that is representative of the geologic processes occurring throughout the broader Nili Fossae region during the Noachian and Hesperian. Northeast Syrtis Major adds to this sequence by exposing the diverse environmental history of this region as observed through the presence of alteration minerals not present in this fidelity or proximity elsewhere in Nili Fossae.

Methodological approach in determination of small spatial units in a highly complex terrain in atmospheric pollution research: the case of Zasavje region in Slovenia.

PubMed

Kukec, Andreja; Boznar, Marija Z; Mlakar, Primoz; Grasic, Bostjan; Herakovic, Andrej; Zadnik, Vesna; Zaletel-Kragelj, Lijana; Farkas, Jerneja; Erzen, Ivan

2014-05-01

The study of atmospheric air pollution research in complex terrains is challenged by the lack of appropriate methodology supporting the analysis of the spatial relationship between phenomena affected by a multitude of factors. The key is optimal design of a meaningful approach based on small spatial units of observation. The Zasavje region, Slovenia, was chosen as study area with the main objective to investigate in practice the role of such units in a test environment. The process consisted of three steps: modelling of pollution in the atmosphere with dispersion models, transfer of the results to geographical information system software, and then moving on to final determination of the function of small spatial units. A methodology capable of designing useful units for atmospheric air pollution research in highly complex terrains was created, and the results were deemed useful in offering starting points for further research in the field of geospatial health.

A Preliminary Analysis of the Reliability and Validity of the Leader Observation System.

DTIC Science & Technology

1982-08-01

financial instituition , a state agency, a medium sized manufacturing plant, a campus police department, and the Navy and Army R.O.T.C. units of a...specifics of the study. The outside observers (N=8) used in the study were graduate students in management . Three were assigned to the financial ... managing Interpersonal conflict etc. between subordinates or others d. routine financial reporting nnd b. appealing to higher authority to bookkeeping

Developing `Butterfly Warriors': a Case Study of Science for Citizenship

NASA Astrophysics Data System (ADS)

Chen, Junjun; Cowie, Bronwen

2013-12-01

Given worldwide concern about a decline in student engagement in school science and an increasing call for science for citizenship in New Zealand Curriculum, this study focused on a butterfly unit that investigated how students in a year-4 primary classroom learnt about New Zealand butterflies through thinking, talking, and acting as citizen scientists. The butterfly unit included five lessons. The researchers observed the lessons and interviewed students and the classroom teacher. The students completed a unit evaluation survey after the unit. Findings indicate that the students enjoyed and were interested in activities such as reading about butterflies, learning and using new vocabulary, drawing butterfly life cycles, as well as hunting, tagging and releasing butterflies and publishing the data they had collected on a dedicated website. Through their participation in the unit, students had opportunities to act locally and globally, and to `see themselves' in science through `being there' experience. Units like this have the potential to develop students' interest for longer-term engagement in science, even those students who may never envision themselves as professional scientists.

New insights on diabetes in Turner syndrome: results from an observational study in adulthood.

PubMed

Ibarra-Gasparini, Daniela; Altieri, Paola; Scarano, Emanuela; Perri, Annamaria; Morselli-Labate, Antonio M; Pagotto, Uberto; Mazzanti, Laura; Pasquali, Renato; Gambineri, Alessandra

2018-03-01

To explore the characteristics of diabetes mellitus in adults with Turner syndrome. Observational study consisting of a prospective phase after the access of adults with Turner syndrome to the Endocrinology Unit (median period of follow-up 15.6, interquartile range: 12.0-24.5 months) and a retrospective collection of data from the diagnosis of Turner syndrome until the time of access to the Endocrinology Unit. A total of 113 Italian Turner syndrome patients were included in the study. During the prospective phase of the study, each patient underwent physical examination, fasting blood sampling, and an oral glucose tolerance test on a yearly basis. Oral glucose tolerance test was used to perform the diagnosis of diabetes mellitus. Before access to the Endocrinology Unit, diabetes mellitus was diagnosed in two Turner syndrome patients. Another five cases of diabetes mellitus were diagnosed at the first access to the Endocrinology Unit, whereas seven new cases of diabetes mellitus were diagnosed during the prospective phase of the study. At the diagnosis of diabetes mellitus, only one patient had fasting glucose above 126 mg/dL, and only two had an HbA1c value >6.5% (48 mmol/mol). When compared to normo-glucose tolerant patients, the diabetic patients had a significantly lower insulin-to-glucose ratio at 30 and 60 min of the oral glucose tolerance test. In the regression analyses, only age was associated with the development of diabetes mellitus. This study confirms that diabetes mellitus is frequent in Turner syndrome and suggests that it is specific to the syndrome. In addition, this study demonstrates that oral glucose tolerance test is a more sensitive test than HbA1c for the diagnosis of diabetes mellitus in Turner syndrome.

Treatment Dosing Patterns and Clinical Outcomes for Patients with Type 2 Diabetes Starting or Switching to Treatment with Insulin Glargine (300 Units per Milliliter) in a Real-World Setting: A Retrospective Observational Study.

PubMed

Gupta, Shaloo; Wang, Hongwei; Skolnik, Neil; Tong, Liyue; Liebert, Ryan M; Lee, Lulu K; Stella, Peter; Cali, Anna; Preblick, Ronald

2018-01-01

Usage patterns and effectiveness of a longer-acting formulation of insulin glargine at a strength of 300 units per milliliter (Gla-300) have not been studied in real-world clinical practice. This study evaluated differences in dosing and clinical outcomes before and after Gla-300 treatment initiation in patients with type 2 diabetes starting or switching to treatment with Gla-300 to assess whether the benefits observed in clinical trials translate into real-world settings. This was a retrospective observational study using medical record data obtained by physician survey for patients starting treatment with insulin glargine at a strength of 100 units per milliliter (Gla-100) or Gla-300, or switching to treatment with Gla-300 from treatment with another basal insulin (BI). Differences in dosing and clinical outcomes before versus after treatment initiation or switching were examined by generalized linear mixed-effects models. Among insulin-naive patients starting BI treatment, no difference in the final titrated dose was observed in patients starting Gla-300 treatment versus those starting Gla-100 treatment [least-squares (LS) mean 0.43 units per kilogram vs 0.44 units per kilogram; P = 0.77]. Both groups had significant hemoglobin A 1c level reductions (LS mean 1.21 percentage points for Gla-300 and 1.12 percentage points for Gla-100 ; both P < 0.001). The relative risk of hypoglycemic events after Gla-300 treatment initiation was lower than that after Gla-100 treatment initiation [0.31, 95% confidence interval (CI) 0.12-0.81; P = 0.018] at similar daily doses. The daily dose of BI was significantly lower after switching to treatment with Gla-300 from treatment with another BI (0.73 units per kilogram before switch vs 0.58 units per kilogram after switch; P = 0.02). The mean hemoglobin A 1c level was significantly lower after switching than before switching (adjusted difference - 0.95 percentage points, 95% CI - 1.13 to - 0.78 percentage points ; P < 0.0001). Hypoglycemic events per patient-year were significantly lower (relative risk 0.17, 95% CI 0.11-0.26; P < 0.0001). Insulin-naive patients starting Gla-300 treatment had fewer hypoglycemic events, a similar hemoglobin A 1c level reduction, and no difference in insulin dose versus patients starting Gla-100 treatment. Patients switching to Gla-300 treatment from treatment with other BIs had significantly lower daily doses of BI, with fewer hypoglycemic events, without compromise of hemoglobin A 1c level reduction. These findings suggest Gla-300 in a real-world setting provides benefits in terms of dosing, with improved hemoglobin A 1c level and hypoglycemia rates. Sanofi US Inc. (Bridgewater, NJ, USA).

Comparison through a prospective and randomized study of two replenishment methods at polyvalent hospitalization units with two-bin storage systems

PubMed

Bernal, José Luis; Mera-Flores, Ana María; Baena Lázaro, Pedro Pablo; Sebastián Viana, Tomás

2017-11-27

Two-bin storage systems increase nursing staff satisfaction and decrease inventories, but the implications that logistic staff would determine the needs of replenishment are unknown. This study aimed to evaluate whether entrust to logistics staff this responsibility at the polyvalent hospitalization units with two-bin storage is associated with higher risk of outstanding orders. This was a prospective randomized experiment whit masking. Outstanding orders were considered variable response, those corresponding to assessments of the logistics staff were included in the control group and those corresponding to the nursing staff in the control group. Concordance between observers was analyzed using the Bland-Altman method; the difference between groups, with the U of Mann-Whitney and the cumulative incidence of outstanding orders and their relative risk was calculated. The mean amount requested by the logistic and nursing staff was 29.9 (SD:167.4) and 36 (SD:190) units respectively, the mean difference between observers was 6.11 (SD:128.95) units and no significant differences were found between groups (p = 0.430). The incidence of outstanding orders was 0.64% in the intervention group and 0.15% in the control group; the relative risk, 2.31 (0.83 - 6.48) and the number of cases required for an outstanding order, 516. Outstanding order relative risk is not associated with the category of the staff that identifies the replenishment needs at the polyvalent hospitalization units.

Recycle Requirements for NASA's 30 cm Xenon Ion Thruster

NASA Technical Reports Server (NTRS)

Pinero, Luis R.; Rawlin, Vincent K.

1994-01-01

Electrical breakdowns have been observed during ion thruster operation. These breakdowns, or arcs, can be caused by several conditions. In flight systems, the power processing unit must be designed to handle these faults autonomously. This has a strong impact on power processor requirements and must be understood fully for the power processing unit being designed for the NASA Solar Electric Propulsion Technology Application Readiness program. In this study, fault conditions were investigated using a NASA 30 cm ion thruster and a power console. Power processing unit output specifications were defined based on the breakdown phenomena identified and characterized.

Theoretical Cognitive Principles Observed in the Social Studies Classroom

ERIC Educational Resources Information Center

Walker, Juan; Langan, Elise; Kemp, Andrew; Pagnotti, John; Russell, William

2016-01-01

Pre-service elementary social studies teachers in the south eastern United States participated in a mixed methods study to determine the degree to which they utilized critical thinking skills. Insight Assessments administered analysis of their reflections, critical thinking skills, and dispositions test. The researchers developed a post survey for…

Studying Zooarchaeology

ERIC Educational Resources Information Center

Moore, Molly; Wolf, Deborah; Butler, Virginia L.

2012-01-01

Children often associate the study of bones with dinosaurs or crime scenes. This unit introduces students to "zooarchaeology," the study of animal remains from archaeological sites. Students in grades 3-5 engage in hands-on activities examining bones, shells, and other "hard parts" of animals. They use their observations as a starting point for…

Neonatal Early Warning Tools for recognising and responding to clinical deterioration in neonates cared for in the maternity setting: A retrospective case-control study.

PubMed

Paliwoda, Michelle; New, Karen; Bogossian, Fiona

2016-09-01

All newborns are at risk of deterioration as a result of failing to make the transition to extra uterine life. Signs of deterioration can be subtle and easily missed. It has been postulated that the use of an Early Warning Tool may assist clinicians in recognising and responding to signs of deterioration earlier in neonates, thereby preventing a serious adverse event. To examine whether observations from a Standard Observation Tool, applied to three neonatal Early Warning Tools, would hypothetically trigger an escalation of care more frequently than actual escalation of care using the Standard Observation Tool. A retrospective case-control study. A maternity unit in a tertiary public hospital in Australia. Neonates born in 2013 of greater than or equal to 34(+0) weeks gestation, admitted directly to the maternity ward from their birthing location and whose subsequent deterioration required admission to the neonatal unit, were identified as cases from databases of the study hospital. Each case was matched with three controls, inborn during the same period and who did not experience deterioration and neonatal unit admission. Clinical and physiological data recorded on a Standard Observation Tool, from time of admission to the maternity ward, for cases and controls were charted onto each of three Early Warning Tools. The primary outcome was whether the tool 'triggered an escalation of care'. Descriptive statistics (n, %, Mean and SD) were employed. Cases (n=26) comprised late preterm, early term and post-term neonates and matched by gestational age group with 3 controls (n=78). Overall, the Standard Observation Tool triggered an escalation of care for 92.3% of cases compared to the Early Warning Tools; New South Wales Health 80.8%, United Kingdom Newborn Early Warning Chart 57.7% and The Australian Capital Territory Neonatal Early Warning Score 11.5%. Subgroup analysis by gestational age found differences between the tools in hypothetically triggering an escalation of care. The Standard Observation Tool triggered an escalation of care more frequently than the Early Warning Tools, which may be as a result of behavioural data captured on the Standard Observation Tool and escalated, which could not be on the Early Warning Tools. Findings demonstrate that a single tool applied to all gestational age ranges may not be effective in identifying early deterioration or may over trigger an escalation of care. Further research is required into the sensitivity and specificity of Early Warning Tools in neonatal sub-populations. Copyright © 2016 Elsevier Ltd. All rights reserved.

Hand hygiene practices in a neonatal intensive care unit: a multimodal intervention and impact on nosocomial infection.

PubMed

Lam, Barbara C C; Lee, Josephine; Lau, Y L

2004-11-01

Health care-associated infections persist as a major problem in most neonatal intensive care units. Hand hygiene has been singled out as the most important measure in preventing hospital-acquired infection. However, hand hygiene compliance among health care workers (HCWs) remains low. The objective of this study was to assess the frequency and nature of patient contacts in neonatal intensive care units and observe the compliance and technique of hand hygiene among HCWs before and after the implementation of a multimodal intervention program. The nature and frequency of patient contacts, the hand hygiene compliance, and hand-washing techniques of HCWs were observed unobtrusively to reflect the baseline compliance and to investigate factors for noncompliance. The intervention consisted of problem-based and task-orientated hand hygiene education, enhancement of minimal handling protocol and clustering of nursing care, liberal provision of alcohol-based hand antiseptic, improvement in hand hygiene facilities, ongoing regular hand hygiene audit, and implementation of health care-associated infection surveillance. The observational study was repeated 6 months after the completion of the intervention program, which extended over 1-year period. Overall hand hygiene compliance increased from 40% to 53% before patient contact and 39% to 59% after patient contact. More marked improvement was observed for high-risk procedures (35%-60%). The average number of patient contacts also decreased from 2.8 to 1.8 per patient per hour. There was improvement in most aspects of hand-washing technique in the postintervention stage. The health care-associated infection rate decreased from 11.3 to 6.2 per 1000 patient-days. A problem-based and task-orientated education program can improve hand hygiene compliance. Enhancement of minimal handling and clustering of nursing procedures reduced the total patient contact episodes, which could help to overcome the major barrier of time constraints. A concurrent decrease in health care-associated infection rate and increase in hand hygiene compliance was observed in this study. The observational study could form part of an ongoing audit to provide regular feedback to HCWs to sustain the compliance.

Cultural traits as units of analysis.

PubMed

O'Brien, Michael J; Lyman, R Lee; Mesoudi, Alex; VanPool, Todd L

2010-12-12

Cultural traits have long been used in anthropology as units of transmission that ostensibly reflect behavioural characteristics of the individuals or groups exhibiting the traits. After they are transmitted, cultural traits serve as units of replication in that they can be modified as part of an individual's cultural repertoire through processes such as recombination, loss or partial alteration within an individual's mind. Cultural traits are analogous to genes in that organisms replicate them, but they are also replicators in their own right. No one has ever seen a unit of transmission, either behavioural or genetic, although we can observe the effects of transmission. Fortunately, such units are manifest in artefacts, features and other components of the archaeological record, and they serve as proxies for studying the transmission (and modification) of cultural traits, provided there is analytical clarity over how to define and measure the units that underlie this inheritance process.

Cultural traits as units of analysis

PubMed Central

O'Brien, Michael J.; Lyman, R. Lee; Mesoudi, Alex; VanPool, Todd L.

2010-01-01

Cultural traits have long been used in anthropology as units of transmission that ostensibly reflect behavioural characteristics of the individuals or groups exhibiting the traits. After they are transmitted, cultural traits serve as units of replication in that they can be modified as part of an individual's cultural repertoire through processes such as recombination, loss or partial alteration within an individual's mind. Cultural traits are analogous to genes in that organisms replicate them, but they are also replicators in their own right. No one has ever seen a unit of transmission, either behavioural or genetic, although we can observe the effects of transmission. Fortunately, such units are manifest in artefacts, features and other components of the archaeological record, and they serve as proxies for studying the transmission (and modification) of cultural traits, provided there is analytical clarity over how to define and measure the units that underlie this inheritance process. PMID:21041205

Application of the U.S. Geological Survey's precipitation-runoff modeling system to the Prairie Dog Creek basin, southeastern Montana

USGS Publications Warehouse

Cary, L.E.

1984-01-01

The U.S. Geological Survey 's precipitation-runoff modeling system was tested using 2 year 's data for the daily mode and 17 storms for the storm mode from a basin in southeastern Montana. Two hydrologic response unit delineations were studied. The more complex delineation did not provide superior results. In this application, the optimum numbers of hydrologic response units were 16 and 18 for the two alternatives. The first alternative with 16 units was modified to facilitate interfacing with the storm mode. A parameter subset was defined for the daily mode using sensitivity analysis. Following optimization, the simulated hydrographs approximated the observed hydrograph during the first year, a year of large snowfall. More runoff was simulated than observed during the second year. There was reasonable correspondence between the observed snowpack and the simulated snowpack the first season but poor the second. More soil moisture was withdrawn than was indicated by soil moisture observations. Optimization of parameters in the storm mode resulted in much larger values than originally estimated, commonly larger than published values of the Green and Ampt parameters. Following optimization, variable results were obtained. The results obtained are probably related to inadequate representation of basin infiltration characteristics and to precipitation variability. (USGS)

Radon potential, geologic formations, and lung cancer risk

PubMed Central

Hahn, Ellen J.; Gokun, Yevgeniya; Andrews, William M.; Overfield, Bethany L.; Robertson, Heather; Wiggins, Amanda; Rayens, Mary Kay

2015-01-01

Objective Exposure to radon is associated with approximately 10% of U.S. lung cancer cases. Geologic rock units have varying concentrations of uranium, producing fluctuating amounts of radon. This exploratory study examined the spatial and statistical associations between radon values and geological formations to illustrate potential population-level lung cancer risk from radon exposure. Method This was a secondary data analysis of observed radon values collected in 1987 from homes (N = 309) in Kentucky and geologic rock formation data from the Kentucky Geological Survey. Radon value locations were plotted on digital geologic maps using ArcGIS and linked to specific geologic map units. Each map unit represented a package of different types of rock (e.g., limestone and/or shale). Log-transformed radon values and geologic formation categories were compared using one-way analysis of variance. Results Observed radon levels varied significantly by geologic formation category. Of the 14 geologic formation categories in north central Kentucky, four were associated with median radon levels, ranging from 8.10 to 2.75 pCi/L. Conclusion Radon potential maps that account for geologic factors and observed radon values may be superior to using observed radon values only. Knowing radon-prone areas could help target population-based lung cancer prevention interventions given the inequities that exist related to radon. PMID:26844090

The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

PubMed

Armstrong, Susan J; Rispel, Laetitia C; Penn-Kekana, Loveday

2015-01-01

Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private) in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36). Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semi-structured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis. The study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers' recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration. The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision of consistent and high-quality patient care.

The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

PubMed Central

Armstrong, Susan J.; Rispel, Laetitia C.; Penn-Kekana, Loveday

2015-01-01

Background Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. Objective This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. Methods During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private) in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36). Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semi-structured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis. Results The study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers’ recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration. Conclusion The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision of consistent and high-quality patient care. PMID:25971397

Time-series intervention analysis of pedestrian countdown timer effects.

PubMed

Huitema, Bradley E; Van Houten, Ron; Manal, Hana

2014-11-01

Pedestrians account for 40-50% of traffic fatalities in large cities. Several previous studies based on relatively small samples have concluded that Pedestrian Countdown Timers (PCT) may reduce pedestrian crashes at signalized intersections, but other studies report no reduction. The purposes of the present article are to (1) describe a new methodology to evaluate the effectiveness of introducing PCT signals and (2) to present results of applying this methodology to pedestrian crash data collected in a large study carried out in Detroit, Michigan. The study design incorporated within-unit as well as between-unit components. The main focus was on dynamic effects that occurred within the PCT unit of 362 treated sites during the 120 months of the study. An interrupted time-series analysis was developed to evaluate whether change in crash frequency depended upon of the degree to which the countdown timers penetrated the treatment unit. The between-unit component involved comparisons between the treatment unit and a control unit. The overall conclusion is that the introduction of PCT signals in Detroit reduced pedestrian crashes to approximately one-third of the preintervention level. The evidence for this reductionis strong and the change over time was shown to be a function of the extent to which the timers were introduced during the intervention period. There was no general drop-off in crash frequency throughout the baseline interval of over five years; only when the PCT signals were introduced in large numbers was consistent and convincing crash reduction observed. Correspondingly, there was little evidence of change in the control unit. Copyright © 2014. Published by Elsevier Ltd.

Humpback whale (Megaptera novaeangliae) song unit and phrase repertoire progression on a subarctic feeding ground.

PubMed

Magnúsdóttir, Edda E; Miller, Patrick J O; Lim, Rangyn; Rasmussen, Marianne H; Lammers, Marc O; Svavarsson, Jörundur

2015-11-01

The songs of the male humpback whales have traditionally been associated with breeding activities at low latitude breeding grounds during winter. This study provides the first detailed analysis of humpback whale songs recorded in the subarctic waters of Iceland using passive acoustic recorders. Recordings were collected during three winter seasons: 2008-2009, 2009-2010, and 2011 during which singing was detected in all seasons. Peak song occurrence was during January-February in all years; this coincides with the timing of the peak breeding season of humpback whales in the Northern hemisphere. A total of 2810 song units from all years were measured and statistically divided into 14 groups, which constructed 25 phrases. The song unit repertoires included stable song unit types that occurred frequently in songs during all years while the occurrence of other song unit types varied more between years. Around 60% of the phrases were conserved between the first two study seasons, while the majority of phrases found during the last study season had not been observed before. This study indicates the importance of a subarctic feeding ground for song progression and song exchange and possibly as an opportunistic mating ground for migrating or overwintering humpback whales.

The Structure of the Protonated Serine Octamer.

PubMed

Scutelnic, Valeriu; Perez, Marta A S; Marianski, Mateusz; Warnke, Stephan; Gregor, Aurelien; Rothlisberger, Ursula; Bowers, Michael T; Baldauf, Carsten; von Helden, Gert; Rizzo, Thomas R; Seo, Jongcheol

2018-06-20

The amino acid serine has long been known to form a protonated "magic-number" cluster containing eight monomer units that shows an unusually high abundance in mass spectra and has a remarkable homochiral preference. Despite many experimental and theoretical studies, there is no consensus on a Ser 8 H + structure that is in agreement with all experimental observations. Here, we present the structure of Ser 8 H + determined by a combination of infrared spectroscopy and ab initio molecular dynamics simulations. The three-dimensional structure that we determine is ∼25 kcal mol -1 more stable than the previous most stable published structure and explains both the homochiral preference and the experimentally observed facile replacement of two serine units.

Dexamethasone Rescues Neurovascular Unit Integrity from Cell Damage Caused by Systemic Administration of Shiga Toxin 2 and Lipopolysaccharide in Mice Motor Cortex

PubMed Central

Pinto, Alipio; Jacobsen, Mariana; Geoghegan, Patricia A.; Cangelosi, Adriana; Cejudo, María Laura; Tironi-Farinati, Carla; Goldstein, Jorge

2013-01-01

Shiga toxin 2 (Stx2)-producing Escherichia coli (STEC) causes hemorrhagic colitis and hemolytic uremic syndrome (HUS) that can lead to fatal encephalopathies. Neurological abnormalities may occur before or after the onset of systemic pathological symptoms and motor disorders are frequently observed in affected patients and in studies with animal models. As Stx2 succeeds in crossing the blood-brain barrier (BBB) and invading the brain parenchyma, it is highly probable that the observed neurological alterations are based on the possibility that the toxin may trigger the impairment of the neurovascular unit and/or cell damage in the parenchyma. Also, lipopolysaccharide (LPS) produced and secreted by enterohemorrhagic Escherichia coli (EHEC) may aggravate the deleterious effects of Stx2 in the brain. Therefore, this study aimed to determine (i) whether Stx2 affects the neurovascular unit and parenchymal cells, (ii) whether the contribution of LPS aggravates these effects, and (iii) whether an inflammatory event underlies the pathophysiological mechanisms that lead to the observed injury. The administration of a sub-lethal dose of Stx2 was employed to study in detail the motor cortex obtained from a translational murine model of encephalopathy. In the present paper we report that Stx2 damaged microvasculature, caused astrocyte reaction and neuronal degeneration, and that this was aggravated by LPS. Dexamethasone, an anti-inflammatory, reversed the pathologic effects and proved to be an important drug in the treatment of acute encephalopathies. PMID:23894578

A prospective, observational registry of patients with severe sepsis: the Canadian Sepsis Treatment and Response Registry.

PubMed

Martin, Claudio M; Priestap, Fran; Fisher, Harold; Fowler, Robert A; Heyland, Daren K; Keenan, Sean P; Longo, Christopher J; Morrison, Teresa; Bentley, Diane; Antman, Neil

2009-01-01

To determine the location of acquisition, timing, and outcomes associated with severe sepsis in community and teaching hospital critical care units. Prospective, observational study. Twelve Canadian community and teaching hospital critical care units. All patients admitted between March 17, 2003, and November 30, 2004 to the study critical care units with at least a 24-hr length of stay or severe sepsis identified during the first 24 hrs. Daily monitoring for severe sepsis. We recorded data describing characteristics of patients, infections, systemic responses, and organ dysfunction. Severe sepsis occurred in 1238 patients (overall rate, 19.0%; range, 8.2%-35.3%). Hospital mortality was 38.1% (95% confidence interval [CI]: 35.4-40.8). Median intensive care unit length of stay was 10.3 days (interquartile range: 5.5, 17.9). Variables associated with mortality in multivariable analysis included age (odds ratio [OR] by decade 1.50; 95% CI: 1.36-1.65), acquisition location of severe sepsis (with community as the reference-hospital [OR: 1.69; CI: 1.16-2.46], early intensive care unit [OR: 2.15; CI: 1.42-3.25], late intensive care unit [OR: 2.65; CI: 1.82-3.87]), late intensive care unit (OR: 2.65; CI: 1.82-3.87), any comorbidity (OR: 1.42; CI: 1.04-1.93), chronic renal failure (OR: 2.03; CI: 1.10-3.76), oliguria (OR: 1.34; CI: 1.02-1.76), thrombocytopenia (OR: 2.12; CI: 1.43-3.13), metabolic acidosis (OR: 1.54; CI: 1.13-2.10), Multiple Organ Dysfunction Score (OR: 1.15; CI: 1.09-1.21) and Acute Physiology and Chronic Health Evaluation II predicted risk (OR: 3.75; CI: 2.08-6.76). These data confirm that sepsis is common and has high mortality in general intensive care unit populations. Our results can inform healthcare system planning and clinical study designs. Modifiable variables associated with worse outcomes, such as nosocomial infection (hospital acquisition), and metabolic acidosis indicate potential targets for quality improvement initiatives that could decrease mortality and morbidity.

Human-induced changes in the hydrology of the Western United States

USGS Publications Warehouse

Barnett, T.P.; Pierce, D.W.; Hidalgo, H.G.; Bonfils, Celine; Santer, B.D.; Das, T.; Bala, G.; Wood, A.W.; Nozawa, T.; Mirin, A.A.; Cayan, D.R.; Dettinger, M.D.

2008-01-01

Observations have shown that the hydrological cycle of the western United States changed significantly over the last half of the 20th century. We present a regional, multivariable climate change detection and attribution study, using a high-resolution hydrologic model forced by global climate models, focusing on the changes that have already affected this primarily arid region with a large and growing population. The results show that up to 60% of the climate-related trends of river flow, winter air temperature, and snow pack between 1950 and 1999 are human-induced. These results are robust to perturbation of study variates and methods. They portend, in conjunction with previous work, a coming crisis in water supply for the western United States.

Turning Over Patient Turnover: An Ethnographic Study of Admissions, Discharges, and Transfers

PubMed Central

Mowinski Jennings, Bonnie; Sandelowski, Margarete; Boshamer, Cary C.; Higgins, Melinda K.

2014-01-01

The impact on nursing work of patient turnover (admissions, discharges, and transfers) became evident in an ethnographic study of turbulence. The patient turnover data were generated from extensive observations, 21 formal interviews, and a year of admission and discharge records on one medical and one surgical unit. Timing of turnover events on the two units differed, but on both units admissions typically interrupted workflow more than did discharges, clustered admissions were more disruptive than staggered admissions, and patient turnover during change of shift was more disruptive than during medication administration. Understanding the complexity of patient turnover will elucidate the work involved and improve the evidence base for nurse staffing, a key determinant of quality and safety of care. PMID:24242196

Organochlorine pesticide residues in human fat in the United Kingdom 1976-7.

PubMed Central

Abbott, D C; Collins, G B; Goulding, R; Hoodless, R A

1981-01-01

Between May 1976 and August 1977 samples of human body fat were taken during routine necropsies in the United Kingdom on 236 subjects aged over 5 years and four infants aged under 4 months. Comparison with results from earlier studies showed a further decline in residues of pp'-dichlorodiphenyltrichloroethane (pp'-DDT) and dieldrin (HEOD) and increased amounts of hexachlorobenzene residues; concentrations of other compounds were similar to those observed in the studies carried out in 1963-4, 1965-7, and 1969-71. Comparison of the data with those from other countries, showed that the concentrations of organochlorine pesticide residues and polychlorobiphenyls in human fat samples from residents of the United Kingdom remain among the lowest in Europe and, indeed, the world. PMID:6797569

Evaluation of a Low-risk Mild Traumatic Brain Injury and Intracranial Hemorrhage Emergency Department Observation Protocol.

PubMed

Yun, Brian J; Borczuk, Pierre; Wang, Lulu; Dorner, Stephen; White, Benjamin A; Raja, Ali S

2017-11-20

Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. This retrospective cohort study was approved by the institutional review board. Study subjects were patients ≥ 18 years of age with an International Classification of Diseases code corresponding to a traumatic ICH and admitted to an ED observation unit (EDOU) of an urban, academic Level I trauma center between February 1, 2015, and January 31, 2017. Patient data and discharge disposition were abstracted from the electronic health record, and imaging data, from the final neuroradiologist report. To measure kappa, two abstractors independently collected data for presence of neuro deficit from a 10% random sample of the medical charts. Using a multivariable logistic regression model with a propensity score of the probability of placement in the EDOU before and after protocol implementation as a covariate, we sought to determine the pre-post effects of implementing a protocol on the composite outcome of admission to the floor, intensive care unit, or operating room from the EDOU and the proportion of patients with worsening findings on repeat computed tomography (CT) head scan in the EDOU. A total of 379 patients were identified during the study period; 83 were excluded as they were found to have no ICH on chart review. Inter-rater reliability kappa statistic was 0.63 for 30 charts. Among the 296 patients who remained eligible and comprised the study population, 143 were in the preprotocol period and 153 after protocol implementation. The EDOU protocol was associated with an independently statistically significant decreased odds ratio (OR) for admission or worsening ICH on repeat CT scan (OR = 0.45, 95% confidence interval [CI] = 0.25-0.82, p = 0.009) in the observation unit. After a stay in the EDOU, 26% (37/143) of patients required an inpatient admission before implementation of the protocol and 13% (20/153) of patients required an inpatient admission after protocol implementation. There was no statistically significant difference in log transformed EDOU length of stay (LOS) between the groups after adjusting for propensity score (p = 0.34). While there was no difference in EDOU LOS, implementing a low-risk mild TBI and ICH protocol in the EDOU may decrease the rate of inpatient admissions from the EDOU. A protocol-driven observation unit may help physicians by standardizing eligibility criteria and by providing guidance on management. As the propensity score method limits our ability to create a straightforward predictive model, a future larger study should validate the results. © 2017 by the Society for Academic Emergency Medicine.

28 CFR 2.9 - Study prior to sentencing.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Study prior to sentencing. 2.9 Section 2... PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS United States Code Prisoners and Parolees § 2.9 Study... sentencing court for observation and study prior to sentencing, under the provisions of 18 U.S.C. 4205(c...

28 CFR 2.9 - Study prior to sentencing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Study prior to sentencing. 2.9 Section 2... PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS United States Code Prisoners and Parolees § 2.9 Study... sentencing court for observation and study prior to sentencing, under the provisions of 18 U.S.C. 4205(c...

Sustainability of protocolized handover of pediatric cardiac surgery patients to the intensive care unit.

PubMed

Chenault, Kristin; Moga, Michael-Alice; Shin, Minah; Petersen, Emily; Backer, Carl; De Oliveira, Gildasio S; Suresh, Santhanam

2016-05-01

Transfer of patient care among clinicians (handovers) is a common source of medical errors. While the immediate efficacy of these initiatives is well documented, sustainability of practice changes that results in better processes of care is largely understudied. The objective of the current investigation was to evaluate the sustainability of a protocolized handover process in pediatric patients from the operating room after cardiac surgery to the intensive care unit. This was a prospective study with direct observation assessment of handover performance conducted in the cardiac ICU (CICU) of a free-standing, tertiary care children's hospital in the United States. Patient transitions from the operating room to the CICU, including the verbal handoff, were directly observed by a single independent observer in all phases of the study. A checklist of key elements identified errors classified as: (1) technical, (2) information omissions, and (3) realized errors. Total number of errors was compared across the different times of the study (preintervention, postintervention, and the current sustainability phase). A total of 119 handovers were studied: 41 preintervention, 38 postintervention, and 40 in the current sustainability phase. The median [Interquartile range (IQR)] number of technical errors was significantly reduced in the sustainability phase compared to the preintervention and postintervention phase, 2 (1-3), 6 (5-7), and 2.5 (2-4), respectively P = 0.0001. Similarly, the median (IQR) number of verbal information omissions was also significantly reduced in the sustainability phase compared to the preintervention and postintervention phases, 1 (1-1), 4 (3-5) and 2 (1-3), respectively. We demonstrate sustainability of an improved handover process using a checklist in children being transferred to the intensive care unit after cardiac surgery. Standardized handover processes can be a sustainable strategy to improve patient safety after pediatric cardiac surgery. © 2016 John Wiley & Sons Ltd.

Repeater F-waves are signs of motor unit pathology in polio survivors.

PubMed

Hachisuka, Akiko; Komori, Tetsuo; Abe, Tatsuya; Hachisuka, Kenji

2015-05-01

The purpose of this study was to determine whether F-waves reveal electrophysiological features of anterior horn cells in polio survivors. Forty-three polio survivors and 20 healthy controls underwent motor nerve conduction studies of the median and tibial nerves bilaterally, including sampling of F-waves elicited by 100 stimuli and the determination of motor unit number estimation (MUNE). A significant increase in abnormally stereotyped ("repeater") F-waves and a reduction of F-wave persistence were observed in both nerves in the polio group as compared with the control group. Repeater F-waves had a negative correlation with MUNE. These trends in F-wave persistence and repeater F-waves after motor unit loss are characteristic findings in polio survivors. Repeater F-waves are a sign of motor unit pathology. © 2014 The Authors. Muscle & Nerve Published by Wiley Periodicals, Inc.

Geomorphology of comet 67P/Churyumov–Gerasimenko

USGS Publications Warehouse

Birch, Samuel P. D.; Tang, Y.; Hayes, A. G.; Kirk, Randolph L.; Bodewitz, D.; Campins, H.; Fernandez, Y.; de Freitas Bart, R.; Kutsop, N. W.; Sierks, H.; Soderblom, J. M.; Squyres, S. W.; Vincent, J.-B.

2017-01-01

We present a global geomorphological map of comet 67P/Churyumov–Gerasimenko (67P/C-G) using data acquired by the Rosetta Orbiter’s OSIRIS Narrow Angle Camera. The images used in our study were acquired between 2014 August and 2015 May, before 67P/C-G passed through perihelion. Imagery of the Southern hemisphere was included in our study, allowing us to compare the contrasting hemispheres of 67P/C-G in a single study. Our work also puts into greater context the morphologies studied in previous works, and also the morphologies observed on previously visited cometary nuclei. Relative to other nuclei, 67P/C-G appears most similar to 81P/Wild 2, with a topographically heterogeneous surface dominated by smooth-floored pits. Our mapping describes the landscapes of 67P/C-G when they were first observed by Rosetta, and our map can be used to detect changes in surface morphologies after its perihelion passage. Our mapping reveals strong latitudinal dependences for emplaced units and a highly heterogeneous surface. Layered bedrock units that represent the exposed nucleus of 67P/C-G are dominant at southern latitudes, while topographically smooth, dust covered regions dominate the Northern hemisphere. Equatorial latitudes are dominated by smooth terrain units that show evidence for flow structures. We observe no obvious differences between the comet’s two lobes, with the only longitudinal variations being the Imhotep and Hatmehit basins. These correlations suggest a strong seasonal forcing on the surface evolution of 67P/C-G, where materials are transported from the Southern hemisphere to Northern hemisphere basins over multiple orbital time-scales.

[Drug administration to pediatric patients: Evaluation of the nurses' preparation habits in pediatric units].

PubMed

Ménétré, S; Weber, M; Socha, M; Le Tacon, S; May, I; Schweitzer, C; Demoré, B

2018-04-01

In hospitals, the nursing staff is often confronted with the problem of the preparation and administration of drugs for their pediatric patients because of the lack of indication, pediatric dosage, and appropriate galenic form. The goal of this study was to give an overview of the nurses' preparation habits in pediatric units and highlight their daily problems. This single-center prospective study was conducted through an observation of the nursing staff during the drug preparation process in medicine, surgery and intensive care units. We included 91 patients (55 boys and 36 girls), with an average age of 6.3 years (youngest child, 10 days old; oldest child, 18 years old). We observed a mean 2.16 drug preparations per patient [1-5]. We collected 197 observation reports regarding 66 injectable drugs and 131 oral drugs (71 liquid forms and 60 solid forms). The majority of these reports concerned central nervous system drugs (63/197), metabolism and digestive system drugs (50/197), and anti-infective drugs (46/197). The study highlights the nurses' difficulties: modification of the solid galenic forms, lack of knowledge on oral liquid form preservation or reconstitution methods, withdrawal of small volumes, and vague and noncompliant labeling. This study led to the creation of a specific working group for pediatrics. This multidisciplinary team meets on a regular basis to work toward improving the current habits to both simplify and secure drug administration to hospitalized children. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Effects of a psychiatric intensive care unit in an acute psychiatric department.

PubMed

Vaaler, A E; Morken, G; Fløvig, J C; Iversen, V C; Linaker, O M

2006-01-01

Psychiatric acute units use different levels of segregation to satisfy needs for containment and decrease in sensory input for behaviourally disturbed patients. Controlled studies evaluating the effects of the procedure are lacking. The aim of the present study was to compare effects in acutely admitted patients with the use of a psychiatric intensive care unit (PICU) and not in a psychiatric acute department. In a naturalistic study, one group of consecutively referred patients had access only to the PICU, the other group to the whole acute unit. Data were obtained for 56 and 62 patients using several scales. There were significant differences in reduction of behaviour associated with imminent, threatening incidents (Broset Violence Checklist), and actual number of such incidents (Staff Observation Aggression Scale-Revised) in favour of the group that was treated in a PICU. The principles of patient segregation in PICUs have favourable effects on behaviours associated with and the actual numbers of violent and threatening incidents.

Evaluating the Community Land Model (CLM4.5) at a coniferous forest site in northwestern United States using flux and carbon-isotope measurements

Treesearch

Henrique F. Duarte; Brett M. Raczka; Daniel M. Ricciuto; John C. Lin; Charles D. Koven; Peter E. Thornton; David R. Bowling; Chun-Ta Lai; Kenneth J. Bible; James R. Ehleringer

2017-01-01

Droughts in the western United States are expected to intensify with climate change. Thus, an adequate representation of ecosystem response to water stress in land models is critical for predicting carbon dynamics. The goal of this study was to evaluate the performance of the Community Land Model (CLM) version 4.5 against observations at an old-growth coniferous forest...

Mapping agroecological zones and time lag in vegetation growth by means of Fourier analysis of time series of NDVI images

NASA Technical Reports Server (NTRS)

Menenti, M.; Azzali, S.; Verhoef, W.; Van Swol, R.

1993-01-01

Examples are presented of applications of a fast Fourier transform algorithm to analyze time series of images of Normalized Difference Vegetation Index values. The results obtained for a case study on Zambia indicated that differences in vegetation development among map units of an existing agroclimatic map were not significant, while reliable differences were observed among the map units obtained using the Fourier analysis.

The physical environment and patients' activities and care: A comparative case study at three newly built stroke units.

PubMed

Anåker, Anna; von Koch, Lena; Sjöstrand, Christina; Heylighen, Ann; Elf, Marie

2018-04-20

To explore and compare the impact of the physical environment on patients' activities and care at three newly built stroke units. Receiving care in a stroke unit instead of in a general ward reduces the odds of death, dependency and institutionalized care. In stroke units, the design of the physical environment should support evidence-based care. Studies on patients' activities in relation to the design of the physical environment of stroke units are scarce. This work is a comparative descriptive case study. Patients (N = 55) who had a confirmed diagnosis of stroke were recruited from three newly built stroke units in Sweden. The units were examined by non-participant observation using two types of data collection: behavioural mapping analysed with descriptive statistics and field note taking analysed with deductive content analysis. Data were collected from April 2013 - December 2015. The units differed in the patients' levels of physical activity, the proportion of the day that patients spent with health professionals and family presence. Patients were more physically active in a unit with a combination of single and multi-bed room designs than in a unit with an entirely single-room design. Stroke units that were easy to navigate and offered variations in the physical environment had an impact on patients' activities and care. Patients' activity levels and interactions appeared to vary with the design of the physical environments of stroke units. Stroke guidelines focused on health status assessments, avoidance of bed-rest and early rehabilitation require a supportive physical environment. © 2018 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

Development of a fire weather index using meteorological observations within the Northeast United States

Treesearch

Michael J. Erickson; Joseph J. Charney; Brian A. Colle

2016-01-01

A fire weather index (FWI) is developed using wildfire occurrence data and Automated Surface Observing System weather observations within a subregion of the northeastern United States (NEUS) from 1999 to 2008. Average values of several meteorological variables, including near-surface temperature, relative humidity, dewpoint, wind speed, and cumulative daily...

A Phloem Sandwich Unit for Observing Bark Beetles, Associated Predators, and Parasites

Treesearch

Donald N. Kim; Mitchel C. Miller

1981-01-01

This paper describes a phloem sandwich that allows observation of parent beetles, their brood, and associates within the inner bark, and permits observation of predator and parasite behavior on the bark surface. The construction of the unit permits the introduction of multiple pairs of beetles into a single sandwich.

Twentieth Century Regional Climate Change During the Summer in the Central United States Attributed to Agricultural Intensification

NASA Astrophysics Data System (ADS)

Alter, Ross E.; Douglas, Hunter C.; Winter, Jonathan M.; Eltahir, Elfatih A. B.

2018-02-01

Both land use changes and greenhouse gas (GHG) emissions have significantly modified regional climate over the last century. In the central United States, for example, observational data indicate that rainfall increased, surface air temperature decreased, and surface humidity increased during the summer over the course of the twentieth century concurrently with increases in both agricultural production and global GHG emissions. However, the relative contributions of each of these forcings to the observed regional changes remain unclear. Results of both regional climate model simulations and observational analyses suggest that much of the observed rainfall increase—as well as the decrease in temperature and increase in humidity—is attributable to agricultural intensification in the central United States, with natural variability and GHG emissions playing secondary roles. Thus, we conclude that twentieth century land use changes contributed more to forcing observed regional climate change during the summer in the central United States than increasing GHG emissions.

Measuring Outcomes of an Intensive Care Unit Family Diary Program.

PubMed

Huynh, Truong-Giang; Covalesky, Miranda; Sinclair, Samantha; Gunter, Heather; Norton, Tamara; Chen, Alice; Yi, Cassia

2017-01-01

Patients discharged from intensive care units are at risk of short- and long-term physical, cognitive, and emotional symptoms known as post-intensive care syndrome. Family members of intensive care unit patients are at risk of similar symptoms known as post-intensive care syndrome-family. Both syndromes are common, and strategies to reduce risk factors should be employed. An intensive care unit diary project to help reduce these syndromes was implemented in 2 intensive care units using an evidence-based framework. The effects of these diaries were studied using the Family Satisfaction with Care in the Intensive Care Unit survey. Rates of referrals to a postintensive care unit recovery clinic were also observed in relation to the diaries. Although preliminary data did not reveal a significant increase in family satisfaction, the surveys provided important staff feedback. The diaries fostered feelings of compassion and caring as well as built trust between staff and family members of intensive care unit patients. The diaries increased referrals to the postintensive care unit recovery clinic. ©2017 American Association of Critical-Care Nurses.

Modeling of unit operating considerations in generating-capacity reliability evaluation. Volume 1. Mathematical models, computing methods, and results. Final report. [GENESIS, OPCON and OPPLAN

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

Patton, A.D.; Ayoub, A.K.; Singh, C.

1982-07-01

Existing methods for generating capacity reliability evaluation do not explicitly recognize a number of operating considerations which may have important effects in system reliability performance. Thus, current methods may yield estimates of system reliability which differ appreciably from actual observed reliability. Further, current methods offer no means of accurately studying or evaluating alternatives which may differ in one or more operating considerations. Operating considerations which are considered to be important in generating capacity reliability evaluation include: unit duty cycles as influenced by load cycle shape, reliability performance of other units, unit commitment policy, and operating reserve policy; unit start-up failuresmore » distinct from unit running failures; unit start-up times; and unit outage postponability and the management of postponable outages. A detailed Monte Carlo simulation computer model called GENESIS and two analytical models called OPCON and OPPLAN have been developed which are capable of incorporating the effects of many operating considerations including those noted above. These computer models have been used to study a variety of actual and synthetic systems and are available from EPRI. The new models are shown to produce system reliability indices which differ appreciably from index values computed using traditional models which do not recognize operating considerations.« less

A comparative study of occupancy and patient care quality in four different types of intensive care units in a children's hospital.

PubMed

Smith, Thomas J

2012-01-01

This paper reports a comparative study of occupancy and patient care quality in four types of intensive care units in a children's hospital,: an Infant Care Center (ICC), a Medical/Surgical (Med/Surg) unit, a Neonatal Intensive Care Unit (NICU), and a Pediatric Intensive Care Unit (PICU), each featuring a mix of multi-bed and private room (PR) patient care environments. The project is prompted by interest by the project sponsor in a pre-occupancy analysis, before the units are upgraded to exclusive PR designs. Methods comprised, for each unit: (1) observations of ergonomic design features; (2) task activity analyses of job performance of selected staff; and (3) use of a survey to collect perceptions by unit nursing and house staff (HS) of indicators of occupancy and patient care quality. (1) the five most common task activities are interaction with patients, charting, and interaction with equipment, co-workers and family members; (2) job satisfaction, patient care, work environment, job, patient care team interaction, and general occupancy quality rankings by ICC and/or NICU respondents are significantly higher than those by other staff respondents; and (3) ergonomic design shortcomings noted are excess noise, problems with equipment, and work environment, job-related health, and patient care quality issues.

Dermoscopy of subungual haemorrhage: its usefulness in differential diagnosis from nail-unit melanoma.

PubMed

Mun, J-H; Kim, G-W; Jwa, S-W; Song, M; Kim, H-S; Ko, H-C; Kim, B-S; Kim, M-B

2013-06-01

Subungual haemorrhages are characterized by well-circumscribed dots or blotches with a red to red-black pigmentation, but some cases can be difficult to distinguish from subungual melanoma by the naked eye alone. Dermoscopy has proven to be a useful, noninvasive tool in the diagnosis of pigmented lesions in the nail; however, few dermoscopic studies of subungual haemorrhages have been reported. To investigate characteristic dermoscopic patterns of subungual haemorrhages, and to find distinctive features that can differentiate them from nail-unit melanomas. Patients with a confirmed diagnosis of either subungual haemorrhage or nail-unit melanoma at a tertiary university hospital were included in the study. Clinical features and dermoscopic patterns were evaluated. Sixty-four patients with a total of 90 lesions of subungual haemorrhage were enrolled in the study. The majority of cases (84%) showed combinations of more than one colour, while 16% had only one colour. The most common colour of the subungual haemorrhages was purple-black, in 37% of cases. A homogeneous pattern was observed in 92% of cases, globular patterns in 42% and streaks in 39%. Peripheral fading and periungual haemorrhages were found in 54% and 22% of cases, respectively. Destruction or dystrophy of the nail plate was observed in 16% of cases. In the 16 cases of nail-unit melanomas, Hutchinson sign, longitudinal irregular bands or lines, triangular shape of bands, vascular pattern, and ulcerations were found in 100%, 81%, 25%, 6% and 81% of cases, respectively. In contrast, these features were not found in subungual haemorrhages. Dermoscopy provides valuable information for the diagnosis of subungual haemorrhage and aids in the differential diagnosis from nail-unit melanoma. © 2013 The Authors. BJD © 2013 British Association of Dermatologists.

Pressure Cooker: Experiences with Student-Centered Teaching and Learning in High-Stakes Assessment Environments.

ERIC Educational Resources Information Center

Passman, Roger

High stakes testing is a given in many public school districts in the United States. This paper reports the chilling effect high stakes testing had on the pedagogy of one teacher. The study took place in a large Midwestern urban district where a university consultant observed a fifth-grade classroom. This researcher was able to observe and…

Stratigraphy of the Kasei Valles region, Mars

NASA Technical Reports Server (NTRS)

Robinson, Mark S.; Tanaka, Kenneth L.

1987-01-01

The thicknesses and geomorphology of the two principal stratigraphic units exposed in Kasei Valles to aid in interpreting the nature of crustal materials and the history of the channeling events in the area are identified and described. Previous studies of Kasei Valles have related the channel landforms to glacial flow, catastrophic flooding, and large-scale eolian erosion. The two units (an upper and a lower unit) form thick sheets, each having distinct geomorphologic features. Thicknesses of the unit were determined through preliminary stereogrammetric profiles taken across many sections of western Kasei Valles and shadow measurements taken of scarp heights from calibrated Viking images having sun angles less than 25 degrees; DN values were examined to confirm that true shadows were observed.

Thirteen Week Oral Toxicity Study of WR238605 with a Thirteen Week Recovery Period in Dogs. Volume 1

DTIC Science & Technology

1993-06-11

SOURCE OF FUNDING NUMBERS PROGRAM ELEMENT NO. 63807A PROJECT NO. 30463807 TASK NO. QC WORK UNIT ACCESSION NO. 073 11. TITLE (Include...reversible, except for the lung lesions (subacute inflammation) and the microscopic changes secondary to the observed hemolytic anemia ( hepatic ... hepatic hemosiderosis). Based upon the these findings, the no observed effect level (NOEL) in this study was equivocal, but was considered to be near the

Hand Hygiene Adherence Among Health Care Workers at Japanese Hospitals: A Multicenter Observational Study in Japan.

PubMed

Sakihama, Tomoko; Honda, Hitoshi; Saint, Sanjay; Fowler, Karen E; Shimizu, Taro; Kamiya, Toru; Sato, Yumiko; Arakawa, Soichi; Lee, Jong Ja; Iwata, Kentaro; Mihashi, Mutsuko; Tokuda, Yasuharu

2016-03-01

Although proper hand hygiene among health care workers is an important component of efforts to prevent health care-associated infection, there are few data available on adherence to hand hygiene practices in Japan. The aim of this study was to examine hand hygiene adherence at teaching hospitals in Japan. An observational study was conducted from July to November 2011 in 4 units (internal medicine, surgery, intensive care, and/or emergency department) in 4 geographically diverse hospitals (1 university hospital and 3 community teaching hospitals) in Japan. Hand hygiene practice before patient contact was assessed by an external observer. In a total of 3545 health care worker-patient observations, appropriate hand hygiene practice was performed in 677 (overall adherence, 19%; 95% confidence interval, 18%-20%). Subgroup rates of hand hygiene adherence were 15% among physicians and 23% among nurses. The ranges of adherence were 11% to 25% between hospitals and 11% to 31% between units. Adherence of the nurses and the physicians to hand hygiene was correlated within each hospital. There was a trend toward higher hand hygiene adherence in hospitals with infection control nurses, compared with hospitals without them (29% versus 16%). The hand hygiene adherence in Japanese teaching hospitals in our sample was low, even lower than reported mean values from other international studies. Greater adherence to hand hygiene should be encouraged in Japan.

Enhanced electric dipole transition in lanthanide complex with organometallic ruthenocene units.

PubMed

Hasegawa, Yasuchika; Sato, Nao; Hirai, Yuichi; Nakanishi, Takayuki; Kitagawa, Yuichi; Kobayashi, Atsushi; Kato, Masako; Seki, Tomohiro; Ito, Hajime; Fushimi, Koji

2015-05-21

Enhanced luminescence of a lanthanide complex with dynamic polarization of the excited state and molecular motion is introduced. The luminescent lanthanide complex is composed of one Eu(hfa)3 (hfa, hexafluoroacetylacetonate) and two phosphine oxide ligands with ruthenocenyl units Rc, [Eu(hfa)3(RcPO)2] (RcPO = diphenylphosphorylruthenocene). The ruthenocenyl units in the phosphine oxide ligands play an important role of switching for dynamic molecular polarization and motion in liquid media. The oxidation states of the ruthenocenyl unit (Rc(1+)/Rc(1+)) are controlled by potentiostatic polarization. Eu(III) complexes attached with bidentate phosphine oxide ligands containing ruthenocenyl units, [Eu(hfa)3(RcBPO)] (RcBPO = 1,1'-bis(diphenylphosphoryl)ruthenocene), and with bidentate phosphine oxide ligands, [Eu(hfa)3(BIPHEPO)] (BIPHEPO =1,1'-biphenyl-2,2'-diylbis(diphenylphosphine oxide), were also prepared as references. The coordination structures and electrochemical properties were analyzed using single crystal X-ray analysis, cyclic voltammetry, and absorption spectroscopy measurements. The luminescence properties were estimated using an optoelectrochemical cell. Under potentiostatic polarization, a significant enhancement of luminescence was successfully observed for [Eu(hfa)3(RcPO)2], while no spectral change was observed for [Eu(hfa)3(RcBPO)]. In this study, the remarkable enhanced luminescence phenomena of Eu(III) complex based on the dynamic molecular motion under potentiostatic polarization have been performed.

Modeling the Hydrologic Processes of a Permeable Pavement ...

EPA Pesticide Factsheets

A permeable pavement system can capture stormwater to reduce runoff volume and flow rate, improve onsite groundwater recharge, and enhance pollutant controls within the site. A new unit process model for evaluating the hydrologic performance of a permeable pavement system has been developed in this study. The developed model can continuously simulate infiltration through the permeable pavement surface, exfiltration from the storage to the surrounding in situ soils, and clogging impacts on infiltration/exfiltration capacity at the pavement surface and the bottom of the subsurface storage unit. The exfiltration modeling component simulates vertical and horizontal exfiltration independently based on Darcy’s formula with the Green-Ampt approximation. The developed model can be arranged with physically-based modeling parameters, such as hydraulic conductivity, Manning’s friction flow parameters, saturated and field capacity volumetric water contents, porosity, density, etc. The developed model was calibrated using high-frequency observed data. The modeled water depths are well matched with the observed values (R2 = 0.90). The modeling results show that horizontal exfiltration through the side walls of the subsurface storage unit is a prevailing factor in determining the hydrologic performance of the system, especially where the storage unit is developed in a long, narrow shape; or with a high risk of bottom compaction and clogging. This paper presents unit

Correlation between differential renal function estimation using CT-based functional renal parenchymal volume and (99m)Tc - DTPA renal scan.

PubMed

Sarma, Debanga; Barua, Sasanka K; Rajeev, T P; Baruah, Saumar J

2012-10-01

Nuclear renal scan is currently the gold standard imaging study to determine differential renal function. We propose helical CT as single modality for both the anatomical and functional evaluation of kidney with impaired function. In the present study renal parenchymal volume is measured and percent total renal volume is used as a surrogate marker for differential renal function. The objective of this study is to correlate between differential renal function estimation using CT-based renal parenchymal volume measurement with differential renal function estimation using (99m)TC - DTPA renal scan. Twenty-one patients with unilateral obstructive uropathy were enrolled in this prospective comparative study. They were subjected to (99m)Tc - DTPA renal scan and 64 slice helical CT scan which estimates the renal volume depending on the reconstruction of arterial phase images followed by volume rendering and percent renal volume was calculated. Percent renal volume was correlated with percent renal function, as determined by nuclear renal scan using Pearson coefficient. RESULTS AND OBSERVATION: A strong correlation is observed between percent renal volume and percent renal function in obstructed units (r = 0.828, P < 0.001) as well as in nonobstructed units (r = 0.827, P < 0.001). There is a strong correlation between percent renal volume determined by CT scan and percent renal function determined by (99m)TC - DTPA renal scan both in obstructed and in normal units. CT-based percent renal volume can be used as a single radiological tests for both functional and anatomical assessment of impaired renal units.

First record of a banded Sandwich Tern (Thalasseus sandvicensis) moving from England to the United States

USGS Publications Warehouse

Spendelow, Jeffrey A.

2015-01-01

A Sandwich Tern (Thalasseus sandvicensis sandvicensis) banded as a chick in 2002 at Coquet Island off the northeast coast of Great Britain was observed at two locations on Cape Cod, Massachusetts, USA, in August and September 2013. This is the first record of a banded Sandwich Tern from the United Kingdom being observed in the United States.

The Many Faces of Language.

ERIC Educational Resources Information Center

Werdmann, Anne M.

In a sixth-grade unit, students learned about people's facial expressions through careful observation, recording, reporting, and generalizing. The students studied the faces of people of various ages; explored "masks" that people wear in different situations; learned about the use of ritual masks; made case studies of individuals to show…

Cattails or Concrete?

ERIC Educational Resources Information Center

Heal, Fred A.; And Others

Developed for elementary science studies, this unit on man and environment requires student involvement in discovery, observation, gathering and recording data, and problem solving. A series of 19 booklets, each designed as an activity which can be completed out-of-doors, comprise this student packet of materials. Topics studied in the activities…

Continental Shelf Morphology and Stratigraphy Offshore San Onofre, CA: The Interplay Between Rates of Eustatic Change and Sediment Supply

USGS Publications Warehouse

Klotsko, Shannon; Driscoll, Neal W.; Kent, Graham; Brothers, Daniel

2016-01-01

New high-resolution CHIRP seismic data acquired offshore San Onofre, southern California reveal that shelf sediment distribution and thickness are primarily controlled by eustatic sea level rise and sediment supply. Throughout the majority of the study region, a prominent abrasion platform and associated shoreline cutoff are observed in the subsurface from ~ 72 to 53 m below present sea level. These erosional features appear to have formed between Melt Water Pulse 1A and Melt Water Pulse 1B, when the rate of sea-level rise was lower. There are three distinct sedimentary units mapped above a regional angular unconformity interpreted to be the Holocene transgressive surface in the seismic data. Unit I, the deepest unit, is interpreted as a lag deposit that infills a topographic low associated with an abrasion platform. Unit I thins seaward by downlap and pinches out landward against the shoreline cutoff. Unit II is a mid-shelf lag deposit formed from shallower eroded material and thins seaward by downlap and landward by onlap. The youngest, Unit III, is interpreted to represent modern sediment deposition. Faults in the study area do not appear to offset the transgressive surface. The Newport Inglewood/Rose Canyon fault system is active in other regions to the south (e.g., La Jolla) where it offsets the transgressive surface and creates seafloor relief. Several shoals observed along the transgressive surface could record minor deformation due to fault activity in the study area. Nevertheless, our preferred interpretation is that the shoals are regions more resistant to erosion during marine transgression. The Cristianitos fault zone also causes a shoaling of the transgressive surface. This may be from resistant antecedent topography due to an early phase of compression on the fault. The Cristianitos fault zone was previously defined as a down-to-the-north normal fault, but the folding and faulting architecture imaged in the CHIRP data are more consistent with a strike-slip fault with a down-to-the-northwest dip-slip component. A third area of shoaling is observed off of San Mateo and San Onofre creeks. This shoaling has a constructional component and could be a relict delta or beach structure. (C) 2015 Elsevier B.V. All rights reserved.

Association between Pseudomonas aeruginosa positive water samples and healthcare-associated cases: nine-year study at one university hospital.

PubMed

Lefebvre, A; Bertrand, X; Quantin, C; Vanhems, P; Lucet, J-C; Nuemi, G; Astruc, K; Chavanet, P; Aho-Glélé, L S

2017-07-01

To study the association between the results of water samples and Pseudomonas aeruginosa healthcare-associated cases in a French university hospital. Generalized Estimating Equations were used on complete case and imputed datasets. The spatial unit was the building and the time unit was the quarter. For the period 2004-2013, 2932 water samples were studied; 17% were positive for P. aeruginosa. A higher incidence of P. aeruginosa cases was associated with a higher proportion of positive water samples (P=0.056 in complete case analysis and P=0.031 with the imputed dataset). The association was no longer observed when haematology and intensive care units were excluded, but was significant in analyses of data concerning intensive care units alone (P<0.001). This study suggests that water outlet contamination in hospitals can lead to an increase in healthcare-associated P. aeruginosa cases in wards dealing with susceptible patients, but does not play a significant role in other wards. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Risk factors for toxoplasmosis in pregnant women in Kent, United Kingdom.

PubMed Central

Nash, J. Q.; Chissel, S.; Jones, J.; Warburton, F.; Verlander, N. Q.

2005-01-01

The aim of this study was to establish the relative importance of various risk factors for toxoplasmosis in a United Kingdom antenatal population. Toxoplasma immune status was determined by an immunoassay and linked to a questionnaire exploring dietary and environmental exposure to toxoplasmosis. The overall seroprevalence found was 9.1% (172/1897). A significantly higher seroprevalence was associated with rural location of the childhood home, childhood home in Europe excluding the United Kingdom, feeding a dog raw meat and increased age. A non-significant higher prevalence of toxoplasmosis was observed in women who had lived with a cat or kitten as a child. In contrast to recent European studies only weak associations between diet and toxoplasmosis were found. Gardening activity was not associated with seropositivity but a non-significant lower seroprevalence was seen in gardeners who always wore gloves. This study confirms that toxoplasma prevalence in the United Kingdom has continued to decline since the 1960s. The increasing seroprevalence with age found in this study, highlights the continuing need to educate women of childbearing age about the risk factors for toxoplasmosis. PMID:15962554

Six Case-Studies of Performance Assessment.

ERIC Educational Resources Information Center

Mitchell, Ruth; Stempel, Amy

Six cases are studied to give some idea of the range of performance assessments in use in the United States. Contrast and comparison are made possible through the study of the following: (1) the South Brunswick (New Jersey) Public Schools Observational Portfolio for kindergarten through grade 12; (2) the Arizona Student Assessment Program (not yet…

Ethnic Heritage and Language Schools in America. Studies in American Folklife, No. 4.

ERIC Educational Resources Information Center

Bradunas, Elena; Topping, Brett, Ed.

This book reports the findings of the Ethnic Heritage and Language Schools Project undertaken by the American Folklife Center in 1982. Twenty-one researchers used participant observation to study ethnic schools in different parts of the United States. The project studied schools that correspond to Fishman's classification of ethnic education…

Improving Teaching through Lesson Study Debriefing

ERIC Educational Resources Information Center

Groth, Randall E.

2011-01-01

The lesson study model of professional development that originated in Japan is becoming increasingly popular in the United States. At its core, lesson study is a means of bringing teachers together to carry out the process of planning a lesson, implementing and observing it, and then examining it during a debriefing session. The debriefing…

Effect of 0.2% chlorhexidine on microbial and fungal contamination of dental unit waterlines

PubMed Central

Agahi, Raha Habib; Hashemipour, Maryam Alsadat; Kalantari, Mahsa; Ayatollah-Mosavi, Amin; Aghassi, Hossein; Nassab, Amir Hossein Gandjalikhan

2014-01-01

Background: It is known that dental unit waterline can be a source of infection. The aim of this study was to evaluate the efficacy of a mouthwash, chlorhexidine, in controlling microbial and fungal contamination of dental unit waterlines. Materials and Methods: In the present experimental study, the water in high-speed handpieces and air/water syringes of 35 dental units in a dental school was investigated microbiologically. Five of the units and one tap water served as controls; 100-200-mL water samples were collected aseptically in sterile containers in the morning after a 2-min purge. Water reservoir bottles were emptied and 50 mL of 0.2% chlorhexidine mouthwash was introduced into the tank. Then the water syringe was used to flush the waterline until the pink-colored chlorhexidine was observed to flow from the water syringe. Before the next day's session and before the students used the unit, two water samples from the water syringe and water turbine was collected. The samples were transferred to the laboratory. After 48 h at 37°C, the microbial colonies were counted. The number of these colonies was evaluated using colony forming unit CFU. Data were analyzed with Mann — Whitney U test and SPSS 13.5 statistical program. The statistical significance was defined at P ≤ 0.05. Results: All 35 units were contaminated before chlorhexidine use; no contamination was detected after adding chlorhexidine to the waterlines of the units. After week 1, 28 of the 30 treated dental unit waterlines (DUWLs) had values of CFU/mL less than 200. Conclusion: The present study showed that the use of chlorhexidine could reduce microbial counts in dental unit waterlines. PMID:25097645

Effect of 0.2% chlorhexidine on microbial and fungal contamination of dental unit waterlines.

PubMed

Agahi, Raha Habib; Hashemipour, Maryam Alsadat; Kalantari, Mahsa; Ayatollah-Mosavi, Amin; Aghassi, Hossein; Nassab, Amir Hossein Gandjalikhan

2014-05-01

It is known that dental unit waterline can be a source of infection. The aim of this study was to evaluate the efficacy of a mouthwash, chlorhexidine, in controlling microbial and fungal contamination of dental unit waterlines. In the present experimental study, the water in high-speed handpieces and air/water syringes of 35 dental units in a dental school was investigated microbiologically. Five of the units and one tap water served as controls; 100-200-mL water samples were collected aseptically in sterile containers in the morning after a 2-min purge. Water reservoir bottles were emptied and 50 mL of 0.2% chlorhexidine mouthwash was introduced into the tank. Then the water syringe was used to flush the waterline until the pink-colored chlorhexidine was observed to flow from the water syringe. Before the next day's session and before the students used the unit, two water samples from the water syringe and water turbine was collected. The samples were transferred to the laboratory. After 48 h at 37°C, the microbial colonies were counted. The number of these colonies was evaluated using colony forming unit CFU. Data were analyzed with Mann - Whitney U test and SPSS 13.5 statistical program. The statistical significance was defined at P ≤ 0.05. All 35 units were contaminated before chlorhexidine use; no contamination was detected after adding chlorhexidine to the waterlines of the units. After week 1, 28 of the 30 treated dental unit waterlines (DUWLs) had values of CFU/mL less than 200. The present study showed that the use of chlorhexidine could reduce microbial counts in dental unit waterlines.

Prevalence of syphilis in pregnancy and prenatal syphilis testing in Brazil: birth in Brazil study.

PubMed

Domingues, Rosa Maria Soares Madeira; Szwarcwald, Celia Landmann; Souza Junior, Paulo Roberto Borges; Leal, Maria do Carmo

2014-10-01

Determine the coverage rate of syphilis testing during prenatal care and the prevalence of syphilis in pregnant women in Brazil. This is a national hospital-based cohort study conducted in Brazil with 23,894 postpartum women between 2011 and 2012. Data were obtained using interviews with postpartum women, hospital records, and prenatal care cards. All postpartum women with a reactive serological test result recorded in the prenatal care card or syphilis diagnosis during hospitalization for childbirth were considered cases of syphilis in pregnancy. The Chi-square test was used for determining the disease prevalence and testing coverage rate by region of residence, self-reported skin color, maternal age, and type of prenatal and child delivery care units. Prenatal care covered 98.7% postpartum women. Syphilis testing coverage rate was 89.1% (one test) and 41.2% (two tests), and syphilis prevalence in pregnancy was 1.02% (95% CI 0.84; 1.25). A lower prenatal coverage rate was observed among women in the North region, indigenous women, those with less education, and those who received prenatal care in public health care units. A lower testing coverage rate was observed among residents in the North, Northeast, and Midwest regions, among younger and non-white skin-color women, among those with lower education, and those who received prenatal care in public health care units. An increased prevalence of syphilis was observed among women with < 8 years of education (1.74%), who self-reported as black (1.8%) or mixed (1.2%), those who did not receive prenatal care (2.5%), and those attending public (1.37%) or mixed (0.93%) health care units. The estimated prevalence of syphilis in pregnancy was similar to that reported in the last sentinel surveillance study conducted in 2006. There was an improvement in prenatal care and testing coverage rate, and the goals suggested by the World Health Organization were achieved in two regions. Regional and social inequalities in access to health care units, coupled with other gaps in health assistance, have led to the persistence of congenital syphilis as a major public health problem in Brazil.

Prevalence of syphilis in pregnancy and prenatal syphilis testing in Brazil: Birth in Brazil study

PubMed Central

Domingues, Rosa Maria Soares Madeira; Szwarcwald, Celia Landmann; Souza, Paulo Roberto Borges; Leal, Maria do Carmo

2014-01-01

OBJECTIVE Determine the coverage rate of syphilis testing during prenatal care and the prevalence of syphilis in pregnant women in Brazil. METHODS This is a national hospital-based cohort study conducted in Brazil with 23,894 postpartum women between 2011 and 2012. Data were obtained using interviews with postpartum women, hospital records, and prenatal care cards. All postpartum women with a reactive serological test result recorded in the prenatal care card or syphilis diagnosis during hospitalization for childbirth were considered cases of syphilis in pregnancy. The Chi-square test was used for determining the disease prevalence and testing coverage rate by region of residence, self-reported skin color, maternal age, and type of prenatal and child delivery care units. RESULTS Prenatal care covered 98.7% postpartum women. Syphilis testing coverage rate was 89.1% (one test) and 41.2% (two tests), and syphilis prevalence in pregnancy was 1.02% (95%CI 0.84;1.25). A lower prenatal coverage rate was observed among women in the North region, indigenous women, those with less education, and those who received prenatal care in public health care units. A lower testing coverage rate was observed among residents in the North, Northeast, and Midwest regions, among younger and non-white skin-color women, among those with lower education, and those who received prenatal care in public health care units. An increased prevalence of syphilis was observed among women with < 8 years of education (1.74%), who self-reported as black (1.8%) or mixed (1.2%), those who did not receive prenatal care (2.5%), and those attending public (1.37%) or mixed (0.93%) health care units. CONCLUSIONS The estimated prevalence of syphilis in pregnancy was similar to that reported in the last sentinel surveillance study conducted in 2006. There was an improvement in prenatal care and testing coverage rate, and the goals suggested by the World Health Organization were achieved in two regions. Regional and social inequalities in access to health care units, coupled with other gaps in health assistance, have led to the persistence of congenital syphilis as a major public health problem in Brazil. PMID:25372167

Health care aides use of time in a residential long-term care unit: a time and motion study.

PubMed

Mallidou, Anastasia A; Cummings, Greta G; Schalm, Corinne; Estabrooks, Carole A

2013-09-01

Organizational resources such as caregiver time use with older adults in residential long-term care facilities (nursing homes) have not been extensively studied, while levels of nurse staffing and staffing-mix are the focus of many publications on all types of healthcare organizations. Evidence shows that front-line caregivers' sufficient working time with residents is associated with performance, excellence, comprehensive care, quality of outcomes (e.g., reductions in pressure ulcers, urinary tract infections, and falls), quality of life, cost savings, and may be affiliated with transformation of organizational culture. To explore organizational resources in a long-term care unit within a multilevel residential facility, to measure healthcare aides' use of time with residents, and to describe working environment and unit culture. An observational pilot study was conducted in a Canadian urban 52-bed long-term care unit within a faith-based residential multilevel care facility. A convenience sample of seven healthcare aides consented to participate. To collect the data, we used an observational sheet (to monitor caregiver time use on certain activities such as personal care, assisting with eating, socializing, helping residents to be involved in therapeutic activities, paperwork, networking, personal time, and others), semi-structured interview (to assess caregiver perceptions of their working environment), and field notes (to illustrate the unit culture). Three hundred and eighty seven hours of observation were completed. The findings indicate that healthcare aides spent most of their working time (on an eight-hour day-shift) in "personal care" (52%) and in "other" activities (23%). One-to-three minute activities consumed about 35% of the time spent in personal care and 20% of time spent in assisting with eating. Overall, caregivers' time spent socializing was less than 1%, about 6% in networking, and less than 4% in paperwork. Re-organizing healthcare aides' routine practices may minimize the short one-to-three minute intervals spent on direct care activities, which can be interpreted as interruptions to continuity of care or waste of time. Fewer interruptions may allow healthcare aides to use their time with residents more effectively. Copyright © 2012 Elsevier Ltd. All rights reserved.

Geophysical Studies Based on Gravity and Seismic Data of Tule Desert, Meadow Valley Wash, and California Wash Basins, Southern Nevada

USGS Publications Warehouse

Scheirer, Daniel S.; Page, William R.; Miller, John J.

2006-01-01

Gravity and seismic data from Tule Desert, Meadow Valley Wash, and California Wash, Nevada, provide insight into the subsurface geometry of these three basins that lie adjacent to rapidly developing areas of Clark County, Nevada. Each of the basins is the product of Tertiary extension accommodated with the general form of north-south oriented, asymmetrically-faulted half-grabens. Geophysical inversion of gravity observations indicates that Tule Desert and Meadow Valley Wash basins are segmented into subbasins by shallow, buried basement highs. In this study, basement refers to pre-Cenozoic bedrock units that underlie basins filled with Cenozoic sedimentary and volcanic units. In Tule Desert, a small, buried basement high inferred from gravity data appears to be a horst whose placement is consistent with seismic reflection and magnetotelluric observations. Meadow Valley Wash consists of three subbasins separated by basement highs at structural zones that accommodated different styles of extension of the adjacent subbasins, an interpretation consistent with geologic mapping of fault traces oblique to the predominant north-south fault orientation of Tertiary extension in this area. California Wash is a single structural basin. The three seismic reflection lines analyzed in this study image the sedimentary basin fill, and they allow identification of faults that offset basin deposits and underlying basement. The degree of faulting and folding of the basin-fill deposits increases with depth. Pre-Cenozoic units are observed in some of the seismic reflection lines, but their reflections are generally of poor quality or are absent. Factors that degrade seismic reflector quality in this area are rough land topography due to erosion, deformed sedimentary units at the land surface, rock layers that dip out of the plane of the seismic profile, and the presence of volcanic units that obscure underlying reflectors. Geophysical methods illustrate that basin geometry is more complicated than would be inferred from extrapolation of surface topography and geology, and these methods aid in defining a three-dimensional framework to understand groundwater storage and flow in southern Nevada.

The relationship between nurse staffing and failure to rescue: where does it matter most?

PubMed

Talsma, AkkeNeel; Jones, Katherine; Guo, Ying; Wilson, Deleise; Campbell, Darrell A

2014-09-01

This study further expands on the relationship between nurse staffing levels and patient outcomes, in particular, failure to rescue. Many studies are based on single-site hospitals or single-year data, thus limiting the generalizations of the findings. The purpose was to evaluate in a multisite multiyear study the relationship between unit-level nurse staffing and FTR mortality, for ICU and non-ICU patients. Using administrative and actual unit level nurse staffing data, we used AHRQ 2003 Patient Safety Indicator (2003) software and matched those with the patient's discharge month. Fixed effects multilevel logistic analyses were used to take into account the hierarchical structure of the database and patient clustering within units. We controlled for patient demographics, clinical conditions, and CCS categories. The majority (94%) of cases were discharged from general care units, ICUs reported higher nurse staffing levels based on patient complexity. Expired cases were 3 years older, male, and nonwhite. For general care discharges, the relationship between RN level HPPD approached significance (P = 0.07), suggesting increased odds of higher FTR mortality with higher staffing levels. We did not observe any of the expected associations between the nurse staffing variables and FTR for either general care unit or ICU discharges. The comprehensive risk adjustments provided adequate "leveling of the playing field" to evaluate the impact of unit-based nurse staffing levels on FTR mortality. Future studies should evaluate the influence of unit environment and patient risk.

Greater Perceived Age Discrimination in England than the United States: Results from HRS and ELSA.

PubMed

Rippon, Isla; Zaninotto, Paola; Steptoe, Andrew

2015-11-01

We examined cross-national differences in perceptions of age discrimination in England and the United States. Under the premise that the United States has had age discrimination legislation in place for considerably longer than England, we hypothesized that perceptions of age discrimination would be lower in the United States. We analyzed data from two nationally representative studies of aging, the U.S. Health and Retirement Study (n = 4,818) and the English Longitudinal Study of Ageing (n = 7,478). Respondents aged 52 years and older who attributed any experiences of discrimination to their age were treated as cases of perceived age discrimination. We used multivariable logistic regression to estimate the odds ratios of experiencing perceived age discrimination in relation to selected sociodemographic factors. Perceptions of age discrimination were significantly higher in England than the United States, with 34.8% of men and women in England reporting age discrimination compared with 29.1% in the United States. Associations between perceived age discrimination and older age and lower levels of household wealth were observed in both countries, but we found differences between England and the United States in the relationship between perceived age discrimination and education. Our study revealed that levels of perceived age discrimination are lower in the United States than England and are less socially patterned. This suggests that differing social and political circumstances in the two countries may have an important role to play. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America.

A View of Hurricane Katrina with Early 2lSt Century Technology

NASA Technical Reports Server (NTRS)

Lin, Xin; Li, J.-L.; Suarez, M. J.; Tompkins, A. M.; Waliser, D. E.; Rienecker, M. M.; Bacmeister, J.; Jiang, J.; Wu, H.-T.; Tassone, C. M.

2006-01-01

Recent advances in space-borne observations and numerical weather prediction models provide new opportunities for improving hurricane forecasts. In this study, state-of-the-art satellite observations are used to document the evolution of one of the most devastating tropical cyclones ever to hit the United States: Hurricane Katrina. The ECMWF and NASA global high-resolution forecasts, the latter being run in experimental mode, are compared with satellite observations, with a focus on precipitation and cloud processes. Future directions on modeling and observations are briefly discussed.

EXPOSURE ASSESSMENT FOR THE NATIONAL CHILDREN'S STUDY: INTEGRATING BIOMONITORING WITH ENVIRONMENTAL MEASURES AND QUESTIONNAIRE/DIARY/OBSERVATIONAL INFORMATION

EPA Science Inventory

The National Children's Study (NCS) is proposed to be the largest and most ambitious study of the health and development of children ever to be undertaken in the United States. The Study is led by the U.S. Department of Health and Human Services - through the National Institutes...

Development and validation of an observation tool for the assessment of nursing pain management practices in intensive care unit in a standardized clinical simulation setting.

PubMed

Gosselin, Emilie; Bourgault, Patricia; Lavoie, Stephan; Coleman, Robin-Marie; Méziat-Burdin, Anne

2014-12-01

Pain management in the intensive care unit is often inadequate. There is no tool available to assess nursing pain management practices. The aim of this study was to develop and validate a measuring tool to assess nursing pain management in the intensive care unit during standardized clinical simulation. A literature review was performed to identify relevant components demonstrating optimal pain management in adult intensive care units and to integrate them in an observation tool. This tool was submitted to an expert panel and pretested. It was then used to assess pain management practice during 26 discrete standardized clinical simulation sessions with intensive care nurses. The Nursing Observation Tool for Pain Management (NOTPaM) contains 28 statements grouped into 8 categories, which are grouped into 4 dimensions: subjective assessment, objective assessment, interventions, and reassessment. The tool's internal consistency was calculated at a Cronbach's alpha of 0.436 for the whole tool; the alpha varies from 0.328 to 0.518 for each dimension. To evaluate the inter-rater reliability, intra-class correlation coefficient was used, which was calculated at 0.751 (p < .001) for the whole tool, with variations from 0.619 to 0.920 (p < .01) between dimensions. The expert panel was satisfied with the content and face validity of the tool. The psychometric qualities of the NOTPaM developed in this study are satisfactory. However, the tool could be improved with slight modifications. Nevertheless, it was useful in assessing intensive care nurses' pain management in a standardized clinical simulation. The NOTPaM is the first tool created for this purpose. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

The molecular structure of the phosphate mineral beraunite Fe2+Fe53+(PO4)4(OH)5ṡ4H2O - A vibrational spectroscopic study

NASA Astrophysics Data System (ADS)

Frost, Ray L.; López, Andrés; Scholz, Ricardo; Xi, Yunfei; Lana, Cristiano

2014-07-01

The mineral beraunite from Boca Rica pegmatite in Minas Gerais with theoretical formula Fe2+Fe53+(PO4)4(OH)5ṡ4H2O has been studied using a combination of electron microscopy with EDX and vibrational spectroscopic techniques. Raman spectroscopy identifies an intense band at 990 cm-1 and 1011 cm-1. These bands are attributed to the PO43- ν1 symmetric stretching mode. The ν3 antisymmetric stretching modes are observed by a large number of Raman bands. The Raman bands at 1034, 1051, 1058, 1069 and 1084 together with the Raman bands at 1098, 1116, 1133, 1155 and 1174 cm-1 are assigned to the ν3 antisymmetric stretching vibrations of PO43- and the HOPO32- units. The observation of these multiple Raman bands in the symmetric and antisymmetric stretching region gives credence to the concept that both phosphate and hydrogen phosphate units exist in the structure of beraunite. The series of Raman bands at 567, 582, 601, 644, 661, 673, and 687 cm-1 are assigned to the PO43- ν2 bending modes. The series of Raman bands at 437, 468, 478, 491, 503 cm-1 are attributed to the PO43- and HOPO32- ν4 bending modes. No Raman bands of beraunite which could be attributed to the hydroxyl stretching unit were observed. Infrared bands at 3511 and 3359 cm-1 are ascribed to the OH stretching vibration of the OH units. Very broad bands at 3022 and 3299 cm-1 are attributed to the OH stretching vibrations of water. Vibrational spectroscopy offers insights into the molecular structure of the phosphate mineral beraunite.

Bis(tetra­methyl­ammonium) tetra­chlorido­zincate(II), phase VI

PubMed Central

Curtiss, Ashley B. S.; Musie, Ghezai T.; Powell, Douglas R.

2008-01-01

Phase VI of bis­(tetra­methyl­ammonium) tetra­chloro­zincate(II), (C4H12N)2[ZnCl4], contains three formula units per asymmetric unit. Several short C—H⋯Cl contacts [2.70 (3) and 2.72 (4) Å] are observed, but they are believed to participate only in van der Waals inter­actions. The crystal studied exhibited inversion twinning. PMID:21200531

A Research Study to Develop an Army-Wide Equal Opportunity Training Model. Volume 1

DTIC Science & Technology

1979-03-01

three areas is detailed below. Personal Discrimination Personal racism (or sexism ) is defined in AR 600-21 in terms of " The acting out of prejudices by...example (6) Diagnosing unit climate on racism / sexism issues (a) unit survey (b) informal feedback (c) personal observation (7) Developing...various communities out of which the modem serviceman emerges. • Group Leadership Practicum-to provide the student with the theory and practice in

Aggression-preventive supervisor behavior: Implications for workplace climate and employee outcomes.

PubMed

Yang, Liu-Qin; Caughlin, David E

2017-01-01

Workplace aggression remains a serious and costly issue for organizations; thus, it is imperative to understand ways to reduce workplace aggression. To address this need, we used 2 independent samples with varied study designs, one at the employee level and the other at both employee and unit levels, to examine the role of aggression-preventive supervisor behavior (APSB) in aggression-prevention processes. In Sample 1 (237 nurses), we used structural equation modeling to examine the role of individual observations of APSB. First, we found that individual employees' observations of APSB positively related to their individual violence-prevention climate (VPC) perceptions. Further, VPC perceptions mediated the relations between APSB and employees' exposure to coworker aggression, job attitudes, and physical symptoms. In Sample 2 (337 nurses), we used multilevel regression analysis to examine the positive role of APSB in managing the aggression process. First, we established further support for many of the findings in Sample 1. In addition, we found that shared unit-level VPC mediated the relations of unit-level APSB with employees' exposure to aggression from coworkers, their physical symptoms, and turnover intention. Finally, evidence from Sample 2 supported favorable, direct relations of individual- or unit-level APSB with employees' aggression-prevention compliance and turnover intention. Implications for studying context-specific leadership behavior and designing aggression-prevention interventions are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Effect of hand sanitizer location on hand hygiene compliance.

PubMed

Cure, Laila; Van Enk, Richard

2015-09-01

Hand hygiene is the most important intervention to prevent infection in hospitals. Health care workers should clean their hands at least before and after contact with patients. Hand sanitizer dispensers are important to support hand hygiene because they can be made available throughout hospital units. The aim of this study was to determine whether the usability of sanitizer dispensers correlates with compliance of staff in using the sanitizer in a hospital. This study took place in a Midwest, 404-bed, private, nonprofit community hospital with 15 inpatient care units in addition to several ambulatory units. The usability and standardization of sanitizers in 12 participating inpatient units were evaluated. The hospital measured compliance of staff with hand hygiene as part of their quality improvement program. Data from 2010-2012 were analyzed to measure the relationship between compliance and usability using mixed-effects logistic regression models. The total usability score (P = .0046), visibility (P = .003), and accessibility of the sanitizer on entrance to the patient room (P = .00055) were statistically associated with higher observed compliance rates. Standardization alone showed no significant impact on observed compliance (P = .37). Hand hygiene compliance can be influenced by visibility and accessibility of dispensers. The sanitizer location should be part of multifaceted interventions to improve hand hygiene. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Geologic Mapping of the V-36 Thetis Regio Quadrangle: 2008 Progress Report

NASA Technical Reports Server (NTRS)

Basilevsky, A. T.; Head, James W.

2008-01-01

As a result of mapping, eleven material stratigraphic units and three structural units have been identified and mapped. The material units include (from older to younger): tessera terrain material (tt), material of densely fractured plains (pdf), material of fractured and ridged plains (pfr), material of shield plains (psh), material of plains with wrinkle ridges (pwr), material of smooth plains of intermediate brightness (psi), material of radardark smooth plains (psd), material of lineated plains (pli) material of lobate plains (plo), material of craters having no radar-dark haloes (c1), and material of craters having clear dark haloes (c2). The morphologies and probably the nature of the material units in the study area are generally similar to those observed in other regions of Venus [2]. The youngest units are lobate plains (plo) which here typically look less lobate than in other areas of the planet. Close to them in age are smooth plains which are indeed smooth and represented by two varieties mentioned above. Lineated plains (pli) are densely fractured in a geometrically regular way. Plains with wrinkle ridges, being morphologically similar to those observed in other regions, here occupy unusually small areas. Shield (psh) plains here are also not abundant. Locally they show wrinkle ridging. Fractured and ridged plains (pfr), which form in other regions, the so called ridge belts, are observed as isolated areas of clusters of ridged plains surrounded by other units. Densely fractured plains (pdf) are present in relatively small areas in association with coronae and corona-like features. Tessera terrain (tt) is dissected by structures oriented in two or more directions. Structures are so densely packed that the morphology (and thus nature) of the precursor terrain is not known. Structural units include tessera transitional terrain (ttt), fracture belts (fb) and rifted terrain (rt). Tessera transitional terrain was first identified and mapped by [4] as areas of fractured and ridged plains (pfr) and densely fractured plains (pdf) deformed by transverse faults that made it formally resemble tessera terrain (tt). The obvious difference between units tt and ttt is the recognizable morphology of precursor terrain of unit ttt. Fracture belts are probably ancient rift zones [3]. Rifted terrain (rt), as in other regions of Venus, is so saturated with faults that according to the recommendation of [1, 5] it should be mapped as a structural unit.

The missing link? Testing a schema account of unitization.

PubMed

Tibon, Roni; Greve, Andrea; Henson, Richard

2018-05-09

Unitization refers to the creation of a new unit from previously distinct items. The concept of unitization has been used to explain how novel pairings between items can be remembered without requiring recollection, by virtue of new, item-like representations that enable familiarity-based retrieval. We tested an alternative account of unitization - a schema account - which suggests that associations between items can be rapidly assimilated into a schema. We used a common operationalization of "unitization" as the difference between two unrelated words being linked by a definition, relative to two words being linked by a sentence, during an initial study phase. During the following relearning phase, a studied word was re-paired with a new word, either related or unrelated to the original associate from study. In a final test phase, memory for the relearned associations was tested. We hypothesized that, if unitized representations act like schemas, then we would observe some generalization to related words, such that memory would be better in the definition than sentence condition for related words, but not for unrelated words. Contrary to the schema hypothesis, evidence favored the null hypothesis of no difference between definition and sentence conditions for related words (Experiment 1), even when each cue was associated with multiple associates, indicating that the associations can be generalized (Experiment 2), or when the schematic information was explicitly re-activated during Relearning (Experiment 3). These results suggest that unitized associations do not generalize to accommodate new information, and therefore provide evidence against the schema account.

Longitudinal Comparison of the Speech and Language Performance of United States-Born and Internationally Adopted Toddlers with Cleft Lip and Palate: A Pilot Study.

PubMed

Scherer, Nancy J; Baker, Shauna; Kaiser, Ann; Frey, Jennifer R

2018-01-01

Objective This study compares the early speech and language development of children with cleft palate with or without cleft lip who were adopted internationally with children born in the United States. Design Prospective longitudinal description of early speech and language development between 18 and 36 months of age. Participants This study compares four children (age range = 19 to 38 months) with cleft palate with or without cleft lip who were adopted internationally with four children (age range = 19 to 38 months) with cleft palate with or without cleft lip who were born in the United States, matched for age, gender, and cleft type across three time points over 10 to 12 months. Main Outcome Measures Children's speech-language skills were analyzed using standardized tests, parent surveys, language samples, and single-word phonological assessments to determine differences between the groups. Results The mean scores for the children in the internationally adopted group were lower than the group born in the United States at all three time points for expressive language and speech sound production measures. Examination of matched pairs demonstrated observable differences for two of the four pairs. No differences were observed in cognitive performance and receptive language measures. Conclusions The results suggest a cumulative effect of later palate repair and/or a variety of health and environmental factors associated with their early circumstances that persist to age 3 years. Early intervention to address the trajectory of speech and language is warranted. Given the findings from this small pilot study, a larger study of the long-term speech and language development of children who are internationally adopted and have cleft palate with or without cleft lip is recommended.

Caring and technology in an intensive care unit: an ethnographic study.

PubMed

Price, Ann M

2013-11-01

Critical care practice is a mixture of caring and technological activities. There is debate about whether the balance between these two elements is correct and a concern that critical care units can dehumanize the patient. This research sought to examine aspects that might affect this balance between the caring and technology within the critical care setting. What aspects affect registered health care professionals' ability to care for patients within the technological environment of a critical care unit? A qualitative approach using ethnography was utilized as this methodology focuses on the cultural elements within a situation. Data collection involved participant observation, document review and semi-structured interviews to triangulate methods as this aids rigour for this approach. A purposeful sample to examine registered health care professionals currently working within the study area was used. A total of 19 participants took part in the study; 8 nurses were observed and 16 health care professionals were interviewed, including nurses, a doctor and 2 physiotherapists. The study took place on a District General Hospital intensive care unit and ethical approval was gained. An overarching theme of the 'Crafting process' was developed with sub themes of 'vigilance', 'focus of attention, 'being present' and 'expectations' with the ultimate goal of achieving the best interests for the individual patient. The areas reflected in this study coincide with the care, compassion, competency, commitment, communication and courage ideas detailed by the Department of Health (2012). Thus, further research to detail more specifically how these areas are measured within critical care may be useful. Caring is a complex concept that is difficult to outline but this article can inform practitioners about the aspects that help and hinder caring in the technical setting to inform training. © 2013 British Association of Critical Care Nurses.

Organisational strategies and midwives' readiness to provide care for out of hospital births: an analysis from the birthplace organisational case studies.

PubMed

McCourt, Christine; Rayment, Juliet; Rance, Susanna; Sandall, Jane

2012-10-01

the objective of the Birthplace in England Case Studies was to explore the organisational and professional issues that may impact on the quality and safety of labour and birth care in different birth settings: Home, Freestanding Midwifery Unit, Alongside Midwifery Unit or Obstetric Unit. This analysis examines the factors affecting the readiness of community midwives to provide women with choice of out of hospital birth, using the findings from the Birthplace in England Case Studies. organisational ethnographic case studies, including interviews with professionals, key stakeholders, women and partners, observations of service processes and document review. a maximum variation sample of four maternity services in terms of configuration, region and population characteristics. All were selected from the Birthplace cohort study sample as services scoring 'best' or 'better' performing in the Health Care Commission survey of maternity services (HCC 2008). professionals and stakeholders (n=86), women (64), partners (6), plus 50 observations and 200 service documents. each service experienced challenges in providing an integrated service to support choice of place of birth. Deployment of community midwives was a particular concern. Community midwives and managers expressed lack of confidence in availability to cover home birth care in particular, with the exception of caseload midwifery and a 'hub and spoke' model of care. Community midwives and women's interviews indicated that many lacked home birth experience and confidence. Those in midwifery units expressed higher levels of support and confidence. maternity services need to consider and develop models for provision of a more integrated model of staffing across hospital and community boundaries. Copyright © 2012 Elsevier Ltd. All rights reserved.

Ethnomathematics study: uncovering units of length, area, and volume in Kampung Naga Society

NASA Astrophysics Data System (ADS)

Septianawati, T.; Turmudi; Puspita, E.

2017-02-01

During this time, mathematics is considered as something neutral and not associated with culture. It can be seen from mathematics learning in the school which adopt many of foreign mathematics learning are considered more advanced (western). In fact, Indonesia is a rich country in cultural diversity. In the cultural activities, there are mathematical ideas that were considered a important thing in the mathematics learning. A study that examines the idea or mathematical practices in a variety of cultural activities are known as ethnomathematics. In Indonesia, there are some ethnic maintain their ancestral traditions, one of them is Kampung Naga. Therefore, this study was conducted in Kampung Naga. This study aims to uncover units of length, area, and volume used by Kampung Naga society. This study used a qualitative approach and ethnography methods. In this research, data collection is done through the principles of ethnography such as observation, interviews, documentation, and field notes. The results of this study are units of length, area, and volume used by Kampung Naga society and its conversion into standard units. This research is expected to give information to the public that mathematics has a relationship with culture and become recommendation to mathematics curriculum in Indonesia.

A comparative analysis of child passenger restraint use in China and the United States.

PubMed

Yang, Jing-Zhen; Li, Li-Ping; Wu, Hong-Qian; McGehee, Daniel; Peek-Asa, Corinne

2017-12-01

Few published studies have examined child passenger safety practices across countries. This study compared the prevalence and associated factors of child passenger restraint use among children, aged 0 to 17 in the state of Iowa in the United States, and the city of Shantou in China. Child restraint use observations were conducted in Iowa and in Shantou in 2012, respectively, among child passengers. Observations in Iowa were conducted at randomly selected gas stations, while in Shantou observations were completed at randomly selected schools or medical clinics. Research observers approached the driver, observed restraint use, and collected brief survey data. A total of 3049 children from Iowa and 3333 children aged 0 to 17 years from Shantou were observed. For children aged 0 to 3 years, only 0.1% were compliantly restrained in Shantou as compared to 95.9% in Iowa. The proportion of children who were compliantly restrained in Shantou increased with age, but generally decreased with age in Iowa. In Shantou, 36.0% of children aged 0 to 3 were sitting in the front seat as compared to only 1.7% of children of the same age in Iowa. Driver seat belt use was significantly associated with child restraint in both Iowa and Shantou; the association was stronger in Iowa than Shantou for all age groups. A significantly higher prevalence of children who were not appropriately restrained was observed in Shantou than in Iowa. Our findings support the need of mandatory child safety restraint use legislation in China.

The intelligence of observation: improving high school students' spatial ability by means of intervention unit

NASA Astrophysics Data System (ADS)

Patkin, Dorit; Dayan, Ester

2013-03-01

This case study of one class versus a control group focused on the impact of an intervention unit, which is not part of the regular curriculum, on the improvement of spatial ability of high school students (forty-six 12th-graders, aged 17-18, both boys and girls) in general as well as from a gender perspective. The study explored three sub-abilities: mental rotation (MR), spatial visualization (VS) and spatial orientation (SO). Findings indicated that the spatial orientation of the experimental group students had considerably improved. The findings also illustrated a significant gender-based advantage in favour of the boys in some of the spatial abilities even before the implementation of the intervention unit. The hypothesis relating to the reduction of the gender differences was not corroborated.

Long-Term Quality Control Program Plan for Cord Blood Banks in Korea: A Pilot Study for Cryopreservation Stability.

PubMed

Seo, Soo Hyun; Shin, Sue; Roh, Eun Youn; Song, Eun Young; Oh, Sohee; Kim, Byoung Jae; Yoon, Jong Hyun

2017-03-01

Maintaining the quality of cryopreserved cord blood is crucial. In this pilot study, we describe the results of the internal quality control program for a cord blood bank thus far. Donated cord blood units unsuitable for transplantation were selected for internal quality control once a month. One unit of cord blood, aliquoted into 21 capillaries, was cryopreserved and thawed annually to analyze the total nucleated cell count, CD34⁺ cell count, cell viability test, and colony-forming units assay. No significant differences in the variables (total nucleated cell count, cell viability, CD34⁺ cell count) were observed between samples cryopreserved for one and two years. Upon comparing the variables before cryopreservation and post thawing with the capillaries of one year of storage, cell viability and CD34⁺ cell counts decreased significantly. The use of cord blood samples in capillaries, which can be easily stored for a long period, was similar to the methods used for testing segments attached to the cord blood unit. The results of this study may be useful for determining the period during which the quality of cryopreserved cord blood units used for transplantation is maintained.

A cost-benefit analysis of demand for food.

PubMed Central

Hursh, S R; Raslear, T G; Shurtleff, D; Bauman, R; Simmons, L

1988-01-01

Laboratory studies of consumer demand theory require assumptions regarding the definition of price in the absence of a medium of exchange (money). In this study we test the proposition that the fundamental dimension of price is a cost-benefit ratio expressed as the effort expended per unit of food value consumed. Using rats as subjects, we tested the generality of this "unit price" concept by varying four dimensions of price: fixed-ratio schedule, number of food pellets per fixed-ratio completion, probability of reinforcement, and response lever weight or effort. Two levels of the last three factors were combined in a 2 x 2 x 2 design giving eight groups. Each group was studied under a series of six FR schedules. Using the nominal values of all factors to determine unit price, we found that grams of food consumed plotted as a function of unit price followed a single demand curve. Similarly, total work output (responses x effort) conformed to a single function when plotted in terms of unit price. These observations provided a template for interpreting the effects of biological factors, such as brain lesions or drugs, that might alter the cost-benefit ratio. PMID:3209958

Long-Term Quality Control Program Plan for Cord Blood Banks in Korea: A Pilot Study for Cryopreservation Stability

PubMed Central

Seo, Soo Hyun; Shin, Sue; Roh, Eun Youn; Song, Eun Young; Oh, Sohee; Kim, Byoung Jae

2017-01-01

Background Maintaining the quality of cryopreserved cord blood is crucial. In this pilot study, we describe the results of the internal quality control program for a cord blood bank thus far. Methods Donated cord blood units unsuitable for transplantation were selected for internal quality control once a month. One unit of cord blood, aliquoted into 21 capillaries, was cryopreserved and thawed annually to analyze the total nucleated cell count, CD34+ cell count, cell viability test, and colony-forming units assay. Results No significant differences in the variables (total nucleated cell count, cell viability, CD34+ cell count) were observed between samples cryopreserved for one and two years. Upon comparing the variables before cryopreservation and post thawing with the capillaries of one year of storage, cell viability and CD34+ cell counts decreased significantly. The use of cord blood samples in capillaries, which can be easily stored for a long period, was similar to the methods used for testing segments attached to the cord blood unit. Conclusions The results of this study may be useful for determining the period during which the quality of cryopreserved cord blood units used for transplantation is maintained. PMID:28028998

Middle School Hypermedia Composition: A Qualitative Case Study

ERIC Educational Resources Information Center

Garthwait, Abigail

2007-01-01

During a six-month naturalistic study, the author conducted an ethnographic examination of a seventh grade hypermedia unit. Beginning with the global question, "In what ways are computers used to support the education of middle school students?" the researcher coded and analyzed observations, interviews and projects. Three themes emerged: the…

Effects of suspended sulfates on human health.

PubMed Central

French, J G

1975-01-01

Recent evidence from epidemiologic studies conducted in several areas of the United States shows an association of excess risk of asthmatic attacks with elevated levels of suspended sulfates within specific temperature ranges. These findings are disscussed in the context of experimental animal studies which tend to support these observations. PMID:1157797

Coronary Heart Disease Knowledge and Risk Factors among Tri-Ethnic College Students

ERIC Educational Resources Information Center

Koutoubi, Samer; Huffman, Fatma G.; Ciccazzo, Michele W.; Himburg, Susan P.; Johnson, Paulette

2005-01-01

Objectives: Coronary heart disease (CHD) is the leading cause of death in the United States and Europe. This study identified and compared nutritional knowledge associated with CHD risk factors among tri-ethnic college students. Design: A quantitative, cross-sectional, observational study using questionnaires. Setting: University laboratory.…

Effectiveness of Using Games in Tertiary-Level Mathematics Classrooms

ERIC Educational Resources Information Center

Afari, Ernest; Aldridge, Jill M.; Fraser, Barry J.

2012-01-01

The primary focus of this study was to investigate the effectiveness of games when used in tertiary-level mathematics classes in the United Arab Emirates. Our study incorporated a mixed-method approach that involved surveys (to assess students' perceptions of the learning environment and attitudes towards mathematics), interviews, observations of…

Observing Black History in Elementary Schools.

ERIC Educational Resources Information Center

Wilson, Herbert A.

Five lesson plans that were prepared for Black History Month can be used to teach purposeful, interesting, and reasonably balanced black history to students in grades 3-6. Objectives for preparing black studies units are to: (1) make reasonably balanced presentations through social studies, language arts, music, and other appropriate subject…

Profiles of Educational Quality in First Grade

ERIC Educational Resources Information Center

Stuhlman, Megan W.; Pianta, Robert C.

2009-01-01

In the present study, we present analyzed profiles of observed classroom experiences in terms of emotional and instructional dimensions of quality. Over 800 first-grade classrooms across the United States were included, selected by virtue of having a student participating in the National Institute of Child Health and Human Development's Study of…

Well-construction and hydrogeologic data for observation wells in the vicinity of a low-level radioactive-waste disposal site near Sheffield, Illinois

USGS Publications Warehouse

Mansue, Lawrence J.; Mills, Patrick C.

1991-01-01

The U.S. Geological Survey conducted hydrogeologic studies at the low-level radioactive-waste disposal site near Sheffield, Illinois, from 1976 through 1987. During that period, 108 observation wells were installed in the vicinity of the disposal site in glacial and post-glacial deposits of Quaternary age and bedrock of Pennsylvanian age. Data in this report include the location of each well, the date each well was drilled, the geologic units penetrated by each well, the physical measurements of each well, the elevations of the top (measuring point) of each well and geologic-unit contacts at each well, and the highest and lowest recorded water levels in each well.

Fungicides affect the production of extracellular mucilaginous material (ECMM) and the peripheral growth unit (PGU) in two wood-rotting basidiomycetes.

PubMed

Vesentini, Damiano; Dickinson, David J; Murphy, Richard J

2006-10-01

This study shows the effect of two fungicides on the production of extracellular mucilaginous material (ECMM) in two wood-rotting basidiomycetes and identifies a mechanism that might be responsible for the variation observed. Increasing concentrations of the fungicides copper sulphate (CuSO4) and cyproconazole in the growth medium increased the proportion of ECMM in the biomass of Trametes versicolor and Gloeophyllum trabeum. These fungicides also caused a reduction in the length of the peripheral growth unit (PGU) of the mycelia leading to a more highly branched morphology and a larger number of hyphal tips, the sites for active secretion of ECMM, per unit length of mycelium. It is postulated that both in T. versicolor and G. trabeum this change in growth leads to the increases observed in the proportion of ECMM in the total biomass. The implications of these results are discussed with a view to a potential protective role of ECMM against stress and toxic environments.

What You See is What You Get: A Summary of Observations in Over 1000 Elementary & Secondary Classrooms. A Study of Schooling in the United States. Technical Report Series, No. 29.

ERIC Educational Resources Information Center

Sirotnik, Kenneth A.

Data from observations of 129 elementary, 362 junior, and 525 high school classes were analyzed to raise questions about classroom environment and classroom practices. Results gathered from four instruments are discussed: (1) physical environment inventory, which recorded classroom architectural arrangement, seating and grouping patterns,…

The effect of topography, vegetation, and weather on cattle distribution at the San Joaquin Experimental Range, California

Treesearch

Norman R. Harris; Douglas E. Johnson; Melvin R. George; Neil K. McDougald

2002-01-01

In this study livestock distribution on the landscape was mapped during two seasons, summer and winter, for two years to determine where livestock congregate and to model factors that influence livestock distribution. Two small herds of cows were observed in separate range units on the San Joaquin Experimental Range for a total of twenty-four 24-hour observation...

Beginning an action research project to investigate the feasibility of a midwife-led normal birthing unit in China.

PubMed

Mander, Rosemary; Cheung, Ngai Fen; Wang, Xiaoli; Fu, Wei; Zhu, Junghong

2010-02-01

To explore issues arising during preliminary stages of a research project in order to consider the feasibility of a midwife-led normal birthing unit in mainland China. Midwife-led normal birthing units, as a route to ensuring normality, have become a feature of western maternity care, but are unknown in China. Action research, using a qualitative descriptive approach, was performed. Data were collected at meetings, by non-participant observation and by face-to-face semi-structured interviews. Observation was undertaken in the midwife-led normal birthing unit and a standard care setting. Data analysis was by thematic analysis using constant comparison techniques. In the labour ward of a large general hospital in a major city, stakeholders included midwifery staff, managers, university staff and researchers. Childbearing women proved keen to use this service, but were unable to participate in the planning. The midwife-led normal birthing unit sought to provide one-to-one care in labour and support by a birth companion. Routine interventions were to be avoided. The midwives in the midwife-led normal birthing unit created a more suitable environment for supportive care. The midwives demonstrated high-quality communication skills. The woman's choice of position/mobility was limited. Difficulties with staffing were identified. The preliminary findings suggest that continuation of the project is feasible. The woman's role demonstrates passivity. The perception of staff shortage has serious implications. This action research project suggests that a study of a midwife-led normal birthing unit in China is feasible, with some attention to staffing issues.

Primary CNS germ cell tumors in Japan and the United States: an analysis of 4 tumor registries

PubMed Central

McCarthy, Bridget J.; Shibui, Soichiro; Kayama, Takamasa; Miyaoka, Etsuo; Narita, Yoshitaka; Murakami, Michiko; Matsuda, Ayako; Matsuda, Tomohiro; Sobue, Tomotaka; Palis, Bryan E.; Dolecek, Therese A.; Kruchko, Carol; Engelhard, Herbert H.; Villano, J. Lee

2012-01-01

Intracranial germ cell tumors (GCTs) are relatively rare. Their incidence has been considered to be higher in East Asia than in the United States. This study estimates the incidence of CNS GCTs in Japan and the United States, investigates gender discrepancies in each country, and describes treatment outcomes. Data on primary CNS GCTs from 4 databases were utilized: population-based malignant incidence data from (1) the Japan Cancer Surveillance Research Group (2004–2006; 14 registries), malignant and nonmalignant incidence data from (2) the Surveillance, Epidemiology, and End Results Program (2004–2008; 17 registries), and hospital-based observed survival data from (3) the Brain Tumor Registry of Japan (1984–2000) and (4) the US National Cancer Data Base (1990–2003). Incidence rates per 100 000 for malignant GCTs were not statistically significantly different between Japan (males = 0.143, females = 0.046) and the United States (males = 0.118, females = 0.030). The malignant incidence-rate ratio was higher for pineal GCTs versus nonpineal (ie, the rest of the brain) GCTs in Japan (11.5:1 vs 1.9:1, respectively) and the United States (16.0:1 vs 1.7:1, respectively). In general, 5-year survival estimates were high: over 75% for all GCTs, and over 81% for germinomas, regardless of the type of treatment in either Japan or the United States. The incidence of primary GCTs is similar between Japan and the United States and has the same gender-based patterns by location. High rates of survival were observed in both countries. PMID:22869621

Implementation of DICOM Modality Worklist at Patient Registration Systems in Radiology Unit

NASA Astrophysics Data System (ADS)

Kartawiguna, Daniel; Georgiana, Vina

2014-03-01

Currently, the information and communication technology is developing very rapidly. A lot of hospitals have digital radiodiagnostic modality that supports the DICOM protocol. However, the implementation of integrated radiology information system with medical imaging equipment is still very limited until now, especially in developing countries like Indonesia. One of the obstacles is high prices for radiology information system. Whereas the radiology information systems can be widely used by radiologists to provide many benefit for patient, hospitals, and the doctors themselves. This study aims to develop a system that integrates the radiology administration information system with radiodiagnostic imaging modalities. Such a system would give some benefits that the information obtained is more accurate, timely, relevant, and accelerate the workflow of healthcare workers. This research used direct observation method to some hospital radiology unit. Data was collected through interviews, questionnaires, and surveys directly to some of the hospital's radiology department in Jakarta, and supported by the literature study. Based on the observations, the prototype of integrated patient registration systems in radiology unit is developed and interfaced to imaging equipment radiodiagnostic using standard DICOM communications. The prototype of radiology patient registration system is tested with the modality MRI and CT scan.

Development of a United States - Mexico emissions inventory for the Big Bend Regional Aerosol and Visibility Observational (BRAVO) Study

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

Hampden Kuhns; Eladio M. Knipping; Jeffrey M. Vukovich,

2005-05-01

The Big Bend Regional Aerosol and Visibility Observational (BRAVO) Study investigated the sources of haze at Big Bend National Park in southwest Texas. The modeling domain includes most of the continental United States and Mexico. The BRAVO emissions inventory was constructed from the 1999 National Emission Inventory for the United States, modified to include finer-resolution data for Texas and 13 U.S. states in close proximity. The inventory includes emissions for CO, nitrogen oxides, sulfur dioxide, volatile organic compounds (VOCs), ammonia, particulate matter (PM) {lt}10 {mu}m in aerodynamic diameter, and PM {lt}2.5 {mu}m in aerodynamic diameter. The SMOKE modeling system wasmore » used to generate gridded emissions fields for use with the Regional Modeling System for Aerosols and Deposition (REMSAD) and the Community Multiscale Air Quality model modified with the Model of Aerosol Dynamics, Reaction, Ionization and Dissolution (CMAQ-MADRID). The compilation of the inventory, supporting model input data, and issues encountered during the development of the inventory are documented. A comparison of the BRAVO emissions inventory for Mexico with other emerging Mexican emission inventories illustrates their uncertainty. 65 refs., 4 figs., 9 tabs.« less

Vibrational spectroscopic study of poldervaartite CaCa[SiO3(OH)(OH)].

PubMed

Frost, Ray L; López, Andrés; Scholz, Ricardo; Lima, Rosa Malena Fernandes

2015-02-25

We have studied the mineral poldervaartite CaCa[SiO3(OH)(OH)] which forms a series with its manganese analogue olmiite CaMn[SiO3(OH)](OH) using a range of techniques including scanning electron microscopy, thermogravimetric analysis, Raman and infrared spectroscopy. Chemical analysis shows the mineral is reasonably pure and contains only calcium and manganese with low amounts of Al and F. Thermogravimetric analysis proves the mineral decomposes at 485°C with a mass loss of 7.6% compared with the theoretical mass loss of 7.7%. A strong Raman band at 852 cm(-1) is assigned to the SiO stretching vibration of the SiO3(OH) units. Two Raman bands at 914 and 953 cm(-1) are attributed to the antisymmetric vibrations. Intense prominent peaks observed at 3487, 3502, 3509, 3521 and 3547 cm(-1) are assigned to the OH stretching vibration of the SiO3(OH) units. The observation of multiple OH bands supports the concept of the non-equivalence of the OH units. Vibrational spectroscopy enables a detailed assessment of the molecular structure of poldervaartite. Copyright © 2014 Elsevier B.V. All rights reserved.

Does neonatal pain management in intensive care units differ between night and day? An observational study

PubMed Central

Guedj, Romain; Danan, Claude; Daoud, Patrick; Zupan, Véronique; Renolleau, Sylvain; Zana, Elodie; Aizenfisz, Sophie; Lapillonne, Alexandre; de Saint Blanquat, Laure; Granier, Michèle; Durand, Philippe; Castela, Florence; Coursol, Anne; Hubert, Philippe; Cimerman, Patricia; Anand, K J S; Khoshnood, Babak; Carbajal, Ricardo

2014-01-01

Objective To determine whether analgesic use for painful procedures performed in neonates in the neonatal intensive care unit (NICU) differs during nights and days and during each of the 6 h period of the day. Design Conducted as part of the prospective observational Epidemiology of Painful Procedures in Neonates study which was designed to collect in real time and around-the-clock bedside data on all painful or stressful procedures. Setting 13 NICUs and paediatric intensive care units in the Paris Region, France. Participants All 430 neonates admitted to the participating units during a 6-week period between September 2005 and January 2006. Data collection During the first 14 days of admission, data were collected on all painful procedures and analgesic therapy. The five most frequent procedures representing 38 012 of all 42 413 (90%) painful procedures were analysed. Intervention Observational study. Main outcome assessment We compared the use of specific analgesic for procedures performed during each of the 6 h period of a day: morning (7:00 to 12:59), afternoon, early night and late night and during daytime (morning+afternoon) and night-time (early night+late night). Results 7724 of 38 012 (20.3%) painful procedures were carried out with a specific analgesic treatment. For morning, afternoon, early night and late night, respectively, the use of analgesic was 25.8%, 18.9%, 18.3% and 18%. The relative reduction of analgesia was 18.3%, p<0.01, between daytime and night-time and 28.8%, p<0.001, between morning and the rest of the day. Parental presence, nurses on 8 h shifts and written protocols for analgesia were associated with a decrease in this difference. Conclusions The substantial differences in the use of analgesics around-the-clock may be questioned on quality of care grounds. PMID:24556241

Trends and demographics in hip arthroscopy in the United States.

PubMed

Montgomery, Scott R; Ngo, Stephanie S; Hobson, Taylor; Nguyen, Shawn; Alluri, Ram; Wang, Jeffrey C; Hame, Sharon L

2013-04-01

The purpose of this study was to evaluate the trends and report on the demographics of patients undergoing hip arthroscopy in the United States. Patients who underwent hip arthroscopy from 2004 to 2009 were identified by searching Current Procedural Terminology codes in the PearlDiver Patient Records Database (PearlDiver Technologies, Fort Wayne, IN), a national database of orthopaedic insurance records. The year of procedure, age, gender, and region of the United States were recorded for each patient. Results were reported for each variable as the incidence of procedures identified per 10,000 patients searched in the database. In total, 3,447 cases of hip arthroscopy were identified between 2004 and 2009. The incidence of procedures increased significantly over the study period, from 1.20 cases per 10,000 patients in 2004 to 5.58 in 2009 (P < .001). Hip arthroscopy was performed most commonly in patients aged 20 to 39 years (P < .05), with an incidence of 4.45 cases in each age group. In contrast to other common arthroscopic procedures searched, no gender differences were observed, with a male-to-female ratio of 0.89 (P = .18). The greatest incidence of hip arthroscopy was observed in the Western region with an incidence of 5.24 cases identified compared with 2.94, 2.70, and 2.56 in the Northeast, Midwest, and South, respectively (P < .001). A 365% increase in the rate of hip arthroscopy was observed in the examined cohort of patients between 2004 and 2009. The majority of cases were performed in patients aged 20 to 39 years, with no difference in gender. The Western region of the United States was found to have a higher incidence of hip arthroscopy compared with the Midwest, South, and Northeast. Level IV, cross-sectional study. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Evaluation of NASA's MERRA Precipitation Product in Reproducing the Observed Trend and Distribution of Extreme Precipitation Events in the United States

NASA Technical Reports Server (NTRS)

Ashouri, Hamed; Sorooshian, Soroosh; Hsu, Kuo-Lin; Bosilovich, Michael G.; Lee, Jaechoul; Wehner, Michael F.; Collow, Allison

2016-01-01

This study evaluates the performance of NASA's Modern-Era Retrospective Analysis for Research and Applications (MERRA) precipitation product in reproducing the trend and distribution of extreme precipitation events. Utilizing the extreme value theory, time-invariant and time-variant extreme value distributions are developed to model the trends and changes in the patterns of extreme precipitation events over the contiguous United States during 1979-2010. The Climate Prediction Center (CPC) U.S.Unified gridded observation data are used as the observational dataset. The CPC analysis shows that the eastern and western parts of the United States are experiencing positive and negative trends in annual maxima, respectively. The continental-scale patterns of change found in MERRA seem to reasonably mirror the observed patterns of change found in CPC. This is not previously expected, given the difficulty in constraining precipitation in reanalysis products. MERRA tends to overestimate the frequency at which the 99th percentile of precipitation is exceeded because this threshold tends to be lower in MERRA, making it easier to be exceeded. This feature is dominant during the summer months. MERRA tends to reproduce spatial patterns of the scale and location parameters of the generalized extreme value and generalized Pareto distributions. However, MERRA underestimates these parameters, particularly over the Gulf Coast states, leading to lower magnitudes in extreme precipitation events. Two issues in MERRA are identified: 1) MERRA shows a spurious negative trend in Nebraska and Kansas, which is most likely related to the changes in the satellite observing system over time that has apparently affected the water cycle in the central United States, and 2) the patterns of positive trend over the Gulf Coast states and along the East Coast seem to be correlated with the tropical cyclones in these regions. The analysis of the trends in the seasonal precipitation extremes indicates that the hurricane and winter seasons are contributing the most to these trend patterns in the southeastern United States. In addition, the increasing annual trend simulated by MERRA in the Gulf Coast region is due to an incorrect trend in winter precipitation extremes.

Evaluation of NASA’s MERRA Precipitation Product in Reproducing the Observed Trend and Distribution of Extreme Precipitation Events in the United States

DOE PAGES

Ashouri, Hamed; Sorooshian, Soroosh; Hsu, Kuo-Lin; ...

2016-02-03

This study evaluates the performance of NASA's Modern-Era Retrospective Analysis for Research and Applications (MERRA) precipitation product in reproducing the trend and distribution of extreme precipitation events. Utilizing the extreme value theory, time-invariant and time-variant extreme value distributions are developed to model the trends and changes in the patterns of extreme precipitation events over the contiguous United States during 1979-2010. The Climate Prediction Center (CPC)U.S.Unified gridded observation data are used as the observational dataset. The CPC analysis shows that the eastern and western parts of the United States are experiencing positive and negative trends in annual maxima, respectively. The continental-scalemore » patterns of change found in MERRA seem to reasonably mirror the observed patterns of change found in CPC. This is not previously expected, given the difficulty in constraining precipitation in reanalysis products. MERRA tends to overestimate the frequency at which the 99th percentile of precipitation is exceeded because this threshold tends to be lower in MERRA, making it easier to be exceeded. This feature is dominant during the summer months. MERRAtends to reproduce spatial patterns of the scale and location parameters of the generalized extreme value and generalized Pareto distributions. However, MERRA underestimates these parameters, particularly over the Gulf Coast states, leading to lower magnitudes in extreme precipitation events. Two issues in MERRA are identified: 1)MERRAshows a spurious negative trend in Nebraska andKansas, which ismost likely related to the changes in the satellite observing system over time that has apparently affected the water cycle in the central United States, and 2) the patterns of positive trend over theGulf Coast states and along the East Coast seem to be correlated with the tropical cyclones in these regions. The analysis of the trends in the seasonal precipitation extremes indicates that the hurricane and winter seasons are contributing the most to these trend patterns in the southeastern United States. The increasing annual trend simulated by MERRA in the Gulf Coast region is due to an incorrect trend in winter precipitation extremes.« less

Observations of resistance through minimum inhibitory concentrations trends for respiratory specimens of commonly isolated organisms.

PubMed

Gillard, Christopher J; Al-Dahir, Sara; Brakta, Fatima

2016-03-01

The objective of this study was to determine minimum inhibitory concentration (MIC) trends among common bacterial organisms found in respiratory isolates in the trauma intensive care unit setting. In this retrospective observational study, MIC data was reviewed over a three year period from January 2009 to December 2011 for the three most frequently identified organisms isolated from respiratory specimens in a trauma intensive care unit along with corresponding hospital data. The most frequently isolated bacterial species identified were Staphylococcus aureus (229 isolates), Pseudomonas aeruginosa (129 isolates), and Acinetobacter species (87 isolates) in the analysis within our institution from 2009-2011. There was considerable variability among the MIC trends for the analyzed organisms. For Pseudomonas isolates, observed sensitivities were as high as 100% for antibiotics ciprofloxacin and imipenem in 2009, but decreased over the next two years in 2010 and 2011. There was considerable variability among the MIC trends for Acinetobacter over the three year period for the antibiotics tested. The MIC data for most Staphylococcus aureus isolates over the three years were sensitive to vancomycin with little change in the observed MIC data. The data reported is observational and indicates the need for future studies to establish a valid relationship of the MIC data over time in our institution particularly among our gram negative organisms, to monitor patterns of antimicrobial resistance. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Longitudinal Associations Between Observed and Perceived Neighborhood Food Availability and Body Mass Index in a Multiethnic Urban Sample.

PubMed

Zenk, Shannon N; Mentz, Graciela; Schulz, Amy J; Johnson-Lawrence, Vicki; Gaines, Causandra R

2017-02-01

Blacks, Hispanics, and women of lower socioeconomic status tend to have a higher risk of obesity. Numerous studies over the past decade examined the role of the neighborhood food environment in body weight. However, few were longitudinal. This longitudinal study examined whether multiple measures of neighborhood food availability were associated with body mass index (BMI) in a predominately Black and Hispanic adult sample living in low- to moderate-income urban neighborhoods. This longitudinal study used two waves of data (2002, 2008), including interviewer-measured height and weight, from a community survey of adults ( n = 219). In both 2002 and 2008, multiple measures characterized neighborhood food availability: GIS-derived availability of retail food outlets (large grocery store, small grocery store, convenience store, liquor stores), observed fruit and vegetable availability (count of stores selling 10 or more fresh fruit or vegetable varieties), and perceived fruit and vegetable access. Random intercept models estimated multivariable associations, controlling for individual-level demographics and neighborhood median household income. Small grocery store availability was associated with 1.22-unit increase in BMI ( p = .047), while each unit increase in perceived fruit and vegetable access was associated with a 0.69-unit decrease in BMI ( p = .055). BMI was not associated with large grocery store, convenience store, or liquor store availability, or with observed fruit and vegetable availability. Findings suggest that improving the neighborhood food environment, particularly at small grocery stores, may help urban residents living in low- to moderate-income neighborhoods achieve healthier body weights over time.

Psychogeriatric inpatient unit design: a literature review.

PubMed

Dobrohotoff, John T; Llewellyn-Jones, Robert H

2011-03-01

In many parts of the world the provision of psychogeriatric inpatient units (PGUs) remains limited. More units will be required over coming decades given rapid population aging. Medline (1950-2010), psycINFO (1806-2009), EMBASE (1980-2009) and CINAHL (1982-2009) were searched for papers about PGU design. Selected non-peer reviewed literature such as government reports and unpublished academic dissertations were also reviewed. Data were also obtained from the literature related to general adult psychiatry inpatient units where there was limited information from studies of units designed for older people. Over 200 papers were reviewed and 130 were included. There are few good quality studies to guide the design of acute PGUs and much of the existing literature is based on opinion and anecdote or, at best, based on observational studies. Randomized controlled studies comparing different designs and assessing outcomes are virtually non-existent. Several studies have identified violence and trauma resulting from hospitalization as significant problems with current acute PGU care. Despite its limitations the available literature provides useful guidance on how PGU design can optimize patient and staff safety and improve clinical outcomes. There are significant problems with current acute PGUs, and patient mix on existing units is an important issue. Future research should examine patient and staff perceptions of different PGU ward environments, the relationship between ward design and clinical outcomes, the effects of segregating patients with challenging behaviors in dementia and the benefits or otherwise of gender segregation.

The Sexual Harassment-Suicide Connection in the U.S. Military: Contextual Effects of Hostile Work Environment and Trusted Unit Leaders.

PubMed

Griffith, James

2017-10-03

Sexual harassment has been associated with suicidal behaviors, and with the rise in suicides in the U.S. military, sexual harassment's role in suicide has been of growing interest. Lacking are studies that examine group- or unit-level variables in the relationship of sexual harassment to suicidal behaviors (thoughts, plans, and attempts). In this study, survey data from soldiers (12,567 soldiers in 180 company-sized units) who completed the Unit Risk Inventory administered during calendar year 2010 were analyzed using hierarchical linear modeling. At the individual level, sexual harassment was associated with a fivefold increase for risk of suicide. Reporting that leaders could be trusted was associated with a decreased suicide risk by about one-third. There was no statistically significant interaction between sexual harassment and trusted leaders in predicting the suicidal behaviors. At the group level, units or companies having higher levels of sexual harassment also had soldiers three times more at risk for suicide. A cross-leveling effect was also observed: Among units having higher levels of sexual harassment, the negative correlation (buffering effect of unit leaders on suicidal behaviors) was diminished. Implications of findings for preventing sexual harassment and suicide risk are discussed. © 2017 The American Association of Suicidology.

For assessment of changes in intraoperative red blood cell transfusion practices over time, the pooled incidence of transfusion correlates highly with total units transfused.

PubMed

Dexter, Franklin; Epstein, Richard H

2017-06-01

Multiple studies nationwide and at single hospitals have examined changes over time in the incidence of perioperative red blood cell (RBC) transfusion. However, the cost of RBC transfusions is related to the number of RBC units transfused, not to the incidence. We evaluate whether the readily available incidence of RBC transfusion can be used as a valid surrogate measure. Observational retrospective study. One tertiary, academic hospital. 394,789 cases of 1885 procedures over N=42 quarters of the year. None. Incidence and number of RBC units transfused intraoperatively. The number of RBC units transfused per case did not follow a Poisson distribution, confirming that the number of units and incidence of transfusion are not interchangeable for analyzing decisions by case. However, with all cases of each quarter combined, the Spearman correlation was 0.98±0.01 between each quarter's incidence of RBC transfusion and mean RBC units transfused per case (P<0.0001). For assessment of changes in intraoperative RBC transfusion practices over years, it is sufficient to analyze the pooled incidence of transfusion, rather than to calculate the number of units transfused. Copyright © 2017 Elsevier Inc. All rights reserved.

Spatial relationships between alcohol-related road crashes and retail alcohol availability.

PubMed

Morrison, Christopher; Ponicki, William R; Gruenewald, Paul J; Wiebe, Douglas J; Smith, Karen

2016-05-01

This study examines spatial relationships between alcohol outlet density and the incidence of alcohol-related crashes. The few prior studies conducted in this area used relatively large spatial units; here we use highly resolved units from Melbourne, Australia (Statistical Area level 1 [SA1] units: mean land area=0.5 km(2); SD=2.2 km(2)), in order to assess different micro-scale spatial relationships for on- and off-premise outlets. Bayesian conditional autoregressive Poisson models were used to assess cross-sectional relationships of three-year counts of alcohol-related crashes (2010-2012) attended by Ambulance Victoria paramedics to densities of bars, restaurants, and off-premise outlets controlling for other land use, demographic and roadway characteristics. Alcohol-related crashes were not related to bar density within local SA1 units, but were positively related to bar density in adjacent SA1 units. Alcohol-related crashes were negatively related to off-premise outlet density in local SA1 units. Examined in one metropolitan area using small spatial units, bar density is related to greater crash risk in surrounding areas. Observed negative relationships for off-premise outlets may be because the origins and destinations of alcohol-affected journeys are in distal locations relative to outlets. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effect of ageing on the force development in tetanic contractions of motor units in rat medial gastrocnemius muscle.

PubMed

Łochyński, Dawid; Kaczmarek, Dominik; Krutki, Piotr; Celichowski, Jan

2010-09-01

The purpose of this study was to determine the effect of ageing on the rate of force generation of motor units, and the mechanical efficiency of contraction produced by a doublet discharge. The study was carried out on isolated motor units of rat medial gastrocnemius muscle of young (5-10 mo) and two groups of old (24-25 and 28-30 mo) Wistar rats. Motor units were classified into the fast fatigable (FF), fast resistant (FR) and slow (S) ones. The force output and rate of force development were determined for non-doublet unfused tetanic contractions evoked by a series of a constant-rate trains of pulses and corresponding doublet contractions starting with an initial brief interpulse interval of 5 ms, and for maximal tetanic contraction. In FF motor units the rate of force development and the force produced by the doublet discharge increased transiently at the age of 24-25 mo, while in S and FR motor units this increase was observed at the age of 28-30 mo. Age-related decrease in the rate of force development of skeletal muscle cannot be attributed to a decline in efficiency of force production by functioning motor units. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Dynamic analysis of temporal moisture profiles in heatset printing studied with near-infrared spectroscopy

NASA Astrophysics Data System (ADS)

Tåg, C.-M.; Toiviainen, M.; Juuti, M.; Gane, P. A. C.

2010-10-01

Dynamic analysis of the water transfer onto coated paper, and its permeation and absorption into the porous structure were studied online in a full-scale heatset web offset printing environment. The moisture content of the paper was investigated at five different positions during the printing process. Changes in the moisture content of the paper were studied as a function of the web temperature, printing speed and silicone application in the folding unit positioned after the hot air drying oven. Additionally, the influence of fountain solution composition on the pick-up by the paper was investigated. The water content of the fountain solution transferred to the paper from the printing units was observed as changes in near-infrared absorbance. A calibration data set enabled the subsequent quantification of the dynamic moisture content of the paper at the studied locations. An increase in the printing speed reduced the water transfer to the paper and an increase in web temperature resulted in a reduction in the moisture content. An increase in the dosage level of the water-silicone mixture was observed as a re-moistening effect of the paper. Differences in the drying strategy resulted in different moisture profiles depending on the type of fountain solution used. As a conclusion, the near-infrared signal provides an effective way to characterize the moisture dynamics online at different press units.

Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital.

PubMed

Kara, İskender; Yıldırım, Fatma; Başak, Dilek Yumuş; Küçük, Hamit; Türkoğlu, Melda; Aygencel, Gülbin; Katı, İsmail; Karabıyık, Lale

2015-06-01

The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012-August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure.

The Effects of Science Models on Students' Understanding of Scientific Processes

NASA Astrophysics Data System (ADS)

Berglin, Riki Susan

This action research study investigated how the use of science models affected fifth-grade students' ability to transfer their science curriculum to a deeper understanding of scientific processes. This study implemented a variety of science models into a chemistry unit throughout a 6-week study. The research question addressed was: In what ways do using models to learn and teach science help students transfer classroom knowledge to a deeper understanding of the scientific processes? Qualitative and quantitative data were collected through pre- and post-science interest inventories, observations field notes, student work samples, focus group interviews, and chemistry unit tests. These data collection tools assessed students' attitudes, engagement, and content knowledge throughout their chemistry unit. The results of the data indicate that the model-based instruction program helped with students' engagement in the lessons and understanding of chemistry content. The results also showed that students displayed positive attitudes toward using science models.

Initial antibiotic selection and patient outcomes: observations from the National Pneumonia Project.

PubMed

Bratzler, Dale W; Ma, Allen; Nsa, Wato

2008-12-01

Guidelines for empirical treatment of hospitalized patients with pneumonia provide specific recommendations for antibiotic selection that are primarily based on findings from observational studies. We conducted a retrospective study of 27,330 community-dwelling, immunocompetent Medicare patients (age, >65 years) with pneumonia who were hospitalized in 1998-1999 and 2000-2001. Associations between initial antimicrobial regimens and risk-adjusted mortality were assessed, accounting for differences in patient characteristics, comorbidities, illness severity, geographic location, and processes of care. Treatment with nonpseudomonal third-generation cephalosporin monotherapy constituted the reference group for comparisons. For patients not in the intensive care unit, initial treatment with fluoroquinolone monotherapy was associated with reduced in-hospital mortality, 14-day mortality, and 30-day mortality rates (adjusted odds ratio [AOR] for 30-day mortality, 0.7; 95% confidence interval [CI], 0.6-0.9; P = .001). The combination of a cephalosporin plus a macrolide was associated with reduced 14-day and 30-day mortality rates (AOR for 30-day mortality, 0.7; 95% CI, 0.6-0.9; P < .001). For intensive care unit patients, the combination of a cephalosporin and a macrolide was associated with reduced in-hospital mortality (AOR, 0.6; 95% CI, 0.3-0.9; P = .018). Initial antimicrobial treatment with the combination of a second- or third-generation cephalosporin and a macrolide or initial treatment with a fluoroquinolone was associated with a reduced 30-day mortality rate, compared with treatment with third-generation cephalosporin monotherapy, among non-intensive care unit patients. Although our results are consistent with other observational studies, controversy continues to exist about the use of nonexperimental cohort studies to demonstrate associations between processes of care, such as antibiotic selection, and patient outcomes.

Aquifer tests and simulation of ground-water flow in Triassic sedimentary rocks near Colmar, Bucks and Montgomery Counties, Pennsylvania

USGS Publications Warehouse

Risser, Dennis W.; Bird, Philip H.

2003-01-01

This report presents the results of a study by the U.S. Geological Survey in cooperation with the U.S. Environmental Protection Agency to evaluate ground-water flow in Triassic sedimentary rocks near Colmar, in Bucks and Montgomery Counties, Pa. The study was conducted to help the U.S. Environmental Protection Agency evaluate remediation alternatives at the North Penn Area 5 Superfund Site near Colmar, where ground water has been contaminated by volatile organic solvents (primarily trichloroethene). The investigation focused on determining the (1) drawdown caused by separately pumping North PennWater Authority wells NP–21 and NP–87, (2) probable paths of groundwater movement under present-day (2000) conditions (with NP–21 discontinued), and (3) areas contributing recharge to wells if pumping from wells NP-21 or NP–87 were restarted and new recovery wells were installed. Drawdown was calculated from water levels measured in observation wells during aquifer tests of NP–21 and NP–87. The direction of ground-water flow was estimated by use of a three-dimensional ground-water-flow model.Aquifer tests were conducted by pumping NP–21 for about 7 days at 257 gallons per minute in June 2000 and NP–87 for 3 days at 402 gallons per minute in May 2002. Drawdown was measured in 45 observation wells during the NP–21 test and 35 observation wells during the NP–87 test. Drawdown in observation wells ranged from 0 to 6.8 feet at the end of the NP–21 test and 0.5 to 12 feet at the end of the NP–87 test. The aquifer tests showed that ground-water levels declined mostly in observation wells that were completed in the geologic units penetrated by the pumped wells. Because the geologic units dip about 27 degrees to the northwest, shallow wells up dip to the southeast of the pumped well showed a good hydraulic connection to the geologic units stressed by pumping. Most observation wells down dip from the pumping well penetrated units higher in the stratigraphic section that were not well connected to the units stressed by pumping. The best hydraulic connection to the pumped wells was indicated by large drawdown in observation wells that penetrate the water-bearing unit encountered below 400 feet below land surface in wells NP–21 and NP–87. The hydraulic connection between wells NP–21 (or NP–87) and observation wells in the southern area of ground-water contamination near the BAE Systems facility is good because the observation wells probably penetrate this water-bearing unit.A 3-dimensional, finite-difference, groundwater- flow model was used to simulate flow paths and areas contributing recharge to wells for current (2000) conditions of pumping in the Colmar area and for hypothetical situations of pumping suggested by the U.S. Environmental Protection Agency that might be used for remediation. Simulations indicate that under current conditions, ground water in the northern area of contamination near the former Stabilus facility moves to the northwest and discharges mostly to West Branch Neshaminy Creek; in the southern area of contamination near BAE Systems facility, ground water probably moves west and discharges to a tributary of West Branch Neshaminy Creek near well NP–21. Model simulations indicate that if NP–21 or NP–87 are pumped at 400 gallons per minute, groundwater recharge is likely captured from the southern area of contamination, but ground-water recharge from the northern area of contamination is less likely to be captured by the pumping. Simulations also indicate that pumping of a new recovery well near BAE Systems facility at 8 gallons per minute and two new recovery wells near the former Stabilus facility at a total of about 30 gallons per minute probably would capture most of the ground-water recharge in the areas where contamination is greatest.

Investigation of magnetization dynamics in 2D Ni80Fe20 diatomic nanodot arrays

NASA Astrophysics Data System (ADS)

De, Anulekha; Mondal, Sucheta; Banerjee, Chandrima; Chaurasiya, Avinash K.; Mandal, Ruma; Otani, Yoshichika; Mitra, Rajib K.; Barman, Anjan

2017-09-01

Magnetization dynamics in Ni80Fe20 (Py) diatomic nanodots (nanodots of the same thickness but with large and small diameters that are closely placed to each other so as to act as a diatomic basis structure) embedded in 2D arrays have been investigated by the Brillouin light scattering technique. A distinct variation of resonant mode characteristics for different in-plane bias magnetic field applied along two different orientations of the lattice has been observed. Micromagnetic simulations reproduced the observed dynamical behaviour and revealed the variation of spatial distribution of collective modes of constituent single nanodots with different diameter and a diatomic unit forming the large array to understand the evolution of the magnetization dynamics from a single dot to the large array via a diatomic unit. The changes in mode frequency, spatial profiles of the modes, and appearance of new modes in a diatomic unit and its array from that of the constituent single dots indicate the strong magnetostatic interaction among the dots within the diatomic unit. Also, the occurrence of the new interacting mode at different frequencies for different orientations of the bias field indicates the change in the nature of interaction among the dots within the diatomic unit with bias magnetic field. The mode profiles also show distinct behaviour for smooth and rough-edged dots. This work motivates the study of magnonic band structure formation of such a dipolarly coupled nanodot array containing a complex double-dot unit cell.

Nurse and Patient Characteristics Associated with Duration of Nurse Talk During Patient Encounters in ICU

PubMed Central

Nilsen, Marci Lee; Sereika, Susan; Happ, Mary Beth

2012-01-01

Background Communication interactions between nurses and mechanically ventilated patients in the intensive care unit (ICU) are typically brief. Factors associated with length of nurses’ communication have not been explored. Objective To examine the association between nurse and patient characteristics and duration of nurse talk. Methods In this secondary analysis, we calculated duration of nurse talk in the first 3-minutes of video-recorded communication observation sessions for each nurse-patient dyad (n=89) in the SPEACS study (4 observation sessions/dyad, n=356). In addition, we explored the association between nurses’ characteristics (age, gender, credentials, nursing experience, and critical care experience) and patients’ characteristics (age, gender, race, education, delirium, agitation-sedation, severity of illness, level of consciousness, prior intubation history, days intubated prior to study enrollment, and type of intubation) on duration of nurse talk during the 3-minute interaction observation. Results Duration of nurse talk ranged from 0–123 seconds and varied significantly over the 4 observation sessions (p=.007). Averaging the duration of nurse talk over the observation sessions, differences in talk time between the units varied significantly by study group (p<.001). Talk duration was negatively associated with a Glasgow Coma Scale ≤ 14 (p=.008). Length of intubation prior to study enrollment had a curvilinear relationship with talking duration (linear p=.002, quadratic p=.013); the point of inflection was at 23 days. Nurse characteristics were not significantly related to duration of nurse talk. Conclusion Length of time the patient is intubated, and the patient’s level of consciousness may influence duration of nurse communication in ICU. PMID:23305914

Southeast Atmosphere Studies: learning from model-observation syntheses

EPA Science Inventory

Concentrations of atmospheric trace species in the United States have changed dramatically over the past several decades in response to pollution control strategies, shifts in domestic energy policy and economics, and economic development (and resulting emission changes) elsewher...

Sedimentology, Petrography and Microfacies of the Paleogene Carbonate Sequence - Yaxcopoil-1 Borehole (Chicxulub, Yucatan)

NASA Astrophysics Data System (ADS)

Escobar-Sanchez, E.; Fucugauchi, J. U.

2013-05-01

Chicxulub crater is one the three largest known impact craters on Earth, formed 66 Ma-old, with multi-ring basin morphology. Crater is located in northwestern Yucatan, southern Gulf of Mexico, with rim diameter of 200 km and crater center at Chicxulub Perto in the coastline. It is buried beneath the carbonate and evaporitic Cenozoic sequence. Study of the structure requires geophysics and drilling, with several boreholes drilled in the peninsula. The Yaxcopoil-1 borehole was drilled south of Merida, about 62 km from center, as part of the Chicxulub Scientific Drilling Program. One of the main objectives was to determine the role of the Chicxulub impact event in the K/Pg mass extinction and boundary events. We present a sedimentological and petrological study of the carbonate sequence in the interval from 404 m to 792 m overlying the K/Pg boundary. The well reached a depth of 1510.6 m. In this interval, we identified twelve units marked by different lithological and sedimentological changes, and supplemented by thin section analysis. Facies are composed mainly of marls, argillaceous, limestones, dolomitized limestones, calcareous breccias and calcarenites with shales thin beds. From the microfacies study we observed several major changes in the microfacies. From bottom of the sequence several textural changes cyclic from mudstone to bioclastic planktic foraminiferal wackestone, bioclastic packstone and some bioclastic grainstone. Two textures dominated in the calcareous sequence: bioclastic wackestone and packstone microfacies. From the microfacies study, we derived inferences on stable environmental conditions. We observed benthic and planktic foraminiferal layers. The benthic foraminifera strongly depend on environmental parameters, such as nutrient supply or oxygenation of the sea bottom water in the Paleocene and Eocene. Changes suggest occurrence of a progradational event, with a relative increase in sea level very slowly, with the sediment enough to overcome the elevation. In the last meters of Unit 2 (778-772 m), a series of thin layers of marl and calcareous shale interbedded with wackestone are interpreted as a transgressive event. In the first few meters of Unit 3 provides greater energy currents causing variations in the grain size. Petrographic observations show that planktonic and benthic facies are arranged as intermittent flows in parts of the unit, which points to flow currents. Predominance of coarse-grained facies rich in carbonates possibly indicates a prograding event into deep areas. In the sequence several possible changes in sea level are recorded, especially from Unit 5 to 8 Unit, where a possible limit between the Paleocene and Eocene is located between Unit 6 and Unit 7, at about 660 m. Biostratigraphy was obtained by zones corresponding to P4 and P5. In Unit 8 contains the first record of turbidite or storm deposits outer shelf environments that could be related to platform progradation. The Paleocene-Eocene thermal maximum represents a period of global warming and sea level rise. The sedimentological and micropaleontological changes may be correlated with the faunal turnover in the Gulf of Mexico, providing a complementary tool for biostratigraphic inferences.

By Force or by Fraud: Optimizing U.S. Information Strategy With Deception

DTIC Science & Technology

2016-06-01

IV. CASE- STUDY ASSESSMENTS ........................................................................37 A. CASE 1 OVERVIEW: THE DHOFAR REBELLION, 1965...xvi SOF Special Operations Forces SOG Studies and Observations Group USIA United States Information Agency VC Viet Cong...The Development of Overt and Covert Propaganda Strategies,” Presidential Studies Quarterly 24, no. 2 (Spring 1994): 265. 6 Ibid. 4 USIA departments

The Effect of Group Research and Cooperative Reading-Writing-Application Techniques in the Unit of "What Is the Earth's Crust Made Of?" on The Academic Achievements of the Students and the Permanent

ERIC Educational Resources Information Center

Aksoy, Gokhan; Gurbuz, Fatih

2013-01-01

The aim of this study is to determine the effect of the group research technique and cooperative reading-writing application technique in the science and technology course in the unit of "what is the Earth's crust made of" on the academic achievement of the students and whether the change observed in the student achievement is permanent…

Digital spatial data for observed, predicted, and misclassification errors for observations in the training dataset for nitrate and arsenic concentrations in basin-fill aquifers in the Southwest Principal Aquifers study area

USGS Publications Warehouse

McKinney, Tim S.; Anning, David W.

2012-01-01

This product "Digital spatial data for observed, predicted, and misclassification errors for observations in the training dataset for nitrate and arsenic concentrations in basin-fill aquifers in the Southwest Principal Aquifers study area" is a 1:250,000-scale point spatial dataset developed as part of a regional Southwest Principal Aquifers (SWPA) study (Anning and others, 2012). The study examined the vulnerability of basin-fill aquifers in the southwestern United States to nitrate contamination and arsenic enrichment. Statistical models were developed by using the random forest classifier algorithm to predict concentrations of nitrate and arsenic across a model grid that represents local- and basin-scale measures of source, aquifer susceptibility, and geochemical conditions.

Prophylactic use of intravascular balloon catheters in women with placenta accreta, increta and percreta.

PubMed

Cali, Giuseppe; Forlani, Francesco; Giambanco, Laura; Amico, Maria Luisa; Vallone, Mario; Puccio, Giuseppe; Alio, Luigi

2014-08-01

To evaluate outcomes of women undergoing cesarean hysterectomy for abnormal invasive placenta (AIP) with and without preoperative balloon catheter placement in internal iliac arteries. A prospective observational study of women with ultrasound diagnosis of AIP and a planned delivery at our institution. From January 2004 to June 2009, all AIP cases were treated with planned multidisciplinary cesarean hysterectomy alone (CHa group). From July 2009 to September 2013 a pre-operative balloon catheter protocol was introduced (BC group). Statistical analysis considered the entire sample (placenta accreta/increta and percreta) and the individual subgroups (accreta/increta vs percreta). Twenty-three cases of AIP (10 accreta/increta and 13 percreta) were treated with cesarean hysterectomy alone, and 30 cases of AIP (12 accreta/increta and 18 percreta) were treated with cesarean hysterectomy and pre-operative balloon catheters. For the entire sample, a significant difference in estimated blood loss and transfused blood products units was observed between CHa group and BC group. When women with placenta accreta/increta and women with placenta percreta were analysed separately, no difference in estimated blood loss and transfused blood products units was found between the BC and the CHa groups in women with placenta accreta/increta. However, in women with placenta percreta, mean estimated blood loss and transfused blood products units were higher in the CHa group compared with BC group (1507ml vs 933.33ml; 3.31 units vs 0.67 units). Postoperative recovery differed between the two groups, but no differences were observed in any other outcomes. Pre-operative placement of intravascular balloon catheters is a feasible treatment for AIP, and is particularly useful in cases of placenta percreta. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Survival rates of IPS empress 2 all-ceramic crowns and fixed partial dentures: results of a 5-year prospective clinical study.

PubMed

Marquardt, Pascal; Strub, Jörg Rudolf

2006-04-01

The aim of this prospective clinical study was to evaluate the survival rates of IPS Empress 2 (Ivoclar Vivadent) all-ceramic crowns and fixed partial dentures (FPDs) after an observation period of up to 5 years. Forty-three patients (19 women and 24 men) were included in this study. The patients were treated with a total of 58 adhesive bonded IPS Empress 2 restorations. A total of 27 single crowns were placed on molars and premolars, and 31 three-unit FPDs were placed in the anterior and premolar regions. Clinical follow-up examinations took place at 6, 12, 24, 36, 48, and 60 months after insertion. Statistical analysis of the data was calculated using the Kaplan-Meier method. Results of the 50-month analysis (interquartile range, 33 to 61 months) showed that the survival rate was 100% for crowns and 70% for FPDs. Six failures that occurred exclusively in the three-unit FPDs were observed. Framework fractures were recorded in three FPD units where the connector dimensions did not meet the manufacturer specifications. Only one FPD exhibited an irreparable partial veneer fracture, and 2 FPDs showed evidence of biologic failures. The accuracy of fit and esthetic parameters were clinically satisfactory for crowns and FPDs. The results of this 5-year clinical evaluation suggest that IPS Empress 2 ceramic is an appropriate material for the fabrication of single crowns. Because of the reduced survival rates, strict conditions should be considered before the use of IPS Empress 2 material for the fabrication of three-unit FPDs.

19 CFR 201.33 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... meetings of the United States International Trade Commission to public observation while protecting the... Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF GENERAL APPLICATION Opening Commission Meetings to Public Observation Pursuant to 5 U.S.C. 552b § 201.33 Purpose and scope. (a...

Earth Observing System (EOS)/Advanced Microwave Sounding Unit-A (AMSU-A): Instrument logic diagrams

NASA Technical Reports Server (NTRS)

1994-01-01

This report contains all of the block diagrams and internal logic diagrams for the Earth Observation System Advanced Microwave Sounding Unit-A (AMSU-A). These diagrams show the signal inputs, outputs, and internal signal flow for the AMSU-A.

How does a Next Generation Science Standard Aligned, Inquiry Based, Science Unit Impact Student Achievement of Science Practices and Student Science Efficacy in an Elementary Classroom?

NASA Astrophysics Data System (ADS)

Whittington, Kayla Lee

This study examined the impact of an inquiry based Next Generation Science Standard aligned science unit on elementary students' understanding and application of the eight Science and Engineering Practices and their relation in building student problem solving skills. The study involved 44 second grade students and three participating classroom teachers. The treatment consisted of a school district developed Second Grade Earth Science unit: What is happening to our playground? that was taught at the beginning of the school year. Quantitative results from a Likert type scale pre and post survey and from student content knowledge assessments showed growth in student belief of their own abilities in the science classroom. Qualitative data gathered from student observations and interviews performed at the conclusion of the Earth Science unit further show gains in student understanding and attitudes. This study adds to the existing literature on the importance of standard aligned, inquiry based science curriculum that provides time for students to engage in science practices.

Feasibility of conducting prospective observational research on critically ill, dying patients in the intensive care unit.

PubMed

van Beinum, Amanda; Hornby, Laura; Dhanani, Sonny; Ward, Roxanne; Chambers-Evans, Jane; Menon, Kusum

2017-01-01

Studying patients during the end of life is important, as it has the potential to lead to improvements in care for the dying. For patients who die after a controlled withdrawal of life-sustaining therapies in the intensive care unit, information about the natural history of death and the process of removing life support has additionally led to advances in practice for deceased organ donation. However, this unique population of severely critically ill and imminently dying patients has been difficult to study, largely due to assumptions made by research teams and ethics boards alike about the logistical difficulties of obtaining consent and completing research procedures before or during the process of withdrawal of life-sustaining therapies. In this paper, we describe the ethics substudy of the first prospective observational research study in Canada to obtain consent and collect clinical data on patients during the process of withdrawal of life-sustaining therapies in the intensive care unit. We describe in detail the process of protocol development, review by five institutional research ethics boards and bedside staff satisfaction with the study. We conclude that prospective research on a critically ill and imminently dying population is feasible and can be conducted in an ethical manner. Further information is needed about the experiences and motivations of families and substitute decision makers who provide consent for research on critically ill intensive care unit patients at the end of life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Access to primary healthcare services: still a way to go].

PubMed

Mendes, Antônio da Cruz Gouveia; Miranda, Gabriella Morais Duarte; Figueiredo, Karla Erika Gouveia; Duarte, Petra Oliveira; Furtado, Betise Mery Alencar Sousa Macau

2012-11-01

This study seeks to evaluate accessibility to the Basic Units of the Family Health Strategy (ESF-UB) and Traditional Basic Units (BU-T) in the city of Recife in 2009. Data were collected through three instruments: a roadmap for systematic observation of the units and questionnaires for users and professional units. This is a descriptive cross-sectional study using a quantitative approach, and 1180 users, 61 doctors and 56 nurses were interviewed. The results showed good ties and recognition of users whereby primary healthcare is seen as the access portal to the health system. In the comparison between ESF-UB and UB-T, evaluations are always more favorable to the family healthcare strategy, though with relatively insignificant differences. The overall result revealed widespread dissatisfaction with the difficulty of obtaining drugs and taking tests, and also with the waiting times and access to specialized care. This showed the existence of organizational problems that may constitute barriers limiting accessibility to basic healthcare services for users.

Use of an attenuated live Salmonella Typhimurium vaccine on three breeding pig units: A longitudinal observational field study.

PubMed

Davies, R; Gosling, R J; Wales, A D; Smith, R P

2016-06-01

The study examined the effects of a licensed live Salmonella Typhimurium vaccine, administered to sows and gilts on three commercial pig units experiencing clinical salmonellosis associated with S. Typhimurium or its monophasic variant. After vaccination, clinical salmonellosis resolved and shedding of S. Typhimurium declined markedly and persistently on all breeding or breeding-finishing units, during the one- to two-year monitoring period. On two finishing units supplied in part by one of the vaccinated herds, pigs from the vaccinated herd were less likely to shed Salmonella than those from non-vaccinating herds, and Salmonella counts in faeces were also lower from the vaccine-linked animals. Non-Typhimurium Salmonella serovars were isolated typically in fewer than 10% of samples, and showed no clear temporal changes in frequency. Vaccination of dams alone with S. Typhimurium was associated with reduced shedding of closely-related serovars among all age groups in this commercial setting. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Cross-cultural comparison of long-term care in the United States and Finland: Research done through a short-term study-abroad experience.

PubMed

Kruger, Tina M; Gilland, Sarah; Frank, Jacquelyn B; Murphy, Bridget C; English, Courtney; Meade, Jana; Morrow, Kaylee; Rush, Evan

2017-01-01

In May 2014, a short-term study-abroad experience was conducted in Finland through a course offered at Indiana State University (ISU). Students and faculty from ISU and Eastern Illinois University participated in the experience, which was created to facilitate a cross-cultural comparison of long-term-care settings in the United States and Finland. With its outstanding system of caring for the health and social needs of its aging populace, Finland is a logical model to examine when considering ways to improve the quality of life for older adults who require care in the United States . Those participating in the course visited a series of long-term-care facilities in the region surrounding Terre Haute, Indiana, then travelled to Lappeenranta, Finland to visit parallel sites. Through limited-participation observation and semistructured interviews, similarities and differences in experiences, educations, and policies affecting long-term care workers in the United States and Finland were identified and are described here.

A containerless levitation setup for liquid processing in a superconducting magnet.

PubMed

Lu, Hui-Meng; Yin, Da-Chuan; Li, Hai-Sheng; Geng, Li-Qiang; Zhang, Chen-Yan; Lu, Qin-Qin; Guo, Yun-Zhu; Guo, Wei-Hong; Shang, Peng; Wakayama, Nobuko I

2008-09-01

Containerless processing of materials is considered beneficial for obtaining high quality products due to the elimination of the detrimental effects coming from the contact with container walls. Many containerless processing methods are realized by levitation techniques. This paper describes a containerless levitation setup that utilized the magnetization force generated in a gradient magnetic field. It comprises a levitation unit, a temperature control unit, and a real-time observation unit. Known volume of liquid diamagnetic samples can be levitated in the levitation chamber, the temperature of which is controlled using the temperature control unit. The evolution of the levitated sample is observed in real time using the observation unit. With this setup, containerless processing of liquid such as crystal growth from solution can be realized in a well-controlled manner. Since the levitation is achieved using a superconducting magnet, experiments requiring long duration time such as protein crystallization and simulation of space environment for living system can be easily succeeded.

Constraints on the Compositions of Phobos and Deimos from Mineral Absorptions

NASA Technical Reports Server (NTRS)

Fraeman, A. A.; Murchie, S. L.; Arvidson, R. E.; Rivkin, A. S.; Morris, R. V.

2013-01-01

The compositions of Phobos and Deimos have remained controversial despite multiple Earth- and space-based observations acquired during the last 40 years. Phobos is composed of at least two spectral units that are both dark yet distinct at visible to near infrared wavelenghts; a spectrally red-sloped "red" unit covers most of the moon and a less red-sloped "blue" unit is present in the ejecta of the approximately 9-km diameter impact crater Stickney [1,2]. Deimos is similar spectrally to Phobos' "red" unit [2]. Here we report results from mapping mineral absorptions on Phobos and Deimos using visible/near infrared observations from the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM). We find evidence for an absorption feature at 0.65 m in the Phobos red unit and Deimos that is reproducible in observations from other instruments. The phase responsible is uncertain but may be a Fe-bearing phyllosilicate and/or graphite, consistent with the notion that Phobos and Deimos have compositions similar to CM carbonaceous chondrites [3].

Hydrogeologic framework, ground-water quality, and simulation of ground-water flow at the Fair Lawn Well Field Superfund site, Bergen County, New Jersey

USGS Publications Warehouse

Lewis-Brown, Jean C.; Rice, Donald E.; Rosman, Robert; Smith, Nicholas P.

2005-01-01

Production wells in the Westmoreland well field, Fair Lawn, Bergen County, New Jersey (the 'Fair Lawn well field Superfund site'), are contaminated with volatile organic compounds, particularly trichloroethylene, tetrachloroethylene, and 1,1,1-trichloroethane. In 1983, the U.S. Environmental Protection Agency (USEPA) placed the Westmoreland well field on its National Priority List of Superfund sites. In an effort to determine ground-water flow directions, contaminant-plume boundaries, and contributing areas to production wells in Fair Lawn, and to evaluate the effect of present pump-and-treat systems on flowpaths of contaminated ground water, the U.S. Geological Survey (USGS), in cooperation with the USEPA, developed a conceptual hydrogeologic framework and ground-water flow model of the study area. MODFLOW-2000, the USGS three-dimensional finite-difference model, was used to delineate contributing areas to production wells in Fair Lawn and to compute flowpaths of contaminated ground water from three potential contaminant sources to the Westmoreland well field. Straddle-packer tests were used to determine the hydrologic framework of, distribution of contaminants in, and hydrologic properties of water-bearing and confining units that make up the fractured-rock aquifer underlying the study area. The study area consists of about 15 square miles in and near Fair Lawn. The area is underlain by 6 to 100 feet of glacial deposits and alluvium that, in turn, are underlain by the Passaic Formation. In the study area, the Passaic Formation consists of brownish-red pebble conglomerate, medium- to coarse-grained feldspathic sandstone, and micaceous siltstone. The bedrock strata strike N. 9o E. and dip 6.5o to the northwest. The bedrock consists of alternating layers of densely fractured rocks and sparsely fractured rocks, forming a fractured-rock aquifer. Ground-water flow in the fractured-rock aquifer is anisotropic as a result of the interlayering of dipping water-bearing and confining units. Wells of similar depth aligned along the strike of the bedding intersect the same water-bearing units, but wells aligned along the dip of the bedding may intersect different water-bearing units. Consequently, wells aligned along strike are in greater hydraulic connection than wells aligned along dip. The Borough of Fair Lawn pumps approximately 770 million gallons per year from 13 production wells. Hydrographs from six observation wells ranging in depth from 162 to 505 feet in Fair Lawn show that water levels in much of the study area are affected by pumping. Straddle packers were used to isolate discrete intervals within six open-hole observation wells owned by the Fair Lawn Water Department. Transmissivity, water-quality, and static-water-level data were obtained from the isolated intervals. Measured transmissivity ranged from near 0 to 8,900 feet squared per day. The broad range in measured transmissivity is a result of the heterogeneity of the fractured-rock aquifer. Eight water-bearing units and eight confining units were identified in the study area on the basis of transmissivity. The water-bearing units range in thickness from 21 to 95 feet; the mean thickness is 50 feet. The confining units range in thickness from 22 to 248 feet; the mean thickness is 83 feet. Water-level and water-quality data indicate effective separation of water-bearing units by the confining units. Water-quality samples were collected from the six observation wells at 16 depth intervals isolated by the straddle packers in 2000 and 2001. Concentrations of volatile organic compounds generally were low in samples from four of the wells, but were higher in samples from a well in Fair Lawn Industrial Park and in a well in the Westmoreland well field. The digital ground-water flow model was used to simulate steady-state scenarios representing conditions in the study area in 1991 and 2000. These years were chosen because during the intervening period,

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

Vlies, C. H. van der, E-mail: c.h.vandervlies@amc.uva.nl; Hoekstra, J.; Ponsen, K. J.

Introduction: Nonoperative management (NOM) has become the treatment of choice for hemodynamically stable patients with blunt splenic injury. Results of outcome after NOM are predominantly based on large-volume studies from level 1 trauma centers in the United States. This study was designed to assess the results of NOM in a relatively low-volume Dutch level 1 trauma center. Methods: An analysis of a prospective trauma registry was performed for a 6-year period before (period 1) and after the introduction and implementation of splenic artery embolization (SAE) (period 2). Primary outcome was the failure rate of initial treatment. Results: A total ofmore » 151 patients were reviewed. An increased use of SAE and a reduction of splenic operations during the second period was observed. Compared with period 1, the failure rate after observation in period 2 decreased from 25% to 10%. The failure rate after SAE in period 2 was 18%. The splenic salvage rate (SSR) after observation increased from 79% in the first period to 100% in the second period. During the second period, all patients with failure after observation were successfully treated with SAE. The SSR after SAE in periods 1 and 2 was respectively 100% and 86%. Conclusions: SAE of patients with blunt splenic injuries is associated with a reduction in splenic operations. The failure and splenic salvage rates in this current study were comparable with the results from large-volume studies of level 1 trauma centers. Nonoperative management also is feasible in a relatively low-volume level 1 trauma center outside the United States.« less

Influence of light curing and sample thickness on microhardness of a composite resin

PubMed Central

Aguiar, Flávio HB; Andrade, Kelly RM; Leite Lima, Débora AN; Ambrosano, Gláucia MB; Lovadino, José R

2009-01-01

The aim of this in vitro study was to evaluate the influence of light-curing units and different sample thicknesses on the microhardness of a composite resin. Composite resin specimens were randomly prepared and assigned to nine experimental groups (n = 5): considering three light-curing units (conventional quartz tungsten halogen [QTH]: 550 mW/cm2 – 20 s; high irradiance QTH: 1160 mW/cm2 – 10 s; and light-emitting diode [LED]: 360 mW/cm2 – 40 s) and three sample thicknesses (0.5 mm, 1 mm, and 2 mm). All samples were polymerized with the light tip 8 mm away from the specimen. Knoop microhardness was then measured on the top and bottom surfaces of each sample. The top surfaces, with some exceptions, were almost similar; however, in relation to the bottom surfaces, statistical differences were found between curing units and thicknesses. In all experimental groups, the 0.5-mm-thick increments showed microhardness values statistically higher than those observed for 1- and -2-mm increments. The conventional and LED units showed higher hardness mean values and were statistically different from the high irradiance unit. In all experimental groups, microhardness mean values obtained for the top surface were higher than those observed for the bottom surface. In conclusion, higher levels of irradiance or thinner increments would help improve hybrid composite resin polymerization. PMID:23674901

Comparison of medicine availability measurements at health facilities: evidence from Service Provision Assessment surveys in five sub-Saharan African countries.

PubMed

Choi, Yoonjoung; Ametepi, Paul

2013-07-09

With growing emphasis on health systems strengthening in global health, various health facility assessment methods have been used increasingly to measure medicine and commodity availability. However, few studies have systematically compared estimates of availability based on different definitions. The objective of this study was to compare estimates of medicine availability based on different definitions. A secondary data analysis was conducted using data from the Service Provision Assessment (SPA)--a nationally representative sample survey of health facilities--conducted in five countries: Kenya SPA 2010, Namibia SPA 2009, Rwanda SPA 2007, Tanzania SPA 2006, and Uganda SPA 2007. For 32 medicines, percent of facilities having the medicine were estimated using five definitions: four for current availability and one for six-month period availability. 'Observed availability of at least one valid unit' was used as a reference definition, and ratios between the reference and each of the other four estimates were calculated. Summary statistics of the ratios among the 32 medicines were calculated by country. The ratios were compared further between public and non-public facilities within each country. Across five countries, compared to current observed availability of at least one valid unit, 'reported availability without observation' was on average 6% higher (ranging from 3% in Rwanda to 8% in Namibia), 'observed availability where all units were valid' was 11% lower (ranging from 2% in Tanzania to 19% in Uganda), and 'six-month period availability' was 14% lower (ranging from 5% in Namibia to 25% in Uganda). Medicine availability estimates vary substantially across definitions, and need to be interpreted with careful consideration of the methods used.

American Social Studies in Japan: Some Observations on the Social Studies Reforms Imposed on the Japanese Educational System after World War Two.

ERIC Educational Resources Information Center

Gunn, Angus M.

This report analyzes three aspects of social studies education in Japan: (1) characteristics of secondary education before World War II, (2) the nature and effects of United States intervention in secondary social studies in 1946, and (3) features of contemporary social studies. Before 1945 the boys' middle school, the Chugakko, was the most…

High gamma power in ECoG reflects cortical electrical stimulation effects on unit activity in layers V/VI

NASA Astrophysics Data System (ADS)

Yazdan-Shahmorad, Azadeh; Kipke, Daryl R.; Lehmkuhle, Mark J.

2013-12-01

Objective. Cortical electrical stimulation (CES) has been used extensively in experimental neuroscience to modulate neuronal or behavioral activity, which has led this technique to be considered in neurorehabilitation. Because the cortex and the surrounding anatomy have irregular geometries as well as inhomogeneous and anisotropic electrical properties, the mechanism by which CES has therapeutic effects is poorly understood. Therapeutic effects of CES can be improved by optimizing the stimulation parameters based on the effects of various stimulation parameters on target brain regions. Approach. In this study we have compared the effects of CES pulse polarity, frequency, and amplitude on unit activity recorded from rat primary motor cortex with the effects on the corresponding local field potentials (LFP), and electrocorticograms (ECoG). CES was applied at the surface of the cortex and the unit activity and LFPs were recorded using a penetrating electrode array, which was implanted below the stimulation site. ECoGs were recorded from the vicinity of the stimulation site. Main results. Time-frequency analysis of LFPs following CES showed correlation of gamma frequencies with unit activity response in all layers. More importantly, high gamma power of ECoG signals only correlated with the unit activity in lower layers (V-VI) following CES. Time-frequency correlations, which were found between LFPs, ECoGs and unit activity, were frequency- and amplitude-dependent. Significance. The signature of the neural activity observed in LFP and ECoG signals provides a better understanding of the effects of stimulation on network activity, representative of large numbers of neurons responding to stimulation. These results demonstrate that the neurorehabilitation and neuroprosthetic applications of CES targeting layered cortex can be further improved by using field potential recordings as surrogates to unit activity aimed at optimizing stimulation efficacy. Likewise, the signatures of unit activity observed as changes in high gamma power in ECoGs suggest that future cortical stimulation studies could rely on less invasive feedback schemes that incorporate surface stimulation with ECoG reporting of stimulation efficacy.

Is the Mantle-Crust Transition in the Finero Complex (southern Alps) a Fossil Continental Moho?

NASA Astrophysics Data System (ADS)

Zanetti, A.; Langone, A.; Tommasi, A.; Vauchez, A.; Padron-Navarta, J. A.; Giovanardi, T.; Mazzucchelli, M.

2017-12-01

The geophysical studies indicate that the mantle-continental crust discontinuity is usually the site of complex intercalations of rocks having different physical and chemical properties. The possibility to directly characterize such rocks is extremely limited, because very few fossil continental Moho discontinuities crop out: in addition, most of them are considered to be representative of island arc environments. To address this issue, a comprehensive investigation has been carried out in the Finero Complex (Ivrea-Verbano Zone; Southern Alps), where the Phlogopite Peridotite (PP) mantle unit is surrounded by mafic-ultramafic rocks interpreted as intrusive crustal bodies. The crustal unit placed in contact with the PP is the Layered Internal Zone (LIZ), which is overlaid by the Amphibole Peridotite unit. At the contact with LIZ, the typical phlogopite-amphibole-harzburgite forming the PP unit is replaced by a weakly-deformed amphibole-biotite-bearing orthopyroxenite layer. Orthopyroxenite amphibole shows the typical LILE and LREE enrichments and the HFSE and HREE depletion observed in the rest of the mantle unit. This suggests that orthopyroxenite was segregated during the pervasive metasomatic event characterising the PP unit. The LIZ is formed by hornblendites, amphibole-garnet gabbros, pyroxenites and garnet hornblendites. The Amphibole Peridotite unit consists of peridotites, hornblendites and pyroxenites. In the LIZ, the melt intrusion locally involved the assimilation of early gabbroic cumulates, and the segregation of garnet hornblendites by substitution of pyroxenites. In the Amphibole Peridotite, late porous-flow melt migration produced secondary recrystallisation fronts, associated to the development of trace element gradients due to ion-exchange processes. Our observations suggest that the transition between PP and LIZ is primary. The LIZ and Amphibole Peridotite units record multiple events of migration of melt, whose composition varied from LREE-depleted to extremely LREE-enriched. The large variety of rocks, geochemical signatures and petrologic processes recorded by the studied mantle-crust transition evidences as it worked for a very long time as a primary lithospheric discontinuity, representing a preferential level of channelling for the uprising melts.

Changing Sexual Attitudes among University Students: A Geographic Comparison.

ERIC Educational Resources Information Center

Taylor, Mary E.

1983-01-01

A college study explored changes in the attitudes of students who completed human sexuality courses in the northeastern and southeastern United States. Changes were observed in students' attitudes toward homosexuality, sex drive, religion, and sexual behavior between consenting adults. (PP)

Situated Teacher Quality: A Case Study of an Experienced Elementary School Teacher

ERIC Educational Resources Information Center

Kolman, Joni S.

2017-01-01

This case study examines how an experienced teacher's practice and pedagogy differs across two high-accountability urban charter schools in the United States of America (USA). Drawing on semi-structured interviews and participant observations, the findings describe variances in Rebecca's planning, use of classroom time, and curriculum flexibility,…

Evaluation of Oral Performance in Outsourced Call Centres: An Exploratory Case Study

ERIC Educational Resources Information Center

Friginal, Eric

2013-01-01

This case study discusses the development and use of an oral performance assessment instrument intended to evaluate Filipino agents' customer service transactions with callers from the United States (US). The design and applications of the instrument were based on a longitudinal, qualitative observation of language training and customer service…

Status and understanding of groundwater quality in the Northern Coast Ranges study unit, 2009: California GAMA Priority Basin Project

USGS Publications Warehouse

Mathany, Timothy M.; Belitz, Kenneth

2015-01-01

Chloroform, simazine, and perchlorate were observed in the Interior Basins and Coastal Basins study areas, predominantly at shallow sites with top-of-perforation depths ≤70 feet below land surface, with modern water (post-1950s), and with oxic groundwater conditions.

Building improved models of sugar maple mortality

Treesearch

Charles H. Perry; Patrick L. Zimmerman

2012-01-01

The decline of sugar maple (Acer saccharum Marsh.) in the northern United States is causing concern, and several studies have identified soil properties that are linked to the observation of dead/dying trees. Unfortunately, the sample of trees supporting these studies is purposive in nature; soil properties are assessed only on those plots where dead...

Conifer root proliferation after 20 years of soil compaction

Treesearch

Matt D. Busse; Gary O. Fiddler; Carol J. Shestak

2017-01-01

Soil compaction is known to limit plant growth by reducing soil macroporosity and restricting gas, water, and root movement. Recent evidence from study sites across the United States and Canada, however, suggests that tree growth is not universally affected by soil compaction from forest harvesting practices. Our observational study examined rooting patterns in mixed...

Working Commitment among Trainee Teachers: A Meta Evaluation Approach

ERIC Educational Resources Information Center

Hamzah, Mohd Sahandri Gani B.; Mohamed, Hapidah Bt.; Abdullah, Saifuddin Kumar B.; Baki, Roselan B.

2008-01-01

The main aim of the study was to evaluate trainee teachers working commitment in their teaching practicum. There were seven component teaching practices and eleven demographic factors. The instrument of the study was extracted from various sources to suit the research design based on Units, Treatments, Observing, and Surveying (UTOS) model…

Reading Habits of College Students in the United States

ERIC Educational Resources Information Center

Huang, SuHua; Capps, Matthew; Blacklock, Jeff; Garza, Mary

2014-01-01

This study employed a convergent mixed-method research design to investigate reading habits of American college students. A total of 1,265 (466 male and 799 female) college students voluntarily participated in the study by completing a self-reported survey. Twelve students participated in semi-structured interviews and classroom observations.…

Rehabilitation of Critical Illness Polyneuropathy and Myopathy Patients: An Observational Study

ERIC Educational Resources Information Center

Novak, Primoz; Vidmar, Gaj; Kuret, Zala; Bizovicar, Natasa

2011-01-01

Critical illness polyneuropathy and myopathy (CIPNM) frequently develops in patients hospitalized in intensive care units. The number of patients with CIPNM admitted to inpatient rehabilitation is increasing. The aim of this study was to comprehensively evaluate the outcome of their rehabilitation. Twenty-seven patients with CIPNM were included in…

[Technical efficiency assessment of public primary care providers in the Basque Country (Spain), 2010-2013].

PubMed

Cordero, José Manuel; Nuño-Solinís, Roberto; Orueta, Juan F; Polo, Cristina; Del Río-Cámara, Mario; Alonso-Morán, Edurne

2016-01-01

To evaluate the technical efficiency of primary care units operating in the Basque Health Service during the period 2010-2013, corresponding to the implementation of a care integration strategy by health authorities. This study included 11 of the 12 primary care units in the Basque Health Service during the period 2010-2013. Data envelopment analysis (DEA) was used to assess the technical efficiency of the units. In particular, we applied the extension DEA windows to analyse all units as if they were in a single period (33 observations) as well as a conditional model, which allowed incorporation of the effect of the characteristics of the population covered. The outputs considered were a quality index based on fulfilment of different requirements related to primary care delivery and the rate of avoidable hospitalizations (treated as an undesirable output). The inputs used were the number of physicians, the number of nurses and the costs of prescriptions. The morbidity index was included as an exogenous variable. The results showed that the efficiency of all the units improved during the study period. However, this improvement was not greater in the units incorporated in the integrated healthcare organisation. In a context of global transformation of care delivery in the Basque country in the study period, primary care units increased their efficiency. However, this effect was not larger in vertically integrated primary care providers. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units.

PubMed

Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B

Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.

Surface and Lightning Sources of Nitrogen Oxides over the United States: Magnitudes, Chemical Evolution, and Outflow

NASA Technical Reports Server (NTRS)

Hudman, Rynda C.; Jacob, Daniel J.; Turquety, Solene; Leinbensperger, E. M.; Murray, L. T.; Wu, Samuel; Gilliland, A. B.; Avery, Melody A.; Bertram, Timothy H.; Brune, W. H.;

Solvent and conformation dependence of amide I vibrations in peptides and proteins containing proline

NASA Astrophysics Data System (ADS)

Roy, Santanu; Lessing, Joshua; Meisl, Georg; Ganim, Ziad; Tokmakoff, Andrei; Knoester, Jasper; Jansen, Thomas L. C.

2011-12-01

We present a mixed quantum-classical model for studying the amide I vibrational dynamics (predominantly CO stretching) in peptides and proteins containing proline. There are existing models developed for determining frequencies of and couplings between the secondary amide units. However, these are not applicable to proline because this amino acid has a tertiary amide unit. Therefore, a new parametrization is required for infrared-spectroscopic studies of proteins that contain proline, such as collagen, the most abundant protein in humans and animals. Here, we construct the electrostatic and dihedral maps accounting for solvent and conformation effects on frequency and coupling for the proline unit. We examine the quality and the applicability of these maps by carrying out spectral simulations of a number of peptides with proline in D2O and compare with experimental observations.

Solvent and conformation dependence of amide I vibrations in peptides and proteins containing proline.

PubMed

Roy, Santanu; Lessing, Joshua; Meisl, Georg; Ganim, Ziad; Tokmakoff, Andrei; Knoester, Jasper; Jansen, Thomas L C

2011-12-21

We present a mixed quantum-classical model for studying the amide I vibrational dynamics (predominantly CO stretching) in peptides and proteins containing proline. There are existing models developed for determining frequencies of and couplings between the secondary amide units. However, these are not applicable to proline because this amino acid has a tertiary amide unit. Therefore, a new parametrization is required for infrared-spectroscopic studies of proteins that contain proline, such as collagen, the most abundant protein in humans and animals. Here, we construct the electrostatic and dihedral maps accounting for solvent and conformation effects on frequency and coupling for the proline unit. We examine the quality and the applicability of these maps by carrying out spectral simulations of a number of peptides with proline in D(2)O and compare with experimental observations.

Constipation and its implications in the critically ill patient.

PubMed

Mostafa, S M; Bhandari, S; Ritchie, G; Gratton, N; Wenstone, R

2003-12-01

Motility of the lower gut has been little studied in intensive care patients. We prospectively studied constipation in an intensive care unit of a university hospital, and conducted a national survey to assess the generalizability of our findings. Constipation occurred in 83% of the patients. More constipated patients (42.5%) failed to wean from mechanical ventilation than non-constipated patients (0%), P<0.05. The median length of stay in intensive care and the proportion of patients who failed to feed enterally were greater in constipated than non-constipated patients (10 vs 6.5 days and 27.5 vs 12.5%, respectively (NS)). The survey found similar observations in other units. Delays in weaning from mechanical ventilation and enteral feeding were reported by 28 and 48% of the units surveyed, respectively. Constipation has implications for the critically ill.

Stratospheric ozone over the United States in summer linked to observations of convection and temperature via chlorine and bromine catalysis

PubMed Central

Anderson, James G.; Weisenstein, Debra K.; Bowman, Kenneth P.; Homeyer, Cameron R.; Smith, Jessica B.; Wilmouth, David M.; Sayres, David S.; Klobas, J. Eric; Dykema, John A.; Wofsy, Steven C.

2017-01-01

We present observations defining (i) the frequency and depth of convective penetration of water into the stratosphere over the United States in summer using the Next-Generation Radar system; (ii) the altitude-dependent distribution of inorganic chlorine established in the same coordinate system as the radar observations; (iii) the high resolution temperature structure in the stratosphere over the United States in summer that resolves spatial and structural variability, including the impact of gravity waves; and (iv) the resulting amplification in the catalytic loss rates of ozone for the dominant halogen, hydrogen, and nitrogen catalytic cycles. The weather radar observations of ∼2,000 storms, on average, each summer that reach the altitude of rapidly increasing available inorganic chlorine, coupled with observed temperatures, portend a risk of initiating rapid heterogeneous catalytic conversion of inorganic chlorine to free radical form on ubiquitous sulfate−water aerosols; this, in turn, engages the element of risk associated with ozone loss in the stratosphere over the central United States in summer based upon the same reaction network that reduces stratospheric ozone over the Arctic. The summertime development of the upper-level anticyclonic flow over the United States, driven by the North American Monsoon, provides a means of retaining convectively injected water, thereby extending the time for catalytic ozone loss over the Great Plains. Trusted decadal forecasts of UV dosage over the United States in summer require understanding the response of this dynamical and photochemical system to increased forcing of the climate by increasing levels of CO2 and CH4. PMID:28584119

Stratospheric ozone over the United States in summer linked to observations of convection and temperature via chlorine and bromine catalysis.

PubMed

Anderson, James G; Weisenstein, Debra K; Bowman, Kenneth P; Homeyer, Cameron R; Smith, Jessica B; Wilmouth, David M; Sayres, David S; Klobas, J Eric; Leroy, Stephen S; Dykema, John A; Wofsy, Steven C

2017-06-20

We present observations defining ( i ) the frequency and depth of convective penetration of water into the stratosphere over the United States in summer using the Next-Generation Radar system; ( ii ) the altitude-dependent distribution of inorganic chlorine established in the same coordinate system as the radar observations; ( iii ) the high resolution temperature structure in the stratosphere over the United States in summer that resolves spatial and structural variability, including the impact of gravity waves; and ( iv ) the resulting amplification in the catalytic loss rates of ozone for the dominant halogen, hydrogen, and nitrogen catalytic cycles. The weather radar observations of ∼2,000 storms, on average, each summer that reach the altitude of rapidly increasing available inorganic chlorine, coupled with observed temperatures, portend a risk of initiating rapid heterogeneous catalytic conversion of inorganic chlorine to free radical form on ubiquitous sulfate-water aerosols; this, in turn, engages the element of risk associated with ozone loss in the stratosphere over the central United States in summer based upon the same reaction network that reduces stratospheric ozone over the Arctic. The summertime development of the upper-level anticyclonic flow over the United States, driven by the North American Monsoon, provides a means of retaining convectively injected water, thereby extending the time for catalytic ozone loss over the Great Plains. Trusted decadal forecasts of UV dosage over the United States in summer require understanding the response of this dynamical and photochemical system to increased forcing of the climate by increasing levels of CO 2 and CH 4 .

Skylab-4 visual observations project: Geological features of southwestern North America

NASA Technical Reports Server (NTRS)

Silver, L. T.

1975-01-01

Visual observations conducted by Skylab-4 crewmen on seven designated geological target areas and other targets of opportunity in parts of southwestern United States and northwestern Mexico were described. The experiments were designed to learn how effectively geologic features could be observed from orbit and what research information could be obtained from the observations when supported by ground studies. For the limited preparation they received, the crewmen demonstrated exceptional observational ability and produced outstanding photographic studies. They also formulated cogent opinions on how to improve future observational and photo-documentation techniques. From the photographs and other observations, it was possible to obtain significant research contributions to on-going field investigations. These contributions were integrated into other aspects of the ground investigations to the following topics: major faults, regional stratigraphy, occurrence of Precambrian crystalline rocks, mapping of Mesozoic volcanic rocks, regional geology.

Korea-United States Air Quality (KORUS-AQ) Campaign

NASA Technical Reports Server (NTRS)

Castellanos, Patricia; Da Silva, Arlindo; Longo-De Freitas, Karla

2017-01-01

The Korea-United States Air Quality (KORUS-AQ) campaign was an international cooperative field study based out of Osan Air Base, Songtan, South Korea (about 60 kilometers south of Seoul) in April-June 2016. A comprehensive suite of instruments capable of measuring atmospheric composition was deployed around the Korean peninsula on aircrafts, ships, and at ground sites in order to characterize local and transboundary pollution. The NASA Goddard Earth Observing System, version 5 (GEOS-5) forecast model was used for near real time meteorological and aerosol forecasting and flight planning during the KORUS-AQ campaign. Evaluation of GEOS-5 against observations from the campaign will help to identify inaccuracies in the models physical and chemical processes in this region within East Asia and lead to further developments of the modeling system.

Exerting control over the helical chirality in the main chain of sergeants-and-soldiers-type poly(quinoxaline-2,3-diyl)s by changing from random to block copolymerization protocols.

PubMed

Nagata, Yuuya; Nishikawa, Tsuyoshi; Suginome, Michinori

2015-04-01

Chiral random poly(quinoxaline-2,3-diyl) polymers of the sergeants-and-soldiers-type (sergeant units bearing (S)-3-octyloxymethyl groups) adopt an M- or P-helical conformation in the presence of achiral units bearing propoxymethyl or butoxy groups (soldier units), respectively. Unusual bidirectional induction of the helical sense can be observed for a copolymer with butoxy soldier units upon changing the mole fraction of the sergeant units. In the presence of 16-20% of sergeant units, the selective induction of a P-helix was observed, while the selective induction of an M-helix was observed for a mole fraction of sergeant units of more than 60%. This phenomenon could be successfully employed to control the helical chirality of copolymers by applying either random or block copolymerization protocols. Random or block copolymerization of sergeant and soldier monomers in a 18:82 ratio resulted in the formation of 250mers with almost absolute P- or M-helical conformation, respectively (>99% ee). Incorporation of a small amount of coordination sites into the random and block copolymers resulted in chiral macromolecular ligands, which allowed the enantioselective synthesis of both enantiomers in the Pd-catalyzed asymmetric hydrosilylation of β-methylstyrene.

Evidence of the Atlantic Multidecadal Oscillation driving multi-decadal variability of summertime surface air quality in the eastern United States: Implications for air quality management in the coming decades

NASA Astrophysics Data System (ADS)

Shen, L.; Mickley, L. J.

2016-12-01

Atlantic sea surface temperatures have a significant influence on the summertime meteorology and air quality in the eastern United States. In this study, we investigate the effect of the Atlantic Multidecadal Oscillation (AMO) on two key air pollutants, surface ozone and PM2.5, over the eastern United States. The shift of AMO from cold to warm phase increases surface air temperatures by 0.5 K across the East and reduces precipitation, resulting in a warmer and drier summer. By applying observed, present-day relationships between these pollutants and meteorological variables to a variety of observations and historical reanalysis datasets, we calculate the impacts of AMO on U.S. air quality. Our study reveals a multidecadal variability in mean summertime (JJA) maximum daily 8-hour (MDA8) ozone and surface PM2.5 concentrations in the eastern United States. In one-half cycle ( 30 years) of the AMO from negative to positive phase with constant anthropogenic emissions, JJA MDA8 ozone concentrations increase by 1-3 ppbv in the Northeast and 2-5 ppbv in the Great Plains; JJA PM2.5 concentrations increase by 0.8-1.2 μg m-3 in the Northeast and Southeast. The resulting impact on mortality rates is 4000 excess deaths per half cycle of AMO. We suggest that a complete picture of air quality management in coming decades requires consideration of the AMO influence.

Anthropogenic emissions of methane in the United States

PubMed Central

Miller, Scot M.; Wofsy, Steven C.; Michalak, Anna M.; Kort, Eric A.; Andrews, Arlyn E.; Biraud, Sebastien C.; Dlugokencky, Edward J.; Eluszkiewicz, Janusz; Fischer, Marc L.; Janssens-Maenhout, Greet; Miller, Ben R.; Miller, John B.; Montzka, Stephen A.; Nehrkorn, Thomas; Sweeney, Colm

2013-01-01

This study quantitatively estimates the spatial distribution of anthropogenic methane sources in the United States by combining comprehensive atmospheric methane observations, extensive spatial datasets, and a high-resolution atmospheric transport model. Results show that current inventories from the US Environmental Protection Agency (EPA) and the Emissions Database for Global Atmospheric Research underestimate methane emissions nationally by a factor of ∼1.5 and ∼1.7, respectively. Our study indicates that emissions due to ruminants and manure are up to twice the magnitude of existing inventories. In addition, the discrepancy in methane source estimates is particularly pronounced in the south-central United States, where we find total emissions are ∼2.7 times greater than in most inventories and account for 24 ± 3% of national emissions. The spatial patterns of our emission fluxes and observed methane–propane correlations indicate that fossil fuel extraction and refining are major contributors (45 ± 13%) in the south-central United States. This result suggests that regional methane emissions due to fossil fuel extraction and processing could be 4.9 ± 2.6 times larger than in EDGAR, the most comprehensive global methane inventory. These results cast doubt on the US EPA’s recent decision to downscale its estimate of national natural gas emissions by 25–30%. Overall, we conclude that methane emissions associated with both the animal husbandry and fossil fuel industries have larger greenhouse gas impacts than indicated by existing inventories. PMID:24277804

Eccentric muscle damage has variable effects on motor unit recruitment thresholds and discharge patterns in elbow flexor muscles.

PubMed

Dartnall, Tamara J; Rogasch, Nigel C; Nordstrom, Michael A; Semmler, John G

2009-07-01

The purpose of this study was to determine the effect of eccentric muscle damage on recruitment threshold force and repetitive discharge properties of low-threshold motor units. Ten subjects performed four tasks involving isometric contraction of elbow flexors while electromyographic (EMG) data were recorded from human biceps brachii and brachialis muscles. Tasks were 1) maximum voluntary contraction (MVC); 2) constant-force contraction at various submaximal targets; 3) motor unit recruitment threshold task; and 4) minimum motor unit discharge rate task. These tasks were performed on three separate days before, immediately after, and 24 h after eccentric exercise of elbow flexor muscles. MVC force declined (42%) immediately after exercise and remained depressed (29%) 24 h later, indicative of muscle damage. Mean motor unit recruitment threshold for biceps brachii was 8.4+/-4.2% MVC, (n=34) before eccentric exercise, and was reduced by 41% (5.0+/-3.0% MVC, n=34) immediately after and by 39% (5.2+/-2.5% MVC, n=34) 24 h after exercise. No significant changes in motor unit recruitment threshold were observed in the brachialis muscle. However, for the minimum tonic discharge rate task, motor units in both muscles discharged 11% faster (10.8+/-2.0 vs. 9.7+/-1.7 Hz) immediately after (n=29) exercise compared with that before (n=32). The minimum discharge rate variability was greater in brachialis muscle immediately after exercise (13.8+/-3.1%) compared with that before (11.9+/-3.1%) and 24 h after exercise (11.7+/-2.4%). No significant changes in minimum discharge rate variability were observed in the biceps brachii motor units after exercise. These results indicate that muscle damage from eccentric exercise alters motor unit recruitment thresholds for >or=24 h, but the effect is not the same in the different elbow flexor muscles.

The Effect of Planetariums on Teaching Specific Astronomy Concepts

NASA Astrophysics Data System (ADS)

Türk, Cumhur; Kalkan, Hüseyin

2015-02-01

This study aimed to determine students' knowledge levels related to specific astronomy concepts and the effect of a planetarium environment on teaching. The study sample included seventh-grade (12-13 years old) students. For this purpose, 240 students of various socioeconomic and cultural levels from six schools (two in the city center, two in the districts and two in the villages) were enrolled in the study. The pretest-posttest control group quasi-experimental design was used in the study. The experimental and control groups were generated by random assignment. The "Solar System and Beyond" unit was selected. In the experimental group, the unit was taught with the use of a planetarium environment, whereas the same unit was taught to the control group students in a classroom environment. A test consisting of 14 multiple-choice questions was used as the pretest and posttest at the beginning and end of the unit. The data obtained were evaluated using the SPSS 20.0 software package program. The study results showed that teaching astronomical concepts in a planetarium environment was more effective than in a classroom environment. The study also revealed that students in the planetarium-assisted group were more successful in comprehending subjects that require 3D thinking, a reference system, changing the time and observation of periodic motion than those in control group.

Short-term outcome of treatment limitation discussions for newborn infants, a multicentre prospective observational cohort study.

PubMed

Aladangady, Narendra; Shaw, Chloe; Gallagher, Katie; Stokoe, Elizabeth; Marlow, Neil

2017-03-01

To determine the short-term outcomes of babies for whom clinicians or parents discussed the limitation of life-sustaining treatment (LST). Prospective multicentre observational study. Two level 3, six level 2 and one level 1 neonatal units in the North-East London Neonatal Network. A total of 87 babies including 68 for whom limiting LST was discussed with parents and 19 babies died without discussion of limiting LST in the labour ward or neonatal unit. Final decision reached after discussions about limiting LST and neonatal unit outcomes (death or survived to discharge) for babies. Withdrawing LST, withholding LST and do not resuscitate (DNR) order was discussed with 48, 16 and 4 parents, respectively. In 49/68 (72%) cases decisions occurred in level 3 and 19 cases in level 2 units. Following the initial discussions, 34/68 parents made the decision to continue LST. In 33/68 cases, a second opinion was obtained. The parents of 14/48 and 2/16 babies did not agree to withdraw and withhold LST, respectively. Forty-seven out of 87 babies (54%) died following limitation of LST, 28/87 (32%) died receiving full intensive care support, 5/87 (6%) survived following a decision to limit LST and 7/87 (8%) babies survived following decision to continue LST. A significant proportion of parents chose to continue treatment following discussions regarding limiting LST for their babies, and a proportion of these babies survived to neonatal unit discharge. The long-term outcomes of babies who survive following limiting LST discussion need to be investigated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A diabetic foot service established by a department of vascular surgery: an observational study.

PubMed

Williams, Dean T; Majeed, Muhammad U; Shingler, Guy; Akbar, Mohammed J; Adamson, Diane G; Whitaker, Christopher J

2012-07-01

The mechanism by which the multidisciplinary approach to diabetic foot disease reduces amputation rates is unclear. Ischemia, sepsis, and necrosis represent aspects of severe diabetic foot disease amenable to intervention. In 2006, a vascular unit introduced a rapid access service for severe foot disease, augmenting the established community provision. This study aimed to determine whether concurrent changes in amputation rates were observed, and to identify areas that may have influenced outcomes. Unit data prospectively collected during 4 years for patients with lower-limb disease were compared with data retrieved over 2 years before the foot service. Outcome measurements were major amputations, foot surgery, vascular interventions, admissions, and length of stay. Major amputation rates associated with diabetes peaked in 2005 at 24.7/10,000 vs. 1.07/10,000 in 2009; (relative risk = 0.043, 95% confidence interval = 0.006-0.322). The proportion of diabetic to nondiabetic amputations decreased; foot surgery rates also dropped (53.7/10,000 in 2006 vs. 7.5/10,000 in 2009). The number of open revascularization procedures decreased, but the rates of endovascular procedures remained generally constant. Hospital admission rates decreased after initially peaking, and the length of stay was unchanged (16 vs. 15.5 days in 2004 and 2009, respectively). The integration of a vascular unit with community care has been associated with improved outcomes for patients with diabetic foot disease. Improvements were not related to the increased number of vascular procedures or hospitalizations, but did coincide with a greater proportion of patients attending the foot unit. The referral of patients to the unit facilitates the rapid management of severe disease, reducing delays deleterious to outcomes. Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

ERP Subsequent Memory Effects Differ between Inter-Item and Unitization Encoding Tasks

PubMed Central

Kamp, Siri-Maria; Bader, Regine; Mecklinger, Axel

2017-01-01

The “subsequent memory paradigm” is an analysis tool to identify brain activity elicited during episodic encoding that is associated with successful subsequent retrieval. Two commonly observed event-related potential “subsequent memory effects” (SMEs) are the parietal SME in the P300 time window and the frontal slow wave SME, but to date a clear characterization of the circumstances under which each SME is observed is missing. To test the hypothesis that the parietal SME occurs when aspects of an experience are unitized into a single item representation, while inter-item associative encoding is reflected in the frontal slow wave effect, participants were assigned to one of two conditions that emphasized one of the encoding types under otherwise matched study phases of a recognition memory experiment. Word pairs were presented either in the context of a definition that allowed to combine the word pairs into a new concept (unitization or item encoding) or together with a sentence frame (inter-item encoding). Performance on the recognition test did not differ between the groups. The parietal SME was only found in the definition group, supporting the idea that this SME occurs when the components of an association are integrated in a unitized item representation. An early prefrontal negativity also exhibited an SME only in this group, suggesting that the formation of novel units occurs through interactions of multiple brain areas. The frontal slow wave SME was pronounced in both groups and may thus reflect processes generally involved in encoding of associations. Our results provide evidence for a partial dissociation of the eliciting conditions of the two types of SMEs and therefore provide a tool for future studies to characterize the different types of episodic encoding. PMID:28194105

ERP Subsequent Memory Effects Differ between Inter-Item and Unitization Encoding Tasks.

PubMed

Kamp, Siri-Maria; Bader, Regine; Mecklinger, Axel

2017-01-01

The "subsequent memory paradigm" is an analysis tool to identify brain activity elicited during episodic encoding that is associated with successful subsequent retrieval. Two commonly observed event-related potential "subsequent memory effects" (SMEs) are the parietal SME in the P300 time window and the frontal slow wave SME, but to date a clear characterization of the circumstances under which each SME is observed is missing. To test the hypothesis that the parietal SME occurs when aspects of an experience are unitized into a single item representation, while inter-item associative encoding is reflected in the frontal slow wave effect, participants were assigned to one of two conditions that emphasized one of the encoding types under otherwise matched study phases of a recognition memory experiment. Word pairs were presented either in the context of a definition that allowed to combine the word pairs into a new concept (unitization or item encoding) or together with a sentence frame (inter-item encoding). Performance on the recognition test did not differ between the groups. The parietal SME was only found in the definition group, supporting the idea that this SME occurs when the components of an association are integrated in a unitized item representation. An early prefrontal negativity also exhibited an SME only in this group, suggesting that the formation of novel units occurs through interactions of multiple brain areas. The frontal slow wave SME was pronounced in both groups and may thus reflect processes generally involved in encoding of associations. Our results provide evidence for a partial dissociation of the eliciting conditions of the two types of SMEs and therefore provide a tool for future studies to characterize the different types of episodic encoding.

Management of cystinuric patients: an observational, retrospective, single-centre analysis.

PubMed

Ahmed, Kamran; Khan, Mohammad Shamim; Thomas, Kay; Challacombe, Ben; Bultitude, Matthew; Glass, Jonathan; Tiptaft, Richard; Dasgupta, Prokar

2008-01-01

A critical appraisal of the management of patients with cystine stones treated in our unit in the past 6 years and to analyze the outcome of multimodality therapies. An observational, single-centre retrospective study. We reviewed the records of all patients with stones referred to our centre over a 6-year period from 1998 to 2005. Data recorded included demographic details, medical therapies received/prescribed, compliance with medical therapies, mode of treatment, stone clearance and any recurrence during this period of study. A total of 30 cystinuric patients were treated in our institution over the period of 6 years from 1998 to early 2005. Of these 16 were males and 14 females with an average age at last follow-up of 39 years (range 15-70). Two patients were successfully managed medically. The remaining patients (n = 28) underwent a total of 237 procedures (pre- and postreferral to our unit), with an average of 7.9 procedures per patient for 126 stone episodes (4.2 episodes/patient). The modes of treatment included extracorporeal shockwave lithotripsy (n = 143), ureterorenoscopy and intracorporeal lithotripsy (n = 50), percutaneous nephrolithotomy (n = 28) and open procedures (n = 16). Two patients needed open surgery at our unit. Prior to referral to our dedicated unit, patients had received treatment with extracorporeal shockwave lithotripsy (multiple sessions), ureteroscopy (n = 14), percutaneous nephrolithotomy (n = 4) and open stone removal (n = 14). Most of the stones at our unit were managed using minimally invasive therapies. Compliance of cystinuric patients with medical treatment is often poor and patients experience recurrent stone episodes requiring multiple interventions. Modern management of cystine calculi should be with staged minimally invasive procedures to avoid the complications of multiple open procedures wherever possible along with appropriate medical prophylaxis.

Sensitivity of simulated maize crop yields to regional climate in the Southwestern United States

NASA Astrophysics Data System (ADS)

Kim, S.; Myoung, B.; Stack, D.; Kim, J.; Hatzopoulos, N.; Kafatos, M.

2013-12-01

The sensitivity of maize yield to the regional climate in the Southwestern United States (SW US) has been investigated by using a crop-yield simulation model (APSIM) in conjunction with meteorological forcings (daily minimum and maximum temperature, precipitation, and radiation) from the North American Regional Reanalysis (NARR) dataset. The primary focus of this study is to look at the effects of interannual variations of atmospheric components on the crop productivity in the SW US over the 21-year period (1991 to 2011). First of all, characteristics and performance of APSIM was examined by comparing simulated maize yields with observed yields from United States Department of Agriculture (USDA) and the leaf-area index (LAI) from MODIS satellite data. Comparisons of the simulated maize yield with the available observations show that the crop model can reasonably reproduce observed maize yields. Sensitivity tests were performed to assess the relative contribution of each climate driver to regional crop yield. Sensitivity experiments show that potential crop production responds nonlinearly to climate drivers and the yield sensitivity varied among geographical locations depending on their mean climates. Lastly, a detailed analysis of both the spatial and temporal variations of each climate driver in the regions where maize is actually grown in three states (CA, AZ, and NV) in the SW US was performed.

Novel variants of the 5S rRNA genes in Eruca sativa.

PubMed

Singh, K; Bhatia, S; Lakshmikumaran, M

1994-02-01

The 5S ribosomal RNA (rRNA) genes of Eruca sativa were cloned and characterized. They are organized into clusters of tandemly repeated units. Each repeat unit consists of a 119-bp coding region followed by a noncoding spacer region that separates it from the coding region of the next repeat unit. Our study reports novel gene variants of the 5S rRNA genes in plants. Two families of the 5S rDNA, the 0.5-kb size family and the 1-kb size family, coexist in the E. sativa genome. The 0.5-kb size family consists of the 5S rRNA genes (S4) that have coding regions similar to those of other reported plant 5S rDNA sequences, whereas the 1-kb size family consists of the 5S rRNA gene variants (S1) that exist as 1-kb BamHI tandem repeats. S1 is made up of two variant units (V1 and V2) of 5S rDNA where the BamHI site between the two units is mutated. Sequence heterogeneity among S4, V1, and V2 units exists throughout the sequence and is not limited to the noncoding spacer region only. The coding regions of V1 and V2 show approximately 20% dissimilarity to the coding regions of S4 and other reported plant 5S rDNA sequences. Such a large variation in the coding regions of the 5S rDNA units within the same plant species has been observed for the first time. Restriction site variation is observed between the two size classes of 5S rDNA in E. sativa.(ABSTRACT TRUNCATED AT 250 WORDS)

Polyprenols in leaves of fruit-trees of Rosaceae family.

PubMed

Swiezewska, E; Chojnacki, T

1996-01-01

In leaves of various species of fruit-trees belonging to the Rosaceae family, large amounts of polyprenyl acetates (0.5-5.0% of dry weight) were found. Discrete constant differences of polyprenol spectrum characteristic of each genus studied: Malus, Prunus and Pyrus were observed. In each species poly-cis-prenols composed of 19 and 20 isoprene units were predominating. In one of the 23 studied species (Prunus incisa) a fraction of long-chain polyprenols composed of 35-45 isoprene units was also present. It seems that this type of unusually long-chain polyprenols could occur also in other plants of the Rosaceae family.

The Economics of an Admissions Holding Unit.

PubMed

Schreyer, Kraftin E; Martin, Richard

2017-06-01

With increasing attention to the actual cost of delivering care, return-on-investment calculations take on new significance. Boarded patients in the emergency department (ED) are harmful to clinical care and have significant financial opportunity costs. We hypothesize that investment in an admissions holding unit for admitted ED patients not only captures opportunity cost but also significantly lowers direct cost of care. This was a three-phase study at a busy urban teaching center with significant walkout rate. We first determined the true cost of maintaining a staffed ED bed for one patient-hour and compared it to alternative settings. The opportunity cost for patients leaving without being seen was then conservatively estimated. Lastly, a convenience sample of admitted patients boarding in the ED was observed continuously from one hour after decision-to-admit until physical departure from the ED to capture a record of every interaction with a nurse or physician. Personnel costs per patient bed-hour were $58.20 for the ED, $24.80 for an inpatient floor, $19.20 for the inpatient observation unit, and $10.40 for an admissions holding area. An eight-bed holding unit operating at practical capacity would free 57.4 hours of bed space in the ED and allow treatment of 20 additional patients. This could yield increased revenues of $27,796 per day and capture opportunity cost of $6.09 million over 219 days, in return for extra staffing costs of $218,650. Analysis of resources used for boarded patients was determined by continuous observation of a convenience sample of ED-boarded patients, which found near-zero interactions with both nursing and physicians during the boarding interval. Resource expense per ED bed-hour is more than twice that in non-critical care inpatient units. Despite the high cost of available resources, boarded non-critical patients receive virtually no nursing or physician attention. An admissions holding unit is remarkably effective in avoiding the mismatch of the low-needs patients in high-cost care venues. Return on investment is enormous, but this assumes existing clinical space for this unit.

Whiteness in the Social Studies Classroom: Students' Conceptions of Race and Ethnicity in United States History

ERIC Educational Resources Information Center

Martell, Christopher C.

2013-01-01

In this study, the researcher examined student conceptions of "Whiteness" as it relates to past and present U.S. history. Using Critical Race Theory as the lens, this study employed mixed methods, analyzing teacher observations, classroom artifacts/student work, survey, and interview data from White students and students of color at an…

Studies of Physical Education in the United States Using SOFIT: A Review

ERIC Educational Resources Information Center

McKenzie, Thomas L.; Smith, Nicole J.

2017-01-01

Purpose: An objective database for physical education (PE) is important for policy and practice decisions, and the System for Observing Fitness Instruction Time (SOFIT) has been identified as an appropriate surveillance tool for PE across the nation. The purpose of this review was to assess peer-reviewed studies using SOFIT to study K-12 PE in…

Culturally and Linguistically Responsive Teaching in Practice: A Case Study of a Fourth-Grade Mainstream Classroom Teacher

ERIC Educational Resources Information Center

Zhang-Wu, Qianqian

2017-01-01

As a result of increases in immigration, more students from culturally and linguistically diverse backgrounds are entering K-12 classrooms in the United States. Thus, the need to study the education of diverse learners is intensified. Drawing upon semi-structured interviews, observations, and informal conversations, this case study examined how a…

Coding and quantification of a facial expression for pain in lambs.

PubMed

Guesgen, M J; Beausoleil, N J; Leach, M; Minot, E O; Stewart, M; Stafford, K J

2016-11-01

Facial expressions are routinely used to assess pain in humans, particularly those who are non-verbal. Recently, there has been an interest in developing coding systems for facial grimacing in non-human animals, such as rodents, rabbits, horses and sheep. The aims of this preliminary study were to: 1. Qualitatively identify facial feature changes in lambs experiencing pain as a result of tail-docking and compile these changes to create a Lamb Grimace Scale (LGS); 2. Determine whether human observers can use the LGS to differentiate tail-docked lambs from control lambs and differentiate lambs before and after docking; 3. Determine whether changes in facial action units of the LGS can be objectively quantified in lambs before and after docking; 4. Evaluate effects of restraint of lambs on observers' perceptions of pain using the LGS and on quantitative measures of facial action units. By comparing images of lambs before (no pain) and after (pain) tail-docking, the LGS was devised in consultation with scientists experienced in assessing facial expression in other species. The LGS consists of five facial action units: Orbital Tightening, Mouth Features, Nose Features, Cheek Flattening and Ear Posture. The aims of the study were addressed in two experiments. In Experiment I, still images of the faces of restrained lambs were taken from video footage before and after tail-docking (n=4) or sham tail-docking (n=3). These images were scored by a group of five naïve human observers using the LGS. Because lambs were restrained for the duration of the experiment, Ear Posture was not scored. The scores for the images were averaged to provide one value per feature per period and then scores for the four LGS action units were averaged to give one LGS score per lamb per period. In Experiment II, still images of the faces nine lambs were taken before and after tail-docking. Stills were taken when lambs were restrained and unrestrained in each period. A different group of five human observers scored the images from Experiment II. Changes in facial action units were also quantified objectively by a researcher using image measurement software. In both experiments LGS scores were analyzed using a linear MIXED model to evaluate the effects of tail docking on observers' perception of facial expression changes. Kendall's Index of Concordance was used to measure reliability among observers. In Experiment I, human observers were able to use the LGS to differentiate docked lambs from control lambs. LGS scores significantly increased from before to after treatment in docked lambs but not control lambs. In Experiment II there was a significant increase in LGS scores after docking. This was coupled with changes in other validated indicators of pain after docking in the form of pain-related behaviour. Only two components, Mouth Features and Orbital Tightening, showed significant quantitative changes after docking. The direction of these changes agree with the description of these facial action units in the LGS. Restraint affected people's perceptions of pain as well as quantitative measures of LGS components. Freely moving lambs were scored lower using the LGS over both periods and had a significantly smaller eye aperture and smaller nose and ear angles than when they were held. Agreement among observers for LGS scores were fair overall (Experiment I: W=0.60; Experiment II: W=0.66). This preliminary study demonstrates changes in lamb facial expression associated with pain. The results of these experiments should be interpreted with caution due to low lamb numbers. Copyright © 2016 Elsevier B.V. All rights reserved.

Readmissions, Observation, and the Hospital Readmissions Reduction Program.

PubMed

Zuckerman, Rachael B; Sheingold, Steven H; Orav, E John; Ruhter, Joel; Epstein, Arnold M

2016-04-21

The Hospital Readmissions Reduction Program, which is included in the Affordable Care Act (ACA), applies financial penalties to hospitals that have higher-than-expected readmission rates for targeted conditions. Some policy analysts worry that reductions in readmissions are being achieved by keeping returning patients in observation units instead of formally readmitting them to the hospital. We examined the changes in readmission rates and stays in observation units over time for targeted and nontargeted conditions and assessed whether hospitals that had greater increases in observation-service use had greater reductions in readmissions. We compared monthly, hospital-level rates of readmission and observation-service use within 30 days after hospital discharge among Medicare elderly beneficiaries from October 2007 through May 2015. We used an interrupted time-series model to determine when trends changed and whether changes differed between targeted and nontargeted conditions. We assessed the correlation between changes in readmission rates and use of observation services after adoption of the ACA in March 2010. We analyzed data from 3387 hospitals. From 2007 to 2015, readmission rates for targeted conditions declined from 21.5% to 17.8%, and rates for nontargeted conditions declined from 15.3% to 13.1%. Shortly after passage of the ACA, the readmission rate declined quickly, especially for targeted conditions, and then continued to fall at a slower rate after October 2012 for both targeted and nontargeted conditions. Stays in observation units for targeted conditions increased from 2.6% in 2007 to 4.7% in 2015, and rates for nontargeted conditions increased from 2.5% to 4.2%. Within hospitals, there was no significant association between changes in observation-unit stays and readmissions after implementation of the ACA. Readmission trends are consistent with hospitals' responding to incentives to reduce readmissions, including the financial penalties for readmissions under the ACA. We did not find evidence that changes in observation-unit stays accounted for the decrease in readmissions.

The importance of unitization for familiarity-based learning.

PubMed

Parks, Colleen M; Yonelinas, Andrew P

2015-05-01

It is often assumed that recollection is necessary to support memory for novel associations, whereas familiarity supports memory for single items. However, the levels of unitization framework assumes that familiarity can support associative memory under conditions in which the components of an association are unitized (i.e., treated as a single coherent item). In the current study we tested two critical assumptions of this framework. First, does unitization reflect a specialized form of learning or is it simply a form of semantic or elaborative encoding, and, second, can the beneficial effects of unitization on familiarity be observed for across-domain associations or are they limited to creating new associations between items that are from the same stimulus domains? Unitization was found to increase associative recognition but not item recognition. It affected familiarity more than recollection, increased associative but not item priming, and was dissociable from levels of processing effects. Moreover, unitization effects were found to be particularly effective in supporting face-word and fractal-sound pairs. The current results indicate that unitization reflects a specialized form of learning that supports associative familiarity of within- and across-domain associations. (c) 2015 APA, all rights reserved).

The importance of unitization for familiarity-based learning

PubMed Central

Parks, Colleen M.; Yonelinas, Andrew P.

2014-01-01

It is often assumed that recollection is necessary to support memory for novel associations, whereas familiarity supports memory for single items. However, the levels of unitization (LOU) framework assumes that familiarity can support associative memory under conditions in which the components of an association are unitized (i.e., treated as a single coherent item). In the current study we test two critical assumptions of this framework. First, does unitization reflect a specialized form of learning or is it simply a form of semantic or elaborative encoding, and, second, can the beneficial effects of unitization on familiarity be observed for across-domain associations or are they limited to creating new associations between items that are from the same stimulus domains? Unitization was found to increase associative recognition but not item recognition, it affected familiarity more so than recollection, it increased associative but not item priming, and it was dissociable from levels of processing effects. Moreover, unitization effects were found to be particularly effective in supporting face-word and fractal-sound pairs. The current results indicate that unitization reflects a specialized form of learning that supports associative familiarity of within- and across-domain associations. PMID:25329077

GROWING SEEDS, TEACHER'S GUIDE.

ERIC Educational Resources Information Center

Elementary Science Study, Newton, MA.

THIS TEACHER'S GUIDE IS DESIGNED FOR USE WITH AN ELEMENTARY SCIENCE STUDY UNIT, "GROWING SEEDS," IN WHICH SUCH BASIC SCIENCE SKILLS AND PROCESSES AS MEASUREMENT, OBSERVATION, AND HYPOTHESIS FORMATION ARE INTRODUCED THROUGH STUDENT ACTIVITIES INVOLVING SEEDS, GERMINATION, AND SEEDLING GROWTH. THE MATERIALS WERE DEVELOPED FOR USE IN…

Remodeling of motor units after nerve regeneration studied by quantitative electromyography.

PubMed

Krarup, Christian; Boeckstyns, Michel; Ibsen, Allan; Moldovan, Mihai; Archibald, Simon

2016-02-01

Peripheral nerve has the capacity to regenerate after nerve lesions; during reinnervation of muscle motor units are gradually reestablished. The aim of this study was to follow the time course of reestablishing and remodeling of motor units in relation to recovery of force after different types of nerve repair. Reinnervation of muscle was compared clinically and electrophysiologically in complete median or ulnar nerve lesions with short gap lengths in the distal forearm repaired with a collagen nerve conduit (11 nerves) or nerve suture (10 nerves). Reestablishment of motor units was studied by quantitative EMG and recording of evoked compound muscle action potential (CMAP) during a 24-month observation period after nerve repair. Force recovered partially to about 80% of normal. Denervation activity gradually decreased during reinnervation though it was still increased at 24 months. Nascent motor unit potentials (MUPs) at early reinnervation were prolonged and polyphasic. During longitudinal studies, MUPs remained prolonged and their amplitudes gradually increased markedly. Firing of MUPs was unstable throughout the study. CMAPs gradually increased and the number of motor units recovered to approximately 20% of normal. There was weak evidence of CMAP amplitude recovery after suture ahead of conduit repair but without treatment related differences at 2 years. Surgical repair of nerve lesions with a nerve conduit or suture supported recovery of force and of motor unit reinnervation to the same extent. Changes occurred at a higher rate during early regeneration and slower after 12 months but should be followed for at least 2 years to assess outcome. EMG changes reflected extensive remodeling of motor units from early nascent units to a mature state with greatly enlarged units due to axonal regeneration and collateral sprouting and maturation of regenerated nerve and reinnervated muscle fibers after both types of repair. Remodeling of motor units after peripheral nerve lesions provides the basis for better recovery of force than the number of motor axons and units. There were no differences after repair with a collagen nerve conduit and nerve suture at short nerve gap lengths. The reduced number of motor units indicates that further improvement of repair procedures and nerve environment is needed. Copyright © 2015 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Development of an observational measure of healthcare worker hand-hygiene behaviour: the hand-hygiene observation tool (HHOT).

PubMed

McAteer, J; Stone, S; Fuller, C; Charlett, A; Cookson, B; Slade, R; Michie, S

2008-03-01

Previous observational measures of healthcare worker (HCW) hand-hygiene behaviour (HHB) fail to provide adequate standard operating procedures (SOPs), accounts of inter-rater agreement testing or evidence of sensitivity to change. This study reports the development of an observational tool in a way that addresses these deficiencies. Observational categories were developed systematically, guided by a clinical guideline, previous measures and pilot hand-hygiene behaviour observations (HHOs). The measure, a simpler version of the Geneva tool, consists of HHOs (before and after low-risk, high-risk or unobserved contact), HHBs (soap, alcohol hand rub, no action, unknown), and type of HCW. Inter-observer agreement for each category was assessed by observation of 298 HHOs and HHBs by two independent observers on acute elderly and intensive care units. Raw agreement (%) and Kappa were 77% and 0.68 for HHB; 83% and 0.77 for HHO; and 90% and 0.77 for HCW. Inter-observer agreement for overall compliance of a group of HCWs was assessed by observation of 1191 HHOs and HHBs by two pairs of independent observers. Overall agreement was good (intraclass correlation coefficient = 0.79). Sensitivity to change was examined by autoregressive time-series modelling of longitudinal observations for 8 months on the intensive therapy unit during an Acinetobacter baumannii outbreak and subsequent strengthening of infection control measures. Sensitivity to change was demonstrated by a rise in compliance from 80 to 98% with an odds ratio of increased compliance of 7.00 (95% confidence interval: 4.02-12.2) P < 0.001.

Hand disinfection in a neonatal intensive care unit: continuous electronic monitoring over a one-year period.

PubMed

Helder, Onno K; van Goudoever, Johannes B; Hop, Wim C J; Brug, Johannes; Kornelisse, René F

2012-10-08

Good hand hygiene compliance is essential to prevent nosocomial infections in healthcare settings. Direct observation of hand hygiene compliance is the gold standard but is time consuming. An electronic dispenser with built-in wireless recording equipment allows continuous monitoring of its usage. The purpose of this study was to monitor the use of alcohol-based hand rub dispensers with a built-in electronic counter in a neonatal intensive care unit (NICU) setting and to determine compliance with hand hygiene protocols by direct observation. A one-year observational study was conducted at a 27 bed level III NICU at a university hospital. All healthcare workers employed at the NICU participated in the study. The use of bedside dispensers was continuously monitored and compliance with hand hygiene was determined by random direct observations. A total of 258,436 hand disinfection events were recorded; i.e. a median (interquartile range) of 697 (559-840) per day. The median (interquartile range) number of hand disinfection events performed per healthcare worker during the day, evening, and night shifts was 13.5 (10.8 - 16.7), 19.8 (16.3 - 24.1), and 16.6 (14.2 - 19.3), respectively. In 65.8% of the 1,168 observations of patient contacts requiring hand hygiene, healthcare workers fully complied with the protocol. We conclude that the electronic devices provide useful information on frequency, time, and location of its use, and also reveal trends in hand disinfection events over time. Direct observations offer essential data on compliance with the hand hygiene protocol. In future research, data generated by the electronic devices can be supplementary used to evaluate the effectiveness of hand hygiene promotion campaigns.

Independence of motor unit recruitment and rate modulation during precision force control.

PubMed

Kamen, G; Du, D C

1999-01-01

The vertebrate motor system chiefly employs motor unit recruitment and rate coding to modulate muscle force output. In this paper, we studied how the recruitment of new motor units altered the firing rate of already-active motor units during precision force production in the first dorsal interosseous muscle. Six healthy adults performed linearly increasing isometric voluntary contractions while motor unit activity and force output were recorded. After motor unit discharges were identified, motor unit firing rates were calculated before and after the instances of new motor unit recruitment. Three procedures were applied to compute motor unit firing rate, including the mean of a fixed number of inter-spike intervals and the constant width weighted Hanning window filter method, as well as a modified boxcar technique. In contrast to previous reports, the analysis of the firing rates of over 200 motor units revealed that reduction of the active firing rates was not a common mechanism used to accommodate the twitch force produced by the recruitment of a new motor unit. Similarly, during de-recruitment there was no tendency for motor unit firing rates to increase immediately following the cessation of activity in other motor units. Considerable consistency in recruitment behavior was observed during repeated contractions. However, firing rates during repeated contractions demonstrated considerably more fluctuation. It is concluded that the neuromuscular system does not use short-term preferential motor unit disfacilitation to effect precise regulation of muscular force output.

Policies for management of postpartum haemorrhage: the HERA cross-sectional study in France.

PubMed

Vendittelli, Françoise; Barasinski, Chloé; Pereira, Bruno; Dreyfus, Michel; Lémery, Didier; Bouvier-Colle, Marie-Hélène

2016-10-01

The principal objective of this study was to describe the policies reported by French maternity units for the prevention and early management of postpartum haemorrhage (PPH). The second objective was to assess their variation according to hospital level and status. Cross-sectional observational study of French maternity units, from January 2010 to April 2011. The medical supervisor (obstetrician or midwife) of participating maternity wards completed a questionnaire designed to ascertain the unit's protocol for preventing and managing PPH after both vaginal and caesarean deliveries at a gestational age >22 weeks (or a birth weight >500g). The main outcome measure was the percentage of units reporting protocols adhering to the principal criteria for adequate management defined by the 2004 French guidelines for PPH. 252 maternity units participated in the survey. Almost all units had a written protocol for PPH (97.2%). For vaginal deliveries, 82.5% of units had a definition of PPH (>500ml) and 92.8% had a policy of preventive oxytocin use. For caesareans, only 23.8% defined PPH (as >1000ml), 68.8% used manual delivery of the placenta, and 76.9% recommended oxytocin injection immediately after the birth. The first-line medication for PPH was oxytocin (96.3%) and the second-line treatment a prostaglandin (97.5%). Level III maternity units had a definition of haemorrhage for vaginal deliveries more often than did other levels of care (P=0.04). Manual removal of the placenta after caesareans was significantly more frequent in level I than level III units (P=0.008) and in private than other types of maternity units. Medical management of haemorrhage did not differ according to level of care or maternity status. The responses by maternity unit supervisors showed significant improvement in the management of PPH accordingly to the 2004 French guidelines, especially for the third stage of labour. This improvement did not differ between hospitals by levels of care or legal status. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Concurrent and lagged effects of registered nurse turnover and staffing on unit-acquired pressure ulcers.

PubMed

Park, Shin Hye; Boyle, Diane K; Bergquist-Beringer, Sandra; Staggs, Vincent S; Dunton, Nancy E

2014-08-01

We examined the concurrent and lagged effects of registered nurse (RN) turnover on unit-acquired pressure ulcer rates and whether RN staffing mediated the effects. Quarterly unit-level data were obtained from the National Database of Nursing Quality Indicators for 2008 to 2010. A total of 10,935 unit-quarter observations (2,294 units, 465 hospitals) were analyzed. This longitudinal study used multilevel regressions and tested time-lagged effects of study variables on outcomes. The lagged effect of RN turnover on unit-acquired pressure ulcers was significant, while there was no concurrent effect. For every 10 percentage-point increase in RN turnover in a quarter, the odds of a patient having a pressure ulcer increased by 4 percent in the next quarter. Higher RN turnover in a quarter was associated with lower RN staffing in the current and subsequent quarters. Higher RN staffing was associated with lower pressure ulcer rates, but it did not mediate the relationship between turnover and pressure ulcers. We suggest that RN turnover is an important factor that affects pressure ulcer rates and RN staffing needed for high-quality patient care. Given the high RN turnover rates, hospital and nursing administrators should prepare for its negative effect on patient outcomes. © Health Research and Educational Trust.

Obesity and excess mortality among the elderly in the United States and Mexico.

PubMed

Monteverde, Malena; Noronha, Kenya; Palloni, Alberto; Novak, Beatriz

2010-02-01

Increasing levels of obesity could compromise future gains in life expectancy in low- and high-income countries. Although excess mortality associated with obesity and, more generally, higher levels of body mass index (BAI) have been investigated in the United States, there is little research about the impact of obesity on mortality in Latin American countries, where very the rapid rate of growth of prevalence of obesity and overweight occur jointly with poor socioeconomic conditions. The aim of this article is to assess the magnitude of excess mortality due to obesity and overweight in Mexico and the United States. For this purpose, we take advantage of two comparable data sets: the Health and Retirement Study 2000 and 2004 for the United States, and the Mexican Health and Aging Study 2001 and 2003 for Mexico. We find higher excess mortality risks among obese and overweight individuals aged 60 and older in Mexico than in the United States. Yet, when analyzing excess mortality among different socioeconomic strata, we observe greater gaps by education in the United States than in Mexico. We also find that although the probability of experiencing obesity-related chronic diseases among individuals with high BMI is larger for the U.S. elderly, the relative risk of dying conditional on experiencing these diseases is higher in Mexico.

Concurrent and Lagged Effects of Registered Nurse Turnover and Staffing on Unit-Acquired Pressure Ulcers

PubMed Central

Park, Shin Hye; Boyle, Diane K; Bergquist-Beringer, Sandra; Staggs, Vincent S; Dunton, Nancy E

2014-01-01

Objective We examined the concurrent and lagged effects of registered nurse (RN) turnover on unit-acquired pressure ulcer rates and whether RN staffing mediated the effects. Data Sources/Setting Quarterly unit-level data were obtained from the National Database of Nursing Quality Indicators for 2008 to 2010. A total of 10,935 unit-quarter observations (2,294 units, 465 hospitals) were analyzed. Methods This longitudinal study used multilevel regressions and tested time-lagged effects of study variables on outcomes. Findings The lagged effect of RN turnover on unit-acquired pressure ulcers was significant, while there was no concurrent effect. For every 10 percentage-point increase in RN turnover in a quarter, the odds of a patient having a pressure ulcer increased by 4 percent in the next quarter. Higher RN turnover in a quarter was associated with lower RN staffing in the current and subsequent quarters. Higher RN staffing was associated with lower pressure ulcer rates, but it did not mediate the relationship between turnover and pressure ulcers. Conclusions We suggest that RN turnover is an important factor that affects pressure ulcer rates and RN staffing needed for high-quality patient care. Given the high RN turnover rates, hospital and nursing administrators should prepare for its negative effect on patient outcomes. PMID:24476194

Evaluation of the importance of time-frequency contributions to speech intelligibility in noise

PubMed Central

Yu, Chengzhu; Wójcicki, Kamil K.; Loizou, Philipos C.; Hansen, John H. L.; Johnson, Michael T.

2014-01-01

Recent studies on binary masking techniques make the assumption that each time-frequency (T-F) unit contributes an equal amount to the overall intelligibility of speech. The present study demonstrated that the importance of each T-F unit to speech intelligibility varies in accordance with speech content. Specifically, T-F units are categorized into two classes, speech-present T-F units and speech-absent T-F units. Results indicate that the importance of each speech-present T-F unit to speech intelligibility is highly related to the loudness of its target component, while the importance of each speech-absent T-F unit varies according to the loudness of its masker component. Two types of mask errors are also considered, which include miss and false alarm errors. Consistent with previous work, false alarm errors are shown to be more harmful to speech intelligibility than miss errors when the mixture signal-to-noise ratio (SNR) is below 0 dB. However, the relative importance between the two types of error is conditioned on the SNR level of the input speech signal. Based on these observations, a mask-based objective measure, the loudness weighted hit-false, is proposed for predicting speech intelligibility. The proposed objective measure shows significantly higher correlation with intelligibility compared to two existing mask-based objective measures. PMID:24815280

Dramatic decline in substance use by HIV-infected pregnant women in the United States from 1990 to 2012.

PubMed

Rough, Kathryn; Tassiopoulos, Katherine; Kacanek, Deborah; Griner, Raymond; Yogev, Ram; Rich, Kenneth C; Seage, George R

2015-01-02

We aimed to describe temporal changes in substance use among HIV-infected pregnant women in the United States from 1990 to 2012. Data came from two prospective cohort studies (Women and Infants Transmission Study and Surveillance Monitoring for Antiretroviral Therapy Toxicities Study). Women were classified as using a substance during pregnancy if they self-reported use or had a positive biological sample. To account for correlation between repeated pregnancies by the same woman, generalized estimating equation models were used to test for temporal trends and evaluate predictors of substance use. Over the 23-year period, substance use among the 5451 HIV-infected pregnant women sharply declined; 82% of women reported substance use during pregnancy in 1990, compared with 23% in 2012. Use of each substance decreased significantly (P < 0.001 for each substance) in an approximately linear fashion, until reaching a plateau in 2006. Multivariable models showed substance use was inversely associated with receiving antiretroviral therapy. Among the subset of 824 women with multiple pregnancies under observation, women who used a substance in their previous pregnancy were at elevated risk of substance use during their next pregnancy (risk ratio, 5.71; 95% confidence interval, 4.63-7.05). A substantial decrease in substance use during pregnancy was observed between 1990 and 2012 in two large US cohorts of HIV-infected women. Substance use prevalence in these cohorts became similar to that of pregnant women in the general US population by the mid-2000s, suggesting that the observed decrease may be due to an epidemiological transition of the HIV epidemic among women in the United States.

Seasonality of Aerosols the Southeastern United States

NASA Astrophysics Data System (ADS)

Ford, B. J.; Heald, C. L.

2012-12-01

Previous studies have suggested that increases in atmospheric aerosols of biogenic origin may have caused regional cooling over the southeastern United States in recent decades. Understanding the sources and behaviors of these aerosols is important for determining their role in a changing climate and managing their air quality impacts. In this study, we investigate the strong seasonality in aerosol optical depth (AOD) observed by MODIS, MISR, and CALIOP instruments over the southeastern United States and show that this is not simulated by a chemical transport model (GEOS-Chem). However, the model does reproduce surface PM 2.5 concentrations in the region as reported by the IMPROVE and Southeastern Aerosol Research and Characterization (SEARCH) networks, as well as the muted seasonality of these concentrations. In addition, these surface measurements show that organic aerosol makes up a small fraction of total PM 2.5 and has relatively little seasonality, which calls into question the importance of biogenic aerosol as a driver for climate change in the region. Sounding profiles and ground observations of relative humidity suggest that the magnitude of seasonality in AOD cannot be explained by seasonal differences in the hygroscopic growth of aerosols. CALIOP measurements of the vertical profile of aerosol extinction confirm that the likely reconciliation of the differences in seasonality between the surface PM 2.5 and AOD observations is the formation of aerosol aloft, a process not captured by the model. These findings provide initial insights for the Southern Oxidant and Aerosol Study (SOAS) campaign in 2013 which aims to investigate the anthropogenic influence on biogenic aerosol formation in the Southeastern US and elucidate the impact on regional climate and air quality.

The Identification of Seniors at Risk (ISAR) score to predict clinical outcomes and health service costs in older people discharged from UK acute medical units.

PubMed

Edmans, Judi; Bradshaw, Lucy; Gladman, John R F; Franklin, Matthew; Berdunov, Vladislav; Elliott, Rachel; Conroy, Simon P

2013-11-01

tools are required to identify high-risk older people in acute emergency settings so that appropriate services can be directed towards them. to evaluate whether the Identification of Seniors At Risk (ISAR) predicts the clinical outcomes and health and social services costs of older people discharged from acute medical units. an observational cohort study using receiver-operator curve analysis to compare baseline ISAR to an adverse clinical outcome at 90 days (where an adverse outcome was any of death, institutionalisation, hospital readmission, increased dependency in activities of daily living (decrease of 2 or more points on the Barthel ADL Index), reduced mental well-being (increase of 2 or more points on the 12-point General Health Questionnaire) or reduced quality of life (reduction in the EuroQol-5D) and high health and social services costs over 90 days estimated from routine electronic service records. two acute medical units in the East Midlands, UK. a total of 667 patients aged ≥70 discharged from acute medical units. an adverse outcome at 90 days was observed in 76% of participants. The ISAR was poor at predicting adverse outcomes (AUC: 0.60, 95% CI: 0.54-0.65) and fair for health and social care costs (AUC: 0.70, 95% CI: 0.59-0.81). adverse outcomes are common in older people discharged from acute medical units in the UK; the poor predictive ability of the ISAR in older people discharged from acute medical units makes it unsuitable as a sole tool in clinical decision-making.

Hydrological Modeling in Alaska with WRF-Hydro

NASA Astrophysics Data System (ADS)

Elmer, N. J.; Zavodsky, B.; Molthan, A.

2017-12-01

The operational National Water Model (NWM), implemented in August 2016, is an instantiation of the Weather Research and Forecasting hydrological extension package (WRF-Hydro). Currently, the NWM only covers the contiguous United States, but will be expanded to include an Alaska domain in the future. It is well known that Alaska presents several hydrological modeling challenges, including unique arctic/sub-arctic hydrological processes not observed elsewhere in the United States and a severe lack of in-situ observations for model initialization. This project sets up an experimental version of WRF-Hydro in Alaska mimicking the NWM to gauge the ability of WRF-Hydro to represent hydrological processes in Alaska and identify model calibration challenges. Recent and upcoming launches of hydrology-focused NASA satellite missions such as the Soil Moisture Active Passive (SMAP) and Surface Water Ocean Topography (SWOT) expand the spatial and temporal coverage of observations in Alaska, so this study also lays the groundwork for assimilating these NASA datasets into WRF-Hydro in the future.

Dynamic Behavior of Engineered Lattice Materials

PubMed Central

Hawreliak, J. A.; Lind, J.; Maddox, B.; Barham, M.; Messner, M.; Barton, N.; Jensen, B. J.; Kumar, M.

2016-01-01

Additive manufacturing (AM) is enabling the fabrication of materials with engineered lattice structures at the micron scale. These mesoscopic structures fall between the length scale associated with the organization of atoms and the scale at which macroscopic structures are constructed. Dynamic compression experiments were performed to study the emergence of behavior owing to the lattice periodicity in AM materials on length scales that approach a single unit cell. For the lattice structures, both bend and stretch dominated, elastic deflection of the structure was observed ahead of the compaction of the lattice, while no elastic deformation was observed to precede the compaction in a stochastic, random structure. The material showed lattice characteristics in the elastic response of the material, while the compaction was consistent with a model for compression of porous media. The experimental observations made on arrays of 4 × 4 × 6 lattice unit cells show excellent agreement with elastic wave velocity calculations for an infinite periodic lattice, as determined by Bloch wave analysis, and finite element simulations. PMID:27321697

Mentalizing skills do not differentiate believers from non-believers, but credibility enhancing displays do.

PubMed

Maij, David L R; van Harreveld, Frenk; Gervais, Will; Schrag, Yann; Mohr, Christine; van Elk, Michiel

2017-01-01

The ability to mentalize has been marked as an important cognitive mechanism enabling belief in supernatural agents. In five studies we cross-culturally investigated the relationship between mentalizing and belief in supernatural agents with large sample sizes (over 67,000 participants in total) and different operationalizations of mentalizing. The relative importance of mentalizing for endorsing supernatural beliefs was directly compared with credibility enhancing displays-the extent to which people observed credible religious acts during their upbringing. We also compared autistic with neurotypical adolescents. The empathy quotient and the autism-spectrum quotient were not predictive of belief in supernatural agents in all countries (i.e., The Netherlands, Switzerland and the United States), although we did observe a curvilinear effect in the United States. We further observed a strong influence of credibility enhancing displays on belief in supernatural agents. These findings highlight the importance of cultural learning for acquiring supernatural beliefs and ask for reconsiderations of the importance of mentalizing.

Mentalizing skills do not differentiate believers from non-believers, but credibility enhancing displays do

PubMed Central

van Harreveld, Frenk; Gervais, Will; Schrag, Yann; Mohr, Christine; van Elk, Michiel

2017-01-01

The ability to mentalize has been marked as an important cognitive mechanism enabling belief in supernatural agents. In five studies we cross-culturally investigated the relationship between mentalizing and belief in supernatural agents with large sample sizes (over 67,000 participants in total) and different operationalizations of mentalizing. The relative importance of mentalizing for endorsing supernatural beliefs was directly compared with credibility enhancing displays–the extent to which people observed credible religious acts during their upbringing. We also compared autistic with neurotypical adolescents. The empathy quotient and the autism-spectrum quotient were not predictive of belief in supernatural agents in all countries (i.e., The Netherlands, Switzerland and the United States), although we did observe a curvilinear effect in the United States. We further observed a strong influence of credibility enhancing displays on belief in supernatural agents. These findings highlight the importance of cultural learning for acquiring supernatural beliefs and ask for reconsiderations of the importance of mentalizing. PMID:28832606

Effectiveness of classroom based crew resource management training in the intensive care unit: study design of a controlled trial

PubMed Central

2011-01-01

Background Crew resource management (CRM) has the potential to enhance patient safety in intensive care units (ICU) by improving the use of non-technical skills. However, CRM evaluation studies in health care are inconclusive with regard to the effect of this training on behaviour and organizational outcomes, due to weak study designs and the scarce use of direct observations. Therefore, the aim of this study is to determine the effectiveness and cost-effectiveness of CRM training on attitude, behaviour and organization after one year, using a multi-method approach and matched control units. The purpose of the present article is to describe the study protocol and the underlying choices of this evaluation study of CRM in the ICU in detail. Methods/Design Six ICUs participated in a paired controlled trial, with one pre-test and two post test measurements (respectively three months and one year after the training). Three ICUs were trained and compared to matched control ICUs. The 2-day classroom-based training was delivered to multidisciplinary groups. Typical CRM topics on the individual, team and organizational level were discussed, such as situational awareness, leadership and communication. All levels of Kirkpatrick's evaluation framework (reaction, learning, behaviour and organisation) were assessed using questionnaires, direct observations, interviews and routine ICU administration data. Discussion It is expected that the CRM training acts as a generic intervention that stimulates specific interventions. Besides effectiveness and cost-effectiveness, the assessment of the barriers and facilitators will provide insight in the implementation process of CRM. Trial registration Netherlands Trial Register (NTR): NTR1976 PMID:22073981

Effectiveness of classroom based crew resource management training in the intensive care unit: study design of a controlled trial.

PubMed

Kemper, Peter F; de Bruijne, Martine; van Dyck, Cathy; Wagner, Cordula

2011-11-10

Crew resource management (CRM) has the potential to enhance patient safety in intensive care units (ICU) by improving the use of non-technical skills. However, CRM evaluation studies in health care are inconclusive with regard to the effect of this training on behaviour and organizational outcomes, due to weak study designs and the scarce use of direct observations. Therefore, the aim of this study is to determine the effectiveness and cost-effectiveness of CRM training on attitude, behaviour and organization after one year, using a multi-method approach and matched control units. The purpose of the present article is to describe the study protocol and the underlying choices of this evaluation study of CRM in the ICU in detail. Six ICUs participated in a paired controlled trial, with one pre-test and two post test measurements (respectively three months and one year after the training). Three ICUs were trained and compared to matched control ICUs. The 2-day classroom-based training was delivered to multidisciplinary groups. Typical CRM topics on the individual, team and organizational level were discussed, such as situational awareness, leadership and communication. All levels of Kirkpatrick's evaluation framework (reaction, learning, behaviour and organisation) were assessed using questionnaires, direct observations, interviews and routine ICU administration data. It is expected that the CRM training acts as a generic intervention that stimulates specific interventions. Besides effectiveness and cost-effectiveness, the assessment of the barriers and facilitators will provide insight in the implementation process of CRM. Netherlands Trial Register (NTR): NTR1976.

Configurations of leadership practices in hospital units.

PubMed

Meier, Ninna

2015-01-01

The purpose of this paper is to explore how leadership is practiced across four different hospital units. The study is a comparative case study of four hospital units, based on detailed observations of the everyday work practices, interactions and interviews with ten interdisciplinary clinical managers. Comparing leadership as configurations of practices across four different clinical settings, the author shows how flexible and often shared leadership practices were embedded in and central to the core clinical work in all units studied here, especially in more unpredictable work settings. Practices of symbolic work and emotional support to staff were particularly important when patients were severely ill. Based on a study conducted with qualitative methods, these results cannot be expected to apply in all clinical settings. Future research is invited to extend the findings presented here by exploring leadership practices from a micro-level perspective in additional health care contexts: particularly the embedded and emergent nature of such practices. This paper shows leadership practices to be primarily embedded in the clinical work and often shared across organizational or professional boundaries. This paper demonstrated how leadership practices are embedded in the everyday work in hospital units. Moreover, the analysis shows how configurations of leadership practices varied in four different clinical settings, thus contributing with contextual accounts of leadership as practice, and suggested "configurations of practice" as a way to carve out similarities and differences in leadership practices across settings.

Impact of the 2008 Global Recession on Air Quality over the United States: Implications for Surface Ozone Levels from Changes in NOx Emissions

NASA Technical Reports Server (NTRS)

Tong, Daniel; Pan, Li; Chen, Weiwei; Lamsal, Lok; Lee, Pius; Tang, Youhua; Kim, Hyuncheol; Kondragunta, Shobha; Stajner, Ivanka

2016-01-01

Satellite and ground observations detected large variability in nitrogen oxides (NOx) during the 2008 economic recession, but the impact of the recession on air quality has not been quantified. This study combines observed NOx trends and a regional chemical transport model to quantify the impact of the recession on surface ozone (O3) levels over the continental United States. The impact is quantified by simulating O3 concentrations under two emission scenarios: business-as-usual (BAU) and recession. In the BAU case, the emission projection from the Cross-State Air Pollution Rule is used to estimate the would-be NOx emission level in 2011. In the recession case, the actual NO2 trends observed from Air Quality System ground monitors and the Ozone Monitoring Instrument on the Aura satellite are used to obtain realistic changes in NOx emissions. The model prediction with the recession effect agrees better with ground O3 observations over time and space than the prediction with the BAU emission. The results show that the recession caused a 12ppbv decrease in surface O3 concentration over the eastern United States, a slight increase (0.51ppbv) over the Rocky Mountain region, and mixed changes in the Pacific West. The gain in air quality benefits during the recession, however, could be quickly offset by the much slower emission reduction rate during the post-recession period.

Coalition Logistics - The Multinational Force and Observers Model

DTIC Science & Technology

1986-05-19

MISSION The mission of the MFO, as specified by the protocol , is to supervise implemeutation of the peace treaty and to employ its best efforts to prevent ...result, a protocol was -- negotiated, calling for a multinational military force and civilian- ---- observer unit to serve in the Sinai--outside the...auspices of the United Nations.2 In this way, the protocol of 3 August 1981 created the Multinational Force and Observers and directed Lhat it be

Understanding the context of balanced scorecard implementation: a hospital-based case study in Pakistan.

PubMed

Rabbani, Fauziah; Lalji, Sabrina Nh; Abbas, Farhat; Jafri, Sm Wasim; Razzak, Junaid A; Nabi, Naheed; Jahan, Firdous; Ajmal, Agha; Petzold, Max; Brommels, Mats; Tomson, Goran

2011-03-31

As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp's context (why), process (how) and content (what) framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire) and qualitative approaches including key informant interviews and participant observation. Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if they are built on existing infrastructures and data networks. Variable levels of the BSC implementation were observed in this study. Those intending to apply the BSC in other hospital settings need to ensure a participatory culture, clear institutional mandate, appropriate leadership support, proper reward and recognition system, and sensitization to BSC benefits.

Gonadotropin-releasing Hormone Agonists, Orchiectomy, and Risk of Cardiovascular Disease: Semi-ecologic, Nationwide, Population-based Study.

PubMed

Thomsen, Frederik Birkebæk; Sandin, Fredrik; Garmo, Hans; Lissbrant, Ingela Franck; Ahlgren, Göran; Van Hemelrijck, Mieke; Adolfsson, Jan; Robinson, David; Stattin, Pär

2017-12-01

In observational studies, men with prostate cancer treated with gonadotropin-releasing hormone (GnRH) agonists had a higher risk of cardiovascular disease (CVD) compared to men who had undergone orchiectomy. However, selection bias may have influenced the difference in risk. To investigate the association of type of androgen deprivation therapy (ADT) with risk of CVD while minimising selection bias. Semi-ecologic study of 6556 men who received GnRH agonists and 3330 men who underwent orchiectomy as primary treatment during 1992-1999 in the Prostate Cancer Database Sweden 3.0. We measured the proportion of men who received GnRH agonists as primary treatment in 580 experimental units defined by healthcare provider, diagnostic time period, and age at diagnosis. Incident or fatal CVD events in units with high and units with low use of GnRH agonists were compared. Net and crude probabilities were also analysed. The risk of CVD was similar between units with the highest and units with the lowest proportion of GnRH agonist use (relative risk 1.01, 95% confidence interval [CI] 0.93-1.11). Accordingly, there was no difference in the net probability of CVD after GnRH agonist compared to orchiectomy (hazard ratio 1.02, 95% CI 0.96-1.09). The 10-yr crude probability of CVD was 0.56 (95% CI 0.55-0.57) for men on GnRH agonists and 0.52 (95% CI 0.50-0.54) for men treated with orchiectomy. The main limitation was the nonrandom allocation to treatment, with younger men with lower comorbidity and less advanced cancer more likely to receive GnRH agonists. Our data do not support previous observations that GnRH agonists increase the risk of CVD in comparison to orchiectomy. We found a similar risk of cardiovascular disease between medical and surgical treatment as androgen deprivation therapy for prostate cancer. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Color-Coded Labels Cued Nurses to Adhere to Central Line Connector Change.

PubMed

Morrison, Theresa Lynch; Laney, Christina; Foglesong, Jan; Brennaman, Laura

2016-01-01

This study examined nurses' adherence to policies regarding needleless connector changes using a novel, day-of-the-week, color-coded label compared with usual care that relied on electronic medical record (EMR) documentation. This was a prospective, comparative study. The study was performed on 4 medical-surgical units in a seasonally fluctuating, 715-bed healthcare system composed of 2 community hospitals. Convenience sample was composed of adults with central lines hospitalized for 4 or more days. At 4-day intervals, investigators observed bedside label use and EMR needleless connector change documentation. Control patients received standard care-needleless connector change with associated documentation in the EMR. Intervention patients, in addition to standard care, had a day-of-the-week, color-coded label placed on each needleless connector. To account for clustering within unit, multinomial logistic regression models using survey sampling methodology were used to conduct Wald χ tests. A multinominal odds ratio and 95% confidence interval (CI) provided an estimate of using labels that were provided on units relative to usual care documentation of needleless connector change in the EMR. In 335 central line observations, the units with labels (n = 205) had a 321% increase rate of documentation of needleless connector change in the EMR (odds ratio, 4.21; 95% CI, 1.76-10.10; P = .003) compared with the usual care control patients. For units with labels, when labels were present, placement of labels on needleless connectors increased the odds that nurses documented connector changes per policy (4.72; 95% CI, 2.02, 10.98; P = .003). Day-of-the-week, color-coded labels cued nurses to document central line needleless connector change in the EMR, which increased adherence to the needleless connector change policy. Providing day-of-the-week, color-coded needleless connector labels increased EMR documentation of timely needleless connector changes. Timely needleless connector changes may lower the incidence of central line-associated bloodstream infection.

Facile analysis of contents and compositions of the chondroitin sulfate/dermatan sulfate hybrid chain in shark and ray tissues.

PubMed

Takeda, Naoko; Horai, Sawako; Tamura, Jun-ichi

2016-04-07

The chondroitin sulfate (CS)/dermatan sulfate (DS) hybrid chain was extracted from specific tissues of several kinds of sharks and rays. The contents and sulfation patterns of the CS/DS hybrid chain were precisely analyzed by digestion with chondroitinases ABC and AC. All samples predominantly contained the A- and C-units. Furthermore, all samples characteristically contained the D-unit. Species-specific differences were observed in the contents of the CS/DS hybrid chain, which were the highest in Mako and Blue sharks and Sharpspine skates, but were lower in Hammerhead sharks. Marked differences were observed in the ratio of the C-unit/A-unit between sharks and rays. The contents of the CS/DS hybrid chain and the ratio of the C-unit/A-unit may be related to an oxidative stress-decreasing ability. Copyright © 2016 Elsevier Ltd. All rights reserved.

An interventional skin care protocol (InSPiRE) to reduce incontinence-associated dermatitis in critically ill patients in the intensive care unit: A before and after study.

PubMed

Coyer, Fiona; Gardner, Anne; Doubrovsky, Anna

2017-06-01

This study aimed to test the effectiveness of a bundle combining best available evidence to reduce the incidence of incontinence-associated dermatitis occurrences in critically ill patients. The study used a before and after design and was conducted in an adult intensive care unit of an Australian quartenary referral hospital. Data, collected by trained research nurses, included demographic and clinical variables, skin assessment, incontinence-associated dermatitis presence and severity. Data were analysed using descriptive and inferential statistics. Of the 207 patients enrolled, 146 patients were mechanically ventilated and incontinent thus eligible for analysis, 80 with 768days of observation in the after/intervention group and 66 with 733days of observation in the before group. Most patients were men, mean age 53 years. Groups were similar on demographic variables. Incontinence-associated dermatitis incidence was lower in the intervention group (15%; 12/80) compared to the control group (32%; 21/66) (p=0.016). Incontinence-associated dermatitis events developed later in the intensive care unit stay in the intervention group (Logrank=5.2, p=<0.022). This study demonstrated that the use of a bundle combining best available evidence reduced the incidence and delayed the development of incontinence-associated dermatitis occurrences in critically ill patients. Systematic ongoing patient assessments, combined with tailored prevention measures are central to preventing incontinence-associated dermatitis in this vulnerable patient group. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Follow-up Survey of the Teaching of Conscious Sedation in Dental Schools of the United Kingdom and Ireland

PubMed Central

Leitch, J; Jauhar, S

2006-01-01

The purpose of this follow-up study was to assess and compare the quantity and quality of dental undergraduate teaching in conscious sedation with comparisons to a previous study conducted in 1998. Questionnaires were designed to collect information about undergraduate sedation education from teaching staff and final-year dental undergraduates at the 15 dental schools in the United Kingdom and Ireland. Staff responses from 9 schools (60%) and student responses from 11 schools (73%) were received. From the students' responses, the mean (range) number of cases observed in inhalational sedation was 7 (0–17) and the mean (range) number performed in inhalational sedation was 4 (0–8). The mean (range) number of cases observed in intravenous sedation was 9 (2–19), and the mean (range) number performed was 5 (0–8). There has been an increase in didactic teaching. There has been a decrease in the observing of inhalational cases, but an increase in the hands-on performance of this type of sedation. There is an increase in the hands-on teaching of intravenous sedation. PMID:16863392

What Happened to the Amateurs After Professionalization? The Amateurization of Astronomy in Britain and the United States

NASA Astrophysics Data System (ADS)

Williams, T. R.

2003-12-01

For nearly two centuries, astronomers have felt the need for a journal in which to publish their results, a venue for meetings in which to discuss those results, and a means for standardizing techniques and coordinating programs within the discipline. These factors are typically the basis on which professional associations have been formed, but in many countries some form of an amateur organization now exists to serve these same purposes. In two case studies, this paper will explore the different paths along which amateur organizations have developed in response to radically different dynamics in the professionalization of astronomy. In Britain, several failures preceded the successful formation of the British Astronomical Association (BAA). Within no more than a decade after its founding, the BAA's specialized observing sections and credible journal were admired by professional and amateur astronomers alike, and served as a model for at least three failed attempts to form a similar organization in the United States. What emerged in the United States instead were six separate specialized observing associations, some of which now legitimately claim international status. This talk will consider how the radically different circumstances under which the professionalization of astronomy occurred in Britain and the United States influenced the amateurization of astronomy in both countries.

Interprofessional collaboration and family member involvement in intensive care units: emerging themes from a multi-sited ethnography.

PubMed

Reeves, Scott; McMillan, Sarah E; Kachan, Natasha; Paradis, Elise; Leslie, Myles; Kitto, Simon

2015-05-01

This article presents emerging findings from the first year of a two-year study, which employed ethnographic methods to explore the culture of interprofessional collaboration (IPC) and family member involvement in eight North American intensive care units (ICUs). The study utilized a comparative ethnographic approach - gathering observation, interview and documentary data relating to the behaviors and attitudes of healthcare providers and family members across several sites. In total, 504 hours of ICU-based observational data were gathered over a 12-month period in four ICUs based in two US cities. In addition, 56 semi-structured interviews were undertaken with a range of ICU staff (e.g. nurses, doctors and pharmacists) and family members. Documentary data (e.g. clinical guidelines and unit policies) were also collected to help develop an insight into how the different sites engaged organizationally with IPC and family member involvement. Directed content analysis enabled the identification and categorization of major themes within the data. An interprofessional conceptual framework was utilized to help frame the coding for the analysis. The preliminary findings presented in this paper illuminate a number of issues related to the nature of IPC and family member involvement within an ICU context. These findings are discussed in relation to the wider interprofessional and health services literature.

Caffeine, cognitive functioning, and white matter lesions in the elderly: establishing causality from epidemiological evidence

PubMed Central

Ritchie, Karen; Artero, Sylvaine; Portet, Florence; Brickman, Adam; Muraskin, Jordan; Beaino, Ephrem; Ancelin, Marie-Laure; Carrière, Isabelle

2010-01-01

Objective The present study examines the epidemiological evidence for a causal relationship between caffeine consumption and cognitive deterioration in the elderly. Methods A population study of 641 elderly persons examining cognitive functioning, caffeine consumption, magnetic resonance imaging volumetrics and other factors known to affect cognitive performance. Results Our findings demonstrate that the association between caffeine consumption and lower cognitive change over time to be statistically significant for women only, taking into account multiple confounders, to be dose-dependent and temporarily related (caffeine consumption precedes cognitive change). Mean log transformed white matter lesion/cranial volume ratios were found to be significantly lower in women consuming more than 3 units of caffeine per day after adjustment for age (−1.23 SD=0.06) than women consuming 2–3 units (−1.04 SD=0.04) or one unit or less (−1.04 SD=0.07, −35% in cm3 compared to low drinkers). This observation is coherent with biological assumptions that caffeine through adenosine is linked to amyloid accumulation and subsequently white matter lesion formation. Conclusions The significant relationship observed between caffeine intake in women and lower cognitive decline is highly likely to be a true causal relationship and not a spurious association. PMID:20164564

Quality of Care in Creches for Disadvantaged Children: A Brazilian Case Study.

ERIC Educational Resources Information Center

Ferreira, M. C. Rossetti; And Others

A study was conducted to critically assess the developmental conditions of 187 children (ages 1 month to 6 years) in eight creches (day nurseries) located in and around Ribeirao Preto, Brazil. Data were collected through informal interviews of day care staff and from 20 hours of direct observations of day care units. Findings indicated inadequate…

Dynamic Emotional Processing in Experiential Therapy: Two Steps Forward, One Step Back

ERIC Educational Resources Information Center

Pascual-Leone, Antonio

2009-01-01

The study of dynamic and nonlinear change has been a valuable development in psychotherapy process research. However, little advancement has been made in describing how moment-by-moment affective processes contribute to larger units of change. The purpose of this study was to examine observable moment-by-moment sequences in emotional processing as…

Impacts of the School Social Unit on Teacher Authority during Work Redesign.

ERIC Educational Resources Information Center

Hart, Ann Weaver

1990-01-01

Work redesign to facilitate teacher empowerment was studied in a year-long comparative case study in two junior-high schools implementing a career-ladder program. Journals of 6 teacher leaders (TLs), 23 teachers, and 3 teacher-specialists; TLs' and novice teachers' midyear surveys; and 61 classroom observations by TLs and principals were analyzed.…

Classroom by Classroom Analysis of the Impact of a Compensatory Education Program.

ERIC Educational Resources Information Center

Forster, Fred; Carpenter, James

The objective of this study was to evaluate the impact of the CO-Plus project by organizing data to utilize the classroom as the basic unit of analysis. The study employed classroom observations, a variety of questionnaire responses from staff and pupils, achievement test scores, and related data. Questionnaire data were summarized using factor…

Perceived Inadequacy: A Study of the Imposter Phenomenon among College and Research Librarians

ERIC Educational Resources Information Center

Clark, Melanie; Vardeman, Kimberly; Barba, Shelley

2014-01-01

The Imposter Phenomenon (IP) is an observed anxiety caused by an individual's feelings of fraudulence, fear of being exposed as a fraud, and inability to internalize personal achievement. This study measures the incidence of the IP among librarians at college and research institutions in the United States and Canada and seeks to identify factors…

Defining Teacher Quality: Teacher Efficacy among First-Year Teachers Involved in an Induction Program

ERIC Educational Resources Information Center

Scott-Coleman, Renette S.

2017-01-01

Studies have shown school districts across the United States strive to meet the needs of first-year teachers by adding various components within a beginning teacher induction program. The purpose of this study was to determine if a relationship existed between beginning teacher induction programming and the overall TEAM observation scores of…

Using Graphic Organizers as a Tool for the Development of Scientific Language

ERIC Educational Resources Information Center

Mercuri, Sandra P.

2010-01-01

This observational study examines the effectiveness of graphic organizers two elementary teachers in California, United States use to teach the content and the academic language of science. The study was done during the 2006-2007 school year. The data was collected through field-notes and the audio recording of instructional activities, and they…

Maternal Sensitivity and Child Secure Base Use in Early Childhood: Studies in Different Cultural Contexts

ERIC Educational Resources Information Center

Posada, German; Trumbell, Jill; Noblega, Magaly; Plata, Sandra; Peña, Paola; Carbonell, Olga A.; Lu, Ting

2016-01-01

This study tested whether maternal sensitivity and child security are related during early childhood and whether such an association is found in different cultural and social contexts. Mother-child dyads (N = 237) from four different countries (Colombia, Mexico, Peru, and the United States) were observed in naturalistic settings when children were…

Turbulent Spot Observations within a Hypervelocity Boundary Layer ona 5-degree Half-Angle Cone

DTIC Science & Technology

2012-04-01

Around the same time, Deissler and Loeffler (1958) studied supersonic transition on a flat plate. Since then, a number of studies of spots in...Department of Engineering Science, Oxford University, Parks Road, Oxford OX1 3PJ, United Kingdom, 1993. Deissler, H.G. and Loeffler , A.L. “Analysis of

Assessment of Quality for Inclusive Programs in Greek Preschool Classrooms

ERIC Educational Resources Information Center

Fyssa, Aristea; Vlachou, Anastasia

2015-01-01

The purpose of this study was to examine the quality of the practices that Greek teachers use to support the inclusion of children with disabilities in general preschools. Fifty-two preschool units for children between 4 and 6 years of age participated in this study. Data were collected through systematic observation with the use of the Inclusive…

Examining Current Beliefs, Practices and Barriers about Technology Integration: A Case Study

ERIC Educational Resources Information Center

Hsu, Pi-Sui

2016-01-01

The purpose of this mixed-methods study was to examine the current beliefs, practices and barriers concerning technology integration of Kindergarten through Grade Six teachers in the midwestern United States. The three data collection methods were online surveys with 152 teachers as well as interviews and observations with 8 teachers. The findings…

Students' Perceived Learning and Anticipated Future Behaviors as a Result of Participation in the Student Judicial Process

ERIC Educational Resources Information Center

Howell, Martin T.

2005-01-01

This qualitative study was undertaken to explore the meaning that students make of their interactions with campus judicial systems. Using a multiple case study approach, 10 students from 3 institutions in the Southeastern United States were observed and interviewed. The findings presented here relate to students' perceived learning and anticipated…

Literacy Practices, Identity and Engagement: Integrating Multifaceted Identities of College Students to Support Learning

ERIC Educational Resources Information Center

Brzeski, Angela

2017-01-01

This article explores the relationship between the identities and engagement in literacy practices across the home and college domains through case studies of two contrasting students studying on a childcare course at a further education (FE) college in the United Kingdom. The data are drawn from classroom observations, analysis of artefacts and…

A Test of High-Order Thinking

ERIC Educational Resources Information Center

Libresco, Andrea S.

2007-01-01

In this article, the author presents a case study of three fourth grade teachers in New York, a state that administers an elementary social studies test, constructed by teachers, that relies on the use of documents in the majority of its questions. Throughout the 2002-2003 school year, the three teachers were observed during every unit of social…

Layering in peralkaline magmas, Ilímaussaq Complex, S Greenland

NASA Astrophysics Data System (ADS)

Hunt, Emma J.; Finch, Adrian A.; Donaldson, Colin H.

2017-01-01

The peralkaline to agpaitic Ilímaussaq Complex, S. Greenland, displays spectacular macrorhythmic (> 5 m) layering via the kakortokite (agpaitic nepheline syenite), which outcrops as the lowest exposed rocks in the complex. This study applies crystal size distribution (CSD) analyses and eudialyte-group mineral chemical compositions to study the marker horizon, Unit 0, and the contact to the underlying Unit - 1. Unit 0 is the best-developed unit in the kakortokites and as such is ideal for gaining insight into processes of crystal formation and growth within the layered kakortokite. The findings are consistent with a model whereby the bulk of the black and red layers developed through in situ crystallisation at the crystal mush-magma interface, whereas the white layer developed through a range of processes operating throughout the magma chamber, including density segregation (gravitational settling and flotation). Primary textures were modified through late-stage textural coarsening via grain overgrowth. An open-system model is proposed, where varying concentrations of halogens, in combination with undercooling, controlled crystal nucleation and growth to form Unit 0. Our observations suggest that the model is applicable more widely to the layering throughout the kakortokite series and potentially other layered peralkaline/agpaitic rocks around the world.

Safe intravenous administration in pediatrics: A 5-year Pediatric Intensive Care Unit experience with smart pumps.

PubMed

Manrique-Rodríguez, S; Sánchez-Galindo, A C; Fernández-Llamazares, C M; Calvo-Calvo, M M; Carrillo-Álvarez, Á; Sanjurjo-Sáez, M

2016-10-01

To estimate the impact of smart pump implementation in a pediatric intensive care unit in terms of number and type of administration errors intercepted. Observational, prospective study carried out from January 2010 to March 2015 with syringe and great volumen infusion pumps available in the hospital. A tertiary level hospital pediatric intensive care unit. Infusions delivered with infusion pumps in all pediatric intensive care unit patients. Design of a drug library with safety limits for all intravenous drugs prescribed. Users' compliance with drug library as well as number and type of errors prevented were analyzed. Two hundred and eighty-three errors were intercepted during 62 months of study. A high risk drug was involved in 58% of prevented errors, such as adrenergic agonists and antagonists, sedatives, analgesics, neuromuscular blockers, opioids, potassium and insulin. Users' average compliance with the safety software was 84%. Smart pumps implementation has proven effective in intercepting high risk drugs programming errors. These results might be exportable to other critical care units, involving pediatric or adult patients. Interdisciplinary colaboration is key to succeed in this process. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Retirada do leito após a descontinuação da ventilação mecânica: há repercussão na mortalidade e no tempo de permanência na unidade de terapia intensiva?

PubMed

Soares, Thiago Rios; Avena, Kátia de Miranda; Olivieri, Flávia Milholo; Feijó, Luciana Ferreira; Mendes, Kristine Menezes Barberino; Souza Filho, Sydney Agareno de; Gomes, André Mansur de Carvalho Guanaes

2010-03-01

To describe the withdrawal of the bed frequency in mechanic ventilation patients and its impact on mortality and length of stay in the intensive care unit. This was a retrospective cohort study in mechanical ventilation patients. Clinical and epidemiological variables, withdrawal of bed related motor therapy, intensive care unit length of stay and mortality were evaluated. We studied 91 patients, mean age of 62.5± 18.8 years, predominantly female (52%) and mean intensive care unit length of stay of 07 days (95% CI, 8-13 days). Considering the withdrawal of the bed or not, no difference was observed between groups regarding length of stay in intensive care unit. Patients who were withdrawn of bed had a lower clinical severity. Their mortality rate was 29.7%. The not withdrawn of bed group had higher both actual and expected mortality. Patients withdrawn of bed following mechanical ventilation discontinuation showed lower mortality. It is suggested that early intensive care unit mobilization and withdrawal of bed should be stimulated.

The impact of a physician-staffed helicopter on outcome in patients admitted to a stroke unit: a prospective observational study.

PubMed

Funder, Kamilia S; Rasmussen, Lars S; Lohse, Nicolai; Hesselfeldt, Rasmus; Siersma, Volkert; Gyllenborg, Jesper; Wulffeld, Sandra; Hendriksen, Ole M; Lippert, Freddy K; Steinmetz, Jacob

2017-02-23

Transportation by helicopter may reduce time to hospital admission and improve outcome. We aimed to investigate the effect of transport mode on mortality, disability, and labour market affiliation in patients admitted to the stroke unit. Prospective, observational study with 5.5 years of follow-up. We included patients admitted to the stroke unit the first three years after implementation of a helicopter emergency medical services (HEMS) from a geographical area covered by both the HEMS and the ground emergency medical services (GEMS). HEMS patients were compared with GEMS patients. Primary outcome was long-term mortality after admission to the stroke unit. Of the 1679 patients admitted to the stroke unit, 1068 were eligible for inclusion. Mortality rates were 9.04 per 100 person-years at risk (PYR) in GEMS patients and 9.71 per 100 PYR in HEMS patients (IRR = 1.09, 95% CI 0.79-1.49; p = 0.60). The 30-day mortality was 7.4% with GEMS and 7.9% with HEMS (OR = 1.02, CI 0.53-1.96; p = 0.96). Incidence rate of involuntary early retirement was 6.97 per 100 PYR and 7.58 per 100 PYR in GEMS and HEMS patients, respectively (IRR = 1.19, CI 0.27-5.26; p = 0.81). Work ability after 2 years and time on social transfer payments did not differ between groups. We found no significant difference in mean modified Rankin Scale score after 3 months (2.21 GEMS vs. 2.09 HEMS; adjusted mean difference = -0.20, CI -0.74-0.33; p = 0.46). The possible benefit of HEMS for neurological outcome is probably difficult to detect by considering mortality, but for the secondary analyses we had less statistical power as illustrated by the wide confidence intervals. Helicopter transport of stroke patients was not associated with reduced mortality or disability, nor improved labour market affiliation compared to patients transported by a ground unit. The study was registered at ClinicalTrials.gov ( NCT02576379 ).

Relationship between unit cell type and porosity and the fatigue behavior of selective laser melted meta-biomaterials.

PubMed

Amin Yavari, S; Ahmadi, S M; Wauthle, R; Pouran, B; Schrooten, J; Weinans, H; Zadpoor, A A

2015-03-01

Meta-materials are structures when their small-scale properties are considered, but behave as materials when their homogenized macroscopic properties are studied. There is an intimate relationship between the design of the small-scale structure and the homogenized properties of such materials. In this article, we studied that relationship for meta-biomaterials that are aimed for biomedical applications, otherwise known as meta-biomaterials. Selective laser melted porous titanium (Ti6Al4V ELI) structures were manufactured based on three different types of repeating unit cells, namely cube, diamond, and truncated cuboctahedron, and with different porosities. The morphological features, static mechanical properties, and fatigue behavior of the porous biomaterials were studied with a focus on their fatigue behavior. It was observed that, in addition to static mechanical properties, the fatigue properties of the porous biomaterials are highly dependent on the type of unit cell as well as on porosity. None of the porous structures based on the cube unit cell failed after 10(6) loading cycles even when the applied stress reached 80% of their yield strengths. For both other unit cells, higher porosities resulted in shorter fatigue lives for the same level of applied stress. When normalized with respect to their yield stresses, the S-N data points of structures with different porosities very well (R(2)>0.8) conformed to one single power law specific to the type of the unit cell. For the same level of normalized applied stress, the truncated cuboctahedron unit cell resulted in a longer fatigue life as compared to the diamond unit cell. In a similar comparison, the fatigue lives of the porous structures based on both truncated cuboctahedron and diamond unit cells were longer than that of the porous structures based on the rhombic dodecahedron unit cell (determined in a previous study). The data presented in this study could serve as a basis for design of porous biomaterials as well as for corroboration of relevant analytical and computational models. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sensitivity of Inverse Estimation of 2004 Elemental Carbon Emissions Inventory in the United States to the Choice of Observational Networks

EPA Science Inventory

Choice of observational networks used for inverse re-estimation of elemental (or black) carbon (EC) emissions in the United States impacts results. We convert the Thermal Optical Transmittance (TOT) EC measurements to the Thermal Optical Reflectance (TOR) equivalent to make full...

Observing and Producing Sounds, Elementary School Science, Level Four, Teaching Manual.

ERIC Educational Resources Information Center

Hale, Helen E.

This pilot teaching unit is one of a series developed for use in elementary school science programs. This unit is designed to help children discover specific concepts which relate to sound, such as volume, pitch, and echo. The student activities employ important scientific processes, such as observation, communication, inference, classification,…

Simulated water budget of a small forested watershed in the continental/maritime hydroclimatic region of the United States

USDA-ARS?s Scientific Manuscript database

Widespread decreases in annualized streamflow have been observed across mountain watersheds in the Pacific Northwest of the United States over the last ~70 years, however in some watersheds, observed streamflow has increased. To deconvolve the combined effects of climate and vegetation on long-term ...

Novel epidemic clones of Listeria monocytogenes, United States, 2011

USDA-ARS?s Scientific Manuscript database

This study determined whether four clinical and five food/environmental isolates associated with the 2011 U.S. cantaloupe listeriosis outbreak were previously identified outbreak strains, if they belonged to previously observed clonal complexes (CCs), to one of the five known epidemic clones (ECs) o...

Multiscale Modeling of Multi-decadal Trends in Ozone across the Northern Hemisphere & United States

EPA Science Inventory

Both observational and modeling studies have demonstrated that pollutants near the Earth’s surface can be convectively lofted to higher altitudes where strong winds can efficiently transport them from one continent to another, thereby impacting air quality on intercontinent...

The impact of summer rainfall on the temperature gradient along the United States-Mexico border

NASA Technical Reports Server (NTRS)

Balling, Robert C., Jr.

1989-01-01

The international border running through the Sonoran Desert in southern Arizona and northern Sonora is marked by a sharp discontinuity in albedo and grass cover. The observed differences in surface properties are a result of long-term, severe overgrazing of the Mexican lands. Recently, investigators have shown the Mexican side of the border to have higher surface and air temperatures when compared to adjacent areas in the United State. The differences in temperatures appear to be more associated with differential evapotranspiration rates than with albedo changes along the border. In this study, the impact of summer rainfall on the observed seasonal and daily gradient in maximum temperature is examined. On a seasonal time scale, the temperature gradient increases with higher moisture levels, probably due to a vegetative response on the United States' side of the border; at the daily level, the gradient in maximum temperature decreases after a rain event as evaporation rates equalize between the countries. The results suggest that temperature differences between vegetated and overgrazed landscapes in arid areas are highly dependent upon the amount of moisture available for evapotranspiration.

Negative workplace behaviours: an ethical dilemma for nurse managers.

PubMed

Lindy, Cheryl; Schaefer, Florence

2010-04-01

To discover nurse managers' perception of negative workplace behaviours (bullying) encountered by staff on their unit. Background Negative workplace behaviour is a worldwide phenomenon happening in all types of work settings. Absent from the literature were studies specific to the nurse managers' perception on this topic. A phenomenological qualitative research methodology was used to gain insight into the perceptions of nurse managers about negative workplace behaviours that they have observed or addressed. Nurse Managers described their perceptions of, and experiences pertaining to, instances of negative workplace behaviour. Six themes emerged from the data analysis: 'that's just how she is', 'they just take it', 'a lot of things going on', 'old baggage', 'three sides to a story' and 'a management perspective'. Nurse Managers had observed, experienced and/or had received reports of negative workplace behaviours. While some felt comfortable addressing the behaviour, others experienced ethical dilemmas when trying to treat all fairly. The results of the present study provide guidance for nurse managers to address negative workplace behaviours occurring on their units.

Noise pollution in the hospital environment of a developing country: A case study of Lahore (Pakistan).

PubMed

Baqar, Mujtaba; Arslan, Muhammad; Abbasi, Saddam A; Ashraf, Uzma; Khalid, Anam; Zahid, Hina

2017-08-24

The present study investigates the noise pollution levels in public- and private-sector hospitals of Lahore. The noise pollution parameters were investigated from 20 public and 10 private hospitals. We observed that the equivalent continuous sound level (Leq) values varied significantly in different departments of the hospitals as well as at different times of the day. The public-sector hospitals had significantly higher noise pollution compared to the private-sector hospitals. The Wilcoxon Mann-Whitney two-sample rank-sum test revealed significant difference between noise levels in intensive care unit (ICU) during morning and in emergency, waiting area, intensive care unit (ICU), and reception during daytimes. However, no significant differences were found for any department during the evening. The Leq values were found to be higher than the international norms (WHO standards) for all hospitals, higher than USEPA for 29 hospitals and higher than local standards for 27 hospitals. Overall, significantly lower sound levels were always observed in private hospitals.

A vibrational spectroscopic study of the silicate mineral lomonosovite Na5Ti2(Si2O7)(PO4)O2

NASA Astrophysics Data System (ADS)

Frost, Ray L.; López, Andrés; Theiss, Frederick L.; Graça, Leonardo M.; Scholz, Ricardo

2015-01-01

The mineral lomonosovite has been studied using a combination of scanning electron microscopy with energy dispersive X-ray analysis and vibrational spectroscopy. Qualitative chemical analysis gave Si, P, Na and Ti as the as major elements with small amounts of Mn, Ca, Fe and Al. The mineral lomonosovite has a formula Na5Ti2(Si2O7)(PO4)O2. Raman bands observed at 909, 925 and 939 cm-1 are associated with phosphate units. Raman bands found at 975, 999, 1070, 1080 and 1084 cm-1 are attributed to siloxane stretching vibrations. The observation of multiple bands in both the phosphate stretching and bending regions supports the concept that the symmetry of the phosphate anion in the structure of lomonosovite is significantly reduced. Infrared spectroscopy identifies bands in the water stretching and bending regions, thus suggesting that water is involved with the structure of lomonosovite either through adsorption on the surface or by bonding to the phosphate units.

Characterization of phyllosilicates observed in the central Mawrth Vallis region, Mars, their potential formational processes, and implications for past climate

USGS Publications Warehouse

McKeown, N.K.; Bishop, J.L.; Noe Dobrea, E.Z.; Ehlmann, B.L.; Parente, M.; Mustard, J.F.; Murchie, S.L.; Swayze, G.A.; Bibring, J.-P.; Silver, E.A.

2009-01-01

Mawrth Vallis contains one of the largest exposures of phyllosilicates on Mars. Nontronite, montmorillonite, kaolinite, and hydrated silica have been identified throughout the region using data from the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM). In addition, saponite has been identified in one observation within a crater. These individual minerals are identified and distinguished by features at 1.38-1.42, ???1.91, and 2.17-2.41 ??m. There are two main phyllosilicate units in the Mawrth Vallis region. The lowermost unit is nontronite bearing, unconformably overlain by an Al-phyllosilicate unit containing montmorillonite plus hydrated silica, with a thin layer of kaolinite plus hydrated silica at the top of the unit. These two units are draped by a spectrally unremarkable capping unit. Smectites generally form in neutral to alkaline environments, while kaolinite and hydrated silica typically form in slightly acidic conditions; thus, the observed phyllosilicates may reflect a change in aqueous chemistry. Spectra retrieved near the boundary between the nontronite and Al-phyllosilicate units exhibit a strong positive slope from 1 to 2 ??m, likely from a ferrous component within the rock. This ferrous component indicates either rapid deposition in an oxidizing environment or reducing conditions. Formation of each of the phyllosilicate minerals identified requires liquid water, thus indicating a regional wet period in the Noachian when these units formed. The two main phyllosilicate units may be extensive layers of altered volcanic ash. Other potential formational processes include sediment deposition into a marine or lacustrine basin or pedogenesis. Copyright 2009 by the American Geophysical Union.

Blood pressure and risk of all-cause mortality in advanced chronic kidney disease and hemodialysis: the CRIC study

PubMed Central

Bansal, Nisha; McCulloch, Charles E.; Rahman, Mahboob; Kusek, John W.; Anderson, Amanda H.; Xie, Dawei; Townsend, Raymond R.; Lora, Claudia M.; Wright, Jackson; Go, Alan S.; Ojo, Akinlolu; Alper, Arnold; Lustigova, Eva; Cuevas, Magda; Kallem, Radhakrishna; Hsu, Chi-yuan

2014-01-01

Studies of hemodialysis patients have shown a U-shaped association between systolic blood pressure (SBP) and mortality. These studies have largely relied on dialysis-unit SBP measures and have not evaluated whether this U-shape also exists in advanced chronic kidney disease (CKD), prior to starting hemodialysis. We determined the association between SBP and mortality at advanced CKD and again after initiation of hemodialysis. This was a prospective study of Chronic Renal Insufficiency Cohort (CRIC) participants with advanced CKD followed through initiation of hemodialysis. We studied the association between SBP and mortality when participants: 1) had an estimated glomerular filtration rate <30 ml/min/1.73m2 (N=1,705); 2) initiated hemodialysis and had dialysis-unit SBP measures (N=403) and; 3) initiated hemodialysis and had out-of-dialysis-unit SBP measured at a CRIC study visit (N=326). Cox models adjusted for demographics, cardiovascular risk factors and dialysis parameters. A quadratic term for SBP was included to test for a U-shaped association. At advanced CKD, there was no association between SBP and mortality (HR 1.02 [95% CI: 0.98–1.07] per every 10 mm Hg increase). Among participants who started hemodialysis, a U-shaped association between dialysis-unit SBP and mortality was observed. In contrast, there was a linear association between out-of-dialysis-unit SBP and mortality (HR 1.26 [95% CI: 1.14–1.40] per every 10 mm Hg increase). In conclusion, more efforts should be made to obtain out-of-dialysis-unit SBP which may merit more consideration as a target for clinical management and in interventional trials. PMID:25287404

Crew resource management training in the intensive care unit. A multisite controlled before-after study.

PubMed

Kemper, Peter F; de Bruijne, Martine; van Dyck, Cathy; So, Ralph L; Tangkau, Peter; Wagner, Cordula

2016-08-01

There is a growing awareness today that adverse events in the intensive care unit (ICU) are more often caused by problems related to non-technical skills than by a lack of technical, or clinical, expertise. Team training, such as crew resource management (CRM), aims to improve these non-technical skills. The present study evaluated the effectiveness of CRM in the ICU. Six ICUs participated in a paired controlled trial, with one pretest and two post-test measurements (after 3 and 12 months). Three ICUs received CRM training and were compared with a matched control unit. The 2-day classroom-based training was delivered to multidisciplinary groups (ie, ICU physicians, nurses, managers). All levels of Kirkpatrick's evaluation framework were assessed using a mixed method design, including questionnaires, observations and routinely administered patient outcome data. Level I-reaction: participants were very positive directly after the training. Level II-learning: attitudes towards behaviour aimed at optimising situational awareness were relatively high at baseline and remained stable. Level III-behaviour: self-reported behaviour aimed at optimising situational awareness improved in the intervention group. No changes were found in observed explicit professional oral communication. Level IV-organisation: patient outcomes were unaffected. Error management culture and job satisfaction improved in the intervention group. Patient safety culture improved in both control and intervention units. We can conclude that CRM, as delivered in the present study, does not change behaviour or patient outcomes by itself, yet changes how participants think about errors and risks. This indicates that CRM requires a combination with other initiatives in order to improve clinical outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Professional Satisfaction within Family Health Units of Central Region].

PubMed

Passadouro, Rui; Ferreira, Pedro Lopes

2016-11-01

Job satisfaction, as an organizational climate indicator, is a complex and subjective phenomenon. It is prone to individual variation, social settings and suitable to multiple explanatory theories. It can impact productivity and absenteeism, predict well-being, and it is associated with mental health, self-esteem and perception of physical health. It is comprised as one of the National Health Service evaluation criteria. This study aimed to assess the level of job satisfaction in family health units of Central Region of the country. This was an observational, cross-sectional study with a descriptive analysis model and a correlational component. The Centro de Estudos e Investigação em Saúde da Universidade de Coimbra's Professional Satisfaction Assessment Instrument was selected as data collection instrument. Among a universe of 809 health professionals, a total of 774 professionals participated in this study population. The observed response rate was 66.4% at the Professional Satisfaction Assessment Instrument, corresponding to 514 professionals. Eighty two per cent of the respondents were female and 18% male. From the total subjects, 64.8% worked in model A units and the remaining 35.2% in model B units. Regarding professional categories, 34.2% were nurses, 39.8% were doctors and 26.0% clinical secretaries. The global level of satisfaction was 71.5% being 67.4% with the quality of the work setting, 78.3% with the quality of the care provided and 80.7% with the continuous improvement of quality. The sample was predominantly composed by female subjects (82%), in line with current gender distribution of professionals. Found levels of job satisfaction (71.5%) were 5.4% lower than previously recorded in 2009. We recommend systematic evaluation of job satisfaction in contracting regimens, similarly to user satisfaction.

Low temperature structural transformation in T[Ni(CN){sub 4}].xpyz with x=1,2; T=Mn,Co,Ni,Zn,Cd; pyz=pyrazine

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

Rodriguez-Hernandez, J.; Instituto de Ciencia y Tecnologia de Materiales, Universidad de La Habana; Lemus-Santana, A.A.

2010-01-15

The materials under study are pillared solids T[Ni(CN){sub 4}].xpyz with one and two (x=1,2) pyrazine (pyz) molecules and where T=Mn, Co, Ni, Zn, Cd. Stimulated by their structural features and potential role as prototype of porous solids for hydrogen storage, the structural stability under cryogenic conditions for this series of pillared solids was studied. At low temperature, in the 100-200 K range, the occurrence of a reversible structural transformation was found. For T=Mn, Co, Zn, Cd, with x=2, the structural transformation was observed to occur around 185 K, and the low temperature phase crystallizes with a monoclinic unit cell (spacemore » group Pc). This structure change results from certain charge redistribution on cooling within the involved ligands. For T=Ni with x=1, both the low and high temperature phases crystallize with unit cells of tetragonal symmetry, within the same space group but with a different unit cell volume. In this case the structure change is observed around 120 K. Above that temperature the rotational states for the pyrazine molecule are thermally excited and all the pyrazine molecules in the structure become equivalent. Under this condition the material structure is described using a smaller structural unit. The structural study using X-ray powder diffraction data was complemented with calorimetric and Raman spectroscopy measurements. For the low temperature phases the crystal structures were solved from Patterson methods and then refined using the Rietveld method. - Graphical abstract: Low temperature ordered structure for pyrazine in T[Ni(CN){sub 4}].pyz.« less

Small scale homelike special care units and traditional special care units: effects on cognition in dementia; a longitudinal controlled intervention study.

PubMed

Kok, Jeroen S; van Heuvelen, Marieke J G; Berg, Ina J; Scherder, Erik J A

2016-02-16

Evidence shows that living in small scale homelike Special Care Units (SCU) has positive effects on behavioural and psychological symptoms of patients with dementia. Effects on cognitive functioning in relation to care facilities, however, are scarcely investigated. The purpose of this study is to gain more insight into the effects of living in small scale homelike Special Care Units, compared to regular SCU's, on the course of cognitive functioning in dementia. A group of 67 patients with dementia who moved from a regular SCU to a small scale homelike SCU and a group of 48 patients with dementia who stayed in a regular SCU participated in the study. Cognitive and behavioural functioning was assessed by means of a neuropsychological test battery and observation scales one month before (baseline), as well as 3 (post) and 6 months (follow-up) after relocation. Comparing the post and follow-up measurement with the baseline measurement, no significant differences on separate measures of cognitive functioning between both groups were found. Additional analyses, however, on 'domain clusters' revealed that global cognitive functioning of the small scale homelike SCU group showed significantly less cognitive decline three months after the transfer (p < 0.05). Effect sizes (95% CI) show a tendency for better aspects of cognition in favour of the homelike small scaled SCU group, i.e., visual memory, picture recognition, cognitive decline as observed by representatives and the clustered domains episodic memory and global cognitive functioning. While there is no significant longitudinal effect on the progression of cognitive decline comparing small scaled homelike SCU's with regular SCU's for patients with dementia, analyses on the domain clusters and effect sizes cautiously suggest differences in favour of the small scaled homelike SCU for different aspects of cognition.

Sensitivity towards elevated pCO2 in great scallop (Pecten maximus Lamarck) embryos and fed larvae

NASA Astrophysics Data System (ADS)

Andersen, Sissel; Grefsrud, Ellen S.; Harboe, Torstein

2017-02-01

The increasing amount of dissolved anthropogenic CO2 has caused a drop in pH values in the open ocean known as ocean acidification. This change in seawater carbonate chemistry has been shown to have a negative effect on a number of marine organisms. Early life stages are the most vulnerable, and especially the organisms that produce calcified structures in the phylum Mollusca. Few studies have looked at effects on scallops, and this is the first study presented including fed larvae of the great scallop (Pecten maximus) followed until day 14 post-fertilization. Fertilized eggs from unexposed parents were exposed to three levels of pCO2 using four replicate units: 465 (ambient), 768 and 1294 µatm, corresponding to pHNIST of 7.94, 7.75 (-0.19 units) and 7.54 (-0.40 units), respectively. All of the observed parameters were negatively affected by elevated pCO2: survival, larval development, shell growth and normal shell development. The latter was observed to be affected only 2 days after fertilization. Negative effects on the fed larvae at day 7 were similar to what was shown earlier for unfed P. maximus larvae. Growth rate in the group at 768 µatm seemed to decline after day 7, indicating that the ability to overcome the environmental change at moderately elevated pCO2 was lost over time. The present study shows that food availability does not decrease the sensitivity to elevated pCO2 in P. maximus larvae. Unless genetic adaptation and acclimatization counteract the negative effects of long term elevated pCO2, recruitment in populations of P. maximus will most likely be negatively affected by the projected drop of 0.06-0.32 units in pH within year 2100.

The perplexing links between contraceptive sterilization and (dis)advantage in ten low-fertility countries.

PubMed

Eeckhaut, Mieke C W; Sweeney, Megan M

2016-01-01

This study investigated the association between contraceptive sterilization and socio-economic status (measured by educational attainment) in ten countries, using data from the 2006-10 National Survey of Family Growth and the 2004-10 Generations and Gender Surveys. The findings confirm that a long-standing association between socio-economic status and sterilization persists in the contemporary United States: female sterilization is associated with economic disadvantage, whereas male sterilization is associated with economic advantage. The latter association is found to be unique to the United States, but female sterilization is associated with disadvantage in most of the other countries studied. While basic demographic background factors such as early childbearing and parity can explain the observed associations in most of the countries, a strong gendered association between sterilization and socio-economic status remains in the United States and Belgium even after adjusting for these factors.

Emergence of structural patterns out of synchronization in networks with competitive interactions

NASA Astrophysics Data System (ADS)

Assenza, Salvatore; Gutiérrez, Ricardo; Gómez-Gardeñes, Jesús; Latora, Vito; Boccaletti, Stefano

2011-09-01

Synchronization is a collective phenomenon occurring in systems of interacting units, and is ubiquitous in nature, society and technology. Recent studies have enlightened the important role played by the interaction topology on the emergence of synchronized states. However, most of these studies neglect that real world systems change their interaction patterns in time. Here, we analyze synchronization features in networks in which structural and dynamical features co-evolve. The feedback of the node dynamics on the interaction pattern is ruled by the competition of two mechanisms: homophily (reinforcing those interactions with other correlated units in the graph) and homeostasis (preserving the value of the input strength received by each unit). The competition between these two adaptive principles leads to the emergence of key structural properties observed in real world networks, such as modular and scale-free structures, together with a striking enhancement of local synchronization in systems with no global order.

Why and How We Made a Problem Oriented AV Teaching Unit for Chemistry Students.

ERIC Educational Resources Information Center

Mulder, T. H. M.; Verdonk, A. H.

1984-01-01

Describes an audiovisual teaching unit on the chemical laboratory technique of recrystallization which was developed along problem-solving lines and based on observation of student laboratory behavior. Discussion includes usual procedures for developing such units, how this unit solves problems typically associated with teaching, and its general…

Information structure and organisation in change of shift reports: An observational study of nursing hand-offs in a Paediatric Intensive Care Unit.

PubMed

Foster-Hunt, Tara; Parush, Avi; Ellis, Jacqueline; Thomas, Margot; Rashotte, Judy

2015-06-01

Patient hand-offs involve the exchange of critical information. Ineffective hand-offs can result in reduced patient safety by leading to wrong treatment, delayed diagnoses or other outcomes that can negatively affect the healthcare system. The objectives of this study were to uncover the structure of the information conveyed during patient hand-offs and look for principles characterising the organisation of the information. With an observational study approach, data was gathered during the morning and evening nursing change of shift hand-offs in a Paediatric Intensive Care Unit. Content analysis identified a common meta-structure used for information transfer that contained categories with varying degrees of information integration and the repetition of high consequence information. Differences were found in the organisation of the hand-off structures, and these varied as a function of nursing experience. The findings are discussed in terms of the potential benefits of computerised tools which utilise standardised structure for information transfer and the implications for future education and critical care skill acquisition. Copyright © 2014 Elsevier Ltd. All rights reserved.

Behavior of P85 and P188 Poloxamer Molecules: Computer Simulations Using United Atom Force Field.

DOE PAGES

Goliaei, Ardeshir; Lau, Edmond Y.; Adhikari, Upendra; ...

2016-05-27

To study the interaction between poloxamer molecules and lipid bilayers using molecular dynamics simulation technique with the united atom resolution, we augmented the GROMOS force field to include poloxamers. We validated the force field by calculating the radii of gyration of two poloxamers, P85 and P188, solvated in water and by considering the poloxamer density distributions at the air/water interface. The emphasis of our simulations was on the study of the interaction between poloxamers and lipid bilayer. At the water/lipid bilayer interface, we observed that both poloxamers studied, P85 and P188, behaved like surfactants: the hydrophilic blocks of poloxamers becamemore » adsorbed at the polar interface, while their hydrophobic block penetrated the interface into the aliphatic tail region of the lipid bilayer. We also observed that when P85 and P188 poloxamers interacted with damaged membranes that contained pores, the hydrophobic blocks of copolymers penetrated into the membrane in the vicinity of the pore and compressed the membrane. Lastly, due to this compression, water molecules were evacuated from the pore.« less

Assessment of the biophysical impacts of utility-scale photovoltaics through observations and modelling

NASA Astrophysics Data System (ADS)

Broadbent, A. M.; Georgescu, M.; Krayenhoff, E. S.; Sailor, D.

2017-12-01

Utility-scale solar power plants are a rapidly growing component of the solar energy sector. Utility-scale photovoltaic (PV) solar power generation in the United States has increased by 867% since 2012 (EIA, 2016). This expansion is likely to continue as the cost PV technologies decrease. While most agree that solar power can decrease greenhouse gas emissions, the biophysical effects of PV systems on surface energy balance (SEB), and implications for surface climate, are not well understood. To our knowledge, there has never been a detailed observational study of SEB at a utility-scale solar array. This study presents data from an eddy covariance observational tower, temporarily placed above a utility-scale PV array in Southern Arizona. Comparison of PV SEB with a reference (unmodified) site, shows that solar panels can alter the SEB and near surface climate. SEB observations are used to develop and validate a new and more complete SEB PV model. In addition, the PV model is compared to simpler PV modelling methods. The simpler PV models produce differing results to our newly developed model and cannot capture the more complex processes that influence PV SEB. Finally, hypothetical scenarios of PV expansion across the continental United States (CONUS) were developed using various spatial mapping criteria. CONUS simulations of PV expansion reveal regional variability in biophysical effects of PV expansion. The study presents the first rigorous and validated simulations of the biophysical effects of utility-scale PV arrays.

The care unit in nursing home research: evidence in support of a definition.

PubMed

Estabrooks, Carole A; Morgan, Debra G; Squires, Janet E; Boström, Anne-Marie; Slaughter, Susan E; Cummings, Greta G; Norton, Peter G

2011-04-14

Defining what constitutes a resident care unit in nursing home research is both a conceptual and practical challenge. The aim of this paper is to provide evidence in support of a definition of care unit in nursing homes by demonstrating: (1) its feasibility for use in data collection, (2) the acceptability of aggregating individual responses to the unit level, and (3) the benefit of including unit level data in explanatory models. An observational study design was used. Research (project) managers, healthcare aides, care managers, nursing home administrators and directors of care from thirty-six nursing homes in the Canadian prairie provinces of Alberta, Saskatchewan and Manitoba provided data for the study. A definition of care unit was developed and applied in data collection and analyses. A debriefing session was held with research managers to investigate their experiences with using the care unit definition. In addition, survey responses from 1258 healthcare aides in 25 of the 36 nursing homes in the study, that had more than one care unit, were analyzed using a multi-level modeling approach. Trained field workers administered the Alberta Context Tool (ACT), a 58-item self-report survey reflecting 10 organizational context concepts, to healthcare aides using computer assisted personal interviews. To assess the appropriateness of obtaining unit level scores, we assessed aggregation statistics (ICC(1), ICC(2), η², and ω²), and to assess the value of using the definition of unit in explanatory models, we performed multi-level modeling. In 10 of the 36 nursing homes, the care unit definition developed was used to align the survey data (for analytic purposes) to specific care units as designated by our definition, from that reported by the facility administrator. The aggregation statistics supported aggregating the healthcare aide responses on the ACT to the realigned unit level. Findings from the multi-level modeling further supported unit level aggregation. A significantly higher percentage of variance was explained in the ACT concepts at the unit level compared to the individual and/or nursing home levels. The statistical results support the use of our definition of care unit in nursing home research in the Canadian prairie provinces. Beyond research convenience however, the results also support the resident unit as an important Clinical Microsystem to which future interventions designed to improve resident quality of care and staff (healthcare aide) worklife should be targeted.

Is Spending More Time Associated With Less Missed Care?: A Comparison of Time Use and Missed Care Across 15 Nursing Units at 2 Hospitals.

PubMed

McNair, Norma; Baird, Jennifer; Grogan, Tristan R; Walsh, Catherine M; Liang, Li-Jung; Worobel-Luk, Pamela; Needleman, Jack; Nuckols, Teryl K

2016-09-01

The aim of this study is to examine the relationship between nursing time use and perceptions of missed care. Recent literature has highlighted the problem of missed nursing care, but little is known about how nurses' time use patterns are associated with reports of missed care. In 15 nursing units at 2 hospitals, we assessed registered nurse (RN) perceptions of missed care, observed time use by RNs, and examined the relationship between time spent and degree of missed care at the nursing unit level. Patterns of time use were similar across hospitals, with 25% of time spent on documentation. For 6 different categories of nursing tasks, no association was detected between time use, including time spent on documentation, and the degree of missed care at the nursing unit level. Nursing time use cannot fully explain variation in missed care across nursing units. Further work is needed to account for patterns of missed care.

A dose-responsive model of smoke inhalation injury. Severity-related alteration in cardiopulmonary function.

PubMed Central

Shimazu, T; Yukioka, T; Hubbard, G B; Langlinais, P C; Mason, A D; Pruitt, B A

1987-01-01

The dose responsiveness of selected physiologic indices was studied in a sheep model of smoke inhalation injury. In this model, graded severity of injury was achieved by changing the contact time with smoke (defined by "unit"), whereas other variables were kept constant. Blood gas and cardiopulmonary indices were measured in 70 sheep, including 12 controls, either 24 or 72 hours after exposure to 3, 6, 9, 12, 15, or 18 units of smoke. A 12-unit dose of smoke was fatal within 72 hours and an 18-unit dose was fatal within 24 hours. The best correlation between smoke dose and response was observed in arterial oxygen tension 24 hours after exposure. At 24 hours, most of the cardiopulmonary indices showed significant change only after a 12-unit exposure. Although the exact shape of the dose-response curve could not be defined, sigmoid or curved linear shape was suggested, reflecting the progressive deterioration. Images Fig. 3. Fig. 4A. Fig. 4B. PMID:3606236

Improvement for enhancing effectiveness of universal power system (UPS) continuous testing process

NASA Astrophysics Data System (ADS)

Sriratana, Lerdlekha

2018-01-01

This experiment aims to enhance the effectiveness of the Universal Power System (UPS) continuous testing process of the Electrical and Electronic Institute by applying work scheduling and time study methods. Initially, the standard time of testing process has not been considered that results of unaccurate testing target and also time wasting has been observed. As monitoring and reducing waste time for improving the efficiency of testing process, Yamazumi chart and job scheduling theory (North West Corner Rule) were applied to develop new work process. After the improvements, the overall efficiency of the process possibly increased from 52.8% to 65.6% or 12.7%. Moreover, the waste time could reduce from 828.3 minutes to 653.6 minutes or 21%, while testing units per batch could increase from 3 to 4 units. Therefore, the number of testing units would increase from 12 units up to 20 units per month that also contribute to increase of net income of UPS testing process by 72%.

Examining curricular coherence in an exemplary elementary school program.

PubMed

Ennis, Catherine D

2008-03-01

A coherent curriculum is characterized by visible connections between purposes and experiences so that students acknowledge the content's immediate value. This study examined an exemplary elementary physical education curriculum for coherence components. Research questions examined the role of coherence in connecting and engaging students meaningfully in physical education. Observations and interviews were conducted to collect qualitative data in one program for 22 weeks. Data were analyzed using open, axial, and selective coding. Results described two units, Balls Skills, leading to modified basketball, and Scooter City, a theme-based unit emphasizing student choice and responsibility. Students reported that both units were enjoyable. Although the Balls Skills unit was well planned, taught, and managed, some students commented that the skill and games content was valuable only in basketball. In the Scooter City unit, students identified numerous connections to out-of-school activities that enhanced content value. Comparisons with Beane's coherence criteria suggested that students valued Scooter City based on concrete connections to their lived experiences.

Cross (Unit)-Level Effects of Cohesion on Relationships of Suicide Thoughts to Combat Exposure, Postdeployment Stressors, and Postdeployment Social Support.

PubMed

Griffith, James

2015-01-01

A behavioral health concern for the US military has been suicide, largely due to its increased prevalence in the last several years during US involvement in the Iraq and Afghanistan wars. Using hierarchical linear modeling (HLM), the present study examined relationships among combat exposure, postdeployment stressors, social support, and unit cohesion. Survey data were obtained from 4,567 soldiers who were members of 50 company-sized units. At the individual level, combat exposure and postdeployment stressors were associated with suicidal thoughts. Postdeployment social support was associated with fewer suicidal thoughts. There was no evidence of the stress-buffering effect of social support. At the group level, reduced risk for suicidal thoughts was associated with units having higher than average cohesion. Reduced risk for suicidal thoughts in conjunction with combat experiences was observed in units having higher than average cohesion, though not reaching a traditional level of statistical significance.

Effects of Patient Care Unit Design and Technology on Nurse and Patient Care Technician Communication.

PubMed

Beck, Mary S; Doscher, Mindy

2018-04-01

The current study described RN and patient care technician (PCT) communication in centralized and hybrid decentralized workstation designs using hands-free communication technology and infrared locator badge technology to facilitate communication. New construction of an oncology unit provided the opportunity to compare staff communication in two different workstation designs. Observations and questionnaires compared nurse and PCT communication in the two-unit designs. Descriptive statistics were used to analyze the differences. The hybrid decentralized unit had increased use of hands-free communication technology and hallway communication by nurses and PCTs, and increased patient room communication by nurses. Perceptions of communication between nurses and PCTs and congruency of priorities for care were similar for both units. The locator badge technology had limited adoption. Replacement of nurse workstations with new construction or remodeling impact staff communication patterns, necessitating that nurse leaders understand the impact of design and technology on communication. [Journal of Gerontological Nursing, 44(4), 17-22.]. Copyright 2018, SLACK Incorporated.

Strategies to increase research-based practice: interplay with unit culture.

PubMed

Pepler, Carolyn J; Edgar, Linda; Frisch, Sara; Rennick, Janet; Swidzinski, Marika; White, Carole; Brown, Thomas; Gross, Julie

2006-01-01

A major focus of clinical nurse specialist nursing practice is the integration of research findings into practice. The purpose of this study was to describe strategies used to facilitate research utilization (RU) by nurses in a practice setting. This multiple-case study identified the strategies that clinical nurse specialists and master's degree-prepared nurse educators, working collaboratively, used to facilitate RU. The setting included 8 units in 4 sites of a university hospital with all willing nurses participating. Open-ended focus groups and individual interviews and observational sessions were conducted using investigator-designed interview guides. Comprehensive qualitative analysis led to identification of categories and themes related to RU and the unit culture that supported it. Findings demonstrated that strategies to facilitate RU by staff at the unit level included conducting original research, supporting nurses participating in research, assessing and meeting staff learning needs, promoting staff attendance at conferences, stimulating goal-setting for presentations and publications, encouraging and responding to new ideas, questioning practice and stimulating inquiry, capitalizing on expertise in research knowledge and skills, and generating information and material resources. Characteristics of unit culture were linked to varying degrees of success with these strategies. The interplay of strategies with unit culture and research-based practice is described. A wide repertoire of strategies is needed to facilitate RU, and the outcome of these strategies is influenced by the unit culture. Consideration of the findings and the scope of the strategies used by nurses in the study can help clinical nurse specialist and other nursing leaders facilitate the building of practice on research.

Dementia care worker stress associations with unit type, resident, and work environment characteristics: a cross-sectional secondary data analysis of the Swiss Nursing Homes Human Resources Project (SHURP).

PubMed

Vogel, Barbara; De Geest, Sabina; Fierz, Katharina; Beckmann, Sonja; Zúñiga, Franziska

2017-03-01

Although caring for residents with dementia in nursing homes is associated with various stressors for care workers, the role of the unit type, and particularly the proportion of residents with dementia, remains unclear. This study aimed to explore associations between unit type and care worker stress, taking into account additional potential stressors. This cross-sectional study was a secondary data analysis in the Swiss Nursing Homes Human Resources Project, which included data from 3,922 care workers from 156 Swiss nursing homes. Care workers' stress was measured with a shortened version of the Health Professions Stress Inventory. Generalized estimating equation models were used to assess care worker stress and its relationships with three unit types (special care units and others with high or low proportions of residents with dementia), work environment factors, and aggressive resident behavior. After including all potential stressors in the models, no significant differences between the three unit types regarding care worker stress were found. However, increased care worker stress levels were significantly related to lower ratings of staffing and resources adequacy, the experience of verbal aggression, and the observation of verbal or physical aggression among residents. Although the unit type plays only a minor role regarding care worker stress, this study confirms that work environment and aggressive behavior of residents are important factors associated with work-related stress. To prevent increases of care worker stress, interventions to improve the work environment and strengthen care workers' ability to cope with aggressive behavior are suggested.

Nurse-Patient Communication Interactions in the Intensive Care Unit

PubMed Central

Happ, Mary Beth; Garrett, Kathryn; Thomas, Dana DiVirgilio; Tate, Judith; George, Elisabeth; Houze, Martin; Radtke, Jill; Sereika, Susan

2011-01-01

Background The inability to speak during critical illness is a source of distress for patients, yet nurse-patient communication in the intensive care unit has not been systematically studied or measured. Objectives To describe communication interactions, methods, and assistive techniques between nurses and nonspeaking critically ill patients in the intensive care unit. Methods Descriptive observational study of the nonintervention/usual care cohort from a larger clinical trial of nurse-patient communication in a medical and a cardiothoracic surgical intensive care unit. Videorecorded interactions between 10 randomly selected nurses (5 per unit) and a convenience sample of 30 critically ill adults (15 per unit) who were awake, responsive, and unable to speak because of respiratory tract intubation were rated for frequency, success, quality, communication methods, and assistive communication techniques. Patients self-rated ease of communication. Results Nurses initiated most (86.2%) of the communication exchanges. Mean rate of completed communication exchange was 2.62 exchanges per minute. The most common positive nurse act was making eye contact with the patient. Although communication exchanges were generally (>70%) successful, more than one-third (37.7%) of communications about pain were unsuccessful. Patients rated 40% of the communication sessions with nurses as somewhat difficult to extremely difficult. Assistive communication strategies were uncommon, with little to no use of assistive communication materials (eg, writing supplies, alphabet or word boards). Conclusions Study results highlight specific areas for improvement in communication between nurses and nonspeaking patients in the intensive care unit, particularly in communication about pain and in the use of assistive communication strategies and communication materials. PMID:21362711

Urinary tract infections due to Trichosporon spp. in severely ill patients in an intensive care unit

PubMed Central

Mattede, Maria das Graças Silva; Piras, Cláudio; Mattede, Kelly Dematte Silva; Ferrari, Aline Trugilho; Baldotto, Lorena Simões; Assbu, Michel Silvestre Zouain

2015-01-01

Objective To evaluate the incidence of urinary tract infections due to Trichosporon spp. in an intensive care unit. Methods This descriptive observational study was conducted in an intensive care unit between 2007 and 2009. All consecutive patients admitted to the intensive care unit with a confirmed diagnosis were evaluated. Results Twenty patients presented with urinary tract infections due to Trichosporon spp. The prevalence was higher among men (65%) and among individuals > 70 years of age (55%). The mortality rate was 20%. The average intensive care unit stay was 19.8 days. The onset of infection was associated with prior use of antibiotics and was more frequent in the fall and winter. Conclusion Infection due to Trichosporon spp. was more common in men and among those > 70 years of age and was associated with the use of an indwelling urinary catheter for more than 20 days and with the use of broadspectrum antibiotics for more than 14 days. In addition, patients with urinary infection due to Trichosporon spp. were most often hospitalized in intensive care units in the fall and winter periods. PMID:26465246

Duration of temporary catheter use for hemodialysis: an observational, prospective evaluation of renal units in Brazil

PubMed Central

2011-01-01

Background For chronic hemodialysis, the ideal permanent vascular access is the arteriovenous fistula (AVF). Temporary catheters should be reserved for acute dialysis needs. The AVF is associated with lower infection rates, better clinical results, and a higher quality of life and survival when compared to temporary catheters. In Brazil, the proportion of patients with temporary catheters for more than 3 months from the beginning of therapy is used as an evaluation of the quality of renal units. The aim of this study is to evaluate factors associated with the time between the beginning of hemodialysis with temporary catheters and the placement of the first arteriovenous fistula in Brazil. Methods This is an observational, prospective non-concurrent study using national administrative registries of all patients financed by the public health system who began renal replacement therapy (RRT) between 2000 and 2004 in Brazil. Incident patients were eligible who had hemodialysis for the first time. Patients were excluded who: had hemodialysis reportedly started after the date of death (inconsistent database); were younger than 18 years old; had HIV; had no record of the first dialysis unit; and were dialyzed in units with less than twenty patients. To evaluate individual and renal unit factors associated with the event of interest, the frailty model was used (N = 55,589). Results Among the 23,824 patients (42.9%) who underwent fistula placement in the period of the study, 18.2% maintained the temporary catheter for more than three months until the fistula creation. The analysis identified five statistically significant factors associated with longer time until first fistula: higher age (Hazard-risk - HR 0.99, 95% CI 0.99-1.00); having hypertension and cardiovascular diseases (HR 0.94, 95% CI 0.9-0.98) as the cause of chronic renal disease; residing in capitals cities (HR 0.92, 95% CI 0.9-0.95) and certain regions in Brazil - South (HR 0.83, 95% CI 0.8-0.87), Midwest (HR 0.88, 95% CI 0.83-0.94), Northeast (HR 0.91, 95% CI 0.88-0.94), or North (HR 0.88, 95% CI 0.83-0.94) and the type of renal unit (public or private). Conclusion Monitoring the provision of arteriovenous fistulas in renal units could improve the care given to patients with end stage renal disease. PMID:22093280

Status and trends of land change in the Midwest–South Central United States—1973 to 2000

USGS Publications Warehouse

Auch, Roger F.; Karstensen, Krista A.; Auch, Roger F.; Karstensen, Krista A.

2015-12-10

U.S. Geological Survey (USGS) Professional Paper 1794–C is the third in a four-volume series on the status and trends of the Nation’s land use and land cover, providing an assessment of the rates and causes of land-use and land-cover change in the Midwest–South Central United States between 1973 and 2000. Volumes A, B, and D provide similar analyses for the Western United States, the Great Plains of the United States, and the Eastern United States, respectively. The assessments of land-use and land-cover trends are conducted on an ecoregion-by-ecoregion basis, and each ecoregion assessment is guided by a nationally consistent study design that includes mapping, statistical methods, field studies, and analysis. Individual assessments provide a picture of the characteristics of land change occurring in a given ecoregion; in combination, they provide a framework for understanding the complex national mosaic of change and also the causes and consequences of change. Thus, each volume in this series provides a regional assessment of how (and how fast) land use and land cover are changing, and why. The four volumes together form the first comprehensive picture of land change across the Nation.Geographic understanding of land-use and land-cover change is directly relevant to a wide variety of stakeholders, including land and resource managers, policymakers, and scientists. The chapters in this volume present brief summaries of the patterns and rates of land change observed in each ecoregion in the Midwest–South Central United States, together with field photographs, statistics, and comparisons with other assessments. In addition, a synthesis chapter summarizes the scope of land change observed across the entire Midwest–South Central United States. The studies provide a way of integrating information across the landscape, and they form a critical component in the efforts to understand how land use and land cover affect important issues such as the provision of ecological goods and services and also the determination of risks to, and vulnerabilities of, human communities. Results from this project also are published in peer-reviewed journals, and they are further used to produce maps of change and other tools for land management, as well as to provide inputs for carbon-cycle modeling and other climate change research.

Evaluating the use of the Cleo 90 infusion set for patients on a palliative care unit.

PubMed

Schneider, Michael; Hoffmann, Martin; Lorenzl, Stefan

2009-08-01

Although the use of subcutaneous infusion is common in palliative care, problems can occur. Normally, butterfly needles are used; however, there are occasional issues with patients being able to walk around or with restless patients who suffer from delirium. In these cases, needles often dislocate; therefore, a small observational study was undertaken to evaluate the use of the Cleo 90 infusion set. The use of this needle system has been well established in diabetic patients who require continuous subcutaneous infusion of insulin, but has never been tested in a wider range of patients with other medications. In this 6-month study, 45 patients were identified for subcutaneous infusion and a total of 112 needles were used for this study, since we initially changed each site after 2 days to control the local site for adverse reactions. We have not observed any complications with drug combinations delivered via the attached tube and the needle, and have used up to five different drugs mixed together in a single syringe. Needles could be used for a mean time of 5 +/- 2 days (range 2-12 days). Local site reactions have been observed only with sodium chloride infusions, which were not delivered via a pump system. Reddening and induration of the skin occurred, but they were reversible after removing the needle. As this was a small study in only one unit, without standardization the results can only be observational. However, it has shown, for the first time, that the Cleo 90 needle can be safe and comfortable.