Elastic-wave propagation and site amplification in the Salt Lake Valley, Utah, from simulated normal faulting earthquakes

USGS Publications Warehouse

Benz, H.M.; Smith, R.B.

1988-01-01

The two-dimensional seismic response of the Salt Lake valley to near- and far-field earthquakes has been investigated from simulations of vertically incident plane waves and from normal-faulting earthquakes generated on the basin-bounding Wasatch fault. The plane-wave simulations were compared with observed site amplifications in the Salt Lake valley, based on seismic recordings from nuclear explosions in southern Nevada, that show 10 times greater amplification with the basin than measured values on hard-rock sites. Synthetic seismograms suggest that in the frequency band 0.3 to 1.5 Hz at least one-half the site amplitication can be attributed to the impedance contrast between the basin sediments and higher velocity basement rocks. -from Authors

Archaeology Through Computational Linguistics: Inscription Statistics Predict Excavation Sites of Indus Valley Artifacts.

PubMed

Recchia, Gabriel L; Louwerse, Max M

2016-11-01

Computational techniques comparing co-occurrences of city names in texts allow the relative longitudes and latitudes of cities to be estimated algorithmically. However, these techniques have not been applied to estimate the provenance of artifacts with unknown origins. Here, we estimate the geographic origin of artifacts from the Indus Valley Civilization, applying methods commonly used in cognitive science to the Indus script. We show that these methods can accurately predict the relative locations of archeological sites on the basis of artifacts of known provenance, and we further apply these techniques to determine the most probable excavation sites of four sealings of unknown provenance. These findings suggest that inscription statistics reflect historical interactions among locations in the Indus Valley region, and they illustrate how computational methods can help localize inscribed archeological artifacts of unknown origin. The success of this method offers opportunities for the cognitive sciences in general and for computational anthropology specifically. Copyright © 2015 Cognitive Science Society, Inc.

Cone penetration tests and soil borings at the Mason Road site in Green Valley, Solano County, California

USGS Publications Warehouse

Bennett, Michael J.; Noce, Thomas E.; Lienkaemper, James J.

2011-01-01

In support of a study to investigate the history of the Green Valley Fault, 13 cone penetration test soundings and 3 auger borings were made at the Mason Road site in Green Valley, Solano County, California. Three borings were made at or near two of the cone penetration test soundings. The soils are mostly clayey with a few sandy layers or lenses. Fine-grained soils range from low plasticity sandy lean clay to very plastic fat clay. Lack of stratigraphic correlation in the subsurface prevented us from determining whether any channels had been offset at this site. Because the soils are generally very clayey and few sand layers or lenses are loose, the liquefaction potential at the site is very low.

West Valley Demonstration Project Annual Site Environmental Report Calendar Year 2011

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

none,

2012-09-27

The West Valley Demonstration Project (WVDP) Annual Site Environmental Report (ASER) for Calendar Year 2011. The report, prepared for the U.S. Department of Energy West Valley Demonstration Project office (DOE-WVDP), summarizes the environmental protection program at the WVDP for calendar year (CY) 2011. Monitoring and surveillance of the facilities used by the DOE are conducted to verify protection of public health and safety and the environment. The report is a key component of DOE’s effort to keep the public informed of environmental conditions at the WVDP. The quality assurance protocols applied to the environmental monitoring program ensure the validity andmore » accuracy of the monitoring data. In addition to demonstrating compliance with environmental laws, regulations, and directives, evaluation of data collected in 2011 continued to indicate that WVDP activities pose no threat to public health or safety, or to the environment.« less

West Valley Demonstration Project Annual Site Environmental Report Calendar Year 2009

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

West Valley Environmental Services LLC

2010-09-17

The West Valley Demonstration Project (WVDP) Annual Site Environmental Report (ASER) for Calendar Year 2009. The report, prepared by the U.S. Department of Energy West Valley Demonstration Project office (DOE-WVDP), summarizes the environmental protection program at the WVDP for calendar year (CY) 2009. Monitoring and surveillance of the facilities used by the DOE are conducted to verify protection of public health and safety and the environment. The report is a key component of DOE’s effort to keep the public informed of environmental conditions at the WVDP. The quality assurance protocols applied to the environmental monitoring program by the DOE ensuremore » the validity and accuracy of the monitoring data. In addition to demonstrating compliance with environmental regulations and directives, evaluation of data collected in 2009 continued to indicate that WVDP activities pose no threat to public health or safety, or to the environment.« less

West Valley Demonstration Project Annual Site Environmental Report Calendar Year 2013

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

Rendall, John D.; Steiner, Alison F.; Pendl, Michael P.

2014-09-16

West Valley Demonstration Project (WVDP) Annual Site Environmental Report (ASER) for Calendar Year 2013. The report, prepared for the U.S. Department of Energy West Valley Demonstration Project office (DOE-WVDP), summarizes the environmental protection program at the WVDP for calendar year (CY) 2013. Monitoring and surveillance of the facilities used by the DOE are conducted to verify protection of public health and safety and the environment. The report is a key component of DOE’s effort to keep the public informed of environmental conditions at the WVDP. The quality assurance protocols applied to the environmental monitoring program ensure the validity and accuracymore » of the monitoring data. In addition to demonstrating compliance with environmental laws, regulations, and directives, evaluation of data collected in 2013 continued to indicate that WVDP activities pose no threat to public health or safety, or to the environment.« less

WEST VALLEY DEMONSTRATION PROJECT ANNUAL SITE ENVIRONMENTAL REPORT CALENDAR YEAR 2002

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

NONE

2003-09-12

This annual environmental monitoring report for the West Valley Demonstration Project (WVDP or Project) is published to inform those with interest about environmental conditions at the WVDP. In accordance with U.S. Department of Energy (DOE) Order 231.1, Environment, Safety, and Health Reporting, the report summarizes calendar year (CY) 2002 environmental monitoring data so as to describe the performance of the WVDP's environmental management system, confirm compliance with standards and regulations, and highlight important programs. In 2002, the West Valley Demonstration Project, the site of a DOE environmental cleanup activity operated by West Valley Nuclear Services Co. (WVNSCO), was in themore » final stages of stabilizing high-level radioactive waste (HLW) that remained at the site after commercial nuclear fuel reprocessing had been discontinued in the early 1970s. The Project is located in western New York State, about 30 miles south of Buffalo, within the New York State-owned Western New York Nuclear Service Center (WNYNSC). The WVDP is being conducted in cooperation with the New York State Energy Research and Development Authority (NYSERDA). Ongoing work activities at the WVDP during 2002 included: (1) completing HLW solidification and melter shutdown; (2) shipping low-level radioactive waste off-site for disposal; (3) constructing a facility where large high-activity components can be safely packaged for disposal; (4) packaging and removing spent materials from the vitrification facility; (5) preparing environmental impact statements for future activities; (6) removing as much of the waste left behind in waste tanks 8D-1 and 8D-2 as was reasonably possible; (7) removing storage racks, canisters, and debris from the fuel receiving and storage pool, decontaminating pool walls, and beginning shipment of debris for disposal; (8) ongoing decontamination in the general purpose cell and the process mechanical cell (also referred to as the head end cells); (9

Seismic site characterization of an urban dedimentary basin, Livermore Valley, California: Site tesponse, basin-edge-induced surface waves, and 3D simulations

USGS Publications Warehouse

Hartzell, Stephen; Leeds, Alena L.; Ramirez-Guzman, Leonardo; Allen, James P.; Schmitt, Robert G.

2016-01-01

Thirty‐two accelerometers were deployed in the Livermore Valley, California, for approximately one year to study sedimentary basin effects. Many local and near‐regional earthquakes were recorded, including the 24 August 2014 Mw 6.0 Napa, California, earthquake. The resulting ground‐motion data set is used to quantify the seismic response of the Livermore basin, a major structural depression in the California Coast Range Province bounded by active faults. Site response is calculated by two methods: the reference‐site spectral ratio method and a source‐site spectral inversion method. Longer‐period (≥1  s) amplification factors follow the same general pattern as Bouguer gravity anomaly contours. Site response spectra are inverted for shallow shear‐wave velocity profiles, which are consistent with independent information. Frequency–wavenumber analysis is used to analyze plane‐wave propagation across the Livermore Valley and to identify basin‐edge‐induced surface waves with back azimuths different from the source back azimuth. Finite‐element simulations in a 3D velocity model of the region illustrate the generation of basin‐edge‐induced surface waves and point out strips of elevated ground velocities along the margins of the basin.

The 1996-2009 borehole dilatometer installations, operation, and maintenance at sites in Long Valley Caldera, CA

USGS Publications Warehouse

Myren, Glenn; Johnston, Malcolm; Mueller, Robert

2011-01-01

High seismicity levels with accelerating uplift (under the resurgent dome) in Long Valley caldera in the eastern Sierra Nevada from 1989 to 1997, triggered upgrades to dilational strainmeters and other instrumentation installed in the early 1980's following a series of magnitude 6 earthquakes. This included two additional high-resolution borehole strainmeters and replacement of the failed strainmeter at Devil's Postpile. The purpose of the borehole-monitoring network is to monitor crustal deformation and other geophysical parameters associated with volcanic intrusions and earthquakes in the Long Valley Caldera. Additional instrumentation was added at these sites to improve the capability of providing continuous monitoring of the magma source under the resurgent dome. Sites were selected in regions of hard crystalline rock, where the expected signals from magmatic activity were calculated to be a maximum and the probability of an earthquake of magnitude 4 or greater is large. For the most part, the dilatometers were installed near existing arrays of surface tiltmeters, seismometers, level line, and GPS arrays. At each site, attempts are made to separate tectonic and volcanic signals from known noise sources in each instrument type. Each of these sites was planned to be a multi-parameter monitoring site, which included measurements of 3-component seismic velocity and acceleration, borehole strain, tilt, pore pressure and magnetic field. Using seismicity, geophysical knowledge, geologic and topographic maps, and geologists recommendations, lists of preliminary sites were chosen. Additional requirements were access, and telemetry constraints. When the final site choice was made, a permit was obtained from the U.S. Forest Service. Following this selection process, two new borehole sites were installed on the north and south side of the Long Valley Caldera in June of 1999. One site was located near Big Spring Campground to the east of Crestview. The second site was

Water-quality assessment of the Rio Grande Valley, Colorado, New Mexico, and Texas; occurrence and distribution of selected pesticides and nutrients at selected surface-water sites in the Mesilla Valley, 1994-95

USGS Publications Warehouse

Healy, D.F.

1996-01-01

The Rio Grande Valley study unit of the U.S. Geological Survey National Water-Quality Assessment Program conducted a two-phase synoptic study of the occurrence and distribution of pesticides and nutrients in the surface water of the Mesilla Valley, New Mexico and Texas. Phase one, conducted in April-May 1994 during the high-flow irrigation season, consisted of a 6-week time- series sampling event during which 17 water-column samples were collected at 3 main-stem sites on the Rio Grande and a synoptic irrigation-run sampling event during which 19 water-column samples were collected at 7 main-stem sites, 10 drain sites, and 2 sites at the discharges of wastewater-treatment plants. Three samples are included in both the time-series and irrigation-run events. Phase two, conducted in January 1995 during the low-flow non-irrigation season, consisted of a non-irrigation synoptic sampling event during which 18 water-column samples were collected at seven main-stem sites, nine drain sites, and two sites at the discharges of wastewater-treatment plants and a bed- material sampling event during which 6 bed-material samples were collected at six sites near the mouths of drains that discharge to the Rio Grande. The 51 water-column samples were analyzed for 78 pesticides and metabolites and 8 nutrients along with other constituents. The six bed-material samples were analyzed for 21 pesticides and metabolites, gross polychlorinated biphenyls, and gross polychlorinated naphthalenes. The presence of dissolved pesticides in the surface water of the Mesilla Valley is erratic. A total of 100 detections of 17 different pesticides were detected in 44 of the water-column samples. As many as 38 percent of these detections may be attributed to pesticide use upstream from the valley or to nonagricultural pesticide use within the valley. There were 29 detections of 10 different pesticides in 17 samples during the irrigation run and 41 detections of 13 pesticides in 16 samples during the non

MX Siting Investigation. Geotechnical Evaluation. Aggregate Resources Study, Lake Valley, Nevada.

DTIC Science & Technology

1981-02-27

KILOMETERS Mx SITING INVESTIGATION IGURE IPARTMENT OF TNt Ag1 FORCE - GMO 2 -_ONiO NATIONAL INC. FlU It FN-TR-37-f 5 2. Aerial and ground reconnaissance...fine, or crushed rock) and potential construction use ( con - crete and/or road base). TOM. FN-TR -37-f 6 2.0 STUDY APPROACH 2.1 EXISTING DATA Collection...2 the southwestern part of Lake Valley. This formation also pro - vides Class I crushed rock aggregate material in the southern White Rock Mountains

MX Siting Investigation. Gravity Survey - Sevier Desert Valley, Utah.

DTIC Science & Technology

1981-01-24

Cheyenne, Wyoming. DMAHTC reduces the data to Simple Bouguer Anomaly (see Section A1.4, Appendix Al.0). The Defense Mapping Agency Aerospace Center...Desert Valley, Utah ......... 2 2 Topographic Setting - Sevier Desert Valley, Utah . 3 LIST OF DRAWINGS Drawing Number 1 Complete Bouguer Anomaly...gravity stations were distributed throughout the valley at an approxi- mate interval of 1.4 miles (2.3 km). Drawing 1 is a Complete Bouguer Anomaly

West Valley Demonstration Project Annual Site Environmental Report (ASER) Calendar Year (2016)

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

Steiner, Alison F.; Pendl, Michael P.; Steiner, II, Robert E.

West Valley Demonstration Project (WVDP) Annual Site Environmental Report (ASER) for Calendar Year 2016. The report, prepared for the U.S. Department of Energy West Valley Demonstration Project office (DOE-WVDP), summarizes the environmental protection program at the WVDP for calendar year (CY) 2016. Monitoring and surveillance of the facilities used by the DOE are conducted to verify protection of public health and safety and the environment. The report is a key component of DOE’s effort to keep the public informed of environmental conditions at the WVDP. The quality assurance protocols applied to the environmental monitoring program ensure the validity and accuracymore » of the monitoring data. In addition to demonstrating compliance with environmental laws, regulations, and directives, evaluation of data collected in 2016 continued to indicate that WVDP activities pose no threat to public health or safety, or to the environment.« less

A feasibility study comparing UK older adult mental health inpatient wards which use protected engagement time with other wards which do not: study protocol.

PubMed

Nolan, Fiona M; Fox, Chris; Cheston, Richard; Turner, David; Clark, Allan; Dodd, Emily; Khoo, Mary-Ellen; Gray, Richard

2016-01-01

Protected engagement time (PET) is a concept of managing staff time on mental health inpatient wards with the aim of increasing staff and patient interaction. Despite apparent widespread use of PET, there remains a dearth of evidence as to how it is implemented and whether it carries benefits for staff or patients. This protocol describes a study which is being carried out on mental health wards caring for older adults (aged over 65) in England. The study shares a large proportion of the procedures, measures and study team membership of a recently completed investigation of the impact of PET in adult acute mental health wards. The study aims to identify prevalence and components of PET to construct a model for the intervention, in addition to testing the feasibility of the measures and procedures in preparation for a randomised trial. The study comprises four modules and uses a mixed methods approach. Module 1 involves mapping all inpatient wards in England which provide care for older adults, including those with dementia, ascertaining how many of these provide PET and in what way. Module 2 uses a prospective cohort method to compare five older adult mental health wards that use PET with five that do not across three National Health Service (NHS) Foundation Trust sites. The comparison comprises questionnaires, observation tools and routinely collected clinical service data and combines validated measures with questions developed specifically for the study. Module 3 entails an in-depth case study evaluation of three of the participating PET wards (one from each NHS Trust site) using semi-structured interviews with patients, carers and staff. Module 4 describes the development of a model and fidelity scale for PET using the information derived from the other modules with a working group of patients, carers and staff. This is a feasibility study to test the application of the measures and methods in inpatient wards for older adults and develop a draft model for the

A ward without patients.

PubMed

1988-01-02

Walk into Brooke ward and it doesn't feel like a ward at all. There are bright-coloured bedspreads, cuddly toys everywhere, a 1930s ball gown hangs above one of the lockers. And of course, there's Emma, the ward cat - continually fussed over by nurses and residents alike.

Hydrological responses to channelization and the formation of valley plugs and shoals

USGS Publications Warehouse

Pierce, Aaron R.; King, Sammy L.

2017-01-01

Rehabilitation of floodplain systems focuses on restoring interactions between the fluvial system and floodplain, however, there is a paucity of information on the effects of valley plugs and shoals on floodplain hydrological processes. We investigated hydrologic regimes in floodplains at three valley plug sites, two shoal sites, and three unchannelized sites. Valley plug sites had altered surface and sub-surface hydrology relative to unchannelized sites, while only sub-surface hydrology was affected at shoal sites. Some of the changes were unexpected, such as reduced flood duration and flood depth in floodplains associated with valley plugs. Our results emphasize the variability associated with hydrologic processes around valley plugs and our rudimentary understanding of the effects associated with these geomorphic features. Water table levels were lower at valley plug sites compared to unchannelized sites, however, valley plug sites had a greater proportion of days when water table inundation was above mean root collar depth than both shoal and unchannelized sites as a result of lower root collar depths and higher deposition rates. This study has provided evidence that valley plugs can affect both surface and sub-surface hydrology in different ways than previously thought and illustrates the variability in hydrological responses to valley plug formation.

West Valley Demonstration Project Annual Site Environmental Report (ASER) for Calendar Year 2014

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

Rendall, John D.; Steiner, Alison F.; Pendl, Michael P.

West Valley Demonstration Project (WVDP) Annual Site Environmental Report (ASER) for Calendar Year 2014. The report, prepared for the U.S. Department of Energy West Valley Demonstration Project office (DOE-WVDP), summarizes the environmental protection program at the WVDP for calendar year (CY) 2014. Monitoring and surveillance of the facilities used by the DOE are conducted to verify protection of public health and safety and the environment. The report is a key component of DOE’s effort to keep the public informed of environmental conditions at the WVDP. The quality assurance protocols applied to the environmental monitoring program ensure the validity and accuracymore » of the monitoring data. In addition to demonstrating compliance with environmental laws, regulations, and directives, evaluation of data collected in 2014 continued to indicate that WVDP activities pose no threat to public health or safety, or to the environment.« less

West Valley Demonstration Project Annual Site Environmental Report (ASER) for Calendar Year 2015

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

Rendall, John D.; Steiner, Alison F.; Pendl, Michael P.

West Valley Demonstration Project (WVDP) Annual Site Environmental Report (ASER) for Calendar Year 2015. The report, prepared for the U.S. Department of Energy West Valley Demonstration Project office (DOE-WVDP), summarizes the environmental protection program at the WVDP for calendar year (CY) 2015. Monitoring and surveillance of the facilities used by the DOE are conducted to verify protection of public health and safety and the environment. The report is a key component of DOE’s effort to keep the public informed of environmental conditions at the WVDP. The quality assurance protocols applied to the environmental monitoring program ensure the validity and accuracymore » of the monitoring data. In addition to demonstrating compliance with environmental laws, regulations, and directives, evaluation of data collected in 2015 continued to indicate that WVDP activities pose no threat to public health or safety, or to the environment.« less

Hydrogeology and simulation of groundwater flow at the Green Valley reclaimed coal refuse site near Terre Haute, Indiana

USGS Publications Warehouse

Bayless, E. Randall; Arihood, Leslie D.; Fowler, Kathleen K.

2011-01-01

The Green Valley reclaimed coal refuse site, near Terre Haute, Ind., was mined for coal from 1948 to 1963. Subsurface coal was cleaned and sorted at land surface, and waste material was deposited over the native glacial till. Approximately 2.7 million cubic yards of waste was deposited over 159 acres (92.3 hectares) in tailings ponds and gob piles. During 1993, the Indiana Department of Natural Resources, Division of Reclamation, improved the site by grading gob piles, filling tailings ponds, and covering the refuse with a layer of glacial drift. During 2008, the Division of Reclamation and U.S. Geological Survey initiated a cooperative investigation to characterize the hydrogeology of the site and construct a calibrated groundwater flow model that could be used to simulate the results of future remedial actions. In support of the modeling, a data-collection network was installed at the Green Valley site to measure weather components, geophysical properties, groundwater levels, and stream and seep flow. Results of the investigation indicate that (1) there is negligible overland flow from the site, (2) the prevailing groundwater-flow direction is from northeast to southwest, with a much smaller drainage to the northeast, (3) there is not a direct hydraulic connection between the refuse and West Little Sugar Creek, (4) about 24 percent of the groundwater recharge emerges through seeps, and water from the seeps evaporates or eventually flows to West Little Sugar Creek and the Green Valley Mine Pond, and (5) about 72 percent of groundwater recharge moves vertically downward from the coal refuse into the till and follows long, slow flow paths to eventual dischage points.

Soils, surficial geology, and geomorphology of the Bear Creek Valley Low-Level Waste Disposal Development and Demonstration Program site

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

Lietzke, D.A.; Lee, S.Y.; Lambert, R.E.

1988-04-01

An intensive soil survey was conducted on the proposed Low-Level Waste Disposal Development and Demonstration Program site (LLWDDD) in Bear Creek Valley. Soils on the site were related to the underlying residuum and to the surficial colluvium and alluvium. Within any particular geologic formation, soils were subdivided based mostly on the degree of weathering, as reflected by saprolite weathering and morphologic features of the soils. Degree of weathering was related both to slope shape and gradient and to the joint-fracture system. Erosion classes were also used to make further subdivisions of any particular soil. Deep pits were dug in eachmore » of the major Conasauga Group formations (Pumpkin Valley, Rogersville, Maryville, and Nolichucky) for soil and saprolite characterization. Because of the widespread presence of alluvium and colluvium, which are potential sources of fill and final cover material, pits and trenches were dug to characterize the properties of these soils and to try to understand the past geomorphic history of the site. The results of the soil survey investigation indicated that the deeply weathered Pumpkin Valley residuum has good potential for the construction of tumuli or other types of belowground or aboveground burial of prepackaged compacted waste. 11 refs., 30 figs., 3 tabs.« less

Hazardous Waste Cleanup: West Valley Demonstration Project USDOE in West Valley, New York

EPA Pesticide Factsheets

The U.S. Department of Energy's West Valley Demonstration Project is located at 10282 Rock Spring Road in West Valley, New York. This is a 167 acre, Department of Energy (DOE)-operated portion of a 3,300-acre site owned by the New York State Energy

Bottomland hardwood establishment and avian colonization of reforested sites in the Mississippi Alluvial Valley

USGS Publications Warehouse

Wilson, R.R.; Twedt, D.J.; Fredrickson, L.H.; King, S.L.; Kaminski, R.M.

2005-01-01

Reforestation of bottomland hardwood sites in the Mississippi Alluvial Valley has markedly increased in recent years, primarily due to financial incentive programs such as the Wetland Reserve Program, Partners for Wildlife Program, and state and private conservation programs. An avian conservation plan for the Mississippi Alluvial Valley proposes returning a substantial area of cropland to forested wetlands. Understanding how birds colonize reforested sites is important to assess the effectiveness of avian conservation. We evaluated establishment of woody species and assessed bird colonization on 89 reforested sites. These reforested sites were primarily planted with heavy-seeded oaks (Quercus spp.) and pecans (Carya illinoensis). Natural invasion of light-seeded species was expected to diversify these forests for wildlife and sustainable timber harvest. Planted tree species averaged 397 + 36 stems/ha-1, whereas naturally invading trees averaged 1675 + 241 stems/ha. However, naturally invading trees were shorter than planted trees and most natural invasion occurred <100 m from an existing forested edge. Even so, planted trees were relatively slow to develop vertical structure, especially when compared with tree species planted and managed for pulpwood production. Slow development of vertical structure resulted in grassland bird species, particularly dickcissel (Spiza americana) and red-winged blackbird (Agelaius phoeniceus), being the dominant avian colonizers for the first 7 years post-planting. High priority bird species (as defined by Partners in Flight), such as prothonotary warbler (Protonotaria citrea) and wood thrush (Hylocichla mustelina), were not frequently detected until stands were 15 years old. Canonical correspondence analysis revealed tree height had the greatest influence on the bird communities colonizing reforested sites. Because colonization by forest birds is dependent on tree height, we recommend inclusion of at least one fast-growing tree

VEGETATION CHARACTERIZATION OF THREE CONTRASTING RIPARIAN SITES, WILLAMETTE VALLEY, OR

EPA Science Inventory

Much of the native riparian vegetation of the Willamette Valley, Oregon, has been replaced with agricultural crops or invasive non-native plant species. Detailed information about current Willamette Valley riparian vegetation is generally lacking. Plant species composition data...

45 CFR 46.409 - Wards.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Wards. 46.409 Section 46.409 Public Welfare... Protections for Children Involved as Subjects in Research § 46.409 Wards. (a) Children who are wards of the state or any other agency, institution, or entity can be included in research approved under § 46.406 or...

45 CFR 46.409 - Wards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Wards. 46.409 Section 46.409 Public Welfare... Protections for Children Involved as Subjects in Research § 46.409 Wards. (a) Children who are wards of the state or any other agency, institution, or entity can be included in research approved under § 46.406 or...

45 CFR 46.409 - Wards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Wards. 46.409 Section 46.409 Public Welfare... Protections for Children Involved as Subjects in Research § 46.409 Wards. (a) Children who are wards of the state or any other agency, institution, or entity can be included in research approved under § 46.406 or...

45 CFR 46.409 - Wards.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Wards. 46.409 Section 46.409 Public Welfare... Protections for Children Involved as Subjects in Research § 46.409 Wards. (a) Children who are wards of the state or any other agency, institution, or entity can be included in research approved under § 46.406 or...

45 CFR 46.409 - Wards.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Wards. 46.409 Section 46.409 Public Welfare... Protections for Children Involved as Subjects in Research § 46.409 Wards. (a) Children who are wards of the state or any other agency, institution, or entity can be included in research approved under § 46.406 or...

Valley floor climate observations from the McMurdo dry valleys, Antarctica, 1986-2000

USGS Publications Warehouse

Doran, P.T.; McKay, C.P.; Clow, G.D.; Dana, G.L.; Fountain, A.G.; Nylen, T.; Lyons, W.B.

2002-01-01

Climate observations from the McMurdo dry valleys, East Antarctica are presented from a network of seven valley floor automatic meteorological stations during the period 1986 to 2000. Mean annual temperatures ranged from -14.8??C to -30.0??C, depending on the site and period of measurement. Mean annual relative humidity is generally highest near the coast. Mean annual wind speed increases with proximity to the polar plateau. Site-to-site variation in mean annual solar flux and PAR is due to exposure of each station and changes over time are likely related to changes in cloudiness. During the nonsummer months, strong katabatic winds are frequent at some sites and infrequent at others, creating large variation in mean annual temperature owing to the warming effect of the winds. Katabatic wind exposure appears to be controlled to a large degree by the presence of colder air in the region that collects at low points and keeps the warm less dense katabatic flow from the ground. The strong influence of katabatic winds makes prediction of relative mean annual temperature based on geographical position (elevation and distance from the coast) alone, not possible. During the summer months, onshore winds dominate and warm as they progress through the valleys creating a strong linear relationship (r2 = 0.992) of increasing potential temperature with distance from the coast (0.09??C km-1). In contrast to mean annual temperature, summer temperature lends itself quite well to model predictions, and is used to construct a statistical model for predicting summer dry valley temperatures at unmonitored sites. Copyright 2002 by the American Geophysical Union.

Comparing regeneration techniques for afforesting previously farmed bottomland hardwood sites in the Lower Mississippi Alluvial Valley, USA

Treesearch

Brian Roy Lockhart; Bob Keeland; John McCoy; Thomas J. Dean

2003-01-01

A study was implemented to test site preparation methods and artificial regeneration of three oak (Quercus spp.) species on four agricultural fields in the Lower Mississippi Alluvial Valley in Louisiana, USA. Six years after establishment, few consistent differences were found in oak density between sowing acorn methods (seed drill versus broadcast...

Ward safety perceived by ward managers in Britain, Germany and Switzerland: identifying factors that improve ability to deal with violence.

PubMed

Lepping, P; Steinert, T; Needham, I; Abderhalden, C; Flammer, E; Schmid, P

2009-09-01

Little is known about how safe nurses feel on psychiatric wards across different European countries. This paper is aim to evaluate how ward safety is perceived by ward managers in Great Britain, Germany and Switzerland. We replicated a Swiss questionnaire study in Germany and Britain, which asked ward managers on adult psychiatric wards to give details about their ward including data on the management of aggression, staffing levels, staff training, standards and type of restraint used, alarm devices, treatment and management of aggression and the existence and perceived efficacy of standards (protocols, guidelines). The British sample had by far the highest staffing levels per psychiatric bed, followed by Switzerland and Germany. The British ward managers by far perceived violence and aggression least as a problem on their wards, followed by Germany and then Switzerland. British ward managers are most satisfied with risk management and current practice dealing with violence. German managers were most likely to use fixation and most likely to have specific documentation for coercive measures. Swiss wards were most likely to use non-specific bedrooms for seclusion and carry alarm devices. British wards were far more likely to have protocols and training for the treatment and management of violence, followed by Switzerland and Germany. British ward managers by far perceived violence and aggression to be a small problem on their wards compared with Swiss and German ward managers. This was associated with the availability of control and restraint teams, regular training, clear protocols and a lesser degree risk assessments, but not staffing levels.

77 FR 63873 - Johnson Controls, Inc. Including On-Site Leased Workers of Valley Staffing and AZ Quality Hudson...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... workers of Johnson Controls, Inc., including on-site leased workers from Valley Staffing, Hudson..., Wisconsin location of Johnson Controls, Inc. The Department has determined that these workers were sufficiently under the control of the subject firm to be considered leased workers. Based on these findings...

Measuring ward round quality in urology.

PubMed

Darbyshire, Daniel; Barrett, Charlotte; Ross, David; Shackley, David

2015-01-01

Ward rounds are the traditional process by which clinical information is interpreted and management plans made in the inpatient setting and the only time during which patient-doctor interaction can reliably occur. Efforts to improve quality and safety have started looking at the ward round but this has mainly been in the acute medical setting. To begin the quality improvement process for Urological ward rounds. Twenty indicators thought to relate to quality were recorded for every weekday ward round by the Urology team for one month. Twenty ward rounds, 93 patient encounters, were reviewed. A consultant was present for 37% of the patient encounters. 84% of observation charts were reviewed; drug charts 28% and antibiotics 70%. Plans were communicated to the doctors, patient and nursing staff. All notes were typed directly onto the electronic system, 20% of notes were checked by the lead clinician. Mean time per patient was 6 minutes. By starting a discussion about ward rounds we aim to align the process with the broader values of the organisation. Ward rounds can be the cornerstone of delivering safe, clean and personal care and measuring this process is vital to understanding efforts to improve them.

MX Siting Investigation. Gravity Survey - Big Smokey Valley, Nevada.

DTIC Science & Technology

1980-11-28

Monte Cristo Range, on the south by Lone Mountain arid Tonopah, Nevada, and on the north by the T1i7 ,abhv i a7e. True area covered by this report lies...Royston Hills and Monte Cristo Range) are chiefly Tertiary tuffs, rhyolites, andesites, and basalts. Basin-fill deposits within the valley reach combined...east of Royston Hills and Monte Cristo Range. At the southern end where the valley bifurcates, faults are interpreted to be near both flanks of Lone

Hydrologic effects of stress-relief fracturing in an Appalachian Valley

USGS Publications Warehouse

Wyrick, Granville G.; Borchers, James W.

1981-01-01

A hydrologic study at Twin Falls State Park, Wyoming County, West Virginia, was made to determine how fracture systems affect the occurrence and movement of ground water in a typical valley of the Appalachian Plateaus Physiographic Province. Twin Falls was selected because it is generally unaffected by factors that would complicate an analysis of the data. The study area was the Black Fork Valley at Twin Falls. The valley is about 3 miles long and 400 to 600 feet wide and is cut into massive sandstone units interbedded with thin coal and shale beds. The study was made to determine how aquifer characteristics were related to fracture systems in this valley, so that the relation could be applied to studies of other valleys. Two sites were selected for test drilling, pumping tests, and geophysical studies. One site is in the upper part of the valley, and the second is near the lower central part. At both sites, ground water occurs mainly in horizontal bedding-plane fractures under the valley floor and in nearly vertical and horizontal slump fractures along the valley wall. The aquifer is under confined conditions under the valley floor and unconfined conditions along the valley wall. The fractures pinch out under the valley walls, which form impermeable barriers. Tests of wells near the valley center indicated a change in storage coefficient as the cone of depression caused by pumping reached the confined-unconfined boundaries; the tests also indicated barrier-image effects when the cone reached the impermeable boundaries. Drawdown from pumping near the center of the valley affected water levels at both sites, indicating a hydraulic connection from the upper to the lower end of the valley. Stream gain-and-loss studies show that ground water discharges to the stream from horizontal fractures beneath Black Fork Falls, near the mouth of Black Fork. The fracture systems that constitute most of the transmissive part of the aquifer at Twin Falls are like those described as

Consumer perspectives in adolescent ward design.

PubMed

Hutton, Alison

2005-05-01

The aim of the study was to gain an understanding of the environment and facilities that adolescents require in a purpose-built adolescent ward. People who are hospitalized have limited control over their care and environment. The experience of hospitalization is also considered a highly stressful event. It is essential that patients have an opportunity to participate in the planning and design of ward environments in order to reduce their stress and better accommodate their treatment needs. An interpretative qualitative design was used. Seven chronically ill adolescents were asked to design their own ward in order to obtain consumer input about what the perceived necessary facilities for adolescent wards. The adolescents provided clear information about the facilities that should be incorporated into an adolescent ward to maintain their privacy and independence. Further research needs to be conducted seeking consumer input, especially if it can enhance the stay of adolescent patients while they are hospitalized. Adolescent voice is more often than not represented by nurses, or other healthcare professionals in the patients' best interest. This practice acts on the assumption that the adult knows best and/or that adolescents are unable to articulate their own needs. Adolescent consumers contribute worthwhile recommendations to how a ward is run providing insight about their needs in the ward environment.

The dating and interpretation of a Mode 1 site in the Luangwa Valley, Zambia.

PubMed

Barham, Lawrence; Phillips, William M; Maher, Barbara A; Karloukovski, Vassil; Duller, Geoff A T; Jain, Mayank; Wintle, Ann G

2011-05-01

Flake based assemblages (Mode 1) comprise the earliest stone technologies known, with well-dated Oldowan sites occurring in eastern Africa between ~2.6-1.7 Ma, and in less securely dated contexts in central, southern and northern Africa. Our understanding of the spread and local development of this technology outside East Africa remains hampered by the lack of reliable numerical dating techniques applicable to non-volcanic deposits. This study applied the still relatively new technique of cosmogenic nuclide burial dating ((10)Be/(26)Al) to calculate burial ages for fluvial gravels containing Mode 1 artefacts in the Luangwa Valley, Zambia. The Manzi River, a tributary of the Luangwa River, has exposed a 4.7 m deep section of fluvial sands with discontinuous but stratified gravel layers bearing Mode 1, possibly Oldowan, artefacts in the basal layers. An unconformity divides the Manzi section, separating Mode 1 deposits from overlying gravels containing Mode 3 (Middle Stone Age) artefacts. No diagnostic Mode 2 (Acheulean) artefacts were found. Cosmogenic nuclide burial dating was attempted for the basal gravels as well as exposure ages for the upper Mode 3 gravels, but was unsuccessful. The complex depositional history of the site prevented the calculation of reliable age models. A relative chronology for the full Manzi sequence was constructed, however, from the magnetostratigraphy of the deposit (N>R>N sequence). Isothermal thermoluminescence (ITL) dating of the upper Mode 3 layers also provided consistent results (~78 ka). A coarse but chronologically coherent sequence now exists for the Manzi section with the unconformity separating probable mid- or early Pleistocene deposits below from late Pleistocene deposits above. The results suggest Mode 1 technology in the Luangwa Valley may post-date the Oldowan in eastern and southern Africa. The dating programme has contributed to a clearer understanding of the geomorphological processes that have shaped the valley and

The dating and interpretation of a Mode 1 site in the Luangwa Valley, Zambia

USGS Publications Warehouse

Barham, L.; Phillips, W.M.; Maher, B.A.; Karloukovski, V.; Duller, G.A.T.; Jain, M.; Wintle, A.G.

2011-01-01

Flake based assemblages (Mode 1) comprise the earliest stone technologies known, with well-dated Oldowan sites occurring in eastern Africa between ??? 2.6-1.7 Ma, and in less securely dated contexts in central, southern and northern Africa. Our understanding of the spread and local development of this technology outside East Africa remains hampered by the lack of reliable numerical dating techniques applicable to non-volcanic deposits. This study applied the still relatively new technique of cosmogenic nuclide burial dating (10Be/26Al) to calculate burial ages for fluvial gravels containing Mode 1 artefacts in the Luangwa Valley, Zambia. The Manzi River, a tributary of the Luangwa River, has exposed a 4.7 m deep section of fluvial sands with discontinuous but stratified gravel layers bearing Mode 1, possibly Oldowan, artefacts in the basal layers. An unconformity divides the Manzi section, separating Mode 1 deposits from overlying gravels containing Mode 3 (Middle Stone Age) artefacts. No diagnostic Mode 2 (Acheulean) artefacts were found. Cosmogenic nuclide burial dating was attempted for the basal gravels as well as exposure ages for the upper Mode 3 gravels, but was unsuccessful. The complex depositional history of the site prevented the calculation of reliable age models. A relative chronology for the full Manzi sequence was constructed, however, from the magnetostratigraphy of the deposit (N>R>N sequence). Isothermal thermoluminescence (ITL) dating of the upper Mode 3 layers also provided consistent results (???78 ka). A coarse but chronologically coherent sequence now exists for the Manzi section with the unconformity separating probable mid- or early Pleistocene deposits below from late Pleistocene deposits above. The results suggest Mode 1 technology in the Luangwa Valley may post-date the Oldowan in eastern and southern Africa. The dating programme has contributed to a clearer understanding of the geomorphological processes that have shaped the valley and

A West Valley Demonstration Project Milestone - Achieving Certification to Ship Waste to the Nevada Test Site

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

Jackson, J. P.; Pastor, R. S.

2002-02-28

The West Valley Demonstration Project (WVDP) has successfully pretreated and vitrified nearly all of the 600,000 gallons of liquid high-level radioactive waste that was generated at the site of the only commercial nuclear fuel reprocessing plant to have operated in the United States. Low-level waste (LLW) generated during the course of the cleanup effort now requires disposal. Currently the WVDP only ships Class A LLW for off-site disposal. It has been shipping Class A wastes to Envirocare of Utah, Inc. since 1997. However, the WVDP may also have a future need to ship Class B and Class C waste, whichmore » Envirocare is not currently authorized to accept. The Nevada Test Site (NTS), a U.S. Department of Energy (DOE) facility, can accept all three waste classifications. The WVDP set a goal to receive certification to begin shipping Class A wastes to NTS by 2001. Formal certification/approval was granted by the DOE Nevada Operations Office on July 12, 2001. This paper discusses how the WVDP contractor, West Valley Nuclear Services Company (WVNSCO), completed the activities required to achieve NTS certification in 2001 to ship waste to its facility. The information and lessons learned provided are significant because the WVDP is the only new generator receiving certification based on an NTS audit in January 2001 that resulted in no findings and only two observations--a rating that is unparalleled in the DOE Complex.« less

Being-in-the-Chemotherapy-Suite versus Being-in-the-Oncology-Ward: An Analytical View of Two Hospital Sites Occupied by People Experiencing Cancer †

PubMed Central

Hughes, Catherine; van Heugten, Kate; Keeling, Sally; Szekely, Francisc

2017-01-01

How do people with cancer occupy places within the health system during their journey through palliative care? The answer to this question was explored by the authors as part of a wider ethnographic study of eight people’s journeys from referral to palliative care services to the end of life. This article reports on findings that have emerged from ongoing analysis that has been completed in the years proceeding data collection. An ethnographic research design was used to collect data about the participants and their family members over a three-year period. Data was collected using participant observation and semi-structured interviews. Over 380 transcripts based on field note entries and taped interviews were produced during the 1121 h of contact with participants and family members that made up the research period. Analysis of these texts identified two focal sites within Christchurch Hospital that were occupied by the participants. These were the Chemotherapy Suite and the Oncology Ward. Drawing on literature concerning previous anthropological analysis, research was conducted to understand how places affect people and how people affect places. The researchers have used a model outlined by the American ethnographer Miles Richardson to analyse two distinct sites within one hospital. As explained in Richardson’s article, whose title is used to model the title of this article, a sense of place becomes apparent when comparing and contrasting two sites within the same location. Richardson’s article is highly interpretative and relies not only on pre-existing theoretical frameworks but also on personal interpretation. The same approach has been used in the current article. Here, ethnographic methods require the researcher’s interpretation of how participants occupied these sites. Following this approach, the Chemotherapy Suite is presented as a place where medicine dominates illness, and appears as distinct from the Oncology Ward, where disease predominates and

AmeriFlux US-SdH Nebraska SandHills Dry Valley

DOE Data Explorer

Arkebauer, Tim J. [University of Nebraska; Billesbach, Dave [University of Nebraska

2016-01-01

This is the AmeriFlux version of the carbon flux data for the site US-SdH Nebraska SandHills Dry Valley. Site Description - The Nebraska SandHills Dry Valley tower is located on public land owned by the University of Nebraska-Lincoln. The site is on a research cattle ranch where grazing primarily takes place.

Hydrogeology of a drift-filled bedrock valley near Lino Lakes, Anoka County, Minnesota

USGS Publications Warehouse

Winter, T.C.; Pfannkuch, H.O.

1976-01-01

The bedrock surface of east-central Minnesota is dissected by an intricate network of valleys. Outside the bedrock valley at site B, 3 mi (4. 8 km) from site A, 100 ft (30 m) of drift overlies the bedrock surface. Observation wells were installed at the two sites to determine the vertical ground-water movement between the various aquifer units and the lateral movement between the two sites. An aquifer test of the lowest valley-fill aquifer at site A showed that the observation well completed in the same aquifer as the pumping well responded immediately; whereas a lag of about 100 min occurred between the lower valley fill and uppermost body of sand and gravel. This indicates that the hydraulic connection between these two layers is poor at the immediate site. Test results show that the lower sand-and-gravel aquifer has a transmissivity between 14,000 and 27,000 ft2/d (1,300 and 2,500 m2/d). Although the hydraulic gradient is vertically downward in the valley, much of the drift fill is poorly permeable. This suggests that the quantity of downward-percolating water reaching the lowest valley-fill aquifer is relatively small at the test site. Because valley cut through a number of bedrock aquifers in the region, they could potentially be an important avenue of contamination from land-surface waste. In addition, the vast network of bedrock valleys in the Twin Cities area might cause contaminants to disseminate rather rapidly throughout a large area.

The northwestern slope valleys (NSVs) region, Mars: A prime candidate site for the future exploration of Mars

USGS Publications Warehouse

Dohm, J.M.; Ferris, J.C.; Barlow, N.G.; Baker, V.R.; Mahaney, W.C.; Anderson, R.C.; Hare, T.M.

2004-01-01

The northwestern slope valleys region is a prime candidate site for future science-driven Mars exploration because it records Noachian to Amazonian Tharsis development in a region that encapsulates (1) a diverse and temporally extensive stratigraphic record, (2) at least three distinct paleohydrologic regimes, (3) gargantuan structurally controlled flood valleys that generally correspond with gravity and magnetic anomalies, possibly marking ancient magnetized rock materials exposed by fluvial activity, (4) water enrichment, as indicated by Mars Odyssey and impact crater analyses, (5) long-lived magma and ground water/ice interactions that could be favorable for the development and sustenance of life, and (6) potential paleosol development. This region has high probability to yield significant geologic, climatic, and exobiologic information that could revolutionize our understanding of Mars. ?? 2003 Elsevier Ltd. All rights reserved.

Simulation for ward processes of surgical care.

PubMed

Pucher, Philip H; Darzi, Ara; Aggarwal, Rajesh

2013-07-01

The role of simulation in surgical education, initially confined to technical skills and procedural tasks, increasingly includes training nontechnical skills including communication, crisis management, and teamwork. Research suggests that many preventable adverse events can be attributed to nontechnical error occurring within a ward context. Ward rounds represent the primary point of interaction between patient and physician but take place without formalized training or assessment. The simulated ward should provide an environment in which processes of perioperative care can be performed safely and realistically, allowing multidisciplinary assessment and training of full ward rounds. We review existing literature and describe our experience in setting up our ward simulator. We examine the facilities, equipment, cost, and personnel required for establishing a surgical ward simulator and consider the scenario development, assessment, and feedback tools necessary to integrate it into a surgical curriculum. Copyright © 2013 Elsevier Inc. All rights reserved.

Site and canopy characteristics associated with oak advance reproduction in mature oak-hickory forests in the ridge and valley province in Tennessee

Treesearch

Leslie S. Chadwell; David S. Buckley

2003-01-01

To investigate hypotheses regarding effects of competitors and site quality on oak regeneration, we documented site factors and oak seedling composition, size, and abundance in the Ridge and Valley Province of Tennessee. Small oak seedlings were most abundant on productive soils and mesic landform positions, whereas large oak seedlings were most abundant on less...

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

NASA Astrophysics Data System (ADS)

Greene, Natasha Ann

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

Robot Assisted Surgical Ward Rounds: Virtually Always There.

PubMed

Croghan, Stefanie M; Carroll, Paul; Reade, Sarah; Gillis, Amy E; Ridgway, Paul F

2018-05-02

 While an explosion in technological sophistication has revolutionized surgery within the operating theatre, delivery of surgical ward-based care has seen little innovation.  Use of telepresence allowing off-site clinicians communicate with patients has been largely restricted to outpatient settings or use of complex, expensive, static devices.  We designed a prospective study to ascertain feasibility and face validity of a remotely controlled mobile audiovisual drone (LUCY) to access inpatients.  This device is, uniquely, lightweight, freely mobile and emulates 'human' interaction by swiveling and adjusting height to patients' eye-level.   METHODS: Robot-assisted ward rounds(RASWR) were conducted over 3 months. A remotely located consultant surgeon communicated with patients/bedside teams via encrypted audiovisual telepresence robot (DoubleRoboticstm, California USA).  Likert-scale satisfaction questionnaires, incorporating free-text sections for mixed-methods data collection, were disseminated to patient and staff volunteers following RASWRs.  The same cohort completed a linked questionnaire following conventional (gold-standard) rounds, acting as control group. Data were paired, and non-parametric analysis performed.  RESULTS: RASWRs are feasible (>90% completed without technical difficulty). The RASWR(n=52 observations) demonstrated face validity with strong correlations (r>0.7; Spearman, p-value <0.05) between robotic and conventional ward rounds among patients and staff on core themes, including dignity/confidentiality/communication/satisfaction with management plan. Patients (96.08%, n=25) agreed RASWR were a satisfactory alternative when consultant physical presence was not possible. There was acceptance of nursing/NCHD cohort (100% (n=11) willing to regularly partake in RASWR).  CONCLUSION: RASWRs receive high levels of patient and staff acceptance, and offer a valid alternative to conventional ward rounds when a consultant cannot be

Operation Ward's Island, A Guide to the Trees and Other Features of Ward's Island.

ERIC Educational Resources Information Center

New York City Board of Education, Brooklyn, NY. Bureau of Curriculum Development.

This guide for teachers, students, and adults illustrates how it is possible to use Ward's Island as an outdoor laboratory. It contains a guide to 30 kinds of trees on the island, along with clearly drawn maps and illustrations. The guide helps the user to locate these trees along two nature trails. A section called "Ward's Island…

Ward rounds, participants, roles and perceptions: literature review.

PubMed

Walton, Victoria; Hogden, Anne; Johnson, Julie; Greenfield, David

2016-05-09

Purpose - The purpose of this paper is to classify and describe the purpose of ward rounds, who attends each round and their role, and participants' perception of each other's role during the respective ward rounds. Design/methodology/approach - A literature review of face-to-face ward rounds in medical wards was conducted. Peer reviewed journals and government publications published between 2000 and 2014 were searched. Articles were classified according to the type of round described in the study. Purposes were identified using keywords in the description of why the round was carried out. Descriptions of tasks and interactions with team members defined participant roles. Findings - Eight round classifications were identified. The most common were the generalised ward; multidisciplinary; and consultant rounds. Multidisciplinary rounds were the most collaborative round. Medical officers were the most likely discipline to attend any round. There was limited reference to allied health clinicians and patient involvement on rounds. Perceptions attendees held of each other reiterated the need to continue to investigate teamwork. Practical implications - A collaborative approach to care planning can occur by ensuring clinicians and patients are aware of different ward round processes and their role in them. Originality/value - Analysis fulfils a gap in the literature by identifying and analysing the different ward rounds being undertaken in acute medical wards. It identifies the complexities in the long established routine hospital processes of the ward round.

Logs and data from trenches across and near the Green Valley Fault at the Mason Road site, Fairfield, Solano County, California, 2006-2009

USGS Publications Warehouse

Lienkaemper, James J.; Sickler, Robert R.; Mahan, Shannon; Brown, Johnathan; Reidy, Liam M.; Kimball, Mindy A.

2012-01-01

The primary purpose of this report is to provide drafted field logs of exploratory trenches excavated across the Green Valley Fault in 2007 and 2009 that show evidence for four surface rupturing earthquakes in the past one thousand years. The site location and site detail are shown on sheet 1. The trench logs are shown on sheets 1, 2, and 3. We also provide radiocarbon laboratory dates used for chronological modeling of the earthquake history. Sheets 4 and 5 show additional data obtained in 2006–2009 to document data obtained in our studies of the long-term geologic slip rate on the Green Valley Fault. However, that effort ultimately did not prove feasible and no slip rate estimate resulted.

Comparison of peak discharges among sites with and without valley fills for the July 8-9, 2001 flood in the headwaters of Clear Fork, Coal River basin, mountaintop coal-mining region, southern West Virginia

USGS Publications Warehouse

Wiley, Jeffrey B.; Brogan, Freddie D.

2003-01-01

The effects of mountaintop-removal mining practices on the peak discharges of streams were investigated in six small drainage basins within a 7-square-mile area in southern West Virginia. Two of the small basins had reclaimed valley fills, one basin had reclaimed and unreclaimed valley fills, and three basins did not have valley fills. Indirect measurements of peak discharge for the flood of July 8-9, 2001, were made at six sites on streams draining the small basins. The sites without valley fills had peak discharges with 10- to 25-year recurrence intervals, indicating that rainfall intensities and totals varied among the study basins. The flood-recurrence intervals for the three basins with valley fills were determined as though the peak discharges were those from rural streams without the influence of valley fills, and ranged from less than 2 years to more than 100 years.

Grizzly Valley fault system, Sierra Valley, CA

USGS Publications Warehouse

Gold, Ryan; Stephenson, William; Odum, Jack; Briggs, Rich; Crone, Anthony; Angster, Steve

2012-01-01

The Grizzly Valley fault system (GVFS) strikes northwestward across Sierra Valley, California and is part of a network of active, dextral strike-slip faults in the northern Walker Lane (Figure 1). To investigate Quaternary motion across the GVFS, we analyzed high-resolution (0.25 m) airborne LiDAR data (Figure 2) in combination with six, high-resolution, P-wave, seismic-reflection profiles [Gold and others, 2012]. The 0.5- to 2.0-km-long seismic-reflection profiles were sited orthogonal to suspected tectonic lineaments identified from previous mapping and our analysis of airborne LiDAR data. To image the upper 400–700 m of subsurface stratigraphy of Sierra Valley (Figure 3), we used a 230-kg accelerated weight drop source. Geophone spacing ranged from 2 to 5 m and shots were co-located with the geophones. The profiles reveal a highly reflective, deformed basal marker that we interpret to be the top of Tertiary volcanic rocks, overlain by a 120- to 300-m-thick suite of subhorizontal reflectors we interpret as Plio-Pleistocene lacustrine deposits. Three profiles image the principle active trace of the GVFS, which is a steeply dipping fault zone that offsets the volcanic rocks and the basin fill (Figures 4 & 5).

Simulated ward round: reducing costs, not outcomes.

PubMed

Ford, Helen; Cleland, Jennifer; Thomas, Ian

2017-02-01

Distractions and interruptions on the ward pose substantial patient safety risks, but medical students receive little training on their management. Although there is some evidence that medical students can be taught how to manage distractions and interruptions in a simulated ward environment, the only model to date is based on individual feedback, which is resource-expensive, mitigating curricular integration. Our aim was to assess the educational utility of a cost-efficient approach to a patient safety-focused simulated ward round. Twenty-three of 55 final-year medical students took part in a cost-reduced simulated ward round. Costs were minimised by providing group rather than individualised feedback, thereby shortening the duration of each simulation and reducing the number of interruptions. The utility of the simulation was assessed via student evaluation and performance on a patient safety station of an objective structured clinical examination (OSCE). The direct costs of the simulation were more than 50 per cent lower per student compared with the original study, mostly as a result of a reduction in the time that faculty members took to give feedback. Students managed distractions better and received higher scores in the OSCE station than those who had not undergone the ward round. Group feedback was evaluated positively by most participants: 94 per cent of those who provided feedback agreed or strongly agreed that the simulation would make them a safer doctor and would improve their handling of distractions. Our aim was to assess the educational utility of a cost-efficient approach to a patient safety-focused simulated ward round DISCUSSION: The costs of a simulated ward round can be significantly reduced whilst maintaining educational utility. These findings should encourage medical schools to integrate ward simulation into curricula. © 2016 John Wiley & Sons Ltd.

Violent events, ward climate and ideas for violence prevention among nurses in psychiatric wards: a focus group study.

PubMed

Lantta, Tella; Anttila, Minna; Kontio, Raija; Adams, Clive E; Välimäki, Maritta

2016-01-01

Patient violence against nurses in their work environments is a widespread global concern, particularly in the field of mental health care. A high prevalence of violent events impacts the well-being of nurses and may also impair overall ward climate. However, it has been proposed that nurses' use limited techniques to prevent patient violence, and, therefore, more comprehensive methods for dealing with patient violence are needed. There is still restricted understanding of the ward climate during the occurrence of a violent event as well as how these incidents could be more effectively prevented. This study aimed to explore nurses' experiences of violent events in psychiatric wards, give insight into ward climates and examine suggestions for violence prevention. This study employed a descriptive, exploratory design including focus groups (n = 5) and open-ended questions. The participants were registered and enrolled nurses (n = 22) working on three closed psychiatric in-patient wards in one Finnish hospital district. Focus groups were tape-recorded, transcribed and analyzed with inductive content analysis. Nurses' experiences of violent events included a variety of warning signs and high-risk situations which helped them to predict forthcoming violence. Patient-instigated violent events were described as complicated situations involving both nurses and patients. When the wards were overloaded with work or emotions, or if nurses had become cynical from dealing with such events, well-being of nurses was impaired and nursing care was complicated. Suggestions for violence prevention were identified, and included, for example, more skilled interaction between nurses and patients and an increase in contact between nurses and patients on the ward. This study revealed the complexity of violent events on psychiatric wards as well as the implications of these events on clinical practice development and training, administration and policy. A routine process is needed

Seismic local site effects characterization in the Andarax River Valley (SE Spain) from ambient seismic noise

NASA Astrophysics Data System (ADS)

Carmona, Enrique; García-Jerez, Antonio; Luzón, Francisco; Sánchez-Martos, Francisco; Sánchez-Sesma, Francisco J.; Piña, José

2014-05-01

This work is focused on the characterization of seismic local effects in the Low Andarax River Valley (SE Spain). The Low Andarax River valley is located in an active seismic region, with the higher seismic hazard values in Spain. The landform is composed mainly by sedimentary materials which increase its seismic hazard due to the amplification of the seismic inputs and spectral resonances. We study seismic local effects in the Low Andarax River by analyzing the Horizontal-to-Vertical Spectral Ratio (HVSR) of ambient noise records. The noise data were recorded during two field campaigns in 2012 and 2013. There have been a total of 374 noise measurements with 15 and 30 minutes duration. The acquisition was performed with a Digital Broadband Seismometer Guralp CMG-6TD. The distance between measurements was about 200 meters, covering an area around 40 km2. There have been 6 significant peak frequencies between 0.3 Hz and 5 Hz. It was possible to find interesting areas with similar spectral peaks that coincide with zones with similar microgravimetric anomalies at the alluvial valley. It is also observed a decrease in the frequency peaks from West to East suggesting increased sediment layer. We also compute the soil models at those sites where geotechnical information is available, assuming that the seismic noise is diffuse. We invert the HVSR for these places using horizontally layered models and in the imaginary part the Green functions at the source. It is observed that the S wave velocity inverted models are consistent with the known geotechnical information obtained from drilled boreholes. We identify the elastodynamic properties of the limestone-dolomite materials with a formation of phyllites and quartzite that form the basement of the depression, and those properties of the Miocene and Pliocene detrital deposits (marls, sandy silts, sands and conglomerates) that fill the valley. These results together with the observed resonant frequencies along the Andarax

Nursing Education Trial Using a Virtual Nightingale Ward.

PubMed

Tsuji, Keiko; Iwata, Naomi; Kodama, Hiromi; Hagiwara, Tomoko; Takai, Kiyako; Sasaki, Yoko; Nagata, Yoshie; Matsumoto, Maki

2017-01-01

Nursing department students are expected to correctly grasp the entire concept of nursing through their education. The authors created a movie of a Nightingale ward (virtual ward, hereafter) with an architectural computer design software for education. The students' reaction to the virtual ward was categorized into three viewpoints: that of nurses, of patients, and of nurses and patients in common. Most of the reactions in each viewpoint were: "easy to observe patients" in the nurses' viewpoint; "no privacy" in the patients' viewpoint; and "wide room" in the common viewpoint, respectively. These reactions show the effectiveness of using a virtual ward in nursing education. Because these reactions are characteristics of a Nightingale ward, and even students, who have generally less experiences, recognized these characteristics from the both viewpoints of nurses and patients.

Introducing the nurse practitioner into the surgical ward: an ethnographic study of interprofessional teamwork practice.

PubMed

Kvarnström, Susanne; Jangland, Eva; Abrandt Dahlgren, Madeleine

2017-08-22

The first nurse practitioners in surgical care were introduced into Swedish surgical wards in 2014. Internationally, organisations that have adopted nurse practitioners into care teams are reported to have maintained or improved the quality of care. However, close qualitative descriptions of teamwork practice may add to existing knowledge of interprofessional collaboration when introducing nurse practitioners into new clinical areas. The aim was to report on an empirical study describing how interprofessional teamwork practice was enacted by nurse practitioners when introduced into surgical ward teams. The study had a qualitative, ethnographic research design, drawing on a sociomaterial conceptual framework. The study was based on 170 hours of ward-based participant observations of interprofessional teamwork practice that included nurse practitioners. Data were gathered from 2014 to 2015 across four surgical sites in Sweden, including 60 interprofessional rounds. The data were analysed with an iterative reflexive procedure involving inductive and theory-led approaches. The study was approved by a Swedish regional ethics committee (Ref. No.: 2014/229-31). The interprofessional teamwork practice enacted by the nurse practitioners that emerged from the analysis comprised a combination of the following characteristic role components: clinical leader, bridging team colleague and ever-present tutor. These role components were enacted at all the sites and were prominent during interprofessional teamwork practice. The participant nurse practitioners utilised the interprofessional teamwork practice arrangements to enact a role that may be described in terms of a quality guarantee, thereby contributing to the overall quality and care flow offered by the entire surgical ward team. © 2017 Nordic College of Caring Science.

The Muralla Pircada: an ancient Andean debris flow retention dam, Santa Rita B archaeological site, Chao Valley, Northern Peru

USGS Publications Warehouse

Brooks, William E.; Willett, Jason C.; Kent, Jonathan D.; Vasquez, Victor; Rosales, Teresa

2005-01-01

Debris flows caused by El Niño events, earthquakes, and glacial releases have affected northern Perú for centuries. The Muralla Pircada, a northeast-trending, 2.5 km long stone wall east of the Santa Rita B archaeological site (Moche-Chimú) in the Chao Valley, is field evidence that ancient Andeans recognized and, more importantly, attempted to mitigate the effects of debris flows. The Muralla is upstream from the site and is perpendicular to local drainages. It is 1–2 m high, up to 5 m wide, and is comprised of intentionally-placed, well-sorted, well-rounded, 20–30 cm cobbles and boulders from nearby streams. Long axes of the stones are gently inclined and parallel local drainage. Case-and-fill construction was used with smaller cobbles and pebbles used as fill. Pre-Muralla debris flows are indicated by meter-sized, angular boulders that were incorporated in-place into construction of the dam and are now exposed in breeches in the dam. Post-Muralla debris flows in the Chao Valley are indicated by meter-sized, angular boulders that now abut the retention dam.

Seismic-refraction study of suspected drift-filled bedrock valleys in Ramsey County, Minnesota

USGS Publications Warehouse

Woodward, D.G.

1985-01-01

A drift-filled bedrock valley was thought to incise the St. Peter aquifer to an altitude between 770 and 800 feet above sea level at the Koppers site. The interpretation of a seismic profile just east of the Koppers site is not conclusive, but suggests that a bedrock valley may be present near the middle of the line. The interpretation of a second seismic profile across the westward extension of the same suspected valley also is not conclusive, but suggests that a bedrock valley may be present at the north end of the line. The optimal field layout for each line at the site (longer shot offsets) could not be obtained because of limited space available in the densely developed residential neighborhoods.

Delivery of pharmaceutical services at ward level in a teaching hospital.

PubMed

Schellack, N; Martins, V; Botha, N; Meyer, J C

2009-03-01

Poor management of pharmaceuticals could lead to wastage of financial resources and poor services in the public sector. The main aim of the study was to investigate the quality of pharmaceutical services at ward level in a teaching hospital. The design of the study was descriptive. Three data collection instruments were designed and pilot-tested prior to the actual data collection. Two structured questionnaires were used to interview the sister-in-charge of each ward and the stock and drug controller at the pharmacy. A checklist for the management of pharmaceuticals was completed for each ward. Descriptive statistics were used to describe and summarise the data. Sisters-in-charge of 30 wards and the stock and drug controller at the pharmacy participated in the study. The relationship with the pharmacy was perceived to be average by 54% (n = 30) of the sisters-in-charge of the wards. Communication with the pharmacy was mainly by telephone and 57% of the sisters-in-charge mentioned that they experienced difficulties in conveying messages to the pharmacy. Ten of the wards received regular ward visits by a pharmacist. Expiry dates were checked by all wards but at different intervals. The majority of the wards (90%) used patient cards, which refer to prescription charts, for stock control and ordering from the pharmacy. Fridge temperatures were checked and charted on a daily basis by 30% of the wards. Written standard operating procedures (SOPs) were used by the pharmacy for issuing ward stock. Although 83% of the wards indicated that they used SOPs, evidence of written SOPs was not available. The results indicated that the management of pharmaceutical services at ward level could be improved. Implementation of appropriate communication systems will enhance cooperation between the pharmacy and the wards. A uniform ward stock control system, either by computer or stock cards, should be introduced. Regular ward visits by a pharmacist to oversee ward stock management are

Ward nurses' knowledge of computed tomography scanning.

PubMed

Majeed, M A; Nayeemuddin, M; Christie, M

Patients benefit from and are reassured by advance information on procedures that they are to undergo. Ward nurses should have adequate knowledge of radiological investigations to ensure proper patient preparation and good interdepartmental communication to avoid delays and cancellations. This study was conducted to assess the ward nurses' knowledge of the process of computed tomography (CT) scanning. One hundred and twenty qualified nurses were asked to complete a questionnaire regarding CT scanning. The findings revealed a suboptimal level of awareness about the process. This is probably due to lack of formal teaching for nurses on the wards in regards the different radiological procedures and patient preparation. There is a strong case for better educational talks on rapidly changing radiological techniques for ward staff to ensure high-quality patient care.

Exploring how ward staff engage with the implementation of a patient safety intervention: a UK-based qualitative process evaluation

PubMed Central

Sheard, Laura; Marsh, Claire; O’Hara, Jane; Armitage, Gerry; Wright, John; Lawton, Rebecca

2017-01-01

Objectives A patient safety intervention was tested in a 33-ward randomised controlled trial. No statistically significant difference between intervention and control wards was found. We conducted a process evaluation of the trial and our aim in this paper is to understand staff engagement across the 17 intervention wards. Design Large qualitative process evaluation of the implementation of a patient safety intervention. Setting and participants National Health Service staff based on 17 acute hospital wards located at five hospital sites in the North of England. Data We concentrate on three sources here: (1) analysis of taped discussion between ward staff during action planning meetings; (2) facilitators’ field notes and (3) follow-up telephone interviews with staff focusing on whether action plans had been achieved. The analysis involved the use of pen portraits and adaptive theory. Findings First, there were palpable differences in the ways that the 17 ward teams engaged with the key components of the intervention. Five main engagement typologies were evident across the life course of the study: consistent, partial, increasing, decreasing and disengaged. Second, the intensity of support for the intervention at the level of the organisation does not predict the strength of engagement at the level of the individual ward team. Third, the standardisation of facilitative processes provided by the research team does not ensure that implementation standardisation of the intervention occurs by ward staff. Conclusions A dilution of the intervention occurred during the trial because wards engaged with Patient Reporting and Action for a Safe Environment (PRASE) in divergent ways, despite the standardisation of key components. Facilitative processes were not sufficiently adequate to enable intervention wards to successfully engage with PRASE components. PMID:28710206

Healthcare Quality Improvement and 'work engagement'; concluding results from a national, longitudinal, cross-sectional study of the 'Productive Ward-Releasing Time to Care' Programme.

PubMed

White, Mark; Butterworth, Tony; Wells, John Sg

2017-08-01

Concerns about patient safety and reducing harm have led to a particular focus on initiatives that improve healthcare quality. However Quality Improvement (QI) initiatives have in the past typically faltered because they fail to fully engage healthcare professionals, resulting in apathy and resistance amongst this group of key stakeholders. Productive Ward: Releasing Time to Care (PW) is a ward-based QI programme created to help ward-based teams redesign and streamline the way that they work; leaving more time to care for patients. PW is designed to engage and empower ward-based teams to improve the safety, quality and delivery of care. The main objective of this study was to explore whether PW sustains the 'engagement' of ward-based teams by examining the longitudinal effect that the national QI programme had on the 'work-engagement' of ward-based teams in Ireland. Utilising the Utrecht Work Engagement Scale questionnaire (UWES-17), we surveyed nine PW (intervention) sites from typical acute Medical/Surgical, Rehabilitation and Elderly services (representing the entire cohort of a national phase of PW implementation in Ireland) and a cohort of matched control sites. The numbers surveyed from the PW group at T1 (up to 3 months after commencing the programme) totalled 253 ward-team members and 249 from the control group. At T2 (12 months later), the survey was repeated with 233 ward-team members from the PW sites and 236 from the control group. Overall findings demonstrated that those involved in the QI initiative had higher 'engagement' scores at T1 and T2 in comparison to the control group. Total 'engagement' score (TES), and its 3 dimensions, were all significantly higher in the PW group at T1, but only the Vigour dimension remained significantly higher at T2 (p = 0.006). Our results lend some support to the assertions of the PW initiative itself and suggest that when compared to a control group, ward-based teams involved in the QI programme are more likely

Developing non-technical ward-round skills.

PubMed

Harvey, Rachel; Mellanby, Edward; Dearden, Effie; Medjoub, Karima; Edgar, Simon

2015-10-01

Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform. There is evidence that newly qualified doctors are not adequately prepared by their undergraduate experiences for this task. The aim of this study was to analyse the challenges pertaining to non-technical skills that students would face during ward rounds, and to create a model that facilitates the transition from medical student to doctor. A total of 217 final-year medical students completed a simulated ward round. Free-text responses were analysed using template analysis applying an a priori template developed from the literature by the research team. This drew on the generic categories of non-technical skills suggested by Flin et al. Ninety-seven per cent of students agreed or strongly agreed that the simulated ward round improved their insight into the challenges of ward rounds and their perceived ability to work efficiently as an active member of the ward round. The responding students (206) submitted written feedback describing the learning that they planned to use: 800 learning points were recorded, and all could be categorised into one of seven non-technical skills. Conducting clinical 'rounds' is one of the most onerous and important duties that every junior doctor is expected to perform We believe that improved task efficiency and insight into the challenges of the ward round gained by medical students will lead to an enhancement in performance during clinical rounds, and will have a positive impact on patient safety. We would suggest that undergraduate medical schools consider this model in the preparation for the clinical practice element of the curriculum. © 2015 John Wiley & Sons Ltd.

Estimation of 1-D velocity models beneath strong-motion observation sites in the Kathmandu Valley using strong-motion records from moderate-sized earthquakes

NASA Astrophysics Data System (ADS)

Bijukchhen, Subeg M.; Takai, Nobuo; Shigefuji, Michiko; Ichiyanagi, Masayoshi; Sasatani, Tsutomu; Sugimura, Yokito

2017-07-01

The Himalayan collision zone experiences many seismic activities with large earthquakes occurring at certain time intervals. The damming of the proto-Bagmati River as a result of rapid mountain-building processes created a lake in the Kathmandu Valley that eventually dried out, leaving thick unconsolidated lacustrine deposits. Previous studies have shown that the sediments are 600 m thick in the center. A location in a seismically active region, and the possible amplification of seismic waves due to thick sediments, have made Kathmandu Valley seismically vulnerable. It has suffered devastation due to earthquakes several times in the past. The development of the Kathmandu Valley into the largest urban agglomerate in Nepal has exposed a large population to seismic hazards. This vulnerability was apparent during the Gorkha Earthquake (Mw7.8) on April 25, 2015, when the main shock and ensuing aftershocks claimed more than 1700 lives and nearly 13% of buildings inside the valley were completely damaged. Preparing safe and up-to-date building codes to reduce seismic risk requires a thorough study of ground motion amplification. Characterizing subsurface velocity structure is a step toward achieving that goal. We used the records from an array of strong-motion accelerometers installed by Hokkaido University and Tribhuvan University to construct 1-D velocity models of station sites by forward modeling of low-frequency S-waves. Filtered records (0.1-0.5 Hz) from one of the accelerometers installed at a rock site during a moderate-sized (mb4.9) earthquake on August 30, 2013, and three moderate-sized (Mw5.1, Mw5.1, and Mw5.5) aftershocks of the 2015 Gorkha Earthquake were used as input motion for modeling of low-frequency S-waves. We consulted available geological maps, cross-sections, and borehole data as the basis for initial models for the sediment sites. This study shows that the basin has an undulating topography and sediment sites have deposits of varying thicknesses

Principal facts for gravity stations in the Elko, Steptoe Valley, Coyote Spring Valley, and Sheep Range areas, eastern and southern Nevada

USGS Publications Warehouse

Berger, D.L.; Schaefer, D.H.; Frick, E.A.

1990-01-01

Principal facts for 537 gravity stations in the carbonate-rock province of eastern and southern Nevada are tabulated and presented. The gravity data were collected in support of groundwater studies in several valleys. The study areas include the Elko area, northern Steptoe Valley, Coyote Spring Valley, and the western Sheep Range area. The data for each site include values for latitude, longitude, altitude, observed gravity, free- air anomaly, terrain correction, and Bouguer anomaly (calculated at a bedrock density of 2.67 g/cu cm. (USGS)

The Las Vegas Valley Seismic Response Project: Ground Motions in Las Vegas Valley from Nuclear Explosions at the Nevada Test Site

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

Rodgers, A; Tkalcic, H; McCallen, D

2005-03-18

Between 2001-2004 the Las Vegas Seismic Response Project has sought to understand the response of Las Vegas Valley (LVV) to seismic excitation. In this study, the author report the findings of this project with an emphasis on ground motions in LVV from nuclear explosions at the Nevada Test Site (NTS). These ground motions are used to understand building structural response and damage as well as human perception. Historical nuclear explosion observations are augmented with earthquake recordings from a temporary deployment of seismometers to improve spatial coverage of LVV. The nuclear explosions were conducted between 1968 and 1989 and were recordedmore » at various sites within Las Vegas. The data from past nuclear tests were used to constrain ground motions in LVV and to gain a predictive capability of ground motions for possible future nuclear tests at NTS. Analysis of ground motion data includes peak ground motions (accelerations and velocities) and amplification of basin sites relative to hard rock sites (site response). Site response was measured with the Standard Spectral Ratios (SSR) technique relative to hard rock reference sites on the periphery of LVV. The site response curves indicate a strong basin amplification of up to a factor of ten at frequencies between 0.5-2 Hz. Amplifications are strongest in the central and northern portions of LVV, where the basin is deeper than 1 km based on the reported basin depths of Langenheim et al (2001a). They found a strong correlation between amplification and basin depth and shallow shear wave velocities. Amplification below 1 Hz is strongly controlled by slowness-averaged shear velocities to depths of 30 and 100 meters. Depth averaged shear velocities to 10 meters has modest control of amplifications between 1-3 Hz. Modeling reveals that low velocity material in the shallow layers (< 200 m) effectively controls amplification. They developed a method to scale nuclear explosion ground motion time series to sites

Exploring how ward staff engage with the implementation of a patient safety intervention: a UK-based qualitative process evaluation.

PubMed

Sheard, Laura; Marsh, Claire; O'Hara, Jane; Armitage, Gerry; Wright, John; Lawton, Rebecca

2017-07-13

A patient safety intervention was tested in a 33-ward randomised controlled trial. No statistically significant difference between intervention and control wards was found. We conducted a process evaluation of the trial and our aim in this paper is to understand staff engagement across the 17 intervention wards. Large qualitative process evaluation of the implementation of a patient safety intervention. National Health Service staff based on 17 acute hospital wards located at five hospital sites in the North of England. We concentrate on three sources here: (1) analysis of taped discussion between ward staff during action planning meetings; (2) facilitators' field notes and (3) follow-up telephone interviews with staff focusing on whether action plans had been achieved. The analysis involved the use of pen portraits and adaptive theory. First, there were palpable differences in the ways that the 17 ward teams engaged with the key components of the intervention. Five main engagement typologies were evident across the life course of the study: consistent, partial, increasing, decreasing and disengaged. Second, the intensity of support for the intervention at the level of the organisation does not predict the strength of engagement at the level of the individual ward team. Third, the standardisation of facilitative processes provided by the research team does not ensure that implementation standardisation of the intervention occurs by ward staff. A dilution of the intervention occurred during the trial because wards engaged with Patient Reporting and Action for a Safe Environment (PRASE) in divergent ways, despite the standardisation of key components. Facilitative processes were not sufficiently adequate to enable intervention wards to successfully engage with PRASE components. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Hydrologic Evaluation of the Jungo Area, Southern Desert Valley, Nevada

USGS Publications Warehouse

Lopes, Thomas J.

2010-01-01

RecologyTM, the primary San Francisco waste-disposal entity, is proposing to develop a Class 1 landfill near Jungo, Nevada. The proposal calls for the landfill to receive by rail about 20,000 tons of waste per week for up to 50 years. On September 22, 2009, the Interior Appropriation (S.A. 2494) was amended to require the U.S. Geological Survey to evaluate the proposed Jungo landfill site for: (1) potential water-quality impacts on nearby surface-water resources, including Rye Patch Reservoir and the Humboldt River; (2) potential impacts on municipal water resources of Winnemucca, Nevada; (3) locations and altitudes of aquifers; (4) how long it will take waste seepage from the site to contaminate local aquifers; and (5) the direction and distance that contaminated groundwater would travel at 95 and 190 years. This evaluation was based on review of existing data and information. Desert Valley is tributary to the Black Rock Desert via the Quinn River in northern Desert Valley. The Humboldt River and Rye Patch Reservoir would not be affected by surface releases from the proposed Jungo landfill site because they are in the Humboldt basin. Winnemucca, on the Humboldt River, is 30 miles east of the Jungo landfill site and in the Humboldt basin. Groundwater-flow directions indicate that subsurface flow near the proposed Jungo landfill site is toward the south-southwest. Therefore, municipal water resources of Winnemucca would not be affected by surface or subsurface releases from the proposed Jungo landfill site. Basin-fill aquifers underlie the 680-square-mile valley floor in Desert Valley. Altitudes around the proposed Jungo landfill site range from 4,162 to 4,175 feet. Depth to groundwater is fairly shallow in southern Desert Valley and is about 60 feet below land surface at the proposed Jungo landfill site. A groundwater divide exists about 7 miles north of the proposed Jungo landfill site. Groundwater north of the divide flows north towards the Quinn River. South of

Groundwater sapping valleys: Experimental studies, geological controls and implications to the interpretation of valley networks on Mars

NASA Technical Reports Server (NTRS)

Kochel, R. Craig

1988-01-01

An integrated approach using experimental laboratory models, field studies of terrestrial analogs, and remote studies of terrestrial field sites were applied to the goals of understanding the nature and morphology of valley networks formed by groundwater sapping. In spite of problems with scaling, the experimental studies provide valuable insights into concepts relating to the initiation, development, and evolution of valleys by groundwater sapping. These investigations are also aimed at developing geomorphic criteria for distinguishing valleys formed by surface runoff from those formed by groundwater sapping processes. Channels that were field classified as sapping vs. runoff were successfully distinguished using statistical analysis of their respective morphologies; therefore, it may be possible to use similar techniques to interpret channel genesis on Mars. The terrestrial and flume studies provide the ground truth dataset which can be used (and will be during the present year) to help interpret the genesis of valley networks on Mars.

The transition from staff nurse to ward leader.

PubMed

Spencer, Caroline; Al-Sadoon, Tara; Hemmings, Laura; Jackson, Karen; Mulligan, Paul

Moving from the staff nurse to ward sister role involves acquiring a range of skills to lead and motivate a team and ensure standards of care are high. Recognising new ward sisters' need for support, a trust developed a training programme to enable them to develop the necessary skills and provide mutual support. This article discusses the development of the programme and offers the reflections of three ward sisters who participated in it.

Developing skills in clinical leadership for ward sisters.

PubMed

Fenton, Katherine; Phillips, Natasha

The Francis report has called for a strengthening of the ward sister's role. It recommends that sisters should operate in a supervisory capacity and should not be office bound. Effective ward leadership has been recognised as being vital to high-quality patient care and experience, resource management and interprofessional working. However, there is evidence that ward sisters are ill equipped to lead effectively and lack confidence in their ability to do so. University College London Hospitals Foundation Trust has recognised that the job has become almost impossible in increasingly large and complex organisations. Ward sisters spend less than 40% of their time on clinical leadership and the trust is undertaking a number of initiatives to support them in this role.

Magnetotelluric Data, Mid Valley, Nevada Test Site, Nevada

USGS Publications Warehouse

Williams, Jackie M.; Wallin, Erin L.; Rodriguez, Brian D.; Lindsey, Charles R.; Sampson, Jay A.

2007-01-01

Introduction The United States Department of Energy (DOE) and the National Nuclear Security Administration (NNSA) at their Nevada Site Office (NSO) are addressing ground-water contamination resulting from historical underground nuclear testing through the Environmental Management (EM) program and, in particular, the Underground Test Area (UGTA) project. One issue of concern is the nature of the somewhat poorly constrained pre-Tertiary geology and its effects on ground-water flow. Ground-water modelers would like to know more about the hydrostratigraphy and geologic structure to support a hydrostratigraphic framework model that is under development for the Rainier Mesa/Shoshone Mountain Corrective Action Unit (CAU). During 2003, the U.S. Geological Survey (USGS), in cooperation with the DOE and NNSA-NSO, collected and processed data at the Nevada Test Site in and near Yucca Flat (YF) to help define the character, thickness, and lateral extent of the pre-Tertiary confining units. We collected 51 magnetotelluric (MT) and audio-magnetotelluric (AMT), stations for that research. In early 2005 we extended that research with 26 additional MT data stations, located on and near Rainier Mesa and Shoshone Mountain (RM-SM). The new stations extended the area of the hydrogeologic study previously conducted in Yucca Flat. This work was done to help refine what is known about the character, thickness, and lateral extent of pre-Tertiary confining units. In particular, a major goal was to define the upper clastic confining unit (UCCU). The UCCU is comprised of late Devonian to Mississippian siliciclastic rocks assigned to the Eleana Formation and Chainman Shale. The UCCU underlies the Yucca Flat area and extends westward towards Shoshone Mountain, southward to Buckboard Mesa, and northward to Rainier Mesa. Late in 2005 we collected another 14 MT stations in Mid Valley and in northern Yucca Flat basin. That work was done to better determine the extent and thickness of the UCCU near

Generalising Ward's Method for Use with Manhattan Distances.

PubMed

Strauss, Trudie; von Maltitz, Michael Johan

2017-01-01

The claim that Ward's linkage algorithm in hierarchical clustering is limited to use with Euclidean distances is investigated. In this paper, Ward's clustering algorithm is generalised to use with l1 norm or Manhattan distances. We argue that the generalisation of Ward's linkage method to incorporate Manhattan distances is theoretically sound and provide an example of where this method outperforms the method using Euclidean distances. As an application, we perform statistical analyses on languages using methods normally applied to biology and genetic classification. We aim to quantify differences in character traits between languages and use a statistical language signature based on relative bi-gram (sequence of two letters) frequencies to calculate a distance matrix between 32 Indo-European languages. We then use Ward's method of hierarchical clustering to classify the languages, using the Euclidean distance and the Manhattan distance. Results obtained from using the different distance metrics are compared to show that the Ward's algorithm characteristic of minimising intra-cluster variation and maximising inter-cluster variation is not violated when using the Manhattan metric.

Advanced seismic imaging of overdeepened alpine valleys

NASA Astrophysics Data System (ADS)

Burschil, Thomas; Buness, Hermann; Tanner, David; Gabriel, Gerald; Krawczyk, Charlotte M.

2017-04-01

Major European alpine valleys and basins are densely populated areas with infrastructure of international importance. To protect the environment by, e.g., geohazard assessment or groundwater estimation, understanding of the geological structure of these valleys is essential. The shape and deposits of a valley can clarify its genesis and allows a prediction of behaviour in future glaciations. The term "overdeepened" refers to valleys and basins, in which pressurized melt-water under the glacier erodes the valley below the fluvial level. Most overdeepened valleys or basins were thus refilled during the ice melt or remain in the form of lakes. The ICDP-project Drilling Overdeepened Alpine Valleys (DOVE) intends to correlate the sedimentary succession from boreholes between valleys in the entire alpine range. Hereby, seismic exploration is essential to predict the most promising well path and drilling site. In a first step, this DFG-funded project investigates the benefit of multi-component techniques for seismic imaging. At two test sites, the Tannwald Basin and the Lienz Basin, the Leibniz Institute for Applied Geophysics acquired P-wave reflection profiles to gain structural and facies information. Built on the P-wave information, several S-wave reflection profiles were acquired in the pure SH-wave domain as well as 6-C reflection profiles using a horizontal S-wave source in inline and crossline excitation and 3-C receivers. Five P-wave sections reveal the structure of the Tannwald Basin, which is a distal branch basin of the Rhine Glacier. Strong reflections mark the base of the basin, which has a maximum depth of 240 metres. Internal structures and facies vary strongly and spatially, but allow a seismic facies characterization. We distinguish lacustrine, glacio-fluvial, and deltaic deposits, which make up the fill of the Tannwald Basin. Elements of the SH-wave and 6-C seismic imaging correlate with major structures in the P-wave image, but vary in detail. Based on

The role of the ward manager in promoting patient safety.

PubMed

Pinnock, David

In this article the role of the ward manager in promoting patient safety is explored. The background to the development of the patient safety agenda is briefly discussed and the relationship between quality and safety is illustrated. The pivotal importance of the role of the ward manager in delivering services to patients is underlined and literature on patient safety is examined to identify what a ward manager can do to make care safer. Possible actions of the ward manager to improve safety discussed in the literature are structured around the Leadership Framework. This framework identifies seven domains for the leadership of service delivery. Ward managers use their personal qualities, and network and work within teams, while managing performance and facilitating innovation, change and measurement for improvement. The challenge of promoting patient safety for ward managers is briefly explored and recommendations for further research are made.

Smoking cessation treatment practices: recommendations for improved adoption on cardiology wards.

PubMed

Berndt, Nadine C; Bolman, Catherine; de Vries, Hein; Segaar, Dewi; van Boven, Irene; Lechner, Lilian

2013-01-01

Smoking cessation treatment practices described by the 5 A's (ask, advise, assess, assist, arrange) are not well applied at cardiology wards because of various reasons, such as a lack of time and appropriate skills of the nursing staff. Therefore, a simplified guideline proposing an ask-advise-refer (AAR) strategy was introduced in Dutch cardiac wards. This study aimed to identify factors that determine the intentions of cardiac ward heads in adopting the simplified AAR guideline, as ward heads are key decision makers in the adoption of new guidelines. Ward heads' perceptions of current smoking cessation practices at the cardiac ward were also investigated. A cross-sectional survey with written questionnaires was conducted among heads of cardiology wards throughout the Netherlands, of whom 117 (64%) responded. According to the heads of cardiac wards, smoking cessation practices by cardiologists and nurses were mostly limited to brief practices that are easy to conduct. Only a minority offered intensive counseling or arranged follow-up contact. Heads with strong intentions of adopting the AAR guideline differed significantly on motivational and organizational attributes and perceived more smoking cessation assistance by other health professionals than did heads with weak intentions of adopting. Positive attitudes, social support toward adoption, and perception of much assistance at the ward were significantly associated with increased intentions to adopt the AAR guideline. Brief smoking cessation practices are adequately performed at cardiac wards, but the most effective practices, offering assistance and arranging for follow-up, are less than optimal. The AAR guideline offers a more feasible approach for busy cardiology wards. To ensure successful adoption of this guideline, the heads of cardiac wards should be convinced of its advantages and be encouraged by a supportive work environment. Policies may also facilitate the adoption of the AAR guideline.

Electronic Printed Ward Round Proformas: Freeing Up Doctors' Time.

PubMed

Fernandes, Darren; Eneje, Philip

2017-01-01

The role of a junior doctor involves preparing for the morning ward round. At a time when there are gaps on rotas and doctors' time is more stretched, this can be a source of significant delay and thus a loss of working time. We therefore looked at ways in which we could make the ward round a more efficient place by introducing specific electronic, printed ward round proformas. We used the average time taken to write proformas per patient and the average time taken per patient on the ward round. This would then enable us to make fair comparisons with future changes that were made using the plan, do, study, and act principles of quality improvement. Our baseline measurement found that the average time taken to write up the proforma for each patient was 1 minute 9 seconds and that the average time taken per patient on the ward round was 8 minutes 30 seconds. With the changes we made during our 3 PDSA cycles and the implementation of an electronic, printed ward round proforma, we found that we were able to reduce the average time spent per patient on the ward round to 6 minutes 32 seconds, an improvement of 1 min 58 seconds per patient. The project has thus enabled us to reduce the time taken per patient during the ward round. This improved efficiency will enable patients to be identified earlier for discharge. It will also aid in freeing up the time of junior doctors, allowing them to complete discharge letters sooner, order investigations earlier and enable them to complete their allocated tasks within contracted hours.

Transport of particle pollution into the Maipo Valley: winter 2015 campaign results

NASA Astrophysics Data System (ADS)

Huneeus, Nicolás; Mazzeo, Andrea; Ordóñez, César; Donoso, Nicolás; Gallardo, Laura; Molina, Luisa; Moreno, Valeria; Muñoz, Ricardo; Orfanoz, Andrea; Vizcarra, Aldo

2016-04-01

Each winter, Santiago (33° 27'S, 70° 40'W) the capital of Chile with a population of about 7 million people, experiences episodes with particulate matter (PM) concentrations larger than allowed by Chilean environmental regulations. Transport and residential heating largely dominate emissions prior to and during these episodes. Important impact of black carbon (BC) on the cryosphere has been documented in other parts of the world associated with urban pollution. In order to explore if BC from Santiago has the potential to reach the Andean cryosphere during the aforementioned episodes, a one week-long campaign was conducted in Santiago and the Maipo Valley between 18th and 25th of July 2015 when the air quality conditions of the city reached twice the critical levels (pre-emergency in Chilean regulations). Measurements were carried out at three sites: downtown Santiago, the entrance of the valley (and outskirts of Santiago) and 12 km inside the Maipo Valley. At each of these sites both surface and vertically distributed measurements were conducted. A meteorological station measuring standard meteorological parameters and an E-Sampler measuring PM10 concentrations were installed at each site. In addition, a tethered balloon equipped with a sonde and a mini-aethalometer was used in each site to measure vertical profiles of standard meteorological parameters and BC concentrations, respectively. The tethered balloon was raised every three hours up to a maximum of 1000 meters above ground level, whenever meteorological conditions allowed. In general, the BC concentrations inside the valley, both at the surface and in the vertical, were dominated by emissions within the valley and BC was limited to shallow layers above the ground. However, on both days with critical air quality levels, winds blowing from the city and deeper BC layers were observed inside the valley. Furthermore, during these days observations at the entrance of the valley and those taken inside were

Reviving post-take surgical ward round teaching.

PubMed

Force, Jade; Thomas, Ian; Buckley, Frances

2014-04-01

Learning in the clinical environment is an important feature of medical education. Ward-round teaching leads to relevant, applied and lasting learning of knowledge, skills and attitudes; however, on fast-paced ward rounds in specialties such as general surgery, the student experience is often suboptimal, and teaching can be overlooked. Clinical teaching fellows (CTFs) are postgraduate doctors ranging from foundation year-2 (FY2) level through to specialty trainees, who have elected to spend up to 2 years out of the programme to teach medical undergraduates. This article explores whether CTFs can successfully support the regular delivery of undergraduate medical teaching on the busy post-take surgical ward round (PTSWR). The CTFs at Raigmore Hospital, Inverness, planned and facilitated weekly, structured teaching sessions to accompany the PTSWR. This educational intervention was evaluated using pre- and post-intervention student questionnaires. The questionnaires focused on student enjoyment and depth of learning using Likert scales and free-text components. Students were also asked about barriers to learning on typical PTSWRs. The consultant surgeons leading on these rounds were issued separate questionnaires, to gauge their evaluation of CTF support. The main barrier to effective undergraduate ward round teaching was a lack of time on the part of clinical staff. Ward rounds accompanied by CTF support significantly increased student enjoyment (p < 0.0001) and perceived learning (p < 0.0001). Consultant surgeons were supportive of the teaching initiative. Support from CTFs on busy PTSWRs optimised student satisfaction, and was welcomed by clinical staff. CTF support could be widened to other busy ward rounds, e.g. acute medical takes, to enhance student learning and reduce the teaching burden on clinical faculty staff. © 2014 John Wiley & Sons Ltd.

TL dating of pottery fragments from four archaeological sites in Taquari Valley, Brazil

NASA Astrophysics Data System (ADS)

Cano, Nilo F.; Machado, Neli T. G.; Gennari, Roseli F.; Rocca, Rene R.; Munita, Casimiro S.; Watanabe, Shigueo

2012-12-01

Sixty-three pottery fragments from four archaeological sites, numbered RST110, RST101, RST114 and RST114, in the Taquari Valley, vicinity of the city of Lajeado, Rio Grande do Sul state, southern Brazil, have been dated by the thermoluminescence method. Some of them from RST110 and RST101 are as old as 1400-1200 years, whereas those from RST114 and RST107 are younger than 800 years. This result indicates that RST101 and RST110 were peopled earlier than RST114 and RST107. The recent dates found are 302, 295 and 146 years and they are possible, since the first German immigrants who arrived in this region encountered Tupi-Guarani Indians still living there. One interesting result refers to the glow curves of quartz grains RST110, RST101 and RST114 that differ from the glow curves of RST107 quartz grains.

Fretted Terrain Valley in Coloe Fossae Region

NASA Technical Reports Server (NTRS)

2006-01-01

[figure removed for brevity, see original site] Figure 1 Click on image for larger version

The image in figure 1 shows lineated valley fill in one of a series of enclosed, intersecting troughs known as Coloe (Choloe) Fossae. Lineated valley fill consists of rows of material in valley centers that are parallel to the valley walls. It is probably made of ice-rich material and boulders that are left behind when the ice-rich material sublimates. Very distinct rows can be seen near the south (bottom) wall of the valley. Lineated valley fill is thought to result from mass wasting (downslope movement) of ice-rich material from valley walls towards their centers. It is commonly found in valleys near the crustal dichotomy that separates the two hemispheres of Mars. The valley shown here joins four other valleys with lineated fill near the top left corner of this image. Their juncture is a topographic low, suggesting that the lineated valley fill from the different valleys may be flowing or creeping towards the low area (movement towards the upper left of the image). The valley walls appear smooth at first glance but are seen to be speckled with small craters several meters in diameter at HiRISE resolution (see contrast-enhanced subimage). This indicates that at least some of the wall material has been stable to mass wasting for some period of time. Also seen on the valley wall are elongated features shaped like teardrops. These are most likely slightly older craters that have been degraded due to potentially recent downhill creep. It is unknown whether the valley walls are shedding material today. The subimage is approximately 140 x 400 m (450 x 1280 ft).

Image PSP_001372_2160 was taken by the High Resolution Imaging Science Experiment (HiRISE) camera onboard the Mars Reconnaissance Orbiter spacecraft on November 11, 2006. The complete image is centered at 35.5 degrees latitude, 56.8 degrees East longitude. The range to the target site was 290.3 km (181

Limnology of the Green Lakes Valley: Phytoplankton ecology and dissolved organic matter biogeochemistry at a long-term ecological research site

USGS Publications Warehouse

Miller, Matthew P.; McKnight, Diane M.

2015-01-01

Background: Surface waters are the lowest points in the landscape, and therefore serve as excellent integrators and indicators of changes taking place in the surrounding terrestrial and atmospheric environment.Aims: Here we synthesise the findings of limnological studies conducted during the past 15 years in streams and lakes in the Green Lakes Valley, which is part of the Niwot Ridge Long-term Ecological Research (LTER) Site.Methods: The importance of these studies is discussed in the context of aquatic ecosystems as indicators, integrators, and regulators of environmental change. Specifically, investigations into climatic, hydrologic, and nutrient controls on present-day phytoplankton, and historical diatom, community composition in the alpine lake, Green Lake 4, are reviewed. In addition, studies of spatial and temporal patterns in dissolved organic matter (DOM) biogeochemistry and reactive transport modelling that have taken place in the Green Lakes Valley are highlighted.Results and conclusions: The findings of these studies identify specific shifts in algal community composition and DOM biogeochemistry that are indicative of changing environmental conditions and provide a framework for detecting future environmental change in the Green Lakes Valley and in other alpine watersheds. Moreover, the studies summarised here demonstrate the importance of long-term monitoring programmes such as the LTER programme.

Noise pollution in intensive care units and emergency wards.

PubMed

Khademi, Gholamreza; Roudi, Masoumeh; Shah Farhat, Ahmad; Shahabian, Masoud

2011-01-01

The improvement of technology has increased noise levels in hospital Wards to higher than international standard levels (35-45 dB). Higher noise levels than the maximum level result in patient's instability and dissatisfaction. Moreover, it will have serious negative effects on the staff's health and the quality of their services. The purpose of this survey is to analyze the level of noise in intensive care units and emergency wards of the Imam Reza Teaching Hospital, Mashhad. This research was carried out in November 2009 during morning shifts between 7:30 to 12:00. Noise levels were measured 10 times at 30-minute intervals in the nursing stations of 10 wards of the emergency, the intensive care units, and the Nephrology and Kidney Transplant Departments of Imam Reza University Hospital, Mashhad. The noise level in the nursing stations was tested for both the maximum level (Lmax) and the equalizing level (Leq). The research was based on the comparison of equalizing levels (Leq) because maximum levels were unstable. In our survey the average level (Leq) in all wards was much higher than the standard level. The maximum level (Lmax) in most wards was 85-86 dB and just in one measurement in the Internal ICU reached 94 dB. The average level of Leq in all wards was 60.2 dB. In emergency units, it was 62.2 dB, but it was not time related. The highest average level (Leq) was measured at 11:30 AM and the peak was measured in the Nephrology nursing station. The average levels of noise in intensive care units and also emergency wards were more than the standard levels and as it is known these wards have vital roles in treatment procedures, so more attention is needed in this area.

Geologic, water-chemistry, and hydrologic data from multiple-well monitoring sites and selected water-supply wells in the Santa Clara Valley, California, 1999-2003

USGS Publications Warehouse

Newhouse, M.W.; Hanson, R.T.; Wentworth, C.M.; Everett, Rhett; Williams, C.F.; Tinsley, J.C.; Noce, T.E.; Carkin, B.A.

2004-01-01

To better identify the three-dimensional geohydrologic framework of the Santa Clara Valley, lithologic, geologic, geophysical, geomechanical, hydraulic, and water-chemistry data were collected from eight ground-water multiple-well monitoring sites constructed in Santa Clara County, California, as part of a series of cooperative studies between the U.S. Geological Survey and the Santa Clara Valley Water District. The data are being used to update and improve the three-dimensional geohydrologic framework of the basin and to address issues related to water supply, water chemistry, sequence stratigraphy, geology, and geological hazards. This report represents a compilation of data collected from 1999 to 2003, including location and design of the monitoring sites, cone penetrometer borings, geologic logs, lithologic logs, geophysical logs, core analysis, water-chemistry analysis, ground-water-level measurements, and hydraulic and geomechanical properties from wells and core samples. Exploratory cone penetrometer borings taken in the upper 17 to 130 feet at six of the monitoring sites identified the base of Holocene as no deeper than 75 feet in the central confined area and no deeper than 35 feet in the southern unconfined areas of the valley. Generalized lithologic characterization from the monitoring sites indicates about four to six different aquifer units separated by relatively fine-grained units occur within the alluvial deposits shallower than 860 feet deep. Analysis of geophysical logs indicates that coarse-grained units varied in thickness between 10 and 25 feet in the southeastern unconfined area of the valley and between 50 and 200 feet in the south-central and southwestern areas of the valley. Deviations from temperature-gradient logs indicate that the majority of horizontal ground-water flow occurs above a depth of 775 feet in the south central and above 510 feet in the southeastern areas of the valley. Bulk physical properties from more than 1,150 feet of

Pumpernickel Valley Geothermal Project Thermal Gradient Wells

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

Z. Adam Szybinski

2006-01-01

, PVTG-1, -2, -3, and -4, and all four encountered geothermal fluids. The holes provided valuable water geochemistry, supporting the geothermometry results obtained from the hot springs and Magma well. The temperature data gathered from all the wells clearly indicates the presence of a major plume of thermal water centered on the Pumpernickel Valley fault, and suggests that the main plume is controlled, at least in part, by flow from this fault system. The temperature data also defines the geothermal resource with gradients >100oC/km, which covers an area a minimum of 8 km2. Structural blocks, down dropped with respect to the Pumpernickel Valley fault, may define an immediate reservoir. The geothermal system almost certainly continues beyond the recently drilled holes and might be open to the east and south, whereas the heat source responsible for the temperatures associated with this plume has not been intersected and must be at a depth greater than 920 meters (depth of the deepest well – Magma well). The geological and structural setting and other characteristics of the Pumpernickel Valley geothermal project area are markedly similar to the portions of the nearby Dixie Valley geothermal field. These similarities include, among others, the numerous, unexposed en echelon faults and large-scale pull-apart structure, which in Dixie Valley may host part of the geothermal field. The Pumpernickel Valley project area, for the majority of which Nevada Geothermal Power Company has geothermal rights, represents a geothermal site with a potential for the discovery of a relatively high temperature reservoir suitable for electric power production. Among locations not previously identified as having high geothermal potential, Pumpernickel Valley has been ranked as one of four sites with the highest potential for electrical power production in Nevada (Shevenell and Garside, 2003). Richards and Blackwell (2002) estimated the total heat loss and the preliminary production capacity for

Patient- and ward-level determinants of nursing time in nursing facilities.

PubMed

Laine, Juha; Noro, Anja; Finne-Soveri, Harriet; Häkkinen, Unto

2005-10-01

To explore the patient- and ward-level determinants of wage-adjusted nursing time in long-term care wards for the elderly with a view to improving efficiency of the use of labour resources. The wage-adjusted nursing time given to patients was obtained from a time measurement study. Patient characteristics were based on the Minimum Data Set 2.0 of the Resident Assessment Instrument for nursing homes. Ordinary least-squares regression analysis and multilevel modelling were used to disentangle the effect of patient- and ward-level factors on nursing time. A significant difference in wage-adjusted nursing time between wards was detected, which was partly explained by characteristics of patients in wards. The combination of patients' physical functioning and cognition and the Resource Utilization Groups RUG-III/22 resource use classification explained 20-25% of patients' nursing time over a 24-hour period. Variables related to the operational environment of the ward did not explain differences in wage-adjusted nursing time once the patient profile of the ward had been controlled for. The results also showed notable unmeasured patient and ward level effects, inefficiency and randomness in the allocation of nursing time. By improving the allocation and use of labour resources, the substantial variation in nursing time between wards could be diminished. Managers should allocate their staff primarily according to patients' resource needs.

Transboundary Contributions To Surface Ozone In California's Central Valley

NASA Astrophysics Data System (ADS)

Post, A.; Faloona, I. C.; Conley, S. A.; Lighthall, D.

2014-12-01

Rising concern over the impacts of exogenous air pollution in California's Central Valley has prompted the establishment of a coastal, high altitude monitoring site at the Chews Ridge Observatory (1550 m) approximately 30 km east of Point Sur in Monterey County, under the auspices of the Monterey Institute for Research in Astronomy. Two and a half years of continuous ozone data are presented in the context of long-range transport and its potential impact on surface air quality in the San Joaquin Valley (SJV). Past attempts to quantify the impact of transboundary ozone on surface levels have relied on uncertain model estimates, or have been limited to weekly ozonesonde data. Here, we present an observationally derived quantification of the contribution of free tropospheric ozone to surface sites in the San Joaquin Valley throughout three ozone seasons (June through September, 2012-2014). The diurnal ozone patterns at Chews Ridge, and their correlations with ozone aloft over the Valley, have been presented previously. Furthermore, reanalysis data of geopotential heights indicate consistent flow from Chews Ridge to the East, directly over the SJV. In a related airborne project we quantify the vertical exchange, or entrainment, rate over the Southern SJV from a series of focused flights measuring ozone concentrations during peak photochemical hours in conjunction with local meteorological data to quantify an ozone budget for the area. By applying the entrainment rates observed in that study here we are able to quantify the seasonal contributions of free tropospheric ozone measured at Chews Ridge to surface sites in the San Joaquin Valley, and compare prior model estimates to our observationally derived values.

An evaluation of the regional acid deposition model surface module for ozone uptake at three sites in the San Joaquin Valley of California

NASA Technical Reports Server (NTRS)

Massman, W. J.; Pederson, J.; Delany, A.; Grantz, D.; Hertog, G. Den; Neumann, H. H.; Oncley, S. P.; Pearson, R., Jr.; Shaw, R. H.

1994-01-01

Plants and soils act as major sinks for the destruction of tropospheric ozone, especially during daylight hours when plant stomata open and are thought to provide the dominant pathway for the uptake of ozone. The present study, part of the California Ozone Deposition Experiment, compares predictions of the regional acid deposition model ozone surface conductance module with surface conductance data derived from eddy covariance measurements of ozone flux taken at a grape, a cotton, and a grassland site in the San Joaquin Valley of California during the summer of 1991. Results indicate that the model (which was developed to provide long-term large-area estimates for the eastern United States) significantly overpredicts the surface conductance at all times of the day for at least two important types of plant cover of the San Joaquin Valley and that it incorrectly partitions the ozone flux between transpiring and nontranspiring components of the surface at the third site. Consequently, the model either overpredicts or inaccurately represents the observed deposition velocities. Other results indicate that the presence of dew does not reduce the rate of ozone deposition, contradicting to model assumptions, and that model assumptions involving the dependency of stomata upon environmental temperature are unnecessary. The effects of measurement errors and biases, arising from the presence of the roughness sublayer and possible photochemical reactions, are also discussed. A simpler model for ozone surface deposition (at least for the San Joaquin Valley) is proposed and evaluated.

Ergonomics in the psychiatric ward towards workers or patients?

PubMed

Silvana, Salerno; Laura, Forcella; Ursula, Di Fabio; Irene, Figà Talamanca; Paolo, Boscolo

2012-01-01

Patient's aggressive behavior is one of the major problem in the psychiatric ward. Here we present the preliminary results of a psychiatric ward case-study, of a public hospital in the Chieti province, in order to plan ergonomic improvement. We applied the Method of Organizational Congruencies in the psychiatric ward in order to study the relationship between organized hospital work and nurses wellbeing in a 24 hour shifts. We observed 58 main phases in the three work shifts. The technical actions are mainly those of any hospital wards (shift briefing, preparing and administering drugs, recording data on clinical charts, etc.). We found important differences mainly due to the nurses overcontrol activities on the patients behavior (preventing suicides or self destructive behavior), the occurrence of restraint procedure towards patients, the pollution due to patient's cigarette smoke. The fear of patient's self destructive behavior or other aggressive behaviour are the main cognitive and social aspects of this hospital ward. Nurses working in this psychiatric ward have to accept: locked doors, poor and polluted environment, restraint procedure with high risk of aggression and no availability of mental health care programs. A new interdisciplinary concept for ergonomics in psychiatry setting may represent a challenge for both nurses and patients and the community.

Water-Quality Data for Selected Stream Sites in Bridgeport Valley, Mono County, California, April 2000 to June 2003

USGS Publications Warehouse

Rockwell, Gerald L.; Honeywell, Paul D.

2004-01-01

The U.S. Geological Survey, in cooperation with the California Regional Water Quality Control Board, Lahonton Region, carried out a water-quality data collection program of selected streams in and near Bridgeport Valley, California, during April 2000 to June 2003. These data were collected to provide information used by the California Regional Water Quality Control Board to develop total maximum daily load standards. Field measurements of streamflow, barometric pressure, dissolved oxygen, pH, specific conductance, and water temperature were made at 15 sites located on 6 streams. Water samples were analyzed for nutrients, major ions, turbidity, fecal coliform, fecal streptococci, and suspended sediment. Field data, turbidity, nutrient, major ion, and sediment concentrations and fecal coliform and fecal streptococci densities are given in tables for each site. Field blank data are also presented in a table.

Debris flow occurrence and sediment persistence, Upper Colorado River Valley, CO

USGS Publications Warehouse

Grimsley, Kyle J; Rathburn, Sara L.; Friedman, Jonathan M.; Mangano, Joseph F.

2016-01-01

Debris flow magnitudes and frequencies are compared across the Upper Colorado River valley to assess influences on debris flow occurrence and to evaluate valley geometry effects on sediment persistence. Dendrochronology, field mapping, and aerial photographic analysis are used to evaluate whether a 19th century earthen, water-conveyance ditch has altered the regime of debris flow occurrence in the Colorado River headwaters. Identifying any shifts in disturbance processes or changes in magnitudes and frequencies of occurrence is fundamental to establishing the historical range of variability (HRV) at the site. We found no substantial difference in frequency of debris flows cataloged at eleven sites of deposition between the east (8) and west (11) sides of the Colorado River valley over the last century, but four of the five largest debris flows originated on the west side of the valley in association with the earthen ditch, while the fifth is on a steep hillslope of hydrothermally altered rock on the east side. These results suggest that the ditch has altered the regime of debris flow activity in the Colorado River headwaters as compared to HRV by increasing the frequency of debris flows large enough to reach the Colorado River valley. Valley confinement is a dominant control on response to debris flows, influencing volumes of aggradation and persistence of debris flow deposits. Large, frequent debris flows, exceeding HRV, create persistent effects due to valley geometry and geomorphic setting conducive to sediment storage that are easily delineated by valley confinement ratios which are useful to land managers.

Debris Flow Occurrence and Sediment Persistence, Upper Colorado River Valley, CO

NASA Astrophysics Data System (ADS)

Grimsley, K. J.; Rathburn, S. L.; Friedman, J. M.; Mangano, J. F.

2016-07-01

Debris flow magnitudes and frequencies are compared across the Upper Colorado River valley to assess influences on debris flow occurrence and to evaluate valley geometry effects on sediment persistence. Dendrochronology, field mapping, and aerial photographic analysis are used to evaluate whether a 19th century earthen, water-conveyance ditch has altered the regime of debris flow occurrence in the Colorado River headwaters. Identifying any shifts in disturbance processes or changes in magnitudes and frequencies of occurrence is fundamental to establishing the historical range of variability (HRV) at the site. We found no substantial difference in frequency of debris flows cataloged at eleven sites of deposition between the east (8) and west (11) sides of the Colorado River valley over the last century, but four of the five largest debris flows originated on the west side of the valley in association with the earthen ditch, while the fifth is on a steep hillslope of hydrothermally altered rock on the east side. These results suggest that the ditch has altered the regime of debris flow activity in the Colorado River headwaters as compared to HRV by increasing the frequency of debris flows large enough to reach the Colorado River valley. Valley confinement is a dominant control on response to debris flows, influencing volumes of aggradation and persistence of debris flow deposits. Large, frequent debris flows, exceeding HRV, create persistent effects due to valley geometry and geomorphic setting conducive to sediment storage that are easily delineated by valley confinement ratios which are useful to land managers.

Debris Flow Occurrence and Sediment Persistence, Upper Colorado River Valley, CO.

PubMed

Grimsley, K J; Rathburn, S L; Friedman, J M; Mangano, J F

2016-07-01

Debris flow magnitudes and frequencies are compared across the Upper Colorado River valley to assess influences on debris flow occurrence and to evaluate valley geometry effects on sediment persistence. Dendrochronology, field mapping, and aerial photographic analysis are used to evaluate whether a 19th century earthen, water-conveyance ditch has altered the regime of debris flow occurrence in the Colorado River headwaters. Identifying any shifts in disturbance processes or changes in magnitudes and frequencies of occurrence is fundamental to establishing the historical range of variability (HRV) at the site. We found no substantial difference in frequency of debris flows cataloged at eleven sites of deposition between the east (8) and west (11) sides of the Colorado River valley over the last century, but four of the five largest debris flows originated on the west side of the valley in association with the earthen ditch, while the fifth is on a steep hillslope of hydrothermally altered rock on the east side. These results suggest that the ditch has altered the regime of debris flow activity in the Colorado River headwaters as compared to HRV by increasing the frequency of debris flows large enough to reach the Colorado River valley. Valley confinement is a dominant control on response to debris flows, influencing volumes of aggradation and persistence of debris flow deposits. Large, frequent debris flows, exceeding HRV, create persistent effects due to valley geometry and geomorphic setting conducive to sediment storage that are easily delineated by valley confinement ratios which are useful to land managers.

Assessment of AVIRIS data from vegetated sites in the Owens Valley, California

NASA Technical Reports Server (NTRS)

Rock, B. N.; Elvidge, Christopher D.; Defeo, N. J.

1988-01-01

Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) data were acquired from the Bishop, CA area, located at the northern end of the Owens Valley, on July 30, 1987. Radiometrically-corrected AVIRIS data were flat-field corrected, and spectral curves produced and analyzed for pixels taken from both native and cultivated vegetation sites, using the JPS SPAM software program and PC-based spreadsheet programs. Analyses focussed on the chlorophyll well and red edge portions of the spectral curves. Results include the following: AVIRIS spectral data are acquired at sufficient spectral resolution to allow detection of blue shifts of both the chlorophyll well and red edge in moisture-stressed vegetation when compared with non-stressed vegetation; a normalization of selected parameters (chlorophyll well and near infrared shoulder) may be used to emphasize the shift in red edge position; and the presence of the red edge in AVIRIS spectral curves may be useful in detecting small amounts (20 to 30 pct cover) of semi-arid and arid vegetation ground cover. A discussion of possible causes of AVIRIS red edge shifts in respsonse to stress is presented.

Magnetotelluric Data, Mid Valley, Nevada Test Site, Nevada.

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

Jackie M. Williams; Erin L. Wallin; Brian D. Rodriguez

2007-08-15

The United States Department of Energy (DOE) and the National Nuclear Security Administration (NNSA) at their Nevada Site Office (NSO) are addressing ground-water contamination resulting from historical underground nuclear testing through the Environmental Management (EM) program and, in particular, the Underground Test Area (UGTA) project. One issue of concern is the nature of the somewhat poorly constrained pre-Tertiary geology and its effects on ground-water flow. Ground-water modelers would like to know more about the hydrostratigraphy and geologic structure to support a hydrostratigraphic framework model that is under development for the Rainier Mesa/Shoshone Mountain Corrective Action Unit (CAU) (Bechtel Nevada, 2006).more » During 2003, the U.S. Geological Survey (USGS), in cooperation with the DOE and NNSA-NSO, collected and processed data at the Nevada Test Site in and near Yucca Flat (YF) to help define the character, thickness, and lateral extent of the pre-tertiary confining units. We collected 51 magnetotelluric (MT) and audio-magnetotelluric (AMT), stations for that research (Williams and others, 2005a, 2005b, 2005c, 2005d, 2005e, 2005f). In early 2005 we extended that research with 26 additional MT data stations (Williams and others, 2006), located on and near Rainier Mesa and Shoshone Mountain (RM-SM). The new stations extended the area of the hydrogeologic study previously conducted in Yucca Flat. This work was done to help refine what is known about the character, thickness, and lateral extent of pre-Tertiary confining units. In particular, a major goal was to define the upper clastic confining unit (UCCU). The UCCU is comprised of late Devonian to Mississippian siliciclastic rocks assigned to the Eleana Formation and Chainman Shale. The UCCU underlies the Yucca Flat area and extends westward towards Shoshone Mountain, southward to Buckboard Mesa, and northward to Rainier Mesa. Late in 2005 we collected another 14 MT stations in Mid Valley and

Comparisons of shear-wave slowness in the Santa Clara Valley, California using blind interpretations of data from invasive and noninvasive methods

USGS Publications Warehouse

Boore, D.M.; Asten, M.W.

2008-01-01

Many groups contributed to a blind interpretation exercise for the determination of shear-wave slowness beneath the Santa Clara Valley. The methods included invasive methods in deep boreholes as well as noninvasive methods using active and passive sources, at six sites within the valley (with most investigations being conducted at a pair of closely spaced sites near the center of the valley). Although significant variability exists between the models, the slownesses from the various methods are similar enough that linear site amplifications estimated in several ways are generally within 20% of one another. The methods were able to derive slownesses that increase systematically with distance from the valley edge, corresponding to a tendency for the sites to be underlain by finer-grained materials away from the valley edge. This variation is in agreement with measurements made in the boreholes at the sites.

Earth-observing satellite intercomparison using the Radiometric Calibration Test Site at Railroad Valley

NASA Astrophysics Data System (ADS)

Czapla-Myers, Jeffrey; McCorkel, Joel; Anderson, Nikolaus; Biggar, Stuart

2018-01-01

This paper describes the current ground-based calibration results of Landsat 7 Enhanced Thematic Mapper Plus (ETM+), Landsat 8 Operational Land Imager (OLI), Terra and Aqua Moderate Resolution Imaging Spectroradiometer (MODIS), Suomi National Polar orbiting Partnership Visible Infrared Imaging Radiometer Suite (VIIRS), and Sentinel-2A Multispectral Instrument (MSI), using an automated suite of instruments located at Railroad Valley, Nevada, USA. The period of this study is 2012 to 2016 for MODIS, VIIRS, and ETM+, 2013 to 2016 for OLI, and 2015 to 2016 for MSI. The current results show that all sensors agree with the Radiometric Calibration Test Site (RadCaTS) to within ±5% in the solar-reflective regime, except for one band on VIIRS that is within ±6%. In the case of ETM+ and OLI, the agreement is within ±3%, and, in the case of MODIS, the agreement is within ±3.5%. MSI agrees with RadCaTS to within ±4.5% in all applicable bands.

Variability of site response in Seattle, Washington

USGS Publications Warehouse

Hartzell, S.; Carver, D.; Cranswick, E.; Frankel, A.

2000-01-01

Ground motion from local earthquakes and the SHIPS (Seismic Hazards Investigation in Puget Sound) experiment is used to estimate site amplification factors in Seattle. Earthquake and SHIPS records are analyzed by two methods: (1) spectral ratios relative to a nearby site on Tertiary sandstone, and (2) a source/site spectral inversion technique. Our results show site amplifications between 3 and 4 below 5 Hz for West Seattle relative to Tertiary rock. These values are approximately 30% lower than amplification in the Duwamish Valley on artificial fill, but significantly higher than the calculated range of 2 to 2.5 below 5 Hz for the till-covered hills east of downtown Seattle. Although spectral amplitudes are only 30% higher in the Duwamish Valley compared to West Seattle, the duration of long-period ground motion is significantly greater on the artificial fill sites. Using a three-dimensional displacement response spectrum measure that includes the effects of ground-motion duration, values in the Duwamish Valley are 2 to 3 times greater than West Seattle. These calculations and estimates of site response as a function of receiver azimuth point out the importance of trapped surface-wave energy within the shallow, low-velocity, sedimentary layers of the Duwamish Valley. One-dimensional velocity models yield spectral amplification factors close to the observations for till sites east of downtown Seattle and the Duwamish Valley, but underpredict amplifications by a factor of 2 in West Seattle. A two-dimensional finite-difference model does equally well for the till sites and the Duwamish Valley and also yields duration estimates consistent with the observations for the Duwamish Valley. The two-dimensional model, however, still underpredicts amplification in West Seattle by up to a factor of 2. This discrepancy is attributed to 3D effects, including basin-edge-induced surface waves and basin-geometry-focusing effects, caused by the proximity of the Seattle thrust fault

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

NASA Astrophysics Data System (ADS)

Lurkittikul, N.; Kittithreerapronchai, O.

2014-06-01

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

Five-year microbiological monitoring of wards and operating theatres in southern Italy.

PubMed

La Fauci, V; Genovese, C; Facciolà, A; Palamara, M A R; Squeri, R

2017-06-01

Nosocomial infections are one of the greatest problems in public health. Several studies have highlighted the role played by the hospital environment as a possible source of transmission of nosocomial pathogens. A five-year monitoring of bacterial contamination on healthcare workers hands, surfaces most closely in contact with inpatient wards, operating theatres and "at rest" and "in use" operating theatre air samples. For the samples, we used sterile swabs, contact slides, manual API, and automated VITEK systems for identification. In the five-year period, a total of 9396 samples were collected and analysed. In ward patients, 4398 samplings were carried out with 4.7%, 9.4%, 7%, 10.8% and 7.9% positive results respectively from 2010 to 2014. For hands, 648 samplings were carried out, with a positivity of 40.74%. In operating theatres, 4188 samples were taken, with a positivity of 11.9%. Regarding air in empty and full theatres, 1962 samplings were carried out with a positivity rate equal to 31.9%. The monitoring showed a low rate of contamination with a progressive decrease in the fiveyear period on operating theatres surfaces and hands, while there was an increase in the surgical site wards and in the air of operating rooms. Our investigation has revealed the presence of pathogens on the assessed surfaces and the need for environmental monitoring, which can be a valuable tool for reducing contamination.

Work organization in hospital wards and nurses' emotional exhaustion: A multi-method study of observation-based assessment and nurses' self-reports.

PubMed

Stab, Nicole; Hacker, Winfried; Weigl, Matthias

2016-09-01

Ward organization is a major determinant for nurses' well-being on the job. The majority of previous research on this relationship is based on single source methods, which have been criticized as skewed estimations mainly due to subjectivity of the ratings and due to common source bias. To investigate the association of ward organization characteristics and nurses' exhaustion by combining observation-based assessments with nurses' self-reports. Cross-sectional study on 25 wards of four hospitals and 245 nurses. Our multi-method approach to evaluate hospital ward organization consisted of on-site observations with a standardized assessment tool and of questionnaires to evaluate nurses' self-reports and exhaustion. After establishing the reliability of our measures, we applied multi-level regression analyses to determine associations between determinant and outcome variables. We found substantial convergence in ward organization between the observation-based assessments and nurses' self-reports, which supports the validity of our external assessments. Furthermore, two observation-based characteristics, namely participation and patient-focused care, were significantly associated with lower emotional exhaustion among the nurses. Our results suggest that observation-based assessments are a valid and feasible way to assess ward organization in hospitals. Nurses' self-reported as well as observation-based ratings on ward organization were associated with nurses' emotional exhaustion. This is of interest mainly for identifying alternative measures in evaluating nurses' work environments, to inform health promotion activities and to evaluate job redesign intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Why patients need leaders: introducing a ward safety checklist

PubMed Central

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

2012-01-01

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

Patients' feelings about ward nursing regimes and involvement in rule construction.

PubMed

Alexander, J

2006-10-01

This study compared two acute psychiatric ward nursing regimes, focusing on ward rules as a means of investigating the relationship between the flexibility/inflexibility of the regimes and patient outcomes. Previous studies identified an association between ward rules and patient aggression. A link between absconding and nurses' attitudes towards rule enforcement has also been explored. However, an in-depth exploration of ward rules from the perspective of nurses and patients had not been undertaken previously. The study aimed to discover the content of rules within acute psychiatric wards; to explore patients' responses to the rules; to evaluate the impact of rules and rule enforcement on nurse-patient relationships and on ward events; and to investigate the relationship between ward rules, ward atmosphere and ward design. The relevance of sociological theory emerged from the data analysis. During this process, the results were moved up to another conceptual level to represent the meaning of lived experience at the level of theory. For example, nurses' descriptions of their feelings in relation to rule enforcement were merged as role ambivalence. This concept was supported by examples from the transcripts. Other possible explanations for the data and the connections between them were checked by returning to each text unit in the cluster and ensuring that it fitted with the emergent theory. The design centred on a comparative interview study of 30 patients and 30 nurses within two acute psychiatric wards in different hospitals. Non-participant observations provided a context for the interview data. Measures of the Ward Atmosphere Scale, the Hospital-Hostel Practices Profile, ward incidents and levels of as required (PRN) medication were obtained. The analysis of the quantitative data was assisted by spss, and the qualitative analysis by QSR *NUDIST. Thematic and interpretative phenomenological methods were used in the analysis of the qualitative data. A series of

Variability in Costs across Hospital Wards. A Study of Chinese Hospitals

PubMed Central

Adam, Taghreed; Evans, David B.; Ying, Bian; Murray, Christopher J. L.

2014-01-01

Introduction Analysts estimating the costs or cost-effectiveness of health interventions requiring hospitalization often cut corners because they lack data and the costs of undertaking full step-down costing studies are high. They sometimes use the costs taken from a single hospital, sometimes use simple rules of thumb for allocating total hospital costs between general inpatient care and the outpatient department, and sometimes use the average cost of an inpatient bed-day instead of a ward-specific cost. Purpose In this paper we explore for the first time the extent and the causes of variation in ward-specific costs across hospitals, using data from China. We then use the resulting model to show how ward-specific costs for hospitals outside the data set could be estimated using information on the determinants identified in the paper. Methodology Ward-specific costs estimated using step-down costing methods from 41 hospitals in 12 provinces of China were used. We used seemingly unrelated regressions to identify the determinants of variability in the ratio of the costs of specific wards to that of the outpatient department, and explain how this can be used to generate ward-specific unit costs. Findings Ward-specific unit costs varied considerably across hospitals, ranging from 1 to 24 times the unit cost in the outpatient department — average unit costs are not a good proxy for costs at specialty wards in general. The most important sources of variability were the number of staff and the level of capacity utilization. Practice Implications More careful hospital costing studies are clearly needed. In the meantime, we have shown that in China it is possible to estimate ward-specific unit costs taking into account key determinants of variability in costs across wards. This might well be a better alternative than using simple rules of thumb or using estimates from a single study. PMID:24874566

The relationship between substance use and exit security on psychiatric wards.

PubMed

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

2011-03-01

In this paper we report on the rates of drug/alcohol use on acute psychiatric wards in relation to levels and intensity of exit security measures. Many inpatient wards have become permanently locked, with staff concerned about the risk of patients leaving the ward and harming themselves or others, and of people bringing illicit substances into the therapeutic environment. In 2004/2005, a cross sectional survey on 136 acute psychiatric wards across three areas of England was undertaken. A comprehensive range of data including door locking and drug/alcohol use were collected over 6 months on each ward. In 2006, supplementary data on door locking and exit security were collected. Door locking, additional exit security measures and substance misuse rates of the 136 wards were analysed and the associations between these were investigated. No consistent relationships were found with exit security features, intensity of drug/alcohol monitoring procedures, or the locking of the ward door. There were indications that use of breath testing for alcohol might reduce usage and that the use of 'sniffer' dogs was associated with greater alcohol use. Greater exit security or locking of the ward door had no influence on rates of use of alcohol or illicit drugs by inpatients and thus cannot form part of any strategy to control substance use by inpatients. There are some grounds to believe that a greater use of screening might help reduce the frequency of alcohol/substance use on wards and may lead to a reduction in verbal abuse. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

Developing a general ward nursing dashboard.

PubMed

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

2014-12-15

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

Death Valley California as seen from STS-59

NASA Image and Video Library

1994-04-13

STS059-86-059 (9-20 April 1994) --- This oblique handheld Hasselblad 70mm photo shows Death Valley, near California's border with Nevada. The valley -- the central feature of Death Valley National Monument -- extends north to south for some 140 miles (225 kilometers). Hemmed in to the east by the Amargosa Range and to the west by the Panamints, its width varies from 5 to 15 miles (8 to 24 kilometers). Using Spaceborne Imaging Radar (SIR-C) and X-band Synthetic Aperture Radar (X-SAR) onboard the Space Shuttle Endeavour, the crew was able to record a great deal of data on this and other sites, as part of NASA's Mission to Planet Earth.

Introduction of a new ward round approach in a cardiothoracic critical care unit.

PubMed

Shaughnessy, Liz; Jackson, Jo

2015-07-01

Francis (2013) described inconsistent ward rounds and failures to conduct ward rounds properly as contributing factors to the poor care seen at the Mid Staffordshire Foundation Trust. He suggested that the absence of a nurse at the bedside had clear consequences for communication, ward round efficiency and patient safety. He recommended that nurses should be actively involved in ward rounds and linked this to high quality patient care. To share an experience of introducing a ward round checklist, a bedside nurse verbal summary and the development of standard operating procedure for Ward Rounds in cardiothoracic critical care unit to improve patient safety and care. Semi structured interviews of six registered nurses. A questionnaire to 69 registered nurses. An electronic questionnaire sent to 23 members of the MDT. An observational audit of seven ward rounds reviewing 69 patients. 97% of nurses agreed that verbal summarizing had improved clarity and 90% felt that it had improved patient care. 87% of the MDT respondents stated that they had noticed an improvement in the attendance of the bedside nurse at the ward round review. The ward round checklist reduced omissions. Communication with patients during ward rounds was an area which needed to be improved. The introduction of a new ward round approach and audit of its practice has enabled an improvement in the quality of patient care by: Giving more opportunity for the nurse to participate and feel part of the ward round. Reduction of omissions through the use of a ward round checklist. Improved clarity among the MDT by the use of bedside nurse verbal summarizing of the plan of care. Nurses' full participation in ward rounds is essential to ensure effective communication and enhance patient safety. © 2015 British Association of Critical Care Nurses.

Climatology of atmospheric PM10 concentration in the Po Valley

NASA Astrophysics Data System (ADS)

Bigi, A.; Ghermandi, G.

2014-01-01

The limits to atmospheric pollutant concentration set by the European Commission provide a challenging target for the municipalities in the Po Valley, because of the characteristic climatic conditions and high population density of this region. In order to assess climatology and trends in the concentration of atmospheric particles in the Po Valley, a dataset of PM10 data from 41 sites across the Po Valley have been analysed, including both traffic and background sites (either urban, suburban or rural). Of these 41 sites, 18 with 10 yr or longer record have been analysed for long term trend in de-seasonalized monthly means, in annual quantiles and in monthly frequency distribution. A widespread significant decreasing trend has been observed at most sites, up to few percent per year, by Generalised Least Square and Theil-Sen method. All 41 sites have been tested for significant weekly periodicity by Kruskal-Wallis test for mean anomalies and by Wilcoxon test for weekend effect magnitude. A significant weekly periodicity has been observed for most PM10 series, particularly in summer and ascribed mainly to anthropic particulate emissions. A cluster analysis has been applied in order to highlight stations sharing similar pollution conditions over the reference period. Five clusters have been found, two gathering the metropolitan areas of Torino and Milano and their respective nearby sites and the other three clusters gathering north-east, north-west and central Po Valley sites respectively. Finally the observed trends in atmospheric PM10 have been compared to trends in provincial emissions of particulates and PM precursors, and analysed along with data on vehicular fleet age, composition and fuel sales. Significant basin-wide drop in emissions occurred for gaseous pollutants, contrarily to emissions of PM10 and PM2.5, whose drop resulted low and restricted to few provinces. It is not clear whether the decrease for only gaseous emissions is sufficient to explain the

Subsurface Salts in Antarctic Dry Valley Soils

NASA Technical Reports Server (NTRS)

Englert, P.; Bishop, J. L.; Gibson, E. K.; Koeberl, C.

2013-01-01

The distribution of water-soluble ions, major and minor elements, and other parameters were examined to determine the extent and effects of chemical weathering on cold desert soils. Patterns at the study sites support theories of multiple salt forming processes, including marine aerosols and chemical weathering of mafic minerals. Periodic solar-mediated ionization of atmospheric nitrogen might also produce high nitrate concentrations found in older sediments. Chemical weathering, however, was the major contributor of salts in Antarctic Dry Valleys. The Antarctic Dry Valleys represent a unique analog for Mars, as they are extremely cold and dry desert environments. Similarities in the climate, surface geology, and chemical properties of the Dry Valleys to that of Mars imply the possible presence of these soil formation mechanisms on Mars, other planets and icy satellites.

The Valley Forge Encampment: Epic on the Schuylkill.

ERIC Educational Resources Information Center

Trussell, John B. B., Jr.

Valley Forge, outside Philadelphia (Pennsylvania), has long been recognized as the site of a great victory of the human spirit. Eleven thousand men including Blacks and Indians resided there during the winter of 1777-78 and triumphed over cold, starvation, nakedness, disease, and uncertainty. The encampment site was unprepared for the tattered,…

Strong ground motion in the Kathmandu Valley during the 2015 Gorkha, Nepal, earthquake

NASA Astrophysics Data System (ADS)

Takai, Nobuo; Shigefuji, Michiko; Rajaure, Sudhir; Bijukchhen, Subeg; Ichiyanagi, Masayoshi; Dhital, Megh Raj; Sasatani, Tsutomu

2016-01-01

On 25 April 2015, a large earthquake of Mw 7.8 occurred along the Main Himalayan Thrust fault in central Nepal. It was caused by a collision of the Indian Plate beneath the Eurasian Plate. The epicenter was near the Gorkha region, 80 km northwest of Kathmandu, and the rupture propagated toward east from the epicentral region passing through the sediment-filled Kathmandu Valley. This event resulted in over 8000 fatalities, mostly in Kathmandu and the adjacent districts. We succeeded in observing strong ground motions at our four observation sites (one rock site and three sedimentary sites) in the Kathmandu Valley during this devastating earthquake. While the observed peak ground acceleration values were smaller than the predicted ones that were derived from the use of a ground motion prediction equation, the observed peak ground velocity values were slightly larger than the predicted ones. The ground velocities observed at the rock site (KTP) showed a simple velocity pulse, resulting in monotonic-step displacements associated with the permanent tectonic offset. The vertical ground velocities observed at the sedimentary sites had the same pulse motions that were observed at the rock site. In contrast, the horizontal ground velocities as well as accelerations observed at three sedimentary sites showed long duration with conspicuous long-period oscillations, due to the valley response. The horizontal valley response was characterized by large amplification (about 10) and prolonged oscillations. However, the predominant period and envelope shape of their oscillations differed from site to site, indicating a complicated basin structure. Finally, on the basis of the velocity response spectra, we show that the horizontal long-period oscillations on the sedimentary sites had enough destructive power to damage high-rise buildings with natural periods of 3 to 5 s.

A comparison of avian communities and habitat characteristics in floodplain forests associated with valley plugs and unchannelized streams

USGS Publications Warehouse

Pierce, Aaron R.; King, Sammy L.

2011-01-01

Channelization of streams associated with floodplain forested wetlands has occurred extensively throughout the world and specifically in the southeastern United States. Channelization of fluvial systems alters the hydrologic and sedimentation processes that sustain these systems. In western Tennessee, channelization and past land-use practices have caused drastic geomorphic and hydrologic changes, resulting in altered habitat conditions that may affect avian communities. The objective of this study was to determine if there were differences in avian communities utilizing floodplain forests along unchannelized streams compared to channelized streams with valley plugs, areas where sediment has completely filled the channel. During point count surveys, 58 bird species were observed at unchannelized sites and 60 species were observed at valley plug sites. Species associated with baldcypress-tupelo (Taxodium-Nyssa) swamps (e.g. Great Egret (Ardea albus) and Black-crowned Night Heron (Nycticorax nycticorax)) and mature hardwood forests with open midstories (e.g. Eastern Wood-Pewee (Contopus virens), Yellow-throated Vireo (Vireo flavifrons), Cerulean Warbler (Dendroica cerulea) and Scarlet Tanager (Piranga olivacea)) were either only found at unchannelized sites or were more abundant at unchannelized sites. Conversely, species associated with open and early successional habitats (e.g. Tree Swallow (Tachycineta bicolor), Northern Mockingbird (Mimus polyglottos) and Blue Grosbeak (Passerina caerulea)) were either only found at valley plug sites or were more abundant at valley plug sites. Results of habitat modelling suggest that the habitat characteristics of floodplain forests at unchannelized sites are more suitable for Neotropical migrant bird species of conservation concern in the region than at valley plug sites. This study, in combination with previous research, demonstrates the ecological impacts of valley plugs span across abiotic and biotic processes and tropic

Does daily nurse staffing match ward workload variability? Three hospitals' experiences.

PubMed

Gabbay, Uri; Bukchin, Michael

2009-01-01

Nurse shortage and rising healthcare resource burdens mean that appropriate workforce use is imperative. This paper aims to evaluate whether daily nursing staffing meets ward workload needs. Nurse attendance and daily nurses' workload capacity in three hospitals were evaluated. Statistical process control was used to evaluate intra-ward nurse workload capacity and day-to-day variations. Statistical process control is a statistics-based method for process monitoring that uses charts with predefined target measure and control limits. Standardization was performed for inter-ward analysis by converting ward-specific crude measures to ward-specific relative measures by dividing observed/expected. Two charts: acceptable and tolerable daily nurse workload intensity, were defined. Appropriate staffing indicators were defined as those exceeding predefined rates within acceptable and tolerable limits (50 percent and 80 percent respectively). A total of 42 percent of the overall days fell within acceptable control limits and 71 percent within tolerable control limits. Appropriate staffing indicators were met in only 33 percent of wards regarding acceptable nurse workload intensity and in only 45 percent of wards regarding tolerable workloads. The study work did not differentiate crude nurse attendance and it did not take into account patient severity since crude bed occupancy was used. Double statistical process control charts and certain staffing indicators were used, which is open to debate. Wards that met appropriate staffing indicators prove the method's feasibility. Wards that did not meet appropriate staffing indicators prove the importance and the need for process evaluations and monitoring. Methods presented for monitoring daily staffing appropriateness are simple to implement either for intra-ward day-to-day variation by using nurse workload capacity statistical process control charts or for inter-ward evaluation using standardized measure of nurse workload intensity

Spatial patterns in electoral wards with high lymphoma incidence in Yorkshire health region.

PubMed Central

Barnes, N.; Cartwright, R. A.; O'Brien, C.; Roberts, B.; Richards, I. D.; Bird, C. C.

1987-01-01

The possibilities of clustering between those electoral wards which display higher than expected incidences of cases of the lymphomas occurring between 1978 and 1982 are examined. Clusters are defined as being those wards with cases in excess (at a probability of less than 10%) which are geographically adjacent to each other. A separate analysis extends the definition of cluster to include high incidence wards that are adjacent or separated by one other ward. The results indicate that many high incidence lymphoma wards do occur close together and when computer simulations are used to compute expected results, many of the observed results are shown to be highly improbable both in the overall number of clustering wards and in the largest number of wards comprising a 'cluster'. PMID:3663469

Hematology and plasma biochemistry values for the giant garter snake (Thamnophis gigas) and valley garter snake (Thamnophis sirtalis fitchi) in the Central Valley of California.

PubMed

Wack, Raymund F; Hansen, Eric; Small, Marilyn; Poppenga, Robert; Bunn, David; Johnson, Christine K

2012-04-01

Hematology and plasma biochemistry parameters are useful in the assessment and management of threatened and endangered species. Although reference ranges are readily available for many mammalian species, reference ranges for snakes are lacking for most species. We determined hematology and plasma biochemistry reference ranges for giant garter snakes (Thamnophis gigas) and valley garter snakes (Thamnophis sirtalis fitchi) living in four management areas in the Central Valley of California. White blood cell, heterophil, lymphocyte, and azurophil counts in giant garter snakes were approximately twice the values of valley garter snakes. Statistically significant differences in aspartate aminotransferase, globulin, and potassium between the two species did not appear clinically significant. No significant differences were found in the measured parameters between male and female giant garter snakes. Some differences were found among collection sites. These reference ranges provide baseline data for comparisons over time and between collection sites.

Glade Valley School: 1909-1985.

ERIC Educational Resources Information Center

Dickson, Kay Reita

This book is a comprehensive history of the Glade Valley School in Allegheny County, North Carolina. It is filled with letters, newspaper reports, first-hand accounts, and photographs that trace the lives of its students and faculty back to opening day in January 1911. The school's site was chosen in 1909 and was deemed favorable because it was…

The geochemistry of groundwater resources in the Jordan Valley: The impact of the Rift Valley brines

USGS Publications Warehouse

Farber, E.; Vengosh, A.; Gavrieli, I.; Marie, Amarisa; Bullen, T.D.; Mayer, B.; Polak, A.; Shavit, U.

2007-01-01

The chemical composition of groundwater in the Jordan Valley, along the section between the Sea of Galilee and the Dead Sea, is investigated in order to evaluate the origin of the groundwater resources and, in particular, to elucidate the role of deep brines on the chemical composition of the regional groundwater resources in the Jordan Valley. Samples were collected from shallow groundwater in research boreholes on two sites in the northern and southern parts of the Jordan Valley, adjacent to the Jordan River. Data is also compiled from previous published studies. Geochemical data (e.g., Br/Cl, Na/Cl and SO4/Cl ratios) and B, O, Sr and S isotopic compositions are used to define groundwater groups, to map their distribution in the Jordan valley, and to evaluate their origin. The combined geochemical tools enabled the delineation of three major sources of solutes that differentially affect the quality of groundwater in the Jordan Valley: (1) flow and mixing with hypersaline brines with high Br/Cl (>2 ?? 10-3) and low Na/Cl (<0.8) ratios; (2) dissolution of highly soluble salts (e.g., halite, gypsum) in the host sediments resulting in typically lower Br/Cl signal (<2 ?? 10-3); and (3) recharge of anthropogenic effluents, primarily derived from evaporated agricultural return flow that has interacted (e.g., base-exchange reactions) with the overlying soil. It is shown that shallow saline groundwaters influenced by brine mixing exhibit a north-south variation in their Br/Cl and Na/Cl ratios. This chemical trend was observed also in hypersaline brines in the Jordan valley, which suggests a local mixing process between the water bodies. ?? 2007 Elsevier Ltd. All rights reserved.

Deep Resistivity Structure of Mid Valley, Nevada Test Site, Nevada

USGS Publications Warehouse

Wallin, Erin L.; Rodriguez, Brian D.; Williams, Jackie M.

2009-01-01

-Tertiary confining units. In particular, a major goal was to define the extent of the upper clastic confining unit (UCCU). The UCCU is composed of late Devonian to Mississippian siliciclastic rocks assigned to the Eleana Formation and Chainman Shale (National Security Technologies, 2007). The UCCU underlies the Yucca Flat area and extends southwestward toward Shoshone Mountain, westward toward Buckboard Mesa, and northwestward toward Rainier Mesa. Late in 2005 we collected data at an additional 14 MT stations in Mid Valley, CP Hills, and northern Yucca Flat. That work was done to better determine the extent and thickness of the UCCU near the boundary between the southeastern RM-SM CAU and the southwestern YF CAU, and also in the northern YF CAU. The MT data have been released in a separate U.S. Geological Survey report (Williams and others, 2007). The Nevada Test Site magnetotelluric data interpretation presented in this report includes the results of detailed two-dimensional (2-D) resistivity modeling for each profile and inferences on the three-dimensional (3-D) character of the geology within the region.

Design Lessons From the Analysis of Nurse Journeys in a Hospital Ward.

PubMed

Nazarian, Masoumeh; Price, Andrew; Demian, Peter; Malekzadeh, Masoud

2018-01-01

The objective is to establish design strategies to help minimize nurse journeys and inform future decision-making. The impact of the ward layout was investigated through a case study ward in a multispecialty hospital in Tehran. Nurse teams have the most direct contact with ward patients. Time spent on activities not part of care provision should be minimized. Literature suggests that a significant part of nurses' time is spent moving between different places within wards, which emphasizes the importance of ward layout. The ethnographic method was adopted for observing nurses' actions based on routes that form a significant share of nurses' daily journeys. Data were collected from 42 nursing staff over 120 hr during different shifts. This provided empirical data on the frequency of each journey which revealed meaningful patterns. Approximately 1,300 room-to-room journeys were made. Conclusions were drawn about the criticality of each route. There is a significant difference between the frequencies of different routes in the case study ward. The distances between origins and destinations of the most frequently used journeys must remain minimal. Awareness of less frequent routes allows for greater flexibility in ward design. Arrangement of ward spaces can minimize journey times. Healthcare planners and designers can explore the implications of chosen systems on walking distance and, consequently, the nursing staff productivity. For existing wards, rearrangement of space utilization can improve staff productivity. The recommendations can be applied wherever productivity is influenced by walking distances.

Flow structure and turbulence characteristics of the daytime atmosphere in a steep and narrow Alpine valley

NASA Astrophysics Data System (ADS)

Weigel, Andreas P.; Rotach, Mathias W.

2004-10-01

Aircraft measurements, radio soundings and sonic data--obtained during the MAP-Riviera field campaign in autumn 1999 in southern Switzerland--are used to investigate the flow structure, temperature profiles and turbulence characteristics of the atmosphere in a steep and narrow Alpine valley under convective conditions. On all predominantly sunny days of the intensive observation periods, a pronounced valley-wind system develops. In the southern half of the valley, the daily up-valley winds have a jet-like structure and are shifted towards the eastern slope. These up-valley winds advect potentially colder air, a process which appears to be balanced by vertical warm air advection from above. The profiles of potential temperature show that, with the onset of up-valley winds, the mixed layer consistently stops growing or--on days with very strong up-valley winds--even stabilizes almost throughout the entire valley atmosphere. This is probably due to a pronounced secondary circulation in the southern part of the valley, which induces advection of warm air from above. The secondary circulation appears to be a consequence of sharp curvature in the along-valley topography. Turbulence variables are calculated from flight legs in the along-valley direction. Turbulent kinetic energy (TKE) scales surprisingly well (i) if a TKE criterion (TKE > 0.5 m2s-2) is employed as a definition of the boundary layer height and (ii) if the 'surface fluxes'--which exhibit a substantial spatial variability--from the slope sites are used rather than those from directly beneath the profile considered. Significant site-to-site differences in incoming solar radiation seem to be the reason for this characteristic behaviour. Profiles of momentum flux--scaled with a surface friction velocity--reveal more scatter than the TKE profiles, but still show a consistent behaviour. A surprisingly strong shear in the cross-valley direction can be observed and is probably a result of the secondary circulation.

Corrective Action Plan for Corrective Action Unit 366: Area 11 Plutonium Valley Dispersion Sites, Nevada National Security Site, Nevada

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

None

This Corrective Action Plan has been prepared for Corrective Action Unit (CAU) 366, Area 11 Plutonium Valley Dispersion Sites, in accordance with the Federal Facility Agreement and Consent Order (FFACO, 1996 as amended). CAU 366 consists of the following six Corrective Action Sites (CASs) located in Area 11 of the Nevada National Security Site: · CAS 11-08-01, Contaminated Waste Dump #1 · CAS 11-08-02, Contaminated Waste Dump #2 · CAS 11-23-01, Radioactively Contaminated Area A · CAS 11-23-02, Radioactively Contaminated Area B · CAS 11-23-03, Radioactively Contaminated Area C · CAS 11-23-04, Radioactively Contaminated Area D Site characterization activities weremore » performed in 2011 and 2012, and the results are presented in Appendix A of the Corrective Action Decision Document (CADD) for CAU 366 (U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office [NNSA/NSO], 2012a). The following closure alternatives were recommended in the CADD: · No further action for CAS 11-23-01 · Closure in place for CASs 11-08-01, 11-08-02, 11-23-02, 11-23-03, and 11-23-04 The scope of work required to implement the recommended closure alternatives includes the following: · Non-engineered soil covers approximately 3 feet thick will be constructed at CAS 11-08-01 over contaminated waste dump (CWD) #1 and at CAS 11-08-02 over CWD #2. · FFACO use restrictions (URs) will be implemented for the areas where the total effective dose (TED) exceeds the final action level (FAL) of 25 millirems per Occasional Use Area year (mrem/OU-yr). The FAL is based on an assumption that the future use of the site includes occasional work activities and that workers will not be assigned to the area on a regular basis. A site worker under this scenario is assumed to be on site for a maximum of 80 hours per year for 5 years. The FFACO UR boundaries will encompass the areas where a worker would be exposed to 25 millirems of radioactivity per year if they are present

Hospital admission avoidance through the introduction of a virtual ward.

PubMed

Jones, Joanne; Carroll, Andrea

2014-07-01

The ageing British population is placing increased demands on the delivery of care in mainstream health-care institutions. While people are living longer, a significant percentage is also living with one or more long-term conditions. These issues, alongside continuing financial austerity measures, require a radical improvement in the care of patients away from hospitals. The Wyre Forest Clinical Commissioning Group introduced a virtual ward model for two main purposes: to save on spiralling costs of hospital admissions, and, secondly, to ensure the preferred wishes of most patients to be cared for and even die at home were achieved. This commentary describes how the virtual ward model was implemented and the impact of preventing unplanned emergency admissions to hospitals. The setting up of enhanced care services and virtual wards in one county is discussed, aiming to highlight success points and potential pitfalls to avoid. The results from the implementation of the virtual ward model show a significant reduction in emergency and avoidable patient admissions to hospital. The success of virtual wards is dependent on integrated working between different health-care disciplines.

Youth Health Coordinating Council Ward 8 Secret Health Clinic Shopper Report

ERIC Educational Resources Information Center

Behrens, Donna

2010-01-01

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

Quaternary Geochronology, Paleontology, and Archaeology of the Upper San Pedro River Valley, Sonora, Mexico

NASA Astrophysics Data System (ADS)

Gaines, E. P.

2013-12-01

This poster presents the results of multi-disciplinary investigations of the preservation and extent of Quaternary fossil-bearing strata in the San Pedro River Valley in Sonora, Mexico. Geologic deposits in the portions of the San Pedro Valley in southern Arizona contain one of the best late Cenozoic fossil records known in North America and the best record of early humans and extinct mammals on the continent. The basin in the U.S. is one of the type locations for the Blancan Land Mammal Age. Hemiphilian and Irvingtonian fossils are common. Rancholabrean remains are widespread. Strata in the valley adjacent to the international border with Mexico have yielded the densest concentration of archaeological mammoth-kill sites known in the western hemisphere. Despite more than 60 years of research in the U.S., however, and the fact that over one third of the San Pedro River lies south of the international boundary, little has been known about the late Cenozoic geology of the valley in Mexico. The study reported here utilized extensive field survey, archaeological documentation, paleontological excavations, stratigraphic mapping and alluvial geochronology to determine the nature and extent of Quaternary fossil-bearing deposits in the portions of the San Pedro Valley in Sonora, Mexico. The results demonstrate that the Plio-Pleistocene fossil -bearing formations known from the valley in Arizona extend into the uppermost reaches of the valley in Mexico. Several new fossil sites were discovered that yielded the remains of Camelids, Equus, Mammuthus, and other Proboscidean species. Late Pleistocene archaeological remains were found on the surface of the surrounding uplands. AMS radiocarbon dating demonstrates the widespread preservation of middle- to late- Holocene deposits. However, the late Pleistocene deposits that contain the archaeological mammoth-kill sites in Arizona are absent in the valley in Mexico, and are now known to be restricted to relatively small portions of

5. Roof Truss Above Service Area, Roof Truss Above Ward, ...

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

5. Roof Truss Above Service Area, Roof Truss Above Ward, Roof Framing Axonometric - National Home for Disabled Volunteer Soldiers - Battle Mountain Sanitarium, Ward 4, 500 North Fifth Street, Hot Springs, Fall River County, SD

Strengthening the role of the ward manager: a review of the literature.

PubMed

Pegram, Anne M; Grainger, Michelle; Sigsworth, Janice; While, Alison E

2014-09-01

The role of the ward manager is integral to service delivery, however, they may lack the necessary authority and autonomy to achieve the organisation and delivery of patient care. To identify initiatives that have strengthened the ward manager role. A review of published literature was undertaken. Data included were drawn from a variety of sources, including policy, professional literature and research studies. Three policy initiatives were identified along with two innovations from ward managers and two recent professional organisation campaigns. One innovation was identified that could improve the process of care delivery thus empowering ward managers' decision making. The literature identified the need for a review of the role, and adequate administrative support and training for the role. The literature reviewed provided little evidence of initiatives to strengthen the role of the ward manager, highlighting the imperative to develop an evidence base. There was consensus on the importance of education and training before and during appointment to the position. The role of the ward manager remains pivotal in care delivery. The focus should be on how best to support ward managers in achieving their role within health-care systems. © 2013 John Wiley & Sons Ltd.

[A project to ameliorate nurses working overtime in psychiatry ward].

PubMed

Feng, Yuen-Hsiang; Li, Hsiu-Chen; Fang, Mao-So

2009-12-01

The authors found nurses working in psychiatry wards were frequently required to work overtime, with average overtime measuring 85 minutes. After analysis, we found main factors leading to overtime to be late new patient admissions, tardy ward inspections by attending physicians, failure to implement workplace regulations, failure by nurses to implement proper shift transfer procedures, and meeting-related delays. This paper proposes an approach by which average overtime for psychiatry ward nurses may be reduced from 85 to 30 minutes. Based on findings, the researchers adjusted the schedule for ward visits by attending physicians, updated and streamlined workplace regulations, ensured administrative procedures were precisely followed, and updated and streamlined standing orders. Average overtime was reduced from 85 to 25 minutes. This research facilitated a reduction in the amount of overtime registered by nurses.

Thermal comfort of patients in hospital ward areas.

PubMed Central

Smith, R. M.; Rae, A.

1977-01-01

The patient is identified as being of prime importance for comfort standards in hospital ward areas, other ward users being expected to adjust their dress to suit the conditions necessary for patients comfort. A study to identify the optimum steady state conditions for patients comfort is then described. Although this study raises some doubts as to the applicability of the standard thermal comfort assessment techniques to ward areas, it is felt that its results give a good indication of the steady-state conditions preferred by the patients. These were an air temperature of between 21-5 degrees and 22 degrees C and a relative humidity of between 30% and 70%, where the air velocity was less than 0-1 m/s and the mean radiant temperature was close to air temperature. PMID:264497

Analysis of Ward identities in supersymmetric Yang-Mills theory

NASA Astrophysics Data System (ADS)

Ali, Sajid; Bergner, Georg; Gerber, Henning; Montvay, Istvan; Münster, Gernot; Piemonte, Stefano; Scior, Philipp

2018-05-01

In numerical investigations of supersymmetric Yang-Mills theory on a lattice, the supersymmetric Ward identities are valuable for finding the critical value of the hopping parameter and for examining the size of supersymmetry breaking by the lattice discretisation. In this article we present an improved method for the numerical analysis of supersymmetric Ward identities, which takes into account the correlations between the various observables involved. We present the first complete analysis of supersymmetric Ward identities in N=1 supersymmetric Yang-Mills theory with gauge group SU(3). The results indicate that lattice artefacts scale to zero as O(a^2) towards the continuum limit in agreement with theoretical expectations.

GPS measurements of strain accumulation across the Imperial Valley, California: 1986-1989

NASA Technical Reports Server (NTRS)

Larsen, Shawn; Reilinger, Robert

1989-01-01

The Global Positioning System (GPS) data collected in southern California from 1986 to 1989 indicate considerable strain accumulation across the Imperial Valley. Displacements are computed at 29 stations in and near the valley from 1986 to 1988, and at 11 sites from 1988 to 1989. The earlier measurements indicate 5.9 +/- 1.0 cm/yr right-lateral differential velocity across the valley, although the data are heavily influenced by the 1987 Superstition Hills earthquake sequence. Some measurements, especially the east-trending displacements, are suspects for large errors. The 1988 to 1989 GPS displacements are best modeled by 5.2 +/- 0.9 cm/yr of valley crossing deformation, but rates calculated from conventional geodetic measurements (3.4 to 4.3 cm/yr) fit the data nearly as well. There is evidence from GPS and Very Long Base Interferometry (VLBI) observations that the present slip rate along the southern San Andreas fault is smaller than the long-term geologic estimate, suggesting a lower earthquake potential than is currently assumed. Correspondingly, a higher earthquake potential is indicated for the San Jacinto fault. The Imperial Valley GPS sites form part of a 183 station network in southern California and northern Baja California, which spans a cross-section of the North American-Pacific plate boundary.

Possible Analogs for Small Valleys on Mars at the Haughton Impact Crater Site, Devon Island, Canadian High Arctic

NASA Technical Reports Server (NTRS)

Lee, P.; Rice, J. W., Jr.; Bunch, Theodore E.; Grieve, R. A. F.; McKay, C. P.; Schutt, J. W.; Zent, A. P.

1999-01-01

Small valleys are perhaps the clearest evidence for an aqueous past on Mars. While small valley formation has occurred even in Amazonian times, most small valleys on Mars are associated with the heavily cratered Noachian terrains. Martian small valleys are often cited as evidence for a putative warmer and wetter climate on Early Mars in which rain and subsequent surface runoff would have acted as significant erosional agents, but the morphology of many small valleys has at the same time been recognized as having several unusual characteristics, making their origin still enigmatic and climatic inferences from them uncertain. Meanwhile, martian climate modeling efforts have been facing difficulties over the past decades with the problem of making the early martian climate warm enough to achieve temperature above 273 K to allow rainfall and the sustained flow of liquid water at the martian surface.

Summative Evaluation on the Hospital Wards. What Do Faculty Say to Learners?

ERIC Educational Resources Information Center

Hasley, Peggy B.; Arnold, Robert M.

2009-01-01

No previous studies have described how faculty give summative evaluations to learners on the medical wards. The aim of this study was to describe summative evaluations on the medical wards. Participants were students, house staff and faculty at the University of Pittsburgh. Ward rotation evaluative sessions were tape recorded. Feedback was…

Geoarchaeology of Paalliq 1 Valley, Kuuvik Bay, Nunavik (Québec)

NASA Astrophysics Data System (ADS)

Barbel, Héloïse; Bhiry, Najat; Todisco, Dominique

2017-04-01

Given its cultural interest for the community of Akulivik, the Kuuvik Bay, Nunavik (Québec) presents an excellent opportunity for archaeologists, geoarchaeologists and paleo-environmentalists to study the significant archaeological and environmental features of Kuuvik Bay. In this research project, we seek to expand our knowledge of the human-environment relationship in Nunavik in the context of climate change. Our focus is on the changes in Dorset and Thule land occupation in the environmental context (especially during the winter) at the Kuuvik Bay which is located about 100 km north from Akulivik,. Intra-site and extra-site geoarchaeological studies have been performed at Structure 10 on the Kuuvik 1516 site as well as in the valley in which it is situated (Paalliq 1 Valley). Many of the multifamily subterranean sod houses recorded at the Kuuvik 1516 site were the first to be inventoried at Nunavik. They had already been observed in Labrador (Eastern Canada), but the modalities of their appearance from the 17th Century continue to be studied. Multifactorial climatic and historical factors have been identified. Our research focuses on the following question: What factors contributed to such an important gathering of archaeological structures in the same site and to the appearance of multifamily subterranean sod houses? Combining extra-site and intra-site approaches, this geoarchaeological study aims to: 1) document the geomorphological context in which the Dorset and Thule occupied the Paalliq 1 Valley, especially in relation to postglacial marine regression (as linked to isostatic rebound), 2) identify processes of cultural and natural formation (biopedologic and sedimentary), and 3) identify the eventual reuse or reorganization phases of Dorset sites by the Thule.

Hydrogeologic and geochemical characterization of groundwater resources in Rush Valley, Tooele County, Utah

USGS Publications Warehouse

Gardner, Philip M.; Kirby, Stefan

2011-01-01

generally flows from the higher altitude recharge areas toward two distinct valley-bottom discharge areas: one in the vicinity of Rush Lake in northern Rush Valley and the other located west and north of Vernon. Average annual discharge from the Rush Valley groundwater basin is estimated to be about 43,000 acre-feet. Most discharge occurs as evapotranspiration in the valley lowlands, as discharge to springs and streams, and as withdrawal from wells. Subsurface discharge outflow to Tooele and Cedar Valleys makes up only a small fraction of natural discharge.Groundwater samples were collected from 25 sites (24 wells and one spring) for geochemical analysis. Dissolved-solids concentrations in water from these sites ranged from 181 to 1,590 milligrams per liter. Samples from seven wells contained arsenic concentrations that exceed the Environmental Protection Agency Maximum Contaminant Level of 10 micrograms per liter. The highest arsenic levels are found north of Vernon and in southeastern Rush Valley. Stable-isotope ratios of oxygen and deuterium, along with dissolved-gas recharge temperatures, indicate that nearly all modern groundwater is meteoric and derived from the infiltration of high altitude precipitation in the mountains. These data are consistent with recharge estimates made using a Basin Characterization Model of net infiltration that shows nearly all recharge occurring as infiltration of precipitation and snowmelt within the mountains surrounding Rush Valley. Tritium concentrations between 0.4 and 10 tritium units indicate the presence of modern (less than 60 years old) groundwater at 7 of the 25 sample sites. Apparent 3H/3He ages, calculated for six of these sites, range from 3 to 35 years. Adjusted minimum radiocarbon ages of premodern water samples range from about 1,600 to 42,000 years with samples from 11 of 13 sites being more than 11,000 years. These data help to identify areas where modern groundwater is circulating through the hydrologic system on time

Riparian valley oak (Quercus lobata) forest restoration on the middle Sacramento River, California

Treesearch

F. Thomas Griggs; Gregory H. Golet

2002-01-01

In 1989 The Nature Conservancy initiated a riparian horticultural restoration program on the floodplain of the middle Sacramento River, California. At nearly all restoration sites Valley oak (Quercus lobata Nee) comprised a major component of the planting design. Valley oaks are a keystone tree species of lowland floodplain habitats in California...

Doctor Ward's Accidental Terrarium.

ERIC Educational Resources Information Center

Hershey, David R.

1996-01-01

Presents the story of the accidental invention of the Wardian case, or terrarium, by Nathaniel Bagshaw Ward. Advocates the use of this story in teaching precollege biology as an illustration of how a chance event can lead to a major scientific advancement and as an example of the common occurrence of multiple discovery in botany. Contains 34…

Valley-dependent band structure and valley polarization in periodically modulated graphene

NASA Astrophysics Data System (ADS)

Lu, Wei-Tao

2016-08-01

The valley-dependent energy band and transport property of graphene under a periodic magnetic-strained field are studied, where the time-reversal symmetry is broken and the valley degeneracy is lifted. The considered superlattice is composed of two different barriers, providing more degrees of freedom for engineering the electronic structure. The electrons near the K and K' valleys are dominated by different effective superlattices. It is found that the energy bands for both valleys are symmetric with respect to ky=-(AM+ξ AS) /4 under the symmetric superlattices. More finite-energy Dirac points, more prominent collimation behavior, and new crossing points are found for K' valley. The degenerate miniband near the K valley splits into two subminibands and produces a new band gap under the asymmetric superlattices. The velocity for the K' valley is greatly renormalized compared with the K valley, and so we can achieve a finite velocity for the K valley while the velocity for the K' valley is zero. Especially, the miniband and band gap could be manipulated independently, leading to an increase of the conductance. The characteristics of the band structure are reflected in the transmission spectra. The Dirac points and the crossing points appear as pronounced peaks in transmission. A remarkable valley polarization is obtained which is robust to the disorder and can be controlled by the strain, the period, and the voltage.

Correlation between levels of conflict and containment on acute psychiatric wards: the city-128 study.

PubMed

Bowers, Len; Stewart, Duncan; Papadopoulos, Chris; Iennaco, Joanne DeSanto

2013-05-01

OBJECTIVE Attainment of safe, calm inpatient psychiatric wards that are conducive to positive therapeutic care is crucial. On such wards, rates of coerced medication, seclusion, manual restraint and other types of containment are comparatively low, and, usually, rates of conflict-for example, aggression, substance use, and absconding-are also low. Sometimes, however, wards maintain low rates of containment even when conflict rates are high. This study investigated wards with the counterintuitive combination of low containment and high conflict or high containment and low conflict. METHODS The authors conducted a secondary analysis of cross-sectional data collected from 136 acute psychiatric wards across England in 2004-2005. The wards were categorized into four groups on the basis of median splits of containment and conflict rates: high conflict and high containment, high conflict and low containment, low conflict and low containment, and low conflict and high containment. Features significantly associated with these ward types were identified. RESULTS Among the variables significantly associated with the various typologies, some-for example, environmental quality-were changeable, and others-such as social deprivation of the area served-were fixed. High-conflict, low-containment wards had higher rates of male staff and lower-quality environments than other wards. Low-conflict, high-containment wards had higher numbers of beds. High-conflict, high-containment wards utilized more temporary staff as well as more unqualified staff. No overall differences were associated with low-conflict, low-containment wards. CONCLUSIONS Wards can make positive changes to achieve a low-containment, nonpunitive culture, even when rates of patient conflict are high.

Effects of ward rotation on subsequent transition processes of Japanese clinical nurses.

PubMed

Fujino, Mitsuku; Nojima, Yoshiko

2005-03-01

The purpose of this study was to examine the experience of Japanese clinical nurses undertaking a ward rotation in a general hospital, and its effects on subsequent processes relating to: (i) perception of ward rotation; (ii) reactions to the ward transition process; and (iii) outcomes of ward rotation. In-depth interviews were conducted with 21 Japanese clinical nurses who had an average of 8.8 years (SD = 5.50) clinical experience. Findings indicated that participants experienced role overload, role incongruity and/or role underload, role overqualification, or role ambiguity in the new environment. These role stresses created critical emotional distress during the transition process. The high desire for career development facilitated the transition process, while lack of preparation inhibited the transition process. To facilitate smooth transition, well-prepared and structured supports based on reliable interpersonal relationships are necessary. The findings offer significant cues for effective ward rotation programs. The implication for nursing administrators is that appropriate ward rotations enhance confidence and promote effective role development in the new clinical setting.

Personnel dose reduction in 90Y microspheres liver-directed radioembolization: from interventional radiology suite to patient ward

PubMed Central

Wong, K K; Tso, W K; Lee, Victor; Luk, M Y; Tong, C C; Chu, Ferdinand

2017-01-01

Objective: To describe a method to reduce the external radiation exposure emitted from the patient after liver-directed radioembolization using 90Y glass microspheres, to quantitatively estimate the occupational dose of medical personnel providing patient care to the patient radioembolized with the use of the method and to discuss radiation exposure to patients who are adjacent if the patient radioembolized needs hospitalization. Methods: A lead-lined blanket of lead equivalence of 0.5 mm was used to cover the patient abdomen immediately after the 90Y radioembolization procedure, in order to reduce the radiation emitted from the patient. The interventional radiologist used a rod-type puncture site compressor for haemostasis to avoid direct contact with possible residual radioactivity at the puncture site. Dose rates were measured at the interventional radiologist chest and hand positions during puncture site pressing for haemostasis with and without the use of the blanket. The measurement results were applied to estimate the occupational dose of colleagues performing patient care to the patient radioembolized. The exposure to patients adjacent in the ward was estimated if the patient radioembolized was hospitalized. Results: The radiation exposures measured at the radiologist chest and hand positions have been significantly reduced with the lead-lined blanket in place. The radiologist, performing puncture site pressing at the end of radioembolization procedure, would receive an average hand dose of 1.95 μSv and body dose under his own lead apron of 0.30 μSv for an average 90Y microsphere radioactivity of 2.54 GBq. Other medical personnel, nurses and porters, would receive occupational doses corresponding to an hour of background radiation. If the patient radioembolized using 90Y needs hospitalization in a common ward, using the lead-lined blanket to cover the abdomen of the patient and keeping a distance of 2 m from the patient who is adjacent would

Nurses caring for ENT patients in a district general hospital without a dedicated ENT ward score significantly less in a test of knowledge than nurses caring for ENT patients in a dedicated ENT ward in a comparable district general hospital.

PubMed

Foxton, C R; Black, D; Muhlschlegel, J; Jardine, A

2014-12-01

To assess whether there is a difference in ENT knowledge amongst nurses caring for patients on a dedicated ENT ward and nurses caring for ENT patients in a similar hospital without a dedicated ENT ward. A test of theoretical knowledge of ENT nursing care was devised and administered to nurses working on a dedicated ENT ward and then to nurses working on generic non-subspecialist wards regularly caring for ENT patients in a hospital without a dedicated ENT ward. The test scores were then compared. A single specialist ENT/Maxillo-Facial/Opthalmology ward in hospital A and 3 generic surgical wards in hospital B. Both hospitals are comparable district general hospitals in the south west of England. Nursing staff working in hospital A and hospital B on the relevant wards were approached during the working day. 11 nurses on ward 1, 10 nurses on ward 2, 11 nurses on ward 3 and 10 nurses on ward 4 (the dedicated ENT ward). Each individual test score was used to generate an average score per ward and these scores compared to see if there was a significant difference. The average score out of 10 on ward 1 was 6.8 (+/-1.6). The average score on ward two was 4.8 (+/-1.6). The average score on ward three was 5.5 (+/-2.1). The average score on ward 4, which is the dedicated ENT ward, was 9.7 (+/-0.5). The differences in average test score between the dedicated ENT ward and all of the other wards are statistically significant. Nurses working on a dedicated ENT ward have an average higher score in a test of knowledge than nurses working on generic surgical wards. This difference is statistically significant and persists despite banding or training. © 2014 John Wiley & Sons Ltd.

Bottom currents observed in and around a submarine valley on the continental slope of the northern South China Sea

NASA Astrophysics Data System (ADS)

Wu, Lunyu; Xiong, Xuejun; Li, Xiaolong; Shi, Maochong; Guo, Yongqing; Chen, Liang

2016-12-01

Bottom currents at about 1000 m depth in and around a submarine valley on the continental slope of the northern South China Sea were studied by a 14-month long experiment from July 2013 to September 2014. The observations reveal that bottom currents are strongly influenced by the topography, being along valley axis or isobaths. Power density spectrum analysis shows that all the currents have significant peaks at diurnal and semi-diurnal frequencies. Diurnal energy is dominant at the open slope site, which is consistent with many previous studies. However, at the site inside the valley the semi-diurnal energy dominates, although the distance between the two sites of observation is quite small (11 km) compared to a typical horizontal first-mode internal tide wavelength (200 km). We found this phenomenon is caused by the focusing of internal waves of certain frequencies in the valley. The inertial peak is found only at the open slope site in the first deployment but missing at the inside valley site and the rest of the deployments. Monthly averaged residual currents reveal that the near-bottom currents on the slope flow southwestward throughout the year except in August and September, 2013, from which we speculate that this is a result of the interaction between a mesoscale eddy and the canyon/sag topography. Currents inside the valley within about 10 mab basically flow along slope and in the layers above the 10 mab the currents are northwestward, that is, from the deep ocean to the shelf. The monthly mean current vectors manifest an Ekman layer-like vertical structure at both sites, which rotate counter-clockwise looking from above.

Students' Perceptions on an Interprofessional Ward Round Training - A Qualitative Pilot Study.

PubMed

Nikendei, C; Huhn, D; Pittius, G; Trost, Y; Bugaj, T J; Koechel, A; Schultz, J-H

2016-01-01

Ward rounds are an essential activity for interprofessional teams in hospital settings and represent complex tasks requiring not only medical knowledge but also communication skills, clinical technical skills, patient management skills and team-work skills. The present study aimed to analyse final year students', nurses' as well as physiotherapists' views on a simulation-based interprofessional ward round training. In two successive passes a total number of 29 final year students, nursing students and physiotherapy students (16 in the first run, 13 in the second) volunteered to participate in two standardized patient ward round scenarios: (1) patient with myocardial infarction, and (2) patient with poorly controlled diabetes. Views on the interprofessional ward round training were assessed using focus groups. Focus group based feedback contained two main categories (A) ward round training benefits and (B) difficulties. Positive aspects enfolded course preparation, setting of the training, the involvement of the participants during training and the positive learning atmosphere. Difficulties were seen in the flawed atmosphere and realization of ward rounds in the daily clinical setting with respect to inter-professional aspects, and course benefit for the different professional groups. The presented inter-professional ward round training represents a well received and valuable model of interprofessional learning. Further research should assess its effectiveness, processes of interprofessional interplay and transfer into clinical practice.

Changes in biodiversity and ecosystem function downstream from mountaintop removal and valley fill coal mining

EPA Science Inventory

Mountaintop removal and valley fill coal mining has altered the physicochemical landscape of the Central Appalachian region in the U.S. Increased specific conductance and levels of component ions downstream from valley fill sites are toxic to aquatic life and can negatively impa...

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

PubMed

Bonner, Gwen; McLaughlin, Sue

2014-05-01

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

Dispersion of Perfluorocarbon Tracers within the Salt Lake Valley during VTMX 2000

NASA Astrophysics Data System (ADS)

Fast, Jerome D.; Allwine, K. Jerry; Dietz, Russell N.; Clawson, Kirk L.; Torcolini, Joel C.

2006-06-01

Six perfluorocarbon tracer experiments were conducted in Salt Lake City, Utah, during October 2000 as part of the Vertical Transport and Mixing (VTMX) field campaign. Four tracers were released at different sites to obtain information on dispersion during stable conditions within down-valley flow, canyon outflow, and interacting circulations in the downtown area. Some of the extensive tracer data that were collected are presented in the context of the meteorological field campaign measurements. Tracer measurements at building-top sites in the downtown area and along the lower slopes of the Wasatch Front indicated that vertical mixing processes transported material up to at least 180 m above the valley floor, although model simulations suggest that tracers were transported upward to much higher elevations. Tracer data provided evidence of downward mixing of canyon outflow, upward mixing within down-valley flow, horizontal transport above the surface stable layer, and transport within horizontal eddies produced by the interaction of canyon and down-valley flows. Although point meteorological measurements are useful in evaluating the forecasts produced by mesoscale models, the tracer data provide valuable information on how the time-varying three-dimensional mean and turbulent motions over urban and valley spatial scales affect dispersion. Although the mean tracer transport predicted by the modeling system employed in this study was qualitatively similar to the measurements, improvements are needed in the treatment of turbulent vertical mixing.

Benefits of automated surface decontamination of a radioiodine ward.

PubMed

Westcott, Eliza; Broadhurst, Alicia; Crossley, Steven; Lee, Lloyd; Phan, Xuyen; Scharli, Rainer; Xu, Yan

2012-02-01

A floor-washing robot has been acquired to assist physicists with decontamination of radioiodine therapy ward rooms after discharge of the patient at Sir Charles Gairdner Hospital. The effectiveness of the robot in decontaminating the ward has been evaluated. A controlled experiment was performed by deliberately contaminating a polyvinyl chloride flooring offcut with 131I followed by automated decontamination with the robot. The extent of fixed and removable contamination was assessed before and after decontamination by two methods: (1) direct Geiger-Mueller counting and (2) beta-counting wipe tests. Surface contamination was also assessed in situ on the ward by Geiger-Mueller counting and wipe testing. Contamination maps confirmed that contamination was removed rather than spread around by the robot. Wipe testing revealed that the robot was successful in clearing approximately 60-80% of removable contamination. The robotic floor-washing device was considered suitable to provide effective automated decontamination of the radioiodine ward. In addition, the robot affords other benefits: the time spent by the physicists decontaminating the room is greatly reduced offering financial and occupational safety and health benefits. The robot has also found utility in other decontamination applications in the healthcare environment.

Birth "Out-of-Hours": An Evaluation of Obstetric Practice and Outcome According to the Presence of Senior Obstetricians on the Labour Ward.

PubMed

Knight, Hannah E; van der Meulen, Jan H; Gurol-Urganci, Ipek; Smith, Gordon C; Kiran, Amit; Thornton, Steve; Richmond, David; Cameron, Alan; Cromwell, David A

2016-04-01

Concerns have been raised that a lack of senior obstetricians ("consultants") on the labour ward outside normal hours may lead to worse outcomes among babies born during periods of reduced cover. We carried out a multicentre cohort study using data from 19 obstetric units in the United Kingdom between 1 April 2012 and 31 March 2013 to examine whether rates of obstetric intervention and outcome change "out-of-hours," i.e., when consultants are not providing dedicated, on-site labour ward cover. At the 19 hospitals, obstetric rotas ranged from 51 to 106 h of on-site labour ward cover per week. There were 87,501 singleton live births during the year, and 55.8% occurred out-of-hours. Women who delivered out-of-hours had slightly lower rates of intrapartum caesarean section (CS) (12.7% versus 13.4%, adjusted odds ratio [OR] 0.94; 95% confidence interval [CI] 0.90 to 0.98) and instrumental delivery (15.6% versus 17.0%, adj. OR 0.92; 95% CI 0.89 to 0.96) than women who delivered at times of on-site labour ward cover. There was some evidence that the severe perineal tear rate was reduced in out-of-hours vaginal deliveries (3.3% versus 3.6%, adj. OR 0.92; 95% CI 0.85 to 1.00). There was no evidence of a statistically significant difference between out-of-hours and "in-hours" deliveries in the rate of babies with a low Apgar score at 5 min (1.33% versus 1.25%, adjusted OR 1.07; 95% CI 0.95 to 1.21) or low cord pH (0.94% versus 0.82%; adjusted OR 1.12; 95% CI 0.96 to 1.31). Key study limitations include the potential for bias by indication, the reliance upon an organisational measure of consultant presence, and a non-random sample of maternity units. There was no difference in the rate of maternal and neonatal morbidity according to the presence of consultants on the labour ward, with the possible exception of a reduced rate of severe perineal tears in out-of-hours vaginal deliveries. Fewer women had operative deliveries out-of-hours. Taken together, the available evidence

Application of curative therapy in the ward. 1920.

PubMed

Marble, Henry Chase

2009-06-01

This Classic article is a reprint of the original work by Henry Chase Marble, Application of Curative Therapy in the Ward. An accompanying biographical sketch on Henry Chase Marble, MD, is available at DOI 10.1007/s11999-009-0789-7 . The Classic Article is (c)1920 by the Journal of Bone and Joint Surgery, Inc. and is reprinted with permission from Marble HC. Application of curative therapy in the ward. J Bone Joint Surg Am. 1920;2:136-138.

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

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

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

Geology of the Thaumasia region, Mars: Plateau development, valley origins, and magmatic evolution

USGS Publications Warehouse

Dohm, J.M.; Tanaka, K.L.

1999-01-01

We have constructed the complex geologic history of the Thaumasia region of Mars on the basis of detailed geologic mapping and relative-age dating of rock units and structure. The Thaumasia plateau dominates the region and consists of high lava plains partly surrounded by rugged highlands, mostly of Noachian and Hesperian age. Long-lived faulting centered near Syria Planum and at lesser sites produced radiating narrow grabens during the Noachian through Early Amazonian and concentric wrinkle ridges during the Late Noachian and Early Hesperian. Fault activity peaked during the Noachian and waned substantially during Late Hesperian and Amazonian time. Volcanism on the Thaumasia plateau was particularly active in comparison with other martian cratered highlands, resulting in fourteen volcanoes and numerous outcrops of smooth, ridged, and lobate plains materials. A particularly extensive set of overlapping lava-flow units was emplaced sequentially from Thaumasia Planum to Syria Planum, spanning from the Late Noachian to the Late Hesperian; lobate flows succeeded smooth flow at the beginning of the Late Hesperian. Deep crustal intrusion and a thickened, buoyant crust may have caused the uplift of the plateau during the Noachian and Early Hesperian, resulting in outward-verging fold-and-thrust plateau margins. This structural style appears similar to that of the young ranges of the Rocky Mountains in the western U.S. Within the plateau, several sites of volcanotectonic activity and valley erosion may be underlain by large and perhaps long-lived magmatic intrusions. One such site occurs at the headland of Warrego Valles. Here, at least two episodes of valley dissection from the Noachian to Early Hesperian occurred during the formation of two nearby rift systems. The site also is a locus of intersection for regional narrow grabens during the Late Noachian and Early Hesperian. However, at the site, such faults diverge or terminate, which suggests that a resistant body of

Occupational exposure to cytotoxic drugs in two UK oncology wards

PubMed Central

Ziegler, E; Mason, H; Baxter, P

2002-01-01

Aims: To investigate the potential exposure to cytotoxic drugs of staff on two oncology wards in a large district, UK hospital under normal working conditions. Methods: Cytotoxic drug exposure was monitored in urine samples, surface wipes, and on disposable gloves by using a number of commonly used marker drugs, namely cyclophosphamide, ifosfamide, methotrexate, and the platino coordinated drugs. Questionnaire data on their work practices, potential exposure, use of protective personal equipment, and relevant training were collected from nursing, domestic, and clerical staff on two oncology wards. Results: The majority of staff were female with a mean age of 31 years. Roughly half of the staff studied were specifically trained nurses with an average of 3.5 years experience of administering cytotoxic drugs. No cytotoxic drug preparation or reconstitution was carried out on the wards. Disposable gloves, plastic armlets and aprons, but not eye protection, were invariably worn where there was potential exposure to cytotoxics. No cytotoxic drug was detected in any of the staff's urine samples. Isolated disposable latex gloves from nurses administering drugs showed some contamination, as did some surfaces within the wards' sluice rooms, but not in the ward areas where the drugs were stored and checked prior to administration. Conclusions: The risk management strategies in place, including use of personal protective equipment, staff training, and other organisational measures, have ensured that internal exposure is lower than the detection limits for the current biological monitoring methods. Levels of contamination appear significantly lower than earlier, non-UK published studies where different risk management strategies were in place and, in particular, ward staff may have been involved in some degree of cytotoxic drug reconstitution. PMID:12205233

ANALYSIS OF LOTIC MACROINVERTEBRATE ASSEMBLAGES IN CALIFORNIA'S CENTRAL VALLEY

EPA Science Inventory

Using multivariate and cluster analyses, we examined the relaitonships between chemical and physical characteristics and macroinvertebrate assemblages at sites sampled by R-EMAP in California's Central Valley. By contrasting results where community structure was summarized as met...

Nurse Satisfaction and Burnout in Shanghai Neurology Wards.

PubMed

Jiang, Hui; Li, Chen; Gu, Yan; Lu, Haiyan

2016-01-01

To explore satisfaction and burnout of nurses working in neurology wards in Shanghai, China. A descriptive cross-sectional questionnaire survey. Three hundred and eighty-seven nurses from 23 neurology wards in 21 tertiary general hospitals were recruited using cluster sampling. The valid response rate was 94.83%. Nurse satisfaction with the salary/wages, the job and the nurse staffing level were 21.79%, 37.33%, and 40.87%. A high nurse burnout rate was found as: emotional exhaustion (EE) ≥ 27 (89.92%); depersonalization (DP) ≥ 10 (92.64%); and reduced personal accomplishment (PA)≤ 33 (79.29%). Most nurses in the neurology wards were dissatisfied and had high levels of burnout. Experienced, intermediate and senior nurses were at the highest risk for job turnover. Nurse administrators should take effective measures to increase nurse satisfaction and decrease burnout to retain experienced nurses and keep the stability of nursing workforce. © 2014 Association of Rehabilitation Nurses.

Distribution of glacial deposits, soils, and permafrost in Taylor Valley, Antarctica

USGS Publications Warehouse

Bockheim, James G.; Prentice, M.L.; McLeod, M.

2008-01-01

We provide a map of lower and central Taylor Valley, Antarctica, that shows deposits from Taylor Glacier, local alpine glaciers, and grounded ice in the Ross Embayment. From our electronic database, which includes 153 sites from the coast 50 km upvalley to Pearse Valley, we show the distribution of permafrost type and soil subgroups according to Soil Taxonomy. Soils in eastern Taylor Valley are of late Pleistocene age, cryoturbated due to the presence of ground ice or ice-cemented permafrost within 70 cm of the surface, and classified as Glacic and Typic Haploturbels. In central Taylor Valley, soils are dominantly Typic Anhyorthels of mid-Pleistocene age that have dry-frozen permafrost within the upper 70 cm. Salt-enriched soils (Salic Anhyorthels and Petrosalic Anhyorthels) are of limited extent in Taylor Valley and occur primarily on drifts of early Pleistocene and Pliocene age. Soils are less developed in Taylor Valley than in nearby Wright Valley, because of lesser salt input from atmospheric deposition and salt weathering. Ice-cemented permafrost is ubiquitous on Ross Sea, pre-Ross Sea, and Bonney drifts that occur within 28 km of the McMurdo coast. In contrast, dry-frozen permafrost is prevalent on older (???115 ky) surfaces to the west. ?? 2008 Regents of the University of Colorado.

Service audit of a forensic rehabilitation ward.

PubMed

Young, Susan; Gudjonsson, Gisli H; Needham-Bennett, Humphrey; Chick, Kay

2009-10-01

An open forensic rehabilitation ward provides an important link bridging the gap between secure and community provisions. This paper provides an audit of such a service by examining the records of an open forensic rehabilitation ward over a five-year period from 1 June 2000 until 31 May 2005. During the audit period there were 51 admissions, involving 45 different patients, and 50 discharges. The majority of the patients came from secure unit facilities, acute psychiatric wards or home. Thirty-nine patients were discharged either into hostels (66%) or their home (12%). The majority of patients (80%) had on admission a primary diagnosis of either schizophrenia or schizoaffective disorder. Most had an extensive forensic history. The focus of their admission was to assess and treat their mental illness/disorder and offending behaviour and this was successful as the majority of patients were transferred to a community placement after a mean of 15 months. It is essential that there is a well-integrated care pathway for forensic patients, involving constructive liaison with generic services and a well-structured treatment programme which integrates the key principles of the 'recovery model' approach to care.

Geohydrology of the Antelope Valley Area, California and design for a ground-water-quality monitoring network

USGS Publications Warehouse

Duell, L.F.

1987-01-01

A basinwide ideal network and an actual network were designed to identify ambient groundwater quality, trends in groundwater quality, and degree of threat from potential pollution sources in Antelope Valley, California. In general, throughout the valley groundwater quality has remained unchanged, and no specific trends are apparent. The main source of groundwater for the valley is generally suitable for domestic, irrigation, and most industrial uses. Water quality data for selected constituents of some network wells and surface-water sites are presented. The ideal network of 77 sites was selected on the basis of site-specific criteria, geohydrology, and current land use (agricultural, residential, and industrial). These sites were used as a guide in the design of the actual network consisting of 44 existing wells. Wells are currently being monitored and were selected whenever possible because of budgetary constraints. Of the remaining ideal sites, 20 have existing wells not part of a current water quality network, and 13 are locations where no wells exist. The methodology used for the selection of sites, constituents monitored, and frequency of analysis will enable network users to make appropriate future changes to the monitoring network. (USGS)

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

PubMed

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

2015-04-01

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

Incidence of surgical-site infections and the validity of the National Nosocomial Infections Surveillance System risk index in a general surgical ward in Santa Cruz, Bolivia.

PubMed

Soleto, Lorena; Pirard, Marianne; Boelaert, Marleen; Peredo, Remberto; Vargas, Reinerio; Gianella, Alberto; Van der Stuyft, Patrick

2003-01-01

To estimate the frequency of and risk factors for surgical-site infections (SSIs) in Bolivia, and to study the performance of the National Nosocomial Infections Surveillance (NNIS) System risk index in a developing country. A prospective study with patient follow-up until the 30th postoperative day. A general surgical ward of a public hospital in Santa Cruz, Bolivia. Patients admitted to the ward between July 1998 and June 1999 on whom surgical procedures were performed. Follow-up was complete for 91.5% of 376 surgical procedures. The overall SSI rate was 12%. Thirty-four (75.6%) of the 45 SSIs were culture positive. A logistic regression model retained an American Society of Anesthesiologists score of more than 1 (odds ratio [OR], 1.87), a not-clean wound class (OR, 2.28), a procedure duration of more than 1 hour (OR, 1.81), and drain (OR, 1.98) as independent risk factors for SSI. There was no significant association between the NNIS System risk index and SSI rates. However, a "local" risk index constructed with the above cutoff points showed a linear trend with SSI (P < .001) and a relative risk of 3.18 for risk class 3 versus a class of less than 3. SSIs cause considerable morbidity in Santa Cruz. Appropriate nosocomial infection surveillance and control should be introduced. The NNIS System risk index did not discriminate between patients at low and high risk for SSI in this hospital setting, but a risk score based on local cutoff points performed substantially better.

Earthquake Hazard Class Mapping by Parcel in Las Vegas Valley

NASA Astrophysics Data System (ADS)

Pancha, A.; Pullammanappallil, S.; Louie, J. N.; Hellmer, W. K.

2011-12-01

Clark County, Nevada completed the very first effort in the United States to map earthquake hazard class systematically through an entire urban area. The map is used in development and disaster response planning, in addition to its direct use for building code implementation and enforcement. The County contracted with the Nevada System of Higher Education to classify about 500 square miles including urban Las Vegas Valley, and exurban areas considered for future development. The Parcel Map includes over 10,000 surface-wave array measurements accomplished over three years using Optim's SeisOpt° ReMi measurement and processing techniques adapted for large scale data. These array measurements classify individual parcels on the NEHRP hazard scale. Parallel "blind" tests were conducted at 93 randomly selected sites. The rms difference between the Vs30 values yielded by the blind data and analyses and the Parcel Map analyses is 4.92%. Only six of the blind-test sites showed a difference with a magnitude greater than 10%. We describe a "C+" Class for sites with Class B average velocities but soft surface soil. The measured Parcel Map shows a clearly definable C+ to C boundary on the west side of the Valley. The C to D boundary is much more complex. Using the parcel map in computing shaking in the Valley for scenario earthquakes is crucial for obtaining realistic predictions of ground motions.

Community Response to Concentrating Solar Power in the San Luis Valley: October 9, 2008 - March 31, 2010

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

Farhar, B. C.; Hunter, L. M.; Kirkland, T. M.

2010-06-01

This report is about the social acceptance of utility-scale concentrating solar power (CSP) plants in the San Luis Valley, approximately 200 miles southwest of Denver, Colorado. The research focused on social factors that may facilitate and impede the adoption and implementation of CSP. During the winter of 2008-2009, interviews were conducted with a purposive sample of 25 CSP-related stakeholders inside and outside the Valley. Interviews focused on the perceived advantages and disadvantages of siting a hypothetical 100-MW CSP facility in the Valley, the level of community support and opposition to CSP development, and related issues, such as transmission. State policymore » recommendations based on the findings include developing education programs for Valley residents, integrating Valley decision makers into an energy-water-land group, providing training for Valley decision makers, offering workforce training, evaluating models of taxation, and forming landholder energy associations. In addition, the SLV could become a laboratory for new approaches to CSP facility and transmission siting decision-making. The author recommends that outside stakeholders address community concerns and engage Valley residents in CSP decisions. Engaging the residents in CSP and transmission decisions, the author says, should take parallel significance with the investment in solar technology.« less

Fort Valley Experimental Forest-A Century of Research 1908-2008

Treesearch

Susan D. Olberding; Margaret M. Moore

2008-01-01

One hundred years ago, the USFS began its forest research program in a two-room cabin near Flagstaff, Arizona, with one staff person, Gustaf A. Pearson. The site became known as the Fort Valley Experiment Station and was the first in a national network of research sites developed to address uncertainties regarding the rehabilitation and conservation for forest and...

Minimum Input Techniques for Valley Oak Restocking

Treesearch

Elizabeth A. Bernhardt; Tedmund J. Swiecki

1991-01-01

We set up experiments at four locations in northern California to demonstrate minimum input techniques for restocking valley oak, Quercus lobata. Overall emergence of acorns planted in 1989 ranged from 47 to 61 percent. Use of supplemental irrigation had a significant positive effect on seedling growth at two of three sites. Mulch, of organic...

A holistic approach to ward design.

PubMed

Mozaffar, Farhang; Jamaleddin, Seyyed; Khakzand, Mehdi

2009-06-01

Three Iranian academics examine how existing experience in inpatient and other ward design can be harnessed to ensure the creation of comfortable, relaxing and, as far as is possible, individually "tailored" hospital accommodation in the future.

Information Needs Assessment for a Medicine Ward-Focused Rounding Dashboard.

PubMed

Aakre, Christopher A; Chaudhry, Rajeev; Pickering, Brian W; Herasevich, Vitaly

2016-08-01

To identify the routine information needs of inpatient clinicians on the general wards for the development of an electronic dashboard. Survey of internal medicine and subspecialty clinicians from March 2014-July 2014 at Saint Marys Hospital in Rochester, Minnesota. An information needs assessment was generated from all unique data elements extracted from all handoff and rounding tools used by clinicians in our ICUs and general wards. An electronic survey was distributed to 104 inpatient medical providers. 89 unique data elements were identified from currently utilized handoff and rounding instruments. All data elements were present in our multipurpose ICU-based dashboard. 42 of 104 (40 %) surveys were returned. Data elements important (50/89, 56 %) and unimportant (24/89, 27 %) for routine use were identified. No significant differences in data element ranking were observed between supervisory and nonsupervisory roles. The routine information needs of general ward clinicians are a subset of data elements used routinely by ICU clinicians. Our findings suggest an electronic dashboard could be adapted from the critical care setting to the general wards with minimal modification.

An outbreak of Burkholderia stabilis colonization in a nasal ward.

PubMed

Wang, Lijun; Wang, Mei; Zhang, Junyi; Wu, Wei; Lu, Yuan; Fan, Yanyan

2015-04-01

The aim of this study was to describe an outbreak of Burkholderia stabilis colonization among patients in a nasal ward. Multilocus sequence typing (MLST) was used for the molecular typing of B. stabilis isolates. Microbiological records were reviewed to delineate the colonization outbreak period. One hundred seventy-one cultures of environment and equipment samples from the nasal ward were performed to trace the source of contamination. Infection control measures were taken in order to end the outbreak. All B. stabilis isolates were identified as a new MLST type, ST821. A total of 53 patients carried this B. stabilis in the nasal ward between March and September 2013, which was defined as the outbreak period. The source of the colonization was not determined because all environment cultures were negative for Burkholderia cepacia complex. No further B. stabilis carriers have been found in the ward since the implementation of interventions. Attention must be paid to asymptomatic colonization in order to identify outbreaks early. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Birth “Out-of-Hours”: An Evaluation of Obstetric Practice and Outcome According to the Presence of Senior Obstetricians on the Labour Ward

PubMed Central

Knight, Hannah E.; van der Meulen, Jan H.; Gurol-Urganci, Ipek; Smith, Gordon C.; Kiran, Amit; Thornton, Steve; Cameron, Alan; Cromwell, David A.

2016-01-01

Background Concerns have been raised that a lack of senior obstetricians (“consultants”) on the labour ward outside normal hours may lead to worse outcomes among babies born during periods of reduced cover. Methods and Findings We carried out a multicentre cohort study using data from 19 obstetric units in the United Kingdom between 1 April 2012 and 31 March 2013 to examine whether rates of obstetric intervention and outcome change “out-of-hours,” i.e., when consultants are not providing dedicated, on-site labour ward cover. At the 19 hospitals, obstetric rotas ranged from 51 to 106 h of on-site labour ward cover per week. There were 87,501 singleton live births during the year, and 55.8% occurred out-of-hours. Women who delivered out-of-hours had slightly lower rates of intrapartum caesarean section (CS) (12.7% versus 13.4%, adjusted odds ratio [OR] 0.94; 95% confidence interval [CI] 0.90 to 0.98) and instrumental delivery (15.6% versus 17.0%, adj. OR 0.92; 95% CI 0.89 to 0.96) than women who delivered at times of on-site labour ward cover. There was some evidence that the severe perineal tear rate was reduced in out-of-hours vaginal deliveries (3.3% versus 3.6%, adj. OR 0.92; 95% CI 0.85 to 1.00). There was no evidence of a statistically significant difference between out-of-hours and “in-hours” deliveries in the rate of babies with a low Apgar score at 5 min (1.33% versus 1.25%, adjusted OR 1.07; 95% CI 0.95 to 1.21) or low cord pH (0.94% versus 0.82%; adjusted OR 1.12; 95% CI 0.96 to 1.31). Key study limitations include the potential for bias by indication, the reliance upon an organisational measure of consultant presence, and a non-random sample of maternity units. Conclusions There was no difference in the rate of maternal and neonatal morbidity according to the presence of consultants on the labour ward, with the possible exception of a reduced rate of severe perineal tears in out-of-hours vaginal deliveries. Fewer women had operative deliveries

MX Siting Investigation. Gravity Survey - Southern Snake Valley (Ferguson Desert), Utah.

DTIC Science & Technology

1980-03-28

Topographic Center (DMAHTC), head- quartered in Cheyenne, Wyoming. DMAHTC reduces the data to Simple Bouguer Anomaly (see Section A1.4, Appendix Al.0...Valley, Utah . . . . . ......... . . . . . 3 3 Complete Bouguer Anomaly Contours 4 Interpreted Gravity Profile SE-3,4 5 Interpreted Gravity Profile SE...observations and reduced them to Simple Bouguer Anomalies (SBA) for each station as described in Appendix Al.0. Up to three levels of terrain corrections were

Ward Identity and Scattering Amplitudes for Nonlinear Sigma Models

NASA Astrophysics Data System (ADS)

Low, Ian; Yin, Zhewei

2018-02-01

We present a Ward identity for nonlinear sigma models using generalized nonlinear shift symmetries, without introducing current algebra or coset space. The Ward identity constrains correlation functions of the sigma model such that the Adler's zero is guaranteed for S -matrix elements, and gives rise to a subleading single soft theorem that is valid at the quantum level and to all orders in the Goldstone decay constant. For tree amplitudes, the Ward identity leads to a novel Berends-Giele recursion relation as well as an explicit form of the subleading single soft factor. Furthermore, interactions of the cubic biadjoint scalar theory associated with the single soft limit, which was previously discovered using the Cachazo-He-Yuan representation of tree amplitudes, can be seen to emerge from matrix elements of conserved currents corresponding to the generalized shift symmetry.

Creating Readers: Vonda Ward--Broward County Library, Fort Lauderdale, FL

ERIC Educational Resources Information Center

Library Journal, 2004

2004-01-01

This article details the work of Vonda Ward--a middle-school teacher turned librarian. When Vonda Ward was a middle-school teacher, she could not get her students to share her excitement about history because they could not read its stories. That is when she realized how much subject mastery depended on the basics. Broward County Library's leaders…

Understanding Particulate Matter Dynamics in the San Joaquin Valley during DISCOVER-AQ, 2013

NASA Astrophysics Data System (ADS)

Prabhakar, G.; Zhang, X.; Kim, H.; Parworth, C.; Pusede, S. E.; Wooldridge, P. J.; Cohen, R. C.; Zhang, Q.; Cappa, C. D.

2015-12-01

Air quality in the California San Joaquin Valley (SJV) during winter continues to be the worst in the state, failing EPA's 24-hour standard for particulate matter. Despite our improved understanding of the sources of particulate matter (PM) in the valley, air-quality models are unable to predict PM concentrations accurately. We aim to characterize periods of high particulate matter concentrations in the San Joaquin Valley based on ground and airborne measurements of aerosols and gaseous pollutants, during the DISCOVER-AQ campaign, 2013. A highly instrumented aircraft flew across the SJV making three transects in a repeatable pattern, with vertical spirals over select locations. The aircraft measurements were complemented by ground measurements at these locations, with extensive chemically-speciated measurements at a ground "supersite" at Fresno. Hence, the campaign provided a comprehensive three-dimensional view of the particulate and gaseous pollutants around the valley. The vertical profiles over the different sites indicate significant variability in the concentrations and vertical distribution of PM around the valley, which are most likely driven by differences in the combined effects of emissions, chemistry and boundary layer dynamics at each site. The observations suggest that nighttime PM is dominated by surface emissions of PM from residential fuel combustion, while early morning PM is strongly influenced by mixing of low-level, above-surface, nitrate-rich layers formed from dark chemistry overnight to the surface.

Iranian nurses' experiences of aggression in psychiatric wards: a qualitative study.

PubMed

Moghadam, Malek Fereidooni; Pazargadi, Mehrnoosh; Khoshknab, Masoud Fallahi

2013-10-01

Aggression from psychiatric patients is a constant problem for care providers that causes major problems in the therapeutic environment, and may have negative effects on the quality of care. Since recognition of aggression with regard to cultural background leads to better control of aggression in the psychiatric wards, this study has been done to clarify Iranian nurses' experiences of aggression in psychiatric wards. A qualitative content analysis study was conducted to explore experiences of nurses. Data analysis revealed four themes: (1) Damage resulting from aggression, (2) Aggression catalysts, (3) Contagious nature of aggression, and (4) Various control strategies. There are various causes for in-patients' aggression, and nurses use various approaches to control it. These approaches are influenced by personnel, facilities, and ward environment. Identifying these factors and strategies can contribute to better management of aggression and, thus, better quality of care in psychiatric wards.

Rock Stripes Pattern in Mars' 'Perseverance Valley'

NASA Image and Video Library

2018-02-15

Textured rows on the ground in this portion of "Perseverance Valley" are under investigation by NASA's Mars Exploration Rover Opportunity, which used its Navigation Camera (Navcam) to take the component images of this downhill-looking scene. The rover took this image on Jan. 4, 2018, during the 4,958th Martian day, or sol, of its work on Mars, looking downhill from a position about one-third of the way down the valley. Perseverance Valley descends the inboard slope of the western rim of Endeavour Crater. A view on the same sol with the rover's front Hazard Avoidance Camera includes ground even closer to the rover at this site. Opportunity was still working close by as it reached the mission's Sol 5,000 (Feb. 16, 2018). In the portion of the valley seen here, soil and gravel have been shaped into a striped pattern in the foreground and partially bury outcrops visible in the midfield. The long dimensions of the stripes are approximately aligned with the downhill direction. The striped pattern resembles a type of feature on Earth (such as on Hawaii's Mauna Kea) that is caused by repeated cycles of freezing and thawing, though other possible origins are also under consideration for the pattern in Perseverance Valley. The view is spans from north on the left to east-southeast on the right. For scale, the foreground rock clump in the lower right is about 11 inches (28 centimeters) in width. https://photojournal.jpl.nasa.gov/catalog/PIA22217

Poverty and violence, frustration and inventiveness: hospital ward life in Bangladesh.

PubMed

Zaman, Shahaduz

2004-11-01

An ethnographic exploration was done in an orthopaedic ward of a government teaching hospital in Bangladesh to understand the nature of hospital culture in the context of Bangladeshi society at large. Life and work in the ward result in a culture that is simultaneously created by its inhabitants and the conditions in which they are situated. The study shows that biomedicine is a product of particular social conditions and that the hospital reflects features of its society. Behind the injuries and broken limbs in the ward are stories of violence, crime, and intolerance occurring in a society where masses of people fight over limited resources. In the ward people interact in an extremely hierarchical manner. The patients, who are mainly from poor economic backgrounds, remain at the bottom of the hierarchy. Doctors and other staff members are often professionally frustrated. Strikes related to hospital staff's various professional demands hamper the regular flow of work in the ward. Family members are engaged in nursing and provide various kinds of support to their hospitalized relatives. Patients give small bribes to ward boys and cleaners to obtain their day-to-day necessities. Patients joke with each other and mock senior doctors. Thus, they neutralize their powerlessness and drive away the monotony of their stay. Doctors develop 'indigenous' solutions to orthopaedic problems. Instead of using high-tech devices, they employ instruments made of bamboo, bricks, and razor blades. This study shows how medical practice takes shape in an understaffed, under-resourced and poorly financed hospital operating in a low-income country.

Circulation in the Hudson Shelf Valley: MESA Physical Oceanographic Studies in New York Bight, 1

NASA Astrophysics Data System (ADS)

Mayer, Dennis A.; Han, Gregory C.; Hansen, Donald V.

1982-11-01

Over 900 days of current velocity data were obtained at mainly two locations in the inner and outer Hudson Shelf Valley (HSV). The large cross-axis depth gradients in the HSV, together with the strong winter cyclones and the baroclinic density distribution over the shelf, are primarily responsible for the major circulation features observed in the valley. CSTD data from 12 cruises and meteorological data from JFK International Airport and an environmental buoy were collected concurrently with the current meter data. Although the mean cross-shelf pressure gradient is generally seaward in the Middle Atlantic Bight, it is shoreward in the HSV below the level of the adjacent continental shelf (shelf horizon), thus imposing a bias toward upvalley flow. The average velocity below the surrounding shelf horizon in the HSV is upvalley or shoreward (west-northwestward ≈ 290° T) in the range of 2-5 cm/s. The circulation in the HSV is seasonal and individual events can drastically alter the mean picture. The several day average upvalley flow can sometimes approach 20 cm/s when intense winter cyclones pass over the bight and can sometimes also be directed downvalley depending upon the path of the winter cyclone. A topographically controlled barotropic flow commonly opposes the dominant (southeast-ward) wind direction even near the surface in the winter. In the context of circulation on the open shelf, upvalley (downvalley) flow events generated by winter cyclones are associated with reduced (enhanced) southwestward flow or flow reversals that are northeastward in the lower half of the water column at LTM, a typical mid/shelf site (Mayer et al., 1979). Current meter data suggest that whether or not reversals occur on the open shelf depends upon the interannual variability of the winter wind regime. Upvalley flow events are not confined only to the winter (unstratified) season but are stronger in the winter and can last for several days and longer. During the summer

Water resources of Parowan Valley, Iron County, Utah

USGS Publications Warehouse

Marston, Thomas M.

2017-08-29

. Groundwater flows from the high-altitude recharge areas downward toward the basin-fill aquifer in Parowan Valley. Almost all groundwater discharge occurs as withdrawals from irrigation wells in the valley with a small amount of discharge from phreatophytic evapotranspiration. Subsurface groundwater discharge to Cedar Valley is likely minimal. Withdrawals from wells during 2013 were about 32,000 acre-ft. The estimated withdrawals from wells from 1994 to 2013 have ranged from 22,000 to 39,000 acre-ft per year. Declining water levels are an indication of the estimated average annual decrease in groundwater storage of 15,000 acre-ft from 1994 to 2013.Groundwater and surface-water samples were collected from 46 sites in Parowan Valley and Cedar Valley near the town of Enoch during June 2013. Groundwater samples from 34 wells were submitted for geochemical analysis. The total dissolved-solids concentration in water from these wells ranged from 142 to 886 milligrams per liter. Results of stable isotope analysis of oxygen and deuterium from groundwater and surface-water samples indicate that most of the groundwater in Parowan Valley and in Cedar Valley near Enoch is similar in isotopic composition to water from mountain streams, which reflects meteoric water recharged in high-altitude areas east of the valley. In addition, results of stable isotope analysis of a subset of samples from wells located near Little Salt Lake may indicate recharge of precipitation that occurred during cooler climatic conditions of the Pleistocene Epoch.

77 FR 33237 - Saline Valley Warm Springs Management Plan/Environmental Impact Statement, Death Valley National...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

... Valley Warm Springs Management Plan/Environmental Impact Statement, Death Valley National Park, Inyo... an Environmental Impact Statement for the Saline Valley Warm Springs Management Plan, Death Valley... analysis process for the Saline Valley Warm Springs Management Plan for Death Valley [[Page 33238...

NNSS Soils Monitoring: Plutonium Valley (CAU366) FY2012

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

Miller, Julianne J.; Mizell, Steve A.; Nikolich, George

2013-01-01

The U.S. Department of Energy (DOE) National Nuclear Security Administration (NNSA), Nevada Site Office (NSO), Environmental Restoration Soils Activity has authorized the Desert Research Institute (DRI) to conduct field assessments of potential sediment transport of contaminated soil from Corrective Action Unit (CAU) 366, Area 11 Plutonium Valley Dispersion Sites Contamination Area (CA) during precipitation runoff events. Field measurements at the T-4 Atmospheric Test Site (CAU 370) suggest that radionuclide-contaminated soils may have migrated along a shallow ephemeral drainage that traverses the site (NNSA/NSO, 2009). (It is not entirely clear how contaminated soils got into their present location at the T-4more » Site, but flow to the channel has been redirected and the contamination does not appear to be migrating at present.) Aerial surveys in selected portions of the Nevada National Security Site (NNSS) also suggest that radionuclide-contaminated soils may be migrating along ephemeral channels in Areas 3, 8, 11, 18, and 25 (Colton, 1999). In Area 11, several low-level airborne surveys of the Plutonium Valley Dispersion Sites (CAU 366) show plumes of Americium 241 (Am-241) extending along ephemeral channels (Figure 1, marker numbers 5 and 6) below Corrective Action Site (CAS) 11-23-03 (marker number 3) and CAS 11 23-04 (marker number 4) (Colton, 1999). Plutonium Valley in Area 11 of the NNSS was selected for the study because of the aerial survey evidence suggesting downstream transport of radionuclide-contaminated soil. The aerial survey (Figure 1) shows a well defined finger of elevated radioactivity (marker number 5) extending to the southwest from the southernmost detonation site (marker number 4). This finger of contamination overlies a drainage channel mapped on the topographic base map used for presentation of the survey data suggesting surface runoff as a likely cause of the contaminated area. Additionally, instrumenting sites strongly suspected of

Hydrogeological Interpretation of Candidate Origin Sites for Martian Meteorite ALH84001

NASA Technical Reports Server (NTRS)

Gulick, Virginia C.; McKay, Chris; Cuzzi, Jeffrey N. (Technical Monitor)

1996-01-01

Barlow (this meeting) has identified two potential source craters for the martian meteorite ALH84001. The craters are at 11.7 deg S, 243.3 deg W (Mare Tyrrhenum site) and 14.0 deg S, 343.5 deg W (Sinus Sabaeus site). As noted by Barlow, both craters lie in the heavily cratered terrain (HCT) and are adjacent to fluvial valleys, Here I explore the fluvial history of these areas based upon the surrounding valley morphology. The most prominent valley network at the Sabaeus site is Evros Vallis. This wide, flat-floored valley is approximately 600 km long with an average width of 2.5 km and a depth of 220 m. The eroded volume of the entire Evros network is approximately 6 x 10(exp 11) cc. This is typical for networks located in the heavily cratered terrain (e.g. Warrego and Parana Valles). Evros is also an isolated valley system. No similar networks are found in the surrounding terrain. Thus it is unlikely that Evros formed as a result of widespread rainfall. A localized water source, such as discharge of a hydrothermal system or localized melting of snowfall, seems more consistent Previous modeling has demonstrated that only hydrothermal systems associated with high permeability subsurfaces can discharge sufficient water to form a valley network. The bulk of the discharge from such systems is consequently low temperature, slightly heated water Precipitation of calcium carbonate by low temperature fluids is consistent with most interpretations of the geochemistry of ALH84001. Available imagery at the Tyrrhenum site is of lesser quality. While eroded units of the HCT are nearby, there are no comparable well developed valley networks at this site. Erosion is instead manifested predominantly as gullies on slopes. This style of erosion suggests that water was not present at this site for the length of time as at the more integrated Sabaeus site. The superposition of fluidized ejecta blankets suggests however that ground water or ground ice was still present at this locality

Application of airborne remote sensing to the ancient Pompeii site

NASA Astrophysics Data System (ADS)

Vitiello, Fausto; Giordano, Antonio; Borfecchia, Flavio; Martini, Sandro; De Cecco, Luigi

1996-12-01

The ancient Pompeii site is in the Sarno Valley, an area of about 400 km2 in the South of Italy near Naples, that was utilized by man since old time (thousands of years ago). Actually the valley is under critical environmental conditions because of the relevant industrial development. ENEA is conducting various studies and research in the valley. ENEA is employing historical research, ground campaigns, cartography and up-to-date airborne multispectral remote sensing technologies to make a geographical information system. Airborne remote sensing technologies are very suitable for situations as that of the Sarno Valley. The paper describes the archaeological application of the research in progress as regarding the ancient site of Pompeii and its fluvial port.

27 CFR 9.57 - Green Valley of Russian River Valley.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Green Valley of Russian River Valley. 9.57 Section 9.57 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL AMERICAN VITICULTURAL AREAS Approved American Viticultural Areas § 9.57 Green Valley of Russian River...

27 CFR 9.57 - Green Valley of Russian River Valley.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Green Valley of Russian River Valley. 9.57 Section 9.57 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS AMERICAN VITICULTURAL AREAS Approved American Viticultural Areas § 9.57 Green Valley of Russian River...

27 CFR 9.57 - Green Valley of Russian River Valley.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Green Valley of Russian River Valley. 9.57 Section 9.57 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS AMERICAN VITICULTURAL AREAS Approved American Viticultural Areas § 9.57 Green Valley of Russian River...

27 CFR 9.57 - Green Valley of Russian River Valley.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Green Valley of Russian River Valley. 9.57 Section 9.57 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS AMERICAN VITICULTURAL AREAS Approved American Viticultural Areas § 9.57 Green Valley of Russian River...

27 CFR 9.57 - Green Valley of Russian River Valley.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Green Valley of Russian River Valley. 9.57 Section 9.57 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL AMERICAN VITICULTURAL AREAS Approved American Viticultural Areas § 9.57 Green Valley of Russian River...

Selenium bioaccumulation in fish exposed to coal ash at the Tennessee Valley Authority Kingston spill site.

PubMed

Mathews, Teresa J; Fortner, Allison M; Jett, R Trent; Morris, Jesse; Gable, Jennifer; Peterson, Mark J; Carriker, Neil

2014-10-01

In December 2008, 4.1 million cubic meters of coal ash were released into the Emory and Clinch Rivers by the Tennessee Valley Authority Kingston Fossil Plant. Coal ash contains several contaminants, including the bioaccumulative metalloid selenium (Se). Because Se is predominantly accumulated in aquatic organisms through dietary rather than aqueous exposure, tissue-based toxicity thresholds for Se are currently being considered. The proposed threshold concentrations range between 4 μg/g and 9 μg/g Se (dry wt.) in whole body fish, with a proposed fillet threshold of 11.8 μg/g. In the present study, the authors examined the spatial and temporal trends in Se bioaccumulation and examined the relationship between the Se content in fillets and in whole bodies of fish collected around the Kingston spill site to determine whether Se bioaccumulation was a significant concern at the ash spill site. Whereas Se concentrations in fish (whole bodies and fillets) were elevated at sampling locations affected by the Kingston ash spill relative to reference locations, concentrations do not appear to be above risk thresholds and have not been increasing over the 5-yr period since the spill. These findings are not only relevant to guiding the human health and ecological risk assessments at the Kingston ash spill site, but because of current national discussions on appropriate guidelines for Se in fish as well for the disposal of coal combustion wastes, the results are also relevant to the general understanding of Se bioaccumulation in contaminated water bodies. © 2014 SETAC.

The impact on the workload of the Ward Manager with the introduction of administrative assistants.

PubMed

Locke, Rachel; Leach, Camilla; Kitsell, Fleur; Griffith, Jacki

2011-03-01

To evaluate the impact on the workload of the Ward Manager (WM) with the introduction of administrative assistants into eight trusts in the South of England in a year-long pilot. Ward Managers are nurse leaders who are responsible for ward management and delivering expert clinical care to patients. They have traditionally been expected to achieve this role without administrative assistance. Meeting the workload demands of multiple roles and overload has meant the leadership and clinical role has suffered, presenting issues of low morale among existing WMs and issues of recruiting the next generation of WMs. Sixty qualitative interviews were carried out with 16 WMs, 12 Ward Manager Assistants (WMAs), and six senior nurse executives about the impact of the introduction of the WMA post. Quantitative data to measure change in WM workload and ward activity was supplied by 24 wards. Ward Managers reported spending reduced time on administrative tasks and having increased time available to spend on the ward with patients and leading staff. With the introduction of WMAs, there was also improvement in key performance measures (the maintenance of quality under service pressures) and increased staff motivation. There was overwhelming support for the introduction of administrative assistants from participating WMs. The WMAs enabled WMs to spend more time with patients and, more widely, to provide greater support to ward teams. The success of the pilot is reflected in wards working hard to be able to extend contracts of WMAs. The extent of the success is reflected in wards that were not participants in the pilot, observing the benefits of the post, having worked to secure funding to recruit their own WMAs. The widespread introduction of administrative assistance could increase ward productivity and provide support for clinical leaders. Continuing professional development for WMs needs to incorporate training about management responsibilities and how to best use administrative

The locked psychiatric ward: hotel or detention camp for people with dual diagnosis.

PubMed

Terkelsen, Toril Borch; Larsen, Inger Beate

2013-10-01

The concepts of autonomy and liberty are established goals in mental health care; however, involuntary commitment is used towards people with mental health and substance abuse problems (dual diagnosis). To explore how patients and staff act in the context of involuntary commitment, how interactions are described and how they might be interpreted. Ethnographic methodology in a locked psychiatric ward in Norway. Two parallel images emerged: (a) The ward as a hotel. Several patients wanted a locked ward for rest and safety, even when admission was classified as involuntary. The staff was concerned about using the ward for real treatment of motivated people, rather than merely as a comfortable hotel for the unmotivated. (b) The ward as a detention camp. Other patients found involuntary commitment and restrictions in the ward as a kind of punishment, offending them as individuals. Contrary, the staff understood people with dual diagnoses more like a generalized group in need of their control and care. Patients and staff have different perceptions of involuntary commitment. Based on the patients' points of view, mental health care ought to be characterized by inclusion and recognition, treating patients as equal citizens comparable to guests in a hotel.

A systems analysis of ward rounds in plastic surgery at a single center

PubMed Central

2017-01-01

Introduction: Ward rounds permeate health care delivery worldwide and form an important daily activity within all hospitals. In this study, the daily morning ward round in plastic surgery was examined from a teleological and systems point of view. Methods: Data were gathered from the following sources to inform the systems analysis: patient interviews, staff interviews, direct observations of the ward round on multiple occasions, and through process mapping. Results: To better understand the ward and its layout, a schematic of it was developed. Following observations of the ward round and the way in which decisions are made on it, an IDEF0 map was developed. Three patients were invited to take part in the study. Three members of staff were interviewed. The overarching themes from the interviews related to aspects of communication which this paper details. Conclusions: This small-scale study demonstrates how the ward round as a process can be assessed, including product quality, process quality, the measurement and management of capacity, the role of standardization, the role and significance of bottlenecks, the key information flows, including the role of feedback, and the motivation and incentives of system participants and ideas for improvement generated. PMID:29177228

A Summary interpretation of geologic, hydrologic, and geophysical data for Yucca Valley, Nevada test site, Nye County, Nevada

USGS Publications Warehouse

Wilmarth, Verl Richard; Healey, D.L.; Clebsch, Alfred; Winograd, I.J.; Zietz, Isadore; Oliver, H.W.

1959-01-01

This report summarizes an interpretation of the geology of Yucca Valley to depths of about 2,300 feet below the surface, the characteristics features of ground water in Yucca and Frenchman Valleys, and the seismic, gravity, and magnetic data for these valleys. Compilation of data, preparation of illustrations, and writing of the report were completed during the period December 26, 1958 to January 10, 1959. Some of the general conclusions must be considered as tentative until more data are available. This work was done by the U.S. Geological Survey on behalf of Albuquerque Operations Office, U.S. Atomic Energy Commission.

Geohydrology of the Unconsolidated Valley-Fill Aquifer in the Meads Creek Valley, Schuyler and Steuben Counties, New York

USGS Publications Warehouse

Miller, Todd S.; Bugliosi, Edward F.; Reddy, James E.

2008-01-01

The Meads Creek valley encompasses 70 square miles of predominantly forested uplands in the upper Susquehanna River drainage basin. The valley, which was listed as a Priority Waterbody by the New York State Department of Environmental Conservation in 2004, is prone to periodic flooding, mostly in its downstream end, where development is occurring most rapidly. Hydraulic characteristics of the unconsolidated valley-fill aquifer were evaluated, and seepage rates in losing and gaining tributaries were calculated or estimated, in an effort to delineate the aquifer geometry and identify the factors that contribute to flooding. Results indicated that (1) Meads Creek gained about 61 cubic feet of flow per second (about 6.0 cubic feet per second per mile of stream channel) from ground-water discharge and inflow from tributaries in its 10.2-mile reach between the northernmost and southernmost measurement sites; (2) major tributaries in the northern part of the valley are not significant sources of recharge to the aquifer; and (3) major tributaries in the central and southern part of the valley provide recharge to the aquifer. The ground-water portion of streamflow in Meads Creek (excluding tributary inflow) was 11.3 cubic feet per second (ft3/s) in the central part of the valley and 17.2 ft3/s in the southern part - a total of 28.5 ft3/s. Ground-water levels were measured in 29 wells finished in unconfined deposits for construction of a potentiometric-surface map to depict directions of ground-water flow within the valley. In general, ground water flows from the edges of the valley toward Meads Creek and ultimately discharges to it. The horizontal hydraulic gradient for the entire 12-mile-long aquifer averages about 30 feet per mile, whereas the gradient in the southern fourth of the valley averages about half that - about 17 feet per mile. A water budget for the aquifer indicated that 28 percent of recharge was derived from precipitation that falls on the aquifer, 32

Great Valley Riparian Habitats and the National Registry of Natural Landmarks

Treesearch

Robert F. Holland; Cynthia L. Roye

1989-01-01

The National Registry of Natural Landmarks is a program established by the National Park Service that seeks to recognize nationally significant examples of the Nation's natural history. Nearly 100 Great Valley riparian sites were evaluated using Park Service criteria. Three sites illustrative of the range of this biotic theme were recommended to the National Park...

Viking landing sites

NASA Technical Reports Server (NTRS)

Panagakos, N.

1973-01-01

A valley near the mouth of the 20,000-foot-deep Martian Grand Canyon has been chosen by NASA as the site of its first automated landing on the planet Mars. The landing site for the second mission of the 1975-76 Viking spacecraft will probably be an area about 1,000 miles northeast of the first site, where the likelihood of water increases the chances of finding evidence of life.

Three-dimensional geological modelling of anthropogenic deposits at small urban sites: a case study from Sheepcote Valley, Brighton, UK.

PubMed

Tame, C; Cundy, A B; Royse, K R; Smith, M; Moles, N R

2013-11-15

Improvements in computing speed and capacity and the increasing collection and digitisation of geological data now allow geoscientists to produce meaningful 3D spatial models of the shallow subsurface in many large urban areas, to predict ground conditions and reduce risk and uncertainty in urban planning. It is not yet clear how useful this 3D modelling approach is at smaller urban scales, where poorly characterised anthropogenic deposits (artificial/made ground and fill) form the dominant subsurface material and where the availability of borehole and other geological data is less comprehensive. This is important as it is these smaller urban sites, with complex site history, which frequently form the focus of urban regeneration and redevelopment schemes. This paper examines the extent to which the 3D modelling approach previously utilised at large urban scales can be extended to smaller less well-characterised urban sites, using a historic landfill site in Sheepcote Valley, Brighton, UK as a case study. Two 3D models were generated and compared using GSI3D™ software, one using borehole data only, one combining borehole data with local geological maps and results from a desk study (involving collation of available site data, including ground contour plans). These models clearly delimit the overall subsurface geology at the site, and allow visualisation and modelling of the anthropogenic deposits present. Shallow geophysical data collected from the site partially validate the 3D modelled data, and can improve GSI3D™ outputs where boundaries of anthropogenic deposits may not be clearly defined by surface, contour or borehole data. Attribution of geotechnical and geochemical properties to the 3D model is problematic without intrusive investigations and sampling. However, combining available borehole data, shallow geophysical methods and site histories may allow attribution of generic fill properties, and consequent reduction of urban development risk and

Light-front Ward-Takahashi identity for two-fermion systems

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

Marinho, J. A. O.; Frederico, T.; Pace, E.

We propose a three-dimensional electromagnetic current operator within light-front dynamics that satisfies a light-front Ward-Takahashi identity for two-fermion systems. The light-front current operator is obtained by a quasipotential reduction of the four-dimensional current operator and acts on the light-front valence component of bound or scattering states. A relation between the light-front valence wave function and the four-dimensional Bethe-Salpeter amplitude both for bound or scattering states is also derived, such that the matrix elements of the four-dimensional current operator can be fully recovered from the corresponding light-front ones. The light-front current operator can be perturbatively calculated through a quasipotential expansion, andmore » the divergence of the proposed current satisfies a Ward-Takahashi identity at any given order of the expansion. In the quasipotential expansion the instantaneous terms of the fermion propagator are accounted for by the effective interaction and two-body currents. We exemplify our theoretical construction in the Yukawa model in the ladder approximation, investigating in detail the current operator at the lowest nontrivial order of the quasipotential expansion of the Bethe-Salpeter equation. The explicit realization of the light-front form of the Ward-Takahashi identity is verified. We also show the relevance of instantaneous terms and of the pair contribution to the two-body current and the Ward-Takahashi identity.« less

Morphology of large valleys on Hawaii - Evidence for groundwater sapping and comparisons with Martian valleys

NASA Technical Reports Server (NTRS)

Kochel, R. Craig; Piper, Jonathan F.

1986-01-01

Morphometric data on the runoff and sapping valleys on the slopes of Hawaii and Molokai in Hawaii are analyzed. The analysis reveals a clear distinction between the runoff valleys and sapping valleys. The Hawaiian sapping valleys are characterized by: (1) steep valley walls and flat floors, (2) amphitheater heads, (3) low drainage density, (4) paucity of downstream tributaries, (5) low frequency of up-dip tributaries, and (6) structural and stratigraphic control on valley patterns. The characteristics of the Hawaiian sapping valleys are compared to Martian valleys and experimental systems, and good correlation between the data is detected. Flume experiments were also conducted to study the evolution of sapping valleys in response to variable structure and stratigraphy.

Identifying positively deviant elderly medical wards using routinely collected NHS Safety Thermometer data: an observational study

PubMed Central

Taylor, Natalie; Kellar, Ian; Pye, Victoria; Mohammed, Mohammed A; Lawton, Rebecca

2018-01-01

Objective The positive deviance approach seeks to identify and learn from exceptional performers. Although a framework exists to apply positive deviance within healthcare organisations, there is limited guidance to support its implementation. The approach has also rarely explored exceptional performance on broad outcomes, been implemented at ward level, or applied within the UK. This study develops and critically appraises a pragmatic method for identifying positively deviant wards using a routinely collected, broad measure of patient safety. Design A two-phased observational study was conducted. During phase 1, cross-sectional and temporal analyses of Safety Thermometer data were conducted to identify a discrete group of positively deviant wards that consistently demonstrated exceptional levels of safety. A group of matched comparison wards with above average performances were also identified. During phase 2, multidisciplinary staff and patients on the positively deviant and comparison wards completed surveys to explore whether their perceptions of safety supported the identification of positively deviant wards. Setting 34 elderly medical wards within a northern region of England, UK. Participants Multidisciplinary staff (n=161) and patients (n=188) clustered within nine positively deviant and comparison wards. Results Phase 1: A combination of analyses identified five positively deviant wards that performed best in the region, outperformed their organisation and performed consistently well over 12 months. Five above average matched comparator wards were also identified. Phase 2: Staff and patient perceptions of safety generally supported the identification of positively deviant wards using Safety Thermometer data, although patient perceptions of safety were less concordant with the routinely collected data. Conclusions This study tentatively supports a pragmatic method of using routinely collected data to identify positively deviant elderly medical wards; however

Beaver assisted river valley formation

USGS Publications Warehouse

Westbrook, Cherie J.; Cooper, D.J.; Baker, B.W.

2011-01-01

We examined how beaver dams affect key ecosystem processes, including pattern and process of sediment deposition, the composition and spatial pattern of vegetation, and nutrient loading and processing. We provide new evidence for the formation of heterogeneous beaver meadows on riverine system floodplains and terraces where dynamic flows are capable of breaching in-channel beaver dams. Our data show a 1.7-m high beaver dam triggered overbank flooding that drowned vegetation in areas deeply flooded, deposited nutrient-rich sediment in a spatially heterogeneous pattern on the floodplain and terrace, and scoured soils in other areas. The site quickly de-watered following the dam breach by high stream flows, protecting the deposited sediment from future re-mobilization by overbank floods. Bare sediment either exposed by scouring or deposited by the beaver flood was quickly colonized by a spatially heterogeneous plant community, forming a beaver meadow. Many willow and some aspen seedlings established in the more heavily disturbed areas, suggesting the site may succeed to a willow carr plant community suitable for future beaver re-occupation. We expand existing theory beyond the beaver pond to include terraces within valleys. This more fully explains how beavers can help drive the formation of alluvial valleys and their complex vegetation patterns as was first postulated by Ruedemann and Schoonmaker in 1938. ?? 2010 John Wiley & Sons, Ltd.

Low-Level Waste Forum notes and summary reports for 1994. Volume 9, Number 3, May-June 1994

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

NONE

1994-06-01

This issue includes the following articles: Vermont ratifies Texas compact; Pennsylvania study on rates of decay for classes of low-level radioactive waste; South Carolina legislature adjourns without extending access to Barnwell for out-of-region generators; Southeast Compact Commission authorizes payments for facility development, also votes on petitions, access contracts; storage of low-level radioactive waste at Rancho Seco removed from consideration; plutonium estimates for Ward Valley, California; judgment issued in Ward Valley lawsuits; Central Midwest Commission questions court`s jurisdiction over surcharge rebates litigation; Supreme Court decides commerce clause case involving solid waste; parties voluntarily dismiss Envirocare case; appellate court affirms dismissal ofmore » suit against Central Commission; LLW Forum mixed waste working group meets; US EPA Office of Radiation and Indoor Air rulemakings; EPA issues draft radiation site cleanup regulation; EPA extends mixed waste enforcement moratorium; and NRC denies petition to amend low-level radioactive waste classification regulations.« less

Rolling out Productive Ward foundation modules across a hospital trust.

PubMed

Foster, Sam; Gordon, Pete; McSherry, Wilfred

The Shrewsbury and Telford Hospitals NHS Trust has spent the last 12 months rolling out the Productive Ward foundation modules across the whole organisation. This has resulted in measurable increases in time spent on direct care, and reduced infection rates and ward non-pay (non-staffing) expenditure. This article discusses the initiative and looks at how problems with the hospital supply chain are being addressed.

Report on the Threatened Valley Elderberry Longhorn Beetle and its Elderberry Food Plant at the Lawrence Livermore National Laboratory--Site 300

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

Arnold, Ph.D., R A; Woollett, J

2004-11-16

This report describes the results of an entomological survey in 2002 to determine the presence of the federally-listed, threatened Valley Elderberry Longhorn Beetle or ''VELB'' (Desmocerus culifornicus dimorphus: Coleoptera, Cerambycidae) and its elderberry food plant (Sumbucus mexicana: Caprifoliaceae) on the Lawrence Livermore National Laboratory's (LLNL) Experimental Test Site, known as Site 300. In addition, an area located immediately southeast of Site 300, which is owned and managed by the California Department of Fish and Game (CDFG), but secured by LLNL, was also included in this survey. This report will refer to the survey areas as the LLNL-Site 300 and themore » CDFG site. The 2002 survey included mapping the locations of elderberry plants that were observed using a global positioning system (GPS) to obtain positional coordinates for every elderberry plant at Site 300. In addition, observations of VELB adults and signs of their infestation on elderberry plants were also mapped using GPS technology. LLNL requested information on the VELB and its elderberry food plants to update earlier information that had been collected in 1991 (Arnold 1991) as part of the 1992 EIS/EIR for continued operation of LLNL. No VELB adults were observed as part of this prior survey. The findings of the 2002 survey reported herein will be used by LLNL as it updates the expected 2004 Environmental Impact Statement for ongoing operations at LLNL, including Site 300.« less

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

ERIC Educational Resources Information Center

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

2013-01-01

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

A systematic literature review of Releasing Time to Care: The Productive Ward.

PubMed

Wright, Stella; McSherry, Wilfred

2013-05-01

This systematic review provides an overview of the literature published on Releasing Time to Care: The Productive Ward between 2005 and June 2011. Releasing Time to Care: The Productive Ward programme was developed by the NHS Institute for Innovation and Improvement and launched in England in 2007. The programme comprises thirteen modules that aim to increase time for direct patient care, improve the patient and staff experience and make changes to the ward environment to improve efficiency. A systematic literature review. The terms 'Releasing Time to Care' and 'Productive Ward' were applied to key healthcare databases; CINAHL, Medline, Science Direct, ProQuest, Health Business Elite, British Nursing Index, Embase, Health Management Information Consortium and PsychInfo. All papers were read and subject to a quality assessment. The literature search identified 95 unique sources. A lack of research on The Productive Ward programme meant it was necessary to include non-empirical literature. In total, 18 articles met the inclusion criteria. Seven key themes were identified: the patient and staff experience, direct care time, patient safety, financial impact, embedding and sustainability, executive support and leadership, and common barriers and determinants of success. It also highlighted areas that require further exploration such as long-term sustainability of the programme and consistent data measurement between organisations. The review tentatively reports how The Productive Ward programme has been used to transform nursing practice for the benefit of patients and frontline staff, and how it resulted in cost savings. The literature review identified a potential positive results bias in the current literature whereby favourable outcomes were reported. This paper summarises the types of evidence and current literature on The Productive Ward providing a reference for frontline staff implementing the programme. © 2013 Blackwell Publishing Ltd.

Suicide amongst psychiatric in-patients who abscond from the ward: a national clinical survey.

PubMed

Hunt, Isabelle M; Windfuhr, Kirsten; Swinson, Nicola; Shaw, Jenny; Appleby, Louis; Kapur, Nav

2010-02-03

Suicide prevention by mental health services requires an awareness of the antecedents of suicide amongst high risk groups such as psychiatric in-patients. The goal of this study was to describe the social and clinical characteristics of people who had absconded from an in-patient psychiatric ward prior to suicide, including aspects of the clinical care they received. We carried out a national clinical survey based on a 10-year (1997-2006) sample of people in England and Wales who had died by suicide. Detailed data were collected on those who had been in contact with mental health services in the year before death. There were 1,851 cases of suicide by current psychiatric in-patients, 14% of all patient suicides. 1,292 (70%) occurred off the ward. Four hundred and sixty-nine of these patients died after absconding from the ward, representing 25% of all in-patient suicides and 38% of those that occurred off the ward. Absconding suicides were characterised by being young, unemployed and homeless compared to those who were off the ward with staff agreement. Schizophrenia was the most common diagnosis, and rates of previous violence and substance misuse were high. Absconders were proportionally more likely than in-patients on agreed leave to have been legally detained for treatment, non-compliant with medication, and to have died in the first week of admission. Whilst absconding patients were significantly more likely to have been under a high level of observation, clinicians reported more problems in observation due to either the ward design or other patients on the ward. Measures that may prevent absconding and subsequent suicide amongst in-patients might include tighter control of ward exits, and more intensive observation of patients, particularly in the early days of admission. Improving the ward environment to provide a supportive and less intimidating experience may contribute to reduced risk.

Central Avra Valley Storage and Recovery Project (CAVSARP) Site, Tucson, Arizona: Floodwater and Soil Moisture Investigations with Extraterrestrial Applications

NASA Technical Reports Server (NTRS)

Rucker, D. F.; Dohm, J. M.; Ferre, T. P. A.; Ip, Felipe; Baker, V. R.; Davies, A. G.; Castano, R.; Chien, S.; Doggett, T. C.

2004-01-01

Planetary geologists, geomorphologists, and hydrologists have hypothesized that Mars is a dynamic, water-enriched planet since the Mariner and Viking missions based on geologic, geomorphic, and topographic information. Recent acquisition of Gamma Ray and Neutron Spectrometer information has added further credence to this hypothesis. A unique investigation is underway to work towards being able to successfully map the extent and depth of water on Mars. Researchers from the University of Arizona and members of the Autonomous Sciencecraft Experiment (ASE) have been compiling multiple layers of information in time and space at the Central Avra Valley Storage and Recovery Project (CAVSARP) site, Tucson, Arizona, for eventual comparative analysis. This information has been acquired from a variety of observational/scientific platforms in controlled conditions. CAVSARP facility:

Clinical Features of Adult Patients Admitted to Pediatric Wards in Japan.

PubMed

Michihata, Nobuaki; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

2015-10-01

Pediatricians generally need to treat adult patients who require long-term care for pediatric diseases. However, little is known about the characteristics of adult patients in pediatric wards. Using a national inpatient database, the aim of this study was to determine the clinical details of adult patients admitted to pediatric wards in Japanese acute-care hospitals. We extracted all inpatients aged ≥19 years who were admitted to pediatric departments in Japan from April 2012 to March 2013. We examined the patients' main diagnoses and the use of life-supporting home medical devices. Of 417,352 patients admitted to pediatric wards during the study period, we identified 4,729 (1.1%) adult patients. The major diagnoses of the adult patients were malignancy, congenital heart disease, epilepsy, and cerebral palsy. More than 35% of the patients with cerebral palsy had a tracheostomy tube, gastrostomy tube, home central venous alimentation, or home respirator. More than 20% of patients aged ≥40 years in pediatric wards had adult diseases, including ischemic heart diseases, cerebrovascular diseases, and adult malignancy. Many adult patients in pediatric wards had adult diseases. It is essential to establish a disease-oriented support system for adults with chronic conditions that originated in their childhood. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Reflective practice and daily ward reality: a covert power game.

PubMed

Mantzoukas, Stefanos; Jasper, Melanie A

2004-11-01

The concept of reflection is propounded in the literature as an epistemology for practice that enables practitioners to solve their daily problematic situations through conscious thought processes which eventually leads to practice-based knowledge. Hence, reflection became a central tenet of both theory development and educational provision in nursing. Furthermore, this centrality of reflection was reinforced by statutory nursing bodies and service providers by adopting it as the means for carrying out adequate professional practice. Although this may be the case, issues of implementation of reflection within the daily reality of practitioners are frequently overlooked within the literature. Moreover, little consideration appears to be given on the impact that the organizational culture and the politics of power may exert on the implementation of reflective practices within daily ward reality. This paper explores how reflection is viewed by nurses within their daily reality in the medical wards, examines the relationships between the organizational culture of these wards and the practitioners and investigates whether reflective methods of practice were being implemented when the study was conducted. An interpretative ethnographical methodology was implemented and the data collecting methods used were observation, interviews and qualitative content analysis with a group of 16 practising nurses from four medical wards of one NHS Trust in England. Two interviews were conducted with each nurse within 3-week intervals. The content of these interviews evolved from the analysis of episodes of practice observed when the nurses were giving nursing care. These data were supplemented by narratives from the nurses' in the form of written reflective accounts that were analysed via qualitative content analysis techniques. Four themes were generated: (i) relationships between nurses and doctors; (ii) relationships between nurses and managers; (iii) nursing practice; and (iv

Design in mind: eliciting service user and frontline staff perspectives on psychiatric ward design through participatory methods.

PubMed

Csipke, Emese; Papoulias, Constantina; Vitoratou, Silia; Williams, Paul; Rose, Diana; Wykes, Til

2016-01-01

Psychiatric ward design may make an important contribution to patient outcomes and well-being. However, research is hampered by an inability to assess its effects robustly. This paper reports on a study which deployed innovative methods to capture service user and staff perceptions of ward design. User generated measures of the impact of ward design were developed and tested on four acute adult wards using participatory methodology. Additionally, inpatients took photographs to illustrate their experience of the space in two wards. Data were compared across wards. Satisfactory reliability indices emerged based on both service user and staff responses. Black and minority ethnic (BME) service users and those with a psychosis spectrum diagnosis have more positive views of the ward layout and fixtures. Staff members have more positive views than service users, while priorities of staff and service users differ. Inpatient photographs prioritise hygiene, privacy and control and address symbolic aspects of the ward environment. Participatory and visual methodologies can provide robust tools for an evaluation of the impact of psychiatric ward design on users.

Design in mind: eliciting service user and frontline staff perspectives on psychiatric ward design through participatory methods

PubMed Central

Csipke, Emese; Papoulias, Constantina; Vitoratou, Silia; Williams, Paul; Rose, Diana; Wykes, Til

2016-01-01

Abstract Background: Psychiatric ward design may make an important contribution to patient outcomes and well-being. However, research is hampered by an inability to assess its effects robustly. This paper reports on a study which deployed innovative methods to capture service user and staff perceptions of ward design. Method: User generated measures of the impact of ward design were developed and tested on four acute adult wards using participatory methodology. Additionally, inpatients took photographs to illustrate their experience of the space in two wards. Data were compared across wards. Results: Satisfactory reliability indices emerged based on both service user and staff responses. Black and minority ethnic (BME) service users and those with a psychosis spectrum diagnosis have more positive views of the ward layout and fixtures. Staff members have more positive views than service users, while priorities of staff and service users differ. Inpatient photographs prioritise hygiene, privacy and control and address symbolic aspects of the ward environment. Conclusions: Participatory and visual methodologies can provide robust tools for an evaluation of the impact of psychiatric ward design on users. PMID:26886239

Three years of hillslope sediment yields following the Valley Complex fires, western Montana

Treesearch

Peter R. Robichaud; Joseph W. Wagenbrenner; Robert E. Brown; Kevin M. Spigel

2009-01-01

The 2000 Bitterroot Valley wildfires provided an opportunity to measure post-fire effects and recovery rates. We established 24 small (0.01 ha [0.02 acre]) plots in four high-severity burn sites. We measured sediment yields at each site with silt fences. We also measured rainfall characteristics, soil water repellency, vegetative cover, and other site characteristics....

ASSESSING TRANSBOUNDARY INFLUENCES IN THE LOWER RIO GRANDE VALLEY

EPA Science Inventory

The Lower Rio Grande Valley Transboundary Air Pollution Project (TAPP) was a U.S.-Mexico Border XXI Program project to assess transboundary air pollution in and near Brownsville, Texas. The study used a three-site air monitoring network very close to the border to capture the d...

Job stressors and social support behaviors: comparing intensive care units to wards in Jordan.

PubMed

Mrayyan, Majd T

2009-02-01

Studies about nurses' stressors and social support behaviors are limited. This study explored differences between Intensive Care Units (ICUs) and wards in regard to Jordanian nurses' job stressors and social support behaviors as well as predictors of the two concepts. A quantitative research design using a survey method was used. The Nursing Stress Scale (NSS) (Gray-Toft & Anderson 1981) and the Inventory of Social Supportive Behaviors (ISSB) (Barrera, Sandler & Ramsay 1981) were used to collect data from a convenience sample of 228 nurses who were working in 12 ICUs and 235 nurses who were working in nine wards of 13 hospitals, with a total response rate of 66.2%. Stressors in ICUs were higher than those in wards. The ICUs scored higher than wards in 'conflict with physicians' subscale of NSS. The ICUs scored higher than wards in 'emotional support' and 'tangible assistance' subscales of ISSB. Shift worked, model of nursing care, and level of education predicted nurses' job stressors in ICUs and wards. 'Model of nursing care' was a shared predictor of social support behaviors in ICUs and wards. High job stressors and low social support behaviors were evidenced in Jordan. Job stressors were higher in ICUs than those in wards, thus more social support behaviors should be provided to nurses in ICUs. Nurses' stressors should be assessed and managed. In all settings in general and in ICUs in particular, nurse managers should use various social support behaviors to buffer the influence of job stressors on nurses.

Diversity of micro-fungi in an Antarctic dry valley

NASA Technical Reports Server (NTRS)

Baublis, J. A.; Wharton, R. A. Jr; Volz, P. A.; Wharton RA, J. r. (Principal Investigator)

1991-01-01

The fungal microflora of a dry valley in Southern Victoria Land near McMurdo Sound, Antarctica, was investigated. Samples were collected from introduced objects such as a mummified penguin and spent chewing tobacco in addition to the sparse soil found in rock fissures, isolated moss colonies, shoreline deposit materials, CaCO3 precipitates, and microbial mat debris obtained from the frozen surface of the lake in the basin of Taylor Valley. Using conventional media and techniques, all collection sites yielded populations of yeasts and filamentous fungi. Water samples and live microbial mats from beneath the lake ice yielded species of fungi along with an abundance of bacteria.

Environment in pediatric wards: light, sound, and temperature.

PubMed

Oliveira, Lia; Gomes, Cláudia; Bacelar Nicolau, Leonor; Ferreira, Luís; Ferreira, Rosário

2015-09-01

The mutual relationship between sleep and disease is well known, becoming more relevant whenever the disease leads to hospitalization. We intend to describe patterns of environmental factors of some pediatric wards, and to verify if these are in line with those recommended. As a secondary aim, we characterize sleep quality during hospitalization. Five pediatric wards of a tertiary-level hospital were included. Light, sound, and temperature were measured and assessed through descriptive statistics. The following recommended values were considered: maximum light 100 Lux, maximum sound 45 dB, and optimal temperature 20-24 °C. A questionnaire was prepared to assess children's sleep, and it was completed by a caregiver. Light values were within the desirable limits for 86% of evaluated time. In all wards, the intensity of sound was much higher than desirable, being above 45 dB during 85% of evaluated time. The temperature was above 24 °C during 78% of total time. Based on 34 answered questionnaires (out of 50 distributed), almost half of the respondents believe that sleep quality and restlessness are worse at the hospital. Most children slept for a longer time at home. Eighteen children awoke more times at the hospital, and those awakenings were mostly attributed to noise. The sound and temperature were higher than recommended. The different values between these wards may be due to different levels of care, but this shows that there are no standard rules on this matter. A worse quality and shorter duration of sleep at hospital were reported. Comprehensive studies are necessary to evaluate the impact of environmental factors on disease recovery. Copyright © 2015 Elsevier B.V. All rights reserved.

Improving the ward-based care of patients post-thyroidectomy.

PubMed

Mahalingam, Sridhayan; Singhal, Rachit; Mugilan, Sridhayani; Choudhury, Natasha

2016-11-02

Nursing staff play a crucial role in managing surgical patients in the postoperative period. However, with an increasing risk of subspecialty wards facing closure as a result of financial pressures within the NHS, the knowledge base and expertise of ward-based nursing staff of surgical subspecialties is becoming increasingly limited. Using patients undergoing thyroidectomy as an example, a quality improvement multidisciplinary audit is presented, which shows how simple targeted interventions through a multidisciplinary approach can help maintain high standards of patient care in a secondary care setting.

Learning through participating on an interprofessional training ward.

PubMed

Lidskog, Marie; Löfmark, Anna; Ahlström, Gerd

2009-09-01

Learning in clinical education can be understood as a process of becoming a legitimate participant in the relevant context. Interprofessional training wards (IPTWs) are designed to give students from educational programmes in health and social care a realistic experience of collaboration for the purpose of developing teamwork skills. IPTWs have been found to be appreciated by the students and to influence students' understanding of each other's professions. The aim of this study was to describe and analyse the students' learning on an interprofessional training ward in care for older persons through focusing on the students' ways of participating in the communities of practice on the ward. A case study design was chosen. Multiple data sources were used. The findings show that the students engaged as active participants in the care. At the same time there was sometimes a discrepancy between on the one hand expectations and goals, on the other hand actual participation. There were difficulties in making the training relevant for all the student groups involved. The findings indicate that in the planning of interprofessional education the choice of setting and learning situations is crucial with regard to the learning that will occur.

M’zab Valley, Algeria

NASA Image and Video Library

2017-12-08

NASA image acquired Feb. 9, 2011 Less than 5 percent of Algeria’s land surface is suitable for growing crops, and most precipitation falls on the Atlas Mountains along the coast. Inland, dust-laden winds blow over rocky plains and sand seas. However, in north central Algeria—off the tip of Grand Erg Occidental and about 450 kilometers (280 miles) south of Algiers—lies a serpentine stretch of vegetation. It is the M’zab Valley, filled with palm groves and dotted with centuries-old settlements. The Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) on NASA’s Terra satellite captured this image of M’zab Valley on February 9, 2011. ASTER combines infrared, red, and green wavelengths of light. Bare rock ranges in color from beige to peach. Buildings and paved surfaces appear gray. Vegetation is red, and brighter shades of red indicate more robust vegetation. This oasis results from water that is otherwise in short supply in the Sahara Desert, thanks to the valley’s approximately 3,000 wells. Chemical analysis of Algerian aquifers, as well studies of topography in Algeria and Tunisia, suggest this region experienced a cooler climate in the late Pleistocene, and potentially heavy monsoon rains earlier in the Holocene. The M’zab region shows evidence of meandering rivers and pinnate drainage patterns. The vegetation lining M’zab Valley highlights this old river valley’s contours. Cool summer temperatures and monsoon rains had long since retreated from the region by eleventh century, but this valley nevertheless supported the establishment of multiple fortified settlements, or ksours. Between 1012 A.D. and 1350 A.D., locals established the ksours of El-Atteuf, Bounoura, Melika, Ghardaïa, and Beni-Isguen. Collectively these cities are now a United Nations Educational, Scientific, and Cultural Organization (UNESCO) World Heritage site. NASA Earth Observatory image by Robert Simmon and Jesse Allen, using data from the GSFC

Protective isolation in single-bed rooms: studies in a modified hospital ward

PubMed Central

Ayliffe, G. A. J.; Collins, B. J.; Lowbury, E. J. L.; Wall, Mary

1971-01-01

Studies were made in a modified hospital ward containing 19 beds, 14 of them in the open ward, one in a window-ventilated side-room, two in rooms with partial-recirculation ventilators giving 7-10 air changes per hour, and two in self-contained isolation suites with plenum ventilation (20 air changes per hour), ultra-violet (UV) barriers at doorways and airlocks. Preliminary tests with aerosols of tracer bacteria showed that few bacteria entered the plenum or recirculation-ventilated rooms. Bacteria released inside mechanically ventilated cubicles escaped into the corridor, but this transfer was reduced by the presence of an airlock. UV barriers at the entrance to the airlock and the cubicle reduced the transfer of bacteria from cubicle to corridor. During a period of 4 years while the ward was in use for surgical and gynaecological patients, the incidence of post-operative sepsis and colonization of wounds by multiple-resistant Staphylococcus aureus was lower (though not significantly lower) in the plenum-ventilated rooms than in the open ward, the recirculator-ventilated cubicles and the window-ventilated cubicles. Nasal acquisition of multiple-resistant Staph. aureus was significantly less common in the plenum-ventilated than in the recirculator-ventilated cubicles and in the other areas. Mean counts of bacteria on settle-plates were significantly lower in the plenum-ventilated cubicles than in the other areas; mean settle-plate counts in the recirculator-ventilated cubicles were significantly lower than in the open ward and in the window-ventilated side-room; similar results were shown by slit-sampling of air. Mean settle-plate counts were significantly lower in all areas when the ward was occupied by female patients. Staph. aureus was rarely carried by air from plenum-ventilated or other cubicles to the open ward, or from the open ward to the cubicles; though staphylococci were transferred from one floor area to another, they did not appear to be redispersed

Protocol to describe the analysis of text-based communication in medical records for patients discharged from intensive care to hospital ward.

PubMed

Parsons Leigh, Jeanna; Brown, Kyla; Buchner, Denise; Stelfox, Henry T

2016-07-08

Effective communication during hospital transitions of patient care is fundamental to ensuring patient safety and continuity of quality care. This study will describe text-based communication included in patient medical records before, during and after patient transfer from the intensive care unit (ICU) to a hospital ward (n=10 days) by documenting (1) the structure and focus of physician progress notes within and between medical specialties, (2) the organisation of subjective and objective information, including the location and accessibility of patient data and whether/how this changes during the hospital stay and (3) missing, illegible and erroneous information. This study is part of a larger mixed methods prospective observational study of ICU to hospital ward transfer practices in 10 ICUs across Canada. Medical records will be collected and photocopied for each consenting patient for a period of up to 10 consecutive days, including the final 2 days in the ICU, the day of transfer and the first 7 days on the ward (n=10 days). Textual analysis of medical record data will be completed by 2 independent reviewers to describe communication between stakeholders involved in ICU transfer. Research ethics board approval has been obtained at all study sites, including the coordinating study centre (which covers 4 Calgary-based sites; UofC REB 13-0021) and 6 additional study sites (UofA Pro00050646; UBC PHC Hi4-01667; Sunnybrook 336-2014; QCH 20140345-01H; Sherbrooke 14-172; Laval 2015-2171). Findings from this study will inform the development of an evidence-based tool that will be used to systematically analyse the series of notes in a patient's medical record. 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/

Identifying positively deviant elderly medical wards using routinely collected NHS Safety Thermometer data: an observational study.

PubMed

Baxter, Ruth; Taylor, Natalie; Kellar, Ian; Pye, Victoria; Mohammed, Mohammed A; Lawton, Rebecca

2018-02-16

The positive deviance approach seeks to identify and learn from exceptional performers. Although a framework exists to apply positive deviance within healthcare organisations, there is limited guidance to support its implementation. The approach has also rarely explored exceptional performance on broad outcomes, been implemented at ward level, or applied within the UK. This study develops and critically appraises a pragmatic method for identifying positively deviant wards using a routinely collected, broad measure of patient safety. A two-phased observational study was conducted. During phase 1, cross-sectional and temporal analyses of Safety Thermometer data were conducted to identify a discrete group of positively deviant wards that consistently demonstrated exceptional levels of safety. A group of matched comparison wards with above average performances were also identified. During phase 2, multidisciplinary staff and patients on the positively deviant and comparison wards completed surveys to explore whether their perceptions of safety supported the identification of positively deviant wards. 34 elderly medical wards within a northern region of England, UK. Multidisciplinary staff (n=161) and patients (n=188) clustered within nine positively deviant and comparison wards. Phase 1: A combination of analyses identified five positively deviant wards that performed best in the region, outperformed their organisation and performed consistently well over 12 months. Five above average matched comparator wards were also identified. Phase 2: Staff and patient perceptions of safety generally supported the identification of positively deviant wards using Safety Thermometer data, although patient perceptions of safety were less concordant with the routinely collected data. This study tentatively supports a pragmatic method of using routinely collected data to identify positively deviant elderly medical wards; however, it also highlights the various challenges that are faced

'Safety by DEFAULT': introduction and impact of a paediatric ward round checklist.

PubMed

Sharma, Sanjiv; Peters, Mark J

2013-10-11

Poor communication is a source of risk. This can be particularly significant in areas of high clinical acuity such as intensive care. Ward rounds are points where large amounts of information must be communicated in a time-limited environment with many competing interests. This has the potential to reduce effective communication and risk patient safety. Checklists have been used in many industries to improve communication and mitigate risk. We describe the introduction of a ward round safety checklist 'DEFAULT' on a paediatric intensive care unit. A non-blinded, pre- and post-intervention observational study was undertaken in a 12-bedded Level 3 tertiary PICU between July 2009 and December 2011. Ward round stakeholders subjectively liked the checklist and felt it improved communication. Introduction of the ward round checklist was associated with an increase in median days between accidental extubations from 14 (range 2 to 86) to 150 (56 to 365) (Mann-Whitney P <0.0001). The ward round checklist was also associated with an increase in the proportion of invasively ventilated patients with target tidal volumes of <8 ml/kg, which increased from 35 of 71 patients at 08.00 representing a proportion of 0.49 (95% CI 0.38 to 0.60) to 23 of 38 (0.61, 0.45 to 0.74). This represented a trend towards an increased proportion of cases in the target range (z = 1.68, P = 0.09). The introduction of a ward round safety checklist was associated with improved communication and patient safety.

"Ward v. Wilbanks": Counselor Educators Respond

ERIC Educational Resources Information Center

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

2014-01-01

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

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

PubMed Central

Nijman, Henk; Simpson, Alan; Jones, Julia

2010-01-01

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

Comparison of student learning in the out-patient clinic and ward round.

PubMed

Davis, M H; Dent, J A

1994-05-01

In undergraduate medical education there is a trend away from ward-based teaching towards out-patient and community-based teaching. To study the potential effects of this altered emphasis on student learning, a pilot group of final-year medical students at the University of Dundee was asked to keep individual structured log-books. These contained details of patients seen during their 3-week orthopaedic attachment in both a ward and out-patient setting. A comparison of perceived learning in the two settings showed that students learned more from attending an out-patient clinic than a ward round, but did not make full use of the learning potential of either. The setting did not particularly influence the balance of learning as categorized here but only the ward round supplied experience of surgical complications. The amount of learning taking place in an out-patient clinic was influenced by student ability, measured by examination performance, but not by clinic work-load. The implications of increased use of out-patient clinics and the advantages and disadvantages of the approach employed are discussed. It is concluded that in the situation studied student learning in the outpatient setting is as good as or superior to the ward setting but should not totally replace it.

The health-care environment on a locked psychiatric ward: an ethnographic study.

PubMed

Johansson, Inger M; Skärsäter, Ingela; Danielson, Ella

2006-12-01

Recent changes in psychiatric hospital care involving a reduction in the number of beds and time spent in hospital motivated the study of conditions of inpatient care on such wards. An ethnographic study of a locked, acute psychiatric ward in a department of psychiatry was performed with the aim of describing the health-care environment in such a ward. The ward admitted patients on both a voluntarily and involuntarily basis. Data were collected by means of 3.5 months of participant observations. The results showed a health-care environment that was overshadowed by control. Staff were in control but they also lacked control; they attempted to master the situation in line with organizational demands and they sometimes failed. At the same time, the staff tried to share the responsibility of caring for patients and next of kin. Patients were controlled by staff; they were the underdogs and dependent on staff for their care and the freedom to leave the ward. Patients tried to make themselves heard and reacted to the control by developing counter-strategies. What this study adds to earlier research is patients' pressure on staff and sometimes quite an open struggle for more control, which may be an expression for an unacceptable imbalance in power between patients and staff.

Valley Fever (Coccidioidomycosis) Statistics

MedlinePlus

... Valley fever may be under-recognized. 2 , 3 Public health surveillance for Valley fever Valley fever is reportable ... MMWR) . Check with your local, state, or territorial public health department for more information about disease reporting requirements ...

Resident consultant obstetrician presence on the labour ward versus other models of consultant cover: a systematic review of intrapartum outcomes.

PubMed

Henderson, J; Kurinczuk, J J; Knight, M

2017-08-01

Several key policy documents have advocated 24-hour consultant obstetrician presence on the labour ward as a means of improving the safety of birth. However, it is unclear what published evidence exists comparing the outcomes of intrapartum care with 24-hour consultant labour ward presence and other models of consultant cover. To collate and critically appraise evidence of the effect of continuous resident consultant obstetrician cover on the labour ward on outcomes of intrapartum care compared with other models of consultant cover. Studies were included which quantitatively compared intrapartum outcomes for women and babies where continuous resident consultant obstetric cover was provided with other models of consultant cover. Quantitative studies within healthcare systems with mixed obstetric-midwifery models of care. Two researchers independently screened titles and full-text publications, extracted data and assessed the quality of included studies. Meta-analysis was performed using REVIEW MANAGER 5.3. About 1508 publications were screened resulting in two papers, three conference abstracts and one letter being included. All were single-site time-period comparison studies. The quality of studies overall was poor with significant risk of bias. The only significant finding in meta-analysis related to instrumental deliveries, which occurred more frequently when there was on-call consultant cover (unadjusted risk ratio 1.14; 95% CI 1.04-1.24). No reliable evidence of the effects of 24-hour resident consultant presence on the labour ward on intrapartum outcomes was identified. More robust research is needed to assess intrapartum outcomes with resident consultant labour ward presence. © 2017 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

Cross-year peer tutoring on internal medicine wards: results of a qualitative focus group analysis.

PubMed

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

2014-01-01

Peer-assisted learning (PAL) has become a well-accepted teaching method within medical education. However, descriptions of on-ward PAL programs are rare. A focus group analysis of a newly established PAL program on an internal medicine ward was conducted to provide insights into PAL teaching from a student perspective. To provide insights into students' experiences regarding their on-ward training with and without accompanying PAL tutors. A total of N=168 medical students in their sixth semester participated in the investigation (intervention group: N=88; control group: N=80). The intervention group took part in the PAL program, while the control group received standard on-ward training. There were seven focus groups with N=43 participants (intervention group: four focus groups, N=28 participants; control group: three focus groups, N=15 participants). The discussions were analyzed using content analysis. The intervention group emphasized the role of the tutors as competent and well-trained teachers, most beneficial in supervising clinical skills. Tutors motivate students, help them to integrate into the ward team, and provide a non-fear-based working relationship whereby students' anxiety regarding working on ward decreases. The control group had to rely on autodidactic learning strategies when neither supervising physicians nor final-year students were available. On-ward PAL programs represent a particularly valuable tool for students' support in training clinical competencies on ward. The tutor-student working alliance acts through its flat hierarchy. Nevertheless, tutors cannot represent an adequate substitute for experienced physicians.

Valley polarization in bismuth

NASA Astrophysics Data System (ADS)

Fauque, Benoit

2013-03-01

The electronic structure of certain crystal lattices can contain multiple degenerate valleys for their charge carriers to occupy. The principal challenge in the development of valleytronics is to lift the valley degeneracy of charge carriers in a controlled way. In bulk semi-metallic bismuth, the Fermi surface includes three cigar-shaped electron valleys lying almost perpendicular to the high symmetry axis known as the trigonal axis. The in-plane mass anisotropy of each valley exceeds 200 as a consequence of Dirac dispersion, which drastically reduces the effective mass along two out of the three orientations. According to our recent study of angle-dependent magnetoresistance in bismuth, a flow of Dirac electrons along the trigonal axis is extremely sensitive to the orientation of in-plane magnetic field. Thus, a rotatable magnetic field can be used as a valley valve to tune the contribution of each valley to the total conductivity. As a consequence of a unique combination of high mobility and extreme mass anisotropy in bismuth, the effect is visible even at room temperature in a magnetic field of 1 T. Thus, a modest magnetic field can be used as a valley valve in bismuth. The results of our recent investigation of angle-dependent magnetoresistance in other semi-metals and doped semiconductors suggest that a rotating magnetic field can behave as a valley valve in a multi-valley system with sizeable mass anisotropy.

Food hygiene on the wards.

PubMed

Steuer, Walter

2007-09-13

A PROBLEM THAT IS OFTEN OVERLOOKED OR SIMPLY NOT GIVEN ENOUGH ATTENTION: the food served to patients from the kitchen is not sterile. If food is allowed to stand at room temperature for a long time, both in the case of food cooked for lunch and of food intended for supper which has been previously chilled, there is the possibility of massive spore germination or of dangerous toxin formation. Therefore regulations on how to handle food and beverages (e.g. tea) must be set out in the infection control policy, and checks carried out to monitor compliance with the rules relating to temperature checks, duration and type of storage, need for reheating, etc. Making staff aware of the issues involved is of paramount importance. These include monitoring hygiene standards in the ward kitchen, formulation of a cleaning policy, periodic bacteriological checks (not only of workstations but also of the dishwasher results), whenever possible the use of disposable cloths for working surfaces and equipment, changing cleaning cloths at least once daily and hygienic hand disinfection before and after handing out food. Foodstuffs brought in by visitors represent a special hygienic and organizational problem because in many cases they already have a high baseline microbial count. Visitors must be made aware that, for example, slices of cake left in the patient's room and often eaten only hours later can pose a risk of infection.In summary, the following principles of food hygiene must be observed on the wards:Maintenance of the cold-hot chainNot only reheat food, but ensure it is well heated throughout Avoid situations giving rise to spore germination in foodstuffs brought in by visitorsCleanliness and minimal contamination of kitchen worktopsCleanliness of crockery and kitchen towels Do not allow food to stand at room temperature for a long time, in particular desserts and confectionery A standard policy must be enforced to define the hygienic status and organization for food

42 CFR 70.7 - Responsibility with respect to minors, wards, and patients.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Responsibility with respect to minors, wards, and... QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.7 Responsibility with respect to minors, wards, and patients. A parent, guardian, physician, nurse, or other such person shall not transport, or...

42 CFR 70.7 - Responsibility with respect to minors, wards, and patients.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Responsibility with respect to minors, wards, and... QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.7 Responsibility with respect to minors, wards, and patients. A parent, guardian, physician, nurse, or other such person shall not transport, or...

42 CFR 70.7 - Responsibility with respect to minors, wards, and patients.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Responsibility with respect to minors, wards, and... QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.7 Responsibility with respect to minors, wards, and patients. A parent, guardian, physician, nurse, or other such person shall not transport, or...

42 CFR 70.7 - Responsibility with respect to minors, wards, and patients.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Responsibility with respect to minors, wards, and... QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.7 Responsibility with respect to minors, wards, and patients. A parent, guardian, physician, nurse, or other such person shall not transport, or...

42 CFR 70.7 - Responsibility with respect to minors, wards, and patients.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Responsibility with respect to minors, wards, and... QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.7 Responsibility with respect to minors, wards, and patients. A parent, guardian, physician, nurse, or other such person shall not transport, or...

Opening the black box in nursing work and management practice: the role of ward managers.

PubMed

Townsend, Keith; Wilkinson, Adrian; Kellner, Ashlea

2015-03-01

This paper aims to identify and explore key obstacles preventing ward managers from effectively performing the human resource management (HRM) responsibilities required in their role. In the context of increasing costs and the decentralisation of responsibility to ward level, the relevance of the ward manager role within the 'black box' between human resource management and firm performance is becoming increasingly pertinent. This paper presents an intensive case study including 37 interviews across all levels of a hospital where senior management attempted to shift to a high performance model of human resource management. The findings indicated that ward managers played a critical role in maintaining and improving employee performance, although they were restricted from effectively performing their responsibilities due to budget pressure and limited managerial skill development. Our findings support the contention that hospitals would benefit from focusing on the critical role of the ward manager as the central locus of influence in high performance human resource management (HPHRM) systems. Investment into high performance human resource management is discouraged if the hospital cannot adequately enable ward managers who are responsible for implementation. Introduction of managerial skills training to potential and existing ward managers is critical. © 2013 John Wiley & Sons Ltd.

Understanding the behavior of carbon dioxide and surface energy fluxes in semiarid Salt Lake Valley, Utah, USA

NASA Astrophysics Data System (ADS)

Ramamurthy, Prathap

This dissertation reports the findings from the Salt Lake Valley flux study. The Salt Lake Valley flux study was designed to improve our understanding of the complex land-atmosphere interactions in urban areas. The flux study used the eddy covariance technique to quantify carbon dioxide and surface energy budget in the semiarid Salt Lake Valley. Apart from quantifying fluxes, the study has also added new insight into the nature of turbulent scalar transport in urban areas and has addressed some of the complications in using Eddy Covariance technique in urban areas. As part of this experiment, eddy fluxes of CO2 and surface energy fluxes were measured at two sites, with distinct urban landforms; One site was located in a suburban neighborhood with substantial vegetative cover, prototypical of many residential neighborhoods in the valley. The other CO2 site was in a preurban surrounding that resembled the Salt Lake Valley before it was urbanized. The two sites were intentionally chosen to illustrate the impact of urbanization on CO 2 and surface energy flux cycles. Results indicate that the suburban site acted as a sink of CO2 during the midday period due to photosynthesis and acted as a source of CO2 during the evening and nighttime periods. The vegetative cover around the suburban site also had a significant impact on the surface energy fluxes. Contribution from latent heat flux was substantially high at the suburban site during the summer months compared to sensible heat. The turbulence investigation found that the general behavior of turbulence was very much influenced by local factors and the statistics did not always obey Monin-Obukhov Similarity parameters. This investigation also found that the scalar (co)spectra observed at the suburban site were characterized by multiple peaks and were different compared to (co)spectra reported over forest and crop canopies. The study also observed multiscale CO2 transport at the suburban site during the convective period

Medical academia clinical experiences of Ward Round Teaching curriculum.

PubMed

Haghani, Fariba; Arabshahi, Seyed Kamran Soltani; Bigdeli, Shoaleh; Alavi, Mousa; Omid, Athar

2014-01-01

Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members' experience on Ward Round Teaching content. This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9). Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation. Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability) were employed (Guba and Lincoln). Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1) tangible teachings (analytic intelligence, technical intelligence, legal duties) and (2) implied teachings (professionalism, professional discipline, professional difficulties). Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners.

Linearized self-consistent GW approach satisfying the Ward identity

NASA Astrophysics Data System (ADS)

Kuwahara, Riichi; Ohno, Kaoru

2014-09-01

We propose a linearized self-consistent GW approach satisfying the Ward identity. The vertex function derived from the Ward-Takahashi identity in the limit of q =0 and ω -ω'=0 is included in the self-energy and the polarization function as a consequence of the linearization of the quasiparticle equation. Due to the energy dependence of the self-energy, the Hamiltonian is a non-Hermitian operator and quasiparticle states are nonorthonormal and linearly dependent. However, the linearized quasiparticle states recover orthonormality and fulfill the completeness condition. This approach is very efficient, and the resulting quasiparticle energies are greatly improved compared to the nonlinearized self-consistent GW approach, although its computational cost is not much increased. We show the results for atoms and dimers of Li and Na compared with other approaches. We also propose convenient ways to calculate the Luttinger-Ward functional Φ based on a plasmon-pole model and calculate the total energy for the ground state. As a result, we conclude that the linearization improves overall behaviors in the self-consistent GW approach.

Medical academia clinical experiences of Ward Round Teaching curriculum

PubMed Central

Haghani, Fariba; Arabshahi, Seyed Kamran Soltani; Bigdeli, Shoaleh; Alavi, Mousa; Omid, Athar

2014-01-01

Background: Medical students spend most of their time in hospital wards and it is necessary to study clinical educational opportunities. This study was aimed to explore faculty members’ experience on Ward Round Teaching content. Methods and Materials: This qualitative study was conducted by purposive sampling with the maximum variation of major clinical departments faculty members in Isfahan University of Medical Sciences (n = 9). Data gathering was based on deep and semi-structured interviews. Data gathering continued till data saturation. Data was analyzed through the Collaizzi method and validated. Strategies to ensure trustworthiness of data (credibility, dependability, conformability, transferability) were employed (Guba and Lincoln). Results: Basic codes extracted from the analyzed data were categorized into two main themes and related subthemes, including (1) tangible teachings (analytic intelligence, technical intelligence, legal duties) and (2) implied teachings (professionalism, professional discipline, professional difficulties). Conclusion: Ward round teaching is a valuable opportunity for learners to learn not only patient care aspects but also ethical values. By appropriate planning, opportunities can be used to teach capabilities that are expected of general practitioners. PMID:24627858

Fort Valley Experimental Forest-A Century of Research 1908-2008 (P-53)

Treesearch

Susan D. Olberding; Margaret M. Moore

2008-01-01

One hundred years ago, the USFS began its forest research program in a two-room cabin near Flagstaff, Arizona, with one staff person, Gustaf A. Pearson. The site became known as the Fort Valley Experiment Station and was the first in a national network of research sites developed to address uncertainties regarding the rehabilitation and conservation for forest and...

Desert Test Site Uniformity Analysis

NASA Technical Reports Server (NTRS)

Kerola, Dana X.; Bruegge, Carol J.

2009-01-01

Desert test sites such as Railroad Valley (RRV) Nevada, Egypt-1, and Libya-4 are commonly targeted to assess the on-orbit radiometric performance of sensors. Railroad Valley is used for vicarious calibration experiments, where a field-team makes ground measurements to produce accurate estimates of top-of-atmosphere (TOA) radiances. The Sahara desert test sites are not instrumented, but provide a stable target that can be used for sensor cross-comparisons, or for stability monitoring of a single sensor. These sites are of interest to NASA's Atmospheric Carbon Observation from Space (ACOS) and JAXA's Greenhouse Gas Observation SATellite (GOSAT) programs. This study assesses the utility of these three test sites to the ACOS and GOSAT calibration teams. To simulate errors in sensor-measured radiance with pointing errors, simulated data have been created using MODIS Aqua data. MODIS data are further utilized to validate the campaign data acquired from June 22 through July 5, 2009. The first GOSAT vicarious calibration experiment was conducted during this timeframe.

Water-quality data from ground- and surface-water sites near concentrated animal feeding operations (CAFOs) and non-CAFOs in the Shenandoah Valley and eastern shore of Virginia, January-February, 2004

USGS Publications Warehouse

Rice, Karen C.; Monti, Michele M.; Ettinger, Matthew R.

2005-01-01

Concentrated animal feeding operations (CAFOs) result from the consolidation of small farms with animals into larger operations, leading to a higher density of animals per unit of land on CAFOs than on small farms. The density of animals and subsequent concentration of animal wastes potentially can cause contamination of nearby ground and surface waters. This report summarizes water-quality data collected from agricultural sites in the Shenandoah Valley and Eastern Shore of Virginia. Five sites, three non-CAFO and two dairy-operation CAFO sites, were sampled in the Shenandoah Valley. Four sites, one non-CAFO and three poultry-operation CAFO sites were sampled on the Eastern Shore. All samples were collected during January and February 2004. Water samples were analyzed for the following parameters and constituents: temperature, specific conductance, pH, and dissolved oxygen; concentrations of the indicator organisms Escherichia coli (E. coli) and enterococci; bacterial isolates of E. coli, enterococci, Salmonella spp., and Campylobacter spp.; sensitivity to antibiotics of E. coli, enterococci, and Salmonella spp.; arsenic, cadmium, chromium3+, copper, nickel, and mercury; hardness, biological oxygen demand, nitrate, nitrite, ammonia, ortho-phosphate, total Kjeldahl nitrogen, chemical oxygen demand, total organic carbon, and dissolved organic carbon; and 45 dissolved organic compounds, which included a suite of antibiotic compounds.Data are presented in tables 5-21 and results of analyses of replicate samples are presented in tables 22-28. A summary of the data in tables 5-8 and 18-21 is included in the report.

Respiratory support in oncology ward setting: a prospective descriptive study.

PubMed

Mishra, Seema; Bhatnagar, Sushma; Gupta, Deepak; Goyal, Gaurav Nirvani; Agrawal, Ravi; Jain, Roopesh; Chauhan, Himanshu

2009-01-01

Mechanical ventilation in cancer patients is a critical issue The present prospective descriptive study was designed (1) to assess the patient population needing respirator support in ward setting at a premier state-run oncology institute in India, (2) to observe and analyze the course of their disease while on respirator, and (3) to coordinate better quality of life measures in cancer patients at the institute based on the present study's outcomes. Beginning from March 2005 to March 2006, all cancer patients who were connected to respirator in the wards were enrolled in the current study. Our anesthesiology department at the cancer institute also has primary responsibility for airway management and mechanical ventilation in high dependency units of oncology wards. Preventilation variables in cancer patients were assessed to judge the futility of mechanical ventilation in ward setting. Subsequently, patients were observed for disease course while on respirator. Final outcome with its etio-pathogenesis was correlated with predicted futility of mechanical ventilation. Over a period of 1 year, 132 (46 men and 86 women) cancer patients with median age 40 years (range 1-75 years) were connected to respirator in oncology wards. Based on the preventilation variables and indications for respirator support, right prediction of medical futility and hospital discharge was made in 77% of patients. Underestimation and overestimation of survival to hospital discharge was made in 10% cases and 13% cases, respectively. Based on preventilation variables, prediction of outcome in cancer patients needing respirator support can be made in 77% cases. This high probability of prediction can be used to educate patients, and their families and primary physicians, for well-informed and documented advance directives, formulated and regularly revised DNAR policies, and judicious use of respirator support for better quality-of-life outcomes.

Ward mortality after ICU discharge: a multicenter validation of the Sabadell score.

PubMed

Fernandez, Rafael; Serrano, Jose Manuel; Umaran, Isabel; Abizanda, Ricard; Carrillo, Andres; Lopez-Pueyo, Maria Jesus; Rascado, Pedro; Balerdi, Begoña; Suberviola, Borja; Hernandez, Gonzalo

2010-07-01

Tools for predicting post-ICU patients' outcomes are scarce. A single-center study showed that the Sabadell score classified patients into four groups with clear-cut differences in ward mortality. To validate the Sabadell score using a prospective multicenter approach. Thirty-one ICUs in Spain. All patients admitted in the 3-month study period. We recorded variables at ICU admission (age, sex, severity of illness, and do-not-resuscitate orders), during the ICU stay (ICU-specific treatments, ICU-acquired infection, and acute renal failure), and at ICU discharge (Sabadell score). Statistical analyses included one-way ANOVA and multiple regression analysis with ward mortality as the dependent variable. We admitted 4,132 patients (mean age 61.5 +/- 16.7 years) with mean predicted mortality of 23.8 +/- 22.7%; 545 patients (13%) died in the ICU and 3,587 (87%) were discharged to the ward. Overall ward mortality was 6.7%; ward mortality was 1.5% (36/2,422) in patients with score 0 (good prognosis), 9% (64/725) in patients with score 1 (long-term poor prognosis), 23% (79/341) in patients with score 2 (short-term poor prognosis), and 64% (63/99) in patients with score 3 (expected hospital death). Variables associated with ward mortality in the multivariate analysis were predicted risk of death (OR 1.016), ICU readmission (OR 5.9), Sabadell score 1 (OR 4.7), Sabadell score 2 (OR 15.7), and Sabadell score 3 (OR 107.2). We confirm the ability of the Sabadell score at ICU discharge to define four groups of patients with very different likelihoods of hospital survival.

Electronic patient record use during ward rounds: a qualitative study of interaction between medical staff.

PubMed

Morrison, Cecily; Jones, Matthew; Blackwell, Alan; Vuylsteke, Alain

2008-01-01

Electronic patient records are becoming more common in critical care. As their design and implementation are optimized for single users rather than for groups, we aimed to understand the differences in interaction between members of a multidisciplinary team during ward rounds using an electronic, as opposed to paper, patient medical record. A qualitative study of morning ward rounds of an intensive care unit that triangulates data from video-based interaction analysis, observation, and interviews. Our analysis demonstrates several difficulties the ward round team faced when interacting with each other using the electronic record compared with the paper one. The physical setup of the technology may impede the consultant's ability to lead the ward round and may prevent other clinical staff from contributing to discussions. We discuss technical and social solutions for minimizing the impact of introducing an electronic patient record, emphasizing the need to balance both. We note that awareness of the effects of technology can enable ward-round teams to adapt their formations and information sources to facilitate multidisciplinary communication during the ward round.

Electronic patient record use during ward rounds: a qualitative study of interaction between medical staff

PubMed Central

Morrison, Cecily; Jones, Matthew; Blackwell, Alan; Vuylsteke, Alain

2008-01-01

Introduction Electronic patient records are becoming more common in critical care. As their design and implementation are optimized for single users rather than for groups, we aimed to understand the differences in interaction between members of a multidisciplinary team during ward rounds using an electronic, as opposed to paper, patient medical record. Methods A qualitative study of morning ward rounds of an intensive care unit that triangulates data from video-based interaction analysis, observation, and interviews. Results Our analysis demonstrates several difficulties the ward round team faced when interacting with each other using the electronic record compared with the paper one. The physical setup of the technology may impede the consultant's ability to lead the ward round and may prevent other clinical staff from contributing to discussions. Conclusions We discuss technical and social solutions for minimizing the impact of introducing an electronic patient record, emphasizing the need to balance both. We note that awareness of the effects of technology can enable ward-round teams to adapt their formations and information sources to facilitate multidisciplinary communication during the ward round. PMID:19025662

Factors impacting perceived safety among staff working on mental health wards

PubMed Central

Brown, Andrew; McCabe, Rhiannah; Rogerson, Michelle; Whittington, Richard

2017-01-01

Background Safety at work is a core issue for mental health staff working on in-patient units. At present, there is a limited theoretical base regarding which factors may affect staff perceptions of safety. Aims This study attempted to identify which factors affect perceived staff safety working on in-patient mental health wards. Method A cross-sectional design was employed across 101 forensic and non-forensic mental health wards, over seven National Health Service trusts nationally. Measures included an online staff survey, Ward Features Checklist and recorded incident data. Data were analysed using categorical principal components analysis and ordinal regression. Results Perceptions of staff safety were increased by ward brightness, higher number of patient beds, lower staff to patient ratios, less dayroom space and more urban views. Conclusions The findings from this study do not represent common-sense assumptions. Results are discussed in the context of the literature and may have implications for current initiatives aimed at managing in-patient violence and aggression. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license. PMID:28904814

Factors impacting perceived safety among staff working on mental health wards.

PubMed

Haines, Alina; Brown, Andrew; McCabe, Rhiannah; Rogerson, Michelle; Whittington, Richard

2017-09-01

Safety at work is a core issue for mental health staff working on in-patient units. At present, there is a limited theoretical base regarding which factors may affect staff perceptions of safety. This study attempted to identify which factors affect perceived staff safety working on in-patient mental health wards. A cross-sectional design was employed across 101 forensic and non-forensic mental health wards, over seven National Health Service trusts nationally. Measures included an online staff survey, Ward Features Checklist and recorded incident data. Data were analysed using categorical principal components analysis and ordinal regression. Perceptions of staff safety were increased by ward brightness, higher number of patient beds, lower staff to patient ratios, less dayroom space and more urban views. The findings from this study do not represent common-sense assumptions. Results are discussed in the context of the literature and may have implications for current initiatives aimed at managing in-patient violence and aggression. None. © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license.

Utility of Ward-Based Retinal Photography in Stroke Patients.

PubMed

Frost, Shaun; Brown, Michael; Stirling, Verity; Vignarajan, Janardhan; Prentice, David; Kanagasingam, Yogesan

2017-03-01

Improvements in acute care of stroke patients have decreased mortality, but survivors are still at increased risk of future vascular events and mitigation of this risk requires thorough assessment of the underlying factors leading to the stroke. The brain and eye share a common embryological origin and numerous similarities exist between the small vessels of the retina and brain. Recent population-based studies have demonstrated a close link between retinal vascular changes and stroke, suggesting that retinal photography could have utility in assessing underlying stroke risk factors and prognosis after stroke. Modern imaging equipment can facilitate precise measurement and monitoring of vascular features. However, use of this equipment is a challenge in the stroke ward setting as patients are frequently unable to maintain the required seated position, and pupil dilatation is often not feasible as it could potentially obscure important neurological signs of stroke progression. This small study investigated the utility of a novel handheld, nonmydriatic retinal camera in the stroke ward and explored associations between retinal vascular features and stroke risk factors. This camera circumvented the practical limitations of conducting retinal photography in the stroke ward setting. A positive correlation was found between carotid disease and both mean width of arterioles (r = .40, P = .00571) and venules (r = .30, P = .0381). The results provide further evidence that retinal vascular features are clinically informative about underlying stroke risk factors and demonstrate the utility of handheld retinal photography in the stroke ward. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Additional weekend allied health services reduce length of stay in subacute rehabilitation wards but their effectiveness and cost-effectiveness are unclear in acute general medical and surgical hospital wards: a systematic review.

PubMed

Sarkies, Mitchell N; White, Jennifer; Henderson, Kate; Haas, Romi; Bowles, John

2018-06-18

Are additional weekend allied health services effective and cost-effective for acute general medical and surgical wards, and subacute rehabilitation hospital wards? Systematic review and meta-analysis of studies published between January 2000 and May 2017. Two reviewers independently screened studies for inclusion, extracted data, and assessed methodological quality. Meta-analyses were conducted for relative measures of effect estimates. Patients admitted to acute general medical and surgical wards, and subacute rehabilitation wards. All services delivered by allied health professionals during weekends (Saturday and/or Sunday). This study limited allied health professions to: occupational therapy, physiotherapy, social work, speech pathology, dietetics, art therapy, chiropractic, exercise physiology, music therapy, oral health (not dentistry), osteopathy, podiatry, psychology, and allied health assistants. Hospital length of stay, hospital re-admission, adverse events, discharge destination, functional independence, health-related quality of life, and cost of hospital care. Nineteen articles (20 studies) were identified, comprising 10 randomised and 10 non-randomised trials. Physiotherapy was the most commonly investigated profession. A meta-analysis of randomised, controlled trials showed that providing additional weekend allied health services in subacute rehabilitation wards reduced hospital length of stay by 2.35days (95% CI 0.45 to 4.24, I 2 =0%), and may be a cost-effective way to improve function (SMD 0.09, 95% CI -0.01 to 0.19, I 2 =0%), and health-related quality of life (SMD 0.10, 95% CI -0.01 to 0.20, I 2 =0%). For acute general medical and surgical hospital wards, it was unclear whether the weekend allied health service model provided in the two identified randomised trials led to significant changes in measured outcomes. The benefit of providing additional allied health services is clearer in subacute rehabilitation settings than for acute general

Henry Ward Beecher: A Nation's Tribune.

ERIC Educational Resources Information Center

Chandler, Daniel Ross

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

Long-term trend and variability of atmospheric PM10 concentration in the Po Valley

NASA Astrophysics Data System (ADS)

Bigi, A.; Ghermandi, G.

2014-05-01

The limits to atmospheric pollutant concentration set by the European Commission provide a challenging target for the municipalities in the Po Valley, because of the characteristic climatic conditions and high population density of this region. In order to assess climatology and trends in the concentration of atmospheric particles in the Po Valley, a data set of PM10 data from 41 sites across the Po Valley have been analysed, including both traffic and background sites (either urban, suburban or rural). Of these 41 sites, 18 with 10 yr or longer record have been analysed for long-term trend in deseasonalized monthly means, in annual quantiles and in monthly frequency distribution. A widespread significant decreasing trend has been observed at most sites, up to a few percent per year, by a generalized least squares and Theil-Sen method. All 41 sites have been tested for significant weekly periodicity by Kruskal-Wallis test for mean anomalies and by Wilcoxon test for weekend effect magnitude. A significant weekly periodicity has been observed for most PM10 series, particularly in summer and ascribed mainly to anthropic particulate emissions. A cluster analysis has been applied in order to highlight stations sharing similar pollution conditions over the reference period. Five clusters have been found, two encompassing the metropolitan areas of Turin and Milan and their respective nearby sites and the other three clusters gathering northeast, northwest and central Po Valley sites respectively. Finally, the observed trends in atmospheric PM10 have been compared to trends in provincial emissions of particulates and PM precursors, and analysed along with data on vehicular fleet age, composition and fuel sales. A significant basin-wide drop in emissions occurred for gaseous pollutants, contrarily to emissions of PM10 and PM2.5, whose drop was low and restricted to a few provinces. It is not clear whether the decrease for only gaseous emissions is sufficient to explain the

Job satisfaction in mainland China: comparing critical care nurses and general ward nurses.

PubMed

Zhang, Aihua; Tao, Hong; Ellenbecker, Carol Hall; Liu, Xiaohong

2013-08-01

To explore the level of nurses' job satisfaction and compare the differences between critical care nurses and general ward nurses in Mainland China. Hospitals continue to experience high nurse turnover. Job satisfaction is a key factor to retain skilled nurses. The differences in job satisfaction among critical care nurses and general ward nurses are unknown. A cross-sectional design was selected for this descriptive correlation study. Cross-sectional study of critical care nurses (n = 446) and general ward nurses (n = 1118) in 9 general hospitals by means of questionnaires that included the Chinese Nurses Job Satisfaction Scale and demographic scale. The data were collected from June 2010-November 2010. Chinese nurses had moderate levels of job satisfaction, were satisfied with co-workers and family/work balance; and dissatisfied with pay and professional promotion. Critical care nurses were younger; less educated and had less job tenure when compared with nurses working on general wards. Critical care nurses were significantly less satisfied than general ward nurses with many aspects of their job. Levels of nurses' job satisfaction can be improved. The lower job satisfaction of critical care nurses compared with general ward nurses should warn the healthcare administrators and managers of potentially increasing the critical care nurses turn over. Innovative and adaptable managerial interventions need to be taken to improve critical care nurse' job satisfaction and retain skilled nurse. © 2012 Blackwell Publishing Ltd.

Aggression in Psychiatric Wards: Effect of the Use of a Structured Risk Assessment.

PubMed

Hvidhjelm, Jacob; Sestoft, Dorte; Skovgaard, Lene Theil; Rasmussen, Kirsten; Almvik, Roger; Bue Bjorner, Jakob

2016-12-01

Health care workers are often exposed to violence and aggression in psychiatric settings. Short-term risk assessments, such as the Brøset Violence Checklist (BVC), are strong predictors of such aggression and may enable staff to take preventive measures against aggression. This study evaluated whether the routine use of the BVC could reduce the frequency of patient aggression. We conducted a study with a semi-random regression discontinuity design in 15 psychiatric wards. Baseline aggression risk was assessed using the Aggression Observation Short Form (AOS) over three months. The BVC was implemented in seven intervention wards, and the risk of aggressive incidents over three months of follow-up was compared with the risk in eight control wards. The analysis was conducted at the ward level because each ward was allocated to the intervention and control groups. At baseline, the risk of aggression varied between wards, from one aggressive incident per patient per 1,000 shifts to 147 aggressive incidents per patient per 1,000 shifts. The regression discontinuity analysis found a 45% reduction in the risk of aggression (Odds Ratio (OR) = 0.55, 95% confidence interval: 0.21-1.43). The study did not find a significant reduction in the risk of aggression after implementing a systematic short-term risk assessment with the BVC. Although our findings suggest that use of the BVC may reduce the risk of aggression, the results need to be confirmed in studies with more statistical power.

Identifying the nontechnical skills required of nurses in general surgical wards.

PubMed

Marshall, Dianne C; Finlayson, Mary P

2018-04-01

To identify the nontechnical skills (NTS) required of nurses in general surgical wards for safe and effective care. As the largest occupational group, nurses are in an ideal position to block the vulnerabilities of patient adverse events in a surgical ward. Previous studies in the surgical environment have identified the NTS required of nurses for safe care in operating rooms; however, these skills have not been identified for nurses in general surgical wards. A nonparticipant observational descriptive design was used. A purposive sample of 15 registered nurses was recruited from four surgical wards and observed for a full shift on a morning, afternoon or night shift. Nonparticipant observations were conducted using field notes to collect data. A coding frame was developed, and an inductive process was used to analyse the data. A taxonomy comprising seven NTS required of nurses in their roles in surgical ward teams emerged from the data analysis. They are communication, leadership and management, planning, decision-making, situation awareness, teamwork and patient advocacy. Patient care provided by general surgical nurses involved the seven identified key NTS. These particular NTS are an important component of safe nursing practice as they underpin the provision of safe and effective care for general surgical patients. Nurses block the trajectory of error by using NTS to address the vulnerabilities in the system that can lead to adverse patient events. Identifying general surgical nurses' NTS enables the development of teaching strategies that target the learning of those skills to achieve successful work outcomes and improve patient safety. © 2018 John Wiley & Sons Ltd.

Do-not-resuscitate policy on acute geriatric wards in Flanders, Belgium.

PubMed

De Gendt, Cindy; Bilsen, Johan; Vander Stichele, Robert; Lambert, Margareta; Den Noortgate, NeleVan; Deliens, Luc

2005-12-01

To describe the historical development and status of a do-not-resuscitate (DNR) policy on acute geriatric wards in Flanders, Belgium, and to compare it with the international situation. Structured mail questionnaires. All 94 acute geriatric wards in hospitals in Flanders in 2002 (the year Belgium voted a law on euthanasia). Head geriatricians. A questionnaire was mailed about the existence, development, and implementation of the DNR policy (guidelines and order forms), with a request to return copies of existing DNR guidelines and DNR order forms. The response was 76.6%, with hospital characteristics not significantly different for responders and nonresponders. Development of DNR policy began in 1985, with a step-up in 1997 and 2001. In 2002, a DNR policy was available in 86.1% of geriatric wards, predominantly with institutional DNR guidelines and individual, patient-specific DNR order forms. Geriatric wards in private hospitals implemented their policy later (P=.01) and more often had order forms (P=.04) than those in public hospitals. The policy was initiated and developed predominantly from an institutional perspective by the hospital. The forms were not standardized and generally lacked room to document patient involvement in the decision making process. Implementation of institutional DNR guidelines and individual DNR order forms on geriatric wards in Flanders lagged behind that of other countries and was still incomplete in 2002. DNR policies varied in content and scope and were predominantly an expression of institutional defensive attitudes rather than a tool to promote patient involvement in DNR and other end-of-life decisions.

Delineation of the Pahute Mesa–Oasis Valley groundwater basin, Nevada

USGS Publications Warehouse

Fenelon, Joseph M.; Halford, Keith J.; Moreo, Michael T.

2016-01-22

This report delineates the Pahute Mesa–Oasis Valley (PMOV) groundwater basin, where recharge occurs, moves downgradient, and discharges to Oasis Valley, Nevada. About 5,900 acre-feet of water discharges annually from Oasis Valley, an area of springs and seeps near the town of Beatty in southern Nevada. Radionuclides in groundwater beneath Pahute Mesa, an area of historical underground nuclear testing at the Nevada National Security Site, are believed to be migrating toward Oasis Valley. Delineating the boundary of the PMOV groundwater basin is necessary to adequately assess the potential for transport of radionuclides from Pahute Mesa to Oasis Valley.The PMOV contributing area is defined based on regional water-level contours, geologic controls, and knowledge of adjacent flow systems. The viability of this area as the contributing area to Oasis Valley and the absence of significant interbasin flow between the PMOV groundwater basin and adjacent basins are shown regionally and locally. Regional constraints on the location of the contributing area boundary and on the absence of interbasin groundwater flow are shown by balancing groundwater discharges in the PMOV groundwater basin and adjacent basins against available water from precipitation. Internal consistency for the delineated contributing area is shown by matching measured water levels, groundwater discharges, and transmissivities with simulated results from a single-layer, steady-state, groundwater-flow model. An alternative basin boundary extending farther north than the final boundary was rejected based on a poor chloride mass balance and a large imbalance in the northern area between preferred and simulated recharge.

Estimation of salt loads for the Dolores River in the Paradox Valley, Colorado, 1980–2015

USGS Publications Warehouse

Mast, M. Alisa

2017-07-13

Regression models that relate total dissolved solids (TDS) concentrations to specific conductance were used to estimate salt loads for two sites on the Dolores River in the Paradox Valley in western Colorado. The salt-load estimates will be used by the Bureau of Reclamation to evaluate salt loading to the river coming from the Paradox Valley and the effect of the Paradox Valley Unit (PVU), a project designed to reduce the salinity of the Colorado River. A second-order polynomial provided the best fit of the discrete data for both sites on the river. The largest bias occurred in samples with elevated sulfate concentrations (greater than 500 milligrams per liter), which were associated with short-duration runoff events in late summer and fall. Comparison of regression models from a period of time before operation began at the PVU and three periods after operation began suggests the relation between TDS and specific conductance has not changed over time. Net salt gain through the Paradox Valley was estimated as the TDS load at the downstream site minus the load at the upstream site. The mean annual salt gain was 137,900 tons per year prior to operation of the PVU (1980–1993) and 43,300 tons per year after the PVU began operation (1997–2015). The difference in annual salt gain in the river between the pre-PVU and post-PVU periods was 94,600 tons per year, which represents a nearly 70 percent reduction in salt loading to the river.

Supporting ward staff in acute care areas: the past, the present and the future?

PubMed

Coad, Sharon; Haines, Susan; Lawrence, Barbara

2002-01-01

Clinical education for acute ward staff caring for critically ill patients has continued to be a strong focus for practice development. Adopting a work-based learning approach to empower ward staff has led to the development of a five-day competency-based high dependency skills course. Developing leadership potential and enhancing networking opportunities for nurses from within critical care and ward areas is essential for the realisation of the aims of Comprehensive Critical Care.

The management pattern carried out in a cataract surgery day ward.

PubMed

Lin, Jing; Fang, Xiaoqun; Wu, Suhong

2013-06-01

To evaluate the management practice and process of a cataract surgery day ward. From January to December in 2012, a portion of the cataract patients were evaluated for the pattern of day ward management. Methods were as follows: 1) Establish the cataract day ward. 2) Enroll the patients who met the following criteria: voluntary, local residents or outsiders who stayed in a hotel near the hospital, accompanied by family, and who had simple senile cataract without any systemic major diseases. 3) Establish the hospitalization process. 4) Analyze the nursing process. After cataract day surgery, the patients were followed for 2 hours and completed a questionnaire about their needs and sentiments. A total of 3971 cases were observed in this study; 49 cases were switched to a normal pattern of hospitalization because of operative complications, 1 case had a strong desire to switch to a normal pattern of hospitalization because of ocular discomfort, 8 cases went back to the hospital for treatment because of ocular pain, and 52 cases called on the phone to seek help. Overall, 3820 cases(96.2%) returned on time the next day to visit the doctor. No patients showed severe postoperative complications and 98% expressed great satisfaction with the day ward process. Only 200 cases expressed great concern about not knowing how to deal with postoperative pain, the changes in condition outside the hospital, the therapeutic effects, and the problem of expense reimburse-ment. Day ward cataract surgery is an efficient and safe mode, and has the potential to relieve the demand for inpatient beds and to ensure timely treatment of the patients. In addition, it helps the patients enjoy health care at public expense, reserving reimbursement for those who need to be hospitalized. Nurses should pay more attention to systemic evaluation of the patients, health education, and psychological guidance, and keep in close communication with doctors, which is the key to ensure the safety of day ward

Paired Magnetic Susceptibility Cyclostratigraphy and Revised Magnetostratigraphy with Late Cretaceous Euler Pole from Forbes Formation, Sand Creek, Sacramento Valley, California

NASA Astrophysics Data System (ADS)

Slotznick, S. P.; Raub, T.; Mitchell, R. N.; Ward, P. D.; Kirschvink, J. L.

2012-12-01

Magnetostratigraphy in Upper Cretaceous rocks of Sacramento Valley has successfully complemented biostratigraphy for correlating between circum-Pacific basins. Most paleomagnetic measurements were done pre-1990 using alternating field demagnetization only, due to oxidation accompanying thermal demagnetization. We present paleomagnetic data collected via thermal demagnetization in a flowing nitrogen atmosphere from 223 cores collected over a 130m of section of Forbes Formation in Sand Creek, CA spanning upper Dobbins Shale, Forbes Unit 2 and lower Unit 3. These results uniformly indicate Reversed Chron 33R, contra previously published magnetostratigraphy of the area (Ward et al. 1983, Verosub et al. 1989). Additionally, these paleomagnetic results yield a tightly-constrained paleolatitude for Forbes Formation of 31±3°, which varies significantly from previous APWP models ca. 83 Ma (Besse and Courtillot, 2002) suggesting an unaccounted-for deficiency in reconstructions of North America at this time. This discrepancy might indicate an inaccurate cratonic reference pole, underestimated intrabatholithic or distributed plate boundary deformation, and/or true polar wander. As opposed to other units yielding anomalous late Cretaceous paleolatitudes from outboard terranes, Forbes Formation in Sacramento Valley laps unambiguously onto the North American continent. A 25m AW34 core was collected using a Winkie drillrig near the top of Dobbins Shale Mbr. Paleomagnetic measurements on subsamples from the Winkie core, unaffected by surface weathering, combine with the surficial dataset, and we propose a new set of Euler pole solutions potentially quantifying Basin and Range extension and late Cretaceous intra-Sierran shear. Through magnetic susceptibility measurements of the Winkie core, we were able to resolve orbital cycles which, paired with rock magnetic measurements, constrain basin subsidence and sedimentation rate off the Sierran arc at its age of termination. Re

A problem of hospital hygiene: the presence of aspergilli in hospital wards with different air-conditioning features.

PubMed

Perdelli, Fernanda; Sartini, Marina; Spagnolo, Anna Maria; Dallera, Maurizio; Lombardi, Roberto; Cristina, Maria Luisa

2006-06-01

A total of 1,030 microbiological samples were taken in 3 hospital wards with different air-conditioning features: no conditioning system (ward A), a conditioning system equipped with minimum efficiency reporting value (MERV) filters (ward B), and a conditioning system thoroughly maintained and equipped with high-efficiency particulate air (HEPA) filters (absolute) (ward C). The air in each ward was sampled, and the bacterial and fungal concentrations were determined by active and passive methods. The concentration of fungi on surfaces was also determined. Active sampling showed positive samples in wards A and B only, with average values of 0.50 colony-forming units (CFU)/m(3) (95% CI, 0.30 to 0.70) in A and 0.16 CFU/m(3) (95% CI, 0.13 to 0.20) in B. Passive sampling was positive only in ward A (mean, 0.14 CFU/cm(2)/h; 95% CI, 0.13 to 0.15). Aspergillus was found in 27% and 22% of sampled surfaces in wards A and B, respectively, but in no samples from ward C. The most commonly found species was A. fumigatus (76% of cases in A and 34% of cases in B). The results show that the use of air-conditioning systems markedly reduces the concentration of aspergilli in the environment. Proper maintenance of these systems is clearly fundamental if their efficacy is to be ensured.

Optical manipulation of valley pseudospin

DOE PAGES

Ye, Ziliang; Sun, Dezheng; Heinz, Tony F.

2016-09-19

The coherent manipulation of spin and pseudospin underlies existing and emerging quantum technologies, including quantum communication and quantum computation. Valley polarization, associated with the occupancy of degenerate, but quantum mechanically distinct valleys in momentum space, closely resembles spin polarization and has been proposed as a pseudospin carrier for the future quantum electronics. Valley exciton polarization has been created in the transition metal dichalcogenide monolayers using excitation by circularly polarized light and has been detected both optically and electrically. In addition, the existence of coherence in the valley pseudospin has been identified experimentally. The manipulation of such valley coherence has, however,more » remained out of reach. In this paper, we demonstrate all-optical control of the valley coherence by means of the pseudomagnetic field associated with the optical Stark effect. Using below-bandgap circularly polarized light, we rotate the valley exciton pseudospin in monolayer WSe 2 on the femtosecond timescale. Both the direction and speed of the rotation can be manipulated optically by tuning the dynamic phase of excitons in opposite valleys. Finally, this study unveils the possibility of generation, manipulation, and detection of the valley pseudospin by coupling to photons.« less

Near Fault Strong Ground Motion Records in the Kathmandu Valley during the 2015 Gorkha Nepal Earthquake

NASA Astrophysics Data System (ADS)

Takai, N.; Shigefuji, M.; Rajaure, S.; Bijukchhen, S.; Ichiyanagi, M.; Dhital, M. R.; Sasatani, T.

2015-12-01

Kathmandu is the capital of Nepal and is located in the Kathmandu Valley, which is formed by soft lake sediments of Plio-Pleistocene origin. Large earthquakes in the past have caused significant damage as the seismic waves were amplified in the soft sediments. To understand the site effect of the valley structure, we installed continuous recording accelerometers in four different parts of the valley. Four stations were installed along a west-to-east profile of the valley at KTP (Kirtipur; hill top), TVU (Kirtipur; hill side), PTN (Patan) and THM (Thimi). On 25 April 2015, a large interplate earthquake Mw 7.8 occurred in the Himalayan Range of Nepal. The focal area estimated was about 200 km long and 150 km wide, with a large slip area under the Kathmandu Valley where our strong motion observation stations were installed. The strong ground motions were observed during this large damaging earthquake. The maximum horizontal peak ground acceleration at the rock site was 271 cm s-2, and the maximum horizontal peak ground velocity at the sediment sites reached 112 cm s-1. We compared these values with the empirical attenuation formula for strong ground motions. We found the peak accelerations were smaller and the peak velocities were approximately the same as the predicted values. The rock site KTP motions are less affected by site amplification and were analysed further. The horizontal components were rotated to the fault normal (N205E) and fault parallel (N115E) directions using the USGS fault model. The velocity waveforms at KTP showed about 5 s triangular pulses on the N205E and the up-down components; however the N115E component was not a triangular pulse but one cycle sinusoidal wave. The velocity waveforms at KTP were integrated to derive the displacement waveforms. The derived displacements at KTP are characterized by a monotonic step on the N205E normal and up-down components. The displacement waveforms of KTP show permanent displacements of 130 cm in the fault

Errors in fluid therapy in medical wards.

PubMed

Mousavi, Maryam; Khalili, Hossein; Dashti-Khavidaki, Simin

2012-04-01

Intravenous fluid therapy remains an essential part of patients' care during hospitalization. There are only few studies that focused on fluid therapy in the hospitalized patients, and there is not any consensus statement about fluid therapy in patients who are hospitalized in medical wards. The aim of the present study was to assess intravenous fluid therapy status and related errors in the patients during the course of hospitalization in the infectious diseases wards of a referral teaching hospital. This study was conducted in the infectious diseases wards of Imam Khomeini Complex Hospital, Tehran, Iran. During a retrospective study, data related to intravenous fluid therapy were collected by two clinical pharmacists of infectious diseases from 2008 to 2010. Intravenous fluid therapy information including indication, type, volume and rate of fluid administration was recorded for each patient. An internal protocol for intravenous fluid therapy was designed based on literature review and available recommendations. The data related to patients' fluid therapy were compared with this protocol. The fluid therapy was considered appropriate if it was compatible with the protocol regarding indication of intravenous fluid therapy, type, electrolyte content and rate of fluid administration. Any mistake in the selection of fluid type, content, volume and rate of administration was considered as intravenous fluid therapy errors. Five hundred and ninety-six of medication errors were detected during the study period in the patients. Overall rate of fluid therapy errors was 1.3 numbers per patient during hospitalization. Errors in the rate of fluid administration (29.8%), incorrect fluid volume calculation (26.5%) and incorrect type of fluid selection (24.6%) were the most common types of errors. The patients' male sex, old age, baseline renal diseases, diabetes co-morbidity, and hospitalization due to endocarditis, HIV infection and sepsis are predisposing factors for the

Investigation of water quality and aquatic-community structure in Village and Valley Creeks, City of Birmingham, Jefferson County, Alabama, 2000-01

USGS Publications Warehouse

McPherson, Ann K.; Abrahamsen, Thomas A.; Journey, Celeste A.

2002-01-01

The U.S. Geological Survey conducted a 16-month investigation of water quality, aquatic-community structure, bed sediment, and fish tissue in Village and Valley Creeks, two urban streams that drain areas of highly intensive residential, commercial, and industrial land use in Birmingham, Alabama. Water-quality data were collected between February 2000 and March 2001 at four sites on Village Creek, three sites on Valley Creek, and at two reference sites near Birmingham?Fivemile Creek and Little Cahaba River, both of which drain less-urbanized areas. Stream samples were analyzed for major ions, nutrients, fecal bacteria, trace and major elements, pesticides, and selected organic constituents. Bed-sediment and fish-tissue samples were analyzed for trace and major elements, pesticides, polychlorinated biphenyls, and additional organic compounds. Aquatic-community structure was evaluated by conducting one survey of the fish community and in-stream habitat and two surveys of the benthic-invertebrate community. Bed-sediment and fish-tissue samples, benthic-invertebrates, and habitat data were collected between June 2000 and October 2000 at six of the nine water-quality sites; fish communities were evaluated in April and May 2001 at the six sites where habitat and benthic-invertebrate data were collected. The occurrence and distribution of chemical constituents in the water column and bed sediment provided an initial assessment of water quality in the streams. The structure of the aquatic communities, the physical condition of the fish, and the chemical analyses of fish tissue provided an indication of the cumulative effects of water quality on the aquatic biota. Water chemistry was similar at all sites, characterized by strong calcium-bicarbonate component and magnesium components. Median concentrations of total nitrogen and total phosphorus were highest at the headwaters of Valley Creek and lowest at the reference site on Fivemile Creek. In Village Creek, median

Doctors' and nurses' perceptions of a ward-based pharmacist in rural northern Sweden.

PubMed

Sjölander, Maria; Gustafsson, Maria; Gallego, Gisselle

2017-08-01

Background This project is part of the prospective quasi experimental proof-of-concept investigation of clinical pharmacist intervention study to reduce drug-related problems among people admitted to a ward in a rural hospital in northern Sweden. Objective To explore doctors' and nurses' perceptions and expectations of having a ward-based pharmacist providing clinical pharmacy services. Setting Medical ward in a rural hospital in northern Sweden. Method Eighteen face-to-face semi-structured interviews were conducted with a purposive sample of doctors and nurses working on the ward where the clinical pharmacy service was due to be implemented. Semi-structured interviews were digitally recorded, transcribed and analysed using thematic analysis. Main outcome measure Perceptions and expectations of nurses and doctors. Results Doctors and nurses had limited experience of working with pharmacists. Most had a vague idea of what pharmacists can contribute within a ward setting. Participants, mainly nurses, suggested inventory and drug distribution roles, but few were aware of the pharmacists' skills and clinical competence. Different views were expressed on whether the new clinical pharmacy service would have an impact on workload. However, most participants took a positive view of having a ward-based pharmacist. Conclusion This study provided an opportunity to explore doctors' and nurses' expectations of the role of clinical pharmacists before a clinical pharmacy service was implemented. To successfully implement a clinical pharmacy service, roles, clinical competence and responsibilities should be clearly described. Furthermore, it is important to focus on collaborative working relationships between doctors, nurses and pharmacists.

Active learning on the ward: outcomes from a comparative trial with traditional methods.

PubMed

Melo Prado, Hegla; Hannois Falbo, Gilliatt; Rodrigues Falbo, Ana; Natal Figueirôa, José

2011-03-01

Academic activity during internship is essentially practical and ward rounds are traditionally considered the cornerstone of clinical education. However, the efficacy and effectiveness of ward rounds for learning purposes have been under-investigated and it is necessary to assess alternative educational paradigms for this activity. This study aimed to compare the educational effectiveness of ward rounds conducted with two different learning methodologies. Student subjects were first tested on 30 true/false questions to assess their initial degree of knowledge on pneumonia and diarrhoea. Afterwards, they attended ward rounds conducted using an active and a traditional learning methodology. The participants were submitted to a second test 48hours later in order to assess knowledge acquisition and were asked to answer two questions about self-directed learning and their opinions on the two learning methodologies used. Seventy-two medical students taking part in a paediatric clinic rotation were enrolled. The active methodology proved to be more effective than the traditional methodology for the three outcomes considered: knowledge acquisition (33 students [45.8%] versus 21 students [29.2%]; p=0.03); self-directed learning (38 students [52.8%] versus 11 students [15.3%]; p<0.001), and student opinion on the methods (61 students [84.7%] versus 38 students [52.8%]; p<0.001). The active methodology produced better results than the traditional methodology in a ward-based context. This study seems to be valuable in terms of the new evidence it demonstrates on learning methodologies in the context of the ward round. © Blackwell Publishing Ltd 2011.

76 FR 2711 - Cinram Distribution, LLC, a Subsidiary of Cinram International, Simi Valley Distribution Center...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-14

... Workers From Labor Ready Southwest, Inc. and Select Remedy Staffing Services, Simi Valley, CA; Amended..., include on-site leased workers from Labor Ready Southwest, Inc., and Select Remedy Staffing Services, Simi... Cinram International, including on-site leased workers from Labor Ready Southwest, Inc., and Select...

Subsurface valleys and geoarcheology of the Eastern Sahara revealed by shuttle radar

USGS Publications Warehouse

McCauley, J.F.; Schaber, G.G.; Breed, C.S.; Grolier, M.J.; Haynes, C.V.; Issawi, B.; Elachi, C.; Blom, R.

1982-01-01

The shuttle imaging radar (SIR-A) carried on the space shuttle Columbia in November 1981 penetrated the extremely dry Selima Sand Sheet, dunes, and drift sand of the eastern Sahara, revealing previously unknown buried valleys, geologic structures, and possible Stone Age occupation sites. Radar responses from bedrock and gravel surfaces beneath windblown sand several centimeters to possibly meters thick delineate sand- and alluvium-filled valleys, some nearly as wide as the Nile Valley and perhaps as old as middle Tertiary. The nov-vanished maijor river systems that carved these large valleys probably accomplished most of the erosional stripping of this extraordinarily flat, hyperarid region. Underfit and incised dry wadis, many superimposed on the large valleys, represent erosion by intermittent running water, probably during Quaternary pluvials. Stone Age artifacts associated with soils in the alluvium suggest that areas near the wadis may have been sites of early human occupation. The presence of old drainage networks beneath the sand sheet provides a geologic explanation for the locations of many playas and present-day oases which have been centers of episodic human habitation. Radar penetration of dry sand and soils varies with the wavelength of the incident signals (24 centimeters for the SIR-A system), incidence angle, and the electrical properties of the materials, which are largely determined by moisture content. The calculated depth of radar penetration of dry sand and granules, based on laboratory measurements of the electrical properties of samples from the Selima Sand Sheet, is at least 5 meters. Recent (September 1982) field studies in Egypt verified SIR-A signal penetration depths of at least 1 meter in the Selima Sand Sheet and in drift sand and 2 or more meters in sand dunes. Copyright ?? 1982 AAAS.

Deformation of ``Villafranchian'' lacustrine sediments in the Chisone Valley (Western Alps, Italy)

NASA Astrophysics Data System (ADS)

Collo, Giovanni; Giardino, Marco

1997-09-01

The Chisone Valley is located in the internal NW Alps, in the Pinerolese District, an area characterized by present low to medium seismicity. Fine-grained sediments (sand, silt and clay with interbedded gravel) crop out in the lower Chisone Valley: they were first interpreted as glaciolacustrine deposits, and then as a lacustrine infilling of the valley floor probably due to differential uplifting of the valley mouth. Review of this data, together with new field and palynological observations, lead us to refer the lacustrine deposits to approximately the Lower Pleistocene (Villafranchian). In many outcrops, the lacustrine deposits show strong soft-sediment deformation such as convolute laminations, water-escape structures and disrupted beds, some of them associated with folds and faults (cm to dm in size); only two sites show metric to decametric folds and faults trending E-W and N-S. Detailed structural analysis conducted along a recently exposed section (Rio Gran Dubbione site) shows several soft-sediment deformation features on the limbs of mesoscale folds. Because of their intimate structural association, the origin of these minor structures seems to be connected to synsedimentary activity on reverse and normal faults (m to dm in size) affecting the lacustrine deposits in the same locality. Soft-sediment deformation features can be interpreted as possible paleoseismites. If so, the present seismicity of the Pinerolese District, which is the major area of such activity in NW Italy, cannot be considered an isolated episode in the geological evolution of the region; even if there is no supporting evidence for continuous seismicity, the deformations in the lacustrine sediments of the Chisone Valley testify to Early Pleistocene seismic activity, probably related to the recent tectonic evolution of the internal side of the NW Alps.

Merging seismic and MT in Garden Valley, Nevada

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

Telleen, K.E.

1986-04-01

In the northern part of Garden Valley, Nevada, a 1978 regional seismic program encountered a large area of poor to no-reflection data. Surface geology suggested that a large high structure might underlie the valley floor, and that shallowly buried basalts were causing the poor data. The implied strongly layered structure of electrical resistivity - resistive basalt on conductive Tertiary clastics on resistive paleozoic carbonates - formed an ideal theater for the magnetotelluric method. In 1984, Conoco acquired 48 magnetotelluric sites on about a half-mile grid. These data supported the presence of a buried high block in the Paleozoic rocks andmore » allowed confident mapping of its outlines. In addition, the magnetotelluric survey showed a thin, shallowly buried resistor coextensive with the seismic no-reflection area. In 1985, a high-effort repeat of the earlier no-reflection seismic line confirmed the high block, improved the fault interpretation, and provided weak guidance on the depth of the targeted Paleozoic rocks. Because Garden Valley's Paleozoic stratigraphy differs negligibly from that at nearby Grant Canyon field, the high block constitutes an attractive prospect - possibly the first one found in Nevada due largely to magnetotelluric surveying.« less

[Project to improve abdominal obesity in day care ward psychiatric patients].

PubMed

Liu, Yu-Chieh; Wang, Hui-Yu; Huang, Hui-Ling; Chen, Min-Li

2011-06-01

Over half (57.14%) of patients in our ward suffer from abdominal obesity. This rate is on a continuing upward trend. Reasons for such obesity include lack of physical activity classes, inadequate physical activity, high calorie diets and unhealthy eating habits, chronic diseases and drug side effects, poor motivation to reduce weight, and lack of crisis awareness of abdominal obesity. This project was designed to lessen the problem of abdominal obesity among psychiatric day care inpatients. Resolution measures implemented included: (1) arranging aerobic exercise classes; (2) scheduling classes to teach patients healthy diet habits and knowledge regarding diseases and drugs; (3) holding a waistline reduction competition; (4) displaying health education bulletin boards; (5) holding a quiz contest with prizes for correct answers. The eight abdominally obese patients in the ward achieved an average waist circumference reduction of 2.9 cm and the overall abdominal obesity rate in the ward fell to 35.7%. BMI, eating habits, and awareness of weight loss importance and motivation all improved. The outcome achieved targeted project objectives. We recommend the integration of obesity prevention into routine ward activities and quality control indicators. Nurses should provide patients with weight loss concepts, regularly monitor risk factors, and encourage patient family cooperation to maintain medical care quality.

[Do-not-resuscitate policy on acute geriatric wards in Flanders, Belgium].

PubMed

De Gendt, C; Bilsen, J; Vander Stichele, R; Lambert, M; Van Den Noortgate, N; Deliens, L

2007-10-01

This study describes the historical development and status of a do-not-resuscitate (DNR) policy on acute geriatric wards in Flanders, Belgium. In 2002 (the year Belgium voted a law on euthanasia), a structured mail questionnaire was sent to all head geriatricians of acute geriatric wards in Flanders (N=94). Respondents were asked about the existence, development, and implementation of the DNR policy (guidelines and order forms). The response was 76.6%. Development of DNR policy began in 1985, with a step-up in 1997 and 200l. In 2002, a DNR policy was available in 86.1% of geriatric wards, predominantly with institutional DNR guidelines and individual, patient-specific DNR order forms. The policy was initiated and developed predominantly from an institutional perspective by the hospital. The forms were not standardized and generally lacked room to document patient involvement in the decision making process. Implementation of institutional DNR guidelines and individual DNR order forms on geriatric wards in Flanders lagged behind that of other countries and was still incomplete in 2002. DNR policies varied in content and scope and were predominantly an expression of institutional defensive attitudes rather than a tool to promote patient involvement in DNR and other end-of-life decisions.

Hinners Point Above Floor of Marathon Valley on Mars

NASA Image and Video Library

2015-09-25

This Martian scene shows contrasting textures and colors of "Hinners Point," at the northern edge of "Marathon Valley," and swirling reddish zones on the valley floor to the left. The view combines six frames taken by the panoramic camera (Pancam) on NASA's Mars Exploration Rover Opportunity on Aug. 14, 2015, during the 4,108th Martian day, or sol, of the rover's work on Mars. The summit takes its informal name as a tribute to Noel Hinners (1935-2014). For NASA's Apollo program, Hinners played important roles in selection of landing sites on the moon and scientific training of astronauts. He then served as NASA associate administrator for space science, director of the Smithsonian National Air and Space Museum, director of NASA's Goddard Space Flight Center, NASA chief scientist and associate deputy administrator of NASA. Subsequent to responsibility for the Viking Mars missions while at NASA, he spent the latter part of his career as vice president for flight systems at Lockheed Martin, where he had responsibility for the company's roles in development and operation of NASA's Mars Global Surveyor, Mars Reconnaissance Orbiter, Mars Odyssey, Phoenix Mars Lander, Stardust and Genesis missions. Marathon Valley cuts generally east-west through the western rim of Endeavour Crater. The valley's name refers to the distance Opportunity drove from its 2004 landing site to arrival at this location in 2014. The valley was a high-priority destination for the rover mission because observations from orbit detected clay minerals there. Dark rocks on Hinners Point show a pattern dipping downward toward the interior of Endeavour, to the right from this viewing angle. The strong dip may have resulted from the violence of the impact event that excavated the crater. Brighter rocks make up the valley floor. The reddish zones there may be areas where water has altered composition. Inspections by Opportunity have found compositions there are higher in silica and lower in iron than the

Auditing Safety of Compounding and Reconstituting of Intravenous Medicines on Hospital Wards in Finland.

PubMed

Suvikas-Peltonen, Eeva; Palmgren, Joni; Häggman, Verner; Celikkayalar, Ercan; Manninen, Raija; Airaksinen, Marja

2017-01-01

On the hospital wards in Finland, nurses generally reconstitute intravenous medicines, such as antibiotics, analgesics, and antiemetics prescribed by doctors. Medicine reconstitution is prone to many errors. Therefore, it is important to identify incorrect practices in the reconstitution of medicine to improve patient safety in hospitals. The aim of this study was to audit the compounding and reconstituting of intravenous medicines on hospital wards in a secondary-care hospital in Finland by using an assessment tool and microbiological testing for identifying issues posing patient safety risks. A hospital pharmacist conducted an external audit by using a validated 65-item assessment tool for safe-medicine compounding practices on 20 wards of the selected hospital. Also, three different microbiological samples were collected to assure the aseptics. Practices were evaluated using a four-point rating scale of "never performed," "rarely performed," "often performed," and "always performed," and were based on observation and interviews with nurses or ward pharmacists. In addition, glove-, settle plate-, and media fill-tests were collected. Associations between microbial sample results and audit-tool results were discussed. Altogether, only six out of the 65 items were fully implemented in all wards; these were related to logistic practices and quality assurance. More than half of the wards used incorrect practices ("rarely performed" or "never performed") for five items. Most of these obviated practices related to aseptic practices. All media-fill tests were clean but the number of colony forming units in glove samples and settle- plate samples varied from 0 to >100. More contamination was found in wards where environmental conditions were inadequate or the use of gloves was incorrect. Compounding practices were [mostly] quite well adapted, but the aseptic practices needed improvement. Attention should have been directed particularly to good aseptic techniques and

Selenium and other elements in juvenile striped bass from the San Joaquin Valley and San Francisco Estuary, California

USGS Publications Warehouse

Saiki, Michael K.; Palawski, Donald U.

1990-01-01

Concentrations of selenium and other trace elements were determined in 55 whole body samples of juvenile anadromous striped bass (Morone saxatilis) from the San Joaquin Valley and San Francisco Estuary, California. The fish (≤1 yr old—the predominant life stage in the San Joaquin Valley) were collected in September–December 1986 from 19 sites in the Valley and 3 sites in the Estuary, and analyzed for the following elements: aluminum (Al), arsenic (As), boron (B), barium (Ba), beryllium (Be), cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), mercury (Hg), magnesium (Mg), molybdenum (Mo), nickel (Ni), lead (Pb), selenium (Se), strontium (Sr), vanadium (V), and zinc (Zn). When compared to concentrations in whole freshwater fish measured by surveys from other waters, a few samples contained higher levels, of As, Cd, Cu, Pb, and Se. The median concentrations of Al, As, Cu, Fe, Mg, Se, and Sr also differed significantly (P⩽0.05) among sites. However, only Se concentrations were highest (up to 7.9 μg/g dry weight) in samples from Valley sites exposed to agricultural subsurface (tile) drainwater; concentrations were lower in samples collected elsewhere. Water quality variables—especially those strongly influenced by tile drainwater (conductivity, total dissolved solids, total alkalinity, and total hardness)—were also significantly correlated (P⩽0.05) with Se concentrations in fish. Selenium concentrations in striped bass from the Estuary were only one-fourth to one-half the concentrations measured in the most contaminated fish from the San Joaquin River.

Uncovering paradoxes from physicians' experiences of patient-centered ward-round.

PubMed

Bååthe, Fredrik; Ahlborg, Gunnar; Edgren, Lars; Lagström, Annica; Nilsson, Kerstin

2016-05-03

Purpose The purpose of this paper is to uncover paradoxes emerging from physicians' experiences of a patient-centered and team-based ward round, in an internal medicine department. Design/methodology/approach Abductive reasoning relates empirical material to complex responsive processes theory in a dialectical process to further understandings. Findings This paper found the response from physicians, to a patient-centered and team-based ward round, related to whether the new demands challenged or confirmed individual physician's professional identity. Two empirically divergent perspectives on enacting the role of physician during ward round emerged: We-perspective and I-perspective, based on where the physician's professional identity was centered. Physicians with more of a We-perspective experienced challenges with the new round, while physicians with more of an I-perspective experienced alignment with their professional identity and embraced the new round. When identity is challenged, anxiety is aroused, and if anxiety is not catered to, then resistance is likely to follow and changes are likely to be hampered. Practical implications For change processes affecting physicians' professional identity, it is important for managers and change leaders to acknowledge paradox and find a balance between new knowledge that needs to be learnt and who the physician is becoming in this new procedure. Originality/value This paper provides increased understanding about how physicians' professional identity is interacting with a patient-centered ward round. It adds to the knowledge about developing health care in line with recent societal requests and with sustainable physician engagement.

Acceptance of the 2009 Henry Baldwin Ward Medal: The accidental parasitologist

USGS Publications Warehouse

Lafferty, Kevin D.

2009-01-01

Members of the Society, President Conn, colleagues, friends, and particularly students, the Ward Medal recipient, from Clarke Read onward, traditionally recounts how their career was shaped. A decade ago, in a crumbling Kona hotel, the ASP's own tattooed lady, Janine Caira, opened her Ward Medal address with: “To all future Ward Medalists, many of whom I trust are sitting in the audience out there today, I say: savor the moment! You have no idea how much easier it is to be sitting out there where you are than standing up here where I am” (Caira 1998). I certainly didn't imagine that Janine was delivering her advice to me and it is presumptuous to imagine my story is a template for shaping a career. As the title of my talk indicates, it was an accident.

Costs of terminal patients who receive palliative care or usual care in different hospital wards.

PubMed

Simoens, Steven; Kutten, Betty; Keirse, Emmanuel; Berghe, Paul Vanden; Beguin, Claire; Desmedt, Marianne; Deveugele, Myriam; Léonard, Christian; Paulus, Dominique; Menten, Johan

2010-11-01

In addition to the effectiveness of hospital care models for terminal patients, policy makers and health care payers are concerned about their costs. This study aims to measure the hospital costs of treating terminal patients in Belgium from the health care payer perspective. Also, this study compares the costs of palliative and usual care in different types of hospital wards. A multicenter, retrospective cohort study compared costs of palliative care with usual care in acute hospital wards and with care in palliative care units. The study enrolled terminal patients from a representative sample of hospitals. Health care costs included fixed hospital costs and charges relating to medical fees, pharmacy and other charges. Data sources consisted of hospital accountancy data and invoice data. Six hospitals participated in the study, generating a total of 146 patients. The findings showed that palliative care in a palliative care unit was more expensive than palliative care in an acute ward due to higher staffing levels in palliative care units. Palliative care in an acute ward is cheaper than usual care in an acute ward. This study suggests that palliative care models in acute wards need to be supported because such care models appear to be less expensive than usual care and because such care models are likely to better reflect the needs of terminal patients. This finding emphasizes the importance of the timely recognition of the need for palliative care in terminal patients treated in acute wards.

NNSS Soils Monitoring: Plutonium Valley (CAU 366) FY2016

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

Nikolich, George; Mizell, Steve; McCurdy, Greg

2017-10-01

Desert Research Institute (DRI) is conducting a field assessment of the potential for contaminated soil transport from the Plutonium Valley Contamination Area (CA) as a result of wind transport and storm runoff in support of National Nuclear Security Administration (NNSA) efforts to complete regulatory closure of the contamination areas. The DRI work is intended to confirm the likely mechanism(s) of transport and determine the meteorological conditions that might cause movement of contaminated soils. The emphasis of the work is on collecting sediment transported by channelized storm runoff at the Plutonium Valley investigation sites. These data will inform closure plans thatmore » are being developed, which will facilitate the appropriate closure design and post-closure monitoring.« less

Assessment of surface water quality of inland valleys for cropping in SW Nigeria

NASA Astrophysics Data System (ADS)

Aboyeji, O. S.; Ogunkoya, O. O.

2017-05-01

Inland valley agro-ecosystems which are a category of wetlands have potential for sustainable crop production relative to uplands. A major challenge to their utilisation in the study area is their heterogeneity in hydrology, morphology, soil types and agro-economy. The study assessed the surface water quality of three typologies of the agro-ecosystems—amphitheatre-like valley-heads (Am), valley-side (VS), and low depression (LD)—for cropping. Surface water of six sites were sampled during the wet and dry seasons. The physicochemical properties and metal concentrations of the samples were analysed. Descriptive statistics and water quality indices were used to assess the suitability of the waters of the agro-ecosystems for cropping. Results showed that the valleys have neutral to slightly alkaline waters. Values of physicochemical parameters are generally within the acceptable range for cropping. The concentration of major cations varied across the inland valley types, but exhibited similar characteristics within each valley. The dominance of the major cations is in the order of Na > Ca > K > Mg. ANOVA results indicated that there is no significant difference in the concentration of heavy metals across the valleys ( F = 2.044, p = 0.138, α = 0.05). Generally, most of the physicochemical parameters and trace metals have low concentrations and are non-toxic to plants. Values of water quality indices (sodium adsorption ratio, soluble sodium percentage, total dissolved solids and permeability index) indicated that the concentrations of minerals in waters across the valley typologies are generally within permissible limits for cropping.

Sacramento Valley, CA, USA

NASA Technical Reports Server (NTRS)

1973-01-01

The Sacramento Valley (40.5N, 121.5W) of California is the northern extension of the Central Valley, main agriculture region of the state. Hundreds of truck farms, vineyards and orchards can be seen throughout the length and breadth of the valley which was reclaimed from the desert by means of intensive and extensive irrigation projects.

LOWER RIO GRANDE VALLEY TRANSBOUNDARY AIR POLLUTION PROJECT (TAPP) (MAIN REPORT)

EPA Science Inventory

The purpose of the Lower Rio Grande Valley Transboundary Air Pollution Project (TAPP) was to obtain air quality data for a full year at three border monitoring sites to assess anthropogenic and biogenic emission impacts and transboundary air pollution transport in the Lower Rio...

Relating fish health and reproductive metrics to contaminant bioaccumulation at the Tennessee Valley Authority Kingston coal ash spill site.

PubMed

Pracheil, Brenda M; Marshall Adams, S; Bevelhimer, Mark S; Fortner, Allison M; Greeley, Mark S; Murphy, Cheryl A; Mathews, Teresa J; Peterson, Mark J

2016-08-01

A 4.1 million m(3) coal ash release into the Emory and Clinch rivers in December 2008 at the Tennessee Valley Authority's Kingston Fossil Plant in east Tennessee, USA, prompted a long-term, large-scale biological monitoring effort to determine if there are chronic effects of this spill on resident biota. Because of the magnitude of the ash spill and the potential for exposure to coal ash-associated contaminants [e.g., selenium (Se), arsenic (As), and mercury (Hg)] which are bioaccumulative and may present human and ecological risks, an integrative, bioindicator approach was used. Three species of fish were monitored-bluegill (Lepomis macrochirus), redear sunfish (L. microlophus), and largemouth bass (Micropterus salmoides)-at ash-affected and reference sites annually for 5 years following the spill. On the same individual fish, contaminant burdens were measured in various tissues, blood chemistry parameters as metrics of fish health, and various condition and reproduction indices. A multivariate statistical approach was then used to evaluate relationships between contaminant bioaccumulation and fish metrics to assess the chronic, sub-lethal effects of exposure to the complex mixture of coal ash-associated contaminants at and around the ash spill site. This study suggests that while fish tissue concentrations of some ash-associated contaminants are elevated at the spill site, there was no consistent evidence of compromised fish health linked with the spill. Further, although relationships between elevated fillet burdens of ash-associated contaminants and some fish metrics were found, these relationships were not indicative of exposure to coal ash or spill sites. The present study adds to the weight of evidence from prior studies suggesting that fish populations have not incurred significant biological effects from spilled ash at this site: findings that are relevant to the current national discussions on the safe disposal of coal ash waste.

Effectiveness of the Solar Panels in the Castro Valley Unified School District Based on Projected Amount of Energy to be Produced

NASA Astrophysics Data System (ADS)

Sparks, J. R.; Palmer, T. C.; Siegel, A. P.

2014-12-01

In recent years Americans have warmed to the idea of installing solar panels to their homes and businesses. These panels help reduce the cost of receiving energy from power plants that lose a lot of energy in transportation. These power plants provide energy by burning gas or coal producing emissions that add to the growing problem of pollution and global warming. In 2010 the Castro Valley Unified School District decided to add solar panels to Canyon Middle School, Castro Valley High School, and Castro Valley Adult School. We researched whether the solar panels reached their projected amount of energy (74%) for the sites where the panels were placed. The solar panels at all three sites were found to exceed these projected amounts. The solar panels at each site produce a little over 74% for the each school.

Why We Are Not Google: Lessons from a Library Web Site Usability Study

ERIC Educational Resources Information Center

Swanson, Troy A.; Green, Jeremy

2011-01-01

In the Fall of 2009, the Moraine Valley Community College Library, using guidelines developed by Jakob Nielsen, conducted a usability study to determine how students were using the library Web site and to inform the redesign of the Web site. The authors found that Moraine Valley's current gateway design was a more effective access point to library…

A Progressive Black Top Hat Transformation Algorithm for Estimating Valley Volumes from DEM Data

NASA Astrophysics Data System (ADS)

Luo, W.; Pingel, T.; Heo, J.; Howard, A. D.

2013-12-01

The amount of valley incision and valley volume are important parameters in geomorphology and hydrology research, because they are related to the amount erosion (and thus the volume of sediments) and the amount of water needed to create the valley. This is not only the case for terrestrial research but also for planetary research as such figuring out how much water was on Mars. With readily available digital elevation model (DEM) data, the Black Top Hat (BTH) transformation, an image processing technique for extracting dark features on a variable background, has been applied to DEM data to extract valley depth and estimate valley volume. However, previous studies typically use one single structuring element size for extracting the valley feature and one single threshold value for removing noise, resulting in some finer features such as tributaries not being extracted and underestimation of valley volume. Inspired by similar algorithms used in LiDAR data analysis to separate above ground features and bare earth topography, here we propose a progressive BTH (PBTH) transformation algorithm, where the structuring elements size is progressively increased to extract valleys of different orders. In addition, a slope based threshold was introduced to automatically adjust the threshold values for structuring elements with different sizes. Connectivity and shape parameters of the masked regions were used to keep the long linear valleys while removing other smaller non-connected regions. Preliminary application of the PBTH to Grand Canyon and two sites on Mars has produced promising results. More testing and fine-tuning is in progress. The ultimate goal of the project is to apply the algorithm to estimate the volume of valley networks on Mars and the volume of water needed to form the valleys we observe today and thus infer the nature of the hydrologic cycle on early Mars. The project is funded by NASA's Mars Data Analysis program.

A ward round proforma improves documentation and communication.

PubMed

Alazzawi, Sulaiman; Silk, Zacharia; Saha, Urmila U; Auplish, Sunil; Masterson, Sean

2016-12-02

This article present the results of an audit cycle which evaluated the quality of inpatient ward round documentation in a busy district general hospital before and after the implementation of a standardized proforma which was specifically designed for trauma and orthopaedic patients. In each cycle, 20 case notes were examined and the data analysed to examine three main areas: Diagnosis, management and/or discharge plan Objective assessments including neurovascular status, weight-bearing status, surgical wound review, observations, results of investigations and decision from the daily trauma meeting Logistics of the documentation such as legibility, date and time, name and grade of the doctor and contact number. This audit demonstrated that using a ward round proforma can significantly enhance the quality of documentation and improve communication between multidisciplinary team members.

Miscellaneous High-Resolution Seismic Imaging Investigations in Salt Lake and Utah Valleys for Earthquake Hazards

USGS Publications Warehouse

Stephenson, W.J.; Williams, R.A.; Odum, J.K.; Worley, D.M.

2007-01-01

Introduction In support of earthquake hazards and ground motion studies by researchers at the Utah Geological Survey, University of Utah, Utah State University, Brigham Young University, and San Diego State University, the U.S. Geological Survey Geologic Hazards Team Intermountain West Project conducted three high-resolution seismic imaging investigations along the Wasatch Front between September 2003 and September 2005. These three investigations include: (1) a proof-of-concept P-wave minivib reflection imaging profile in south-central Salt Lake Valley, (2) a series of seven deep (as deep as 400 m) S-wave reflection/refraction soundings using an S-wave minivib in both Salt Lake and Utah Valleys, and (3) an S-wave (and P-wave) investigation to 30 m at four sites in Utah Valley and at two previously investigated S-wave (Vs) minivib sites. In addition, we present results from a previously unpublished downhole S-wave investigation conducted at four sites in Utah Valley. The locations for each of these investigations are shown in figure 1. Coordinates for the investigation sites are listed in Table 1. With the exception of the P-wave common mid-point (CMP) reflection profile, whose end points are listed, these coordinates are for the midpoint of each velocity sounding. Vs30 and Vs100, also shown in Table 1, are defined as the average shear-wave velocities to depths of 30 and 100 m, respectively, and details of their calculation can be found in Stephenson and others (2005). The information from these studies will be incorporated into components of the urban hazards maps along the Wasatch Front being developed by the U.S. Geological Survey, Utah Geological Survey, and numerous collaborating research institutions.

Scaling the Morphology of Sapping and Pressurized Groundwater Experiments to Martian Valleys

NASA Astrophysics Data System (ADS)

Marra, W. A.; Kleinhans, M. G.

2013-12-01

. Groundwater flow piracy of multiple valleys within one system are characterized by equal ratios of width and length development, a property that is absent in case of a local groundwater source which does not induce flow piracy. In case of pressurized groundwater release, the sediment surface in the source area fractured and pits developed due to high groundwater pressure. The resulting valley head consisted of feather-shaped converging flow features. Scaling of the non-fluvial features that relate to groundwater pressure is possible by using hydrological modelling of groundwater pressure and geophysical modelling of the behaviour of the material under such pressures. Our results on sapping valley formation, combined with insights from multiple terrestrial sites of similar valleys contribute to the discussion of some enigmatic valleys on Mars. We provide several quantitative morphological measures, which directly relate to the formative process, which is valuable in linking morphology to the formative process. Our results on pressurized groundwater release prove a long-standing hypothesis on the formation on some of the largest valleys observed in our solar system. In both cases, the insights in the formative processes enable us to quantify the amount of water required for the formation of groundwater-induced Martian valleys.

Superfund Record of Decision (EPA Region 9): San Fernando Valley Area 2, operable unit 2, Los Angeles County, CA, June 1993

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

Not Available

1993-06-01

This decision document presents the selected remedial action for the Glendale North Operable Unit, San Fernando Valley Area 2 Superfund site. The remedy involves groundwater extraction and treatment for the shallow aquifer system in the Glendale area of the San Fernando Valley.

Superfund Record of Decision (EPA Region 9): San Fernando Valley Area 2, operable unit 3, Los Angeles County, CA, June 1993

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

Not Available

1993-06-01

This decision document presents the selected remedial action for the Glendale South Operable Unit, San Fernando Valley Area 2 Superfund site. The remedy involves groundwater extraction and treatment for the shallow aquifer system in the Glendale area of the San Fernando Valley.

LLWnotes - Volume 11, Number 3

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

NONE

1996-04-01

This document is the April 1996 issue of LLWnotes. It contains articles and news items on the following topics: news items related to states and compacts, Low-Level Radioactive Waste (LLW) Forum activities, and court rulings and calendars. State and compact items featured include Texas licensing procedures, renewal of Envirocare`s license, and Ward Valley. Massachusetts Board suspension of some siting tasks and Massachusetts Court rules for US DOE regarding rebates are also reported.

Theory of mind in schizophrenia: correlation with clinical symptomatology, emotional recognition and ward behavior.

PubMed

Lee, Woo Kyeong; Kim, Yong Kyu

2013-09-01

Several studies have suggested the presence of a theory of mind (ToM) deficit in schizophrenic disorders. This study examined the relationship of emotion recognition, theory of mind, and ward behavior in patients with schizophrenia. Fifty-five patients with chronic schizophrenia completed measures of emotion recognition, ToM, intelligence, Positive and Negative Syndrome Scale (PANSS) and Nurse's Observation Scale for Inpatient Evaluation (NOSIE). Theory of mind sum score correlated significantly with IQ, emotion recognition, and ward behavior. Ward behavior was linked to the duration of the illness, and even more so to theory of mind deficits. Theory of mind contributed a significant proportion of the amount of variance to explain social behavior on the ward. Considering our study results, impaired theory of mind contributes significantly to the understanding of social competence in patients with schizophrenia. Copyright © 2012 Wiley Publishing Asia Pty Ltd.

Images of recovery: a photo-elicitation study on the hospital ward.

PubMed

Radley, Alan; Taylor, Diane

2003-01-01

The authors attempted to discover the part the physical setting of the ward plays in patients' recovery by asking patients to take photographs of their ward, its spaces and objects, and then interviewing them about these images in hospital and subsequently in their homes. Photography allowed the patients to identify and capture aspects of the setting that they found salient and provided the photo-elicitation material for the interviews. Based on these data, the authors present (a) a critical discussion of the use of photography as method and its implications for qualitative analysis, (b) an overview of the kinds of image taken with respect to the ward and the course of patients' recovery, and (c) a theoretical analysis, employing Walter Benjamin's use of the concept of mimesis, that understands recovery as a bodily act in response to the shock to the senses that hospitalization and surgery produce.

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

PubMed Central

Bowers, L

2014-01-01

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

75 FR 61174 - Warner Valley Comprehensive Site Plan, Final Environmental Impact Statement, Lassen Volcanic...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

... Warner Valley fen and wetland areas; (3) Removal or repair of Dream Lake Dam and restoration of... project planning area. This area includes Dream Lake Dam, built in 1932 by Alex Sifford, which impounds an... built the 10 structures which now form the core of Drakesbad Guest Ranch Historic District (both Dream...

Outside the operating room: How a robotics program changed resource utilization on the inpatient Ward.

PubMed

Leung, Annie; Abitbol, Jeremie; Ramana-Kumar, Agnihotram V; Fadlallah, Bassam; Kessous, Roy; Cohen, Sabine; Lau, Susie; Salvador, Shannon; Gotlieb, Walter H

2017-04-01

To analyze the changes in the composition of the gynecologic oncology inpatient ward following the implementation of a robotic surgery program and its impact on inpatient resource utilization and costs. Retrospective review of the medical charts of patients admitted onto the gynecologic oncology ward the year prior to and five years after the implementation of robotics. The following variables were collected: patient characteristics, hospitalization details (reason for admission and length of hospital stay), and resource utilization (number of hospitalization days, consultations, and imaging). Following the introduction of robotic surgery, there were more admissions for elective surgery yet these accounted for only 21% of the inpatient ward in terms of number of hospital days, compared to 36% prior to the robotic program. This coincided with a sharp increase in the overall number of patients operated on by a minimally invasive approach (15% to 76%, p<0.0001). The cost per surgical admission on the inpatient ward decreased by 59% ($9827 vs. $4058) in the robotics era. The robotics program contributed to a ward with higher proportion of patients with complex comorbidities (Charlson≥5: RR 1.06), Stage IV disease (RR 1.30), and recurrent disease (RR 1.99). Introduction of robotic surgery allowed for more patients to be treated surgically while simultaneously decreasing inpatient resource use. With more patients with non-surgical oncological issues and greater medical complexity, the gynecologic oncology ward functions more like a medical rather than surgical ward after the introduction of robotics, which has implications for hospital-wide resource planning. Copyright © 2017 Elsevier Inc. All rights reserved.

Seismic Wave Amplification in Las Vegas: Site Characterization Measurements and Response Models

NASA Astrophysics Data System (ADS)

Louie, J. N.; Anderson, J. G.; Luke, B.; Snelson, C.; Taylor, W.; Rodgers, A.; McCallen, D.; Tkalcic, H.; Wagoner, J.

2004-12-01

As part of a multidisciplinary effort to understand seismic wave amplification in Las Vegas Valley, we conducted geotechnical and seismic refraction field studies, geologic and lithologic interpretation, and geophysical model building. Frequency-dependent amplifications (site response) and peak ground motions strongly correlate with site conditions as characterized by the models. The models include basin depths and velocities, which also correlate against ground motions. Preliminary geologic models were constructed from detailed geologic and fault mapping, logs of over 500 wells penetrating greater than 200 m depth, gravity-inversion results from the USGS, and USDA soil maps. Valley-wide refraction studies we conducted in 2002 and 2003 were inverted for constraints on basin geometry, and deep basin and basement P velocities with some 3-d control to depths of 5 km. Surface-wave studies during 2002-2004 characterized more than 75 sites within the Valley for shear velocity to depths exceeding 100 m, including all the legacy sites where nuclear-blast ground motions were recorded. The SASW and refraction-microtremor surface-surveying techniques proved to provide complementary, and coordinating Rayleigh dispersion-curve data at a dozen sites. Borehole geotechnical studies at a half-dozen sites confirmed the shear-velocity profiles that we derived from surface-wave studies. We then correlated all the geotechnical data against a detailed stratigraphic model, derived from drilling logs, to create a Valley-wide model for shallow site conditions. This well-log-based model predicts site measurements better than do models based solely on geologic or soil mapping.

Sacramento Valley, CA, USA

NASA Image and Video Library

1973-06-22

SL2-04-179 (22 June 1973) --- The Sacramento Valley (40.5N, 121.5W) of California is the northern extension of the Central Valley, main agriculture region of the state. Hundreds of truck farms, vineyards and orchards can be seen throughout the length and breadth of the valley which was reclaimed from the desert by means of intensive and extensive irrigation projects. Photo credit: NASA

MX Siting Investigation Geotechnical Evaluation Verification Study - Cave Valley, Nevada. Volume I. Synthesis.

DTIC Science & Technology

1981-10-26

areas of non- rippable materials may be encountered throughout the northwestern portion of the valley. Laboratory test results and field observations...non- rippable at shallow depths, thereby classifying them in this instance as areas of rock and/or shallow rock. When this occurs, these areas may...OCCUR- Rock is defined as any earth material which is not rippable RING WITHIN 50 FEET 015m) AND by conventional excavation methods. Where available

Observation of acoustic valley vortex states and valley-chirality locked beam splitting

NASA Astrophysics Data System (ADS)

Ye, Liping; Qiu, Chunyin; Lu, Jiuyang; Wen, Xinhua; Shen, Yuanyuan; Ke, Manzhu; Zhang, Fan; Liu, Zhengyou

2017-05-01

We report an experimental observation of the classical version of valley polarized states in a two-dimensional hexagonal sonic crystal. The acoustic valley states, which carry specific linear momenta and orbital angular momenta, were selectively excited by external Gaussian beams and conveniently confirmed by the pressure distribution outside the crystal, according to the criterion of momentum conservation. The vortex nature of such intriguing bulk crystal states was directly characterized by scanning the phase profile inside the crystal. In addition, we observed a peculiar beam-splitting phenomenon, in which the separated beams are constructed by different valleys and locked to the opposite vortex chirality. The exceptional sound transport, encoded with valley-chirality locked information, may serve as the basis of designing conceptually interesting acoustic devices with unconventional functions.

Dry Valleys, Antarctica

NASA Image and Video Library

2009-11-02

The McMurdo Dry Valleys are a row of valleys west of McMurdo Sound, Antarctica. They are so named because of their extremely low humidity and lack of snow and ice cover. This image was acquired December 8, 2002 by NASA Terra spacecraft.

Obeying patient's rights on the basis of maternity ward.

PubMed

Leszczyńska, K; Dymczyk, K; Wac, K; Krajewska, K

2005-01-01

This work is an attempt to evaluate the extent of knowledge concerning patient's rights and chances to execute these rights in everyday hospital reality. We have collected opinions of the patients from the maternity ward of Independent Central Public Clinical Hospital of Medical University of Silesia in Katowice. We also interested in participation of medical staff in respecting and realization of patient's rights it has become the main objective of this work. To collect the patient's opinions we used a specially prepared questionnaire which has measured obeying patient's rights in the following aspects: the rights to make decisions, the rights to information including the right to inspect medical data, the right to respect privacy and dignity, the right to treatment and care, the right to be in touch with relatives, the right the priest's care, the rights to file a complaint, the right to obey patient's rights. Patient's rights in a delivery room and a maternity ward are not respected to a satisfactory extent which is confirmed by the research results. During the hospitalization the patients aren't informed and they do not acquire almost any knowledge concerning their rights. The patient staying in a maternity ward is in most cases only a passive receiver of medical service.

An experimental ward. Improving care and learning.

PubMed

Ronan, L; Stoeckle, J D

1992-01-01

The rapidly changing health care system is still largely organized according to old, and increasingly outdated models. The contemporary demands of patient care and residency training call for an experimental ward, which can develop and test new techniques in hospital organization and the delivery of care in a comprehensive way.

Superfund Record of Decision (EPA Region 9): North Hollywood/Burbank Well Field Area 1, San Fernando Valley Site, California (first remedial action), September 1987. Final report

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

Not Available

1987-09-24

The North Hollywood - Burbank Well Field (NHBWF) is located within the San Fernando Valley Ground Water basin, which can provide drinking water for approximately 500,000 people residing in the San Fernando Valley and Los Angeles. In 1980 TCE and PCE were discovered in 25% of DWP's wells. In July 1981, DWP and the Southern California Association of Governments began a two-year study funded by EPA. The study revealed the occurrence of ground-water contamination plume patterns that are spreading toward the southeast. The primary contaminant of concern to the ground-water is TCE with PCE and other VOCs present. The selectedmore » remedial action for the site is ground-water pump and treatment using aeration and granular-activated-carbon - air-filtering units, with discharge to the DWP Pumping Station for chlorination and distribution. Spent carbon will be removed and replaced with fresh carbon, with the spent carbon scheduled either for disposal or regeneration. The estimated capital cost for this remedial action is $2,192,895 with present worth OandM of $2,284,105.« less

Multiple challenges of antibiotic use in a large hospital in Ethiopia - a ward-specific study showing high rates of hospital-acquired infections and ineffective prophylaxis.

PubMed

Gutema, Girma; Håkonsen, Helle; Engidawork, Ephrem; Toverud, Else-Lydia

2018-05-03

This project aims to study the use of antibiotics in three clinical wards in the largest tertiary teaching hospital in Ethiopia for a period of 1 year. The specific aims were to assess the prevalence of patients on antibiotics, quantify the antibiotic consumption and identify the main indications of use. The material was all the medical charts (n = 2231) retrieved from three clinical wards (internal medicine, gynecology/obstetrics and surgery) in Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa between September 2013 and September 2014. Data collection was performed manually by four pharmacists. Each medical chart represented one patient. About 60% of the patients were admitted to internal medicine, 20% to each of the other two wards. The number of bed days (BD) was on average 16.5. Antibiotics for systemic use were prescribed to 73.7% of the patients (on average: 2.1 antibiotics/patient) of whom 86.6% got a third or fourth generation cephalosporin (mainly ceftriaxone). The average consumption of antibiotics was 81.6 DDD/100BD, varying from 91.8 in internal medicine and 71.6 in surgery to 47.6 in gynecology/obstetrics. The five most frequently occurring infections were pneumonia (26.6%), surgical site infections (21.5%), neutropenic fever (6.9%), sepsis (6.4%) and urinary tract infections (4.7%). About one fourth of the prescriptions were for prophylactic purposes. Hospital acquired infections occurred in 23.5% of the patients (353 cases of surgical site infection). The prescribing was based on empirical treatment and sensitivity testing was reported in only 3.8% of the cases. In the present study from three wards in the largest tertiary teaching hospital in Ethiopia, three out of four patients were prescribed antibiotics, primarily empirically. The mean antibiotic consumption was 81.6 DDD/100BD. Surgical site infections constituted a large burden of the infections treated in the hospital, despite extensive prescribing of prophylaxis. The findings show

Post natal use of analgesics: comparisons between conventional postnatal wards and a maternity hotel.

PubMed

Nordeng, Hedvig; Eskild, Anne; Nesheim, Britt-Ingjerd

2010-04-01

To investigate factors related to analgesic use after delivery, and especially whether rates of analgesic use were different in a midwife-managed maternity hotel as compared to conventional postnatal wards. One maternity hotel and two conventional postnatal wards at Ullevål University Hospital in Oslo, Norway. Data were obtained from hospital records for 804 women with vaginal deliveries. Postnatal analgesic use. Overall, approximately half the women used analgesics after vaginal delivery in both conventional postnatal wards and maternity hotel. The factors that were significantly associated with use of analgesics postnatally in multivariate analysis were multiparity, having a non-Western ethnicity, smoking in pregnancy, younger age, instrumental delivery, analgesic use during labour, maternal complications post partum, and duration of postnatal stay 4 days or more. The use of analgesics is determined by socio-demographic and obstetric factors rather than the organisation of the ward.

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

PubMed Central

Bate, J. G.

1961-01-01

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

An aeromagnetic survey in the Valley of Ten Thousand Smokes, Alaska. M.S. Thesis

NASA Technical Reports Server (NTRS)

Anma, K.

1971-01-01

Geologic and magnetic studies of the Katmai area have further demonstrated the close relationship between the Katmai Caldera, Novarupta plug, and the pyroclastic flows in the Valley of Ten Thousand Smokes. The magnetic fields observed appear to be associated with the thickness of the pyroclastic flow and the different rock units within it for lower flight levels, and also the contrast between the valley fill and the rock units at the Valley margins. Consistent magnetic anomalies are associated with the larger fumarole lines, which were presumably sites of large scale activity, while the smaller fumaroles are not usually seen in the aeromagnetic map. A possible correlation between low positive anomalies and nuee ardente deposits was revealed by the aeromagnetic survey, but was not strong. A ground survey was also carried out in several parts of the Valley with a view to detailed delineation of the magnetic signatures of the pyroclastic flow, as an aid to interpreting the aeromagnetic date.

Patient and visitor violence towards staff on medical and psychiatric wards in India.

PubMed

Raveesh, B N; Lepping, Peter; Lanka, Sri V K; Turner, Jim; Krishna, Murali

2015-02-01

Patient and visitor violence (PVV) towards staff is common across health settings. It has negative effects on staff and treatment provision. Little data is available from the developing world. To examine the prevalence of PVV in India and make comparisons with the existing data. We administered an abbreviated version of the Survey of Violence Experienced by Staff (SOVES-A) in English in Mysore on medical and psychiatric wards. 249 staff participated. 16% of staff in psychiatric wards were subjected to some form of PVV in the past 4 weeks which is lower than in the developed world. 57% of staff on medical wards experienced PVV which is similar to the developed world. Patients and Visitors were almost equal sources of this violence. Verbal abuse was more common than threats and physical assaults. Training in aggression management may be a protective factor. PVV is a significant problem in India, especially on medical wards. Aggression management training may be a way to reduce the prevalence of PVV. Copyright © 2014 Elsevier B.V. All rights reserved.

Agricultural Influences on Cache Valley, Utah Air Quality During a Wintertime Inversion Episode

NASA Astrophysics Data System (ADS)

Silva, P. J.

2017-12-01

Several of northern Utah's intermountain valleys are classified as non-attainment for fine particulate matter. Past data indicate that ammonium nitrate is the major contributor to fine particles and that the gas phase ammonia concentrations are among the highest in the United States. During the 2017 Utah Winter Fine Particulate Study, USDA brought a suite of online and real-time measurement methods to sample particulate matter and potential gaseous precursors from agricultural emissions in the Cache Valley. Instruments were co-located at the State of Utah monitoring site in Smithfield, Utah from January 21st through February 12th, 2017. A Scanning mobility particle sizer (SMPS) and aerodynamic particle sizer (APS) acquired size distributions of particles from 10 nm - 10 μm in 5-min intervals. A URG ambient ion monitor (AIM) gave hourly concentrations for gas and particulate ions and a Chromatotec Trsmedor gas chromatograph obtained 10 minute measurements of gaseous sulfur species. High ammonia concentrations were detected at the Smithfield site with concentrations above 100 ppb at times, indicating a significant influence from agriculture at the sampling site. Ammonia is not the only agricultural emission elevated in Cache Valley during winter, as reduced sulfur gas concentrations of up to 20 ppb were also detected. Dimethylsulfide was the major sulfur-containing gaseous species. Analysis indicates that particle growth and particle nucleation events were both observed by the SMPS. Relationships between gas and particulate concentrations and correlations between the two will be discussed.

Occurrence of airborne vancomycin- and gentamicin-resistant bacteria in various hospital wards in Isfahan, Iran

PubMed Central

Mirhoseini, Seyed Hamed; Nikaeen, Mahnaz; Khanahmad, Hossein; Hassanzadeh, Akbar

2016-01-01

Background: Airborne transmission of pathogenic resistant bacteria is well recognized as an important route for the acquisition of a wide range of nosocomial infections in hospitals. The aim of this study was to determine the prevalence of airborne vancomycin and gentamicin (VM and GM) resistant bacteria in different wards of four educational hospitals. Materials and Methods: A total of 64 air samples were collected from operating theater (OT), Intensive Care Unit (ICU), surgery ward, and internal medicine ward of four educational hospitals in Isfahan, Iran. Airborne culturable bacteria were collected using all glass impingers. Samples were analyzed for the detection of VM- and GM-resistant bacteria. Results: The average level of bacteria ranged from 99 to 1079 CFU/m3. The highest level of airborne bacteria was observed in hospital 4 (628 CFU/m3) and the highest average concentration of GM- and VM-resistant airborne bacteria were found in hospital 3 (22 CFU/m3). The mean concentration of airborne bacteria was the lowest in OT wards and GM- and VM-resistant airborne bacteria were not detected in this ward of hospitals. The highest prevalence of antibiotic-resistant airborne bacteria was observed in ICU ward. There was a statistically significant difference for the prevalence of VM-resistant bacteria between hospital wards (P = 0.012). Conclusion: Our finding showed that the relatively high prevalence of VM- and GM-resistant airborne bacteria in ICUs could be a great concern from the point of view of patients' health. These results confirm the necessity of application of effective control measures which significantly decrease the exposure of high-risk patients to potentially airborne nosocomial infections. PMID:27656612

Occurrence of airborne vancomycin- and gentamicin-resistant bacteria in various hospital wards in Isfahan, Iran.

PubMed

Mirhoseini, Seyed Hamed; Nikaeen, Mahnaz; Khanahmad, Hossein; Hassanzadeh, Akbar

2016-01-01

Airborne transmission of pathogenic resistant bacteria is well recognized as an important route for the acquisition of a wide range of nosocomial infections in hospitals. The aim of this study was to determine the prevalence of airborne vancomycin and gentamicin (VM and GM) resistant bacteria in different wards of four educational hospitals. A total of 64 air samples were collected from operating theater (OT), Intensive Care Unit (ICU), surgery ward, and internal medicine ward of four educational hospitals in Isfahan, Iran. Airborne culturable bacteria were collected using all glass impingers. Samples were analyzed for the detection of VM- and GM-resistant bacteria. The average level of bacteria ranged from 99 to 1079 CFU/m(3). The highest level of airborne bacteria was observed in hospital 4 (628 CFU/m(3)) and the highest average concentration of GM- and VM-resistant airborne bacteria were found in hospital 3 (22 CFU/m(3)). The mean concentration of airborne bacteria was the lowest in OT wards and GM- and VM-resistant airborne bacteria were not detected in this ward of hospitals. The highest prevalence of antibiotic-resistant airborne bacteria was observed in ICU ward. There was a statistically significant difference for the prevalence of VM-resistant bacteria between hospital wards (P = 0.012). Our finding showed that the relatively high prevalence of VM- and GM-resistant airborne bacteria in ICUs could be a great concern from the point of view of patients' health. These results confirm the necessity of application of effective control measures which significantly decrease the exposure of high-risk patients to potentially airborne nosocomial infections.

Challenges of Obtaining Informed Consent in Emergency Ward: A Qualitative Study in One Iranian Hospital

PubMed Central

Davoudi, Nayyereh; Nayeri, Nahid Dehghan; Zokaei, Mohammad Saeed; Fazeli, Nematallah

2017-01-01

Background and Objective: Regarding the fact that emergency ward has unique characteristics, whose uniqueness affects informed consent processes by creating specific challenges. Hence, it seems necessary to identify the process and challenges of informed consent in the emergency ward through a qualitative study to understand actual patients’ and health care providers’ experiences, beliefs, values, and feelings about the informed consent in the emergency ward. Through such studies, new insight can be gained on the process of informed consent and its challenges with the hope that the resulting knowledge will enable the promotion of ethical, legal as well as effective health services to the patients in the emergency ward. Method: In this qualitative study, research field was one of the emergency wards of educational and public hospitals in Iran. Field work and participant observation were carried out for 515 hours from June 2014 to March 2016. Also, conversations and semi-structured interviews based on the observations were conducted. The participants of the study were nurses and physicians working in the emergency ward, as well as patients and their attendants who were involved in the process of obtaining informed consent. Results: Three main categories were extracted from the data: a sense of frustration; reverse protection; and culture of paternalism in consent process. Conclusion: Findings of this study can be utilized in correcting the structures and processes of obtaining informed consent together with promotion of patients' ethical and legal care in emergency ward. In this way, the approaches in consent process will be changed from paternalistic approach to patient-centered care which concomitantly protects patient’s autonomy. PMID:29399235

Ground-water conditions in southern Utah Valley and Goshen Valley, Utah

USGS Publications Warehouse

Cordova, R.M.

1970-01-01

The investigation of ground-water conditions in southern Utah Valley and Goshen Valley, Utah, was made by the U. S. Geological Survey as part of a cooperative program with the Utah Department of Natural Resources, Division of Water Rights, to investigate the water resources of the State. The purposes of the investigation were to (1) determine the occurrence, recharge, discharge, movement, storage, chemical quality, and availability of ground water; (2) appraise the effects of increased withdrawal of water from wells; and (3) evaluate the effect of the Central Utah Project on the ground-water reservoir and the water supply of Utah Lake.This report presents a description of the aquifer system in the two valleys, a detailed description of the ground-water resources, and conclusions about potential development and its effect on the hydrologic conditions in the valleys. Two supplementary reports are products of the investigation. A basic-data release (Cordova, 1969) contains most of the basic data collected for the investigation, including well characteristics, drillers' logs, water levels, pumpage from wells, chemical analyses of ground and surface waters, and discharge of selected springs, drains, and streams. An interpretive report (Cordova and Mower, 1967) contains the results of a large-scale aquifer test in southern Utah Valley.

Interpretive geologic cross sections for the Death Valley regional flow system and surrounding areas, Nevada and California

USGS Publications Warehouse

Sweetkind, D.S.; Dickerson, R.P.; Blakely, R.J.; Denning, Paul

2001-01-01

This report presents a network of 28 geologic cross sections that portray subsurface geologic relations within the Death Valley regional ground-water system, a ground-water basin that encompasses a 3? x 3? area (approximately 70,000 km2) in southern Nevada and eastern California. The cross sections transect that part of the southern Great Basin that includes Death Valley, the Nevada Test Site, and the potential high-level nuclear waste underground repository at Yucca Mountain. The specific geometric relationships portrayed on the cross sections are discussed in the context of four general sub-regions that have stratigraphic similarities and general consistency of structural style: (1) the Nevada Test Site vicinity; (2) the Spring Mountains, Pahrump Valley and Amargosa Desert region; (3) the Death Valley region; and (4) the area east of the Nevada Test Site. The subsurface geologic interpretations portrayed on the cross sections are based on an integration of existing geologic maps, measured stratigraphic sections, published cross sections, well data, and geophysical data and interpretations. The estimated top of pre-Cenozoic rocks in the cross sections is based on inversion of gravity data, but the deeper parts of the sections are based on geologic conceptual models and are more speculative. The region transected by the cross sections includes part of the southern Basin and Range Province, the northwest-trending Walker Lane belt, the Death Valley region, and the northern Mojave Desert. The region is structurally complex, where a locally thick Tertiary volcanic and sedimentary section unconformably overlies previously deformed Proterozoic through Paleozoic rocks. All of these rocks have been deformed by complex Neogene ex-tensional normal and strike-slip faults. These cross sections form a three-dimensional network that portrays the interpreted stratigraphic and structural relations in the region; the sections form part of the geologic framework that will be

Ground-water quality in east-central Idaho valleys

USGS Publications Warehouse

Parliman, D.J.

1982-01-01

From May through November 1978, water quality, geologic, and hydrologic data were collected for 108 wells in the Lemhi, Pahsimeroi, Salman River (Stanley to Salmon), Big Lost River, and Little Lost River valleys in east-central Idaho. Data were assembled to define, on a reconnaissance level, water-quality conditions in major aquifers and to develop an understanding of factors that affected conditions in 1978 and could affect future ground-water quality. Water-quality characteristics determined include specific conductance, pH, water temperature, major dissolved cations, major dissolved anions, and coliform bacteria. Concentrations of hardness, nitrite plus nitrate, coliform bacteria, dissolved solids, sulfate, chloride, fluoride , iron, calcium, magnesium, sodium, potassium or bicarbonate exceed public drinking water regulation limits or were anomalously high in some water samples. Highly mineralized ground water probably is due to the natural composition of the aquifers and not to surface contamination. Concentrations of coliform bacteria that exceed public drinking water limits and anomalously high dissolved nitrite-plus-nitrite concentrations are from 15- to 20-year old irrigation wells in heavily irrigated or more densely populated areas of the valleys. Ground-water quality and quantity in most of the study area are sufficient to meet current (1978) population and economic demands. Ground water in all valleys is characterized by significant concentrations of calcium, magnesium, and bicarbonate plus carbonate ions. Variations in the general trend of ground-water composition (especially in the Lemhi Valley) probably are most directly related to variability in aquifer lithology and proximity of sampling site to source of recharge. (USGS)

Mapping Ecosystem Services in the Jordan Valley, Jordan

NASA Astrophysics Data System (ADS)

Luz, Ana; Marques, Ana; Ribeiro, Inês; Alho, Maria; Catarina Afonso, Ana; Almeida, Erika; Branquinho, Cristina; Talozi, Samer; Pinho, Pedro

2016-04-01

In the last decade researchers started using ecosystem services as a new framework to understand the relationships between environment and society. Habitat quality and water quality are related with ecosystem services regulation and maintenance, or even provision. According to the Common International Classification of Ecosystem Services (CICES) both habitat quality and water quality are associated with lifecycle maintenance, habitat and gene pool protection, and water conditions, among others. As there is increased pressure on habitats and rivers especially for agricultural development, mapping and evaluating habitat and water quality has important implications for resource management and conservation, as well as for rural development. Here, we model and map habitat and water quality in the Jordan Valley, Jordan. In this study, we aim to identify and analyse ecosystem services both through 1) habitat quality and 2) water quality modelling using InVest, an integrated valuation of ecosystem services and tradeoffs. The data used in this study mainly includes the LULC, Jordan River watershed and main threats and pollutants in the study area, such as agriculture, industry, fish farms and urbanization. Results suggest a higher pressure on natural habitats in the Northern region of the Jordan Valley, where industry is dominant. Agriculture is present along the Jordan Valley and limits the few natural forested areas. Further, water pollution is mainly concentrated in disposal sites due to the low flow of the Jordan River. Our results can help to identify areas where natural resources and water resource management is most needed in the Jordan Valley. Acknowledgements: Transbasin FP7 project

Hinners Point Above Floor of Marathon Valley on Mars Enhanced Color

NASA Image and Video Library

2015-09-25

This Martian scene shows contrasting textures and colors of "Hinners Point," at the northern edge of "Marathon Valley," and swirling reddish zones on the valley floor to the left. In this version of the image, the landscape is presented in enhanced color to make differences in surface materials more easily visible. The summit takes its informal name as a tribute to Noel Hinners (1935-2014). For NASA's Apollo program, Hinners played important roles in selection of landing sites on the moon and scientific training of astronauts. He then served as NASA associate administrator for space science, director of the Smithsonian National Air and Space Museum, director of NASA's Goddard Space Flight Center, NASA chief scientist and associate deputy administrator of NASA. Subsequent to responsibility for the Viking Mars missions while at NASA, he spent the latter part of his career as vice president for flight systems at Lockheed Martin, where he had responsibility for the company's roles in development and operation of NASA's Mars Global Surveyor, Mars Reconnaissance Orbiter, Mars Odyssey, Phoenix Mars Lander, Stardust and Genesis missions. Marathon Valley cuts generally east-west through the western rim of Endeavour Crater. The valley's name refers to the distance Opportunity drove from its 2004 landing site to arrival at this location in 2014. The valley was a high-priority destination for the rover mission because observations from orbit detected clay minerals there. Dark rocks on Hinners Point show a pattern dipping downward toward the interior of Endeavour, to the right from this viewing angle. The strong dip may have resulted from the violence of the impact event that excavated the crater. Brighter rocks make up the valley floor. The reddish zones there may be areas where water has altered composition. Inspections by Opportunity have found compositions there are higher in silica and lower in iron than the typical composition of rocks on Endeavour's rim. The scene spans

Limits of Freedom: The Ward Churchill Case

ERIC Educational Resources Information Center

O'Nell, Robert M.

2006-01-01

The University of Colorado's Ward Churchill is but the latest in a long line of professors whose volatile statements have created controversy for themselves and their universities. Specific personnel matters in the case have been meticulously addressed in Boulder, but several larger questions have been curiously neglected. One might well ask, for…

Forecasting Daily Patient Outflow From a Ward Having No Real-Time Clinical Data

PubMed Central

Tran, Truyen; Luo, Wei; Phung, Dinh; Venkatesh, Svetha

2016-01-01

Background: Modeling patient flow is crucial in understanding resource demand and prioritization. We study patient outflow from an open ward in an Australian hospital, where currently bed allocation is carried out by a manager relying on past experiences and looking at demand. Automatic methods that provide a reasonable estimate of total next-day discharges can aid in efficient bed management. The challenges in building such methods lie in dealing with large amounts of discharge noise introduced by the nonlinear nature of hospital procedures, and the nonavailability of real-time clinical information in wards. Objective Our study investigates different models to forecast the total number of next-day discharges from an open ward having no real-time clinical data. Methods We compared 5 popular regression algorithms to model total next-day discharges: (1) autoregressive integrated moving average (ARIMA), (2) the autoregressive moving average with exogenous variables (ARMAX), (3) k-nearest neighbor regression, (4) random forest regression, and (5) support vector regression. Although the autoregressive integrated moving average model relied on past 3-month discharges, nearest neighbor forecasting used median of similar discharges in the past in estimating next-day discharge. In addition, the ARMAX model used the day of the week and number of patients currently in ward as exogenous variables. For the random forest and support vector regression models, we designed a predictor set of 20 patient features and 88 ward-level features. Results Our data consisted of 12,141 patient visits over 1826 days. Forecasting quality was measured using mean forecast error, mean absolute error, symmetric mean absolute percentage error, and root mean square error. When compared with a moving average prediction model, all 5 models demonstrated superior performance with the random forests achieving 22.7% improvement in mean absolute error, for all days in the year 2014. Conclusions In the

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

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

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

Analysis of Mining-induced Valley Closure Movements

NASA Astrophysics Data System (ADS)

Zhang, C.; Mitra, R.; Oh, J.; Hebblewhite, B.

2016-05-01

Valley closure movements have been observed for decades in Australia and overseas when underground mining occurred beneath or in close proximity to valleys and other forms of irregular topographies. Valley closure is defined as the inward movements of the valley sides towards the valley centreline. Due to the complexity of the local geology and the interplay between several geological, topographical and mining factors, the underlying mechanisms that actually cause this behaviour are not completely understood. A comprehensive programme of numerical modelling investigations has been carried out to further evaluate and quantify the influence of a number of these mining and geological factors and their inter-relationships. The factors investigated in this paper include longwall positional factors, horizontal stress, panel width, depth of cover and geological structures around the valley. It is found that mining in a series passing beneath the valley dramatically increases valley closure, and mining parallel to valley induces much more closure than other mining orientations. The redistribution of horizontal stress and influence of mining activity have also been recognised as important factors promoting valley closure, and the effect of geological structure around the valley is found to be relatively small. This paper provides further insight into both the valley closure mechanisms and how these mechanisms should be considered in valley closure prediction models.

The Inter-Valley Soil Comparative Survey: the ecology of Dry Valley edaphic microbial communities

PubMed Central

Lee, Charles K; Barbier, Béatrice A; Bottos, Eric M; McDonald, Ian R; Cary, Stephen Craig

2012-01-01

Recent applications of molecular genetics to edaphic microbial communities of the McMurdo Dry Valleys and elsewhere have rejected a long-held belief that Antarctic soils contain extremely limited microbial diversity. The Inter-Valley Soil Comparative Survey aims to elucidate the factors shaping these unique microbial communities and their biogeography by integrating molecular genetic approaches with biogeochemical analyses. Although the microbial communities of Dry Valley soils may be complex, there is little doubt that the ecosystem's food web is relatively simple, and evidence suggests that physicochemical conditions may have the dominant role in shaping microbial communities. To examine this hypothesis, bacterial communities from representative soil samples collected in four geographically disparate Dry Valleys were analyzed using molecular genetic tools, including pyrosequencing of 16S rRNA gene PCR amplicons. Results show that the four communities are structurally and phylogenetically distinct, and possess significantly different levels of diversity. Strikingly, only 2 of 214 phylotypes were found in all four valleys, challenging a widespread assumption that the microbiota of the Dry Valleys is composed of a few cosmopolitan species. Analysis of soil geochemical properties indicated that salt content, alongside altitude and Cu2+, was significantly correlated with differences in microbial communities. Our results indicate that the microbial ecology of Dry Valley soils is highly localized and that physicochemical factors potentially have major roles in shaping the microbiology of ice-free areas of Antarctica. These findings hint at links between Dry Valley glacial geomorphology and microbial ecology, and raise previously unrecognized issues related to environmental management of this unique ecosystem. PMID:22170424

27 CFR 9.132 - Rogue Valley.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Rogue Valley. 9.132... Rogue Valley. (a) Name. The name of the viticultural area described in this section is “Rouge Valley.” (b) Approved map. The appropriate map for determining the boundaries of the Rogue Valley viticultural...

The effects of leadership and ward factors on job satisfaction in nursing homes: a multilevel approach.

PubMed

Havig, Anders K; Skogstad, Anders; Veenstra, Marijke; Romøren, Tor I

2011-12-01

To examine (1) the relationships between job satisfaction and task- and relationship-oriented leadership and (2) the direct and moderating effects on job satisfaction of three ward-level factors: workload, use of teams and staff stability. Job satisfaction in nursing homes is vital to meeting the challenges related to recruitment and turnover. Cross-sectional design. A multilevel analysis approach was used to recognise a hierarchal structure of determined factors and to capture variation in job satisfaction at the individual and ward level. A questionnaire was sent to 444 registered nurses, auxiliary nurses and unskilled nursing assistants. Structured interviews were administered to 40 ward managers and 13 directors, and 900 hours of field observations was conducted in 40 nursing home wards throughout Norway. We found a significant relationship between job satisfaction and task-oriented and relationship-oriented leadership styles, with a stronger effect for task orientation. The effect of the two leadership styles varied significantly across wards. Furthermore, staff stability had both a significant positive direct effect and a moderating effect on job satisfaction, whereas the two other ward-level predictors yielded no significant contributions. The relatively stronger effect of task-oriented leadership on job satisfaction, particularly in wards with low staff stability, is in contrast to most previous studies and suggests that there may be specific conditions in nursing homes that favour the use of this leadership style. The varying effect of both leadership styles indicates that staff in different nursing home wards could benefit from the use of different leadership styles. The study highlights the importance of using different leadership behaviour and the importance of high staff stability to ensure job satisfaction among nursing home personnel. © 2011 Blackwell Publishing Ltd.

Observational study of aggressive behaviour and coercion on an Indian acute ward.

PubMed

Danivas, Vijay; Lepping, Peter; Punitharani, Shivanna; Gowrishree, Handithavalli; Ashwini, Kundapur; Raveesh, Bevinahalli Nanjegowda; Palmstierna, Tom

2016-08-01

We evaluated prevalence of aggressive behaviour and coercive measures on an acute Indian psychiatric ward where relatives are always present at the ward. Non-interacting, independent observers (specifically trained mental health clinicians) on an Indian acute, 20-bedded psychiatric ward gave structured reports on all violent episodes and coercive measures during a 30-day period. They used the Staff Observation Aggression Scale -Revised, Indian (SOAS-RI). The severity of the SOAS-RI reports were independently analysed by one of the authors. 229 violent incidents were recorded, involving 63% of admitted patients. 27% of all admitted patients were subjected to intravenous injections. Relatives provoked 35% of the incidents and were the target in 56% of the incidents. Patientś own relatives were involved in managing the aggression in 35% of the incidents. Relatives of other patients were involved in 14% of the incidents. The likelihood of a patient to be physically restrained and that a relative would be participating in the coercive measures was increased when medical staff was targeted. Relatives are commonly triggers and victims of aggressions on the inverstigated acute Indian psychiatric wards. Doctors and nurses are less likely to be victims but aggression towards them leads more commonly to coercive measures. Copyright © 2016 Elsevier B.V. All rights reserved.

The ward atmosphere important for the psychosocial work environment of nursing staff in psychiatric in-patient care

PubMed Central

2011-01-01

Background The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. Methods 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. Results The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. Conclusions The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways. PMID:21679430

Seasonal and diurnal variations of methane and carbon dioxide in the highly polluted Kathmandu Valley, Nepal

NASA Astrophysics Data System (ADS)

Mahata, Khadak; Panday, Arnico; Rupakheti, Maheswar; Lawrence, Mark

2016-04-01

Anthropogenic emissions of carbon dioxide and methane - key greenhouse gases (GHGs) - are primary causes of global warming and resultant impacts. The atmospheric warming is more pronounced and likely to cause more serious damage in vulnerable areas such as the Hindukush-Karakorum-Himalayan region (HKH). The HKH region is a data gap region according to the 5th Assessment report of the intergovernmental panel on climate change (IPCC). In order to understand the mixing ratios and variability of the key GHGs in the foothills of the Central Himalaya, we carried out continuous measurements of CO2, CH4, CO, and water vapor at Bode (an urban site in the Kathmandu valley, Nepal) for a year (March 2013 - Feb 2014), and again at Bode and at Chanban (a background outside the Valley) for 3 months (July 15 - Oct 3, 2015), with two state-of-the-art cavity ring-down instruments (Picarro G2401). The measurements were carried out as a part of the international air pollution measurement campaign: SusKat- ABC (Sustainable atmosphere for the Kathmandu Valley - Atmospheric Brown Clouds). The annual average CO2 and CH4 concentrations at Bode were 419 ± 24 and 2.192 ± 0.224 ppm, respectively, which are notably higher than those observed at the background site at Mauna Loa Observatory in the same period. The CO2concentration at Bode was high during the pre-monsoon period and low during the monsoon, while CH4 was high in winter and lower during the pre-monsoon period. The monthly CO2concentration was highest in April. Forest fires and agro-waste burning in the region, and the local emissions in the Kathmandu valley were the main sources of the high CO2 in the pre-monsoon period. CH4 showed a maximum in September due to additional emissions from paddy fields. Seasonally, winter has the highest CH4 concentration which is due to brick production, which is a seasonal activity, and other local sources combined with the shallow mixing layer height in winter. The diurnal pattern of CO2 and CH4

Three Bridge Fryer's Ford Bridge, Nimrod Bridge, and Ward's ...

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

Three Bridge - Fryer's Ford Bridge, Nimrod Bridge, and Ward's Crossing Bridge - Fryer's Ford Bridge, Spanning East Fork of Point Remove Creek at Fryer Bridge Road (CR 67), Solgohachia, Conway County, AR

Missed Opportunities for Nutritional Rehabilitation in Children Admitted to Surgical Wards

PubMed Central

Dave, Pooja; Nimbalkar, Somashekhar; Phatak, Ajay; Desai, Rajendra; Srivastava, Shirish

2016-01-01

Background. Malnutrition in children has serious health and economic consequences. We studied documentation of malnutrition, actual prevalence, and treatment given in children admitted to surgical wards. Methods. Retrospective study of 154 patients aged <5 yrs admitted to general surgical, orthopedic, and otorhinolaryngology wards. Records were evaluated for completeness of data, way of documentation, and data quality. Descriptive analysis was done. If malnutrition was not identified and/or proper action was not taken, it was defined as a “missed opportunity.” Results. Of 154 records audited, 100 (64.94%) were males, 108 (70.13%) were from general surgery ward, and 78 (50.65%) were residing in suburban area. The mean (SD) age of the study population was 2.32 (1.16) years whereas mean (SD) duration of stay was 5.84 (6.29) days. Weight and height were mentioned in 116 (75.32%) and 8 (5.19%) records, respectively, mostly by nonsurgical personnel. Documentation and treatment of malnutrition were poor. Out of 106 apparently correct weight records, 19 (17.93%) children were severely undernourished and 30 (28.30%) were moderately undernourished whereas 20 (18.87%) children were not undernourished but required nutritional attention. Conclusion. There is poor documentation of nutritional indicators of children admitted to surgical wards. From data that was available, it is apparent that malnutrition is at high levels. “Identification” and hence management of malnutrition need more attention. PMID:27429836

Clinical leadership for high-quality care: developing future ward leaders.

PubMed

Enterkin, Judith; Robb, Elizabeth; McLaren, Susan

2013-03-01

This paper reports upon the development, delivery and evaluation of a leadership programme for aspiring Ward Leaders in one National Health Service Trust in England. The ward sister role is fundamental to quality patient care and clinical leadership, however the role is increasingly difficult to recruit to. A lack of formal preparation and skills development for the role has been widely acknowledged. An evaluation of a programme of education for leadership. Three cohorts (n = 60) completed the programme. Semi-structured questionnaires were completed by participants (n = 36: 60%) at the conclusion of the programme. Qualitative data from questionnaires was analysed using a thematic approach. Participants reported increased political, organizational and self-awareness, increased confidence, feelings of empowerment and the ability to empower others. Opportunities for networking with peers were valued within the action learning approach. For some participants, career intentions were clarified through reflection. The majority of participants had benefited from the leadership programme and valued this development as an empowering preparation for future careers. Investment in leadership preparation for future ward sister roles is strongly recommended as part of a strategy designed to enhance quality improvement, career path development, workforce empowerment and retention. © 2012 Blackwell Publishing Ltd.

[Dementia-friendly hospital wards : Expert recommendations for planning and design].

PubMed

Büter, K; Motzek, T; Dietz, B; Hofrichter, L; Junge, M; Kopf, D; von Lützau-Hohlbein, H; Traxler, S; Zieschang, T; Marquardt, G

2017-01-01

Hospitals face great challenges in the necessity of providing care for the rising number of elderly patients with dementia. The adaptation of the spatial environment represents an important component to improve the care situation of patients with dementia. For more than 30 years research results from long-term care have provided evidence on the therapeutic effect of numerous architectural features on people with dementia. Due to specific medical and organizational requirements in hospitals, the transferability of these findings is, however, limited. An interdisciplinary workshop with experts from the fields of medicine, nursing, gerontology, self-help and architecture was conducted in July 2015. Based on existing research findings and experiences from pilot projects, the spatial requirements for dementia-friendly hospital wards were collated, suggested solutions were discussed from different perspectives and finally design recommendations were derived. The article gives a first comprehensive overview of architectural measures that are required for the design of dementia-friendly hospital wards. The recommendations provided range from architectural criteria, such as the size and spatial structure of hospital wards, to interior design elements, including orientation and navigation aids and the use of light and colors. Furthermore, information about the planning process are given.

Characteristics of aggression among psychiatric inpatients by ward type in Japan: Using the Staff Observation Aggression Scale - Revised (SOAS-R).

PubMed

Sato, Makiko; Noda, Toshie; Sugiyama, Naoya; Yoshihama, Fumihiro; Miyake, Michi; Ito, Hiroto

2017-12-01

Aggressive behaviour by psychiatric patients is a serious issue in clinical practice, and adequate management of such behaviour is required, with careful evaluation of the factors causing the aggression. To examine the characteristics of aggressive incidents by ward type, a cross-sectional descriptive study was conducted for 6 months between April 2012 and June 2013 using the Staff Observation Aggression Scale - Revised, Japanese version (SOAS-R) in 30 wards across 20 Japanese psychiatric hospitals. Participating wards were categorized into three types based on the Japanese medical reimbursement system: emergency psychiatric, acute psychiatric, and standard wards (common in Japan, mostly treating non-acute patients). On analyzing the 443 incidents reported, results showed significant differences in SOAS-R responses by ward type. In acute and emergency psychiatric wards, staff members were the most common target of aggression. In acute psychiatric wards, staff requiring patients to take medication was the most common provocation, and verbal aggression was the most commonly used means. In emergency psychiatric wards, victims felt threatened. In contrast, in standard wards, both the target and provocation of aggression were most commonly other patients, hands were used, victims reported experiencing physical pain, and seclusion was applied to stop their behaviour. These findings suggest that ward environment was an important factor influencing aggressive behaviour. Ensuring the quality and safety of psychiatric care requires understanding the characteristics of incidents that staff are likely to encounter in each ward type, as well as implementing efforts to deal with the incidents adequately and improve the treatment environment. © 2016 Australian College of Mental Health Nurses Inc.

Wintertime Ambient Ammonia Concentrations in Northern Utah's Urban Valleys

NASA Astrophysics Data System (ADS)

Hammond, I. A.; Martin, R. S.; Silva, P.; Baasandorj, M.

2017-12-01

Many of the population centers in northern Utah are currently classified as non-attainment or serious non-attainment, Wasatch Front, for PM2.5 and previous studies have shown ammonium nitrate to often be the largest contributor to the particulate mass. Furthermore, measurements have shown several of the Wasatch Front cities and Cache Valley (UT/ID) consistently recorded some of the highest ambient ammonia (NH3) concentrations in the continental United States. As a part of the multi-organization 2017 Utah Winter Fine Particulate Study real-time NH3 concentrations were monitored in the Cache Valley at the Logan, UT site, collocated at an EPA sampling trailer near the Utah State University (USU) campus. A Picarro model G2508 was to used collect 5-sec averaged concentrations of NH3, carbon dioxide (CO2), and methane (CH4) from January 16th to February 14th, 2017. Parts of three inversion events, wherein the PM2.5 concentrations approached or exceeded the National Ambient Air Quality Standards, were captured during the sampling period, including a 10-day event from January 25th to February 4th. Concentrations of all three of the observed species showed significant accumulation during the events, with NH3 concentrations ranging from below the detection limit (<0.5 ppb) to >70 ppb. Preliminary analysis suggested the temporal NH3 changes tracked the increase in PM2.5 throughout the inversion events; however, a one-day period of NH3 depletion during the main inversion event was observed while PM2.5 continued to increase. Additionally, a network of passive NH3 samplers (Ogawa Model 3300) were arrayed at 25 sites throughout the Cache Valley and at 11 sites located along the Wasatch Front. These networks sampled for three 7-day periods, during the same study time frame. Ion chromatographic (IC) analyses of the sample pads are not yet finalized; however, preliminary results show concentrations in the tens of ppb and seemingly spatially correlate with previous studies showing

The Effects of Mountaintop Mines and Valley Fills on Aquatic ...

EPA Pesticide Factsheets

EPA announced the availability of the final report, The Effects of Mountaintop Mines and Valley Fills on Aquatic Ecosystems of the Central Appalachian Coalfields. This report assesses the state of the science on the environmental impacts of mountaintop mines and valley fills (MTM-VF) on streams in the central Appalachian coalfields. These coalfields cover about 48,000 square kilometers (122 million acres) in West Virginia, Kentucky, Virginia and Tennessee, USA. Our reviews focused on the impacts on mountaintop removal coal mining, which as its name suggests, involves removing all or some portion of the top of a mountain or ridge to expose and mine one or more coal seams. The excess overburden is disposed of in constructed fills in small valleys or hollows adjacent to the mining site. Our conclusions, based on evidence from the peer-reviewed literature and from the U.S. Environmental Protection Agency's Programmatic Environmental Impact Statement released in 2005, are that mountaintop mines and valley fills lead directly to five principal alterations of stream ecosystems: springs and ephemeral, intermittent and perennial streams are permanently lost with the removal of the mountain and from burial under fill, concentrations of major chemical ions are persistently elevated downstream, degraded water quality reaches levels that are acutely lethal to organisms in standard aquatic toxicity tests, selenium concentrations are elevated, reaching concentrations t

Appraisal of the water resources of Death Valley, California-Nevada

USGS Publications Warehouse

Miller, Glenn Allen

1977-01-01

The hydrologic system in Death Valley is probably in a steady-state condition--that is, recharge and discharge are equal, and net changes in the quantity of ground water in storage are not occurring. Recharge to ground water in the valley is derived from interbasin underflow and from local precipitation. The two sources may be of the same magnitude. Ground water beneath the valley moves toward the lowest area, a 200-square-mile saltpan, much of which is underlain by rock salt and other saline minerals, probably to depths of hundreds of feet or even more than 1,000 feet. Some water discharges from the saltpan by evaportranspiration. Water beneath the valley floor, excluding the saltpan, typically contains between 3,000 and 5,000 milligrams per liter of dissolved solids. Water from most springs and seeps in the mountains contains a few hundred to several hundred milligrams per liter of dissolved solids. Water from large springs that probably discharge from interbasin flow systems typically contains between 500 and 1,000 milligrams per liter dissolved solids. Present sites of intensive use by man are supplied by springs, with the exception of the Stovepipe Wells Hotel area. Potential sources of supply for this area include (1) Emigrant Spring area, (2) Cottonwood Spring, and (3) northern Mesquite Flat. (Woodard-USGS)

Hydrologic and hydraulic analyses at Akin Branch and Cayce Valley Branch, Columbia, Tennessee

USGS Publications Warehouse

Outlaw, George S.

1993-01-01

The U.S. Geological Survey, in cooperation with the City of Columbia, Tennessee, conducted hydrologic and hydraulic analyses at Akin Branch and Cayce Valley Branch in the Little Bigby Creek watershed, Columbia, Tennessee, from 1990 through 1991. Results of the analyses can be used by city planners in the development of plans to replace several deteriorating and inadequate drainage structures. Akin Branch and Cayce Valley Branch drain small watersheds of 1.69 and 1.04 square miles, respectively. Flood discharges for 5-, lo-, and 25-year recurrence-interval storm events were calculated at the stream mouths using flood-frequency relations developed for use at small urban streams in Tennessee. For each stream, flood discharges at locations upstream from the mouth were calculated by subdividing the watershed and assigning a percentage of the discharge at the mouth, based on drainage area, to each subarea. Flood profiles for the selected recurrence-interval flood discharges were simulated for Akin Branch and Cayce Valley Branch for existing conditions and conditions that might exist if drainage improvements such as larger culverts and bridges and channel improvements are constructed. The results of the simulations were used to predict changes in flood elevations that might result from such drainage improvements. Analyses indicate that reductions in existing flood elevations of as much as 2.1 feet for the 5-year flood at some sites on Akin Branch and as much as 3.8 feet for the 5-year flood at some sites on Cayce Valley Branch might be expected with the drainage improvements.

Does doctors' workload impact supervision and ward activities of final-year students? A prospective study.

PubMed

Celebi, Nora; Tsouraki, Rodoula; Engel, Corinna; Holderried, Friederike; Riessen, Reimer; Weyrich, Peter

2012-06-11

Hospital doctors face constantly increasing workloads. Besides caring for patients, their duties also comprise the education of future colleagues. The aim of this study was to objectively investigate whether the workload arising from increased patient care interferes with student supervision and is associated with more non-medical activities of final-year medical students. A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period at the beginning of their internship in Internal Medicine. Students categorized their activities--both medical and non-medical--according to whether they had: (1) only watched, (2) assisted the ward resident, (3) performed the activity themselves under supervision of the ward resident, or (4) performed the activity without supervision. The activities reported on a particular day were matched with a ward specific workload-index derived from the hospital information system, including the number of patients treated on the corresponding ward on that day, a correction factor according to the patient comorbidity complexity level (PCCL), and the number of admissions and discharges. Both students and ward residents were blinded to the study question. A total of 32 diaries (59 %, 442 recorded working days) were handed back. Overall, the students reported 1.2 ± 1.3 supervised, 1.8 ± 1.6 medical and 3.6 ± 1.7 non-medical activities per day. The more supervised activities were reported, the more the number of reported medical activities increased (p < .0001). No relationship between the ward specific workload and number of medical activities could be shown. There was a significant association between ward doctors' supervision of students and the number of medical activities performed by medical students. The workload had no significant effect on supervision or the number of medical or non-medical activities of final-year students.

Ground-water modeling of the Death Valley Region, Nevada and California

USGS Publications Warehouse

Belcher, W.R.; Faunt, C.C.; Sweetkind, D.S.; Blainey, J.B.; San Juan, C. A.; Laczniak, R.J.; Hill, M.C.

2006-01-01

The Death Valley regional ground-water flow system (DVRFS) of southern Nevada and eastern California covers an area of about 100,000 square kilometers and contains very complex geology and hydrology. Using a computer model to represent the complex system, the U.S. Geological Survey simulated ground-water flow in the Death Valley region for use with U.S. Department of Energy projects in southern Nevada. The model was created to help address contaminant cleanup activities associated with the underground nuclear testing conducted from 1951 to 1992 at the Nevada Test Site and to support the licensing process for the proposed geologic repository for high-level nuclear waste at Yucca Mountain, Nevada.

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

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

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

Identification of the benefits, enablers and barriers to integrating junior pharmacists into the ward team within one UK-based hospital

PubMed Central

Hung, Man Yui; Wright, David John; Blacklock, Jeanette; Needle, Richard John

2017-01-01

Introduction A high nurse-vacancy rate combined with high numbers of applications for junior pharmacist roles resulted in Colchester Hospital University National Health System Foundation Trust trial employing junior pharmacists into traditional nursing posts with the aim of integrating pharmacists into the ward team and enhancing local medicines optimization. The aim of the evaluation was to describe the implementation process and practice of the integrated care pharmacists (ICPs) in order to inform future innovations of a similar nature. Methods Four band 6 ward-based ICPs were employed on two wards funded within current ward staffing expenditure. With ethical committee approval, interviews were undertaken with the ICPs and focus groups with ward nurses, senior ward nurses and members of the medical team. Data were analyzed thematically to identify service benefits, barriers and enablers. Routine ward performance data were obtained from the two ICP wards and two wards selected as comparators. Appropriate statistical tests were performed to identify differences in performance. Results Four ICPs were interviewed, and focus groups were undertaken with three junior nurses, four senior nurses and three medical practitioners. Service enablers were continuous ward time, undertaking drug administration, positive feedback and use of effective communication methods. Barriers were planning, funding model, career development, and interprofessional working and social isolation. ICPs were believed to save nurse time and improve medicines safety. The proportion of patients receiving medicine reconciliation within 24 hours increased significantly in the ICP wards. All ICPs had resigned from their role within 12 months. Discussion It was believed that by locating pharmacists on the ward full time and allowing them to undertake medicines administration and medicines reconciliation, the nursing time would be saved and medicines safety improved. There was however significant learning

Identification of the benefits, enablers and barriers to integrating junior pharmacists into the ward team within one UK-based hospital.

PubMed

Hung, Man Yui; Wright, David John; Blacklock, Jeanette; Needle, Richard John

2017-01-01

A high nurse-vacancy rate combined with high numbers of applications for junior pharmacist roles resulted in Colchester Hospital University National Health System Foundation Trust trial employing junior pharmacists into traditional nursing posts with the aim of integrating pharmacists into the ward team and enhancing local medicines optimization. The aim of the evaluation was to describe the implementation process and practice of the integrated care pharmacists (ICPs) in order to inform future innovations of a similar nature. Four band 6 ward-based ICPs were employed on two wards funded within current ward staffing expenditure. With ethical committee approval, interviews were undertaken with the ICPs and focus groups with ward nurses, senior ward nurses and members of the medical team. Data were analyzed thematically to identify service benefits, barriers and enablers. Routine ward performance data were obtained from the two ICP wards and two wards selected as comparators. Appropriate statistical tests were performed to identify differences in performance. Four ICPs were interviewed, and focus groups were undertaken with three junior nurses, four senior nurses and three medical practitioners. Service enablers were continuous ward time, undertaking drug administration, positive feedback and use of effective communication methods. Barriers were planning, funding model, career development, and interprofessional working and social isolation. ICPs were believed to save nurse time and improve medicines safety. The proportion of patients receiving medicine reconciliation within 24 hours increased significantly in the ICP wards. All ICPs had resigned from their role within 12 months. It was believed that by locating pharmacists on the ward full time and allowing them to undertake medicines administration and medicines reconciliation, the nursing time would be saved and medicines safety improved. There was however significant learning to be derived from the implementation

Basin-floor Lake Bonneville stratigraphic section as revealed in paleoseismic trenches at the Baileys Lake site, West Valley fault zone, Utah

USGS Publications Warehouse

Hylland, Michael D.; DuRoss, Christopher B.; McDonald, Greg N.; Olig, Susan S.; Oviatt, Charles G.; Mahan, Shannon; Crone, Anthony J.; Personius, Stephen

2012-01-01

 Recent paleoseismic trenching on the Granger fault of the West Valley fault zone in Salt Lake County, Utah, exposed a nearly complete section of late Pleistocene Lake Bonneville deposits, and highlights challenges related to accurate interpretation of basin-floor stratigraphy in the absence of numerical age constraints. We used radiocarbon and luminescence dating as well as ostracode biostratigraphy to provide chronostratigraphic control on the Lake Bonneville section exposed at the Baileys Lake trench site. The fault trenches exposed folded and faulted pre- to post- Bonneville sediments, including about 0.7 m of pre-Bonneville wetland/fluvial-marsh deposits, a nearly complete Bonneville section 2.5–4.0 m thick, and 0.4–1.0 m of post-Bonneville deposits consisting primarily of loess with minor scarp-derived colluvium. The relatively thin Bonneville section compares favorably with basin-floor Bonneville sections documented in boreholes and seismic reflection profiles beneath Great Salt Lake. Distinctive features of the Bonneville section at the Baileys Lake site include a sequence of turbidites in the upper part of the Bonneville transgressive deposits, evidence for an earthquake during Provo-shoreline time that disturbed lake-bottom sediments and destroyed any stratigraphic signature of the Bonneville Flood, tufa deposition associated with Gilbert-phase shoreline transgression, and stratigraphic evidence for two Gilbert transgressions across the site.

Hydrogeology and water quality of the West Valley Creek Basin, Chester County, Pennsylvania

USGS Publications Warehouse

Senior, Lisa A.; Sloto, Ronald A.; Reif, Andrew G.

1997-01-01

.5 inches in 1990 and 13.7 inches in 1991. Ground-water quality in the basin reflects differences in lithology and has been affected by human activities. Ground water in the carbonate rocks is naturally hard, has a near neutral pH, and contains more dissolved solids and less dissolved iron, manganese, and radon-222 than ground water in the noncarbonate rocks, which is soft, with moderately acidic to acidic pH. Regional contamination by chloride and nitrate and local contamination by organic compounds and metals was detected. Natural background concentrations are estimated to be about 1 milligram per liter for nitrate as nitrogen and less than 3 milligrams per liter for chloride. Ground water in unsewered areas and agricultural areas of the basin has median concentrations of nitrate that are greater than those in ground water from other areas; septic system effluent and fertilizer are probable sources of elevated nitrate. Water samples from wells in urbanized areas contain greater concentrations of chloride than samples from wells in residential areas; road salt is the probable source of elevated chloride. Organic solvents, especially trichloroethylene, were detected in 30 percent of the wells sampled in the urbanized carbonate valley. Most of the organic solvents and some of the metals in ground water were detected near old industrial sites.Base-flow stream quality of West Valley Creek was determined at 15 sites from monthly sampling for 1 year. Differences in stream quality reflect differences in lithology, land use, and point sources in tributary subbasins and mainstem reaches. The chemical composition of base flow in the mainstem is dominated by ground-water discharge from carbonate rocks. Elevated concentrations of nitrate (greater than 3 milligrams per liter as nitrogen) in base flow were measured in a tributary draining agricultural land and in a tributary draining an unsewered residential area. Elevated concentrations of phosphate (greater than 0.5 milligrams per

Microbiological Assessment of Indoor Air of Teaching Hospital Wards: A case of Jimma University Specialized Hospital.

PubMed

Fekadu, Samuel; Getachewu, Bahilu

2015-04-01

Hospital environment represents a congenial situation where microorganisms and susceptible patients are indoors together. Thus, the objective of this study is to provide fundamental data related to the microbial quality of indoor air of Jimma University Specialized Hospital wards, to estimate the health hazard and to create standards for indoor air quality control. The microbial quality of indoor air of seven wards of Jimma University Specialized Hospital was determined. Passive air sampling technique, using open Petri-dishes containing different culture media, was employed to collect sample twice daily. The concentrations of bacteria and fungi aerosols in the indoor environment of the wards ranged between 2123 - 9733 CFU/m(3). The statistical analysis showed that the concentrations of bacteria that were measured in all studied wards were significantly different from each other (p-value=0.017), whereas the concentrations of fungi that were measured in all sampled wards were not significantly different from each other (p-value=0.850). Moreover, the concentrations of bacteria that were measured at different sampling time (morning and afternoon) were significantly different (p-value =0.001). All wards that were included in the study were heavily contaminated with bacteria and fungi. Thus, immediate interventions are needed to control those environmental factors which favor the growth and multiplication of microbes, and it is vital to control visitors and students in and out the wards. Moreover, it is advisable that strict measures be put in place to check the increasing microbial load in the hospital environment.

[Extralegal coercive measures in psychiatric wards-- patients' perspectives].

PubMed

Jensen, Hans Mørch; Poulsen, Henrik Day

2006-02-06

A revision of the Danish Mental Health Act is planned to take place in 2005-2006. The Ministry of Health requires investigation into whether extralegal coercive measures take place in psychiatric wards. Extralegal coercion refers to restrictions and rules not included in the current Mental Health Act and considered by patients to be coercion. Twenty-two psychiatric patients participated in four group interviews directed by two physicians at four University Hospitals in Copenhagen, Denmark. The patients were asked to define what they perceived as extralegal coercion, house rules and psychiatric treatment. The majority of patients perceived lack of single rooms, restrictions on leaving the ward and shielding, i.e., being confined to one's room, to be extralegal coercion. A few also found the pressure to take medication and collection of clothes items to be extralegal coercion. Rules on smoking, clothing, day and night routines, the use of radio and TV, drugs, alcohol, visits, eating and the use of telephones were considered not extralegal coercion but necessary house rules. House rules should be clear and stated in writing. Restrictions on the use of money and locking of the front door at night were accepted in certain situations, hence not considered to be extralegal coercion. Extralegal coercion does occur in psychiatric wards but in certain situations is accepted if documented. House rules are considered to be necessary and not extralegal coercion. Increased use of compulsory protocols for documenting coercive measures was not considered to be necessary, but documentation in patients' files was useful alternative.

Hydrogeologic framework and estimates of groundwater storage for the Hualapai Valley, Detrital Valley, and Sacramento Valley basins, Mohave County, Arizona

USGS Publications Warehouse

Truini, Margot; Beard, L. Sue; Kennedy, Jeffrey; Anning, Dave W.

2013-01-01

We have investigated the hydrogeology of the Hualapai Valley, Detrital Valley, and Sacramento Valley basins of Mohave County in northwestern Arizona to develop a better understanding of groundwater storage within the basin fill aquifers. In our investigation we used geologic maps, well-log data, and geophysical surveys to delineate the sedimentary textures and lithology of the basin fill. We used gravity data to construct a basin geometry model that defines smaller subbasins within the larger basins, and airborne transient-electromagnetic modeled results along with well-log lithology data to infer the subsurface distribution of basin fill within the subbasins. Hydrogeologic units (HGUs) are delineated within the subbasins on the basis of the inferred lithology of saturated basin fill. We used the extent and size of HGUs to estimate groundwater storage to depths of 400 meters (m) below land surface (bls). The basin geometry model for the Hualapai Valley basin consists of three subbasins: the Kingman, Hualapai, and southern Gregg subbasins. In the Kingman subbasin, which is estimated to be 1,200 m deep, saturated basin fill consists of a mixture of fine- to coarse-grained sedimentary deposits. The Hualapai subbasin, which is the largest of the subbasins, contains a thick halite body from about 400 m to about 4,300 m bls. Saturated basin fill overlying the salt body consists predominately of fine-grained older playa deposits. In the southern Gregg subbasin, which is estimated to be 1,400 m deep, saturated basin fill is interpreted to consist primarily of fine- to coarse-grained sedimentary deposits. Groundwater storage to 400 m bls in the Hualapai Valley basin is estimated to be 14.1 cubic kilometers (km3). The basin geometry model for the Detrital Valley basin consists of three subbasins: northern Detrital, central Detrital, and southern Detrital subbasins. The northern and central Detrital subbasins are characterized by a predominance of playa evaporite and fine

31 flavors to 50 shades of grey: battling Phytophthoras in native habitats managed by the Santa Clara Valley Water District

Treesearch

Janet Hillman; Tedmund J. Swiecki; Elizabeth A. Bernhardt; Heather K. Mehl; Tyler B. Bourret; David Rizzo

2017-01-01

The Santa Clara Valley Water District (District) is a wholesale water supplier for 1.8 million people in Santa Clara County, California. Capital, water utility, and stream maintenance projects result in extensive, long-term mitigation requirements in riparian, wetland, and upland habitats throughout the county. In 2014, several restoration sites on the valley floor and...

Data network, collection, and analysis in the Diamond Valley flow system, central Nevada

USGS Publications Warehouse

Knochenmus, Lari A.; Berger, David L.; Moreo, Michael T.; Smith, J. LaRue

2011-01-01

Future groundwater development and its effect on future municipal, irrigation, and alternative energy uses in the Diamond Valley flow system are of concern for officials in Eureka County, Nevada. To provide a better understanding of the groundwater resources, the U.S. Geological Survey, in cooperation with Eureka County, commenced a multi-phase study of the Diamond Valley flow system in 2005. Groundwater development primarily in southern Diamond Valley has resulted in water-level declines since the 1960s ranging from less than 5 to 100 feet. Groundwater resources in the Diamond Valley flow system outside of southern Diamond Valley have been relatively undeveloped. Data collected during phase 2 of the study (2006-09) included micrometeorological data at 4 evapotranspiration stations, 3 located in natural vegetation and 1 located in an agricultural field; groundwater levels in 95 wells; water-quality constituents in aquifers and springs at 21 locations; lithologic information from 7 recently drilled wells; and geophysical logs from 3 well sites. This report describes what was accomplished during phase 2 of the study, provides the data collected, and presents the approaches to strengthen relations between evapotranspiration rates measured at micrometeorological stations and spatially distributed groundwater discharge. This report also presents the approach to improve delineation of areas of groundwater discharge and describes the current methodology used to improve the accuracy of spatially distributed groundwater discharge rates in the Diamond Valley flow system.

MX Siting Investigation. Water Resources Program. Volume II. Review Draft, Water Appropriations Hearing Presentation and Support Documentation, Dry Lake Valley, Nevada.

DTIC Science & Technology

1981-09-30

will be required to de - liver the 651 gpm (41 l/s) needed for peak water use at the LSC. The existing Air Force test well at 3S-64E-12ca has been pumped...Valley is probably over 10,000 feet (3048 m) thick in the central part of the valley and is composed of alluvial fan, fluvial, playa , srl lacustrine...VALLEY T3.NSmIP STATION T E𔃾P SP. or SS. SILICA C AL C IU4 ACG. E5SILJ4 SCDIU I QANSA-SECT 5 6 C1 Ŕ VQ %;,. DES C CONE PH SOLIDS (5102) CA V$ A% 1 IN/6

A Systematic Review of Early Warning Systems' Effects on Nurses' Clinical Performance and Adverse Events Among Deteriorating Ward Patients.

PubMed

Lee, Ju-Ry; Kim, Eun-Mi; Kim, Sun-Aee; Oh, Eui Geum

2018-04-25

Early warning systems (EWSs) are an integral part of processes that aim to improve the early identification and management of deteriorating patients in general wards. However, the widespread implementation of these systems has not generated robust data regarding nurses' clinical performance and patients' adverse events. This review aimed to determine the ability of EWSs to improve nurses' clinical performance and prevent adverse events among deteriorating ward patients. The PubMed, CINAHL, EMBASE, and Cochrane Library databases were searched for relevant publications (January 1, 1997, to April 12, 2017). In addition, a grey literature search evaluated several guideline Web sites. The main outcome measures were nurses' clinical performance (vital sign monitoring and rapid response team notification) and patients' adverse events (in-hospital mortality, cardiac arrest, and unplanned intensive care unit [ICU] admission). The search identified 888 reports, although only five studies fulfilled the inclusion criteria. The findings of these studies revealed that EWSs implementation had a positive effect on nurses' clinical performance, based on their frequency of documenting vital signs that were related to the patient's clinical deterioration. In addition, postimplementation reductions were identified for cardiac arrest, unplanned ICU admission, and unexpected death. It seems that EWSs can improve nurses' clinical performance and prevent adverse events (e.g., in-hospital mortality, unplanned ICU admission, and cardiac arrest) among deteriorating ward patients. However, additional high-quality evidence is needed to more comprehensively evaluate the effects of EWSs on these outcomes.

Fretted Terrain Valleys

NASA Technical Reports Server (NTRS)

2004-01-01

30 October 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows shallow tributary valleys in the Ismenius Lacus fretted terrain region of northern Arabia Terra. These valleys exhibit a variety of typical fretted terrain valley wall and floor textures, including a lineated, pitted material somewhat reminiscent of the surface of a brain. Origins for these features are still being debated within the Mars science community; there are no clear analogs to these landforms on Earth. This image is located near 39.9oN, 332.1oW. The picture covers an area about 3 km (1.9 mi) wide. Sunlight illuminates the scene from the lower left.

Social influence on 5-year survival in a longitudinal chemotherapy ward co-presence network.

PubMed

Lienert, Jeffrey; Marcum, Christopher Steven; Finney, John; Reed-Tsochas, Felix; Koehly, Laura

2017-09-01

Chemotherapy is often administered in openly designed hospital wards, where the possibility of patient-patient social influence on health exists. Previous research found that social relationships influence cancer patient's health; however, we have yet to understand social influence among patients receiving chemotherapy in the hospital. We investigate the influence of co-presence in a chemotherapy ward. We use data on 4,691 cancer patients undergoing chemotherapy in Oxfordshire, United Kingdom who average 59.8 years of age, and 44% are Male. We construct a network of patients where edges exist when patients are co-present in the ward, weighted by both patients' time in the ward. Social influence is based on total weighted co-presence with focal patients' immediate neighbors, considering neighbors' 5-year mortality. Generalized estimating equations evaluated the effect of neighbors' 5-year mortality on focal patient's 5-year mortality. Each 1,000-unit increase in weighted co-presence with a patient who dies within 5 years increases a patient's mortality odds by 42% ( β = 0.357, CI:0.204,0.510). Each 1,000-unit increase in co-presence with a patient surviving 5 years reduces a patient's odds of dying by 30% ( β = -0.344, CI:-0.538,0.149). Our results suggest that social influence occurs in chemotherapy wards, and thus may need to be considered in chemotherapy delivery.

[The Family Counsel for Wards of the state. Its essential role in adoption matters].

PubMed

Thieffry, S

1989-03-01

Every regional branch of the Agency of Health and Social Affairs includes a Child Welfare Service (CWS) whose responsibilities include ensuring the best possible guardianship and future for children registered as Wards of the State. The CWS must immediately register as a Ward of the State every child fitting the criteria for one of the categories defined by the July 11 1966 Act, and take the earliest possible steps towards adoption of such Wards. To achieve these two objectives, a Family Council has been created within the CWS. This Council, that includes eight members with various types of experience or competence in matters of guardianship and adoption, is responsible for pronouncing the registration of Wards and achieving their adoption. Rather than a discussion of general considerations, we have elected to describe the methodical agenda and progress of the Paris CWS Family Council's regular meetings. Emphasis is put on the important aspects of wards eligible for adoption, on the investigation at the homes of candidates and on the "matching" which should be sought for between adoptive families and adoptees. Without doubt, the Family Council's systematic work, denoting a high level of awareness of its responsibilities, is the cause of the significant increase in the number of adoptions and, above all, of the recent availability of adoption to categories that were formerly neglected or permanently "abandoned".

Overview of Reclamation's geothermal program in Imperial Valley, California

NASA Technical Reports Server (NTRS)

Fulcher, M. K.

1974-01-01

The Bureau of Reclamation is presently involved in a unique Geothermal Resource Development Program in Imperial Valley, California. The main purpose of the investigations is to determine the feasibility of providing a source of fresh water through desalting geothermal fluids stored in the aquifers underlying the valley. Significant progress in this research and development stage to date includes extensive geophysical investigations and the drilling of five geothermal wells on the Mesa anomaly. Four of the wells are for production and monitoring the anomaly, and one will be used for reinjection of waste brines from the desalting units. Two desalting units, a multistage flash unit and a vertical tube evaporator unit, have been erected at the East Mesa test site. The units have been operated on shakedown and continuous runs and have produced substantial quantities of high-quality water.

Patients' and relatives' experiences of transfer from intensive care unit to wards.

PubMed

Cullinane, James P; Plowright, Catherine I

2013-11-01

This literature review looks at the evidence around transferring patients from intensive care units (ICU) to wards. The literature informs us that patients and their families experience problems when being transferred from an ICU environment and that this increases overall anxiety. The effects of surviving critical illness often have a profound psychological impact on patients and families This study examines the experiences of adult patients, and their families, following their transfer from the ICU to the ward. Five themes emerged from this literature review: physical responses, psychological responses, information and communication, safety and security, and the needs of relatives. This review reminds us that these problems can be reduced if information and communication around time of transfers were improved. As critical care nurses it is essential that we prepare patients and families for transfer to wards. © 2013 British Association of Critical Care Nurses.

Testing of the Prototype Mars Drill and Sample Acquisition System in the Mars Analog Site of the Antarctica's Dry Valleys

NASA Astrophysics Data System (ADS)

Zacny, K.; Paulsen, G.; McKay, C.; Glass, B. J.; Marinova, M.; Davila, A. F.; Pollard, W. H.; Jackson, A.

2011-12-01

We report on the testing of the one meter class prototype Mars drill and cuttings sampling system, called the IceBreaker in the Dry Valleys of Antarctica. The drill consists of a rotary-percussive drill head, a sampling auger with a bit at the end having an integrated temperature sensor, a Z-stage for advancing the auger into the ground, and a sampling station for moving the augered ice shavings or soil cuttings into a sample cup. In November/December of 2010, the IceBreaker drill was tested in the Uni-versity Valley (within the Beacon Valley region of the Antarctic Dry Valleys). University Valley is a good analog to the Northern Polar Regions of Mars because a layer of dry soil lies on top of either ice-cemeted ground or massive ice (depending on the location within the valley). That is exactly what the 2007 Phoenix mission discovered on Mars. The drill demonstrated drilling in ice-cemented ground and in massive ice at the 1-1-100-100 level; that is the drill reached 1 meter in 1 hour with 100 Watts of power and 100 Newton Weight on Bit. This corresponds to an average energy of 100 Whr. At the same time, the bit temperature measured by the bit thermocouple did not exceed more than 10 °C above the formation temperature. The temperature also never exceeded freezing, which minimizes chances of getting stuck and also of altering the materials that are being sampled and analyzed. The samples in the forms of cuttings were acquired every 10 cm intervals into sterile bags. These tests have shown that drilling on Mars, in ice cemented ground with limited power, energy and Weight on Bit, and collecting samples in discrete depth intervals is possible within the given mass, power, and energy levels of a Phoenix-size lander and within the duration of a Phoenix-like mission.

Atmospheric transport of organophosphate pesticides from California's Central Valley to the Sierra Nevada Mountains

USGS Publications Warehouse

Zabik, John M.; Seiber, James N.

1993-01-01

Atmospheric transport of organophosphate pesticides from California's Central Valley to the Sierra Nevada mountains was assessed by collecting air- and wet-deposition samples during December, January, February, and March, 1990 to 1991. Large-scale spraying of these pesticides occurs during December and January to control insect infestations in valley orchards. Sampling sites were placed at 114- (base of the foothills), 533-, and 1920-m elevations. Samples acquired at these sites contained chlorpyrifos [phosphorothioic acid; 0,0-diethyl 0-(3,5,6-trichloro-2-pyridinyl) ester], parathion [phosphorothioic acid, 0-0-diethylo-(4-nitrophenyl) ester], diazinon {phosphorothioic acid, 0,0-diethyl 0-[6-methyl-2-(1-methylethyl)-4-pyrimidinyl] ester} diazinonoxon {phosphoric acid, 0,0-diethyl 0-[6-methyl-2-(1-methylethyl)-4-pyrimidinyl] ester}, and paraoxon [phosphoric acid, 0,0-diethyl 0-(4-nitrophenyl) ester] in both air and wet deposition samples. Air concentrations of chloropyrifos, diazinon and parathion ranged from 13 to 13 000 pg/m3 at the base of the foothills. At 533-m air concentrations were below the limit of quantification (1.4 pg/m3) to 83 pg/m3 and at 1920 m concentrations were below the limit of quantification. Concentrations in wet deposition varied with distance and elevation from the Central Valley. Rainwater concentrations at the base of the foot hills ranged from 16 to 7600 pg/mL. At 533-m rain and snow water concentrations ranged from below the limit of quantification (1.3 pg/mL) to 140 pg/mL and at 1920 m concentrations ranged from below the limit of quantification to 48 pg/mL. These findings indicate that atmospheric transport of pesticides applied in the valley to the Sierra Nevada mountains is occurring, but the levels decrease as distance and elevation increase from the valley floor.

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

PubMed

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

2007-10-01

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

The perceptions of the ward atmosphere in four Jordanian psychiatric hospitals from the perspective of patients' relatives.

PubMed

Al-Sagarat, Ahmad; Moxham, Lorna; Curtis, Janette; Crooke, Patrick

2014-10-01

To describes the perceptions of the ward atmosphere of psychiatric hospitals from the perspective of the relatives of people who were inpatients in those hospitals. A nonexperimental descriptive survey was used. Data were collected using the Arabic version of Moos Ward Atmosphere Scale Ideal and Real forms. Data indicate that even though relatives of Jordanian mental health patients were generally positive about the ward atmosphere, they would like to see changes. By describing their current and ideal treatment environments, participants have provided information that can guide interventions to change the ward atmosphere and thus help foster better patient treatment outcomes. © 2014 Wiley Periodicals, Inc.

Observations of Air Quality at the Edge of Kathmandu, Nepal, and the Diurnal Cycle of Air Pollution In and Around the Kathmandu Valley

NASA Astrophysics Data System (ADS)

Panday, A. K.; Prinn, R. G.; Regmi, R. P.

2006-12-01

The Kathmandu Valley is a bowl-shaped basin in the Nepal Himalaya, with a rapidly growing city surrounded by rice fields and steep terraced and forested mountain slopes. The valley's air quality is influenced by urban and rural emissions, nocturnal pooling of cold air, slope winds, and a daily exchange of air through mountain passes. To understand these processes and to inform air pollution policy in Nepal, we have carried out the most comprehensive study of air pollution in Nepal to date. During the 9-month dry season of 2004-2005, we carried out continuous measurements every minute of carbon monoxide, ozone, PM10, wind speed, wind direction, solar radiation, temperature, and humidity on the eastern edge of Kathmandu city, at a site that daily received air from both the city and rural areas. We recorded the diurnal cycle of the vertical temperature structure and stability with temperature loggers on towers and mountains. A sodar measured the mixed layer height and upper-level winds. 24-hour simultaneous bag sampling campaigns on mountain peaks, passes, the rural valley, and within the city provided glimpses of the spatial patterns of the diurnal cycle of CO -- a useful tracer of anthropogenic emissions. We measured winds on mountain passes and ozone on mountain peaks. At our main measurement site we found a daily-recurring pattern of CO and PM10, with an afternoon low showing rural background levels, even though the arriving air had traversed the city. This was followed by an evening peak starting at sunset, a second low late at night, and a morning peak enhanced by re-circulation. Pollutants emitted in the valley only traveled out of the valley between the late morning and sunset. During winter months, rush hour was outside of this period, enhancing the morning and evening peaks. Within the city, ozone dropped to zero at night. At mid-day we observed an ozone peak enhanced by photochemical production when the air mass that had been stagnant over the city swept

Geologic history of the Yosemite Valley

USGS Publications Warehouse

Matthes, Francois E.

1930-01-01

Projection of the longitudinal profiles of these hanging valleys forward to the axis of the Merced Canyon shows that they are closely accordant in height. Their profiles indicate a series of points on a former profile of the Merced with respect to which the side streams had graded their courses prior to the last uplift. This old profile can be extended upward into the glaciated part of the Merced Canyon above El Portal and even into the profoundly glaciated Yosemite Valley, accordant points being furnished by a number of hanging side valleys (due allowance being made for glacial erosion suffered by those valleys). However, not all the hanging valleys of the Yosemite region are accordant with this set. Several of them, including the upland valley of Yosemite Creek, constitute a separate set indicating another old profile of the Merced at a level 600 to 1,000 feet higher than the first. Others, including the hanging gulch of lower Bridalveil Creek, point to an old profile of the Merced about 1,200 feet lower than the first. There are thus three distinct sets of hanging valleys produced in three cycles of stream erosion. The valleys of the upper set, like those of the middle set, were left hanging as a result of rapid trenching by the Merced induced by an uplift of the range, there having been two such uplifts. Only the valleys of the lower set hang because of glacial deepening and widening of the Yosemite Valley, the cycle in which they were cut having been interrupted by the advent of the Pleistocene glaciers. They consequently indicate the preglacial depth of the Yosemite Valley. That depth, measured from the brow of El Capitan, was about 2,400 feet; measured from the rim at Glacier Point it was about 2,000 feet.

Improving detection of patient deterioration in the general hospital ward environment.

PubMed

Vincent, Jean-Louis; Einav, Sharon; Pearse, Rupert; Jaber, Samir; Kranke, Peter; Overdyk, Frank J; Whitaker, David K; Gordo, Federico; Dahan, Albert; Hoeft, Andreas

2018-05-01

: Patient monitoring on low acuity general hospital wards is currently based largely on intermittent observations and measurements of simple variables, such as blood pressure and temperature, by nursing staff. Often several hours can pass between such measurements and patient deterioration can go unnoticed. Moreover, the integration and interpretation of the information gleaned through these measurements remains highly dependent on clinical judgement. More intensive monitoring, which is commonly used in peri-operative and intensive care settings, is more likely to lead to the early identification of patients who are developing complications than is intermittent monitoring. Early identification can trigger appropriate management, thereby reducing the need for higher acuity care, reducing hospital lengths of stay and admission costs and even, at times, improving survival. However, this degree of monitoring has thus far been considered largely inappropriate for general hospital ward settings due to device costs and the need for staff expertise in data interpretation. In this review, we discuss some developing options to improve patient monitoring and thus detection of deterioration in low acuity general hospital wards.

Mars: Periglacial Morphology and Implications for Future Landing Sites

NASA Technical Reports Server (NTRS)

Heldmann, Jennifer L.; Schurmeier, Lauren; McKay, Christopher; Davila, Alfonso; Stoker, Carol; Marinova, Margarita; Wilhelm, Mary Beth

2015-01-01

At the Mars Phoenix landing site and in much of the Martian northern plains, there is ice-cemented ground beneath a layer of dry permafrost. Unlike most permafrost on Earth, though, this ice is not liquid at any time of year. However, in past epochs at higher obliquity the surface conditions during summer may have resulted in warmer conditions and possible melting. This situation indicates that the ice-cemented ground in the north polar plains is likely to be a candidate for the most recently habitable place on Mars as near-surface ice likely provided adequate water activity approximately 5 Myr ago. The high elevation Dry Valleys of Antarctica provide the best analog on Earth of Martian ground ice. These locations are the only places on Earth where ice-cemented ground is found beneath dry permafrost. The Dry Valleys are a hyper-arid polar desert environment and in locations above 1500 m elevation, such as University Valley, air temperatures do not exceed 0 C. Thus, similarly to Mars, liquid water is largely absent here and instead the hydrologic cycle is dominated by frozen ice and vapor phase processes such as sublimation. These conditions make the high elevation Dry Valleys a key Mars analog location where periglacial processes and geomorphic features can be studied in situ. This talk will focus on studies of University Valley as a Mars analog for periglacial morphology and ice stability. We will review a landing site selection study encompassing this information gleaned from the Antarctic terrestrial analog studies plus Mars spacecraft data analysis to identify candidate landing sites for a future mission to search for life on Mars.

Pharmacy sales data versus ward stock accounting for the surveillance of broad-spectrum antibiotic use in hospitals.

PubMed

Haug, Jon B; Myhr, Randi; Reikvam, Asmund

2011-12-13

Antibiotic consumption in hospitals is commonly measured using the accumulated amount of drugs delivered from the pharmacy to ward held stocks. The reliability of this method, particularly the impact of the length of the registration periods, has not been evaluated and such evaluation was aim of the study. During 26 weeks, we performed a weekly ward stock count of use of broad-spectrum antibiotics--that is second- and third-generation cephalosporins, carbapenems, and quinolones--in five hospital wards and compared the data with corresponding pharmacy sales figures during the same period. Defined daily doses (DDDs) for antibiotics were used as measurement units (WHO ATC/DDD classification). Consumption figures obtained with the two methods for different registration intervals were compared by use of intraclass correlation analysis and Bland-Altman statistics. Broad-spectrum antibiotics accounted for a quarter to one-fifth of all systemic antibiotics (ATC group J01) used in the hospital and varied between wards, from 12.8 DDDs per 100 bed days in a urological ward to 24.5 DDDs in a pulmonary diseases ward. For the entire study period of 26 weeks, the pharmacy and ward defined daily doses figures for all broad-spectrum antibiotics differed only by 0.2%; however, for single wards deviations varied from -4.3% to 6.9%. The intraclass correlation coefficient, pharmacy versus ward data, increased from 0.78 to 0.94 for parenteral broad-spectrum antibiotics with increasing registration periods (1-4 weeks), whereas the corresponding figures for oral broad-spectrum antibiotics (ciprofloxacin) were from 0.46 to 0.74. For all broad-spectrum antibiotics and for parenteral antibiotics, limits of agreement between the two methods showed, according to Bland-Altman statistics, a deviation of ± 5% or less from average mean DDDs at 3- and 4-weeks registration intervals. Corresponding deviation for oral antibiotics was ± 21% at a 4-weeks interval. There is a need for caution in

Exploring ward nurses' perceptions of continuing education in clinical settings.

PubMed

Govranos, Melissa; Newton, Jennifer M

2014-04-01

Health care systems demand that nurses are flexible skilful workers who maintain currency and competency in order to deliver safe effective patient centered care. Nurses must continually build best practice into their care and acquire lifelong learning. Often this learning is acquired within the work environment and is facilitated by the clinical nurse educator. Understanding clinical nurses' values and needs of continuing education is necessary to ensure appropriate education service delivery and thus enhance patient care. To explore clinical ward-based nurses' values and perceptions towards continuing education and what factors impact on continuing education in the ward. A case study approach was utilized. A major teaching hospital in Melbourne, Australia. A range of clinical nursing staff (n=23). Four focus groups and six semi-structured individual interviews were undertaken. Focus group interviews explored participants' values and perceptions on continuing education through a values clarification tool. Thematic analysis of interviews was undertaken to identify themes and cluster data. Three central themes: 'culture and attitudes', 'what is learning?' and 'being there-being seen', emerged reflecting staffs' values and perceptions of education and learning in the workplace. Multiple factors influence ward nurses' ability and motivation to incorporate lifelong learning into their practice. Despite variance in nurses' values and perceptions of CE in clinical environments, CE was perceived as important. Nurses yearned for changes to facilitate lifelong learning and cultivate a learning culture. Clinical nurse educators need to be cognizant of adult learners' characteristics such as values, beliefs, needs and potential barriers, to effectively facilitate support in a challenging and complex learning environment. Organizational support is essential so ward managers in conjunction with educational departments can promote and sustain continuing education, lifelong

Contribution from geriatric medicine within acute medical wards.

PubMed Central

Burley, L E; Currie, C T; Smith, R G; Williamson, J

1979-01-01

In 1977 a scheme of attachment to acute medical wards of consultants in geriatric medicine and associated junior medical staff was instituted in a large Edinburgh teaching hospital. The effect on admissions of patients aged 65 and over was examined for comparable periods before and during this arrangement. Mean and median stays were reduced for both sexes but more noticeably for women. The mean stay for all women aged over 65 was reduced from 25 to 16 days and for women aged over 85 from 50 to 19 days. The proportion staying under two weeks was significantly increased in both sexes, and the proportion discharged home also increased, correspondingly fewer patients being transferred to convalescent wards. These changes were not accompanied by increased transfers to the geriatric department, and probably the skills and extra resources available to the geriatric service were the factors mainly responsible for the changes in performance. PMID:572732

76 FR 22746 - Conecuh Valley Railway, LLC-Acquisition and Operation Exemption-Conecuh Valley Railroad Co., Inc.

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-22

... Railway, LLC--Acquisition and Operation Exemption--Conecuh Valley Railroad Co., Inc. Conecuh Valley Railway, LLC (CVR), a noncarrier, has filed a verified notice of exemption under 49 CFR 1150.31 to acquire from Conecuh Valley Railroad Co., Inc. (COEH), and to operate [[Page 22747

Cost-effectiveness of Ward Closure to Control Outbreaks of Norovirus Infection in United Kingdom National Health Service Hospitals.

PubMed

Sadique, Zia; Lopman, Ben; Cooper, Ben S; Edmunds, W John

2016-02-01

Norovirus is the most common cause of outbreaks of acute gastroenteritis in National Health Service hospitals in the United Kingdom. Wards (units) are often closed to new admissions to stop the spread of the virus, but there is limited evidence describing the cost-effectiveness of ward closure. An economic analysis based on the results from a large, prospective, active-surveillance study of gastroenteritis outbreaks in hospitals and from an epidemic simulation study compared alternative ward closure options evaluated at different time points since first infection, assuming different efficacies of ward closure. A total of 232 gastroenteritis outbreaks occurring in 14 hospitals over a 1-year period were analyzed. The risk of a new outbreak in a hospital is significantly associated with the number of admission, general medical, and long-stay wards that are concurrently affected but is less affected by the level of community transmission. Ward closure leads to higher costs but reduces the number of new outbreaks by 6%-56% and the number of clinical cases by 1%-55%, depending on the efficacy of the intervention. The incremental cost per outbreak averted varies from £10 000 ($14 000) to £306 000 ($428 000), and the cost per case averted varies from £500 ($700) to £61 000 ($85 000). The cost-effectiveness of ward closure decreases as the efficacy of the intervention increases, and the cost-effectiveness increases with the timing of the intervention. The efficacy of ward closure is critical from a cost-effectiveness perspective. Ward closure may be cost-effective, particularly if targeted to high-throughput units. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Controlled Confrontation: The Ward Grievance Procedure of the California Youth Authority. An Exemplary Project.

ERIC Educational Resources Information Center

National Inst. of Law Enforcement and Criminal Justice (Dept. of Justice/LEAA), Washington, DC.

The Ward Grievance Procedure of the California Youth Authority is one of 17 programs that earned the National Institute's "Exemplary" label. This brochure provides the requisite practical information for those who wish to test or consider testing the ward grievance procedure. The program was developed as a way of dealing with the questions raised…

Ward identity and basis tensor gauge theory at one loop

NASA Astrophysics Data System (ADS)

Chung, Daniel J. H.

2018-06-01

Basis tensor gauge theory (BTGT) is a reformulation of ordinary gauge theory that is an analog of the vierbein formulation of gravity and is related to the Wilson line formulation. To match ordinary gauge theories coupled to matter, the BTGT formalism requires a continuous symmetry that we call the BTGT symmetry in addition to the ordinary gauge symmetry. After classically interpreting the BTGT symmetry, we construct using the BTGT formalism the Ward identities associated with the BTGT symmetry and the ordinary gauge symmetry. For a way of testing the quantum stability and the consistency of the Ward identities with a known regularization method, we explicitly renormalize the scalar QED at one loop using dimensional regularization using the BTGT formalism.

Outbreak of respiratory syncytial virus (RSV) infection in immunocompromised adults on a hematology ward.

PubMed

Jensen, Tomas Ostergaard; Stelzer-Braid, Sacha; Willenborg, Christiana; Cheung, Carol; Andresen, David; Rawlinson, William; Clezy, Kate

2016-10-01

We describe an outbreak of respiratory syncytial virus (RSV) infection on a hematology ward without allogeneic stem cell transplant patients. Twelve patients and one staff member infected with RSV were identified from the laboratory database. Five patients had lower respiratory tract infection, seven had upper respiratory tract infection, one was asymptomatic, and there were two (15.4%) deaths. Most patients had overlapping periods of potential infectiousness on the ward. Sequencing was possible on eight specimens and five of these had identical sequences. Results were consistent with transmission occurring both on the ward and by introduction of RSV from the community. J. Med. Virol. 88:1827-1831, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Death Valley, California

NASA Image and Video Library

1994-04-11

. Death Valley is also one of the primary calibration sites for SIR-C/X-SAR. The bright dots near the center of the image are corner reflectors that have been set-up to calibrate the radar as the Shuttle passes overhead. Thirty triangular-shaped reflectors (they look like aluminum pyramids) have been deployed by the calibration team from JPL over a 40 kilometer by 40 kilometer area in and around Death Valley. The calibration team will also deploy transponders (electronic reflectors) and recievers to measure the radar signals from SIR-C/X-SAR on the ground. Spaceborne Imaging Radar-C and X-Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth (MTPE). The radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-Band (24 cm), C-Band (6 cm), and X-Band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was develpoed by NASA's Jet Propulsion Laboratory (JPL). X-SAR was developed by the Dornire and Alenia Spazio Companies for the German Space Agency, Deutsche Agentur fuer Raumfahrtangelegenheiten (DARA), and the Italian Space Agency, Agenzia Spaziale Italiana (ASI). JPL Photo ID: P-43883

Clinical nursing leaders' perceptions of nutrition quality indicators in Swedish stroke wards: a national survey.

PubMed

Persenius, Mona; Hall-Lord, Marie-Louise; Wilde-Larsson, Bodil; Carlsson, Eva

2015-09-01

To describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards. A high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality. Using a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants. Most clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results. Using the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed. The use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework. © 2013 John Wiley & Sons Ltd.

Care management and nursing governance in a maternity ward: grounded theory.

PubMed

Copelli, Fernanda Hannah da Silva; Oliveira, Roberta Juliane Tono de; Santos, José Luís Guedes Dos; Magalhães, Aline Lima Pestana; Gregório, Vitória Regina Petters; Erdmann, Alacoque Lorenzini

2017-01-01

To understand the care management strategies used by nurses in the governance of nursing practice in a maternity ward. Qualitative study based on grounded theory conducted with 27 participants, partitioned into four sample groups. The data were collected through semi-structured interviews and analyzed through open, axial, and selective coding. The care management strategies used by the nurses were: planning professional practice, leading the nursing team, search for scientific knowledge, and training inthe best practices in obstetric care. Associating care management with nursing governance can foster better care outcomes and strengthen nursing autonomy when coordinating nursing work in maternity wards.

Energy Balance, Evapo-transpiration and Dew deposition in the Dead Sea Valley

NASA Astrophysics Data System (ADS)

Metzger, Jutta; Corsmeier, Ulrich

2016-04-01

The Dead Sea is a unique place on earth. It is a terminal hypersaline lake, located at the lowest point on earth with a lake level of currently -429 m above mean sea level (amsl). It is located in a transition zone of semiarid to arid climate conditions, which makes it highly sensible to climate change (Alpert1997, Smiatek2011). The Virtual Institute DEad SEa Research Venue (DESERVE) is an international project funded by the German Helmholtz Association and was established to study coupled atmospheric hydrological, and lithospheric processes in the changing environment of the Dead Sea. At the moment the most prominent environmental change is the lake level decline of approximately 1 m / year due to anthropogenic interferences (Gertman, 2002). This leads to noticeable changes in the fractions of the existing terrestrial surfaces - water, bare soil and vegetated areas - in the valley. Thus, the partitioning of the net radiation in the valley changes as well. To thoroughly study the atmospheric and hydrological processes in the Dead Sea valley, which are driven by the energy balance components, sound data of the energy fluxes of the different surfaces are necessary. Before DESERVE no long-term monitoring network simultaneously measuring the energy balance components of the different surfaces in the Dead Sea valley was available. Therefore, three energy balance stations were installed at three characteristic sites at the coast-line, over bare soil, and within vegetation, measuring all energy balance components by using the eddy covariance method. The results show, that the partitioning of the energy into sensible and latent heat flux on a diurnal scale is totally different at the three sites. This results in gradients between the sites, which are e.g. responsible for the typical diurnal wind systems at the Dead Sea. Furthermore, driving forces of evapo-transpiration at the sites were identified and a detailed analysis of the daily evaporation and dew deposition rates

Ground-water quality and geochemistry of Las Vegas Valley, Clark County, Nevada, 1981-83; implementation of a monitoring network

USGS Publications Warehouse

Dettinger, M.D.

1987-01-01

As a result of rapid urban growth in Las Vegas Valley, rates of water use and wastewater disposal have grown rapidly during the last 25 years. Concern has developed over the potential water quality effects of this growth. The deep percolation of wastewater and irrigation return flow (much of which originates as imported water from Lake Mead), along with severe overdraft conditions in the principal aquifers of the valley, could combine to pose a long-term threat to groundwater quality. The quantitative investigations of groundwater quality and geochemical conditions in the valley necessary to address these concerns would include the establishment of data collection networks on a valley-wide scale that differ substantially from existing networks. The valley-wide networks would have a uniform areal distribution of sampling sites, would sample from all major depth zones, and would entail repeated sampling from each site. With these criteria in mind, 40 wells were chosen for inclusion in a demonstration monitoring network. Groundwater in the northern half of the valley generally contains 200 to 400 mg/L of dissolved solids, and is dominated by calcium, magnesium , and bicarbonate ions, reflecting a chemical equilibrium between the groundwater and the dominantly carbonate rocks in the aquifers of this area. The intermediate to deep groundwater in the southern half of the valley is of poorer quality (containing 700 to 1,500 mg/L of dissolved solids) and is dominated by calcium, magnesium, sulfate, and bicarbonate ions, reflecting the occurrence of other rock types including evaporite minerals among the still-dominant carbonate rocks in the aquifers of this part of the valley. The poorest quality groundwater in the valley is generally in the lowland parts of the valley in the first few feet beneath the water table, where dissolved solids concentrations range from 2,000 to > 7,000 mg/L , and probably reflects the effects of evaporite dissolution, secondary recharge, and

34 CFR 300.45 - Ward of the State.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 2 2011-07-01 2010-07-01 true Ward of the State. 300.45 Section 300.45 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH...

34 CFR 300.45 - Ward of the State.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Ward of the State. 300.45 Section 300.45 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH...

Topological Valley Currents in Gapped Dirac Materials

NASA Astrophysics Data System (ADS)

Lensky, Yuri D.; Song, Justin C. W.; Samutpraphoot, Polnop; Levitov, Leonid S.

2015-06-01

Gapped 2D Dirac materials, in which inversion symmetry is broken by a gap-opening perturbation, feature a unique valley transport regime. Topological valley currents in such materials are dominated by bulk currents produced by electronic states just beneath the gap rather than by edge modes. The system ground state hosts dissipationless persistent valley currents existing even when topologically protected edge modes are absent. Valley currents induced by an external bias are characterized by a quantized half-integer valley Hall conductivity. The undergap currents dominate magnetization and the charge Hall effect in a light-induced valley-polarized state.

Field Surveys, IOC Valleys. Volume III, Part II. Cultural Resources Survey, Pine and Wah Wah Valleys, Utah.

DTIC Science & Technology

1981-08-01

valleys are typical of the Basin and Range Province, characterized by parallel, north-south trending mountain ranges, separated by hydrologically closed... basins . Pine and Wah Wah valleys each have hardpan-playas in their lowest areas. State Highway 21 runs roughly northwest-southeast through both val...have been important for prehis- toric and historic use of the area. Pine Valley: Pine and Wah Wah valleys are closed alluvial basins . The central part

Characterization of a 21-Story Reinforced Building in the Valley of Mexico Using MEMS Accelerometers.

NASA Astrophysics Data System (ADS)

Husker, A. L.; Dominguez, L. A.; Becerril, A.; Espejo, L.; Cochran, E. S.

2014-12-01

Low cost MEMS accelerometers are becoming increasingly higher resolution making them useful in strong motion studies. Here we present a building response analysis in the lakebed zone of the Valley of Mexico. The Valley of Mexico represents one of the highest seismic risk locations in the world and incorporates Mexico City and part of Mexico State. More than 20 million people live there and it is the political and economic center of Mexico. In addition the valley has very high site effects with amplifications 100 - 500 times that of sites outside of the basin (Singh et al., 1988; Singh et al., 1995). We instrumented a 21-story building with MEMS accelerometers as part of the Quake Catcher Network or Red Atrapa Sismos as it is called in Mexico. The building known as the Centro Cultural de Tlateloco is located in an important historical and political area as well as a zone with some of the highest amplifications in the Valley of Mexico that had some of the worst destruction after the 1985 M8.1 Michoacan earthquake. During the earthquake most of the buildings that failed were between 7 - 18 stories tall. The peak accelerations near Tlateloco were at periods of 2 seconds. Since the earthquake the building has been retrofitted with N-S crossing supports to help withstand another earthquake. We present the measurements of frequencies and amplifications between floors for the length of the building.

Mapping nurses' activities in surgical hospital wards: A time study.

PubMed

van den Oetelaar, W F J M; van Stel, H F; van Rhenen, W; Stellato, R K; Grolman, W

2018-01-01

Balancing the number of nursing staff in relation to the number of patients is important for hospitals to remain efficient and optimizing the use of resources. One way to do this is to work with a workload management method. Many workload management methods use a time study to determine how nurses spend their time and to relate this to patient characteristics in order to predict nurse workload. In our study, we aim to determine how nurses spend their working day and we will attempt to explain differences between specialized surgical wards. The research took place in an academic hospital in the Netherlands. Six surgical wards were included, capacity 15 to 30 beds. We have used a work sampling methodology where trained observers registered activities of nurses and patient details every ten minutes during the day shift for a time period of three weeks. The work sampling showed that nurses spend between 40.1% and 55.8% of their time on direct patient care. In addition to this, nurses spend between 11.0% and 14.1% on collective patient care. In total, between 52.1% and 68% of time spent on tasks is directly patient related. We found significant differences between wards for 10 of the 21 activity groups. We also found that nurses spend on average 31% with the patient (bedside), which is lower than in another study (37%). However, we noticed a difference between departments. For regular surgical departments in our study this was on average 34% and for two departments that have additional responsibilities in training and education of nursing students, this was on average 25%. We found a relatively low percentage of time spent on direct plus indirect care, and a lower percentage of time spent with the patient. We suspect that this is due to the academic setting of the study; in our hospital, there are more tasks related to education than in hospitals in other study settings. We also found differences between the wards in our study, which are mostly explained by differences

Site response, shallow shear-wave velocity, and wave propagation at the San Jose, California, dense seismic array

USGS Publications Warehouse

Hartzell, S.; Carver, D.; Williams, R.A.; Harmsen, S.; Zerva, A.

2003-01-01

Ground-motion records from a 52-element dense seismic array near San Jose, California, are analyzed to obtain site response, shallow shear-wave velocity, and plane-wave propagation characteristics. The array, located on the eastern side of the Santa Clara Valley south of the San Francisco Bay, is sited over the Evergreen basin, a 7-km-deep depression with Miocene and younger deposits. Site response values below 4 Hz are up to a factor of 2 greater when larger, regional records are included in the analysis, due to strong surface-wave development within the Santa Clara Valley. The pattern of site amplification is the same, however, with local or regional events. Site amplification increases away from the eastern edge of the Santa Clara Valley, reaching a maximum over the western edge of the Evergreen basin, where the pre-Cenozoic basement shallows rapidly. Amplification then decreases further to the west. This pattern may be caused by lower shallow shear-wave velocities and thicker Quaternary deposits further from the edge of the Santa Clara Valley and generation/trapping of surface waves above the shallowing basement of the western Evergreen basin. Shear-wave velocities from the inversion of site response spectra based on smaller, local earthquakes compare well with those obtained independently from our seismic reflection/refraction measurements. Velocities from the inversion of site spectra that include larger, regional records do not compare well with these measurements. A mix of local and regional events, however, is appropriate for determination of site response to be used in seismic hazard evaluation, since large damaging events would excite both body and surface waves with a wide range in ray parameters. Frequency-wavenumber, plane-wave analysis is used to determine the backazimuth and apparent velocity of coherent phases at the array. Conventional, high-resolution, and multiple signal characterization f-k power spectra and stacked slowness power spectra are

Social influence on 5-year survival in a longitudinal chemotherapy ward co-presence network

PubMed Central

LIENERT, JEFFREY; MARCUM, CHRISTOPHER STEVEN; FINNEY, JOHN; REED-TSOCHAS, FELIX; KOEHLY, LAURA

2018-01-01

Chemotherapy is often administered in openly designed hospital wards, where the possibility of patient–patient social influence on health exists. Previous research found that social relationships influence cancer patient’s health; however, we have yet to understand social influence among patients receiving chemotherapy in the hospital. We investigate the influence of co-presence in a chemotherapy ward. We use data on 4,691 cancer patients undergoing chemotherapy in Oxfordshire, United Kingdom who average 59.8 years of age, and 44% are Male. We construct a network of patients where edges exist when patients are co-present in the ward, weighted by both patients’ time in the ward. Social influence is based on total weighted co-presence with focal patients’ immediate neighbors, considering neighbors’ 5-year mortality. Generalized estimating equations evaluated the effect of neighbors’ 5-year mortality on focal patient’s 5-year mortality. Each 1,000-unit increase in weighted co-presence with a patient who dies within 5 years increases a patient’s mortality odds by 42% (β = 0.357, CI:0.204,0.510). Each 1,000-unit increase in co-presence with a patient surviving 5 years reduces a patient’s odds of dying by 30% (β = −0.344, CI:−0.538,0.149). Our results suggest that social influence occurs in chemotherapy wards, and thus may need to be considered in chemotherapy delivery. PMID:29503731

My Ward: The Story of St Thomas', Guy's and the Evelina Children's Hospitals and their Ward Names Wendy Mathews My Ward: The Story of St Thomas', Guy's and the Evelina Children's Hospitals and their Ward Names | Walpole House Publishing £5 I 135pp | 9780956394200 0956394205 [Formula: see text].

PubMed

2011-05-01

This is a fascinating record of the stories behind the names of wards at three London hospitals and of the hospitals themselves. Made possible by a grant from Guy's and st Thomas' Charity, it is beautifully produced and illustrated and is a great historical read.

Does doctors’ workload impact supervision and ward activities of final-year students? A prospective study

PubMed Central

2012-01-01

Background Hospital doctors face constantly increasing workloads. Besides caring for patients, their duties also comprise the education of future colleagues. The aim of this study was to objectively investigate whether the workload arising from increased patient care interferes with student supervision and is associated with more non-medical activities of final-year medical students. Methods A total of 54 final-year students were asked to keep a diary of their daily activities over a three-week period at the beginning of their internship in Internal Medicine. Students categorized their activities – both medical and non-medical - according to whether they had: (1) only watched, (2) assisted the ward resident, (3) performed the activity themselves under supervision of the ward resident, or (4) performed the activity without supervision. The activities reported on a particular day were matched with a ward specific workload-index derived from the hospital information system, including the number of patients treated on the corresponding ward on that day, a correction factor according to the patient comorbidity complexity level (PCCL), and the number of admissions and discharges. Both students and ward residents were blinded to the study question. Results A total of 32 diaries (59 %, 442 recorded working days) were handed back. Overall, the students reported 1.2 ± 1.3 supervised, 1.8 ±1.6 medical and 3.6 ± 1.7 non-medical activities per day. The more supervised activities were reported, the more the number of reported medical activities increased (p < .0001). No relationship between the ward specific workload and number of medical activities could be shown. Conclusions There was a significant association between ward doctors’ supervision of students and the number of medical activities performed by medical students. The workload had no significant effect on supervision or the number of medical or non-medical activities of final-year students. PMID

A landscape scale valley confinement algorithm: Delineating unconfined valley bottoms for geomorphic, aquatic, and riparian applications

Treesearch

David E. Nagel; John M. Buffington; Sharon L. Parkes; Seth Wenger; Jaime R. Goode

2014-01-01

Valley confinement is an important landscape characteristic linked to aquatic habitat, riparian diversity, and geomorphic processes. This report describes a GIS program called the Valley Confinement Algorithm (VCA), which identifies unconfined valleys in montane landscapes. The algorithm uses nationally available digital elevation models (DEMs) at 10-30 m resolution to...

Graphene Nanobubbles as Valley Filters and Beam Splitters

NASA Astrophysics Data System (ADS)

Settnes, Mikkel; Power, Stephen R.; Brandbyge, Mads; Jauho, Antti-Pekka

2016-12-01

The energy band structure of graphene has two inequivalent valleys at the K and K' points of the Brillouin zone. The possibility to manipulate this valley degree of freedom defines the field of valleytronics, the valley analogue of spintronics. A key requirement for valleytronic devices is the ability to break the valley degeneracy by filtering and spatially splitting valleys to generate valley polarized currents. Here, we suggest a way to obtain valley polarization using strain-induced inhomogeneous pseudomagnetic fields (PMFs) that act oppositely on the two valleys. Notably, the suggested method does not involve external magnetic fields, or magnetic materials, unlike previous proposals. In our proposal the strain is due to experimentally feasible nanobubbles, whose associated PMFs lead to different real space trajectories for K and K' electrons, thus allowing the two valleys to be addressed individually. In this way, graphene nanobubbles can be exploited in both valley filtering and valley splitting devices, and our simulations reveal that a number of different functionalities are possible depending on the deformation field.

Inappropriate use of urinary catheters and its common complications in different hospital wards.

PubMed

Davoodian, Parivash; Nematee, Maryam; Sheikhvatan, Mehrdad

2012-01-01

Inappropriate use of indwelling urinary catheters (IUCs) and their related complications is one of the most important problems in hospital wards. The aim of this study was to evaluate inappropriate use of IUCs and their complications among patients in Tehran, Iran. Two hundred and six consecutive patients hospitalized in the intensive care unit (ICU) as well as medical and surgical wards at the Shahid Mohammadi Hospital in Bandarabbas from September 1 to 30, 2005 and in whom IUCs were used, were studied. Data collected included age of the patients, diagnoses, reason for use of IUC and the complications related to it. Overall, 164 patients (79.6%) had IUCs used appropriately while 42 of them (20.6%) were catheterized unjustifiably. Inappropriate use of IUCs in the ICU, medical and surgical wards was reported in 12 (18.5%), 16 (19.0%) and 14 patients (24.6%), respectively. The most common complication of IUCs was urinary tract infection, which occurred in 91 patients (44.2%) and hematuria, which was seen in 3.9% of the patients. Our study suggests that inappropriate use of IUCs is prevalent, particularly in the surgical wards, and the most common complication observed was catheter-associated urinary tract infection.

Zeolite Formation and Weathering Processes in Dry Valleys of Antartica: Martian Analogs

NASA Technical Reports Server (NTRS)

Gibson, E. K., Jr.; Wentworth, S. J.; McKay, D. S.; Socki, R. A.

2004-01-01

Terrestrial weathering processes in cold-desert climates such as the Dry Valleys of Antarctica may provide an excellent analog to chemical weathering and diagenesis of soils on Mars. Detailed studies of soil development and the chemical and mineralogical alterations occurring within soil columns in Wright Valley, Antarctica show incredible complexity in the upper meter of soil. Previous workers noted the ice-free Dry Valleys are the best terrestrial approximations to contemporary Mars. Images returned from the Pathfinder and Spirit landers show similarities to surfaces observed within the Dry Valleys. Similarities to Mars that exist in these valleys are: mean temperatures always below freezing (-20 C), no rainfall, sparse snowfall-rapidly removed by sublimation, desiccating winds, diurnal freeze-thaw cycles (even during daylight hours), low humidity, oxidative environment, relatively high solar radiation and low magnetic fields . The Dry Valley soils contain irregular distributions and low abundances of soil microorganisms that are somewhat unusual on Earth. Physical processes-such as sand abrasion-are dominant mechanisms of rock weathering in Antarctica. However, chemical weathering is also an important process even in such extreme climates. For example, ionic migration occurs even in frozen soils along liquid films on individual soil particles. It has also been shown that water with liquid-like properties is present in soils at temperatures on the order of approx.-80 C and it has been observed that the percentage of oxidized iron increases with increasing soil age and enrichments in oxidized iron occurs toward the surface. The presence of evaporates is evident and appear similar to "evaporite sites" within the Pathfinder and Spirit sites. Evaporites indicate ionic migration and chemical activity even in the permanently frozen zone. The presence of evaporates indicates that chemical weathering of rocks and possibly soils has been active. Authogenic zeolites have

77 FR 6586 - GE Oil & Gas Operations, LLC Including On-Site Leased Workers From Adecco, Argus Technical, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-08

..., LLC Including On-Site Leased Workers From Adecco, Argus Technical, Inc., Fox Valley Metrology URS Corp... the certification for workers of the subject firm. New information shows that workers leased from Fox... from Fox Valley Metrology, URS Corp. and CompuCom working on-site at the Oshkosh, Wisconsin location of...

A preliminary investigation of the variables affecting the distribution of giant gartersnakes (Thamnophis gigas) in the Sacramento Valley, California

USGS Publications Warehouse

Halstead, Brian J.; Skalos, Shannon M.; Casazza, Michael L.; Wylie, Glenn D.

2015-09-30

Giant gartersnakes (Thamnophis gigas) comprise a species of rare, semi-aquatic snake precinctive to the Central Valley of California. Because of the loss of more than 90% of their natural habitat, giant gartersnakes are listed as Threatened by the United States and California endangered species acts. Little is known, however, about the distribution of giant gartersnakes in the Sacramento Valley, which is where most extant populations occur. We conducted detection-nondetection surveys for giant gartersnakes throughout the rice-growing regions of the Sacramento Valley, and used occupancy models to examine evidence for the effects of landscape-scale GIS-derived variables, local habitat and vegetation composition, and prey communities on patterns of giant gartersnake occurrence. Although our results are based on a relatively small sample of sites, we found that distance to historic marsh, relative fish count, and an interaction of distance to historic marsh with proportion of habitat composed of submerged vegetation were important variables for explaining occupancy of giant gartersnakes. In particular, giant gartersnakes were more likely to occur closer to historic marsh and where relatively fewer fish were captured in traps. At locations in or near historic marsh, giant gartersnakes were more likely to occur in areas with less submerged vegetation, but this relationship was reversed (and more uncertain) at sites distant from historic marsh. Additional research with a larger sample of sites would further elucidate the distribution of giant gartersnakes in the Sacramento Valley.

Infilling and flooding of the Mekong River incised valley during deglacial sea-level rise

NASA Astrophysics Data System (ADS)

Tjallingii, Rik; Stattegger, Karl; Wetzel, Andreas; Van Phach, Phung

2010-06-01

The abrupt transition from fluvial to marine deposition of incised-valley-fill sediments retrieved from the southeast Vietnamese shelf, accurately records the postglacial transgression after 14 ka before present (BP). Valley-filling sediments consist of fluvial mud, whereas sedimentation after the transgression is characterized by shallow-marine carbonate sands. This change in sediment composition is accurately marked in high-resolution X-ray fluorescence (XRF) core scanning records. Rapid aggradation of fluvial sediments at the river mouth nearly completely filled the Mekong incised valley prior to flooding. However, accumulation rates strongly reduced in the valley after the river-mouth system flooded and stepped back. This also affected the sediment supply to deeper parts of the southeast Vietnamese shelf. Comparison of the Mekong valley-filling with the East Asian sea-level history of sub- and inter-tidal sediment records shows that the transgressive surface preserved in the incised-valley-fill records is a robust sea-level indicator. The valley was nearly completely filled with fluvial sediments between 13.0 and 9.5 ka BP when sea-level rose rather constantly with approximately 10 mm/yr, as indicated by the East Asian sea-level record. At shallower parts of the shelf, significant sediment reworking and the establishment of estuarine conditions at the final stage of infilling complicates accurate dating of the transgressive surface. Nevertheless, incised-valley-fill records and land-based drill sites indicate a vast and rapid flooding of the shelf from the location of the modern Vietnamese coastline to the Cambodian lowlands between 9.5 ka and 8.5 ka BP. Fast flooding of this part of the shelf is related with the low shelf gradient and a strong acceleration of the East Asian sea-level rise from 34 to 9 meter below modern sea level (mbsl) corresponding to the sea-level jump of melt water pulse (MWP) 1C.

Pattern of ground deformation in Kathmandu valley during 2015 Gorkha Earthquake, central Nepal

NASA Astrophysics Data System (ADS)

Ghimire, S.; Dwivedi, S. K.; Acharya, K. K.

2016-12-01

The 25th April 2015 Gorkha Earthquake (Mw=7.8) epicentered at Barpak along with thousands of aftershocks released seismic moment nearly equivalent to an 8.0 Magnitude earthquake rupturing a 150km long fault segment. Although Kathmandu valley was supposed to be severely devastated by such major earthquake, post earthquake scenario is completely different. The observed destruction is far less than anticipated as well as the spatial pattern is different than expected. This work focuses on the behavior of Kathmandu valley sediments during the strong shaking by the 2015 Gorkha Earthquake. For this purpose spatial pattern of destruction is analyzed at heavily destructed sites. To understand characteristics of subsurface soil 2D-MASW survey was carried out using a 24-channel seismograph system. An accellerogram recorded by Nepal Seismological Center was analyzed to characterize the strong ground motion. The Kathmandu valley comprises fluvio-lacustrine deposit with gravel, sand, silt and clay along with few exposures of basement rocks within the sediments. The observations show systematic repetition of destruction at an average interval of 2.5km mostly in sand, silt and clay dominated formations. Results of 2D-MASW show the sites of destruction are characterized by static deformation of soil (liquefaction and southerly dipping cracks). Spectral analysis of the accelerogram indicates maximum power associated with frequency of 1.0Hz. The result of this study explains the observed spatial pattern of destruction in Kathmandu valley. This is correlated with the seismic energy associated with the frequency of 1Hz, which generates an average wavelength of 2.5km with an average S-wave velocity of 2.5km/s. The cumulative effect of dominant frequency and associated wavelength resulted in static deformation of surface soil layers at an average interval of 2.5km. This phenomenon clearly describes the reason for different scenario than that was anticipated in Kathmandu valley.

Dementia buddying as a vehicle for person-centred care? The performance of a volunteer-led pilot on two hospital wards.

PubMed

Preston, Claire; Burch, Sarah

2018-01-01

Objectives To understand and explain whether a dementia buddies pilot introduced into two adjacent mental health hospital wards in England was achieving its aim of enhancing person-centred care. Methods The research used a cultural lens to evaluate the dementia buddies pilot. It comprised 20 in-depth semi-structured interviews with staff, volunteers and carers in the two wards where the pilot was introduced. Results The pilot's ability to deliver positive outcomes depended on its compatibility with the culture of the ward and it performed better in the ward where a person-centred culture of care already existed. In this ward, the pilot became a catalyst for improved experience among patients, carers and staff, whereas in the second ward, the pilot faced resistance from staff and achieved less. Conclusions This finding underlines the benefit of focusing on workplace culture to understand the performance of volunteer-led initiatives. It also shows that existing ward culture is a determining factor in the capacity for dementia buddy schemes to act as vehicles for culture change.

Monitoring of heavy flooding by orbital remote sensing: The example of the Doce river valley. [Doce River Valley, Brazil

NASA Technical Reports Server (NTRS)

Dejesusparada, N. (Principal Investigator); Novo, E. M. L. D.; Dossantos, A. P.

1981-01-01

The application of temporal LANDSAT data to study floods was verified, and the natural features responsible for this phenomenon were surveyed using the Doce river valley as a test site, because of the catastrophic (1978-1979) flood. Data from LANDSAT images and CCT's were used. Geomorphical mapping evaluated morphostructural features. Seven and nine classes of water surfaces for dry and rainy seasons were analyzed. The magnitude of the changes from preflood to postflood stage are estimated. The single Pixel program was applied to correlate the drainage basin characteristics to the grey level of LANDSAT data.

Seasonal Variability of PM2.5, BC, and PM2.5 Chemical Characteristics at Busy Roadways in Kathmandu Valley, Nepal

NASA Astrophysics Data System (ADS)

Shakya, K. M.; Rupakheti, M.; Peltier, R.

2016-12-01

Kathmandu valley located in the foothills of Himalaya in Nepal suffers from serious air pollution problems. Near-roadway PM2.5 and BC were measured at six sites in the Kathmandu valley using a portable scattering nephelometer (pDR-1500, Thermo Inc., US) and a microaethalometer (Aeth Labs, US), respectively. 37 mm polytetrafluoroethylene filter samples were analyzed by a laboratory-based X-ray fluorescence (XRF) spectrometer (QUANT'X, Thermo Inc., US) for elements, with subsequent filter extraction in deionized water followed by ion chromatography (ICS-1100, Thermo Inc., US) for water-soluble ions. PM2.5 concentrations at six different locations in the Kathmandu Valley, Nepal showed distinct seasonal variability. There was a reduction of 57-74% in PM2.5 levels during the monsoonal period (July 20 - August 22, 2014) compared to the drier winter season (February 16 - April 4, 2014). Daily means of PM2.5 were 124.76 and 45.92 μg/m3 during winter and monsoon, respectively. BC concentrations, however, were marginally reduced during the monsoon (13.46 μgC/m3) compared to that in winter (16.74 μgC/m3). Four sites located along a busy commercial ring road had higher PM2.5 levels than the two sites located inside the ring road. Chemical analysis of 24 hour PM2.5 filter samples shows dust and traffic sources as the most important PM emission source at these locations. Silica, calcium, aluminum, and iron were the most abundant elements during both winter and monsoon, with the total concentrations of 12.13 and 8.85 μg/m3, respectively. Coefficient of divergence calculated from the four main sites resulted in more heterogeneity for chemical species compared to PM2.5 and BC. This suggests though PM2.5 and BC levels might be similar in the valley, their emission sources and production might differ across the valley. Our findings provide important insights on physical and chemical characteristics of particulate matter and its sources, which will be useful in designing

Geohydrology and Water Quality of the Valley-Fill Aquifer System in the Upper Sixmile Creek and West Branch Owego Creek Valleys in the Town of Caroline, Tompkins County, New York

USGS Publications Warehouse

Miller, Todd S.

2009-01-01

, a school, and several farms and small businesses. Most groundwater that is withdrawn from pumped wells is returned to the groundwater system via septic systems. Groundwater in the upper and basal confined aquifers in the upper Sixmile Creek valley is under artesian conditions everywhere except where the water discharges to springs along bluffs in the western end of the Sixmile Creek valley. Principal sources of recharge to the confined aquifers are (1) the sides of the valley where the confined aquifers may extend up along the flank of the bedrock valley wall and crop out at land surface or are overlain and in contact with surficial coarse-grained deltaic and fluvial sediments that provide a pathway through which direct precipitation and seepage losses from tributary streams can reach the buried aquifers, or (2) where the buried aquifers are isolated and receive recharge only from adjacent fine-grained sediment and bedrock. The base-flow and runoff components of total streamflow at two streamgages, Sixmile Creek at Brooktondale and Sixmile Creek at Bethel Grove, were calculated using hydrograph-separation techniques from 2003 to 2007 discharge records. Base flow constituted 64 and 56 percent of the total annual flow at the Brooktondale and Bethel Grove streamgages, respectively. Water-quality samples were collected from 2003 to 2005, with 10 surface-water samples collected seasonally during base-flow conditions at the Sixmile Creek at Brooktondale streamgage, and 12 samples were collected during base-flow conditions at several selected tributaries from 2004 to 2005. The predominant cation detected in the surface-water samples was calcium, but moderate amounts of magnesium, silica, and sodium were also detected; the major anions were bicarbonate, chloride, and sulfate. Sodium and chloride concentrations were relatively low in all samples but increased downstream from the Sixmile Creek sampling site at Six Hundred Road near Slaterville Springs, NY, to B

The Long Valley Caldera GIS database

USGS Publications Warehouse

Battaglia, Maurizio; Williams, M.J.; Venezky, D.Y.; Hill, D.P.; Langbein, J.O.; Farrar, C.D.; Howle, J.F.; Sneed, M.; Segall, P.

2003-01-01

This database provides an overview of the studies being conducted by the Long Valley Observatory in eastern California from 1975 to 2001. The database includes geologic, monitoring, and topographic datasets related to Long Valley caldera. The CD-ROM contains a scan of the original geologic map of the Long Valley region by R. Bailey. Real-time data of the current activity of the caldera (including earthquakes, ground deformation and the release of volcanic gas), information about volcanic hazards and the USGS response plan are available online at the Long Valley observatory web page (http://lvo.wr.usgs.gov). If you have any comments or questions about this database, please contact the Scientist in Charge of the Long Valley observatory.

Analyzing tree cores to detect petroleum hydrocarbon-contaminated groundwater at a former landfill site in the community of Happy Valley-Goose Bay, eastern Canadian subarctic.

PubMed

Fonkwe, Merline L D; Trapp, Stefan

2016-08-01

This research examines the feasibility of analyzing tree cores to detect benzene, toluene, ethylbenzene, and m, p, o-xylene (BTEX) compounds and methyl tertiary-butyl ether (MTBE) in groundwater in eastern Canada subarctic environments, using a former landfill site in the remote community of Happy Valley-Goose Bay, Labrador. Petroleum hydrocarbon contamination at the landfill site is the result of environmentally unsound pre-1990s disposal of households and industrial solid wastes. Tree cores were taken from trembling aspen, black spruce, and white birch and analyzed by headspace-gas chromatography-mass spectrometry. BTEX compounds were detected in tree cores, corroborating known groundwater contamination. A zone of anomalously high concentrations of total BTEX constituents was identified and recommended for monitoring by groundwater wells. Tree cores collected outside the landfill site at a local control area suggest the migration of contaminants off-site. Tree species exhibit different concentrations of BTEX constituents, indicating selective uptake and accumulation. Toluene in wood exhibited the highest concentrations, which may also be due to endogenous production. Meanwhile, MTBE was not found in the tree cores and is considered to be absent in the groundwater. The results demonstrate that tree-core analysis can be useful for detecting anomalous concentrations of petroleum hydrocarbons, such as BTEX compounds, in subarctic sites with shallow unconfined aquifers and permeable soils. This method can therefore aid in the proper management of contamination during landfill operations and after site closures.

Pharmacy sales data versus ward stock accounting for the surveillance of broad-spectrum antibiotic use in hospitals

PubMed Central

2011-01-01

Background Antibiotic consumption in hospitals is commonly measured using the accumulated amount of drugs delivered from the pharmacy to ward held stocks. The reliability of this method, particularly the impact of the length of the registration periods, has not been evaluated and such evaluation was aim of the study. Methods During 26 weeks, we performed a weekly ward stock count of use of broad-spectrum antibiotics - that is second- and third-generation cephalosporins, carbapenems, and quinolones - in five hospital wards and compared the data with corresponding pharmacy sales figures during the same period. Defined daily doses (DDDs) for antibiotics were used as measurement units (WHO ATC/DDD classification). Consumption figures obtained with the two methods for different registration intervals were compared by use of intraclass correlation analysis and Bland-Altman statistics. Results Broad-spectrum antibiotics accounted for a quarter to one-fifth of all systemic antibiotics (ATC group J01) used in the hospital and varied between wards, from 12.8 DDDs per 100 bed days in a urological ward to 24.5 DDDs in a pulmonary diseases ward. For the entire study period of 26 weeks, the pharmacy and ward defined daily doses figures for all broad-spectrum antibiotics differed only by 0.2%; however, for single wards deviations varied from -4.3% to 6.9%. The intraclass correlation coefficient, pharmacy versus ward data, increased from 0.78 to 0.94 for parenteral broad-spectrum antibiotics with increasing registration periods (1-4 weeks), whereas the corresponding figures for oral broad-spectrum antibiotics (ciprofloxacin) were from 0.46 to 0.74. For all broad-spectrum antibiotics and for parenteral antibiotics, limits of agreement between the two methods showed, according to Bland-Altman statistics, a deviation of ± 5% or less from average mean DDDs at 3- and 4-weeks registration intervals. Corresponding deviation for oral antibiotics was ± 21% at a 4-weeks interval

Bottomland Forests in the Lower Mississippi Alluvial Valley associated with the endangered Lindera melissifolia

Treesearch

Tracy S. Hawkins; Daniel A. Skojac; Brian R. Lockhart; Theodor D. Leininger; Margaret S. Devall; Nathan M. Shiff

2009-01-01

Forest canopy and subcanopy data were collected from and compared amongfive disjunct bottomland hardwood forests in the Lower Mississippi Alluvial Valley, each withknown occurrence of a population of the federally endangered shrub Lindera melissifolia. Allstudy sites are cut-over forests, underlain by...

Staff perception of patient discharge from ICU to ward-based care.

PubMed

James, Stephen; Quirke, Sara; McBride-Henry, Karen

2013-11-01

The quality of information exchange between intensive care unit (ICU) and ward nurses, when patients are transferred out of intensive care, is important to the continuity of safe care. This research aimed to explore nurses' experiences of the discharge process from ICU to the ward environment. The study was conducted in a New Zealand Metropolitan hospital, using an exploratory descriptive design we adapted a questionnaire based on Whittaker and Ball's research on ICU patient handover. The questionnaires were then analysed using a descriptive thematic approach. The response rate of 48% included 45 ICU and 47 ward nurses. Key findings were that the written and verbal communication needs differ dependent upon setting and the timing of a discharge. Timing of handover also requires negotiation. Being able to negotiate the timing and nature of handover is important for nurses. In addition, standardized approaches to communication are believed to enhance patient safety. Standardized handover, with content and processes that are mutually negotiated, is crucial to providing the safest environment for patients. © 2013 The Authors. Nursing in Critical Care © 2013 British Association of Critical Care Nurses.

Drinking Water Quality Surveillance in a Vulnerable Urban Ward of Ahmedabad.

PubMed

Iyer, Veena; Choudhury, Nandini; Azhar, Gulrez Shah; Somvanshi, Bhushan

2014-05-01

The World Bank estimates that 21% of all communicable diseases in India are related to unsafe water with diarrhoea alone causing more than 0.1 million deaths annually. The WHO drinking water surveillance parameters of quality, quantity, accessibility, affordability and continuity were assessed in one vulnerable ward of Ahmedabad-a fast growing city in Western India. Interviews with key informants of the ward office, health centre and water supply department, secondary analysis and mapping of field test reports and a questionnaire-based survey of different household types were conducted. We found that Ahmedabad Municipal Corporation (AMC) supplies water to the ward intermittently for two hours during the day. Housing society clusters supplement their AMC water supply with untested bore-well water. The water quality surveillance system is designed for a twenty-four-hour piped distribution of treated surface water. However, in order to maintain surveillance over an intermittent supply that includes ground water, the sampling process should include periodic surveys of water actually consumed by the citizens. The laboratory capacity of the Central Water Testing Laboratory should expand to include more refined tests for microbial and chemical contamination.

Modelling the Crust beneath the Kashmir valley in Northwestern Himalaya

NASA Astrophysics Data System (ADS)

Mir, R. R.; Parvez, I. A.; Gaur, V. K.; A.; Chandra, R.; Romshoo, S. A.

2015-12-01

We investigate the crustal structure beneath five broadband seismic stations in the NW-SE trendingoval shaped Kashmir valley sandwiched between the Zanskar and the Pir Panjal ranges of thenorthwestern Himalaya. Three of these sites were located along the southwestern edge of the valley andthe other two adjoined the southeastern. Receiver Functions (RFs) at these sites were calculated usingthe iterative time domain deconvolution method and jointly inverted with surface wave dispersiondata to estimate the shear wave velocity structure beneath each station. To further test the results ofinversion, we applied forward modelling by dividing the crust beneath each station into 4-6homogeneous, isotropic layers. Moho depths were separately calculated at different piercing pointsfrom the inversion of only a few stacked receiver functions of high quality around each piercing point.These uncertainties were further reduced to ±2 km by trial forward modelling as Moho depths werevaried over a range of ±6 km in steps of 2 km and the synthetic receiver functions matched with theinverted ones. The final values were also found to be close to those independently estimated using theH-K stacks. The Moho depths on the eastern edge of the valley and at piercing points in itssouthwestern half are close to 55 km, but increase to about 58 km on the eastern edge, suggesting thathere, as in the central and Nepal Himalaya, the Indian plate dips northeastwards beneath the Himalaya.We also calculated the Vp/Vs ratio beneath these 5 stations which were found to lie between 1.7 and1.76, yielding a Poisson's ratio of ~0.25 which is characteristic of a felsic composition.

27 CFR 9.78 - Ohio River Valley.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Ohio River Valley. 9.78... River Valley. (a) Name. The name of the viticultural area described in this section is “Ohio River Valley.” (b) Approved maps. The approved maps for determining the boundary of the Ohio River Valley...

Valley dependent transport in graphene L junction

NASA Astrophysics Data System (ADS)

Chan, K. S.

2018-05-01

We studied the valley dependent transport in graphene L junctions connecting an armchair lead and a zigzag lead. The junction can be used in valleytronic devices and circuits. Electrons injected from the armchair lead into the junction is not valley polarized, but they can become valley polarized in the zigzag lead. There are Fermi energies, where the current in the zigzag lead is highly valley polarized and the junction is an efficient generator of valley polarized current. The features of the valley polarized current depend sensitively on the widths of the two leads, as well as the number of dimers in the armchair lead, because this number has a sensitive effect on the band structure of the armchair lead. When an external potential is applied to the junction, the energy range with high valley polarization is enlarged enhancing its function as a generator of highly valley polarized current. The scaling behavior found in other graphene devices is also found in L junctions, which means that the results presented here can be extended to junctions with larger dimensions after appropriate scaling of the energy.

Experiences of Patients in Acute and Closed Psychiatric Wards: A Systematic Review.

PubMed

Nugteren, Willem; van der Zalm, Yvonne; Hafsteinsdóttir, Thóra B; van der Venne, Cokky; Kool, Nienke; van Meijel, Berno

2016-10-01

To obtain insight into the patients' experiences during treatment in an acute, closed psychiatric ward. A systematic literature search was conducted in the databases Medline, Embase, CINAHL, and Cochrane. Ten articles were selected. Four main themes emerged from the literature: (a) the inappropriate use of the ward rules, (b) nurses' lack of time for interacting with patients, (c) the feeling of humiliation, and (d) the involvement of significant others. Nurses can use the findings of this systematic review to improve quality of care in acute psychiatric units. © 2015 Wiley Periodicals, Inc.

Rift Valley fever.

PubMed

Paweska, J T

2015-08-01

Rift Valley fever (RVF) is a mosquito-borne zoonotic viral disease affecting domestic and wild ruminants, camels and humans. The causative agent of RVF, the RVF virus (RVFV), has the capacity to cause large and severe outbreaks in animal and human populations and to cross significant natural geographic barriers. Rift Valley fever is usually inapparent in non-pregnant adult animals, but pregnant animals and newborns can be severely affected; outbreaks are characterised by a sudden onset of abortions and high neonatal mortality. The majority of human infections are subclinical or associated with moderate to severe, non-fatal, febrile illness, but some patients may develop a haemorrhagic syndrome and/or ocular and neurological lesions. In both animals and humans, the primary site of RVFV replication and tissue pathology is the liver. Outbreaks of RVF are associated with persistent high rainfalls leading to massive flooding and the emergence of large numbers of competent mosquito vectors that transmit the virus to a wide range of susceptible vertebrate species. Outbreaks of RVF have devastating economic effects on countries for which animal trade constitutes the main source of national revenue. The propensity of the virus to spread into new territories and re-emerge in traditionally endemic regions, where it causes large outbreaks in human and animal populations, presents a formidable challenge for public and veterinary health authorities. The presence of competent mosquito vectors in RVF-free countries, the wide range of mammals susceptible to the virus, altering land use, the global changes in climate, and increased animal trade and travel are some of the factors which might contribute to international spread of RVF.

Factors affecting staff morale on inpatient mental health wards in England: a qualitative investigation

PubMed Central

2011-01-01

Background Good morale among staff on inpatient psychiatric wards is an important requirement for the maintenance of strong therapeutic alliances and positive patient experiences, and for the successful implementation of initiatives to improve care. More understanding is needed of mechanisms underlying good and poor morale. Method We conducted individual and group interviews with staff of a full range of disciplines and levels of seniority on seven NHS in-patient wards of varying types in England. Results Inpatient staff feel sustained in their potentially stressful roles by mutual loyalty and trust within cohesive ward teams. Clear roles, supportive ward managers and well designed organisational procedures and structures maintain good morale. Perceived threats to good morale include staffing levels that are insufficient for staff to feel safe and able to spend time with patients, the high risk of violence, and lack of voice in the wider organisation. Conclusions Increasing employee voice, designing jobs so as to maximise autonomy within clear and well-structured operational protocols, promoting greater staff-patient contact and improving responses to violence may contribute more to inpatient staff morale than formal support mechanisms. PMID:21510852

Medical ward round competence in internal medicine - an interview study towards an interprofessional development of an Entrustable Professional Activity (EPA).

PubMed

Wölfel, Teresa; Beltermann, Esther; Lottspeich, Christian; Vietz, Elisa; Fischer, Martin R; Schmidmaier, Ralf

2016-07-11

The medical ward round is a central but complex activity that is of relevance from the first day of work. However, difficulties for young doctors have been reported. Instruction of ward round competence in medical curricula is hampered by the lack of a standardized description of the procedure. This paper aims to identify and describe physicians' tasks and relevant competences for conducting a medical ward round on the first day of professional work. A review of recent literature revealed known important aspects of medical ward rounds. These were used for the development of a semi-structured interview schedule. Medical ward round experts working at different hospitals were interviewed. The sample consisted of 14 ward physicians (M = 8.82 years of work experience) and 12 nurses (M = 14.55 years of work experience) working in different specializations of internal medicine. All interviews were audiotaped, fully transcribed, and analyzed using an inductive-deductive coding scheme. Nine fields of competences with 18 related sub-competences and 62 observable tasks were identified as relevant for conducting a medical ward round. Over 70 % of the experts named communication, collaborative clinical reasoning and organization as essential competences. Deeper analysis further unveiled the importance of self-management, management of difficult situations, error management and teamwork. The study is the first to picture ward round competences and related tasks in detail and to define an EPA "Conducting an internal medicine ward round" based on systematic interprofessional expert interviews. It thus provides a basis for integration of ward round competences in the medical curricula in an evidence based manner and gives a framework for the development of instructional intervention studies and comparative studies in other medical fields.

Abundance and sexual size dimorphism of the giant gartersnake (Thamnophis gigas) in the Sacramento valley of California

USGS Publications Warehouse

Wylie, G.D.; Casazza, Michael L.; Gregory, C.J.; Halstead, B.J.

2010-01-01

The Giant Gartersnake (Thamnophis gigas) is restricted to wetlands of the Central Valley of California. Because of wetland loss in this region, the Giant Gartersnake is both federally and state listed as threatened. We conducted markrecapture studies of four populations of the Giant Gartersnake in the Sacramento Valley (northern Central Valley), California, to obtain baseline data on abundance and density to assist in recovery planning for this species. We sampled habitats that ranged from natural, unmanaged marsh to constructed managed marshes and habitats associated with rice agriculture. Giant Gartersnake density in a natural wetland (1.90 individuals/ha) was an order of magnitude greater than in a managed wetland subject to active season drying (0.17 individuals/ha). Sex ratios at all sites were not different from 1 1, and females were longer and heavier than males. Females had greater body condition than males, and individuals at the least disturbed sites had significantly greater body condition than individuals at the managed wetland. The few remaining natural wetlands in the Central Valley are important, productive habitat for the Giant Gartersnake, and should be conserved and protected. Wetlands constructed and restored for the Giant Gartersnake should be modeled after the permanent, shallow wetlands representative of historic Giant Gartersnake habitat. ?? 2010 Society for the Study of Amphibians and Reptiles.

Down in the Valley.

ERIC Educational Resources Information Center

Salter, Linda Graef

1999-01-01

Describes the partnerships formed by West Valley Mission Community College District (California) with its surrounding Silicon Valley business community in an effort to benefit workforce development. Asserts that community colleges are uniquely positioned to provide a lifelong education that will yield a skilled workforce to meet the needs of…

Improving the Quality of Ward-based Surgical Care With a Human Factors Intervention Bundle.

PubMed

Johnston, Maximilian J; Arora, Sonal; King, Dominic; Darzi, Ara

2018-01-01

This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety. A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards. Twenty-seven junior and senior surgeons completed validated questionnaires assessing supervision, escalation of care, and safety culture pre and post-intervention along with interviews to further explore the impact of the intervention. Patient outcomes pre and postintervention were also analyzed. Questionnaires revealed significant improvements in supervision postintervention (senior median pre 5 vs post 7, P = 0.002 and junior 4 vs 6, P = 0.039) and senior surgeon approachability (junior 5 vs 6, P = 0.047). Both groups agreed that they would feel safer as a patient in their hospital postintervention (senior 3 vs 4.5, P = 0.021 and junior 3 vs 4, P = 0.034). The interviews confirmed that the safety culture of the department had improved. There were no differences in inpatient mortality, cardiac arrest, reoperation, or readmission rates pre and postintervention. Improving supervision and introducing clear protocols can improve safety culture on the surgical ward. Future work should evaluate the effect these measures have on patient outcomes in multiple institutions.

'Take Ten' improving the surgical post-take ward round: a quality improvement project.