WorldWideScience

Sample records for discharge medlineplus medical

  1. Medical Encyclopedia: MedlinePlus

    Science.gov (United States)

    ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow us Disclaimers Copyright ...

  2. Traumatic Brain Injury: MedlinePlus Health Topic

    Science.gov (United States)

    ... injury - discharge (Medical Encyclopedia) Also in Spanish Chronic subdural hematoma (Medical Encyclopedia) Also in Spanish EEG (Medical Encyclopedia) ... Intracranial pressure monitoring (Medical Encyclopedia) Also in Spanish Subdural hematoma (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus ...

  3. NIH MedlinePlus the Magazine: Health, Medical & Wellness Articles

    Science.gov (United States)

    ... to the Web site for NIH MedlinePlus, the magazine. Our purpose is to present you with the ... sponsorship and other charitable donations for NIH MedlinePlus magazine's publication and distribution, many more thousands of Americans ...

  4. Wilms' Tumor: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Wilms tumor (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Wilms Tumor updates ... ENCYCLOPEDIA After chemotherapy - discharge Wilms tumor Related Health Topics Kidney Cancer National Institutes of Health The primary ...

  5. Colonoscopy: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Virtual colonoscopy (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Colonoscopy updates by ... Colonoscopy Colonoscopy discharge Sigmoidoscopy Virtual colonoscopy Related Health Topics Colonic Diseases Colonic Polyps Colorectal Cancer National Institutes ...

  6. For Distinguished Public Service: Medical Library Association Honors FNLM and NIH MedlinePlus Magazine | NIH ...

    Science.gov (United States)

    ... Medical Library Association Honors FNLM and NIH MedlinePlus Magazine Past Issues / Summer 2011 Table of Contents MLA ... From You We want your feedback on the magazine and ideas for future issues, as well as ...

  7. Laser Eye Surgery: MedlinePlus Health Topic

    Science.gov (United States)

    ... corneal surgery - discharge (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Laser Eye Surgery ... surgery - what to ask your doctor Related Health Topics Refractive Errors National Institutes of Health The primary ...

  8. Bone Marrow Transplantation: MedlinePlus Health Topic

    Science.gov (United States)

    ... marrow transplant - discharge (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Bone Marrow Transplantation ... transplant - slideshow Graft-versus-host disease Related Health Topics Bone Marrow Diseases Stem Cells National Institutes of ...

  9. Mobile MedlinePlus | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... version of this page please turn Javascript on. Mobile MedlinePlus Past Issues / Spring 2013 Table of Contents Trusted medical information on your mobile phone http://m.medlineplus.gov Wondering what the ...

  10. Mobile MedlinePlus | NIH MedlinePlus Magazine

    Science.gov (United States)

    ... version of this page please turn Javascript on. Mobile MedlinePlus Past Issues / Winter 2010 Table of Contents Trusted medical information on your mobile phone http://m.medlineplus.gov Wondering what the ...

  11. Medical Injury Identification Using Hospital Discharge Data

    National Research Council Canada - National Science Library

    Layde, Peter M; Meurer, Linda N; Guse, Clare; Meurer, John R; Yang, Hongyan; Laud, Prakash; Kuhn, Evelyn M; Brasel, Karen J; Hargarten, Stephen W

    2005-01-01

    .... The development, validation, and testing of screening criteria for medical injury was based on International Classification of Disease code discharge diagnoses using 2001 patient data from Wisconsin hospitals...

  12. A Leader in Clinical Trials, Medical Data, & Electronic Health Information | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of C. Everett Koop, the former Surgeon General; Charles Drew, the “father of the blood bank”; Rosalind ... MedlinePlus information resources about prescriptions. Soon, such information will be available through one click on the name ...

  13. Impact of Pharmacist Facilitated Discharge Medication Reconciliation

    Directory of Open Access Journals (Sweden)

    Todd M. Super

    2014-07-01

    Full Text Available Preventable adverse drug events occur frequently at transitions in care and are a problem for many patients following hospital discharge. Many of these problems can be attributed to poor medication reconciliation. The purpose of this study was to assess the impact that direct pharmacist involvement in the discharge medication reconciliation process had on medication discrepancies, patient outcomes, and satisfaction. A cohort study of 70 patients was designed to assess the impact of pharmacist facilitated discharge medication reconciliation at a 204-bed community hospital in Battle Creek, Michigan, USA. Discharge summaries were analyzed to compare patients who received standard discharge without pharmacist involvement to those having pharmacist involvement. The total number of discrepancies in the group without pharmacist involvement was significantly higher than that of the pharmacist facilitated group.

  14. Pneumocystis Infections: MedlinePlus Health Topic

    Science.gov (United States)

    ... Pneumocystis jiroveci pneumonia (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Pneumocystis Infections updates ... GO MEDICAL ENCYCLOPEDIA Pneumocystis jiroveci pneumonia Related Health Topics HIV/AIDS HIV/AIDS and Infections Pneumonia National ...

  15. Psoriatic Arthritis: MedlinePlus Health Topic

    Science.gov (United States)

    ... Handouts Psoriatic arthritis (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Psoriatic Arthritis updates ... this? GO MEDICAL ENCYCLOPEDIA Psoriatic arthritis Related Health Topics Arthritis Psoriasis National Institutes of Health The primary ...

  16. Cardiac Arrest: MedlinePlus Health Topic

    Science.gov (United States)

    ... Handouts Cardiac arrest (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Cardiac Arrest updates ... this? GO MEDICAL ENCYCLOPEDIA Cardiac arrest Related Health Topics Arrhythmia CPR Pacemakers and Implantable Defibrillators National Institutes ...

  17. Kawasaki Disease: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Kawasaki disease (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Kawasaki Disease updates ... GO MEDICAL ENCYCLOPEDIA Electrocardiogram Kawasaki disease Related Health Topics Vasculitis National Institutes of Health The primary NIH ...

  18. Hearing Aids: MedlinePlus Health Topic

    Science.gov (United States)

    ... for hearing loss (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Hearing Aids updates ... MEDICAL ENCYCLOPEDIA Devices for hearing loss Related Health Topics Cochlear Implants Hearing Disorders and Deafness National Institutes ...

  19. Pulmonary Rehabilitation: MedlinePlus Health Topic

    Science.gov (United States)

    ... Handouts Postural drainage (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Pulmonary Rehabilitation updates ... this? GO MEDICAL ENCYCLOPEDIA Postural drainage Related Health Topics Lung Diseases National Institutes of Health The primary ...

  20. Milestones in Medical Research, The Human Genome and ClinicalTrials.gov | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... the information in this issue of NIH MedlinePlus magazine helps you and your loved ones stay healthier! ... From You! We want your feedback on the magazine, ideas for future issues, as well as questions ...

  1. Female Infertility: MedlinePlus Health Topic

    Science.gov (United States)

    ... Prolactin blood test (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Female Infertility updates ... Serum progesterone Show More Show Less Related Health Topics Assisted Reproductive Technology Infertility Male Infertility National Institutes ...

  2. Folic Acid: MedlinePlus Health Topic

    Science.gov (United States)

    ... acid in diet (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Folic Acid updates ... acid - test Folic acid in diet Related Health Topics Vitamins National Institutes of Health The primary NIH ...

  3. Chiropractic: MedlinePlus Health Topic

    Science.gov (United States)

    ... for back pain (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Chiropractic updates by ... ENCYCLOPEDIA Chiropractic care for back pain Related Health Topics Back Pain Complementary and Integrative Medicine National Institutes ...

  4. Child Safety: MedlinePlus Health Topic

    Science.gov (United States)

    ... injuries in children (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Child Safety updates ... safety Preventing head injuries in children Related Health Topics Infant and Newborn Care Internet Safety Motor Vehicle ...

  5. Diets: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Mediterranean diet (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Diets updates by ... foods Diet-busting foods Mediterranean diet Related Health Topics Child Nutrition DASH Eating Plan Diabetic Diet Nutrition ...

  6. Collapsed Lung: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Pneumothorax - infants (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Collapsed Lung updates ... Lung surgery Pneumothorax - slideshow Pneumothorax - infants Related Health Topics Chest Injuries and Disorders Lung Diseases Pleural Disorders ...

  7. Male Infertility: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Testicular biopsy (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Male Infertility updates ... analysis Sperm release pathway Testicular biopsy Related Health Topics Assisted Reproductive Technology Female Infertility Infertility National Institutes ...

  8. Hip Replacement: MedlinePlus Health Topic

    Science.gov (United States)

    ... invasive hip replacement (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Hip Replacement updates ... replacement - precautions Minimally invasive hip replacement Related Health Topics Hip Injuries and Disorders National Institutes of Health ...

  9. Diabetes: MedlinePlus Health Topic

    Science.gov (United States)

    ... High blood sugar (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Diabetes updates by ... ketones test Show More Show Less Related Health Topics A1C Blood Sugar Diabetes and Pregnancy Diabetes Complications ...

  10. Platelet Disorders: MedlinePlus Health Topic

    Science.gov (United States)

    ... Thromobocytopenia - drug-induced (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Platelet Disorders updates ... Willebrand disease Show More Show Less Related Health Topics Bleeding Disorders Blood Clots Blood Count Tests Blood ...

  11. Cardiac Rehabilitation: MedlinePlus Health Topic

    Science.gov (United States)

    ... in Spanish Electrocardiogram (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Cardiac Rehabilitation updates ... How to take your pulse Pulse Related Health Topics Heart Attack Heart Diseases How to Prevent Heart ...

  12. Dialysis: MedlinePlus Health Topic

    Science.gov (United States)

    ... access for hemodialysis (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Dialysis updates by ... for hemodialysis Show More Show Less Related Health Topics Creatinine Kidney Cysts Kidney Failure Peritoneal Disorders National ...

  13. Diabetic Diet: MedlinePlus Health Topic

    Science.gov (United States)

    ... Sweeteners - sugar substitutes (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Diabetic Diet updates ... you have diabetes Sweeteners - sugar substitutes Related Health Topics Blood Sugar Diabetes Diabetes in Children and Teens ...

  14. Infection Control: MedlinePlus Health Topic

    Science.gov (United States)

    ... Staph infections - hospital (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Infection Control updates ... infections when visiting Staph infections - hospital Related Health Topics Hepatitis HIV/AIDS MRSA National Institutes of Health ...

  15. Vaginitis: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Vulvovaginitis - overview (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Vaginitis updates by ... Vaginitis test - wet mount Vulvovaginitis - overview Related Health Topics Trichomoniasis Vaginal Diseases Yeast Infections Other Languages Find ...

  16. Kidney Tests: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Total protein (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Kidney Tests updates ... hour volume Show More Show Less Related Health Topics Kidney Cancer Kidney Diseases National Institutes of Health ...

  17. Ischemic Stroke: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Thrombolytic therapy (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Ischemic Stroke updates ... cardiogenic embolism Stroke - slideshow Thrombolytic therapy Related Health Topics Hemorrhagic Stroke Stroke Stroke Rehabilitation National Institutes of ...

  18. FNLM 2013 Events & Programs Announced | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... study in their field of expertise. Annual Awards Dinner In 2013, the Awards Dinner to celebrate advances ... Mobile MedlinePlus! Trusted medical information on your mobile phone. http://m.medlineplus.gov and in Spanish at ...

  19. "Bionic Man" Showcases Medical Research | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: The Bionic Man Meet the Bionic Man Past Issues / Fall 2014 Table of Contents The ... medical imaging, visit www.nibib.nih.gov "Bionic Man" Showcases Medical Research The National Institute of Biomedical ...

  20. Does providing prescription information or services improve medication adherence among patients discharged from the emergency department? A randomized controlled trial.

    Science.gov (United States)

    McCarthy, Melissa L; Ding, Ru; Roderer, Nancy K; Steinwachs, Donald M; Ortmann, Melinda J; Pham, Julius Cong; Bessman, Edward S; Kelen, Gabor D; Atha, Walter; Retezar, Rodica; Bessman, Sara C; Zeger, Scott L

    2013-09-01

    We determine whether prescription information or services improve the medication adherence of emergency department (ED) patients. Adult patients treated at one of 3 EDs between November 2010 and September 2011 and prescribed an antibiotic, central nervous system, gastrointestinal, cardiac, or respiratory drug at discharge were eligible. Subjects were randomly assigned to usual care or one of 3 prescription information or services intervention groups: (1) practical services to reduce barriers to prescription filling (practical prescription information or services); (2) consumer drug information from MedlinePlus (MedlinePlus prescription information or services); or (3) both services and information (combination prescription information or services). Self-reported medication adherence, measured by primary adherence (prescription filling) and persistence (receiving medicine as prescribed) rates, was determined during a telephone interview 1 week postdischarge. Of the 3,940 subjects enrolled and randomly allocated to treatment, 86% (N=3,386) completed the follow-up interview. Overall, primary adherence was 88% and persistence was 48%. Across the sites, primary adherence and persistence did not differ significantly between usual care and the prescription information or services groups. However, at site C, subjects who received the practical prescription information or services (odds ratio [OR]=2.4; 95% confidence interval [CI] 1.4 to 4.3) or combination prescription information or services (OR=1.8; 95% CI 1.1 to 3.1) were more likely to fill their prescription compared with usual care. Among subjects prescribed a drug that treats an underlying condition, subjects who received the practical prescription information or services were more likely to fill their prescription (OR=1.8; 95% CI 1.0 to 3.1) compared with subjects who received usual care. Prescription filling and receiving medications as prescribed was not meaningfully improved by offering patients patient

  1. factors associated with discharge against medical advice among

    African Journals Online (AJOL)

    Hospital environmental factors have a significant relationship with discharge against medical advice. A similar study ..... contractors, and by reinforcing the infection control committee this will .... Sources: Field survey, 2015. The results in Table ...

  2. Discharge from hospital against medical advice among paediatric ...

    African Journals Online (AJOL)

    Twenty eight (87.5%) of the 32 children whose social class were available came from low social class. Conclusions: Discharge against medical advice is not infrequent in the study population. We recommend health education and free medical care for under-five children and comprehensive implementation of National ...

  3. [The information about discharge medication: what do general practitioners need?].

    Science.gov (United States)

    Adam, Henning; Niebling, Wilhelm-Bernhard; Schott, Gisela

    2015-04-01

    The information about the patient's discharge medication (DM) in the discharge letter guarantees the subsequent pharmacotherapy at the interface between tertiary to primary care. International data however shows that general practitioners (GPs) receive discharge letters with a delay and relevant information about DM is lacking. The aim of this study was to assess the point of view of German GPs concerning the information about DM, since no recent data about this topic is available. In a postal survey 516 GPs in the city of Berlin were contacted and asked about the transit of discharge letters and the information about DM. Results | 117 GPs answered the questionnaire (23 %). Most frequently, the patient himself handed over the information about DM to the GP on the day of his first visit in the practice after discharge. However, more than two third of GPs wished to receive the information before the patient's first consultation (73 %). Therefore, the majority preferred the electronic communication via fax (46 %) or email (9 %). Almost half of the GPs stated that discharge letters were lacking information about changes in medication and reasons for these changes. At the same time, nearly all GPs thought that these informational aspects were important. GPs wish an early and electronic transit of the DM with information concerning changes in medication and reasons. If these wishes were considered, a continuous and thus safer pharmacotherapy at the interface could be guaranteed. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Articles about MedlinePlus

    Science.gov (United States)

    ... MedlinePlus → Articles about MedlinePlus URL of this page: https://medlineplus.gov/bibliography.html Articles about MedlinePlus To ... Dec 29]; 3(5):256-60. Available from: http://ecp.acponline.org/sepoct00/nlm.htm . Marill JL, ...

  5. Pharmacist-led discharge medication counselling: A scoping review.

    Science.gov (United States)

    Bonetti, Aline F; Reis, Wálleri C; Lombardi, Natália Fracaro; Mendes, Antonio M; Netto, Harli Pasquini; Rotta, Inajara; Fernandez-Llimos, Fernando; Pontarolo, Roberto

    2018-04-24

    Discharge medication counselling has produced improved quality of care and health outcomes, especially by reducing medication errors and readmission rates, and improving medication adherence. However, no studies have assembled an evidence-based discharge counselling process for clinical pharmacists. Thus, the present study aims to map the components of the pharmacist-led discharge medication counselling process. We performed a scoping review by searching electronic databases (Pubmed, Scopus, and DOAJ) and conducting a manual search to identify studies published up to July 2017. Studies that addressed pharmacist-led discharge medication counselling, regardless of the population, clinical conditions, and outcomes evaluated, were included. A total of 1563 studies were retrieved, with 75 matching the inclusion criteria. Thirty-two different components were identified, and the most prevalent were the indication of the medications and adverse drug reactions, which were reported in more than 50% of the studies. The components were reported similarly by studies from the USA and the rest of the world, and over the years. However, 2 differences were identified: the use of a dosage schedule, which was more frequent in studies published in 2011 or before and in studies outside the USA; and the teach-back technique, which was used more frequently in the USA. Poor quality reporting was also observed, especially regarding the duration of the counselling, the number of patients, and the medical condition. Mapping the components of the pharmacist-led discharge counselling studies through a scoping review allowed us to reveal how this service is performed around the world. Wide variability in this process and poor reporting were identified. Future studies are needed to define the core outcome set of this clinical pharmacy service to allow the generation of robust evidence and reproducibility in clinical practice. © 2018 John Wiley & Sons, Ltd.

  6. MedlinePlus Connect in Use

    Science.gov (United States)

    ... MedlinePlus Connect in Use URL of this page: https://medlineplus.gov/connect/users.html MedlinePlus Connect in ... will change.) Old URLs New URLs Web Application https://apps.nlm.nih.gov/medlineplus/services/mpconnect.cfm? ...

  7. Welcome to NIH MedlinePlus, the magazine

    Science.gov (United States)

    ... from the world's largest medical library, NIH's National Library of Medicine. MedlinePlus has extensive information from the NIH and other trusted sources on more than 700 diseases and conditions. There ...

  8. Mentoring in Medicine | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... front is Andrew Morrison, MIM vice president of marketing. Giving Students a Vision of Healthcare Careers Research ... federal tax purposes. Web site: www.fnlm.org Mobile MedlinePlus! Trusted medical information on your mobile phone. ...

  9. Sexual Problems in Men: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish Retrograde ejaculation (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Sexual Problems in ... Premature ejaculation Reifenstein syndrome Retrograde ejaculation Related Health Topics Erectile Dysfunction Penis Disorders Prostate Diseases Testicular Disorders ...

  10. Baby Health Checkup: MedlinePlus Health Topic

    Science.gov (United States)

    ... Know (Centers for Disease Control and Prevention) - PDF Topic Image MedlinePlus Email Updates Get Baby Health Checkup ... GO MEDICAL ENCYCLOPEDIA Well-child visits Related Health Topics Childhood Immunization Common Infant and Newborn Problems Infant ...

  11. Cancer--Living with Cancer: MedlinePlus Health Topic

    Science.gov (United States)

    ... during cancer treatment (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Cancer--Living with ... care plan Show More Show Less Related Health Topics Cancer Cancer Chemotherapy Palliative Care National Institutes of ...

  12. How to Prevent Heart Disease: MedlinePlus Health Topic

    Science.gov (United States)

    ... and your heart (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get How to Prevent ... your heart Stress and your heart Related Health Topics Blood Thinners Cholesterol Heart Diseases Heart Health Tests ...

  13. Child Mental Health: MedlinePlus Health Topic

    Science.gov (United States)

    ... events and children (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Child Mental Health ... in childhood Traumatic events and children Related Health Topics Bullying Child Behavior Disorders Mental Disorders Mental Health ...

  14. Blood Count Tests: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish WBC count (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Blood Count Tests ... WBC count Show More Show Less Related Health Topics Bleeding Disorders Blood Laboratory Tests National Institutes of ...

  15. Hormone Replacement Therapy: MedlinePlus Health Topic

    Science.gov (United States)

    ... of hormone therapy (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Hormone Replacement Therapy ... Estrogen overdose Types of hormone therapy Related Health Topics Menopause National Institutes of Health The primary NIH ...

  16. Prostate radiation - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000399.htm Prostate radiation - discharge To use the sharing features on ... keeping or getting an erection may occur after prostate radiation therapy. You may not notice this problem ...

  17. Brain injury - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000163.htm Brain injury - discharge To use the sharing features on ... know was in the hospital for a serious brain injury. At home, it will take time for ...

  18. Brain aneurysm repair - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000123.htm Brain aneurysm repair - discharge To use the sharing features ... this page, please enable JavaScript. You had a brain aneurysm . An aneurysm is a weak area in ...

  19. Atrial fibrillation - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000237.htm Atrial fibrillation - discharge To use the sharing features on this ... have been in the hospital because you have atrial fibrillation . This condition occurs when your heart beats faster ...

  20. Pneumonia - adults - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000017.htm Pneumonia in adults - discharge To use the sharing features on this page, please enable JavaScript. You have pneumonia, which is an infection in your lungs. In ...

  1. Knee arthroscopy - discharge

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000199.htm Knee arthroscopy - discharge To use the sharing features on this ... surgery to treat problems in your knee (knee arthroscopy). You may have been checked for: Torn meniscus. ...

  2. Cosmetic breast surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000273.htm Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  3. Shoulder surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000179.htm Shoulder surgery - discharge To use the sharing features on this page, please enable JavaScript. You had shoulder surgery to repair the tissues inside or around your ...

  4. MedlinePlus

    Data.gov (United States)

    U.S. Department of Health & Human Services — MedlinePlus is the National Institutes of Health's Web site for patients and their families and friends. Produced by the National Library of Medicine, the world’s...

  5. MedlinePlus Tour

    Science.gov (United States)

    ... captioning, click the CC button on the lower right-hand corner of the player. Video player keyboard shortcuts Transcript Welcome to MedlinePlus, the consumer health information website from the National Library of ...

  6. Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

    LENUS (Irish Health Repository)

    Grimes, Tamasine C

    2011-03-01

    Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation.

  7. Search Tips: MedlinePlus

    Science.gov (United States)

    ... of this page: https://medlineplus.gov/searchtips.html Search Tips To use the sharing features on this page, please enable JavaScript. How do I search MedlinePlus? The search box appears at the top ...

  8. MedlinePlus FAQ: Framing

    Science.gov (United States)

    ... URL of this page: https://medlineplus.gov/faq/framing.html I'd like to link to MedlinePlus, ... M. encyclopedia. Our license agreements do not permit framing of their content from our site. For more ...

  9. Linking to MedlinePlus

    Science.gov (United States)

    ... want to link patients or healthcare providers from electronic health record (EHR) systems to relevant MedlinePlus information, use MedlinePlus ... updates Subscribe to RSS Follow us Disclaimers Copyright Privacy Accessibility Quality Guidelines Viewers & Players MedlinePlus Connect for ...

  10. Friends of the National Library of Medicine, Welcome to NIH MedlinePlus, the magazine | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... Contents Dear Readers, WELCOME to NIH MedlinePlus , the magazine. The purpose of NIH MedlinePlus , the magazine, is to provide you with a FREE , trusted ... medical information. Published four times a year, the magazine showcases the National Institutes of Health's (NIH) latest ...

  11. Using the Electronic Medical Record to Enhance Physician-Nurse Communication Regarding Patients' Discharge Status.

    Science.gov (United States)

    Driscoll, Molly; Gurka, David

    2015-01-01

    The fast-paced environment of hospitals contributes to communication failures between health care providers while impacting patient care and patient flow. An effective mechanism for sharing patients' discharge information with health care team members is required to improve patient throughput. The communication of a patient's discharge plan was identified as crucial in alleviating patient flow delays at a tertiary care, academic medical center. By identifying the patients who were expected to be discharged the following day, the health care team could initiate discharge preparations in advance to improve patient care and patient flow. The patients' electronic medical record served to convey dynamic information regarding the patients' discharge status to the health care team via conditional discharge orders. Two neurosciences units piloted a conditional discharge order initiative. Conditional discharge orders were designed in the electronic medical record so that the conditions for discharge were listed in a dropdown menu. The health care team was trained on the conditional discharge order protocol, including when to write them, how to find them in the patients' electronic medical record, and what actions should be prompted by these orders. On average, 24% of the patients discharged had conditional discharge orders written the day before discharge. The average discharge time for patients with conditional discharge orders decreased by 83 minutes (0.06 day) from baseline. Qualitatively, the health care team reported improved workflows with conditional orders. The conditional discharge orders allowed physicians to communicate pending discharges electronically to the multidisciplinary team. The initiative positively impacted patient discharge times and workflows.

  12. MedlinePlus FAQ: What's the difference between MedlinePlus and MedlinePlus Connect?

    Science.gov (United States)

    ... MedlinePlus Connect is a free service that allows electronic health record (EHR) systems to easily link users to MedlinePlus, ... updates Subscribe to RSS Follow us Disclaimers Copyright Privacy Accessibility Quality Guidelines Viewers & Players MedlinePlus Connect for ...

  13. MedlinePlus Connect: How it Works

    Science.gov (United States)

    ... Connect → How it Works URL of this page: https://medlineplus.gov/connect/howitworks.html MedlinePlus Connect: How ... will change.) Old URLs New URLs Web Application https://apps.nlm.nih.gov/medlineplus/services/mpconnect.cfm? ...

  14. The incidence and severity of errors in pharmacist-written discharge medication orders

    OpenAIRE

    Onatade, Raliat; Sawieres, Sara; Veck, Alexandra; Smith, Lindsay; Gore, Shivani; Al-Azeib, Sumiah

    2017-01-01

    Background Errors in discharge prescriptions are problematic. When hospital pharmacists write discharge prescriptions improvements are seen in the quality and efficiency of discharge. There is limited information on the incidence of errors in pharmacists’ medication orders. Objective To investigate the extent and clinical significance of errors in pharmacist-written discharge medication orders. Setting 1000-bed teaching hospital in London, UK. Method Pharmacists in this London hospital routin...

  15. A de-identifier for medical discharge summaries.

    Science.gov (United States)

    Uzuner, Ozlem; Sibanda, Tawanda C; Luo, Yuan; Szolovits, Peter

    2008-01-01

    Clinical records contain significant medical information that can be useful to researchers in various disciplines. However, these records also contain personal health information (PHI) whose presence limits the use of the records outside of hospitals. The goal of de-identification is to remove all PHI from clinical records. This is a challenging task because many records contain foreign and misspelled PHI; they also contain PHI that are ambiguous with non-PHI. These complications are compounded by the linguistic characteristics of clinical records. For example, medical discharge summaries, which are studied in this paper, are characterized by fragmented, incomplete utterances and domain-specific language; they cannot be fully processed by tools designed for lay language. In this paper, we show that we can de-identify medical discharge summaries using a de-identifier, Stat De-id, based on support vector machines and local context (F-measure=97% on PHI). Our representation of local context aids de-identification even when PHI include out-of-vocabulary words and even when PHI are ambiguous with non-PHI within the same corpus. Comparison of Stat De-id with a rule-based approach shows that local context contributes more to de-identification than dictionaries combined with hand-tailored heuristics (F-measure=85%). Comparison with two well-known named entity recognition (NER) systems, SNoW (F-measure=94%) and IdentiFinder (F-measure=36%), on five representative corpora show that when the language of documents is fragmented, a system with a relatively thorough representation of local context can be a more effective de-identifier than systems that combine (relatively simpler) local context with global context. Comparison with a Conditional Random Field De-identifier (CRFD), which utilizes global context in addition to the local context of Stat De-id, confirms this finding (F-measure=88%) and establishes that strengthening the representation of local context may be more

  16. MedlinePlus Connect: Web Service

    Science.gov (United States)

    ... MedlinePlus Connect → Web Service URL of this page: https://medlineplus.gov/connect/service.html MedlinePlus Connect: Web ... will change.) Old URLs New URLs Web Application https://apps.nlm.nih.gov/medlineplus/services/mpconnect.cfm? ...

  17. MedlinePlus Connect: Web Application

    Science.gov (United States)

    ... MedlinePlus Connect → Web Application URL of this page: https://medlineplus.gov/connect/application.html MedlinePlus Connect: Web ... will change.) Old URLs New URLs Web Application https://apps.nlm.nih.gov/medlineplus/services/mpconnect.cfm? ...

  18. MedlinePlus Connect: Technical Information

    Science.gov (United States)

    ... MedlinePlus Connect → Technical Information URL of this page: https://medlineplus.gov/connect/technical.html MedlinePlus Connect: Technical ... will change.) Old URLs New URLs Web Application https://apps.nlm.nih.gov/medlineplus/services/mpconnect.cfm? ...

  19. MedlinePlus Connect: Email List

    Science.gov (United States)

    ... MedlinePlus Connect → Email List URL of this page: https://medlineplus.gov/connect/emaillist.html MedlinePlus Connect: Email ... will change.) Old URLs New URLs Web Application https://apps.nlm.nih.gov/medlineplus/services/mpconnect.cfm? ...

  20. Hospitalist and Internal Medicine Leaders' Perspectives of Early Discharge Challenges at Academic Medical Centers.

    Science.gov (United States)

    Patel, Hemali; Fang, Margaret C; Mourad, Michelle; Green, Adrienne; Wachter, Robert M; Murphy, Ryan D; Harrison, James D

    2018-06-01

    Improving early discharges may improve patient flow and increase hospital capacity. We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness of early-discharge initiatives. We assembled a list of hospitalist and general internal medicine leaders at 115 US-based academic medical centers. We emailed each institutional representative a 30-item online survey regarding early-discharge initiatives. The survey included questions on discharge prioritization, the prevalence and effectiveness of early-discharge initiatives, and barriers to implementation. We received 61 responses from 115 institutions (53% response rate). Forty-seven (77%) "strongly agreed" or "agreed" that early discharge was a priority. "Discharge by noon" was the most cited goal (n = 23; 38%) followed by "no set time but overall goal for improvement" (n = 13; 21%). The majority of respondents reported early discharge as more important than obtaining translators for non-English-speaking patients and equally important as reducing 30-day readmissions and improving patient satisfaction. The most commonly reported factors delaying discharge were availability of postacute care beds (n = 48; 79%) and patient-related transport complications (n = 44; 72%). The most effective early discharge initiatives reported involved changes to the rounding process, such as preemptive identification and early preparation of discharge paperwork (n = 34; 56%) and communication with patients about anticipated discharge (n = 29; 48%). There is a strong interest in increasing early discharges in an effort to improve hospital throughput and patient flow. © 2017 Society of Hospital Medicine.

  1. Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

    LENUS (Irish Health Repository)

    Grimes, Tamasine C

    2012-02-01

    AIMS: Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS: The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS: Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS: The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care.

  2. Quality of medication information in discharge summaries from hospitals: an audit of electronic patient records.

    Science.gov (United States)

    Garcia, Beate Hennie; Djønne, Berit Svendsen; Skjold, Frode; Mellingen, Ellen Marie; Aag, Trine Iversen

    2017-12-01

    Background Low quality of medication information in discharge summaries from hospitals may jeopardize optimal therapy and put the patient at risk for medication errors and adverse drug events. Objective To audit the quality of medication information in discharge summaries and explore factors associated with the quality. Setting Helgelandssykehuset Mo i Rana, a rural hospital in central Norway. Method For each month in 2013, we randomly selected 60 discharge summaries from the Department of Medicine and Surgery (totally 720) and evaluated the medication information using eight Norwegian quality criteria. Main outcome measure Mean score per discharge summary ranging from 0 (lowest quality) to 16 (highest quality). Results Mean score per discharge summary was 7.4 (SD 2.8; range 0-14), significantly higher when evaluating medications used regularly compared to mediations used as needed (7.80 vs. 6.52; p < 0.001). Lowest score was achieved for quality criteria concerning generic names, indications for medication use, reasons why changes had been made and information about the source for information. Factors associated with increased quality scores are increasing numbers of medications and male patients. Increasing age seemed to be associated with a reduced score, while type of department was not associated with the quality. Conclusion In discharge summaries from 2013, we identified a low quality of medication information in accordance with the Norwegian quality criteria. Actions for improvement are necessary and follow-up studies to monitor quality are needed.

  3. Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives.

    Science.gov (United States)

    Kennelty, Korey A; Chewning, Betty; Wise, Meg; Kind, Amy; Roberts, Tonya; Kreling, David

    2015-01-01

    Community pharmacists play a vital part in reconciling medications for patients transitioning from hospital to community care, yet their roles have not been fully examined in the extant literature. The objectives of this study were to: 1) examine the barriers and facilitators community pharmacists face when reconciling medications for recently discharged patients; and 2) identify pharmacists' preferred content and modes of information transfer regarding updated medication information for recently discharged patients. Community pharmacists were purposively and conveniently sampled from the Wisconsin (U.S. state) pharmacist-based research network, Pharmacy Practice Enhancement and Action Research Link (PEARL Rx). Community pharmacists were interviewed face-to-face, and transcriptions from audio recordings were analyzed using directed content analysis. The Theory of Planned Behavior (TPB) guided the development of questions for the semi-structured interviews. Interviewed community pharmacists (N = 10) described the medication reconciliation process to be difficult and time-consuming for recently discharged patients. In the context of the TPB, more barriers than facilitators of reconciling medications were revealed. Themes were categorized as organizational and individual-level themes. Major organizational-level factors affecting the medication reconciliation process included: pharmacy resources, discharge communication, and hospital resources. Major individual-level factors affecting the medication reconciliation process included: pharmacists' perceived responsibility, relationships, patient perception of pharmacist, and patient characteristics. Interviewed pharmacists consistently responded that several pieces of information items would be helpful when reconciling medications for recently discharged patients, including the hospital medication discharge list and stop-orders for discontinued medications. The TPB was useful for identifying barriers and facilitators of

  4. Angioplasty and stent placement - carotid artery - discharge

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000235.htm Angioplasty and stent placement - carotid artery - discharge To use the sharing ... the hospital. You may have also had a stent (a tiny wire mesh tube) placed in the ...

  5. Angioplasty and stent placement - peripheral arteries - discharge

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000234.htm Angioplasty and stent placement - peripheral arteries - discharge To use the sharing ... peripheral artery). You may have also had a stent placed. To perform the procedure: Your doctor inserted ...

  6. Health Videos: MedlinePlus

    Science.gov (United States)

    ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow us Disclaimers Copyright ...

  7. Antibiotic Resistance: MedlinePlus Health Topic

    Science.gov (United States)

    ... GO GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Health Topics → Antibiotic Resistance URL of this page: https://medlineplus.gov/antibioticresistance. ...

  8. MedlinePlus Milestones: 1998-present

    Science.gov (United States)

    ... Connect , a service linking patients or providers in electronic health record (EHR) systems to related MedlinePlus information on conditions ... updates Subscribe to RSS Follow us Disclaimers Copyright Privacy Accessibility Quality Guidelines Viewers & Players MedlinePlus Connect for ...

  9. MedlinePlus XML Data Sources

    Science.gov (United States)

    ... on MedlinePlus health topic pages. With the Web service, software developers can build applications that leverage the authoritative, reliable health information in MedlinePlus. The MedlinePlus Web service is free of charge and does not require ...

  10. Medical rehabilitation of leprosy patients discharged home in abia and ebonyi States of Nigeria.

    Science.gov (United States)

    Enwereji, Ezinne Ezinna; Ahuizi, Eke Reginald; Iheanocho, Okereke Chukwunenye; Enwereji, Kelechi Okechukwu

    2011-11-01

    To examine the extent to which medical coverage is available to discharged leprosy patients in communities. Evidence has shown that after care services, follow-up visits and national disease prevention programs are important components of medical rehabilitation to leprosy patients discharged home after treatment. Denying them accessibility to these services could expose them to multiple disabilities as well as several disease conditions including HIV/AIDS. These adverse health conditions could be averted if health workers extend healthcare services to discharged leprosy patients. This study was conducted to examine the extent to which discharged leprosy patients have access to healthcare services in the communities. All 33 leprosy patients who were fully treated with multi-drug therapy (MDT) and discharged home in the two leprosy settlements in Abia and Ebonyi States of Nigeria were included in this study. The list of discharged leprosy patients studied and their addresses were provided by the leprosy settlements where they were treated. Also, snowball-sampling method was used to identify some of the leprosy patients whose addresses were difficult to locate in the communities. Instruments for data collection were questionnaire, interview guide and checklist. These were administered because respondents were essentially those with no formal education. Analysis of data was done quantitatively and qualitatively. Findings showed that 20 (60.6%) of discharged patients did not receive health programs like HIV/AIDS prevention or family planning. Also, follow-up visits and after-care services were poor. About 14 (42.4%) of the patients live in dirty and overcrowded houses. On the whole, discharged patients were poorly medically rehabilitated (mean score: 4.7±1.1 out of total score of 7). Denying discharged leprosy patients opportunity of accessing health care services could increase prevalence of infectious diseases including HIV/AIDS among them. There is need to extend

  11. [Impact of a software application to improve medication reconciliation at hospital discharge].

    Science.gov (United States)

    Corral Baena, S; Garabito Sánchez, M J; Ruíz Rómero, M V; Vergara Díaz, M A; Martín Chacón, E R; Fernández Moyano, A

    2014-01-01

    To assess the impact of a software application to improve the quality of information concerning current patient medications and changes on the discharge report after hospitalization. To analyze the incidence of errors and to classify them. Quasi-experimental pre / post study with non-equivalent control group study. Medical patients at hospital discharge. implementation of a software application. Percentage of reconciled patient medication on discharge, and percentage of patients with more than one unjustified discrepancy. A total of 349 patients were assessed; 199 (pre-intervention phase) and 150 (post-intervention phase). Before the implementation of the application in 157 patients (78.8%) medication reconciliation had been completed; finding reconciliation errors in 99 (63.0%). The most frequent type of error, 339 (78.5%), was a missing dose or administration frequency information. After implementation, all the patient prescriptions were reconciled when the software was used. The percentage of patients with unjustified discrepancies decreased from 63.0% to 11.8% with the use of the application (psoftware application has been shown to improve the quality of the information on patient treatment on the hospital discharge report, but it is still necessary to continue development as a strategy for improving medication reconciliation. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  12. NIH Institutes and MLN MedlinePlus Advisory Board | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  13. Effect of therapeutic interchange on medication reconciliation during hospitalization and upon discharge in a geriatric population.

    Directory of Open Access Journals (Sweden)

    Jessica S Wang

    Full Text Available Therapeutic interchange of a same class medication for an outpatient medication is a widespread practice during hospitalization in response to limited hospital formularies. However, therapeutic interchange may increase risk of medication errors. The objective was to characterize the prevalence and safety of therapeutic interchange.Secondary analysis of a transitions of care study. We included patients over age 64 admitted to a tertiary care hospital between 2009-2010 with heart failure, pneumonia, or acute coronary syndrome who were taking a medication in any of six commonly-interchanged classes on admission: proton pump inhibitors (PPIs, histamine H2-receptor antagonists (H2 blockers, hydroxymethylglutaryl CoA reductase inhibitors (statins, angiotensin-converting enzyme (ACE inhibitors, angiotensin receptor blockers (ARBs, and inhaled corticosteroids (ICS. There was limited electronic medication reconciliation support available. Main measures were presence and accuracy of therapeutic interchange during hospitalization, and rate of medication reconciliation errors on discharge. We examined charts of 303 patients taking 555 medications at time of admission in the six medication classes of interest. A total of 244 (44.0% of medications were therapeutically interchanged to an approved formulary drug at admission, affecting 64% of the study patients. Among the therapeutically interchanged drugs, we identified 78 (32.0% suspected medication conversion errors. The discharge medication reconciliation error rate was 11.5% among the 244 therapeutically interchanged medications, compared with 4.2% among the 311 unchanged medications (relative risk [RR] 2.75, 95% confidence interval [CI] 1.45-5.19.Therapeutic interchange was prevalent among hospitalized patients in this study and elevates the risk for potential medication errors during and after hospitalization. Improved electronic systems for managing therapeutic interchange and medication reconciliation

  14. Prescribing error at hospital discharge: a retrospective review of medication information in an Irish hospital.

    Science.gov (United States)

    Michaelson, M; Walsh, E; Bradley, C P; McCague, P; Owens, R; Sahm, L J

    2017-08-01

    Prescribing error may result in adverse clinical outcomes leading to increased patient morbidity, mortality and increased economic burden. Many errors occur during transitional care as patients move between different stages and settings of care. To conduct a review of medication information and identify prescribing error among an adult population in an urban hospital. Retrospective review of medication information was conducted. Part 1: an audit of discharge prescriptions which assessed: legibility, compliance with legal requirements, therapeutic errors (strength, dose and frequency) and drug interactions. Part 2: A review of all sources of medication information (namely pre-admission medication list, drug Kardex, discharge prescription, discharge letter) for 15 inpatients to identify unintentional prescription discrepancies, defined as: "undocumented and/or unjustified medication alteration" throughout the hospital stay. Part 1: of the 5910 prescribed items; 53 (0.9%) were deemed illegible. Of the controlled drug prescriptions 11.1% (n = 167) met all the legal requirements. Therapeutic errors occurred in 41% of prescriptions (n = 479) More than 1 in 5 patients (21.9%) received a prescription containing a drug interaction. Part 2: 175 discrepancies were identified across all sources of medication information; of which 78 were deemed unintentional. Of these: 10.2% (n = 8) occurred at the point of admission, whereby 76.9% (n = 60) occurred at the point of discharge. The study identified the time of discharge as a point at which prescribing errors are likely to occur. This has implications for patient safety and provider work load in both primary and secondary care.

  15. Oral nutritional support of older (65 years+) medical and surgical patients after discharge from hospital

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Holst, Mette; Rasmussen, Henrik Højgaard

    2013-01-01

    To estimate the effectiveness of oral nutritional support compared to placebo or usual care in improving clinical outcome in older (65 years+) medical and surgical patients after discharge from hospital. Outcome goals were: re-admissions, survival, nutritional and functional status, quality of life...

  16. Discharge communication from inpatient care: an audit of written medical discharge summary procedure against the new National Health Service Standard for clinical handover.

    Science.gov (United States)

    Reid, Daniel Brooks; Parsons, Shaun R; Gill, Stephen D; Hughes, Andrew J

    2015-04-01

    To audit written medical discharge summary procedure and practice against Standard Six (clinical handover) of the Australian National Safety and Quality Health Service Standards at a major regional Victorian health service. Department heads were invited to complete a questionnaire about departmental discharge summary practices. Twenty-seven (82%) department heads completed the questionnaire. Seven (26%) departments had a documented discharge summary procedure. Fourteen (52%) departments monitored discharge summary completion and 13 (48%) departments monitored the timeliness of completion. Seven (26%) departments informed the patient of the content of the discharge summary and six (22%) departments provided the patient with a copy. Seven (26%) departments provided training for staff members on how to complete discharge summaries. Completing discharge summaries was usually delegated to the medical intern. The introduction of the National Service Standards prompted an organisation-wide audit of discharge summary practices against the external criterion. There was substantial variation in the organisation's practices. The Standards and the current audit results highlight an opportunity for the organisation to enhance and standardise discharge summary practices and improve communication with general practice.

  17. Medication reconciliation in acute care: ensuring an accurate drug regimen on admission and discharge.

    Science.gov (United States)

    Rodehaver, Claire; Fearing, Deb

    2005-07-01

    Several factors contribute to the potential for patient confusion regarding his or her medication regimen, including multiple names for a single drug and formulary variations when the patient receives medications from more than one pharmacy. A 68-year-old woman was discharged from the hospital on a HMG-CoA reductase inhibitor (statin) and resumed her home statin. Eleven days later she returned to the hospital with a diagnosis of severe rhabdomyolysis due to statin overdose. IMPLEMENTING SOLUTIONS: Miami Valley Hospital, Dayton, Ohio, implemented a reconciliation process and order form at admission and discharge to reduce the likelihood that this miscommunication would recur. Initial efforts were trialed on a 44-bed orthopedic unit, with spread of the initiative to the cardiac units and finally to the remaining 22 nursing units. The team successfully implemented initiation of the order sheet, yet audits indicated the need for improvement in reconciling the medications within 24 hours of admission and in reconciling the home medications at the point of discharge. Successful implementation of the order sheet to drive reconciliation takes communication, perseverance, and a multidisciplinary team approach.

  18. Discharge against medical advice at a tertiary center in southeastern Nigeria: sociodemographic and clinical dimensions

    Directory of Open Access Journals (Sweden)

    Boniface Eze

    2010-09-01

    Full Text Available Boniface Eze1, Kenneth Agu2, Jones Nwosu31Department of Ophthalmology, 2Department of Surgery, 3Department of Otorhinolaryngology, University of Nigeria Teaching Hospital (UNTH, Ituku-Ozalla, Enugu, Enugu State, Nigeria Objective: To assess the sociodemographic and clinical characteristics of patients discharged against medical advice (DAMA at the University of Nigeria Teaching Hospital (UNTH, Enugu, Nigeria.Methods: The UNTH’s admission and discharge records between 1997 and 2006 were examined. Patients DAMA were identified; relevant sociodemographic and clinical data were extracted from their recalled clinical charts. Data were analyzed to generate rates, percentages, and proportions, and a level of P < 0.05 (one degree of freedom was considered statistically significant.Results: Of the 64,856 admissions (45.2% male, 54.8% female, 113 (0.002%; males: 54%, females: 46% were discharged against medical advice. DAMA rate was highest in Surgery (0.4%, and lowest in Obstetrics and Gynecology (0.1% and Pediatrics (0.1%. Infections (32.7%, trauma (29.2%, and cancer (16.8% were the leading diagnoses in patients DAMA. Financial constraints (37.2%, unsatisfactory response to treatment (17.7%, and dissatisfaction with hospital environment (15.0% were the main reasons for patients choosing to discharge themselves. DAMA was associated with a short admission period (P < 0.05, patients having high levels of formal education (P < 0.05, and those who had not been previously hospitalized (P < 0.05; but not with age (P = 0.398, gender (P = 0.489, or employment (P = 0.091.Conclusion: Comparatively, the rate of DAMA at UNTH is low. The causes of DAMA are preventable; for example, strengthening of the national health insurance scheme, enhancement of doctor-patient communication, and improvement of hospital environment would further reduce DAMA rate. Keywords: discharge against medical advice, tertiary center, sociodemographic characteristics, clinical

  19. Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial

    Directory of Open Access Journals (Sweden)

    Alfredo D. Oliveira-Filho

    2014-12-01

    Full Text Available Background: Effective interventions to improve medication adherence are usually complex and expensive. Objective: To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD. Method: A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4. The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates. Results: 61 patients were randomized to intervention (n = 30 and control (n = 31 groups. The mean age of the patients was 61 years (SD 12.73, 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3. Medication adherence was correlated to intervention (p = 0.04 and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups. Conclusion: The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes.

  20. Discharge Against Medical Advice in the Pediatric Wards in Boo-ali Sina Hospital, Sari, Iran 2010.

    Science.gov (United States)

    Mohseni Saravi, Benyamin; Reza Zadeh, Esmaeil; Siamian, Hasan; Yahghoobian, Mahboobeh

    2013-12-01

    Since children neither comprehended nor contribute to the decision, discharge against medical advice is a challenge of health care systems in the world. Therefore, the current study was designed to determine the rate and causes of discharge against medical advice. This descriptive cross-sectional study was done by reviewing the medical records by census method. Data was analyzed using SPSS software and x(2) statistics was used to determine the relationship between variables. The value of P<0.05 was considered significant. Rate of discharged against medical advice was 108 (2.2%). Mean of age and length of stay were 2.8±4 (SD).3 years old and 3.7±5.4 (SD) days, respectively. Totally, 95 patients (88.7%) had health insurance and 65 (60.2%) patients lived in urban areas. History of psychiatric disease and addiction in 22 (20.6%) of the parents were negative. In addition, 100 (92.3%) patients admitted for medical treatment and the others for surgery. The relationship of the signatory with patients (72.3%) was father. Of 108 patients discharged against medical advice, 20 (12%) were readmitted. The relationship between the day of discharge and discharge against medical advice was significant (ρ =0/03). Rate of discharge against medical advice in Boo-ali hospital is the same as the other studies in the same range. The form which is used for this purpose did not have suitable data elements about description of consequence of such discharge, and it has not shown the real causes of discharge against medical advice.

  1. Consumer perspectives of medication-related problems following discharge from hospital in Australia: a quantitative study.

    Science.gov (United States)

    Eassey, Daniela; Smith, Lorraine; Krass, Ines; McLAchlan, Andrew; Brien, Jo-Anne

    2016-06-01

    The aim of this study was to investigate the consumer's perspectives and experiences regarding medication related problems (MRPs) following discharge from hospital. A cross-sectional study was conducted using an online 80-question survey. Survey participants were recruited through an online market research company. Five hundred and six participants completed the survey. Participants were included if they were aged 50 years or older, taking 5 or more prescription medicines, had been admitted to hospital with a minimum stay of 24 h, admitted to hospital within the last 4 months and discharged from hospital within the last 1 month. The survey comprised questions measuring: health literacy, health status, medication safety (measured by reported MRPs), missed dose(s), role of health professionals, health services and cost, and socio-demographic status. Descriptive and univariate statistics and logistic regression analysis was performed to examine the predictors of experiencing MRPs. Four main risk factors of MRPs emerged as significant: health literacy (P < 0.05), health status (P < 0.05), consumer engagement (P < 0.05) and cost of medicines (P = 0.001). Participants reporting a lack of perceived control over their medicines (OR 6.3; 95% CI: 3.4-11.8) or those who played less of a role in follow-up discussions with their healthcare professionals (OR 7.6; 95% CI: 1.3-45.7) were more likely to experience a self-reported MRP. This study provides insight into consumers' experiences and perceptions of self-reported MRPs following hospital discharge. Results highlight novel findings demonstrating the importance of consumer engagement in developing processes to ensure medication safety on patient discharge. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  2. Discharge against medical advice in a pediatric emergency center in the State of Qatar

    Directory of Open Access Journals (Sweden)

    Hala Abdulateef

    2012-05-01

    Full Text Available Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followed by a phone call, and a questionnaire, which was completed by the departmental patient representative. Results: 99,133 patients attended the facility during the study period. Of those, 106 left the facility against medical advice. Ninety-four guardians were successfully contacted. 90% of the cases were in children below 2 years of age. In 87% of the cases the mother was the main decision maker for leaving against medical advice. Domestic obligations were the leading cause of DAMA (discharge against medical advice, reported in 45% of the cases. Respondents reported that the consequences of DAMA were well explained by medical staff before they left the facility however, they had not met with the departmental patient representative during their stay. Conclusion:As the majority of DAMA cases occurred in infants, medical staff should address the concerns of this group early on in the course of treatment. Maintaining communication and providing support, in particular for mothers of higher risk groups may help to reduce the rate of DAMA cases.

  3. Pending studies at hospital discharge: a pre-post analysis of an electronic medical record tool to improve communication at hospital discharge.

    Science.gov (United States)

    Kantor, Molly A; Evans, Kambria H; Shieh, Lisa

    2015-03-01

    Achieving safe transitions of care at hospital discharge requires accurate and timely communication. Both the presence of and follow-up plan for diagnostic studies that are pending at hospital discharge are expected to be accurately conveyed during these transitions, but this remains a challenge. To determine the prevalence, characteristics, and communication of studies pending at hospital discharge before and after the implementation of an electronic medical record (EMR) tool that automatically generates a list of pending studies. Pre-post analysis. 260 consecutive patients discharged from inpatient general medicine services from July to August 2013. Development of an EMR-based tool that automatically generates a list of studies pending at discharge. The main outcomes were prevalence and characteristics of pending studies and communication of studies pending at hospital discharge. We also surveyed internal medicine house staff on their attitudes about communication of pending studies. Pre-intervention, 70% of patients had at least one pending study at discharge, but only 18% of these were communicated in the discharge summary. Most studies were microbiology cultures (68%), laboratory studies (16%), or microbiology serologies (10%). The majority of study results were ultimately normal (83%), but 9% were newly abnormal. Post-intervention, communication of studies pending increased to 43% (p pending studies, but in usual practice, the presence of these studies has rarely been communicated to outpatient providers in the discharge summary. Communication significantly increased with the implementation of an EMR-based tool that automatically generated a list of pending studies from the EMR and allowed users to import this list into the discharge summary. This is the first study to our knowledge to introduce an automated EMR-based tool to communicate pending studies.

  4. Medications Associated with Geriatric Syndromes (MAGS) and their Prevalence in Older Hospitalized Adults Discharged to Skilled Nursing Facilities

    Science.gov (United States)

    Saraf, Avantika A.; Peterson, Alec W.; Simmons, Sandra F.; Schnelle, John F.; Bell, Susan P.; Kripalani, Sunil; Myers, Amy P.; Mixon, Amanda S.; Long, Emily A.; Jacobsen, J. Mary Lou; Vasilevskis, Eduard E.

    2016-01-01

    Background More than half of the hospitalized older adults discharged to skilled nursing facilities (SNFs) have more than three geriatric syndromes. Pharmacotherapy may be contributing to geriatric syndromes in this population. Objectives Develop a list of medications associated with geriatric syndromes and describe their prevalence in patients discharged from acute care to skilled nursing facilities (SNFs) Design Literature review and multidisciplinary expert panel discussion, followed by cross-sectional analysis. Setting Academic Medical Center in the United States Participants 154 hospitalized Medicare beneficiaries discharged to SNFs Measurements Development of a list of medications that are associated with six geriatric syndromes. Prevalence of the medications associated with geriatric syndromes was examined in the hospital discharge sample. Results A list of 513 medications was developed as potentially contributing to 6 geriatric syndromes: cognitive impairment, delirium, falls, reduced appetite or weight loss, urinary incontinence, and depression. Medications included 18 categories. Antiepileptics were associated with all syndromes while antipsychotics, antidepressants, antiparkinsonism and opioid agonists were associated with 5 geriatric syndromes. In the prevalence sample, patients were discharged to SNFs with an overall average of 14.0 (±4.7) medications, including an average of 5.9 (±2.2) medications that could contribute to geriatric syndromes, with falls having the most associated medications at discharge, 5.5 (±2.2). Conclusions Many commonly prescribed medications are associated with geriatric syndromes. Over 40% of all medications ordered upon discharge to SNFs were associated with geriatric syndromes and could be contributing to the high prevalence of geriatric syndromes experienced by this population. PMID:27255830

  5. Do language fluency and other socioeconomic factors influence the use of PubMed and MedlinePlus?

    Science.gov (United States)

    Sheets, L; Gavino, A; Callaghan, F; Fontelo, P

    2013-01-01

    Increased usage of MedlinePlus by Spanish-speakers was observed after introduction of MedlinePlus in Spanish. This probably reflects increased usage of MEDLINE and PubMed by those with greater fluency in the language in which it is presented; but this has never been demonstrated in English speakers. Evidence that lack of English fluency deters international healthcare personnel from using PubMed could support the use of multi-language search tools like Babel-MeSH. This study aims to measure the effects of language fluency and other socioeconomic factors on PubMed MEDLINE and MedlinePlus access by international users. We retrospectively reviewed server pageviews of PubMed and MedlinePlus from various periods of time, and analyzed them against country statistics on language fluency, GDP, literacy rate, Internet usage, medical schools, and physicians per capita, to determine whether they were associated. We found fluency in English to be positively associated with pageviews of PubMed and MedlinePlus in countries with high literacy rates. Spanish was generally found to be positively associated with pageviews of MedlinePlus en Español. The other parameters also showed varying degrees of association with pageviews. After adjusting for the other factors investigated in this study, language fluency was a consistently significant predictor of the use of PubMed, MedlinePlus English and MedlinePlus en Español. This study may support the need for multi-language search tools and may increase access of health information resources from non-English speaking countries.

  6. Dose-current discharge correlation analysis in a Mather type Plasma Focus device for medical applications

    Science.gov (United States)

    Sumini, M.; Mostacci, D.; Tartari, A.; Mazza, A.; Cucchi, G.; Isolan, L.; Buontempo, F.; Zironi, I.; Castellani, G.

    2017-11-01

    In a Plasma Focus device the plasma collapses into the pinch where it reaches thermonuclear conditions for a few tens of nanoseconds, becoming a multi-radiation source. The nature of the radiation generated depends on the gas filling the chamber and the device working parameters. The self-collimated electron beam generated in the backward direction with respect to the plasma motion is one of the main radiation sources of interest also for medical applications. The electron beam may be guided against a high Z material target to produce an X-ray beam. This technique offers an ultra-high dose rate source of X-rays, able to deliver during the pinch a massive dose (up to 1 Gy per discharge for the PFMA-3 test device), as measured with EBT3 GafchromicⒸfilm tissue equivalent dosimeters. Given the stochastic behavior of the discharge process, a reliable on-line estimate of the dose-delivered is a very challenging task, in some way preventing a systematic application as a potentially interesting therapy device. This work presents an approach to linking the dose registered by the EBT3 GafchromicⒸfilms with the information contained in the signal recorded during the current discharge process. Processing the signal with the Wigner-Ville distribution, a spectrogram was obtained, displaying the information on intensity at various frequency scales, identifying the band of frequencies representative of the pinch events and define some patterns correlated with the dose.

  7. Using 340B drug discounts to provide a financially sustainable medication discharge service.

    Science.gov (United States)

    Wu, Timothy; Williams, Carla; Vranek, Kathryn; Mattingly, T Joseph

    2018-03-27

    The 340B Drug Pricing Program was intended to stretch federal resources by providing significant discounts to covered entities providing care to underserved populations. Program implementation and evidence of expanding services to higher income patients has brought more scrutiny and calls for elimination of the program. While additional review and reform may be warranted, profitability from 340B discounts enables covered entities to provide additional services that may not be feasible in absence of the program. This case report demonstrates one institution's use of 340B discounts to financially justify providing bedside medication delivery services for patients at the time of discharge from an inpatient admission. A simple financial model was developed using hospital data and inputs from available literature to estimate gross profit and earnings before interest, taxes, depreciation, and amortization (EBITDA) with and without 340B discounts. Without the 340B drug price discounts, the service would operate at a financial loss, and further investigation must be done to determine whether other clinical or economic benefits would warrant discharge medication delivery at the institution. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  8. Newborn Screening: MedlinePlus Health Topic

    Science.gov (United States)

    ... more articles Reference Desk Glossary (National Center for Biotechnology Information) Find an Expert Eunice Kennedy Shriver National ... other than English on Newborn Screening NIH MedlinePlus Magazine Hearing Loss: Screening Newborns Screening Newborns' Hearing Now ...

  9. MedlinePlus: Awards and Recognition

    Science.gov (United States)

    ... winner of the 2005 World Summit on the Information Society Awards for e-health. Winner of the Thomas Reuters/Frank Bradway Rogers Information Advancement Award in 2014 for MedlinePlus Connect and ...

  10. Back Cover: NIH MedlinePlus Salud

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues NIH MedlinePlus Salud Past Issues / Winter 2009 Table of Contents For ... this page please turn Javascript on. ¡A su salud! Los Institutos Nacionales de la Salud (NIH, por ...

  11. MedlinePlus: Quinoa Black Bean Salad

    Science.gov (United States)

    ... this page: https://medlineplus.gov/recipe/quinoablackbeansalad.html Quinoa Black Bean Salad To use the sharing features ... a side dish. Ingredients 1/2 cup dry quinoa 1 and 1/2 cups water 1 and ...

  12. Mobility Aids: MedlinePlus Health Topic

    Science.gov (United States)

    ... Mobility Problems (AGS Foundation for Health in Aging) Topic Image MedlinePlus Email Updates Get Mobility Aids updates ... standing and walking Using a cane Related Health Topics Assistive Devices Other Languages Find health information in ...

  13. Genetic Testing: MedlinePlus Health Topic

    Science.gov (United States)

    ... Your Family's Health (National Institutes of Health) - PDF Topic Image MedlinePlus Email Updates Get Genetic Testing updates ... testing and your cancer risk Karyotyping Related Health Topics Birth Defects Genetic Counseling Genetic Disorders Newborn Screening ...

  14. Pneumococcal Infections: MedlinePlus Health Topic

    Science.gov (United States)

    ... Prevention, Immunization Action Coalition) - PDF Also in Spanish Topic Image MedlinePlus Email Updates Get Pneumococcal Infections updates ... ray Meningitis - pneumococcal Sputum gram stain Related Health Topics Meningitis Pneumonia Sepsis Sinusitis Streptococcal Infections National Institutes ...

  15. Healthy Aging: MedlinePlus Health Topic

    Science.gov (United States)

    ... Aging National Institute on Aging Also in Spanish Topic Image MedlinePlus Email Updates Get Healthy Aging updates ... 65 Health screening - women - over 65 Related Health Topics Exercise for Seniors Nutrition for Seniors Seniors' Health ...

  16. Eye Wear: MedlinePlus Health Topic

    Science.gov (United States)

    ... When You Exercise (National Institute on Aging) - PDF Topic Image MedlinePlus Email Updates Get Eye Wear updates by email What's this? GO Related Health Topics Refractive Errors National Institutes of Health The primary ...

  17. Menopause: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish What is Menopause? (National Institute on Aging) Topic Image MedlinePlus Email Updates Get Menopause updates by ... test Menopause Types of hormone therapy Related Health Topics Hormone Replacement Therapy Menstruation Premature Ovarian Failure National ...

  18. Dry Mouth: MedlinePlus Health Topic

    Science.gov (United States)

    ... MEDLINE/PubMed (National Library of Medicine) Article: Transcription profiling of peripheral B cells in antibody-positive primary ... our quality guidelines . About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  19. Combating HIV/AIDS | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  20. Helping others hear better | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  1. Mary Tyler Moore Helps Launch NIH MedlinePlus Magazine

    Science.gov (United States)

    ... Issues Mary Tyler Moore Helps Launch NIH MedlinePlus Magazine Past Issues / Winter 2007 Table of Contents For ... Javascript on. Among those attending the NIH MedlinePlus magazine launch on Capitol Hill were (l-r) NIH ...

  2. Recovery and Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  3. Racing Against Lung Cancer | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  4. Exploring Graphic Medicine | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  5. The Opioid Crisis | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  6. The ABCs of GERD | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  7. A Lifelong Asthma Struggle | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  8. NIH on the web | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  9. Hope for Aphasia Patients | NIH MedlinePlus Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.9 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  10. Surgery of the Future | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.9 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  11. 10 NIH Research Highlights | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  12. Expanding Hearing Healthcare | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  13. NIH on the web | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  14. MedlinePlus FAQ: Disease or Condition Information

    Science.gov (United States)

    ... on the Health Topics button on the MedlinePlus homepage. You can also find the Health Topics button ... MedlinePlus Connect for EHRs For Developers U.S. National Library of Medicine 8600 Rockville Pike, Bethesda, MD 20894 ...

  15. We need to talk: Primary care provider communication at discharge in the era of a shared electronic medical record.

    Science.gov (United States)

    Sheu, Leslie; Fung, Kelly; Mourad, Michelle; Ranji, Sumant; Wu, Ethel

    2015-05-01

    Poor communication between hospitalists and outpatient physicians can contribute to adverse events after discharge. Electronic medical records (EMRs) shared by inpatient and outpatient clinicians offer primary care providers (PCPs) better access to information surrounding a patient's hospitalization. However, the PCP experience and subsequent expectations for discharge communication within a shared EMR are unknown. We surveyed PCPs 1 year after a shared EMR was implemented at our institution to assess PCP satisfaction with current discharge communication practices and identify areas for improvement. Seventy-five of 124 (60%) clinicians completed the survey. Although most PCPs reported receiving automated discharge notifications (71%), only 39% felt that notifications plus discharge summaries were adequate for safe transitions of care. PCPs expressed that complex hospitalizations necessitated additional communication via e-mail or telephone; only 31% reported receiving such communication. The content most important in additional communication included medication changes, follow-up actions, and active medical issues. Despite optimized access to information provided by a shared EMR, only 52% of PCPs were satisfied with current discharge communication. PCPs express a continued need for high-touch communication for safe transitions of care. Further standardization of discharge communication practices is necessary. © 2015 Society of Hospital Medicine.

  16. Admission Systolic Blood Pressure Predicts the Number of Blood Pressure Medications at Discharge in Patients With Primary Intracerebral Hemorrhage.

    Science.gov (United States)

    Khawaja, Ayaz M; Shiue, Harn; Boehme, Amelia K; Albright, Karen C; Venkatraman, Anand; Kumar, Gyanendra; Lyerly, Michael J; Hays-Shapshak, Angela; Mirza, Maira; Gropen, Toby I; Harrigan, Mark R

    2018-03-01

    Control of systolic blood pressure (SBP) after primary intracerebral hemorrhage improves outcomes. Factors determining the number of blood pressure medications (BPM) required for goal SBP<160 mm Hg at discharge are unknown. We hypothesized that higher admission-SBPs require a greater number of BPM for goal discharge-SBP<160 mm Hg, and investigated factors influencing this goal. We conducted a retrospective review of 288 patients who presented with primary intracerebral hemorrhage. Admission-SBP was obtained. Primary outcome was the number of BPM at discharge. Comparison was made between patients presenting with and without a history of hypertension, and patients discharged on <3 and ≥3 BPM. Patients with hypertension history had a higher median admission-SBP compared with those without (180 vs. 157 mm Hg, P=0.0001). In total, 133 of 288 (46.2%) patients were discharged on <3 BPM; 155/288 (53.8%) were discharged on ≥3 BPM. Hypertension history (P<0.0001) and admission-SBP (P<0.0001) predicted the number of BPM at discharge. In patients without hypertension history, every 10 mm Hg increase in SBP resulted in an absolute increase of 0.5 BPM at discharge (P=0.0011), whereas in those with hypertension, the absolute increase was 1.3 BPM (P=0.0012). In comparison with patients discharged on <3 BPM, patients discharged on ≥3 BPM were more likely to have a higher median admission-SBP, be younger in age, belong to the African-American race, have a history of diabetes, have higher median admission-National Institutes of Health Stroke Scale and modified Rankin Scale of 4 to 5 at discharge. An understanding of the factors influencing BPM at discharge may help clinicians better optimize blood pressure control both before and after discharge.

  17. The Process of Parents' Decision-Making to Discharge Their Child against Medical Advice (DAMA: A grounded theory study

    Directory of Open Access Journals (Sweden)

    Nikbakht Nasrabadi Alireza

    2016-05-01

    Full Text Available Discharge against medical advice (DAMA refers to the phenomenon that patient or the patient’s surrogate decides to leave the hospital before the attending physician confirms the patient is discharged. Children are much more vulnerable to such discharges. This process occurs with different mechanisms that identifying them can be helpful in reducing this phenomenon. We aimed to explore the process of parents' decision-making to discharge their child against medical advice. In-depth, semi-structured interviews were conducted with 10 fathers, 10 mothers, 6 nurses and 3 physician assistants and the data were collected to the point of saturation. Grounded theory methodology was adopted for data collection and analysis. The results of qualitative analysis in the field of the parents' decisionmaking on the DAMA revealed 4 main themes: "lack of family-centered care", "disruption of the parenting process", "distrust to the medical team and center" and "psychological strategy of shirk responsibility for child care and treatment ". By providing family-centered care, adopting measures to empowering the families, developing the trust of parents to the health care team and developing a discharge plan from the beginning of children hospitalization with the cooperation of health care team and parents and considering all factors such as child's special health condition and parent's health related perceptions and beliefs, children will not be discharged against medical advice and will experience better outcomes.

  18. Subscribe to NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... turn Javascript on. Subscribe to NIH MedlinePlus the magazine NIH MedlinePlus the magazine is published quarterly, in print and on the ... up for a free subscription to NIH MedlinePlus Magazine. Librarians may order this magazine in bulk . Please ...

  19. Posthospital Discharge Medical Care Costs and Family Burden Associated with Osteoporotic Fracture Patients in China from 2011 to 2013

    Directory of Open Access Journals (Sweden)

    Zhao Xie

    2015-01-01

    Full Text Available Objectives. This study collected and evaluated data on the costs of outpatient medical care and family burden associated with osteoporosis-related fracture rehabilitation following hospital discharge in China. Materials and Methods. Data were collected using a patient questionnaire from osteoporosis-related fracture patients (N = 123 who aged 50 years and older who were discharged between January 2011 and January 2013 from 3 large hospitals in China. The survey captured posthospital discharge direct medical costs, indirect medical costs, lost work time for caregivers, and patient ambulatory status. Results. Hip fracture was the most frequent fracture site (62.6%, followed by vertebral fracture (34.2%. The mean direct medical care costs per patient totaled 3,910¥, while mean indirect medical costs totaled 743¥. Lost work time for unpaid family caregivers was 16.4 days, resulting in an average lost income of 3,233¥. The average posthospital direct medical cost, indirect medical cost, and caregiver lost income associated with a fracture patient totaled 7,886¥. Patients’ ambulatory status was negatively impacted following fracture. Conclusions. Significant time and cost of care are placed on patients and caregivers during rehabilitation after discharge for osteoporotic fracture. It is important to evaluate the role and responsibility for creating the growing and inequitable burden placed on patients and caregivers following osteoporotic fracture.

  20. Assessing medication adherence and healthcare utilization and cost patterns among hospital-discharged patients with schizoaffective disorder.

    Science.gov (United States)

    Karve, Sudeep; Markowitz, Michael; Fu, Dong-Jing; Lindenmayer, Jean-Pierre; Wang, Chi-Chuan; Candrilli, Sean D; Alphs, Larry

    2014-06-01

    Hospital-discharged patients with schizoaffective disorder have a high risk of re-hospitalization. However, limited data exist evaluating critical post-discharge periods during which the risk of re-hospitalization is significant. Among hospital-discharged patients with schizoaffective disorder, we assessed pharmacotherapy adherence and healthcare utilization and costs during sequential 60-day clinical periods before schizoaffective disorder-related hospitalization and post-hospital discharge. From the MarketScan(®) Medicaid database (2004-2008), we identified patients (≥18 years) with a schizoaffective disorder-related inpatient admission. Study measures including medication adherence and healthcare utilization and costs were assessed during sequential preadmission and post-discharge periods. We conducted univariate and multivariable regression analyses to compare schizoaffective disorder-related and all-cause healthcare utilization and costs (in 2010 US dollars) between each adjacent 60-day post-discharge periods. No adjustment was made for multiplicity. We identified 1,193 hospital-discharged patients with a mean age of 41 years. The mean medication adherence rate was 46% during the 60-day period prior to index inpatient admission, which improved to 80% during the 60-day post-discharge period. Following hospital discharge, schizoaffective disorder-related healthcare costs were significantly greater during the initial 60-day period compared with the 61- to 120-day post-discharge period (mean US$2,370 vs US$1,765; p schizoaffective disorder-related costs declined during the 61- to 120-day post-discharge period and remained stable for the remaining post-discharge periods (days 121-365). We observed considerably lower (46%) adherence during 60 days prior to the inpatient admission; in comparison, adherence for the overall 6-month period was 8% (54%) higher. Our study findings suggest that both short-term (e.g., 60 days) and long-term (e.g., 6-12 months) medication

  1. Gas discharge visualization: an imaging and modeling tool for medical biometrics.

    Science.gov (United States)

    Kostyuk, Nataliya; Cole, Phyadragren; Meghanathan, Natarajan; Isokpehi, Raphael D; Cohly, Hari H P

    2011-01-01

    The need for automated identification of a disease makes the issue of medical biometrics very current in our society. Not all biometric tools available provide real-time feedback. We introduce gas discharge visualization (GDV) technique as one of the biometric tools that have the potential to identify deviations from the normal functional state at early stages and in real time. GDV is a nonintrusive technique to capture the physiological and psychoemotional status of a person and the functional status of different organs and organ systems through the electrophotonic emissions of fingertips placed on the surface of an impulse analyzer. This paper first introduces biometrics and its different types and then specifically focuses on medical biometrics and the potential applications of GDV in medical biometrics. We also present our previous experience with GDV in the research regarding autism and the potential use of GDV in combination with computer science for the potential development of biological pattern/biomarker for different kinds of health abnormalities including cancer and mental diseases.

  2. The impact of three discharge coding methods on the accuracy of diagnostic coding and hospital reimbursement for inpatient medical care.

    Science.gov (United States)

    Tsopra, Rosy; Peckham, Daniel; Beirne, Paul; Rodger, Kirsty; Callister, Matthew; White, Helen; Jais, Jean-Philippe; Ghosh, Dipansu; Whitaker, Paul; Clifton, Ian J; Wyatt, Jeremy C

    2018-07-01

    Coding of diagnoses is important for patient care, hospital management and research. However coding accuracy is often poor and may reflect methods of coding. This study investigates the impact of three alternative coding methods on the inaccuracy of diagnosis codes and hospital reimbursement. Comparisons of coding inaccuracy were made between a list of coded diagnoses obtained by a coder using (i)the discharge summary alone, (ii)case notes and discharge summary, and (iii)discharge summary with the addition of medical input. For each method, inaccuracy was determined for the primary, secondary diagnoses, Healthcare Resource Group (HRG) and estimated hospital reimbursement. These data were then compared with a gold standard derived by a consultant and coder. 107 consecutive patient discharges were analysed. Inaccuracy of diagnosis codes was highest when a coder used the discharge summary alone, and decreased significantly when the coder used the case notes (70% vs 58% respectively, p coded from the discharge summary with medical support (70% vs 60% respectively, p coding with case notes, and 35% for coding with medical support. The three coding methods resulted in an annual estimated loss of hospital remuneration of between £1.8 M and £16.5 M. The accuracy of diagnosis codes and percentage of correct HRGs improved when coders used either case notes or medical support in addition to the discharge summary. Further emphasis needs to be placed on improving the standard of information recorded in discharge summaries. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Barriers to discharge in an acute care medical teaching unit: a qualitative analysis of health providers’ perceptions

    Directory of Open Access Journals (Sweden)

    Okoniewska B

    2015-02-01

    Full Text Available Barbara Okoniewska,1 Maria Jose Santana,1 Horacio Groshaus,2 Svetlana Stajkovic,3 Jennifer Cowles,4 David Chakrovorty,5 William A Ghali1 1Department of Community Health Sciences, W21C Research and Innovation Centre, Institute of Public Health, 2Department of Internal Medicine, University of Calgary, 3Community Based Practice, 4Foothills Medical Centre, 5Department of Quality and Healthcare Improvement, Alberta Health Services, Calgary, AB, Canada Background: The complex process of discharging patients from acute care to community care requires a multifaceted interaction between all health care providers and patients. Poor communication in a patient’s discharge can result in post hospital adverse events, readmission, and mortality. Because of the gravity of these problems, discharge planning has been emphasized as a potential solution. The purpose of this paper is to identify communication barriers to effective discharge planning in an acute care unit of a tertiary care center and to suggest solutions to these barriers. Methods: Health care providers provided comments to a single open-ended question: “What are the communication barriers between the different health care providers that limit an effective discharge of patients from Unit 36?” We conducted qualitative thematic analysis by identifying themes related to communication barriers affecting a successful discharge process. Results: Three broad themes related to barriers to the discharge process were identified: communication, lack of role clarity and lack of resources. We also identified two themes for opportunities for improvement, ie, structure and function of the medical team and need for leadership. Conclusion: While it was evident that poor communication was an overarching barrier identified by health care providers, other themes emerged. In an effort to increase inter-team communication, “bullet rounds”, a condensed form of discharge rounds, were introduced to the medical

  4. Discharge Medication Counseling and its Correlation with Reducing Readmissions for Patients with Chronic Obstructive Pulmonary Disease Exacerbations

    Directory of Open Access Journals (Sweden)

    Emily M. Laswell

    2015-01-01

    Full Text Available Objective: To determine the impact of pharmacist-provided discharge medication counseling on 30 and 90 day hospital readmissions and ED visits in patients admitted with COPD exacerbation. Methods: A hospital-wide improvement was initiated, where COPD patients received discharge medication counseling and follow up phone call by a pharmacist. A pilot study was implemented, and data on readmission rates at 30- and 90-days were collected and compared to a hand-matched, retrospective control group that had not received discharge counseling by a pharmacist. Differences in readmission rates were analyzed using Chi-squared tests. Results: A total of 28 patients received discharge counseling by the pharmacist and were compared to 28 retrospective patients. Differences in 30-day and 90-day readmission rates were not significant (p=1.000 and p=0.589, respectively. After thirty days, 7 (25% intervention and 7 (25% retrospective group patients had been readmitted. After ninety days, 11 (39.3% intervention and 13 (46.4% non-intervention patients had been readmitted. Since a small cohort of patients received discharge counseling, the study did not meet power. Conclusions: Although not statistically significant, patients who received discharge medication counseling provided by a pharmacist had lower 90-day readmission rates post discharge. As regulations are implemented that penalize hospitals for readmissions that occur within 30 days of discharge, it is imperative that health care systems develop new strategies aimed at reducing readmission rates. Further studies that are adequately powered are needed to assess the impact pharmacists can have on readmission rates.   Type: Original Research

  5. Nutritional predictors of mortality after discharge in elderly patients on a medical ward.

    Science.gov (United States)

    Buscemi, Silvio; Batsis, John A; Parrinello, Gaspare; Massenti, Fatima M; Rosafio, Giuseppe; Sciascia, Vittoria; Costa, Flavia; Pollina Addario, Sebastiano; Mendola, Serena; Barile, Anna M; Maniaci, Vincenza; Rini, Nadia; Caimi, Gregorio

    2016-07-01

    Malnutrition in elderly inpatients hospitalized on medical wards is a significant public health concern. The aim of this study was to investigate nutritional markers as mortality predictors following discharge in hospitalized medical elderly patients. This is a prospective observational cohort study with follow-up of 48 months. Two hundred and twenty-five individuals aged 60 and older admitted from the hospital emergency room in the past 48 h were investigated at the medical ward in the University hospital in Palermo (Italy). Anthropometric and clinical measurements, Mini-nutritional Assessment (MNA) questionnaire, bioelectrical (BIA) phase angle (PA), grip strength were obtained all within 48 h of admission. Mortality data were verified by means of mortality registry and analysed using Cox-proportional hazard models. Ninety (40%) participants died at the end of follow-up. There were significant relationships between PA, MNA score, age and gender on mortality. Patients in the lowest tertile of PA (< 4·6°) had higher mortality estimates [I vs II tertile: hazard ratio (HR) = 3·40; 95% confidence interval (CI): 2·01-5·77; II vs III tertile: HR = 3·83; 95% CI: 2·21-6·64; log-rank test: χ(2) = 43·6; P < 0·001]. Similarly, the survival curves demonstrated low MNA scores (< 22) were associated with higher mortality estimates (HR = 1·85; 95% CI: 1·22-2·81 χ(2) = 8·2; P = 0·004). The MNA and BIA-derived phase angle are reasonable tools to identify malnourished patients at high mortality risk and may represent useful markers in intervention trials in this high-risk subgroup. © 2016 Stichting European Society for Clinical Investigation Journal Foundation.

  6. Pediatrician’s perspectives on discharge against medical advice (DAMA among pediatric patients: a qualitative study

    Directory of Open Access Journals (Sweden)

    Macrohon Bernadette C

    2012-06-01

    Full Text Available Abstract Background The phenomenon of discharge against medical advice (DAMA among pediatric patients places pediatricians in a dilemma between respect for the parent’s decision and the desire to provide complete care for the vulnerable child-patient. Little has been written about factors that affect a pediatrician’s decision to allow a parent to discharge his child against medical advice. This qualitative study aims to answer the question of how pediatric residents in a tertiary government hospital perceive and decide on a DAMA request from a parent or primary caregiver. Methods Using a focus group discussion approach, 11 pediatric residents from a government-run tertiary hospital were recruited for the study. The session was digitally recorded and dominant themes were coded and identified. Results There were three prominent themes that arose in the discussion: variability of definitions of DAMA, factors considered before “allowing” the patient to be DAMA, and the implications of a DAMA request on their performance as pediatricians. Definitions vary from one resident to another based on the main reason for DAMA (terminal, cultural, or financial. A conflict was noted in the definition of Home per Request (HPR versus DAMA. Factors that influence a pediatrician to sign out a case as DAMA include: their ability to do something about the reason given for the DAMA request, the condition of the patient when the DAMA request was given, their impression of the kind of care that the parents provide, and their legal liabilities. Pediatric residents generally maintain a positive attitude towards the parents who request for DAMA and in the event of readmission, accept the patient into their care again. The occurrence of a variety of definitions and subcategories for DAMA may cause confusion among the pediatricians and should be clarified. The familiarity with cultural traditions contributes to their ability to handle situations that may lead to DAMA

  7. NLM MedlinePlus Magazine Team | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... Home Current issue contents Magazine Team Follow us Magazine Team National Library of Medicine at the National ... MLS, MA TREASURER Dennis Cryer, MD NIH MedlinePlus magazine is published by Friends of the NLM in ...

  8. MedlinePlus FAQ: Can you tell me how to cite MedlinePlus pages?

    Science.gov (United States)

    ... MedlinePlus, the National Library of Medicine recommends the citation style below, based upon Citing Medicine . This style, like many other citation styles, requires that for online references you include the ...

  9. MedlinePlus FAQ: MedlinePlus and MEDLINE/PubMed

    Science.gov (United States)

    ... What is the difference between MedlinePlus and MEDLINE/PubMed? To use the sharing features on this page, ... latest health professional articles on your topic. MEDLINE/PubMed: Is a database of professional biomedical literature Is ...

  10. MedlinePlus FAQ: Will MedlinePlus work on my mobile device?

    Science.gov (United States)

    ... mobile.html Question: Will MedlinePlus work on my mobile device? To use the sharing features on this page, ... Some video content might not play on your mobile device. See our FAQ on playing videos on phones ...

  11. NLM MedlinePlus Magazine Team | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... Robert George DIRECTOR OF OPERATIONS Carolyn Medeiros DIRECTOR, BUSINESS DEVELOPMENT Michele Tezduyar MANAGING EDITOR Emily Poe SENIOR ... MD 20814 CONNECT WITH US Follow us on Facebook Facebook MedlinePlus www.facebook.com/mplus.gov Facebook ...

  12. Do patients discharged from advanced practice physiotherapy-led clinics re-present to specialist medical services?

    Science.gov (United States)

    Chang, Angela T; Gavaghan, Belinda; O'Leary, Shaun; McBride, Liza-Jane; Raymer, Maree

    2017-05-15

    Objective The aim of the present study was to determine the rates of re-referral to specialist out-patient clinics for patients previously managed and discharged from an advanced practice physiotherapy-led service in three metropolitan hospitals. Methods A retrospective audit was undertaken of 462 patient cases with non-urgent musculoskeletal conditions discharged between 1 April 2014 and 30 March 2015 from three metropolitan hospitals. These patients had been discharged from the physiotherapy-led service without requiring specialist medical review. Rates and patterns of re-referral to specialist orthopaedic, neurosurgical, chronic pain, or rheumatology services within 12 months of discharge were investigated. Results Forty-six of the 462 patients (10.0%) who were managed by the physiotherapy-led service were re-referred to specialist medical orthopaedic, neurosurgical, chronic pain or rheumatology departments within 12 months of discharge. Only 22 of these patients (4.8%) were re-referred for the same condition as managed previously and discharged. Conclusions Ninety-five per cent of patients with non-urgent musculoskeletal conditions managed by an advanced practice physiotherapy-led service at three metropolitan hospitals did not re-present to access public specialist medical services for the same condition within 12 months of discharge. This is the first time that re-presentation rates have been reported for patients managed in advanced practice physiotherapy services and the findings support the effectiveness of these models of care in managing demand for speciality out-patient services. What is known about the topic? Advanced practice physiotherapy-led services have been implemented to address the needs of patients referred with non-urgent musculoskeletal conditions to hospital specialist out-patient services. Although this model is widely used in Australia, there has been very little information about whether patients managed in these services subsequently re

  13. Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India.

    Science.gov (United States)

    Devpura, Bhanu; Bhadesia, Pranav; Nimbalkar, Somashekhar; Desai, Sandeep; Phatak, Ajay

    2016-01-01

    Objective . We explored reasons for discharged against medical advice (DAMA) of neonates from a neonatal intensive care unit (NICU) through in-depth interviews of the parents/guardians. Methods . Of 456 babies admitted to NICU during April 2014 to March 2015, 116 babies were DAMA. Parents of randomly selected 50 babies of these 116, residing within 50 kilometers, were approached for in-depth interviews at their homes. Audio recordings were done and manually transcribed, analyzed in detail to explore common threads leading to DAMA. Basic demographic information of the newborns was retrieved from hospital records. Results . The prevalence of DAMA was 25.4%. Of 50 parents approached, 41 in-depth interviews were completed. Nonaffordability (38.6%), no improvement (14.6%), poor prognosis (12%), and inappropriate behavior of the patient relation office personnel (10.6%) were major factors contributing to DAMA. Parents of 6.6% neonates wanted guarantee of survival and 5.3% parents reported poor behavior of nurses. No gender bias was observed related to DAMA. One-third of neonates (34.1%) were DAMA on first day of admission. Conclusions . The issue of DAMA needs attention. Besides nonaffordability and clinical characteristics of the baby, communication (breaking bad news, counseling, etc.) and lack of adequate infrastructure for relatives emerged as modifiable factors leading to DAMA.

  14. Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India

    Directory of Open Access Journals (Sweden)

    Bhanu Devpura

    2016-01-01

    Full Text Available Objective. We explored reasons for discharged against medical advice (DAMA of neonates from a neonatal intensive care unit (NICU through in-depth interviews of the parents/guardians. Methods. Of 456 babies admitted to NICU during April 2014 to March 2015, 116 babies were DAMA. Parents of randomly selected 50 babies of these 116, residing within 50 kilometers, were approached for in-depth interviews at their homes. Audio recordings were done and manually transcribed, analyzed in detail to explore common threads leading to DAMA. Basic demographic information of the newborns was retrieved from hospital records. Results. The prevalence of DAMA was 25.4%. Of 50 parents approached, 41 in-depth interviews were completed. Nonaffordability (38.6%, no improvement (14.6%, poor prognosis (12%, and inappropriate behavior of the patient relation office personnel (10.6% were major factors contributing to DAMA. Parents of 6.6% neonates wanted guarantee of survival and 5.3% parents reported poor behavior of nurses. No gender bias was observed related to DAMA. One-third of neonates (34.1% were DAMA on first day of admission. Conclusions. The issue of DAMA needs attention. Besides nonaffordability and clinical characteristics of the baby, communication (breaking bad news, counseling, etc. and lack of adequate infrastructure for relatives emerged as modifiable factors leading to DAMA.

  15. Welcome to NIH MedlinePlus magazine!

    Science.gov (United States)

    ... companion Web site medlineplus.gov are the best sources of health information for you and yours. Try them. You'll come to rely on what they can do for your good health. Sincerely, Donald West King, M.D., Chairman Friends of the National Library of Medicine Winter 2009 Issue: Volume 4 Number ...

  16. Heart Surgery: MedlinePlus Health Topic

    Science.gov (United States)

    ... Living With Related Issues Specifics See, Play and Learn Videos and Tutorials Research Clinical Trials Journal Articles Resources ... Also in Spanish Videos and Tutorials MedlinePlus: Surgery Videos ... strategy is better to reduce postoperative stroke... Article: Ferumoxtyol-enhanced MR ...

  17. Angina - discharge

    Science.gov (United States)

    Chest pain - discharge; Stable angina - discharge; Chronic angina - discharge; Variant angina - discharge; Angina pectoris - discharge; Accelerating angina - discharge; New-onset angina - discharge; Angina-unstable - discharge; ...

  18. A Study of the Impact of Cannabis on Doses of Discharge Antipsychotic Medication in Individuals with Schizophrenia or Schizoaffective Disorder.

    Science.gov (United States)

    Babatope, Taiwo; Chotalia, Jigar; Elkhatib, Rania; Mohite, Satyajit; Shah, Joel; Goddu, Sumana; Patel, Ruchir Arvind; Aimienwanu, Osarhiemen Ruth; Patel, Devanshu; Makanjuola, Titilayo; Okusaga, Olaoluwa O

    2016-12-01

    Patients with schizophrenia or schizoaffective disorder have a high prevalence of comorbid cannabis use disorder (CUD). CUD has been associated with poorer outcomes in patients. We compared doses of antipsychotic medications at the time of discharge from hospital among inpatients with schizophrenia or schizoaffective disorder with or without concurrent cannabis use. We reviewed the medical records of patients (N = 8157) with schizophrenia or schizoaffective disorder discharged from the hospital between 2008 and 2012. The patients were divided into two groups; those with urine drug tests positive for cannabis and those negative for cannabis. Doses of antipsychotic medications were converted to chlorpromazine equivalents. Bivariate analyses were done with Student's t test for continuous variables and χ 2 test for categorical variables. Linear regression was carried out to adjust for potential confounders. Unadjusted analysis revealed that the cannabis positive group was discharged on lower doses of antipsychotic medication compared with the cannabis negative group (geometric mean chlorpromazine equivalent doses 431.22 ± 2.20 vs 485.18 ± 2.21; P schizoaffective disorder.

  19. Effectiveness of post-discharge case management in general-medical outpatients: a randomized, controlled trial

    NARCIS (Netherlands)

    Latour, Corine H. M.; de Vos, Rien; Huyse, Frits J.; de Jonge, Peter; van Gemert, Liesbeth A. M.; Stalman, Wim A. B.

    2006-01-01

    This study was initiated to determine the impact of post-discharge, nurse-led, home-based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N=147) were

  20. Effectiveness of post-discharge case management in general-medical outpatients: A randomized, controlled trial

    NARCIS (Netherlands)

    Latour-Delfgaauw, C.H.M.; Vos, R.; Huyse, F.J.; de Jonge, P.; van Gemert, L.A.M.; Stalman, W.A.B.

    2006-01-01

    This study was initiated to determine the impact of post-discharge, nurse-led, home-based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N=147) were

  1. Effectiveness of post-discharge case management in general-medical outpatients: A randomized, controlled trial

    NARCIS (Netherlands)

    Latour, C.H.M.; de Vos, R.; Huyse, F.J.; De Jonge, P.; van Gemert, L.A.M.; Stalman, W.A.B.

    2006-01-01

    This study was initiated to determine the impact of post- discharge, nurse- led, home- based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N = 147)

  2. Effectiveness of post-discharge case management in general-medical outpatients : A randomized, controlled trial

    NARCIS (Netherlands)

    Latour, Corine H. M.; de Vos, Rien; Huyse, Frits J.; de Jonge, Peter; van Gemert, Liesbeth A. M.; Stalman, Wim A. B.

    2006-01-01

    This study was initiated to determine the impact of post- discharge, nurse- led, home- based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N = 147)

  3. MedlinePlus Connect: Linking Patient Portals and Electronic Health Records to Health Information

    Science.gov (United States)

    ... Here: Home → MedlinePlus Connect URL of this page: https://medlineplus.gov/connect/overview.html MedlinePlus Connect Linking ... will change.) Old URLs New URLs Web Application https://apps.nlm.nih.gov/medlineplus/services/mpconnect.cfm? ...

  4. NIH Institutes and MLN MedlinePlus Advisory Board

    Science.gov (United States)

    ... main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.9 mb] ... nih.gov (301) 496-7301 National Institute of Mental Health (NIMH) www.nimh.nih.gov 1-866- ...

  5. MedlinePlus FAQ: Listing Your Web Site

    Science.gov (United States)

    ... JavaScript. Answer: MedlinePlus is a selected list of authoritative resources. MedlinePlus uses quality guidelines to evaluate Web ... ensure that the information we link to is authoritative, accurate, up-to-date, educational and available at ...

  6. Review of medical discharge summaries and medical documentation in a metropolitan hospital: impact on diagnostic-related groups and Weighted Inlier Equivalent Separation.

    Science.gov (United States)

    Chin, N; Perera, P; Roberts, A; Nagappan, R

    2013-07-01

    Accurate and comprehensive clinical documentation is crucial for effective ongoing patient care, follow up and to optimise case mix-based funding. Each Diagnostic Related Group (DRG) is assigned a 'weight', leading to Weighted Inlier Equivalent Separation (WIES), a system many public and private hospitals in Australia subscribe to. To identify the top DRG in a general medical inpatient service, the completeness of medical discharge documentation, commonly missed comorbidities and system-related issues and subsequent impact on DRG and WIES allocation. One hundred and fifty completed discharge summaries were randomly selected from the top 10 medical DRG in our health service. From a detailed review of the clinical documentation, principal diagnoses, associated comorbidities and complications, where appropriate, the DRG and WIES were modified. Seventy-two (48%) of the 150 reviewed admissions resulted in a revision of DRG and WIES equivalent to an increase of AUD 142,000. Respiratory-based DRG generated the largest revision of DRG and WIES, while 'Cellulitis' DRG had the largest relative change. Twenty-seven per cent of summaries reviewed necessitated a change in coding with no subsequent change in DRG allocation or WIES. Acute renal failure, anaemia and electrolyte disturbances were the most commonly underrepresented entities in clinical discharge documentation. Seven patients had their WIES downgraded. Comprehensive documentation of principal diagnosis/diagnoses, comorbidities and their complications is imperative to optimal DRG and WIES allocation. Regular meetings between clinical and coding staff improve the quality and timeliness of medical documentation, ensure adequate communication with general practitioners and lead to appropriate funding. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  7. Perceptions among general medical practitioners toward implementation of medication reconciliation program for patients discharged from hospitals in Penang, Malaysia.

    Science.gov (United States)

    Hassali, Mohamed Azmi Ahmad; Al-Haddad, Mahmoud; Shafie, Asrul Akmal; Tangiisuran, Balamurugan; Saleem, Fahad; Atif, Muhammad; Al-Qazaz, Harith

    2012-06-01

    This study aims to explore the perceptions of general practitioners (GPs) from the state of Penang toward the feasibility of implementing the medication reconciliation program in Malaysia. A cross-sectional descriptive study using a validated, self-completed anonymous 18-item questionnaire was undertaken over a period of 2 months in 2010. The study was conducted in the state of Penang, Malaysia. A letter consisting of survey questionnaires and prepaid return envelope were mailed to 429 GPs identified from the Private Medical Practice Control Department Registry. A total of 86 responses were received with response rate of 20.1%. Majority (90.1%) of the respondents agreed that medication reconciliation can be a feasible strategy to improve medication safety, and 97.7% confirmed that having an accurate up-to-date list of the patient's previous medication will be useful in the rational prescribing process. However, about half (56.9%) of them felt that standardization of the medication reconciliation process in all clinics will be difficult to achieve. Three quarters (73.2%) of the respondents believed that the involvement of GPs alone is insufficient, and 74.5% agreed that this program should be expanded to community pharmacy setting. More than 90% of the respondents agreed upon the medication reconciliation card proposed by the researchers. General practitioners in Penang are generally in favor of the implementation of medication reconciliation program in their practice. Because medication reconciliation has been shown to reduce many medicine-related problems, it is thus worth considering the feasibility of nationwide implementation of such program.

  8. Frequency and causes of discharges against medical advice from hospital cardiac care units of East Azerbaijan, Iran

    Directory of Open Access Journals (Sweden)

    Saber Azami-Aghdash

    2016-05-01

    Full Text Available Introduction: Discharges against medical advice (DAMA is a common problem of hospitals that could lead increasing the complications and readmission. For this, the aim of this study is to investigate the frequency and effective factors of DAMA in patients with cardiovascular disease in hospital cardiac care units (CCU of East Azerbaijan, Iran. Methods: This cross-sectional study was performed, in 2013, in Tabriz University of Medical Sciences, Iran. Required information was extracted using valid and reliable forms of medical records of 2000 patients admitted to 20 CCU in 17 hospitals of East Azerbaijan, by two trained interviewers. Data analysis was performed using descriptive statistics (frequency, mean, percentage, etc., chi-square test, and linear regression model using the SPSS software. The tests were considered a statistically significant level of 0.05%. Results: The results showed that 272 patients (13.6% were DAMA from the hospital. The frequency of DAMA was in men more than women. The most frequency of discharge has occurred in the range of 40-80 years old. Results of linear regression showed that there was a significant correlation between DAMA and type of insurance, history of myocardial infarction (MI, comorbid disease, cause of hospitalization, location of hospital, and staying < 48 hours (P < 0.050. Conclusion: In this study, the rate of DAMA was relatively high compared with similar studies and it is considered as a concern problem that should study the reasons and its effective factors and plan effective interventions to reduce them.

  9. Transcript for Understanding Medical Words: A Tutorial

    Science.gov (United States)

    ... medlineplus.gov/medicalwordstranscript.html Transcript for Understanding Medical Words: A Tutorial To use the sharing features on ... get to what those mean in a minute. Word Roots Word Roots. Let's begin with body parts. ...

  10. Influence of superstition on the date of hospital discharge and medical cost in Japan: retrospective and descriptive study.

    Science.gov (United States)

    Hira, K; Fukui, T; Endoh, A; Rahman, M; Maekawa, M

    To determine the influence of superstition about Taian (a lucky day)-Butsumetsu (an unlucky day) on decision to leave hospital. To estimate the costs of the effect of this superstition. Retrospective and descriptive study. University hospital in Kyoto, Japan. Patients who were discharged alive from Kyoto University Hospital from 1 April 1992 to 31 March 1995. Mean number, age, and hospital stay of patients discharged on each day of six day cycle. The mean number, age, and hospital stay of discharged patients were highest on Taian and lowest on Butsumetsu (25.8 v 19.3 patients/day, P=0.0001; 43.9 v 41.4 years, P=0.0001; and 43.1 v 33.3 days, P=0.0001 respectively). The effect of this difference on the hospital's costs was estimated to be 7.4 million yen (¿31 000). The superstition influenced the decision to leave hospital, contributing to higher medical care costs in Japan. Although hospital stays need to be kept as short as possible to minimise costs, doctors should not ignore the possible psychological effects on patients' health caused by dismissing the superstition.

  11. The effect of a clinical pharmacist discharge service on medication discrepancies in patients with heart failure

    NARCIS (Netherlands)

    R.N. Eggink; A.W. Lenderink (Albert); J.W. Widdershoven (Jos); P.M.L.A. van den Bemt (Patricia)

    2010-01-01

    textabstractObjective: Heart failure patients are regularly admitted to hospital and frequently use multiple medication. Besides intentional changes in pharmacotherapy, unintentional changes may occur during hospitalisation. The aim of this study was to investigate the effect of a clinical

  12. A cascade of classifiers for extracting medication information from discharge summaries

    Directory of Open Access Journals (Sweden)

    Halgrim Scott

    2011-07-01

    Full Text Available Abstract Background Extracting medication information from clinical records has many potential applications, and recently published research, systems, and competitions reflect an interest therein. Much of the early extraction work involved rules and lexicons, but more recently machine learning has been applied to the task. Methods We present a hybrid system consisting of two parts. The first part, field detection, uses a cascade of statistical classifiers to identify medication-related named entities. The second part uses simple heuristics to link those entities into medication events. Results The system achieved performance that is comparable to other approaches to the same task. This performance is further improved by adding features that reference external medication name lists. Conclusions This study demonstrates that our hybrid approach outperforms purely statistical or rule-based systems. The study also shows that a cascade of classifiers works better than a single classifier in extracting medication information. The system is available as is upon request from the first author.

  13. Sterilization and decontamination of medical instruments by low-pressure plasma discharges: application of Ar/O2/N2 ternary mixture

    International Nuclear Information System (INIS)

    Kylian, O; Rossi, F

    2009-01-01

    A low-pressure inductively coupled plasma discharge sustained in an argon-oxygen-nitrogen ternary mixture is studied in order to evaluate its properties in terms of sterilization and decontamination of surfaces of medical instruments. It is demonstrated by direct comparison with discharges operated in oxygen-nitrogen and oxygen-argon mixtures that application of an Ar/O 2 /N 2 mixture offers the possibility to combine advantageous properties of the binary mixtures, namely, the capability of an O 2 /N 2 plasma to emit intense UV radiation needed for effective inactivation of bacterial spores together with high removal rates of biological substances from Ar/O 2 discharge. Moreover, optimal conditions for both effects are obtained at a similar ternary discharge mixture composition, which is of much interest for real applications, since it offers a highly effective process desired for the safety of medical instruments.

  14. Sterilization and decontamination of medical instruments by low-pressure plasma discharges: application of Ar/O{sub 2}/N{sub 2} ternary mixture

    Energy Technology Data Exchange (ETDEWEB)

    Kylian, O [Charles University, Faculty of Mathematics and Physics, V Holesovickach 2, Prague 8, 180 00 (Czech Republic); Rossi, F, E-mail: francois.rossi@jrc.i [European Commission, Joint Research Centre, Institute for Health and Consumer Protection, Via E Fermi 2749, 21027 Ispra (Vatican City State, Holy See) (Italy)

    2009-04-21

    A low-pressure inductively coupled plasma discharge sustained in an argon-oxygen-nitrogen ternary mixture is studied in order to evaluate its properties in terms of sterilization and decontamination of surfaces of medical instruments. It is demonstrated by direct comparison with discharges operated in oxygen-nitrogen and oxygen-argon mixtures that application of an Ar/O{sub 2}/N{sub 2} mixture offers the possibility to combine advantageous properties of the binary mixtures, namely, the capability of an O{sub 2}/N{sub 2} plasma to emit intense UV radiation needed for effective inactivation of bacterial spores together with high removal rates of biological substances from Ar/O{sub 2} discharge. Moreover, optimal conditions for both effects are obtained at a similar ternary discharge mixture composition, which is of much interest for real applications, since it offers a highly effective process desired for the safety of medical instruments.

  15. HIV Viral Load: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/hivviralload.html HIV Viral Load To use the sharing features on this page, please enable JavaScript. What is an HIV Viral Load? An HIV viral load is a ...

  16. BUN (Blood Urea Nitrogen): MedlinePlus Lab Test Information

    Science.gov (United States)

    ... https://medlineplus.gov/labtests/bunbloodureanitrogen.html BUN (Blood Urea Nitrogen) To use the sharing features on this ... please enable JavaScript. What is a BUN (Blood Urea Nitrogen) Test? A BUN, or blood urea nitrogen ...

  17. Protein in Urine: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/proteininurine.html Protein in Urine To use the sharing features on this page, please enable JavaScript. What is a Protein in Urine Test? A protein in urine test ...

  18. Bacteria Culture Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/bacteriaculturetest.html Bacteria Culture Test To use the sharing features on this page, please enable JavaScript. What is a Bacteria Culture Test? Bacteria are a large group of ...

  19. Treating Cataracts | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... Claudine Klose, 63, lives on a farm in New York's Hudson Valley. She had successful cataract surgery in 2013 and shared her experience recently with NIH MedlinePlus magazine. What did you notice about your vision that ...

  20. Epithelial Cells in Urine: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... page: https://medlineplus.gov/labtests/epithelialcellsinurine.html Epithelial Cells in Urine To use the sharing features on ... page, please enable JavaScript. What is an Epithelial Cells in Urine Test? Epithelial cells are a type ...

  1. Bilirubin Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/bilirubinbloodtest.html Bilirubin Blood Test To use the sharing features on this page, please enable JavaScript. What is a Bilirubin Blood Test? A bilirubin blood test measures the ...

  2. Anion Gap Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... https://medlineplus.gov/labtests/aniongapbloodtest.html Anion Gap Blood Test To use the sharing features on this page, please enable JavaScript. What is an Anion Gap Blood Test? An anion gap blood test is a way ...

  3. Hepatitis Panel: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/hepatitispanel.html Hepatitis Panel To use the sharing features on this page, please enable JavaScript. What is a Hepatitis Panel? Hepatitis is a type of liver disease. ...

  4. AST Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... page: https://medlineplus.gov/labtests/asttest.html AST Test To use the sharing features on this page, please enable JavaScript. What is an AST Test? AST (aspartate aminotransferase) is an enzyme that is ...

  5. Chlamydia Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... page: https://medlineplus.gov/labtests/chlamydiatest.html Chlamydia Test To use the sharing features on this page, please enable JavaScript. What is a Chlamydia Test? Chlamydia is one of the most common sexually ...

  6. Hemoglobin Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... page: https://medlineplus.gov/labtests/hemoglobintest.html Hemoglobin Test To use the sharing features on this page, please enable JavaScript. What is a Hemoglobin Test? A hemoglobin test measures the levels of hemoglobin ...

  7. Amylase Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... page: https://medlineplus.gov/labtests/amylasetest.html Amylase Test To use the sharing features on this page, please enable JavaScript. What is an Amylase Test? An amylase test measures the amount of amylase ...

  8. Lipase Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... page: https://medlineplus.gov/labtests/lipasetest.html Lipase Test To use the sharing features on this page, please enable JavaScript. What is a lipase test? Lipase is a type of protein made by ...

  9. Cortisol Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... page: https://medlineplus.gov/labtests/cortisoltest.html Cortisol Test To use the sharing features on this page, please enable JavaScript. What is a Cortisol Test? Cortisol is a hormone that affects almost every ...

  10. Hematocrit Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... page: https://medlineplus.gov/labtests/hematocrittest.html Hematocrit Test To use the sharing features on this page, please enable JavaScript. What is a Hematocrit Test? A hematocrit test is a type of blood ...

  11. Procalcitonin Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... page: https://medlineplus.gov/labtests/procalcitonintest.html Procalcitonin Test To use the sharing features on this page, please enable JavaScript. What is a Procalcitonin Test? A procalcitonin test measures the level of procalcitonin ...

  12. MedlinePlus Connect: Frequently Asked Questions (FAQs)

    Science.gov (United States)

    ... topic data in XML format. Using the Web service, software developers can build applications that utilize MedlinePlus health topic information. The service accepts keyword searches as requests and returns relevant ...

  13. Chloride Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/chloridebloodtest.html Chloride Blood Test To use the sharing features on this page, please enable JavaScript. What is a Chloride Blood Test? A chloride blood test measures the ...

  14. Heavy Metal Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/heavymetalbloodtest.html Heavy Metal Blood Test To use the sharing features ... this page, please enable JavaScript. What is a Heavy Metal Blood Test? A heavy metal blood test ...

  15. Flu (Influenza) Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/fluinfluenzatest.html Flu (Influenza) Test To use the sharing features on this page, please enable JavaScript. What is a Flu (Influenza) Test? Influenza, known as the flu , is ...

  16. Tetanus, Diphtheria, and Pertussis Vaccines: MedlinePlus Health Topic

    Science.gov (United States)

    ... Know (Centers for Disease Control and Prevention) - PDF Topic Image MedlinePlus Email Updates Get Tetanus, Diphtheria, and ... updates by email What's this? GO Related Health Topics Childhood Immunization Diphtheria Immunization Tetanus Whooping Cough National ...

  17. Nutrition for Seniors: MedlinePlus Health Topic

    Science.gov (United States)

    ... America) National Institute on Aging Also in Spanish Topic Image MedlinePlus Email Updates Get Nutrition for Seniors updates by email What's this? GO Related Health Topics Nutrition Seniors' Health National Institutes of Health The ...

  18. Allergy Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/allergybloodtest.html Allergy Blood Test To use the sharing features on this page, please enable JavaScript. What is an Allergy Blood Test? Allergies are a common and chronic ...

  19. Lipoprotein (a) Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/lipoproteinabloodtest.html Lipoprotein (a) Blood Test To use the sharing features ... this page, please enable JavaScript. What is a Lipoprotein (a) Blood Test? A lipoprotein (a) test measures ...

  20. We’re All in This Together | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [4.3 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  1. Achoo! Cold, Flu, or Something Else? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  2. Psoriasis: On the Road to Discovery | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.9 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  3. Nick Jonas on Type 1 Diabetes | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.9 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  4. Asthma: What You Need to Know | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  5. Preventing Pregnancy with a Gel for Men? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  6. Caregiving: It Takes a Village | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  7. Breathtaking: Managing a COPD Diagnosis | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  8. Understanding and preventing tick bites | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.9 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  9. Battling C. Difficile: Don’t Delay | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  10. From the lab - Exercise Key to Keeping Weight Off | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  11. From the lab - Can Potassium Help Your Heart? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  12. Sickle Cell Disease: What You Should Know | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  13. A Journey with Mid-life Hearing Loss | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  14. Joint Replacement Surgery: What you Need to Know | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  15. The Future of Asthma Monitoring | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  16. Too ‘Stubborn’ to Give in to COPD | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  17. Cholesterol: The Good, the Bad, and the Unhealthy | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  18. Palliative Care: A Spectrum of Support | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  19. Confronting 9/11 Trauma from Childhood into Adulthood | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  20. Solving the Undiagnosed Disease Puzzle at NIH | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  1. Love and Life without Gluten | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  2. A Couple’s Caregiving Journey | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  3. Surgeon General Outlines Opioid Plan | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  4. From the lab - Testing Malaria-Resistant Mosquitoes | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  5. A Path to Hope for Sickle Cell Disease | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  6. Step Inside NIH’s Sickle Cell Branch | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  7. From the lab - Progress Against Zika | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [4.3 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  8. A Closer Look at Cancer Imaging Tools | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  9. Exploring the Celiac Disease Mystery | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  10. Beyond Pain Relief: Total Knee Replacement Surgery | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  11. TV Star Jim Parsons Shines Light on NIH Research | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  12. Advance Care Plan: A Checklist for the Future | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  13. Understanding Asthma from the Inside Out | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [2.68 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  14. Keys to Recovery after Knee Replacement Surgery | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  15. Fighting the Flu with a Universal Vaccine | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  16. Hospitals as a 'risk environment': an ethno-epidemiological study of voluntary and involuntary discharge from hospital against medical advice among people who inject drugs.

    Science.gov (United States)

    McNeil, Ryan; Small, Will; Wood, Evan; Kerr, Thomas

    2014-03-01

    People who inject drugs (PWID) experience high levels of HIV/AIDS and hepatitis C (HCV) infection that, together with injection-related complications such as non-fatal overdose and injection-related infections, lead to frequent hospitalizations. However, injection drug-using populations are among those most likely to be discharged from hospital against medical advice, which significantly increases their likelihood of hospital readmission, longer overall hospital stays, and death. In spite of this, little research has been undertaken examining how social-structural forces operating within hospital settings shape the experiences of PWID in receiving care in hospitals and contribute to discharges against medical advice. This ethno-epidemiological study was undertaken in Vancouver, Canada to explore how the social-structural dynamics within hospitals function to produce discharges against medical advice among PWID. In-depth interviews were conducted with thirty PWID recruited from among participants in ongoing observational cohort studies of people who inject drugs who reported that they had been discharged from hospital against medical advice within the previous two years. Data were analyzed thematically, and by drawing on the 'risk environment' framework and concepts of social violence. Our findings illustrate how intersecting social and structural factors led to inadequate pain and withdrawal management, which led to continued drug use in hospital settings. In turn, diverse forms of social control operating to regulate and prevent drug use in hospital settings amplified drug-related risks and increased the likelihood of discharge against medical advice. Given the significant morbidity and health care costs associated with discharge against medical advice among drug-using populations, there is an urgent need to reshape the social-structural contexts of hospital care for PWID by shifting emphasis toward evidence-based pain and drug treatment augmented by harm

  17. Understanding Medical Words: A Tutorial from the National Library of Medicine

    Science.gov (United States)

    ... page: https://medlineplus.gov/medicalwords.html Understanding Medical Words: A Tutorial from the National Library of Medicine ... enable JavaScript. This tutorial teaches you about medical words. You'll learn about how to put together ...

  18. Trajectories of life satisfaction five years after medical discharge for traumatically acquired disability.

    Science.gov (United States)

    Hernandez, Caitlin L; Elliott, Timothy R; Berry, Jack W; Underhill, Andrea T; Fine, Philip R; Lai, Mark H C

    2014-05-01

    We studied the predictive impact of family satisfaction, marital status, and functional impairment on the trajectories of life satisfaction over the first 5 years following medical treatment for traumatic spinal cord injury, burns, or interarticular fractures (total N = 662). It was anticipated that fewer functional impairments, being married, and greater family satisfaction would predict higher life satisfaction trajectories. The Functional Independence Measure, the Family Satisfaction Scale, and the Life Satisfaction Index were administered 12, 24, 48, and 60 months postdischarge. Trajectory modeling revealed that greater functional impairment significantly predicted lower life satisfaction, regardless of injury type. However, this association diminished when marital status and family satisfaction were entered into the models. Greater family satisfaction and being married predicted greater life satisfaction across time. Moreover, there was no evidence for increases in life satisfaction trajectories over time: Trajectories were stable across time for all injury groups. Results suggest that being married and greater family satisfaction promote life satisfaction among those who traumatically acquire disability, and these beneficial effects may be more salient than the degree of functional impairment imposed by the condition. (c) 2014 APA, all rights reserved.

  19. Cost-effectiveness of a health-social partnership transitional program for post-discharge medical patients

    Directory of Open Access Journals (Sweden)

    Wong Frances Kam Yuet

    2012-12-01

    Full Text Available Abstract Background Readmissions are costly and have implications for quality of care. Studies have been reported to support effects of transitional care programs in reducing hospital readmissions and enhancing clinical outcomes. However, there is a paucity of studies executing full economic evaluation to assess the cost-effectiveness of these transitional care programs. This study is therefore launched to fill this knowledge gap. Methods Cost-effectiveness analysis was conducted alongside a randomized controlled trial that examined the effects of a Health-Social Transitional Care Management Program (HSTCMP for medical patients discharged from an acute regional hospital in Hong Kong. The cost and health outcomes were compared between the patients receiving the HSTCMP and usual care. The total costs comprised the pre-program, program, and healthcare utilization costs. Quality of life was measured with SF-36 and transformed to utility values between 0 and 1. Results The readmission rates within 28 (control 10.2%, study 4.0% and 84 days (control 19.4%, study 8.1% were significantly higher in the control group. Utility values showed no difference between the control and study groups at baseline (p = 0.308. Utility values for the study group were significantly higher than in the control group at 28 (p  Conclusions Previous studies on transitional care focused mainly on clinical outcomes and not too many included cost as an outcome measure. Studies examining the cost-effectiveness of the post-discharge support services are scanty. This study is the first to examine the cost-effectiveness of a transitional care program that used nurse-led services participated by volunteers. Results have shown that a health-social partnership transitional care program is cost-effective in reducing healthcare costs and attaining QALY gains. Economic evaluation helps to inform funders and guide decisions for the effective use of competing healthcare resources.

  20. A comparison of discharge functional status after rehabilitation in skilled nursing, home health, and medical rehabilitation settings for patients after lower-extremity joint replacement surgery.

    Science.gov (United States)

    Mallinson, Trudy R; Bateman, Jillian; Tseng, Hsiang-Yi; Manheim, Larry; Almagor, Orit; Deutsch, Anne; Heinemann, Allen W

    2011-05-01

    To examine differences in outcomes of patients after lower-extremity joint replacement across 3 post-acute care (PAC) rehabilitation settings. Prospective observational cohort study. Skilled nursing facilities (SNFs; n=5), inpatient rehabilitation facilities (IRFs; n=4), and home health agencies (HHAs; n=6) from 11 states. Patients with total knee (n=146) or total hip replacement (n=84) not related to traumatic injury. None. Self-care and mobility status at PAC discharge measured by using the Inpatient Rehabilitation Facility Patient Assessment Instrument. Based on our study sample, HHA patients were significantly less dependent than SNF and IRF patients at admission and discharge in self-care and mobility. IRF and SNF patients had similar mobility levels at admission and discharge and similar self-care at admission, but SNF patients were more independent in self-care at discharge. After controlling for differences in patient severity and length of stay in multivariate analyses, HHA setting was not a significant predictor of self-care discharge status, suggesting that HHA patients were less medically complex than SNF and IRF patients. IRF patients were more dependent in discharge self-care even after controlling for severity. For the full discharge mobility regression model, urinary incontinence was the only significant covariate. For the patients in our U.S.-based study, direct discharge to home with home care was the optimal strategy for patients after total joint replacement surgery who were healthy and had social support. For sicker patients, availability of 24-hour medical and nursing care may be needed, but intensive therapy services did not seem to provide additional improvement in functional recovery in these patients. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Utilization of Evidence-Based Secondary Prevention Medications at the Time of Discharge in Patients with Acute Coronary Syndrome (ACS) in Qatar.

    Science.gov (United States)

    El-Hajj, Maguy S; Saad, Ahned; Al-Suwaidi, Jassim; Al-Marridi, Wafa Z; Elkhalifa, Dana H; Mohamed, Alaa A; Mahfoud, Ziyad R

    2016-01-01

    In Qatar, ACS (Acute Coronary Syndrome) has become the leading cause of morbidity and mortality. Guidelines recommend that ACS patients should receive indefinite treatment with antiplatelets, β-blockers, angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and statins. The study objectives were to assess the use of evidence-based secondary prevention medication at discharge among ACS patients in Qatar and to determine the clinical and demographic characteristics associated with the use of these medications. A retrospective medical record review was conducted at the Heart Hospital in Qatar. A random sample of 1068 ACS patients was selected. Patient characteristics were summarized. Prevalence of medications at discharge were computed for each medication as well as for medication combinations. Multiple logistic regression was used to detect patient variables that were associated with the outcomes. A p≤0.05 was considered significant. -Percentage of ACS patients discharged on each of the following medications: antiplatelets (aspirin, clopidogrel), β-blockers, ACEI or ARBs and statins and on the combination of these medications-Association between the use of these medications and patient characteristics. In total, 1064 records were reviewed. The majority were males (85.3%) and about 1 in 5 (18.7%) were Qatari. At discharge, patients were prescribed the following: aspirin (96.0%), clopidogrel (92.0%), β-blockers (90.6%) and statins (97.7%). ACEI and ARBs were prescribed to 63.5 and 11.3%, respectively. The concurrent 4 medications (aspirin or clopidogrel, statins or other lowering cholesterol medication, β-blockers and ACEI or ARB) were prescribed to 773 patients (77.8%; 95% confidence interval: 75.2-80.4%). Being overweight or obese, and having PCI (percutaneous coronary intervention) or hypertension were associated with higher prescription of the concurrent medications. Those with diabetes had a 52% increase in the odds of

  2. Predictors associated with unplanned hospital readmission of medical and surgical intensive care unit survivors within 30 days of discharge.

    Science.gov (United States)

    Ohnuma, Tetsu; Shinjo, Daisuke; Brookhart, Alan M; Fushimi, Kiyohide

    2018-01-01

    Reducing the 30-day unplanned hospital readmission rate is a goal for physicians and policymakers in order to improve quality of care. However, data on the readmission rate of critically ill patients in Japan and knowledge of the predictors associated with readmission are lacking. We investigated predictors associated with 30-day rehospitalization for medical and surgical adult patients separately. Patient data from 502 acute care hospitals with intensive care unit (ICU) facilities in Japan were retrospectively extracted from the Japanese Diagnosis Procedure Combination (DPC) database between April 2012 and February 2014. Factors associated with unplanned hospital readmission within 30 days of hospital discharge among medical and surgical ICU survivors were identified using multivariable logistic regression analysis. Of 486,651 ICU survivors, we identified 5583 unplanned hospital readmissions within 30 days of discharge following 147,423 medical hospitalizations (3.8% readmitted) and 11,142 unplanned readmissions after 339,228 surgical hospitalizations (3.3% readmitted). The majority of unplanned hospital readmissions, 60.9% of medical and 63.1% of surgical case readmissions, occurred within 15 days of discharge. For both medical and surgical patients, the Charlson comorbidity index score; category of primary diagnosis during the index admission (respiratory, gastrointestinal, and metabolic and renal); hospital length of stay; discharge to skilled nursing facilities; and having received a packed red blood cell transfusion, low-dose steroids, or renal replacement therapy were significantly associated with higher unplanned hospital readmission rates. From patient data extracted from a large Japanese national database, the 30-day unplanned hospital readmission rate after ICU stay was 3.4%. Further studies are required to improve readmission prediction models and to develop targeted interventions for high-risk patients.

  3. Pancreatitis - discharge

    Science.gov (United States)

    Chronic pancreatitis - discharge; Pancreatitis - chronic - discharge; Pancreatic insufficiency - discharge; Acute pancreatitis - discharge ... You were in the hospital because you have pancreatitis. This is a swelling of the pancreas. You ...

  4. Medication adherence and utilization in patients with schizophrenia or bipolar disorder receiving aripiprazole, quetiapine, or ziprasidone at hospital discharge: A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Berger Ariel

    2012-08-01

    Full Text Available Abstract Background Schizophrenia and bipolar disorder are chronic debilitating disorders that are often treated with second-generation antipsychotic agents, such as aripiprazole, quetiapine, and ziprasidone. While patients who are hospitalized for schizophrenia and bipolar disorder often receive these agents at discharge, comparatively little information exists on subsequent patterns of pharmacotherapy. Methods Using a database linking hospital admission records to health insurance claims, we identified all patients hospitalized for schizophrenia (ICD-9-CM diagnosis code 295.XX or bipolar disorder (296.0, 296.1, 296.4-296.89 between January 1, 2001 and September 30, 2008 who received aripiprazole, quetiapine, or ziprasidone at discharge. Patients not continuously enrolled for 6 months before and after hospitalization (“pre-admission” and “follow-up”, respectively were excluded. We examined patterns of use of these agents during follow-up, including adherence with treatment (using medication possession ratios [MPRs] and cumulative medication gaps [CMGs] and therapy switching. Analyses were undertaken separately for patients with schizophrenia and bipolar disorder, respectively. Results We identified a total of 43 patients with schizophrenia, and 84 patients with bipolar disorder. During the 6-month period following hospitalization, patients with schizophrenia received an average of 101 therapy-days with the second-generation antipsychotic agent prescribed at discharge; for patients with bipolar disorder, the corresponding value was 68 therapy-days. Mean MPR at 6 months was 55.1% for schizophrenia patients, and 37.3% for those with bipolar disorder; approximately one-quarter of patients switched to another agent over this period. Conclusions Medication compliance is poor in patients with schizophrenia or bipolar disorder who initiate treatment with aripiprazole, quetiapine, or ziprasidone at hospital discharge.

  5. Is a Widely Available Cure for Sickle Cell Disease on the Horizon? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  6. Journalist Liz Hernandez hopes to make Alzheimer’s a thing of the past | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [4.3 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  7. Finding Better and More Personalized Ways to Diagnose Cancer at NIH | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  8. From the lab - CancerSEEK: Blood Test Could Detect Cancer Earlier | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  9. From Bench to Bedside: Researchers of NIH’s Clinical Center | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [1.5 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  10. From the lab - Brain Scan Technology Extends Treatment Window for Stroke | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  11. Heart pacemaker - discharge

    Science.gov (United States)

    Cardiac pacemaker implantation - discharge; Artificial pacemaker - discharge; Permanent pacemaker - discharge; Internal pacemaker - discharge; Cardiac resynchronization therapy - discharge; CRT - discharge; ...

  12. Interdisciplinary collaboration in the provision of a pharmacist-led discharge medication reconciliation service at an Irish teaching hospital.

    LENUS (Irish Health Repository)

    Holland, Deirdre M

    2015-04-01

    Medication reconciliation is a basic principle of good medicines management. With the establishment of the National Acute Medicines Programme in Ireland, medication reconciliation has been mandated for all patients at all transitions of care. The clinical pharmacist is widely credited as the healthcare professional that plays the most critical role in the provision of medication reconciliation services.

  13. "I have nine specialists. They need to swap notes!" Australian patients' perspectives of medication-related problems following discharge from hospital.

    Science.gov (United States)

    Eassey, Daniela; McLachlan, Andrew J; Brien, Jo-Anne; Krass, Ines; Smith, Lorraine

    2017-10-01

    Research has shown that patients are most susceptible to medication-related problems (MRPs) when transitioning from hospital to home. Currently, the literature in this area focuses on interventions, which are mainly orientated around the perspective of the health-care professional and do not take into account patient perspectives and experiences. To capture the experiences and perceptions of Australian patients regarding MRPs following discharge from hospital. A cross-sectional study was conducted using a questionnaire collecting quantitative and qualitative data. Thematic analysis was conducted of the qualitative data. Survey participants were recruited through The Digital Edge, an online market research company. Five hundred and six participants completed the survey. A total of 174 participants self-reported MRPs. Two concepts and seven subthemes emerged from the analysis. The first concept was types of MRPs and patient experiences. Three themes were identified: unwanted effects from medicines, confusion about medicines and unrecognized medicines. The second concept was patient engagement in medication management, of which four themes emerged: informing patients, patient engagement, communication amongst health-care professionals and conflicting advice. This study provides an important insight into patients' experiences and perceptions of MRPs following discharge from hospital. Future direction for practice and research should look into implementing patient-centred care at the time of hospital discharge to ensure the provision of clear and consistent information, and developing ways to support and empower patients to ensure a smooth transition post-discharge from hospital. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  14. Medical Research | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... on television or read about it in the paper. Perhaps you hear that a certain drug causes a 300% increase in strokes. That's a large ... complex experiments or have more experience with the topic. Many large clinical ... there side effects? Sometimes the side effects are almost as serious ...

  15. Inadequate recording of alcohol-drinking, tobacco-smoking and discharge diagnosis in medical in-patients: failure to recognize risks including drug interactions.

    Science.gov (United States)

    Bairstow, B M; Burke, V; Beilin, L J; Deutscher, C

    1993-11-01

    The records of 62 men and 43 women, 14-88 years old, admitted to general medical wards in a public teaching hospital during 1991 were examined for discharge medications and for the recording of alcohol-drinking, tobacco-smoking and discharge diagnosis. Drinking and smoking status was unrecorded in 22.9% and 21.9% of patients respectively. Twenty-four patients had 31 potential drug interactions which were related to the number of drugs prescribed and to drinking alcohol; 10.5% of the patients had interactions involving alcohol and 2.9% tobacco. Six patients received relatively or absolutely contraindicated drugs, including one asthmatic given two beta-blockers. The drugs prescribed indicated that some patients had conditions such as gastro-oesophageal disorders, diabetes and obstructive airways disease which had not been recorded. Inadequate recording of diagnoses, alcohol and smoking status creates risks to patients and may cause opportunities for preventive care to be missed. This study provides the basis for the development of undergraduate and postgraduate education programmes to address these issues and so decrease risks to patients which arise from inadequate recording practices. Incomplete diagnoses also adversely affect hospital funding where this depends on case-mix diagnostic groups. Quality assurance programmes and other strategies are being implemented to improve medical recording and prescribing habits.

  16. Nipple Discharge

    Science.gov (United States)

    ... any unexpected nipple discharge evaluated by a doctor. Nipple discharge in men under any circumstances could be a problem and needs further evaluation. One or both breasts may produce a nipple discharge, either spontaneously or when you squeeze your ...

  17. Effects of electronic communication between the GP and the pharmacist. The quality of medication data on admission and after discharge

    NARCIS (Netherlands)

    van der Kam, WJ; Meyboom-de Jong, B; Tromp, T; Moorman, PW; van der Lei, J

    2001-01-01

    Background. When a patient is admitted to a hospital, the need for information about the medications prescribed is an important issue. Objectives. Our aim was to assess whether electronic communication between the GP and the pharmacist provides better information regarding current medication when a

  18. Parkinson's Disease Research at NIH | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Parkinson's Disease Parkinson's Disease Research at NIH Past Issues / Winter 2014 ... areas of its research: MedlinePlus . medlineplus.gov . Type "Parkinson's disease" in the Search box. NIHSeniorHealth —Parkinson's Disease ...

  19. Angioplasty: MedlinePlus Health Topic

    Science.gov (United States)

    ... segment (Medical Encyclopedia) Also in Spanish Directional coronary atherectomy (DCA) (Medical Encyclopedia) Also in Spanish Percutaneous transluminal ... segment Coronary artery balloon angioplasty - slideshow Directional coronary atherectomy ... transluminal coronary angioplasty (PTCA) Stent Related ...

  20. Impact of pharmacists assisting with prescribing and undertaking medication review on oxycodone prescribing and supply for patients discharged from surgical wards.

    Science.gov (United States)

    Tran, T; Taylor, S E; Hardidge, A; Findakly, D; Aminian, P; Elliott, R A

    2017-10-01

    Overprescribing of oxycodone is a contributor to the epidemic of prescription opioid misuse and deaths. Practice models to optimize oxycodone prescribing and supply need to be evaluated. We explored the impact of pharmacist-assisted discharge prescribing and medication review on oxycodone prescribing and supply for patients discharged from surgical wards. A retrospective audit was conducted on two surgical inpatient wards following a 16-week prospective pre- and post-intervention study. During the pre-intervention period, discharge prescriptions were prepared by hospital doctors and then reviewed by a ward pharmacist (WP) before being dispensed. Post-intervention, prescriptions were prepared by a project pharmacist in consultation with hospital doctors and then reviewed by a WP and dispensed. Proportion of patients who were prescribed, and proportion supplied, oxycodone on discharge; Median amount (milligrams) of oxycodone prescribed and supplied, for patients who were prescribed and supplied at least one oxycodone-containing preparation, respectively. A total of 320 and 341 patients were evaluated pre- and post-intervention, respectively. Pre-intervention, 75.6% of patients were prescribed oxycodone; after WP review, 60.3% were supplied oxycodone (Psupplied was 100 milligrams/patient. Post-intervention, 68.6% of patients were prescribed oxycodone; after WP review, 57.8% were supplied oxycodone (Psupplied was 50 milligrams/patient (difference in amount prescribed and supplied: 50 milligrams, Psupplied oxycodone but not the amount supplied/patient. Having a pharmacist assist with prescribing reduced the amount of oxycodone supplied. © 2017 John Wiley & Sons Ltd.

  1. Medical and Non-Medical Predictors of Disability Discharge Disposition for Navy Personnel with a Back Problem: A Focus on Entitlement

    Science.gov (United States)

    1988-03-28

    Washington D.C. 20350-1000. Stryker, S., & Gottlieb, A. (1981). Attribution theory and symbolic interactionism : A comparison. In J.H. Howes, W...ERFORMIING ORGANIZATION 6b OFFiCE SYMBOL 7a NAME OF MONITORING ORGANIZATION (If applicable) Naval Health Research Center 40 Commander, Naval Medical Command...Washington, DC 20372 ea NAME OF FUNDING/SPONSORING Bb OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION Naval Medical (If applicable

  2. Management of Discharge of Low Level Liquid Radioactive Waste Generated in Medical, Educational, Research and Industrial Facilities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-07-15

    Although published information on management technologies suitable for radioactive effluents is readily available, smaller facilities such as hospitals, universities and research laboratories in some countries can benefit from more detailed guidance on identifying optimal arrangements for effectively managing their radioactive liquid effluents. A wide range of circumstances exist globally, given that the generation of radioactive liquid effluents may be regular or irregular, and the liquid effluents may be suitable for direct discharge to the environment, or may require a period of decay storage prior to discharge. Countries typically fit into one of the four following categories with respect to the status of their arrangements for the management of radioactive liquid effluents: (1) The country does not have sufficient technical, regulatory and organizational infrastructure to effectively manage its radioactive liquid effluents; (2) The country's technical infrastructure for effectively managing its radioactive liquid effluents is almost sufficient, but it is not supported by an acceptable level of regulatory and organizational capacity (e.g. legal infrastructure, administrative infrastructure); (3) The country has sufficient technical, regulatory and organizational capacity, but it is known that the application of the requirements for proper management of radioactive liquid effluents is, in many cases, not being carried out to the standard indicated by official reports; (4) The country has well developed and established regulatory and organizational capacity, which is complemented by an acceptable level of relevant technical infrastructure such that the radioactive liquid effluents can be properly managed. Facilities, as well as countries, in the first three categories will find information in this publication to assist their further development. Even countries that already have the necessary infrastructure to properly manage their liquid radioactive effluents may

  3. Management of Discharge of Low Level Liquid Radioactive Waste Generated in Medical, Educational, Research and Industrial Facilities

    International Nuclear Information System (INIS)

    2013-07-01

    Although published information on management technologies suitable for radioactive effluents is readily available, smaller facilities such as hospitals, universities and research laboratories in some countries can benefit from more detailed guidance on identifying optimal arrangements for effectively managing their radioactive liquid effluents. A wide range of circumstances exist globally, given that the generation of radioactive liquid effluents may be regular or irregular, and the liquid effluents may be suitable for direct discharge to the environment, or may require a period of decay storage prior to discharge. Countries typically fit into one of the four following categories with respect to the status of their arrangements for the management of radioactive liquid effluents: (1) The country does not have sufficient technical, regulatory and organizational infrastructure to effectively manage its radioactive liquid effluents; (2) The country's technical infrastructure for effectively managing its radioactive liquid effluents is almost sufficient, but it is not supported by an acceptable level of regulatory and organizational capacity (e.g. legal infrastructure, administrative infrastructure); (3) The country has sufficient technical, regulatory and organizational capacity, but it is known that the application of the requirements for proper management of radioactive liquid effluents is, in many cases, not being carried out to the standard indicated by official reports; (4) The country has well developed and established regulatory and organizational capacity, which is complemented by an acceptable level of relevant technical infrastructure such that the radioactive liquid effluents can be properly managed. Facilities, as well as countries, in the first three categories will find information in this publication to assist their further development. Even countries that already have the necessary infrastructure to properly manage their liquid radioactive effluents may

  4. Libraries in New Jersey: MedlinePlus

    Science.gov (United States)

    ... deborah.org/ Camden Cooper University Hospital Cooper Medical School of Rowan University Library 1 Cooper Plaza Camden, NJ 08103 856-342- ... 8285 http://www.valleyhealth.com Stratford Rowan University School of Osteopathic Medicine ... Library 1 Medical Center Drive Stratford, NJ 08084-1504 ...

  5. Shoulder replacement - discharge

    Science.gov (United States)

    Total shoulder arthroplasty - discharge; Endoprosthetic shoulder replacement - discharge; Partial shoulder replacement - discharge; Partial shoulder arthroplasty - discharge; Replacement - shoulder - discharge; Arthroplasty - shoulder - discharge

  6. Risk-adjustment models for heart failure patients' 30-day mortality and readmission rates: the incremental value of clinical data abstracted from medical charts beyond hospital discharge record.

    Science.gov (United States)

    Lenzi, Jacopo; Avaldi, Vera Maria; Hernandez-Boussard, Tina; Descovich, Carlo; Castaldini, Ilaria; Urbinati, Stefano; Di Pasquale, Giuseppe; Rucci, Paola; Fantini, Maria Pia

    2016-09-06

    Hospital discharge records (HDRs) are routinely used to assess outcomes of care and to compare hospital performance for heart failure. The advantages of using clinical data from medical charts to improve risk-adjustment models remain controversial. The aim of the present study was to evaluate the additional contribution of clinical variables to HDR-based 30-day mortality and readmission models in patients with heart failure. This retrospective observational study included all patients residing in the Local Healthcare Authority of Bologna (about 1 million inhabitants) who were discharged in 2012 from one of three hospitals in the area with a diagnosis of heart failure. For each study outcome, we compared the discrimination of the two risk-adjustment models (i.e., HDR-only model and HDR-clinical model) through the area under the ROC curve (AUC). A total of 1145 and 1025 patients were included in the mortality and readmission analyses, respectively. Adding clinical data significantly improved the discrimination of the mortality model (AUC = 0.84 vs. 0.73, p < 0.001), but not the discrimination of the readmission model (AUC = 0.65 vs. 0.63, p = 0.08). We identified clinical variables that significantly improved the discrimination of the HDR-only model for 30-day mortality following heart failure. By contrast, clinical variables made little contribution to the discrimination of the HDR-only model for 30-day readmission.

  7. Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Kjær, Stine; Hansen, Birthe Stenbæk

    2013-01-01

    Objective:To assess the additional benefits of individualized nutritional counselling by a registered dietitian in geriatric patients' home after discharge from hospital, in relation to risk of re-admissions, functional status, nutritional status, use of social services and mortality.Design:Twelv......Objective:To assess the additional benefits of individualized nutritional counselling by a registered dietitian in geriatric patients' home after discharge from hospital, in relation to risk of re-admissions, functional status, nutritional status, use of social services and mortality.......Design:Twelve-week single-blind randomized controlled study.Setting and subjects:Geriatric medical patients (65+ years) at nutritional risk.Interventions:Participants were randomly allocated to receive a visit in their homes, either three individualized nutritional counselling by a registered dietitian complemented......, rehabilitation capacity), nutritional status (weight, BMI, energy and protein intake), need of social services (home care, home nursing, meals-on-wheels) and mortality.Results:One hundred and fifty-two patients were included; 132 (87%) completed the first and 124 (82%) the second data collection after 12 weeks...

  8. Erectile Dysfunction: MedlinePlus Health Topic

    Science.gov (United States)

    ... Men's Health (Hormone Health Network) Also in Spanish Sex and the Man With Cancer (American Cancer Society) Also in Spanish Specifics Bent Penis (Mayo Foundation for Medical Education and Research) Videos and Tutorials Simultaneous Inflatable Penile Prosthesis (IPP) and ...

  9. Health Screening: MedlinePlus Health Topic

    Science.gov (United States)

    ... I Have an Eye Exam? (Prevent Blindness America) Lipid Panel (American Association for Clinical Chemistry) Lung Cancer Screening (Mayo Foundation for Medical Education and Research) Also in Spanish Skin Cancer Screening (National Cancer ...

  10. Urinary Incontinence: MedlinePlus Health Topic

    Science.gov (United States)

    ... your doctor, or surgery. NIH: National Institute of Diabetes and Digestive and Kidney Diseases Start Here Urinary Incontinence (Mayo Foundation for Medical Education and Research) Urinary Tract Health (National Institute of Child Health and Human Development) ...

  11. [Team Collaboration in Home Medical Care to Support Patients at the End-of-Life - Review of Service Personnel Meeting on Discharge Day].

    Science.gov (United States)

    Ogiwara, Miyoko; Irino, Hiromi; Yamaoka, Keita; Fujimaki, Yoko; Watanabe, Mutsuko; Yamamoto, Takeshi; Hirohara, Masayoshi; Kushida, Kazuki

    2018-03-01

    Due to the rising number of patients at the terminal stage or with high dependence on medical care, the cooperation of 2 teams, the hospital discharge support team and the home support team, has become very important. The recent spread of the Internet has enabled both patients and their families who have chosen home care to obtain a wide range of information about home services, as well as diseases, and form a picture of what will happen. However, there are actually many cases in which patients and families find that things are not as they imagined, and they are uneasy and unsure of what to do. Here, we report a case in which the mismatch between the patient's and family's expectations created an unsatisfactory care situation.

  12. Agreement between hospital discharge diagnosis codes and medical records to identify metastatic colorectal cancer and associated comorbidities in elderly patients.

    Science.gov (United States)

    Gouverneur, A; Dolatkhani, D; Rouyer, M; Grelaud, A; Francis, F; Gilleron, V; Fourrier-Réglat, A; Noize, P

    2017-08-01

    Quality of coding to identify cancers and comorbidities through the French hospital diagnosis database (Programme de médicalisation des systèmes d'information, PMSI) has been little investigated. Agreement between medical records and PMSI database was evaluated regarding metastatic colorectal cancer (mCRC) and comorbidities. From 01/01/2013 to 06/30/2014, 74 patients aged≥65years at mCRC diagnosis were identified in Bordeaux teaching hospital. Data on mCRC and comorbidities were collected from medical records. All diagnosis codes (main, related and associated) registered into the PMSI were extracted. Agreement between sources was evaluated using the percent agreement for mCRC and the kappa (κ) statistic for comorbidities. Agreement for primary CRC and mCRC was higher using all types of diagnosis codes instead of the main one exclusively (respectively 95% vs. 53% for primary CRC and 91% vs. 24% for mCRC). Agreement was substantial (κ 0.65) for cardiovascular diseases, notably atrial fibrillation (κ 0.77) and hypertension (κ 0.68). It was moderate for psychiatric disorders (κ 0.49) and respiratory diseases (κ 0.48), although chronic obstructive pulmonary disease had a good agreement (κ 0.75). Within the class of endocrine, nutritional and metabolic diseases (κ 0.55), agreement was substantial for diabetes (κ 0.91), obesity (κ 0.82) and hypothyroidism (κ 0.72) and moderate for hypercholesterolemia (κ 0.51) and malnutrition (κ 0.42). These results are reassuring with regard to detection through PMSI of mCRC if all types of diagnosis codes are considered and useful to better choose comorbidities in elderly mCRC patients that could be well identified through hospital diagnosis codes. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. Weight Control: MedlinePlus Health Topic

    Science.gov (United States)

    ... loss medications Show More Show Less Related Health Topics Body Weight Diets Eating Disorders Exercise and Physical Fitness Nutrition Obesity Weight Loss Surgery National Institutes of Health The primary NIH organization for research on Weight Control is the National Institute of ...

  14. Red Blood Cell Antibody Screen: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... medlineplus.gov/labtests/redbloodcellantibodyscreen.html Red Blood Cell Antibody Screen To use the sharing features on this page, please enable JavaScript. What is an RBC Antibody Screen? An RBC (red blood cell) antibody screen ...

  15. The Match of Her Life | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... answer questions for this issue of NIH MedlinePlus magazine about her breast cancer. You discovered you had ... way of healing. As this issue of the magazine went to press, Navratilova was receiving radiation therapy ...

  16. Respiratory Syncytial Virus (RSV) Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/respiratorysyncytialvirusrsvtest.html Respiratory Syncytial Virus (RSV) Test To use the sharing ... is an RSV test? RSV , which stands for respiratory syncytial virus, is an infection that affects the ...

  17. Prostate-Specific Antigen (PSA) Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... medlineplus.gov/labtests/prostatespecificantigenpsatest.html Prostate-Specific Antigen (PSA) Test To use the sharing features on this ... enable JavaScript. What is a prostate-specific antigen (PSA) test? A prostate-specific antigen (PSA) test measures ...

  18. To Your Health: NLM update transcript - NIH MedlinePlus magazine Winter 2018

    Science.gov (United States)

    ... who is a star of 'The Big Bang Theory' television show, and the producer/narrator of a ... trials, NIH MedlinePlus magazine reports the current life expectancy of a person with sickle cell disease is ...

  19. NIH Launches National COPD Action Plan | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... COPD Action Plan Follow us NIH Launches National COPD Action Plan Photo: National Heart, Lung, and Blood ... questions for NIH MedlinePlus magazine. Why was the COPD National Action Plan created? The staggering numbers associated ...

  20. From the lab - Eyes May be ‘Windows to the Brain’ in Stroke Patients | NIH MedlinePlus the Magazine

    Science.gov (United States)

    Skip to main content NIH MedlinePlus the Magazine NIH MedlinePlus Salud Download the Current Issue PDF [3.1 mb] Trusted Health Information from the National Institutes of Health Home Current Issue ...

  1. NIPPLE DISCHARGE

    Directory of Open Access Journals (Sweden)

    T. N. Bukharova

    2008-01-01

    Full Text Available According to the data available in the literature, as high as 50% of women have benign breast tumors frequently accompanied by nip- ple discharge. Nipple discharge may be serous, bloody, purulent, and colostric. The most common causes are breast abscess, injury, drugs, prolactinoma, intraductal pappiloma, ductal ectasia, intraductal cancer (not more than 10%.

  2. Heart valve surgery - discharge

    Science.gov (United States)

    ... ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College ... Editorial team. Related MedlinePlus Health Topics Heart Surgery Heart Valve Diseases Browse the Encyclopedia A.D.A.M., Inc. ...

  3. Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: A targeted needs assessment using the Intervention Mapping framework.

    Science.gov (United States)

    Kerstenetzky, Luiza; Birschbach, Matthew J; Beach, Katherine F; Hager, David R; Kennelty, Korey A

    2018-02-01

    Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy. We report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to SNF and LTC pharmacy staff. Applying the Intervention Mapping (IM) framework, a targeted needs assessment was performed using quantitative and qualitative methods. Using the hospital discharge medication list as reference, medication discrepancies in the SNF and LTC pharmacy lists were identified. SNF and LTC pharmacy staffs were also interviewed regarding the continuity of medication information post-discharge from the hospital. At least one medication discrepancy was discovered in 77.6% (n = 45/58) of SNF and 76.0% (n = 19/25) of LTC pharmacy medication lists. A total of 191 medication discrepancies were identified across all SNF and LTC pharmacy records. Of the 69 SNF staff interviewed, 20.3% (n = 14) reported patient care delays due to omitted documents during the hospital-to-SNF transition. During interviews, communication between the SNF/LTC pharmacy and the discharging hospital was described by facility staff as unidirectional with little opportunity for feedback on patient care concerns. The targeted needs assessment guided by the IM framework has lent to several planned process improvements initiatives to help reduce medication discrepancies during the hospital-to-SNF transition as well as improve communication between healthcare entities. Opening lines of

  4. Ileostomy - discharge

    Science.gov (United States)

    ... dried fruits (such as raisins), mushrooms, chunky relishes, coconut, and some Chinese vegetables. Tips for when no ... ask your doctor Living with your ileostomy Low-fiber diet Small bowel resection - discharge Total colectomy or ...

  5. Urinary incontinence surgery - female - discharge

    Science.gov (United States)

    ... activities, such as golfing, playing tennis, bowling, running, biking, weight lifting, gardening or mowing, and vacuuming for ... A.D.A.M. Editorial team. Related MedlinePlus Health Topics Urinary Incontinence Browse the Encyclopedia A.D. ...

  6. [GP medication prioritisation in older patients with multiple comorbidities recently discharged from hospital: a case-based bottom-up approach].

    Science.gov (United States)

    Herrmann, M L H; von Waldegg, G H; Kip, M; Lehmann, B; Andrusch, S; Straub, H; Robra, B-P

    2015-01-01

    After the hospital discharge of older patients with multiple morbidities, GPs are often faced with the task of prioritising the patients' drug regimens so as to reduce the risk of overmedication. How do GPs prioritise such medications in multimorbid elderly patients at the transition between inpatient and home care? The experience by the GPs is documented in typical case vignettes. 44 GPs in Sachsen-Anhalt were recruited--they were engaged in focus group discussions and interviewed using semi-standardised questionnaires. Typical case vignettes were developed, relevant to the everyday care that elderly patients would typically receive from their GPs with respect to their drug optimisation. According to the results of the focus groups, the following issues affect GPs' decisions: drug and patient safety, their own competence in the health system, patient health literacy, evidence base, communication between secondary and primary care (and their respective influences on each other). When considering individual cases, patient safety, patient wishes, and quality of life were central. This is demonstrated by the drug dispositions of one exemplary case vignette. GPs do prioritise drug regimens with rational criteria. Initial problem delineation, process documentation and the design of a transferable product are interlinking steps in the development of case vignettes. Care issues of drug therapy in elderly patients with multiple morbidities should be investigated further with larger representative samples in order to clarify whether the criteria used here are applied contextually or consistently. Embedding case vignettes into further education concepts is also likely to be useful. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Extended thromboprophylaxis with low-molecular-weight heparins after hospital discharge in high-risk surgical and medical patients: a review.

    Science.gov (United States)

    Huo, Michael H; Muntz, James

    2009-06-01

    Prophylaxis against venous thromboembolism (VTE) is routinely administered during the hospital stay in at-risk surgical and medical patients. However, in high-risk groups, the risk of deep-vein thrombosis or pulmonary embolism may persist for several weeks after discharge. The standard duration of thromboprophylaxis (6-14 days) may not provide adequate protection against such events. This article reviews published data on the efficacy and safety profile of extended-duration thromboprophylaxis in patients at high risk for VTE, the potential cost-effectiveness of such treatment, and practical aspects of ensuring an effective transition from the inpatient to the outpatient setting. MEDLINE and the Cochrane Database of Systematic Reviews were searched through January 2009 for relevant English-language reports of clinical trials, abstracts, and case reports. The search terms included, but were not limited to, venous thromboembolism, pulmonary embolism, anticoagulation, thromboprophylaxis, prolonged duration, and extended duration. The reference lists of the identified articles were reviewed for additional relevant publications. Congress Web sites were also consulted. The principal criteria for inclusion of a study were that it have a prospective, randomized design and include a control group. Case series and retrospective analyses were excluded. Studies have found that extended-duration thromboprophylaxis (28-45 days) with low-molecular-weight heparins (LMWHs) can reduce the risk of VTE in high-risk patients. In separate meta-analyses, extended-duration thromboprophylaxis with LMWH was associated with significant reductions in the likelihood of symptomatic VTE compared with standard-duration thromboprophylaxis in patients undergoing major orthopedic surgery (odds ratio [OR] = 0.38; 95% CI, 0.24-0.61) or major abdominal or pelvic surgery (Peto OR = 0.22; 95% CI, 0.06-0.80). There was large heterogeneity in the reported rates of major and minor bleeding. The occurrence of

  8. The MedlinePlus public user interface: studies of design challenges and opportunities

    Science.gov (United States)

    Marill, Jennifer L.; Miller, Naomi; Kitendaugh, Paula

    2006-01-01

    Question: What are the challenges involved in designing, modifying, and improving a major health information portal that serves over sixty million page views a month? Setting: MedlinePlus, the National Library of Medicine's (NLM's) consumer health Website, is examined. Method: Challenges are presented as six “studies,” which describe selected design issues and how NLM staff resolved them. Main Result: Improving MedlinePlus is an iterative process. Changes in the public user interface are ongoing, reflecting Web design trends, usability testing recommendations, user survey results, new technical requirements, and the need to grow the site in an orderly way. Conclusion: Testing and analysis should accompany Website design modifications. New technologies may enhance a site but also introduce problems. Further modifications to MedlinePlus will be informed by the experiences described here. PMID:16404467

  9. Discharge Dialogue

    DEFF Research Database (Denmark)

    Horsbøl, Anders

    2012-01-01

    For several years, efforts have been made to strengthen collaboration between health professionals with different specializations and to improve patient transition from hospital to home (care). In the Danish health care system, these efforts have concentrated on cancer and heart diseases, whereas...... coordinator, employed at the hospital, is supposed to anticipate discharge and serve as mediator between the hospital and the municipal home care system. Drawing on methods from discourse and interaction analysis, the paper studies the practice of the discharge coordinator in two encounters between patients...... how the home context provides different resources for identification of patient needs and mutual decision making....

  10. The Relaxation Exercise and Social Support Trial (RESST: a community-based randomized controlled trial to alleviate medically unexplained vaginal discharge symptoms

    Directory of Open Access Journals (Sweden)

    Kobeissi Loulou

    2012-11-01

    Full Text Available Abstract Background Symptoms such as medically unexplained vaginal discharge (MUVD are common and bothersome, leading to potentially unnecessary use of resources. Methods A community-based individually randomized controlled trial to assess the effectiveness of a relatively simple, culturally appropriate multi-component intervention on reducing reported MUVD, among women suffering from low-moderate levels of common mental distress. The setting was a socio-economically deprived, informal settlement in the southern suburbs of Beirut, Lebanon. The intervention comprised up to 12 group sessions implemented over a six-week period, each divided into a psychosocial and a relaxation exercise component. The primary outcome was self-reported MUVD, which was defined as a complaint of vaginal discharge upon ruling out reproductive tract infections (RTIs, through lab analysis. Anxiety and/or depression symptoms were the secondary outcomes for this trial. These were assessed using an Arabic validated version of the Hopkins Symptoms Checklist-25 (HSCL-25. Assessments were done at baseline and six months using face-to face interviews, pelvic examinations and laboratory tests. Women were randomized into either intervention or control group. Blinding on the intervention status was not possible for both logistic and ethical reasons, especially as knowledge of involvement in the intervention was integral to its delivery. Intent to treat analysis was used. Results Of 75 women randomized to the intervention, 48% reported MUVD at 6 months compared with 63% of 73 in the control group (difference of -15%, 95% confidence interval (CI -31%, 0%, p=0.067. Adjustments for baseline imbalances and any factors relating to consent had no appreciable effect on these results. The risk of MUVD was reduced in absolute terms by 2.4% for each intervention session attended (95% CI -4.9%, 0.0%, p=0.049. While there was also marginal evidence of a beneficial effect on anxiety, there was

  11. Angioplasty and stent - heart - discharge

    Science.gov (United States)

    Drug-eluting stents - discharge; PCI - discharge; Percutaneous coronary intervention - discharge; Balloon angioplasty - discharge; Coronary angioplasty - discharge; Coronary artery angioplasty - discharge; Cardiac ...

  12. Radiological discharges

    International Nuclear Information System (INIS)

    Woodliffe, J.

    1990-01-01

    Current practice of North Sea States on the discharge and disposal of liquid radioactive wastes to the North Sea are based on the declaration issued at the Second International Conference on the Protection of the North Sea, known as the London Declaration. This has three main points the first of which emphasises the application of the Best Available Technology to protect the North Sea, the second provides a framework on which future controls on radioactive discharges should be based. The third identifies two parts of the framework; to take into account the recommendations of international organizations and that any repositories of radioactive waste which are built should not pollute the North Sea. This chapter looks at how the concensus based on the London Declaration is working, gauges the progress made in the implementation of the policy goal, identifies existing and future areas for concern and proposes ways of strengthening the control of radioactive discharges. The emphasis is on the United Kingdom practice and regulations for liquid wastes, most of which comes from the Sellafield Reprocessing Plant. (author)

  13. Married...with Food Allergies | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... this page please turn Javascript on. Feature: Food Allergies Married...with Food Allergies Past Issues / Spring 2011 Table of Contents Photo: ... life together and a common problem—severe food allergies. NIH MedlinePlus magazine’s Naomi Miller caught up with ...

  14. Alpha-fetoprotein (AFP) Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/alphafetoproteinafptest.html Alpha-fetoprotein (AFP) Test To use the sharing features on this page, please enable JavaScript. What is an Alpha-fetoprotein (AFP) Test? Alpha-fetoprotein (AFP) is a protein ...

  15. Hemoglobin A1c (HbA1c) Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... page: https://medlineplus.gov/labtests/hemoglobina1chba1ctest.html Hemoglobin A1c (HbA1c) Test To use the sharing features on this page, please enable JavaScript. What is a hemoglobin A1c (HbA1c) test? A hemoglobin A1c (HbA1c) test measures ...

  16. High school peer tutors teach MedlinePlus: a model for Hispanic outreach*

    Science.gov (United States)

    Warner, Debra G.; Olney, Cynthia A.; Wood, Fred B.; Hansen, Lucille; Bowden, Virginia M.

    2005-01-01

    Objectives: The objective was to introduce the MedlinePlus Website to the predominantly Hispanic residents of the Lower Rio Grande Valley region of Texas by partnering with a health professions magnet high school (known as Med High). Methods: Community assessment was used in the planning stages and included pre-project focus groups with students and teachers. Outreach methods included peer tutor selection, train-the-trainer sessions, school and community outreach, and pre- and posttests of MedlinePlus training sessions. Evaluation methods included Web statistics; end-of-project interviews; focus groups with students, faculty, and librarians; and end-of-project surveys of students and faculty. Results: Four peer tutors reached more than 2,000 people during the project year. Students and faculty found MedlinePlus to be a useful resource. Faculty and librarians developed new or revised teaching methods incorporating MedlinePlus. The project enhanced the role of school librarians as agents of change at Med High. The project continues on a self-sustaining basis. Conclusions: Using peer tutors is an effective way to educate high school students about health information resources and, through the students, to reach families and community members. PMID:15858628

  17. Carbon Dioxide (CO2) in Blood: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/carbondioxideco2inblood.html Carbon Dioxide (CO2) in Blood To use the sharing features ... this page, please enable JavaScript. What is a Carbon Dioxide (CO2) Blood Test? Carbon dioxide (CO2) is an ...

  18. Welcome from Library Director Donald A.B. Lindberg, M.D. | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... turn Javascript on. Welcome to the NIH MedlinePlus Magazine. Past Issues / Spring 2013 Table of Contents Donald ... about their efforts to cure disease. Lastly, the magazine's lively graphics, fun quizzes and practical tips have ...

  19. National Library of Medicine Celebrates 30 Years of Progress and Charts the Future | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... described the genesis of the National Center for Biotechnology Information (NCBI); the Visible Human Project (a digital ... expand the publication and distribution of NIH MedlinePlus magazine, thousands and thousands more people will gain valuable, ...

  20. Hysterectomy - vaginal - discharge

    Science.gov (United States)

    Vaginal hysterectomy - discharge; Laparoscopically assisted vaginal hysterectomy - discharge; LAVH - discharge ... you were in the hospital, you had a vaginal hysterectomy. Your surgeon made a cut in your ...

  1. Lung surgery - discharge

    Science.gov (United States)

    ... Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... milk) for 2 weeks after video-assisted thoracoscopic surgery and 6 to 8 weeks after open surgery. ...

  2. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  3. Yeast Infection Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... cheese-like discharge Painful urination Redness in the vagina Yeast infection of the penis may cause: Redness Scaling Rash ... on the location of your symptoms: If a vaginal yeast infection is suspected , your health care provider will perform ...

  4. Recurrent vaginal discharge in children.

    Science.gov (United States)

    McGreal, Sharon; Wood, Paul

    2013-08-01

    Childhood vaginal discharge remains a frequent reason for referral from primary to secondary care. The Pediatric and Adolescent Gynecology (PAG) service at Kettering General Hospital was established in 1993 and provides a specialized service that meets the needs of children with gynaecological conditions. To investigate recurrent vaginal discharge noting symptomatology, defining pathogens, common and rarer causes, exploring management regimes, and any changes in practice over time. Retrospective review spanning 15 years identifying prepubertal children attending the outpatient PAG clinic with recurrent vaginal discharge. We reviewed the medical notes individually. 110 patients were identified; 85% were referred from primary care. The age distribution was bimodal at four and eight years. Thirty-five percent of our patients were discharged after the initial consultation. The commonest cause of discharge was vulvovaginitis (82%). Other important causes included suspected sexual abuse (5%), foreign body (3%), labial adhesions (3%), vaginal agenesis (2%). 35% of patients were admitted for vaginoscopy. Vaginal discharge is the most common gynecological symptom in prepubertal girls and can cause repeated clinical episodes. Vulvovaginitis is the most common cause and often responds to simple hygiene measures. Awareness of the less common causes of vaginal discharge is essential. Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  5. Potentiality Studies of Stainless Steel 304 Material for Production of Medical Equipment using Micro Electrical Discharge Machining (micro-EDM) Analysis and Modeling

    DEFF Research Database (Denmark)

    Puthumana, Govindan

    2016-01-01

    Stainless steel 304 (SS304) is a material widely used for production of medical equipment mainly because of its anti-corrosive properties. It has excellent mechanical properties, strength and reliability because of which it is one of the best materials for fabrication of medical devices. This paper...... and process parameters were developed. Grey relational analysis was used to optimize the micro-EDM quality characteristics, and the highest grey relational grade (GRG) of 0.8021 was obtained at a voltage of 100 V and a capacitance of 0.4 μF....

  6. Tennis elbow surgery - discharge

    Science.gov (United States)

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  7. Ankle replacement - discharge

    Science.gov (United States)

    ... total - discharge; Total ankle arthroplasty - discharge; Endoprosthetic ankle replacement - discharge; Osteoarthritis - ankle ... You had an ankle replacement. Your surgeon removed and reshaped ... an artificial ankle joint. You received pain medicine and were ...

  8. Hip fracture - discharge

    Science.gov (United States)

    ... neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge ... in the hospital for surgery to repair a hip fracture, a break in the upper part of ...

  9. Asthma - child - discharge

    Science.gov (United States)

    Pediatric asthma - discharge; Wheezing - discharge; Reactive airway disease - discharge ... Your child has asthma , which causes the airways of the lungs to swell and narrow. In the hospital, the doctors and nurses helped ...

  10. The effect of an interactive follow-up program on ostomy adjustment of inpatients after their discharge from surgical wards of the hospitals affiliated to Isfahan University of Medical Sciences.

    Science.gov (United States)

    Hamidi, Yaser; Moeini, Mahin; Yousefi, Hojatollah

    2018-04-07

    Ostomy patients suffer from many physical and mental problems, which can be solved to a large extent with the help of education and follow-up programs. These follow-ups can be done in person or on the telephone by the nurses, or even, by sending a text message that is an easier way for the patients to adapt to their condition. This study aimed to investigate the effect of an interactive follow-up program on the adjustment of ostomy inpatients after being discharged. This study is a clinical trial, conducted on 64 ostomy patients who were discharged from the surgical wards of the hospital affiliated to Isfahan University of Medical Sciences. Subjects in the experimental group participated in a 6-week follow-up program via text message. The information about the patients were collected by Olbrisch Ostomy Adjustment Scale. The obtained results have suggested that 34.4% of the patients in the experimental group and 28.1% of the patients in the control group were female. Before the intervention, comparing the mean score of ostomy adjustment and its dimensions in the two groups showed no significant difference (P > 0.05). However, a significant difference was observed between the two groups immediately after the intervention (P  0.05). The findings of this study suggested that using SMS can be considered as a proper tool or method for following up the ostomy patients.

  11. Prostate brachytherapy - discharge

    Science.gov (United States)

    Implant therapy - prostate cancer - discharge; Radioactive seed placement - discharge ... You had a procedure called brachytherapy to treat prostate cancer. Your treatment lasted 30 minutes or more, ...

  12. Excimer lamp pumped by a triggered discharge

    Energy Technology Data Exchange (ETDEWEB)

    Baldacchini, G.; Bollanti, S.; Di Lazzaro, P.; Flora, F.; Giordano, G.; Letardi, T.; Renieri, A.; Schina, G. [ENEA, Centro Ricerche Frascati, Rome (Italy). Dip. Innovazione; Clementi, G.; Muzzi, F.; Zheng, C.E. [EL.EN. (Electronic Engineering), Florence (Italy)

    1996-11-01

    Radiation characteristics and discharge performances of an excimer lamp are described. The discharge of the HCl/Xe gas mixture at an atmospheric pressure, occurring near the quartz tube wall, is initiated by a trigger wire. A maximum total UV energy of about 0.4 J in a (0.8-0.9) {mu}s pulse, radiated from a 10 cm discharge length, is obtained with a total discharge input energy of 8 J. Excimer lamps are the preferred choice for medical and material processing irradiations, when the monochromaticity or coherence of UV light is not required, due to their low cost, reliability and easy maintenance.

  13. Exercise for Seniors: MedlinePlus Health Topic

    Science.gov (United States)

    ... GO MEDICAL ENCYCLOPEDIA Exercise and age Related Health Topics Exercise and Physical Fitness Seniors' Health Sports Fitness National Institutes of Health The primary NIH organization for research on Exercise for Seniors is the National Institute ...

  14. Treating ADHD | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... this page please turn JavaScript on. Feature: Understanding ADHD Treating ADHD Past Issues / Spring 2014 Table of Contents Currently available treatments aim at reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types ...

  15. The Visible Humans | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... in contrast to similar images drawn by Leonardo DaVinci around 1500. Photos By: Karl Hoehne, University Medical ... develop products like artificial limbs; or to create tools to help surgeons rehearse operations. They've even ...

  16. Coronary Artery Bypass Surgery: MedlinePlus Health Topic

    Science.gov (United States)

    ... Living With Related Issues Specifics See, Play and Learn Images Videos and Tutorials Research Clinical Trials Journal Articles Resources ... bypass surgery - slideshow (Medical Encyclopedia) Also in ... is better to reduce postoperative stroke... Article: Blood transfusion and ...

  17. Kids and Concussions | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... know the extent of that impact," if it's short-term, long-term, temporary or permanent. NIH neuropsychologist Alison ... later." Post-concussion symptoms include difficulty concentrating, headaches, memory ... medical attention as soon as possible. Keep the child still, ...

  18. Mucus in Urine: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... is normal. An excess amount may indicate a urinary tract infection (UTI) or other medical condition. A test called urinalysis ... your urinalysis if you have symptoms of a UTI. These include: Frequent urge to urinate, but little ...

  19. Pending laboratory tests and the hospital discharge summary in patients discharged to sub-acute care.

    Science.gov (United States)

    Walz, Stacy E; Smith, Maureen; Cox, Elizabeth; Sattin, Justin; Kind, Amy J H

    2011-04-01

    Previous studies have noted a high (41%) prevalence and poor discharge summary communication of pending laboratory (lab) tests at the time of hospital discharge for general medical patients. However, the prevalence and communication of pending labs within a high-risk population, specifically those patients discharged to sub-acute care (i.e., skilled nursing, rehabilitation, long-term care), remains unknown. To determine the prevalence and nature of lab tests pending at hospital discharge and their inclusion within hospital discharge summaries, for common sub-acute care populations. Retrospective cohort study. Stroke, hip fracture, and cancer patients discharged from a single large academic medical center to sub-acute care, 2003-2005 (N = 564) Pending lab tests were abstracted from the laboratory information system (LIS) and from each patient's discharge summary, then grouped into 14 categories and compared. Microbiology tests were sub-divided by culture type and number of days pending prior to discharge. Of sub-acute care patients, 32% (181/564) were discharged with pending lab tests per the LIS; however, only 11% (20/181) of discharge summaries documented these. Patients most often left the hospital with pending microbiology tests (83% [150/181]), particularly blood and urine cultures, and reference lab tests (17% [30/181]). However, 82% (61/74) of patients' pending urine cultures did not have 24-hour preliminary results, and 19% (13/70) of patients' pending blood cultures did not have 48-hour preliminary results available at the time of hospital discharge. Approximately one-third of the sub-acute care patients in this study had labs pending at discharge, but few were documented within hospital discharge summaries. Even after considering the availability of preliminary microbiology results, these omissions remain common. Future studies should focus on improving the communication of pending lab tests at discharge and evaluating the impact that this improved

  20. Psoriasis Doesn't Slow Down Texan Brian LaFoy | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... willing to do. I'm one of the lucky ones." Find Out More National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) MedlinePlus-Psoriasis Clinical Trials Search Psoriasis Spring 2017 Issue: Volume 12 Number 1 Page 22 MedlinePlus Subscribe Magazine Information Contact ...

  1. Take this Quick Quiz: Alcohol and Medications | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... 12 ounces of regular beer 5 ounces of wine 1.5 ounces of 80-proof distilled spirits none of the above all of the above ... can or bottle of regular beer, ale, or wine cooler; one 8- or 9-ounce can or bottle ... distilled spirits such as whiskey, gin, vodka, or rum. False. ...

  2. Life Works: Explore Health and Medical Science Careers | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... and education was always a priority in our house. They encouraged my brother and me to pursue higher education and ... Italian and proficient as an Italian cook. On my return to the U.S., I was assigned to the White House and had the privilege of providing dental care ...

  3. Vessel Sewage Discharges

    Science.gov (United States)

    Vessel sewage discharges are regulated under Section 312 of the Clean Water Act, which is jointly implemented by the EPA and Coast Guard. This homepage links to information on marine sanitation devices and no discharge zones.

  4. Colleagues Pay Tribute to Dr. Donald A.B. Lindberg, Retiring After Three Decades of NLM Leadership | NIH MedlinePlus ...

    Science.gov (United States)

    ... informatics and helped establish the National Center for Biotechnology Information (NCBI), a course-changing development that could ... expand the publication and distribution of NIH MedlinePlus magazine, thousands and thousands more people will gain valuable, ...

  5. Early discharge following birth

    DEFF Research Database (Denmark)

    Nilsson, Ingrid M. S.; Kronborg, Hanne; Knight, Christopher H.

    2017-01-01

    .26–0.48) and primiparous compared to multiparous had an OR of 0.22 (CI 0.17–0.29) for early discharge. Other predictors for early discharge were: no induction of labour, no epidural painkiller, bleeding less than 500 ml during delivery, higher gestational age, early expected discharge and positive breastfeeding experience...

  6. Heart attack - discharge

    Science.gov (United States)

    ... and lifestyle Cholesterol - drug treatment Controlling your high blood pressure Deep vein thrombosis - discharge Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ask your doctor Heart bypass ... pacemaker - discharge High blood pressure - what to ask your doctor How to read ...

  7. [Quality indicators for the assessment of ST-segment elevation acute myocardial infarction (STEMI) networks. How hospital discharge records could be integrated with Emergency medical services data: the Emilia-Romagna STEMI network experience].

    Science.gov (United States)

    Pavesi, Pier Camillo; Guastaroba, Paolo; Casella, Gianni; Berti, Elena; De Palma, Rossana; Di Bartolomeo, Stefano; Di Pasquale, Giuseppe

    2015-09-01

    The assessment of the regional network for ST-segment elevation acute myocardial infarction (STEMI) is fundamental for quality assurance. Since 2011 all Italian Health Authorities, in addition to hospital discharge records (HDR), must provide a standardized information flow (ERD) about emergency department (ED) and emergency medical system (EMS) activities. The aim of this study was to evaluate whether data integration of ERD with HDR may allow the development of appropriate quality indicators. Patients admitted to coronary care units (CCU) for STEMI between January 1 to December 31, 2013, were identified from the regional HDR database. All data were linked to those of the regional ERD database. Four quality indicators were defined: 1) rates of EMS activation, 2) rates of EMS direct transfer to the catheterization laboratory (Cath-lab), 3) transfer rates from a Spoke to a Hub hospital with angioplasty facilities, and 4) median time spent in ED. In 2013, 2793 patients with STEMI were admitted to the CCU. Of these, 1684 patients (60%) activated EMS and were transported to Spoke or Hub hospitals; 955 (57%) entered directly in CCU/Cath-lab; 677 were transferred directly to a Hub hospital ED without being admitted to a Spoke hospital. The median ED time in Hub hospital was 47 min (IQR 24-136) and in Spoke hospital 53 min (IQR 30-131). The integration among administrative data banks (i.e., HDR with ERD) allowed the assessment of the regional STEMI network and the identification of potentially useful quality indicators. Their easy availability should enable comparisons with local, national and international standards, and may favor quality improvement.

  8. Glow discharging device

    International Nuclear Information System (INIS)

    Maeno, Katsuki; Kawasaki, Kozo; Hiratsuka, Hajime; Kawashima, Shuichi.

    1989-01-01

    In a thermonuclear device, etc. impurities adsorbed to inner walls of a vacuum vessel by glow discharge are released to clean the vacuum vessel for preventing intrusion of the impurities into plasmas. The object of the present invention is to minimize the capacity of a power source equipment for the glow discharge device to the least extent. That is, a stabilization resistance is connected in series between each of a plurality of anodes which are inserted and arranged at the inside of a vacuum vessel as a cathode and a power source respectively. The resistance value R is selected so as to satisfy the relation: R < (Vi - Vm)/Ii, in which Vi: glow discharge starting voltage, Vm: glow discharge keeping voltage, Ii: glow discharge starting current. Accordingly, if a voltage is applied from a power source to a plurality of anodes, scattering of electric discharge between the anodes can be suppressed and the effect of voltage drop during discharge by the stabilization resistance can be eliminated. As a result, it is possible to provide an economically advantageous glow discharge device with the capacity for the power source facility being to the least extent. (K.M.)

  9. CO-AXIAL DISCHARGES

    Science.gov (United States)

    Luce, J.S.; Smith, L.P.

    1960-11-22

    A method and apparatus are given for producing coaxial arc discharges in an evacuated enclosure and within a strong, confining magnetic field. The arcs are maintained at a high potential difference. Electrons will diffuse to the more positive arc from the negative arc, and positive ions will diffuse from the more positive arc to the negative arc. Coaxial arc discharges have the advantage that ions which return to strike the positive arc discharge will lose no energy since they do not strike a solid wall or electrode. Those discharges are useful in confining an ionized plasma between the discharges, and have the advantage of preventing impurities from the walls of the enclosure from entering ihe plasma area because of the arc barrier set up bv the cylindrical outer arc.

  10. Modelling electric discharge chemistry

    International Nuclear Information System (INIS)

    McFarlane, J.; Wren, J.C.

    1991-07-01

    The chemistry occurring in a electric discharge was modelled to predict how it would be influenced by discharge conditions. The discharge was characterized by a calculated Boltzmann electron-energy distribution, from which rate constants for electron-molecule processes in air were determined. These rate constants were used in a chemical kinetics calculation that also included reactions between neutral molecules, ions, free radicals and electronically excited species. The model describes how the discharge chemistry was influenced by humidity, electric field, electron number density, and concentrations of key reagents identified in the study. The use of an electric discharge to destroy airborne contaminant molecules was appraised, the targeted contaminants being CF 2 Cl 2 , HCN, and SO 2 . The modelling results indicate that an electric discharge should be able to remove HCN and CF 2 Cl 2 effectively, especially if the discharge conditions have been optimized. Effective destruction is achieved with a moderate electric field (over 1 x 10 -15 V.cm 2 ), a substantial electron number density (over 1 x 10 12 cm -3 ), and the presence of H 2 0 in the process air. The residence time in the discharge was also shown to be important in contaminant destruction. An attempt was made to explain the results of the electric discharge abatement of SO 2 , a component of a simulated flue-gas mixture. Results from the model indicate that the discharge parameters that increase the concentration of hydroxyl radical also increase the rate of decomposition of SO 2 . An objective of the study was to explain the apparent enhancement of SO 2 destruction by the presence of a small amount of NO 2 . It was thought that a likely explanation would be the stabilization of HOSO 2 , an important intermediate in the oxidation of SO 2 by NO 2 . (49 figs., 14 tabs., 75 refs.)

  11. Surgical discharge summaries: improving the record.

    Science.gov (United States)

    Adams, D C; Bristol, J B; Poskitt, K R

    1993-03-01

    The problem area of communication between hospital and general practitioners may potentially be improved by the advent of new information technology. The introduction of a regional computer database for general surgery allows the rapid automated production of discharge summaries and has provided us with the opportunity for auditing the quality of old and new styles of discharge communication. A total of 118 general practitioners were sent a postal questionnaire to establish their views on the relative importance of various aspects of patient information and management after discharge. A high response rate (97%) indicated the interest of general practitioners in this topic. The majority (73%) believed that summaries should be delayed no more than 3 days. The structured and shortened new format was preferred to the older style of discharge summary. The older format rarely arrived within an appropriate time and its content was often felt to be either inadequate (35%) or excessive (7%) compared with the new format (8% and 1%, respectively). The diagnosis, information given to the patient, clinic date, list of medications and investigations were considered the more important details in the summary. Improvements in the discharge information were suggested and have subsequently been incorporated in our discharge policy. The use of new information technology, intended to facilitate clinical audit, has improved our ability to generate prompt, well-structured discharge summaries which are accepted by the general practitioners.

  12. Discharge lamp technologies

    Science.gov (United States)

    Dakin, James

    1994-01-01

    This talk is an overview of discharge lamp technology commonly employed in general lighting, with emphasis on issues pertinent to lighting for plant growth. Since the audience is primarily from the plant growth community, and this begins the light source part of the program, we will start with a brief description of the discharge lamps. Challenges of economics and of thermal management make lamp efficiency a prime concern in controlled environment agriculture, so we will emphasize science considerations relating to discharge lamp efficiency. We will then look at the spectra and ratings of some representative lighting products, and conclude with a discussion of technological advances.

  13. Capacitor discharge engineering

    CERN Document Server

    Früngel, Frank B A

    1976-01-01

    High Speed Pulse Technology, Volume III: Capacitor Discharge Engineering covers the production and practical application of capacitor dischargers for the generation and utilization of high speed pulsed of energy in different forms. This nine-chapter volume discusses the principles of electric current, voltage, X-rays, gamma rays, heat, beams of electrons, neutrons and ions, magnetic fields, sound, and shock waves in gases and liquids. Considerable chapters consider the applications of capacitor discharges, such as impulse hardening of steel, ultrapulse welding of precision parts, X-ray flash t

  14. Predicting tile drainage discharge

    DEFF Research Database (Denmark)

    Iversen, Bo Vangsø; Kjærgaard, Charlotte; Petersen, Rasmus Jes

    used in the analysis. For the dynamic modelling, a simple linear reservoir model was used where different outlets in the model represented tile drain as well as groundwater discharge outputs. This modelling was based on daily measured tile drain discharge values. The statistical predictive model...... was based on a polynomial regression predicting yearly tile drain discharge values using site specific parameters such as soil type, catchment topography, etc. as predictors. Values of calibrated model parameters from the dynamic modelling were compared to the same site specific parameter as used...

  15. High blood pressure medications

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007484.htm High blood pressure medicines To use the sharing features on this page, please enable JavaScript. Treating high blood pressure will help prevent problems such as heart disease, ...

  16. Electric discharge during electrosurgery.

    Science.gov (United States)

    Shashurin, Alexey; Scott, David; Zhuang, Taisen; Canady, Jerome; Beilis, Isak I; Keidar, Michael

    2015-04-16

    Electric discharge utilized for electrosurgery is studied by means of a recently developed method for the diagnostics of small-size atmospheric plasma objects based on Rayleigh scattering of microwaves on the plasma volume. Evolution of the plasma parameters in the near-electrode sheaths and in the positive column is measured and analyzed. It is found that the electrosurgical system produces a glow discharge of alternating current with strongly contracted positive column with current densities reaching 10(3) A/cm(2). The plasma electron density and electrical conductivities in the channel were found be 10(16) cm(-3) and (1-2) Ohm(-1) cm(-1), respectively. The discharge interrupts every instance when the discharge-driving AC voltage crosses zero and re-ignites again every next half-wave at the moment when the instant voltage exceeds the breakdown threshold.

  17. Vaginal delivery - discharge

    Science.gov (United States)

    Pregnancy - discharge after vaginal delivery ... You may have bleeding from your vagina for up to 6 weeks. Early on, you may pass some small clots when you first get up. Bleeding will slowly become ...

  18. Brain radiation - discharge

    Science.gov (United States)

    Radiation - brain - discharge; Cancer - brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation ... Decadron) while you are getting radiation to the brain. It may make you hungrier, cause leg swelling ...

  19. Discharges for lighting

    International Nuclear Information System (INIS)

    Stoffels, W W; Nimalasuriya, T; Flikweert, A J; Mulders, H C J

    2007-01-01

    The most common man-made discharge is a lamp. Even though lamps are often considered a mature technology, the discharge physics is often poorly understood. Two recent initiatives discussed here show that plasma research can help to make significant improvements. First we discuss color separation in metal halide lamps, which is a problem that prevents these highly efficient lamps from being used in more applications. Secondly a novel lamp concept is presented that may replace the current mercury based fluorescent lamps

  20. Discharge lamp technologies

    Energy Technology Data Exchange (ETDEWEB)

    Dakin, J. [GE Lighting, Cleveland, OH (United States)

    1994-12-31

    This talk is an overview of discharge lamp technology commonly employed in general lighting, with emphasis on issues pertinent to lighting for plant growth. Since the audience is primarily from the plant growth community, and this begins the light source part of the program, we will start with a brief description of the discharge lamps. Challenges of economics and of thermal management make lamp efficiency a prime concern in controlled environment agriculture, so we will emphasize science considerations relating to discharge lamp efficiency. We will then look at the spectra and ratings of some representative lighting products, and conclude with a discussion of technological advance. A general overview of discharge lighting technology can be found in the book of Waymouth (1971). A recent review of low pressure lighting discharge science is found in Dakin (1991). The pioneering paper of Reiling (1964) provides a good introduction to metal halide discharges. Particularly relevant to lighting for plant growth, a recent and thorough treatment of high pressure Na lamps is found in the book by deGroot and vanVliet (1986). Broad practical aspects of lighting application are thoroughly covered in the IES Lighting Handbook edited by Kaufman (1984).

  1. Chaos in gas discharges

    International Nuclear Information System (INIS)

    Piel, A.

    1993-01-01

    Many gas discharges exhibit natural oscillations which undergo a transition from regular to chaotic behavior by changing an experimental parameter or by applying external modulation. Besides several isolated investigations, two classes of discharge phenomena have been studied in more detail: ionization waves in medium pressure discharges and potential relaxation oscillations in filament cathode discharges at very low pressure. The latter phenomenon will be discussed by comparing experimental results from different discharge arrangements with particle-in-cell simulations and with a model based on the van-der-Pol equation. The filament cathode discharge has two stable modes of operation: the low current anode-glow-mode and the high current temperature-limited-mode, which form the hysteresis curve in the I(U) characteristics. Close to the hysteresis point of the AGM periodic relaxation oscillations occur. The authors demonstrate that the AGM can be understood by ion production in the anode layer, stopping of ions by charge exchange, and trapping in the virtual cathode around the filament. The relaxation oscillations consist of a slow filling phase and a rapid phase that invokes formation of an unstable double-layer, current-spiking, and ion depletion from the cathodic plasma. The relaxation oscillations can be mode-locked by external modulation. Inside a mode-locked state, a period doubling cascade is observed at high modulation degree

  2. Early discharge hospital at home.

    Science.gov (United States)

    Gonçalves-Bradley, Daniela C; Iliffe, Steve; Doll, Helen A; Broad, Joanna; Gladman, John; Langhorne, Peter; Richards, Suzanne H; Shepperd, Sasha

    2017-06-26

    0.40 to 0.98; N = 574, 4 trials, low-certainty evidence) and might slightly improve patient satisfaction (N = 795, low-certainty evidence). Hospital at home probably reduces hospital length of stay, as moderate-certainty evidence found that people assigned to hospital at home are discharged from the intervention about seven days earlier than people receiving inpatient care (95% CI 10.19 to 3.17 days earlier, N = 528, 4 trials). It is uncertain whether hospital at home has an effect on cost (very low-certainty evidence).Studies recruiting people with a mix of medical conditionsEarly discharge hospital at home probably makes little or no difference to mortality (RR 1.07, 95% CI 0.76 to 1.49; N = 1247, 8 trials, moderate-certainty evidence). In people with chronic obstructive pulmonary disease (COPD) there was insufficient information to determine the effect of these two approaches on mortality (RR 0.53, 95% CI 0.25 to 1.12, N = 496, 5 trials, low-certainty evidence). The intervention probably increases the risk of hospital readmission in a mix of medical conditions, although the results are also compatible with no difference and a relatively large increase in the risk of readmission (RR 1.25, 95% CI 0.98 to 1.58, N = 1276, 9 trials, moderate-certainty evidence). Early discharge hospital at home may decrease the risk of readmission for people with COPD (RR 0.86, 95% CI 0.66 to 1.13, N = 496, 5 trials low-certainty evidence). Hospital at home may lower the risk of living in an institutional setting (RR 0.69, 0.48 to 0.99; N = 484, 3 trials, low-certainty evidence). The intervention might slightly improve patient satisfaction (N = 900, low-certainty evidence). The effect of early discharge hospital at home on hospital length of stay for older patients with a mix of conditions ranged from a reduction of 20 days to a reduction of less than half a day (moderate-certainty evidence, N = 767). It is uncertain whether hospital at home has an effect on cost (very low

  3. The Past, Present, and Future of Discharge Planning in Taiwan

    Directory of Open Access Journals (Sweden)

    Shu-Chuan Lin

    2013-06-01

    Full Text Available Discharge planning is an interdisciplinary approach to provide continuity of care; it is a process that includes identification, assessment, goal setting, planning, implementation, coordination, and evaluation. Discharge planning has been viewed as a major way to enhance a smooth transition for patients from the hospital to home or other chronic care units and as a solution to solve problems associated with postdischarge care. The promotion of discharge planning began in the United States in the 1960s. Nursing scholars from Taiwan learned about the concept of discharge planning from the United States in the early 1980s and subsequently introduced it to Taiwanese medical institutions in 1985. A policy to promote discharge planning in Taiwan was announced by the Executive Yuan, Department of Health in 1993. Following the healthcare reforms in 1995, discharge planning has since been strongly promoted. Studies concerning discharge planning in Taiwan showed some promising results, including increased satisfaction of patients and their families, improved preparation of caregivers, and improved quality of life for patients. However, patients receiving interdisciplinary discharge planning services were still in the minority. There was no standard evaluation procedure for interdisciplinary discharge planning, and a high percentage of patients thought that hospitals handled the postdischarge long-term care services referral procedure inadequately. Despite the positive attitudes toward discharge planning, many physicians still demonstrate an unsatisfactory level of knowledge and behaviors with regard to discharge planning. To enhance the implementation of discharge planning, a standard evaluation procedure for interdisciplinary discharge planning and improved physician awareness concerning the importance of discharge planning are needed. In Taiwan, the improvement of discharge planning in the foreseeable future is promising with the accreditation of the

  4. TBI Patient, Injury, Therapy, and Ancillary Treatments Associated with Outcomes at Discharge and 9 Months Post-discharge

    Science.gov (United States)

    Horn, Susan D.; Corrigan, John D.; Beaulieu, Cynthia L.; Bogner, Jennifer; Barrett, Ryan S.; Giuffrida, Clare G.; Ryser, David K.; Cooper, Kelli; Carroll, Deborah M.; Deutscher, Daniel

    2015-01-01

    Objective To examine associations of patient and injury characteristics, inpatient rehabilitation therapy activities, and neurotropic medications with outcomes at discharge and 9 months post-discharge for patients with traumatic brain injury (TBI) Design Prospective, longitudinal observational study Setting 10 inpatient rehabilitation centers (9 US, 1 Canada) Participants Consecutive patients (n=2130) enrolled between 2008 and 2011, admitted for inpatient rehabilitation after an index TBI injury Interventions Not applicable Main Outcome Measures Rehabilitation length of stay, discharge to home, and Functional Independence Measure (FIM) at discharge and 9 months post-discharge Results The admission FIM Cognitive score was used to create 5 relatively homogeneous subgroups for subsequent analysis of treatment outcomes. Within each subgroup, significant associations were found between outcomes and patient and injury characteristics, time spent in therapy activities, and medications used. Patient and injury characteristics explained on average 35.7% of the variation in discharge outcomes and 22.3% in 9-month outcomes. Adding time spent and level of effort in therapy activities, as well as percent of stay using specific medications, explained approximately 20.0% more variation for discharge outcomes and 12.9% for 9-month outcomes. After patient, injury, and treatment characteristics were used to predict outcomes, center differences added only approximately 1.9% additional variance explained. Conclusions At discharge, greater effort during therapy sessions, time spent in more complex therapy activities, and use of specific medications were associated with better outcomes for patients in all admission FIM Cognitive subgroups. At 9 months post-discharge, similar but less pervasive associations were observed for therapy activities, but not classes of medications. Further research is warranted to examine more specific combinations of therapy activities and medications that

  5. Multipactor discharge apparatus

    International Nuclear Information System (INIS)

    1976-01-01

    The invention deals with a multipactor discharge apparatus which can be used for tuning microwave organs such as magnetron oscillators and other cavity resonators. This apparatus is suitable for delivering an improved tuning effect in a resonation organ wherefrom the working frequency must be set. This apparatus is equipped with two multipactor discharge electrodes set in a configuration such to that a net current flows from one electrode to another. These electrodes are parallel and flat. The apparatus can be used in magnetron devices as well for continuous waves as for impulses

  6. Red herring vaginal discharge.

    Science.gov (United States)

    Lee, Jun Hee; Pringle, Kirsty; Rajimwale, Ashok

    2013-09-18

    Labial hair tourniquet syndrome is a rare condition that can be easily misdiagnosed and ultimately lead to irreversible damage. An 11-year-old premenarche girl presented with a 5-day history of pain and swelling in the labia with associated vaginal discharge. The general practitioner treated her with clotrimazole without improvement. On examination, there was an oedematous swelling of the right labia with a proximal hair tourniquet. Local anaesthetic was applied and the hair removed with forceps. There was instant relief of pain and the discharge stopped within 24 h. The patient was sent home with a course of antibiotics.

  7. Travelling-wave-sustained discharges

    International Nuclear Information System (INIS)

    Schlueter, Hans; Shivarova, Antonia

    2007-01-01

    This review is on discharges maintained by travelling waves: new plasma sources, discovered in 1974 and considered as a prototype of the gas discharges according to their definition as nonlinear systems which unify in a self-consistent manner plasmas and fields. In the presentation here of the fluid-plasma models of the diffusion-controlled regime of the travelling-wave-sustained discharges (TWSDs), the basic features of the discharge maintenance-the discharge self-consistency and the electron heating in the high-frequency field-are stressed. Operation of stationary and pulsed discharges, discharge maintenance without and in external magnetic fields as well as discharge production in different gases (argon, helium, helium-argon gas mixtures and hydrogen) are covered. Modulation instability of diffusion-controlled discharges and discharge filamentation at higher gas pressures are also included in the review. Experimental findings which motivate aspects of the reported modelling are pointed out

  8. Discharges from nuclear power stations

    International Nuclear Information System (INIS)

    1991-02-01

    HM Inspectorate of Pollution commissioned, with authorising responsibilities in England and Wales, a study into the discharges of radioactive effluents from Nuclear Power Stations. The study considered arisings from nuclear power stations in Europe and the USA and the technologies to treat and control the radioactive discharges. This report contains details of the technologies used at many nuclear power stations to treat and control radioactive discharges and gives, where information was available, details of discharges and authorised discharge limits. (author)

  9. Older veterans and emergency department discharge information.

    Science.gov (United States)

    Hastings, Susan; Stechuchak, Karen; Oddone, Eugene; Weinberger, Morris; Tucker, Dana; Knaack, William; Schmader, Kenneth

    2012-10-01

    Study goals were to assess older veterans' understanding of their emergency department (ED) discharge information and to determine the association between understanding discharge information and patient assessment of overall quality of care. Telephone interviews were conducted with 305 patients aged 65 or older (or their proxies) within 48 h of discharge from a Veterans Affairs Medical Center ED. Patients were asked about their perceived understanding (at the time of ED discharge) of information about their ED diagnosis, expected course of illness, contingency plan (ie, return precautions, who to call if it got worse, potential medication side effects) and follow-up care. Overall quality of ED care was rated on a four-point scale of poor, fair, good or excellent. Patients or their proxies reported not understanding information about their ED diagnosis (21%), expected course of illness (50%), contingency plan (43%), and how soon they needed to follow-up with their primary care provider (25%). In models adjusted for age and race, a positive association was observed between perceived understanding of the cause of the problem (OR 2.3; 95% CI 1.3 to 4.0), expected duration of symptoms (OR 1.6; 95% CI 1.0 to 2.5) and the contingency plan (OR 2.2; CI 1.3 to 3.4), and rating overall ED care as excellent. Older veterans may not understand key items of information at the time ED discharge, and this may have an impact on how they view the quality of ED care. Strategies are needed to improve communication of ED discharge information to older veterans and their families.

  10. The Future of Personalized Medicine | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... about your family's medical history. What is a family medical history? It is knowing the medical challenges faced ... is very important to systematically collect your family medical history. Collecting a family history sounds complicated. Fortunately, it isn't. The ...

  11. Discharge of radionuclides in liquid effluent

    International Nuclear Information System (INIS)

    Duggleby, J.C.

    1985-01-01

    One of the aims of the Radiation Health Committee of the National Health and Medical Research Council, through Council recommendations, is to achieve some degree of uniformity in State legislation applied to the public health aspects of radiation. In developing the recommendation on the discharge of radionuclides to sewerage systems the Committee made use of the comparatively new concept of the Annual Limit on Intake (ALI)

  12. Vessel Sewage Discharges: No-Discharge Zones (NDZs)

    Science.gov (United States)

    States may petition the EPA to establish areas, called no discharge zones (NDZs), where vessel sewage discharges are prohibited. This page describes how NDZs are designated, the types of designations, who enforces them, and how to comply.

  13. Monitoring of lightning discharge

    International Nuclear Information System (INIS)

    Grigor'ev, V.A.

    2001-01-01

    The paper presents a brief description of a lightning discharge recording system developed at the NPO 'Monitoring Techniques' under the direction of V.M. Moskolenko (Moscow). The system provides information about dangerous environmental occurrences such as tornados and hurricanes, making the forecast of extreme situations possible, especially in the areas of dangerous industries and objects. The created automatic system can be useful in solving the tasks relating to nuclear test monitoring. (author)

  14. Underwater Ship Husbandry Discharges

    Science.gov (United States)

    2011-11-01

    which entered into force in September of 2008, prohibits the use of harmful organotins such as tributyltin ( TBT ) in AFCs used on international...States. The use of TBT AFCs is explicitly prohibited under the VGP, and vessels must remove such coatings or paint over them to prevent toxic ...to hull husbandry include (1) the discharge of toxic chemicals used as biocides in AFCs and (2) biofouling as a vector for aquatic nuisance species

  15. Radioactive wastes and discharges

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The guide sets out the radiation safety requirements and limits for the treatment of radioactive waste. They shall be observed when discharging radioactive substances into the atmosphere or sewer system, or when delivering solid, low-activity waste to a landfill site without a separate waste treatment plan. The guide does not apply to the radioactive waste resulting from the utilisation of nuclear energy or natural resources.

  16. Radioactive wastes and discharges

    International Nuclear Information System (INIS)

    2000-01-01

    The guide sets out the radiation safety requirements and limits for the treatment of radioactive waste. They shall be observed when discharging radioactive substances into the atmosphere or sewer system, or when delivering solid, low-activity waste to a landfill site without a separate waste treatment plan. The guide does not apply to the radioactive waste resulting from the utilisation of nuclear energy or natural resources

  17. Plasma Discharge Process in a Pulsed Diaphragm Discharge System

    Science.gov (United States)

    Duan, Jianjin; Hu, Jue; Zhang, Chao; Wen, Yuanbin; Meng, Yuedong; Zhang, Chengxu

    2014-12-01

    As one of the most important steps in wastewater treatment, limited study on plasma discharge process is a key challenge in the development of plasma applications. In this study, we focus on the plasma discharge process of a pulsed diaphragm discharge system. According to the analysis, the pulsed diaphragm discharge proceeds in seven stages: (1) Joule heating and heat exchange stage; (2) nucleated site formation; (3) plasma generation (initiation of the breakdown stage); (4) avalanche growth and plasma expansion; (5) plasma contraction; (6) termination of the plasma discharge; and (7) heat exchange stage. From this analysis, a critical voltage criterion for breakdown is obtained. We anticipate this finding will provide guidance for a better application of plasma discharges, especially diaphragm plasma discharges.

  18. Compact Intracloud Discharges

    Energy Technology Data Exchange (ETDEWEB)

    Smith, David A. [Univ. of Colorado, Boulder, CO (United States)

    1998-11-01

    In November of 1993, mysterious signals recorded by a satellite-borne broadband VHF radio science experiment called Blackboard led to a completely unexpected discovery. Prior to launch of the ALEXIS satellite, it was thought that its secondary payload, Blackboard, would most often detect the radio emissions from lightning when its receiver was not overwhelmed by noise from narrowband communication carriers. Instead, the vast majority of events that triggered the instrument were isolated pairs of pulses that were one hundred times more energetic than normal thunderstorm electrical emissions. The events, which came to be known as TIPPs (for transionospheric pulse pairs), presented a true mystery to the geophysics community. At the time, it was not even known whether the events had natural or anthropogenic origins. After two and one half years of research into the unique signals, two ground-based receiver arrays in New Mexico first began to detect and record thunderstorm radio emissions that were consistent with the Blackboard observations. On two occasions, the ground-based systems and Blackboard even recorded emissions that were produced by the same exact events. From the ground based observations, it has been determined that TIPP events areproduced by brief, singular, isolated, intracloud electrical discharges that occur in intense regions of thunderstorms. These discharges have been dubbed CIDS, an acronym for compact intracloud discharges. During the summer of 1996, ground-based receiver arrays were used to record the electric field change signals and broadband HF emissions from hundreds of CIDS. Event timing that was accurate to within a few microseconds made possible the determination of source locations using methods of differential time of arrival. Ionospheric reflections of signals were recorded in addition to groundwave/line-of-sight signals and were used to determine accurate altitudes for the discharges. Twenty-four CIDS were recorded from three

  19. Knee joint replacement - discharge

    Science.gov (United States)

    ... such as downhill skiing or contact sports like football and soccer. But, you should be able to ... herein should not be used during any medical emergency or for the diagnosis or treatment of any ...

  20. Hip replacement - discharge

    Science.gov (United States)

    ... such as downhill skiing or contact sports like football and soccer. But you should be able to ... herein should not be used during any medical emergency or for the diagnosis or treatment of any ...

  1. Refractive corneal surgery - discharge

    Science.gov (United States)

    ... surgery. Avoid contact sports (such as boxing and football) for the first 4 weeks after surgery. DO ... herein should not be used during any medical emergency or for the diagnosis or treatment of any ...

  2. Concussion - child - discharge

    Science.gov (United States)

    ... child's provider about: Playing contact sports, such as football, hockey, and soccer Riding a bicycle, motorcycle, or ... herein should not be used during any medical emergency or for the diagnosis or treatment of any ...

  3. Elbow replacement - discharge

    Science.gov (United States)

    ... hammering. Do impact sports, such as boxing or football. Do physical activities that need quick stop and ... herein should not be used during any medical emergency or for the diagnosis or treatment of any ...

  4. Epilepsy - children - discharge

    Science.gov (United States)

    ... should know about your child's seizures and seizure medicines. Your child should wear a medical alert bracelet. Tell family ... sooner. Follow instructions on how to give the medicine to the child. When a seizure occurs, the main goal is ...

  5. Continuous pile discharging machine

    International Nuclear Information System (INIS)

    Smith, P.P.

    1976-01-01

    A device for discharging cartridges from tubes under fluid pressure includes a cylindrical housing adapted to be seated in a leak-tight manner on the end of one of the tubes, a chute depending from the cylindrical housing near the end seated on the end of the tube, a rotatable piston having a wrench on the forward end thereof disposed in the cylindrical housing and adapted to manipulate a plug in the end of the tube, and a telescopic hydraulic ram adapted to move the piston toward the plug. In addition the wrench contains a magnet which prevents inadvertent uncoupling of the wrench and the plug. 7 claims, 10 drawing figures

  6. Capacitive discharge exciplex lamps

    Energy Technology Data Exchange (ETDEWEB)

    Sosnin, E A; Erofeev, M V; Tarasenko, V F [High Current Electronics Institute, 2/3, Akademichesky Ave., Tomsk 634055 (Russian Federation)

    2005-09-07

    Simple-geometry exciplex lamps of a novel type excited by a capacitive discharge (CD-excilamps) have been investigated. An efficient radiation has been obtained on KrBr*, KrCl*, XeBr*, XeCl* molecules and I* atom. The highest values of efficiency of various working molecules are approximately 10-18%. The lifetime of the operating gas mixture in KrCl*, XeCl*, I* and XeBr* exciplex lamps excited by a CD is above 1000 h. Owing to the above-mentioned characteristics, the exciplex lamps excited by a CD are supposed to be very promising for various applications.

  7. Capacitive discharge exciplex lamps

    International Nuclear Information System (INIS)

    Sosnin, E A; Erofeev, M V; Tarasenko, V F

    2005-01-01

    Simple-geometry exciplex lamps of a novel type excited by a capacitive discharge (CD-excilamps) have been investigated. An efficient radiation has been obtained on KrBr*, KrCl*, XeBr*, XeCl* molecules and I* atom. The highest values of efficiency of various working molecules are approximately 10-18%. The lifetime of the operating gas mixture in KrCl*, XeCl*, I* and XeBr* exciplex lamps excited by a CD is above 1000 h. Owing to the above-mentioned characteristics, the exciplex lamps excited by a CD are supposed to be very promising for various applications

  8. Continuous pile discharging machine

    Science.gov (United States)

    Smith, Phillips P.

    1976-05-11

    A device for discharging cartridges from tubes under fluid pressure includes a cylindrical housing adapted to be seated in a leak-tight manner on the end of one of the tubes, a chute depending from the cylindrical housing near the end seated on the end of the tube, a rotatable piston having a wrench on the forward end thereof disposed in the cylindrical housing and adapted to manipulate a plug in the end of the tube, and a telescopic hydraulic ram adapted to move the piston toward the plug. In addition the wrench contains a magnet which prevents inadvertent uncoupling of the wrench and the plug.

  9. Applying the welfare model to at-own-risk discharges.

    Science.gov (United States)

    Krishna, Lalit Kumar Radha; Menon, Sumytra; Kanesvaran, Ravindran

    2017-08-01

    "At-own-risk discharges" or "self-discharges" evidences an irretrievable breakdown in the patient-clinician relationship when patients leave care facilities before completion of medical treatment and against medical advice. Dissolution of the therapeutic relationship terminates the physician's duty of care and professional liability with respect to care of the patient. Acquiescence of an at-own-risk discharge by the clinician is seen as respecting patient autonomy. The validity of such requests pivot on the assumptions that the patient is fully informed and competent to invoke an at-own-risk discharge and that care up to the point of the at-own-risk discharge meets prevailing clinical standards. Palliative care's use of a multidisciplinary team approach challenges both these assumptions. First by establishing multiple independent therapeutic relations between professionals in the multidisciplinary team and the patient who persists despite an at-own-risk discharge. These enduring therapeutic relationships negate the suggestion that no duty of care is owed the patient. Second, the continued employ of collusion, familial determinations, and the circumnavigation of direct patient involvement in family-centric societies compromises the patient's decision-making capacity and raises questions as to the patient's decision-making capacity and their ability to assume responsibility for the repercussions of invoking an at-own-risk discharge. With the validity of at-own-risk discharge request in question and the welfare and patient interest at stake, an alternative approach to assessing at-own-risk discharge requests are called for. The welfare model circumnavigates these concerns and preserves the patient's welfare through the employ of a multidisciplinary team guided holistic appraisal of the patient's specific situation that is informed by clinical and institutional standards and evidenced-based practice. The welfare model provides a robust decision-making framework for

  10. Automated pictographic illustration of discharge instructions with Glyph: impact on patient recall and satisfaction

    Science.gov (United States)

    Perri-Moore, Seneca; Kuang, Jinqiu; Bray, Bruce E; Ngo, Long; Doig, Alexa; Zeng-Treitler, Qing

    2016-01-01

    Objectives First, to evaluate the effect of standard vs pictograph-enhanced discharge instructions on patients’ immediate and delayed recall of and satisfaction with their discharge instructions. Second, to evaluate the effect of automated pictograph enhancement on patient satisfaction with their discharge instructions. Materials and Methods Glyph, an automated healthcare informatics system, was used to automatically enhance patient discharge instructions with pictographs. Glyph was developed at the University of Utah by our research team. Patients in a cardiovascular medical unit were randomized to receive pictograph-enhanced or standard discharge instructions. Measures of immediate and delayed recall and satisfaction with discharge instructions were compared between two randomized groups: pictograph (n = 71) and standard (n = 73). Results Study participants who received pictograph-enhanced discharge instructions recalled 35% more of their instructions at discharge than those who received standard discharge instructions. The ratio of instructions at discharge was: standard = 0.04 ± 0.03 and pictograph-enhanced = 0.06 ± 0.03. The ratio of instructions at 1 week post discharge was: standard = 0.04 ± 0.02 and pictograph-enhanced 0.04 ± 0.02. Additionally, study participants who received pictograph-enhanced discharge instructions were more satisfied with the understandability of their instructions at 1 week post-discharge than those who received standard discharge instructions. Discussion Pictograph-enhanced discharge instructions have the potential to increase patient understanding of and satisfaction with discharge instructions. Conclusion It is feasible to automatically illustrate discharge instructions and provide them to patients in a timely manner without interfering with clinical work. Illustrations in discharge instructions were found to improve patients’ short-term recall of discharge instructions and delayed satisfaction (1-week post hospitalization

  11. Cryogenic high current discharges

    International Nuclear Information System (INIS)

    Meierovich, B.E.

    1994-01-01

    Z-pinches formed from frozen deuterium fibers by a rapidly rising current have enhanced stability and high neutron yield. The efforts to understand the enhanced stability and neutron yield on the basis of classical picture of Bennett equilibrium of the current channel has not given satisfactory results. The traditional approach does not take into account the essential difference between the frozen deuterium fiber Z-pinches and the usual Z-pinches such as exploding wires or classical gas-puffed Z-pinches. The very low temperature of the fiber atoms (10 K), together with the rapidly rising current, result in the coexistence of a high current channel with unionized fiber atoms for a substantial period of time. This phenomena lasts during the risetime. This approach takes into account the difference of the breakdown in a dielectric deuterium fiber and the breakdown in a metallic wire. This difference is essential to the understanding of specific features of cryogenic high current discharges. Z-pinches in frozen deuterium fibers should be considered as a qualitatively new phenomenon on the boundary of cryogenic and high current physics. It is a start of a new branch in plasma physics: the physics of cryogenic high current discharges

  12. Improving Posthospital Discharge Telephone Reach Rates Through Prehospital Discharge Face-to-Face Meetings.

    Science.gov (United States)

    Vergara, Franz H; Sheridan, Daniel J; Sullivan, Nancy J; Budhathoki, Chakra

    The purpose of this study was to determine whether a face-to-face meeting with patients by a telephonic case manager prehospital discharge would result in increased telephone follow-up (TFU) reach rates posthospital discharge. Acute care adult medicine inpatient units. A quasiexperimental design was utilized. Two adult inpatient medicine units were selected as the intervention and comparison groups. The framework of the study is the transitions theory. A convenience sampling technique was used, whereby 88 eligible patients on the intervention unit received face-to-face meetings prehospital discharge whereas 123 patients on the comparison unit received standard care (no face-to-face meetings). Cross-tabulation and chi-square tests were employed to examine the association of face-to-face meeting intervention and TFU reach rates. Implementing brief (face-to-face meetings by a telephonic case manager prehospital discharge resulted in a TFU reach rate of 87% on the intervention unit, whereas the comparison unit only had a 58% TFU reach rate (p communication with more patients posthospital discharge. A brief prehospital discharge face-to-face meeting with patients assisted them to understand the reasons for a posthospital discharge telephone call, identified the best times to call using accurate telephone numbers, and taught patients how best to prepare for the call. In addition, by meeting patients face-to-face, the telephonic case manager was no longer an unknown person on the telephone asking them questions about their medical condition. These factors combined may have significantly helped to increase TFU reach rates.

  13. Anxiety Distorders: Types, Diagnosis and Treatment | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... medications used for anxiety disorders are antidepressants, anti-anxiety drugs, and beta-blockers. Be aware that some medications are effective only ... anxiety disorders. Benzodiazepines (anti-anxiety medications) The anti-anxiety medications called benzodiazepines ... control some of the physical symptoms ...

  14. Diffusion of condenser water discharge

    International Nuclear Information System (INIS)

    Iwakiri, Toshio

    1977-01-01

    Thermal and nuclear power stations in Japan are mostly located in coastal area, and the cooling water is discharged into sea as warm water. Recently, large interest is taken in this matter, and it is desirable to predict the diffusion of warm discharge accurately and to take effective measures for lowering the temperature. As for the methods of predicting the diffusion of warm discharge, simplified estimation, mathematical analysis and hydrographical model experiment are used corresponding to objects and conditions. As for the measures to lower temperature, the method of discharging warm water into deep sea bottom was confirmed to be very effective. In this paper, the phenomena of diffusion of warm discharge in sea, the methods of predicting the diffusion of warm discharge, and the deep sea discharge as the measure for lowering temperature are outlined. The factors concerning the diffusion of warm discharge in sea are the conditions of discharge, topography and sea state, and the diffusion is roughly divided into mixing diffusion in the vicinity of warm water outlet and eddy diffusion in distant region. It is difficult to change artificially the conditions of diffusion in distant region, and the measures of raising the rate of dilution in near region are effective, therefore the deep sea discharge is adopted. (Kako, I.)

  15. Medical Movies on the Web Debuts with Gene Kelly's "Combat Fatigue Irritability" 1945 Film | NIH MedlinePlus the ...

    Science.gov (United States)

    ... National Library of Medicine (NLM) is a World War II U.S. Navy training film directed by and starring Gene Kelly, who was then a rising Hollywood star. Combat Fatigue Irritability is a historically significant, yet ...

  16. Heart bypass surgery - minimally invasive - discharge

    Science.gov (United States)

    ... invasive direct coronary artery bypass - discharge; MIDCAB - discharge; Robot assisted coronary artery bypass - discharge; RACAB - discharge; Keyhole ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  17. Vaginal Discharge: What's Normal, What's Not

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Vaginal Discharge: What's Normal, What's Not KidsHealth / For Teens / ... Discharge: What's Normal, What's Not Print What Is Vaginal Discharge? Vaginal discharge is fluid that comes from ...

  18. Analysis of Multipactor Discharge

    International Nuclear Information System (INIS)

    Lau, Y. Y.

    2005-01-01

    Several comprehensive studies of radio frequency (rf) breakdown and rf heating are reported. They are of general interest to magnetic confinement fusion, rf linac, and high power microwave source development. The major results include: (1) a ground-breaking theory of multipactor discharge on dielectric, including a successful proof-of-principle experiment that verified the newly developed scaling laws, (2) an in depth investigation of the failure mechanisms of diamond windows and ceramic windows, and of the roles of graphitization, thin films of coating and contaminants, and (3) a most comprehensive theory, to date, on the heating of particulates by an electromagnetic pulse, and on the roles of rf magnetic field heating and of rf electric field heating, including the construction of new scaling laws that govern them. The above form a valuable knowledge base for the general problem of heating phenomenology

  19. Radioactive wastes and discharges

    International Nuclear Information System (INIS)

    1993-01-01

    According to the Section 24 of the Finnish Radiation Decree (1512/91), the Finnish Centre for Radiation and Nuclear Safety shall specify the concentration and activity limits and principles for the determination whether a waste can be defined as a radioactive waste or not. The radiation safety requirements and limits for the disposal of radioactive waste are given in the guide. They must be observed when discharging radioactive waste into the atmosphere or sewer system, or when delivering solid low-activity waste to a landfill site without a separate waste disposal plan. The guide does not apply to the radioactive waste resulting from the utilization of nuclear energy of natural resources. (4 refs., 1 tab.)

  20. Post discharge issues identified by a call-back program: identifying improvement opportunities.

    Science.gov (United States)

    Ojeda, Patricia I; Kara, Areeba

    2017-12-01

    The period following discharge from the hospital is one of heightened vulnerability. Discharge instructions serve as a guide during this transition. Yet, clinicians receive little feedback on the quality of this document that ties into the patients' experience. We reviewed the issues voiced by discharged patients via a call-back program and compared them to the discharge instructions they had received. At our institution, patients receive an automated call forty-eight hours following discharge inquiring about progress. If indicated by the response to the call, they are directed to a nurse who assists with problem solving. We reviewed the nursing documentation of these encounters for a period of nine months. The issues voiced were grouped into five categories: communication, medications, durable medical equipment/therapies, follow up and new or ongoing symptoms. The discharge instructions given to each patient were reviewed. We retrieved data on the number of discharges from each specialty from the hospital over the same period. A total of 592 patients voiced 685 issues. The numbers of patients discharged from medical or surgical services identified as having issues via the call-back line paralleled the proportions discharged from medical and surgical services from the hospital during the same period. Nearly a quarter of the issues discussed had been addressed in the discharge instructions. The most common category of issues was related to communication deficits including missing or incomplete information which made it difficult for the patient to enact or understand the plan of care. Medication prescription related issues were the next most common. Resource barriers and questions surrounding medications were often unaddressed. Post discharge issues affect patients discharged from all services equally. Data from call back programs may provide actionable targets for improvement, identify the inpatient team's 'blind spots' and be used to provide feedback to clinicians.

  1. Dicarboxylic acids from electric discharge

    Science.gov (United States)

    Zeitman, B.; Chang, S.; Lawless, J. G.

    1974-01-01

    An investigation was conducted concerning the possible synthesis of a suite of dicarboxylic acids similar to that found in the Murchison meteorite. The investigation included the conduction of a chemical evolution experiment which simulated electric discharge through the primitive atmosphere of the earth. The suite of dicarboxylic acids obtained in the electric discharge experiment is similar to that of the Murchison meteorite, except for the fact that 2-chlorosuccinic acid is present in the spark discharge.

  2. My Family Health Portrait, A tool from the Surgeon General | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. My Family Health Portrait, A tool from the Surgeon General ... use Why is it important to know my family medical history? Your family medical history is a ...

  3. Spectrum of vaginal discharge in a tertiary care setting.

    Science.gov (United States)

    Sivaranjini, R; Jaisankar, Tj; Thappa, Devinder Mohan; Kumari, Rashmi; Chandrasekhar, Laxmisha; Malathi, M; Parija, Sc; Habeebullah, S

    2013-07-01

    Vaginal discharge is one of the common reasons for gynecological consultation. Many of the causes of vaginitis have a disturbed vaginal microbial ecosystem associated with them. Effective treatment of vaginal discharge requires that the etiologic diagnosis be established and identifying the same offers a precious input to syndromic management and provides an additional strategy for human immunodeficiency virus prevention. The present study was thus carried out to determine the various causes of vaginal discharge in a tertiary care setting. A total of 400 women presenting with vaginal discharge of age between 20 and 50 years, irrespective of marital status were included in this study and women who had used antibiotics or vaginal medication in the previous 14 days and pregnant women were excluded. Of the 400 women with vaginal discharge studied, a diagnosis was established in 303 women. Infectious causes of vaginal discharge were observed in 207 (51.75%) women. Among them, bacterial vaginosis was the most common cause seen in 105 (26.25%) women. The other infections observed were candidiasis alone (61, 15.25%), trichomoniasis alone (12, 3%), mixed infections (22, 5.5%) and mucopurulent cervicitis (7 of the 130 cases looked for, 8.46%). Among the non-infectious causes, 72 (18%) women had physiological vaginal discharge and 13 (3.3%) women had cervical in situ cancers/carcinoma cervix. The pattern of infectious causes of vaginal discharge observed in our study was comparable with the other studies in India. Our study emphasizes the need for including Papanicolaou smear in the algorithm for evaluation of vaginal discharge, as it helps establish the etiology of vaginal discharge reliably and provides a valuable opportunity to screen for cervical malignancies.

  4. Discharge cleaning for a tokamak

    International Nuclear Information System (INIS)

    Ishii, Shigeyuki

    1983-01-01

    Various methods of discharge cleaning for tokamaks are described. The material of the first walls of tokamaks is usually stainless steel, inconel, titanium and so on. Hydrogen is exclusively used as the discharge gas. Glow discharge cleaning (GDC), Taylor discharge cleaning (TDC), and electron cyclotron resonance discharge cleaning (ECR-DC) are discussed in this paper. The cleaning by GDC is made by moving a movable anode to the center of a tokamak vassel. Taylor found the good cleaning effect of induced discharge by high pressure and low power discharge. This is called TDC. When the frequency of high frequency discharge in a magnetic field is equal to that of the electron cyclotron resonance, the break down potential is lowered if the pressure is sufficiently low. The ECR-CD is made by using this effect. In TDC and ECR-DC, the electron temperature, which has a close relation to the production rate of H 0 , can be controlled by the pressure. In GDC, the operating pressure was improved by the radio frequency glow (RG) method. However, there is still the danger of arcing. In case of GDC and ECR-DC, the position of plasma can be controlled, but not in case of TDC. The TDC is accepted by most of takamak devices in the world. (Kato, T.)

  5. The practice of terminal discharge.

    Science.gov (United States)

    Radha Krishna, Lalit Kumar; Murugam, Vengadasalam; Quah, Daniel Song Chiek

    2017-01-01

    'Terminal discharges' are carried out in Singapore for patients who wish to die at home. However, if due diligence is not exercised, parallels may be drawn with euthanasia. We present a theoretical discussion beginning with the definition of terminal discharges and the reasons why they are carried out in Singapore. By considering the intention behind terminal discharges and utilising a multidisciplinary team to deliberate on the clinical, social and ethical intricacies with a patient- and context-specific approach, euthanasia is avoided. It is hoped that this will provide a platform for professionals in palliative medicine to negotiate challenging issues when arranging a terminal discharge, so as to avoid the pitfall of committing euthanasia in a country such as Singapore where euthanasia is illegal. It is hoped that a set of guidelines for terminal discharges may someday be realised to assist professionals in Singapore and around the world.

  6. The ASDEX Upgrade discharge schedule

    International Nuclear Information System (INIS)

    Neu, G.; Engelhardt, K.; Raupp, G.; Treutterer, W.; Zasche, D.; Zehetbauer, T.

    2007-01-01

    ASDEX Upgrade's recently commissioned discharge control system (DCS) marks the transition from a traditional programmed system to a highly flexible 'data driven' one. The allocation of application processes (APs) to controllers, the interconnection of APs through uniquely named signals, and AP control parameter values are all defined as data, and can easily be adapted to the requirements of a particular discharge. The data is laid down in a set of XML documents which APs request via HTTP from a configuration server before a discharge. The use of XML allows for easy parsing, and structural validation through (XSD) schemas. The central input to the configuration process is the discharge schedule (DS), which embodies the dynamic behaviour of a planned discharge as reference trajectories grouped in segments, concatenated through transition conditions. Editing, generation and validation tools, and version control through CVS allow for efficient management of DSs

  7. Omission of Dysphagia Therapies in Hospital Discharge Communications

    Science.gov (United States)

    Kind, Amy; Anderson, Paul; Hind, Jacqueline; Robbins, JoAnne; Smith, Maureen

    2009-01-01

    Background Despite the wide implementation of dysphagia therapies, it is unclear whether these therapies are successfully communicated beyond the inpatient setting. Objective To examine the rate of dysphagia recommendation omissions in hospital discharge summaries for high-risk sub-acute care (i.e., skilled nursing facility, rehabilitation, long-term care) populations. Design Retrospective cohort study Subjects All stroke and hip fracture patients billed for inpatient dysphagia evaluations by speech-language pathologists (SLPs) and discharged to sub-acute care in 2003-2005 from a single large academic medical center (N=187). Measurements Dysphagia recommendations from final SLP hospital notes and from hospital (physician) discharge summaries were abstracted, coded, and compared for each patient. Recommendation categories included: dietary (food and liquid), postural/compensatory techniques (e.g., chin-tuck), rehabilitation (e.g., exercise), meal pacing (e.g., small bites), medication delivery (e.g., crush pills), and provider/supervision (e.g., 1-to-1 assist). Results 45% of discharge summaries omitted all SLP dysphagia recommendations. 47%(88/186) of patients with SLP dietary recommendations, 82%(93/114) with postural, 100%(16/16) with rehabilitation, 90%(69/77) with meal pacing, 95%(21/22) with medication, and 79%(96/122) with provider/supervision recommendations had these recommendations completely omitted from their discharge summaries. Conclusions Discharge summaries omitted all categories of SLP recommendations at notably high rates. Improved post-hospital communication strategies are needed for discharges to sub-acute care. PMID:20098999

  8. 42 CFR 35.4 - Noncompliance; discharge or transfer.

    Science.gov (United States)

    2010-10-01

    ... 35.4 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND... persistent failure or refusal to comply with such rules, instructions, or regulations is seriously impeding the course of his own care and treatment, or that of other patients, he may (1) discharge the patient...

  9. Communication at the interface between hospitals and primary care - a general practice audit of hospital discharge summaries.

    Science.gov (United States)

    Belleli, Esther; Naccarella, Lucio; Pirotta, Marie

    2013-12-01

    Timeliness and quality of hospital discharge summaries are crucial for patient safety and efficient health service provision after discharge. We audited receipt rates, timeliness and the quality of discharge summaries for 49 admissions among 38 patients in an urban general practice. For missing discharge summaries, a hospital medical record search was performed. Discharge summaries were received for 92% of identified admissions; 73% were received within three days and 55% before the first post-discharge visit to the general practitioner (GP). Administrative information and clinical content, including diagnosis, treatment and follow-up plans, were well reported. However, information regarding tests, referrals and discharge medication was often missing; 57% of summaries were entirely typed and 13% had legibility issues. Completion rates were good but utility was compromised by delays, content omissions and formatting. Digital searching enables extraction of information from rich existing datasets contained in GP records for accurate measurement of discharge summary receipt rate and timing.

  10. Discharge Planning in Chronic Conditions

    Science.gov (United States)

    McMartin, K

    2013-01-01

    Background Chronically ill people experience frequent changes in health status accompanied by multiple transitions between care settings and care providers. Discharge planning provides support services, follow-up activities, and other interventions that span pre-hospital discharge to post-hospital settings. Objective To determine if discharge planning is effective at reducing health resource utilization and improving patient outcomes compared with standard care alone. Data Sources A standard systematic literature search was conducted for studies published from January 1, 2004, until December 13, 2011. Review Methods Reports, randomized controlled trials, systematic reviews, and meta-analyses with 1 month or more of follow-up and limited to specified chronic conditions were examined. Outcomes included mortality/survival, readmissions and emergency department (ED) visits, hospital length of stay (LOS), health-related quality of life (HRQOL), and patient satisfaction. Results One meta-analysis compared individualized discharge planning to usual care and found a significant reduction in readmissions favouring individualized discharge planning. A second meta-analysis compared comprehensive discharge planning with postdischarge support to usual care. There was a significant reduction in readmissions favouring discharge planning with postdischarge support. However, there was significant statistical heterogeneity. For both meta-analyses there was a nonsignificant reduction in mortality between the study arms. Limitations There was difficulty in distinguishing the relative contribution of each element within the terms “discharge planning” and “postdischarge support.” For most studies, “usual care” was not explicitly described. Conclusions Compared with usual care, there was moderate quality evidence that individualized discharge planning is more effective at reducing readmissions or hospital LOS but not mortality, and very low quality evidence that it is more

  11. Legal aspects of thermal discharges

    International Nuclear Information System (INIS)

    Martin, A.J.

    1974-01-01

    An overview of those legal areas which directly affect technical and planning decisions is presented in the form of 2 legal approaches which constrain the indiscriminate release of thermal discharges to receiving waters. One takes the form of private remedies which have traditionally been available to aggrieved parties who are in some way damaged by the harmful discharge. The 2nd approach utilizes the various statutory constraints leading to direct governmental action. It appears that statutory law is playing the prominent role in restricting the temperature to which receiving waters may be raised as a result of such discharges by using effluent limitations and water quality standards. (Water Resour. Abstr.)

  12. An introduction to gas discharges

    CERN Document Server

    Howatson, A M

    2013-01-01

    An Introduction to Gas Discharges: Second Edition aims to provide a compact introduction to the subject of gas discharges, which continues to make both scientific and industrial progress. In this second edition, the author has made minor corrections, rewritten and expanded some sections, used SI units and modernized notions, in hopes of making the book more up to date. Included in the book is a short history of the subject, an introduction that enumerates the types of gas discharges, the fundamental processes, and then moves on to the more specific areas such as the breakdown, the self-sustai

  13. CQI project improves discharge process.

    Science.gov (United States)

    1998-08-01

    At Gibson Rehab Center in Williamsport, PA, a continuous quality improvement project to bolster the institution's discharge planning process has resulted in increased satisfaction and an award for quality. The 15-month project was spearheaded by a multidisciplinary team charged with identifying areas that had a significant impact on customer service and suggesting better ways of delivering that service. Among the changes the group suggested were establishing a weekly discharge planning group for new neuro patients, assigning a discharge coordinator for each treatment team, and creating an interdisciplinary communication sheet for the home health therapy staff.

  14. A Rare Case of Foreign Body Causing Recurrent Vaginal Discharge in Prepubertal Child

    OpenAIRE

    Gobbur, Vijayalakshmi.R.; Gobbur, Raghavendra.H.; Patil, Ashwini.G; Endigeri, Preetish

    2015-01-01

    Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. Here, we report a 3 -year -old girl with complaint of recurrent vaginal discharge occasionally blood stained not relieved despite few antibiotics courses. On X -...

  15. Is Genetic Testing Right for You? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... Testing CLINSEQ®: A Large-Scale Medical Sequencing Clinical Research Pilot Study Prenatal Screening - Prenatal testing information, including ultrasound, amniocentesis, and chorionic villus sampling ( ...

  16. Readability of patient discharge instructions with and without the use of electronically available disease-specific templates.

    Science.gov (United States)

    Mueller, Stephanie K; Giannelli, Kyla; Boxer, Robert; Schnipper, Jeffrey L

    2015-07-01

    Low health literacy is common, leading to patient vulnerability during hospital discharge, when patients rely on written health instructions. We aimed to examine the impact of the use of electronic, patient-friendly, templated discharge instructions on the readability of discharge instructions provided to patients at discharge. We performed a retrospective cohort study of 233 patients discharged from a large tertiary care hospital to their homes following the implementation of a web-based "discharge module," which included the optional use of diagnosis-specific templated discharge instructions. We compared the readability of discharge instructions, as measured by the Flesch Reading Ease Level test (FREL, on a 0-100 scale, with higher scores indicating greater readability) and the Flesch-Kincaid Grade Level test (FKGL, measured in grade levels), between discharges that used templated instructions (with or without modification) versus discharges that used clinician-generated instructions (with or without available templated instructions for the specific discharge diagnosis). Templated discharge instructions were provided to patients in 45% of discharges. Of the 55% of patients that received clinician-generated discharge instructions, the majority (78.1%) had no available templated instruction for the specific discharge diagnosis. Templated discharge instructions had higher FREL scores (71 vs. 57, P readability (a higher FREL score and a lower FKGL score) than the use of clinician-generated discharge instructions. The main reason for clinicians to create discharge instructions was the lack of available templates for the patient's specific discharge diagnosis. Use of electronically available templated discharge instructions may be a viable option to improve the readability of written material provided to patients at discharge, although the library of available templates requires expansion. © The Author 2015. Published by Oxford University Press on behalf of the

  17. Vaginal itching and discharge - child

    Science.gov (United States)

    Pruritus vulvae; Itching - vaginal area; Vulvar itching; Yeast infection - child ... Common causes of vaginal itching and discharge in young girls include: Chemicals such as perfumes and dyes in detergents, fabric softeners, creams, ointments, ...

  18. Microwave discharges in capillary tubes

    International Nuclear Information System (INIS)

    Dervisevic, Emil

    1984-01-01

    This research thesis aims at being a contribution to the study of microwave discharge by a surface wave, and more precisely focusses on the discharge in capillary tubes filled with argon. The author first present theoretical models which describe, on the one hand, the propagation of the surface wave along the plasma column, and, on the other hand, longitudinal and radial profiles of the main discharge characteristics. The second part addresses the study of the influence of parameters (gas pressure and tube radius) on discharge operation and characteristics. Laws of similitude as well as empirical relationships between argon I and argon II emission line intensities, electron density, and electric field in the plasma have been established [fr

  19. Ion source of discharge type

    Energy Technology Data Exchange (ETDEWEB)

    Enchevich, I.B. [TRIUMF, Cyclotron Div., Vancouver, British Columbia (Canada); Korenev, S.A. [JINR, Hihg Energy Physics Lab., Dubna, Moscow (Russian Federation)

    1992-07-01

    A new scheme of ion source based on a dielectric surface sliding discharge is described. The conditions to form this type of discharge are analyzed and experimental results are shown. The main parameters of this ion source are: accelerating voltage U = 1/20kV; continuous extracted ion beam; current density j = 0.01/0.5 A/cm{sup 2}; ions of Cl, F, C, H; residual gas pressure P = 10{sup -6} Torr. A magnetic system is used to separate the different types of ions. The dielectric material in the discharge circuit (anode plasma emitter) defines the type of ions. The emission characteristics of plasma emitter and the discharge parameters are presented. The ion current yield satisfies the Child-Langmuir law. (author)

  20. Ion source of discharge type

    International Nuclear Information System (INIS)

    Enchevich, I.B.; Korenev, S.A.

    1992-07-01

    A new scheme of ion source based on a dielectric surface sliding discharge is described. The conditions to form this type of discharge are analyzed and experimental results are shown. The main parameters of this ion source are: accelerating voltage U = 1/20kV; continuous extracted ion beam; current density j = 0.01/0.5 A/cm 2 ; ions of Cl, F, C, H; residual gas pressure P = 10 -6 Torr. A magnetic system is used to separate the different types of ions. The dielectric material in the discharge circuit (anode plasma emitter) defines the type of ions. The emission characteristics of plasma emitter and the discharge parameters are presented. The ion current yield satisfies the Child-Langmuir law. (author)

  1. Radioactive discharges from Sellafield (UK)

    International Nuclear Information System (INIS)

    Pentreath, R.J.

    1985-01-01

    This study of low-level liquid radioactive discharges from the British Nuclear Fuels Ltd Sellafield site into the eastern basin of the Irish Sea, prepared on the basis of existing publications and documents, reviews chemical forms and rate of discharges, physical oceanography, sediment distribution and fisheries of the Irish Sea, behaviour of radionuclides in seawater, association with sedimentary materials, accumulation of radionuclides by biological materials, environmental monitoring, surveillance and assessment of radiation exposure of the public and impact on the environment

  2. aetiological agents of ear discharge: a two year re- view in a ...

    African Journals Online (AJOL)

    2014-06-01

    Jun 1, 2014 ... SUMMARY. Background: The discharging ear is a common presentation in medical practice affecting all age groups but primarily children. This study shows the current aetiological causes of ear discharge and their antibiograms, data which would guide empirical treat- ment of ear infections, and also form ...

  3. Chronic obstructive pulmonary disease - adults - discharge

    Science.gov (United States)

    ... coughing up dark mucus Your fingertips or the skin around your fingernails are blue Alternative Names COPD - adults - discharge; Chronic obstructive airways disease - adults - discharge; Chronic obstructive lung disease - adults - discharge; ...

  4. Ballooning stability of JET discharges

    International Nuclear Information System (INIS)

    Huysmans, G.T.A.; Goedbloed, J.P.; Galvao, R.M.O.; Lazzaro, E.; Smeulders, P.

    1989-01-01

    Conditions under which ballooning modes are expected to be excited have recently been obtained in two different types of discharges in JET. In the first type, extremely large pressure gradients have been produced in the plasma core through pellet injections in the current rise phase followed by strong additional heating. In the second type, the total pressure of the discharge is approaching the Troyon limit. The stability of these discharges with respect to the ideal MHD ballooning modes has been studied with the stability code HBT. The equilibria are reconstructed with the IDENTC code using the external magnetic measurements and the experimental pressure profile. The results show that the evaluated high beta discharge is unstable in the central region of the plasma. This instability is related to the low shear and not to a large pressure gradient, as expected at the Troyon limit. In the pellet discharges the regions with the large pressure gradients are unstable to ballooning modes at the time of the beta decay, which ends the period of enhanced performance. The maximum pressure gradient in these discharges is limited by the boundary of the first region of stability. The observed phenomena at the beta decay are similar to those observed at the beta limit in DIII-D and TFTR. (author)

  5. Filamentary and diffuse barrier discharges

    International Nuclear Information System (INIS)

    Kogelschatz, U.

    2001-01-01

    Barrier discharges, sometimes also referred to as dielectric-barrier discharges or silent discharges, are characterized by the presence of at least one insulating layer in contact with the discharge between two planar or cylindrical electrodes connected to an ac power supply. The main advantage of this type of electrical discharge is, that non-equilibrium plasma conditions in atmospheric-pressure gases can be established in an economic and reliable way. This has led to a number of important applications including industrial ozone generation, surface modification of polymers, plasma chemical vapor deposition, excitation of CO 2 lasers, excimer lamps and, most recently, large-area flat plasma display panels. Depending on the application, the width of the discharge gap can range from less than 0.1 mm to about 100 mm and the applied frequency from below line frequency to several gigahertz. Typical materials used for the insulating layer (dielectric barrier) are glass, quartz, ceramics but also thin enamel or polymer layers

  6. Discharged of the nuclear wastes by health service centres

    International Nuclear Information System (INIS)

    Mazur, G.; Jednorog, S.

    1993-01-01

    In this paper Polish national regulation in radiation protection on nuclear medical domain was discussed. The method of utilized nuclear wastes in medical and science centres was deliberate. From many years activity of wastes from Nuclear Medicine Department of Central Clinical Hospital Armed Forces Medical Academy and Radiation Protection Department of Armed Forces Institute of Hygiene and Epidemiology was measured. In debate centres radiation monitoring was performed. In this purpose the beta global activity and gamma spectrometry measurement of discharged wastes occurred. From last year in discussed centres wastes activity do not increased permissible levels. (author). 3 refs, 5 tabs

  7. Emergency department discharge prescription interventions by emergency medicine pharmacists.

    Science.gov (United States)

    Cesarz, Joseph L; Steffenhagen, Aaron L; Svenson, James; Hamedani, Azita G

    2013-02-01

    We determine the rate and details of interventions associated with emergency medicine pharmacist review of discharge prescriptions for patients discharged from the emergency department (ED). Additionally, we evaluate care providers' satisfaction with such services provided by emergency medicine pharmacists. This was a prospective observational study in the ED of an academic medical center that serves both adult and pediatric patients. Details of emergency medicine pharmacist interventions on discharge prescriptions were compiled with a standardized form. Interventions were categorized as error prevention or optimization of therapy. The staff of the ED was surveyed related to the influence and satisfaction of this new emergency medicine pharmacist-provided service. The 674 discharge prescriptions reviewed by emergency medicine pharmacists during the study period included 602 (89.3%) for adult patients and 72 (10.7%) for pediatric patients. Emergency medicine pharmacists intervened on 68 prescriptions, resulting in an intervention rate of 10.1% (95% confidence interval [CI] 8.0% to 12.7%). The intervention rate was 8.5% (95% CI 6.4% to 11.1%) for adult prescriptions and 23.6% for pediatric prescriptions (95% CI 14.7% to 35.3%) (difference 15.1%; 95% CI 5.1% to 25.2%). There were a similar number of interventions categorized as error prevention and optimization of medication therapy, 37 (54%) and 31 (46%), respectively. More than 95% of survey respondents believed that the new pharmacist services improved patient safety, optimized medication regimens, and improved patient satisfaction. Emergency medicine pharmacist review of discharge prescriptions for discharged ED patients has the potential to significantly improve patient care associated with suboptimal prescriptions and is highly valued by ED care providers. Copyright © 2012. Published by Mosby, Inc.

  8. Classification of electrical discharges in DC Accelerators

    Energy Technology Data Exchange (ETDEWEB)

    Banerjee, Srutarshi, E-mail: sruban.stephens@gmail.com [Accelerator and Pulse Power Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Deb, A.K. [Department of Electrical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302 (India); Rajan, Rehim N. [Accelerator and Pulse Power Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Kishore, N.K. [Department of Electrical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302 (India)

    2016-08-11

    Controlled electrical discharge aids in conditioning of the system while uncontrolled discharges damage its electronic components. DC Accelerator being a high voltage system is no exception. It is useful to classify electrical discharges according to the severity. Experimental prototypes of the accelerator discharges are developed. Photomultiplier Tubes (PMTs) are used to detect the signals from these discharges. Time and Frequency domain characteristics of the detected discharges are used to extract features. Machine Learning approaches like Fuzzy Logic, Neural Network and Least Squares Support Vector Machine (LSSVM) are employed to classify the discharges. This aids in detecting the severity of the discharges.

  9. Characterization of a dielectric barrier discharge in controlled atmosphere

    Science.gov (United States)

    Kogelheide, Friederike; Offerhaus, Björn; Bibinov, Nikita; Bracht, Vera; Smith, Ryan; Lackmann, Jan-Wilm; Awakowicz, Peter; Stapelmann, Katharina; Bimap Team; Aept Team

    2016-09-01

    Non-thermal atmospheric-pressure plasmas are advantageous for various biomedical applications as they make a contact- and painless therapy possible. Due to the potential medical relevance of such plasma sources further understanding of the chemical and physical impact on biological tissue regarding the efficacy and health-promoting effect is necessary. The knowledge of properties and effects offers the possibility to configure plasmas free of risk for humans. Therefore, tailoring the discharge chemistry in regard to resulting oxidative and nitrosative effects on biological tissue by adjusting different parameters is of growing interest. In order to ensure stable conditions for the characterization of the discharge, the used dielectric barrier discharge was mounted in a vessel. Absolutely calibrated optical emission spectroscopy was carried out to analyze the electron density and the reduced electric field. The rather oxygen-based discharge was tuned towards a more nitrogen-based discharge by adjusting several parameters as reactive nitrogen species are known to promote wound healing. Furthermore, the impact of an ozone-free discharge has to be studied. This work was funded by the German Research Foundation (DFG) with the packet grant PAK 816 `Plasma Cell Interaction in Dermatology'.

  10. An evaluation of paediatric medicines reconciliation at hospital discharge into the community

    OpenAIRE

    Huynh, Chi; Wong, Ian Chi Kei; Tomlin, Stephen; Halford, Ellisha; Jani, Yogini; Ghaleb, Maisoon

    2016-01-01

    OBJECTIVE: A UK national survey of primary care physicians has indicated that the medication information on hospital discharge summary was incomplete or inaccurate most of the time. Internationally, studies have shown that hospital pharmacist's interventions reduce these discrepancies in the adult population. There have been no published studies on the incidence and severity of the discrepancies of the medication prescribed for children specifically at discharge to date. The objectives of thi...

  11. Magnitude of Anemia at Discharge Increases 30-Day Hospital Readmissions.

    Science.gov (United States)

    Koch, Colleen G; Li, Liang; Sun, Zhiyuan; Hixson, Eric D; Tang, Anne; Chagin, Kevin; Kattan, Michael; Phillips, Shannon C; Blackstone, Eugene H; Henderson, J Michael

    2017-12-01

    Anemia during hospitalization is associated with poor health outcomes. Does anemia at discharge place patients at risk for hospital readmission within 30 days of discharge? Our objectives were to examine the prevalence and magnitude of anemia at hospital discharge and determine whether anemia at discharge was associated with 30-day readmissions among a cohort of hospitalizations in a single health care system. From January 1, 2009, to August 31, 2011, there were 152,757 eligible hospitalizations within a single health care system. The endpoint was any hospitalization within 30 days of discharge. The University HealthSystem Consortium's clinical database was used for demographics and comorbidities; hemoglobin values are from the hospitals' electronic medical records, and readmission status was obtained from the University HealthSystem Consortium administrative data systems. Mild anemia was defined as hemoglobin of greater than 11 to less than 12 g/dl in women and greater than 11 to less than 13 g/dl in men; moderate, greater than 9 to less than or equal to 11 g/dl; and severe, less than or equal to 9 g/dl. Logistic regression was used to assess the association of anemia and 30-day readmissions adjusted for demographics, comorbidity, and hospitalization type. Among 152,757 hospitalizations, 72% of patients were discharged with anemia: 31,903 (21%), mild; 52,971 (35%), moderate; and 25,522 (17%), severe. Discharge anemia was associated with severity-dependent increased odds for 30-day hospital readmission compared with those without anemia: for mild anemia, 1.74 (1.65-1.82); moderate anemia, 2.76 (2.64-2.89); and severe anemia, 3.47 (3.30-3.65), P < 0.001. Anemia at discharge is associated with a severity-dependent increased risk for 30-day readmission. A strategy focusing on anemia treatment care paths during index hospitalization offers an opportunity to influence subsequent readmissions.

  12. The Pioneering Legacy of Betty Ford | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... Ford Photo: AP “Mrs. Ford was a courageous pioneer, a groundbreaking First Lady , and a forceful advocate ... and drug addiction, located next to the Eisenhower Medical Center in Rancho Mirage, California. The facility offers ...

  13. "Beyond the Diagnosis" Making the Invisible Patients Visible | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... playing guitar, riding his pedal bike, bowling on Xbox Kinect, and swinging in his new sensory room. ... taps, 10 surgeries, five Port-a-Caths, and one medical tattoo. He is quite proud of getting ...

  14. “We feel deep compassion for patients...” | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... please turn Javascript on. Feature: Medical Mysteries “We feel deep compassion for patients...” Past Issues / Spring 2011 ... hope and maybe even relief. As doctors, we feel deep compassion for patients who have been without ...

  15. Estimating sediment discharge: Appendix D

    Science.gov (United States)

    Gray, John R.; Simões, Francisco J. M.

    2008-01-01

    Sediment-discharge measurements usually are available on a discrete or periodic basis. However, estimates of sediment transport often are needed for unmeasured periods, such as when daily or annual sediment-discharge values are sought, or when estimates of transport rates for unmeasured or hypothetical flows are required. Selected methods for estimating suspended-sediment, bed-load, bed- material-load, and total-load discharges have been presented in some detail elsewhere in this volume. The purposes of this contribution are to present some limitations and potential pitfalls associated with obtaining and using the requisite data and equations to estimate sediment discharges and to provide guidance for selecting appropriate estimating equations. Records of sediment discharge are derived from data collected with sufficient frequency to obtain reliable estimates for the computational interval and period. Most sediment- discharge records are computed at daily or annual intervals based on periodically collected data, although some partial records represent discrete or seasonal intervals such as those for flood periods. The method used to calculate sediment- discharge records is dependent on the types and frequency of available data. Records for suspended-sediment discharge computed by methods described by Porterfield (1972) are most prevalent, in part because measurement protocols and computational techniques are well established and because suspended sediment composes the bulk of sediment dis- charges for many rivers. Discharge records for bed load, total load, or in some cases bed-material load plus wash load are less common. Reliable estimation of sediment discharges presupposes that the data on which the estimates are based are comparable and reliable. Unfortunately, data describing a selected characteristic of sediment were not necessarily derived—collected, processed, analyzed, or interpreted—in a consistent manner. For example, bed-load data collected with

  16. Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction

    Directory of Open Access Journals (Sweden)

    Meredith Gilliam

    2017-03-01

    Full Text Available Background: Incomplete or delayed access to discharge information by outpatient providers and patients contributes to discontinuity of care and poor outcomes. Objective: To evaluate the effect of a new electronic discharge summary tool on the timeliness of documentation and communication with outpatient providers. Methods: In June 2012, we implemented an electronic discharge summary tool at our 145-bed university-affiliated Veterans Affairs hospital. The tool facilitates completion of a comprehensive discharge summary note that is available for patients and outpatient medical providers at the time of hospital discharge. Discharge summary note availability, outpatient provider satisfaction, and time between the decision to discharge a patient and discharge note completion were all evaluated before and after implementation of the tool. Results: The percentage of discharge summary notes completed by the time of first post-discharge clinical contact improved from 43% in February 2012 to 100% in September 2012 and was maintained at 100% in 2014. A survey of 22 outpatient providers showed that 90% preferred the new summary and 86% found it comprehensive. Despite increasing required documentation, the time required to discharge a patient, from physician decision to discharge note completion, improved from 5.6 h in 2010 to 4.1 h in 2012 (p = 0.04, and to 2.8 h in 2015 (p < 0.001. Conclusion: The implementation of a novel discharge summary tool improved the timeliness and comprehensiveness of discharge information as needed for the delivery of appropriate, high-quality follow-up care, without adversely affecting the efficiency of the discharge process.

  17. Glow discharge in singlet oxygen

    International Nuclear Information System (INIS)

    Vagin, N.P.; Ionin, A.A.; Klimachev, Yu.M.; Sinitsyn, D.V.; Yuryshev, N.N.; Kochetov, I.V.; Napartovich, A.P.

    2003-01-01

    Currently, there is no experimental data on the plasma balance in gas mixtures with a high content of singlet delta oxygen O 2 ( 1 Δ g ). These data can be obtained by studying the parameters of an electric discharge in singlet oxygen produced by a chemical generator. The O 2 ( 1 Δ g ) molecules significantly change the kinetics of electrons and negative ions in plasma. Hence, the discharge conditions at low and high O 2 ( 1 Δ g ) concentrations are very different. Here, the parameters of the positive column of a glow discharge in a gas flow from a chemical singlet-oxygen generator are studied. It is experimentally shown that, at an O 2 ( 1 Δ g ) concentration of 50% and at pressures of 1.5 and 2 torr, the electric field required to sustain the discharge is considerably lower than in the case when all of the oxygen molecules are in the ground state. A theoretical model of the glow discharge is proposed whose predictions are in good agreement with the experimental data

  18. Electron runaway in rf discharges

    International Nuclear Information System (INIS)

    Chen, F.F.

    1992-10-01

    The critical electric field is computed as a function of pressure and starting energy for electrons to run away to high energies in moderate pressure discharges. The runaway conditions depend critically on the shape of the elastic cross section vs. energy curve. Computations are made for H, H 2 , and He gases, and it is shown that runaway occurs much more readily in atomic hydrogen than in the other gases. The values of the runaway fields are larger than would normally occur in dc discharges, where large voltages would lead to arc formation. However, in rf discharges such electric fields can be sustained over times long compared to electron transit times but short compared to ion transit times. (author)

  19. Discharge quenching circuit for counters

    International Nuclear Information System (INIS)

    Karasik, A.S.

    1982-01-01

    A circuit for quenching discharges in gas-discharge detectors with working voltage of 3-5 kV based on transistors operating in the avalanche mode is described. The quenching circuit consists of a coordinating emitter follower, amplifier-shaper for avalanche key cascade control which changes potential on the counter electrodes and a shaper of discharge quenching duration. The emitter follower is assembled according to a widely used flowsheet with two transistors. The circuit permits to obtain a rectangular quenching pulse with front of 100 ns and an amplitude of up to 3.2 kV at duration of 500 μm-8 ms. Application of the quenching circuit described permits to obtain countering characteristics with the slope less than or equal to 0.02%/V and plateau extent greater than or equal to 300 V [ru

  20. Influence of gas discharge parameters on emissions from a dielectric barrier discharge excited argon excimer lamp

    Directory of Open Access Journals (Sweden)

    Mike Collier

    2011-11-01

    Full Text Available A dielectric barrier discharge excited neutral argon (Ar I excimer lamp has been developed and characterised. The aim of this study was to develop an excimer lamp operating at atmospheric pressure that can replace mercury lamps and vacuum equipment used in the sterilisation of medical equipment and in the food industry. The effects of discharge gas pressure, flow rate, excitation frequency and pulse width on the intensity of the Ar I vacuum ultraviolet (VUV emission at 126 nm and near infrared (NIR lines at 750.4 nm and 811.5 nm have been investigated. These three lines were chosen as they represent emissions resulting from de-excitation of excimer states that emit energetic photons with an energy of 9.8 eV. We observed that the intensity of the VUV Ar2* excimer emission at 126 nm increased with increasing gas pressure, but decreased with increasing excitation pulse frequency and pulse width. In contrast, the intensities of the NIR lines decreased with increasing gas pressure and increased with increasing pulse frequency and pulse width. We have demonstrated that energetic VUV photons of 9.8 eV can be efficiently generated in a dielectric barrier discharge in Ar.

  1. Bacterial decontamination using ambient pressure nonthermal discharges

    Energy Technology Data Exchange (ETDEWEB)

    Birmingham, J.G.; Hammerstrom, D.J.

    2000-02-01

    Atmospheric pressure nonthermal plasmas can efficiently deactivate bacteria in gases, liquids, and on surfaces, as well as can decompose hazardous chemicals. This paper focuses on the changes to bacterial spores and toxic biochemical compounds, such as mycotoxins, after their treatment in ambient pressure discharges. The ability of nonthermal plasmas to decompose toxic chemicals and deactivate hazardous biological materials has been applied to sterilizing medical instruments, ozonating water, and purifying air. In addition, the fast lysis of bacterial spores and other cells has led us to include plasma devices within pathogen detection instruments, where nucleic acids must be accessed. Decontaminating chemical and biological warfare materials from large, high value targets such as building surfaces, after a terrorist attack, are especially challenging. A large area plasma decontamination technology is described.

  2. State Waste Discharge Permit application, 183-N Backwash Discharge Pond

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    As part of the Hanford Federal Facility Agreement and Consent Order negotiations (Ecology et al. 1994), the US Department of Energy, Richland Operations Office, the US Environmental Protection Agency, and the Washington State Department of Ecology agreed that liquid effluent discharges to the ground on the Hanford Site which affect groundwater or have the potential to affect groundwater would be subject to permitting under the structure of Chapter 173--216 (or 173--218 where applicable) of the Washington Administrative Code, the State Waste Discharge Permit Program. As a result of this decision, the Washington State Department of Ecology and the US Department of Energy, Richland Operations Office entered into Consent Order No. DE91NM-177, (Ecology and DOE-RL 1991). The Consent Order No. DE91NM-177 requires a series of permitting activities for liquid effluent discharges. Liquid effluents on the Hanford Site have been classified as Phase I, Phase II, and Miscellaneous Streams. The Consent Order No. DE91NM-177 establishes milestones for State Waste Discharge Permit application submittals for all Phase I and Phase II streams, as well as the following 11 Miscellaneous Streams as identified in Table 4 of the Consent Order No. DE91NM-177.

  3. The Effect of Flow Distribution on the Concentration of NO Produced by Pulsed Arc Discharge

    International Nuclear Information System (INIS)

    Hu Hui; Bao Bin; Wang Heli; Liang Haiyan; He Junjia; He Zhenghao; Li Jin

    2007-01-01

    As a new method to cure acute respiratory distress syndrome (ARDS), high blood pressure and some illnesses related to the lung, NO has recently received more attention. Thermal plasmas produced by arc discharge can create medical NO, but the concentration of NO 2 produced by arc discharge must be controlled simultaneously. This paper investigates the characteristics and regulations of NO production at different flow distribution by pulsed arc discharge in dry air with a special pulsed power. The experimental results show that the flow distribution has a considerable effect on the NO concentration, the stabilization of NO. The production of NO 2 could be controlled and the ratio of NO 2 /NO was decreased to about 10% in the arc discharge. Therefore, the arc discharge could produce stable inhaled NO for medical treatment by changing the flow distribution

  4. Current-Induced Membrane Discharge

    DEFF Research Database (Denmark)

    Andersen, Mathias Bækbo; van Soestbergen, M.; Mani, A.

    2012-01-01

    . Salt depletion leads to a large electric field resulting in a local pH shift within the membrane with the effect that the membrane discharges and loses its ion selectivity. Since salt co-ions, H+ ions, and OH- ions contribute to OLC, CIMD interferes with electrodialysis (salt counterion removal...... neglects chemical effects and remains to be quantitatively tested. Here, we show that charge regulation and water self-ionization can lead to OLC by "current-induced membrane discharge'' (CIMD), even in the absence of fluid flow, in ion-exchange membranes much thicker than the local Debye screening length...

  5. Plasma Discharge in Toroidal System

    International Nuclear Information System (INIS)

    Usada, Widdi; Suryadi; Purwadi, Agus; Kasiyo

    1996-01-01

    A toroidal discharge apparatus has been made as an initial research in magnetic confinement system. This system consists of a capacitor, a RF source, an igniter system, a primary coil, a torus, and completed by Rogowski probe as a current detector. In this system, the discharge occurs when the minimum voltage is operated at 5 kV. The experiment result shows that the coupling factor is 0.35, it is proved that there is an equality between estimated and measurement results of the primary inductance i.e 8.5 μH

  6. Taming Instabilities in Plasma Discharges

    International Nuclear Information System (INIS)

    Klinger, T.; Krahnstover, N. O.; Mausbach, T.; Piel, A.

    2000-01-01

    Recent experimental work on taming instabilities in plasma discharges is discussed. Instead of suppressing instabilities, it is desired to achieve control over their dynamics, done by perturbing appropriately the current flow in the external circuit of the discharge. Different discrete and continuous feedback as well as open-loop control schemes are applied. Chaotic oscillations in plasma diodes are controlled using the OGY discrete feedback scheme. This is demonstrated both in experiment and computer simulation. Weakly developed ionization wave turbulence is tamed by continuous feedback control. Open-loop control of stochastic fluctuations - stochastic resonance - is demonstrated in a thermionic plasma diode. (author)

  7. Discharge documentation of patients discharged to subacute facilities: a three-year quality improvement process across an integrated health care system.

    Science.gov (United States)

    Gandara, Esteban; Ungar, Jonathan; Lee, Jason; Chan-Macrae, Myrna; O'Malley, Terrence; Schnipper, Jeffrey L

    2010-06-01

    Effective communication among physicians during hospital discharge is critical to patient care. Partners Healthcare (Boston) has been engaged in a multi-year process to measure and improve the quality of documentation of all patients discharged from its five acute care hospitals to subacute facilities. Partners first engaged stakeholders to develop a consensus set of 12 required data elements for all discharges to subacute facilities. A measurement process was established and later refined. Quality improvement interventions were then initiated to address measured deficiencies and included education of physicians and nurses, improvements in information technology, creation of or improvements in discharge documentation templates, training of hospitalists to serve as role models, feedback to physicians and their service chiefs regarding reviewed cases, and case manager review of documentation before discharge. To measure improvement in quality as a result of these efforts, rates of simultaneous inclusion of all 12 applicable data elements ("defect-free rate") were analyzed over time. Some 3,101 discharge documentation packets of patients discharged to subacute facilities from January 1, 2006, through September 2008 were retrospectively studied. During the 11 monitored quarters, the defect-free rate increased from 65% to 96% (p improvements were seen in documentation of preadmission medication lists, allergies, follow-up, and warfarin information. Institution of rigorous measurement, feedback, and multidisciplinary, multimodal quality improvement processes improved the inclusion of data elements in discharge documentation required for safe hospital discharge across a large integrated health care system.

  8. Spheres of discharge of springs

    Science.gov (United States)

    Springer, Abraham E.; Stevens, Lawrence E.

    2009-02-01

    Although springs have been recognized as important, rare, and globally threatened ecosystems, there is as yet no consistent and comprehensive classification system or common lexicon for springs. In this paper, 12 spheres of discharge of springs are defined, sketched, displayed with photographs, and described relative to their hydrogeology of occurrence, and the microhabitats and ecosystems they support. A few of the spheres of discharge have been previously recognized and used by hydrogeologists for over 80 years, but others have only recently been defined geomorphologically. A comparison of these spheres of discharge to classification systems for wetlands, groundwater dependent ecosystems, karst hydrogeology, running waters, and other systems is provided. With a common lexicon for springs, hydrogeologists can provide more consistent guidance for springs ecosystem conservation, management, and restoration. As additional comprehensive inventories of the physical, biological, and cultural characteristics are conducted and analyzed, it will eventually be possible to associate spheres of discharge with discrete vegetation and aquatic invertebrate assemblages, and better understand the habitat requirements of rare or unique springs species. Given the elevated productivity and biodiversity of springs, and their highly threatened status, identification of geomorphic similarities among spring types is essential for conservation of these important ecosystems.

  9. Problems with textile wastewater discharge

    International Nuclear Information System (INIS)

    Rantala, Pentti

    1987-01-01

    The general character of textile industry wastewaters is briefly discussed. General guidelines and practice in Finland when discharging textile industry wastewaters to municipal sewer systems is described. A survey revealed that most municipalities experience some problems due to textile industry wastewaters. Pretreatment is not always practiced and in some cases pretreatment is not operated efficiently. (author)

  10. Discharge measurements at gaging stations

    Science.gov (United States)

    Turnipseed, D. Phil; Sauer, Vernon B.

    2010-01-01

    The techniques and standards for making discharge measurements at streamflow gaging stations are described in this publication. The vertical axis rotating-element current meter, principally the Price current meter, has been traditionally used for most measurements of discharge; however, advancements in acoustic technology have led to important developments in the use of acoustic Doppler current profilers, acoustic Doppler velocimeters, and other emerging technologies for the measurement of discharge. These new instruments, based on acoustic Doppler theory, have the advantage of no moving parts, and in the case of the acoustic Doppler current profiler, quickly and easily provide three-dimensional stream-velocity profile data through much of the vertical water column. For much of the discussion of acoustic Doppler current profiler moving-boat methodology, the reader is referred to U.S. Geological Survey Techniques and Methods 3-A22 (Mueller and Wagner, 2009). Personal digital assistants (PDAs), electronic field notebooks, and other personal computers provide fast and efficient data-collection methods that are more error-free than traditional hand methods. The use of portable weirs and flumes, floats, volumetric tanks, indirect methods, and tracers in measuring discharge are briefly described.

  11. Ions mobilities in corona discharge

    International Nuclear Information System (INIS)

    Bakhtaev, Sh. A.; Bochkareva, G. V.; Sydykova, G. K.

    2000-01-01

    Ion mobility in unipolar corona at small inter-electron distances (up to 0.01 m) when as coroning element serves micro-wire is consider. Experimental data of ion mobility in corona discharge external zone in atmospheric air are obtained and its comparative analysis with known data is worked out. (author)

  12. Air corona discharge chemical kinetics

    International Nuclear Information System (INIS)

    Kline, L.E.; Kanter, I.E.

    1984-01-01

    We have theoretically studied the initial chemical processing steps which occur in pulseless, negative, dc corona discharges in flowing air. A rate equation model is used because these discharges consist of a very small ionization zone near the pin with most of the pin-plane gap filled by a drift zone where both the electric field and the electron density are relatively uniform. The primary activated species are N 2 (A),O and O 2 (a 1 Δ). The predicted activated species density due to one discharge is 100 ppm per ms . mA cm 2 assuming E/n=60 Td. In pure, dry air the final product due to these activated species is primarily O 3 . The NO /sub x/ production is about 0.5 ppm per mA. In moist air there is an additional production of about 1.5 ppm per mA of HO /sub x/ species. The predicted ozone formation reactions will be ''intercepted'' when impurities are present in the air. Impurities present at densities below about 0.1% will react primarily with the activated species rather than with electrons. Hence the predicted activated species density provides an estimate of the potential chemical processing performance of the discharge

  13. Electronic Discharge Letter Mobile App

    NARCIS (Netherlands)

    Lezcano, Leonardo; Triana, Michel; Ternier, Stefaan; Hartkopf, Kathleen; Stieger, Lina; Schroeder, Hanna; Sopka, Sasa; Drachsler, Hendrik; Maher, Bridget; Henn, Patrick; Orrego, Carola; Specht, Marcus

    2014-01-01

    The electronic discharge letter mobile app takes advantage of Near Field Communication (NFC) within the PATIENT project and a related post-doc study. NFC enabled phones to read passive RFID tags, but can also use this short-range wireless technology to exchange (small) messages. NFC in that sense

  14. Discharge cleaning of carbon deposits

    International Nuclear Information System (INIS)

    Mozetic, M.; Vesel, A.; Drenik, A.

    2006-01-01

    Experimental results of discharge cleaning of carbon deposits are presented. Deposits were prepared by creating plasma in pure methane. The methane was cracked in RF discharge at the output power of 250 W. The resultant radicals were bonded to the wall of discharge vessel forming a thin film of hydrogenated black carbon with the thickness of about 200nm. The film was then cleaned in situ by oxygen plasma with the density of about 1x10 16 m -3 , electron temperature of 5 eV, neutral gas kinetic temperature of about 100 0 C and neutral atom density of 6x10 21 m -3 . The treatment time was 30 minutes. The efficiency of plasma cleaning was monitored by optical emission spectroscopy. As long as the wall was contaminated with carbon deposit, substantial emission of the CO molecules was detected. As the cleaning was in progress, the CO emission was decreasing and vanished after 30 minutes when the discharge vessel became free of any carbon. The results are explained by interaction of plasma radicals with carbon deposits. (author)

  15. Temporal association between hospitalization and rate of falls after discharge.

    Science.gov (United States)

    Mahoney, J E; Palta, M; Johnson, J; Jalaluddin, M; Gray, S; Park, S; Sager, M

    2000-10-09

    Evidence suggests that acute illness and hospitalization may increase the risk for falls. To evaluate the rate of falls, and associated risk factors, for 90 days following hospital discharge. We consecutively enrolled 311 patients, aged 65 years and older, discharged from the hospital after an acute medical illness and receiving home-nursing services. Patients were assessed within 5 days of discharge for prehospital and current functioning by self-report, and balance, vision, cognition, and delirium by objective measures. Patients were followed up weekly for 13 weeks for falls, injuries, and health care use. The rate of falls was significantly higher in the first 2 weeks after hospitalization (8.0 per 1000 person-days) compared with 3 months later (1.7 per 1000 person-days) (P =.002). Fall-related injuries accounted for 15% of all hospitalizations in the first month after discharge. Independent prehospital risk factors significantly associated with falls included dependency in activities of daily living, use of a standard walker, 2 or more falls, and more hospitalizations in the year prior. Posthospital risk factors included use of a tertiary amine tricyclic antidepressant, probable delirium, and poorer balance, while use of a cane was protective. The rate of falls is substantially increased in the first month after medical hospitalization, and is an important cause of injury and morbidity. Posthospital risk factors may be potentially modifiable. Efforts to assess and modify risk factors should be integral to the hospital and posthospital care of older adults (those aged >/=65 years).

  16. NIH Research: Cancers: A "Constellation" of Diseases | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... in the control of cancer has required new knowledge from the many fields of research that the NCI supports. As ... to solve our most difficult problems. Funding for many kinds of medical ... must balance our knowledge about the public health burden of each cancer ...

  17. NIH Research Addresses Aging Issues and Disparities in Oral Health | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... affect oral health. Poor blood glucose control in diabetes, for example, can put you at risk for periodontal (gum) disease. Cancer treatments can cause a host of oral problems. Medications can damage oral tissues and/or decrease salivary flow, causing dry mouth. It’s also important to know ...

  18. New discharge tube with virtual cathode

    International Nuclear Information System (INIS)

    Seidelmann, L.; Aubrecht, L.

    2003-01-01

    Till this time known methods of the excitation of the discharge between electrodes are using either secondary or thermo emission of electrons by the cathode. Usually we speak about the self-maintained discharge. Lifetime of the cathode, that is shortened by the emission, limits in principle, the lifetime of the whole discharge tube. The discharge can, according to the present state of the art, be induced also by the inductive way. Arrangement for excitation of such discharge is rather expensive. The construction of the inductive excited discharge tube is considerably influenced by the necessity of the limitation of the losses in excitation magnetic circuits. Especially length of the discharge and pressure of the working gas are limited by the economic standpoints. Function of the discharge is always connected with unwanted electromagnetic radiation, whose restraint is expensive and represents limiting factor for arrangement of the discharge tube (Authors)

  19. Feasibility of wear compensation in micro EDM milling based on discharge counting and discharge population characterization

    DEFF Research Database (Denmark)

    Bissacco, Giuliano; Hansen, Hans Nørgaard; Tristo, G.

    2011-01-01

    This paper investigates the applicability of real time wear compensation in micro EDM milling based on discharge counting and discharge population characterization. Experiments were performed involving discharge counting and tool electrode wear measurement in a wide range of process parameters...

  20. Discharge and infection in retinoblastoma post-enucleation sockets

    Directory of Open Access Journals (Sweden)

    Mourits DL

    2017-03-01

    Full Text Available Daphne L Mourits,1 Dyonne T Hartong,1 Andries E Budding,2 Machteld I Bosscha,1 H Stevie Tan,1 Annette C Moll1 1Department of Ophthalmology, VU University Medical Center, 2Department of Microbiology, Academic Medical Center, Amsterdam, the Netherlands Purpose: To investigate the causes and treatment options for socket discharge and infection in patients enucleated for retinoblastoma (Rb. Methods: A questionnaire was filled out by (parents of ocular prosthesis-wearing patients with a history of enucleation as treatment for Rb. We collected data on patients’ characteristics, cleaning habits of the prosthesis, frequency of socket irritation, discharge, and infection, and use of antibiotics. With ordinal logistic regression analysis, factors related to the outcome parameters (frequency of irritation, mucoid and purulent discharge were identified. In a subset of young asymptomatic and symptomatic patients, a swab culture of the socket was performed to determine the presence of microorganisms. Results: A total of 186 patients or their parents (mean age of the patients: 17.3 years, ranging from 0.8 to 88.3 years filled out the questionnaire. Irritation, mucoid discharge, and purulent discharge were frequently (once a month or more often experienced in 75 (39.5%, 127 (66.8%, and 15 (13.2% sockets, respectively. Younger age was associated with a higher frequency of mucoid and purulent discharge. Radiation therapy, chemotherapy, gender, age at surgery, cleaning frequency, and nocturnal wear were not associated with the outcome parameters. In a subgroup of 26 patients, the sockets were swabbed and cultured. All symptomatic patients had a positive bacterial culture versus 15% (2/13 of the asymptomatic patients (P<0.001. Common cold was correlated with both symptoms and presence of bacteria. Haemophilus influenzae and Staphylococcus aureus were the species most frequently cultured. Conclusion: Ocular prosthesis-wearing patients often experienced mucoid

  1. Relativistic Electrons in Electric Discharges

    DEFF Research Database (Denmark)

    Cinar, Deniz

    at the time when also gigantic electric discharges were observed at 10-90 km altitude in the stratosphere and mesosphere, the so called “jets” and “sprites”, commonly referred to as “Transient Luminous Events” (TLEs). TGFs were _rst thought connected to TLEs, but later research has pointed to lightning......Thunderstorms generate bursts of X- and Gamma radiation. When observed from spacecraft, the bursts are referred to as “Terrestrial Gamma-ray Flashes” (TGFs). They are bremsstrahlung from energetic electrons accelerated in thunderstorm electric _elds. The TGFs were _rst observed in the 90ties...... discharges as the source. The “Atmosphere-Space Interactions Monitor” (ASIM) for the International Space Station in 2016, led by DTU Space, and the French microsatellite TARANIS, also with launch in 2016, will identify with certainty the source of TGFs. In preparation for the missions, the Ph.D. project has...

  2. Runaway electrons in toroidal discharges

    International Nuclear Information System (INIS)

    Knoepfel, H.

    1979-01-01

    Experimental and theoretical studies of runaway electrons in toroidal devices are reviewed here, with particular reference to tokamaks. The complex phenomenology of runaway effects, which have been the subject of research for the past twenty years, is organized within the framework of a number of physical models. The mechanisms and rates for runaway production are discussed first, followed by sections on runaway-driven kinetic relaxation processes and runaway orbit confinement. Next, the equilibrium and stability of runaway-dominated discharges are reviewed. Models for runaway production at early times in the discharge and the scaling of runaway phenomena to larger devices are also discussed. Finally, detection techniques and possible applications of runaways are mentioned. (author)

  3. Current discharge management of acute coronary syndromes: baseline results from a national quality improvement initiative.

    Science.gov (United States)

    Wai, A; Pulver, L K; Oliver, K; Thompson, A

    2012-05-01

    Evidence-practice gaps exist in the continuum of care for patients with acute coronary syndromes (ACS), particularly at hospital discharge. We aimed to describe the methodology and baseline results of the Discharge Management of Acute Coronary Syndromes (DMACS) project, focusing on the prescription of guideline-recommended medications, referral to cardiac rehabilitation and communication between the hospital, patient and their primary healthcare professionals. DMACS employed Drug Use Evaluation methodology involving data collection, evaluation and feedback, and targeted educational interventions. Adult patients with ACS discharged during a 4-month period were eligible to participate. Data were collected (maximum 50 patients) at each site through an inpatient medical record review, a general practitioner (GP) postal/fax survey conducted 14 days post discharge and a patient telephone survey 3 months post discharge. Forty-nine hospitals participated in the audit recruiting 1545 patients. At discharge, 57% of patients were prescribed a combination of antiplatelet agent(s), beta-blocker, statin and angiotensin-converting enzyme inhibitor and/or angiotensin II-antagonist. At 3 months post discharge, 48% of patients reported using the same combination. Some 67% of patients recalled being referred to cardiac rehabilitation; of these, 33% had completed the programme. In total, 83% of patients had a documented ACS management plan at discharge. Of these, 90% included a medication list, 56% a chest pain action plan and 54% risk factor modification advice. Overall, 65% of GPs rated the quality of information received in the discharge summary as 'very good' to 'excellent'. The findings of our baseline audit showed that despite the robust evidence base and availability of national guidelines, the management of patients with ACS can be improved. These findings will inform a multifaceted intervention strategy to improve adherence to guidelines for the discharge management of

  4. Pediatric cardiac surgery Parent Education Discharge Instruction (PEDI) program: a pilot study.

    Science.gov (United States)

    Staveski, Sandra L; Zhelva, Bistra; Paul, Reena; Conway, Rosalind; Carlson, Anna; Soma, Gouthami; Kools, Susan; Franck, Linda S

    2015-01-01

    In developing countries, more children with complex cardiac defects now receive treatment for their condition. For successful long-term outcomes, children also need skilled care at home after discharge. The Parent Education Discharge Instruction (PEDI) program was developed to educate nurses on the importance of discharge teaching and to provide them with a structured process for conducting parent teaching for home care of children after cardiac surgery. The aim of this pilot study was to generate preliminary data on the feasibility and acceptability of the nurse-led structured discharge program on an Indian pediatric cardiac surgery unit. A pre-/post-design was used. Questionnaires were used to evaluate role acceptability, nurse and parent knowledge of discharge content, and utility of training materials with 40 nurses and 20 parents. Retrospective audits of 50 patient medical records (25 pre and 25 post) were performed to evaluate discharge teaching documentation. Nurses' discharge knowledge increased from a mean of 81% to 96% (P = .001) after participation in the training. Nurses and parents reported high levels of satisfaction with the education materials (3.75-4 on a 4.00-point scale). Evidence of discharge teaching documentation in patient medical records improved from 48% (12 of 25 medical records) to 96% (24 of 25 medical records) six months after the implementation of the PEDI program. The structured nurse-led parent discharge teaching program demonstrated feasibility, acceptability, utility, and sustainability in the cardiac unit. Future studies are needed to examine nurse, parent, child, and organizational outcomes related to this expanded nursing role in resource-constrained environments. © The Author(s) 2014.

  5. Energy discharge heater power supply

    International Nuclear Information System (INIS)

    Jaskierny, W.

    1992-11-01

    The heater power supply is intended to supply capacitively stored,energy to embedded heater strips in cryo magnets. The amount of energy can be controlled by setting different charge different capacitor values. Two chassis' can be operated in series or interlocks are provided. The charge voltage, number of capacitors pulse can be monitored. There and dual channel has two discharge supplies in one chassis. This report reviews the characteristics of this power supply further

  6. Electrostatic probes in luminescent discharges

    International Nuclear Information System (INIS)

    Cunha Raposo, C. da.

    1980-01-01

    A system to produce luminescent type plasma by continuos discharge and ionization by high frequency was constructed. The ionization was done in the air and in the argon under pressures from 3 to 10 mmHg. The parameters of a non magnetized collisional plasma and the parameters of a magnetized plasma such as, density, eletron temperature and potential, using a Langmuir probe with plane geometry, were determined. (M.C.K.) [pt

  7. Internal Electrostatic Discharge Monitor - IESDM

    Science.gov (United States)

    Kim, Wousik; Goebel, Dan M.; Jun, Insoo; Garrett, Henry B.

    2011-01-01

    A document discusses an innovation designed to effectively monitor dielectric charging in spacecraft components to measure the potential for discharge in order to prevent damage from internal electrostatic discharge (IESD). High-energy electrons penetrate the structural materials and shielding of a spacecraft and then stop inside dielectrics and keep accumulating. Those deposited charges generate an electric field. If the electric field becomes higher than the breakdown threshold (approx. =2 x 10(exp 5) V/cm), discharge occurs. This monitor measures potentials as a function of dielectric depth. Differentiation of potential with respect to the depth yields electric field. Direct measurement of the depth profile of the potential in a dielectric makes real-time electronic field evaluation possible without simulations. The IESDM has been designed to emulate a multi-layer circuit board, to insert very thin metallic layers between the dielectric layers. The conductors serve as diagnostic monitoring locations to measure the deposited electron-charge and the charge dynamics. Measurement of the time-dependent potential of the metal layers provides information on the amount of charge deposited in the dielectrics and the movement of that charge with time (dynamics).

  8. Leaving the hospital - your discharge plan

    Science.gov (United States)

    ... patientinstructions/000867.htm Leaving the hospital - your discharge plan To use the sharing features on this page, ... once you leave. This is called a discharge plan. Your health care providers at the hospital will ...

  9. EPA Region 1 No Discharge Zones

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset details No Discharge Zones (NDZ) for New England. Boaters may not discharge waste into these areas. Boundaries were determined mostly by Federal...

  10. Early hospital discharge and early puerperal complications.

    Science.gov (United States)

    Ramírez-Villalobos, Dolores; Hernández-Garduño, Adolfo; Salinas, Aarón; González, Dolores; Walker, Dilys; Rojo-Herrera, Guadalupe; Hernández-Prado, Bernardo

    2009-01-01

    To evaluate the association between time of postpartum discharge and symptoms indicative of complications during the first postpartum week. Women with vaginal delivery at a Mexico City public hospital, without complications before the hospital discharge, were interviewed seven days after delivery. Time of postpartum discharge was classified as early (25 hours). The dependent variable was defined as the occurrence and severity of puerperal complication symptoms. Out of 303 women, 208 (68%) were discharged early. However, women with early discharge and satisfactory prenatal care had lower odds of presenting symptoms in early puerperium than women without early discharge and inadequate prenatal care (OR 0.36; 95% confidence intervals = 0.17-0.76). There was no association between early discharge and symptoms of complications during the first postpartum week; the odds of complications were lower for mothers with early discharge and satisfactory prenatal care.

  11. Capacitor discharges, magnetohydrodynamics, X-rays, ultrasonics

    CERN Document Server

    Früngel, Frank B A

    1965-01-01

    High Speed Pulse Technology, Volume 1: Capacitor Discharges - Magnetohydrodynamics - X-Rays - Ultrasonics deals with the theoretical and engineering problems that arise in the capacitor discharge technique.This book discusses the characteristics of dielectric material, symmetrical switch tubes with mercury filling, and compensation conductor forms. The transformed discharge for highest current peaks, ignition transformer for internal combustion engines, and X-ray irradiation of subjects in mechanical motion are also elaborated. This text likewise covers the transformed capacitor discharge in w

  12. Basic Studies of Distributed Discharge Limiters

    Science.gov (United States)

    2014-02-10

    electron avalanche ionization discharges induced by a focused 110 GHz millimeter-wave beam in atmospheric air. Discharges take place in a free volume of...plasma. 3.1.7 Vacuum Ultraviolet emission from pulsed discharges at atmospheric pressure. Fig. 6. Energy level diagram for molecular and...the utilized spectral simulation software, SPECTRAPLOT. 3.1.8 Non-intrusive diagnostic method for dissociation degree in pulsed discharges

  13. Radio frequency discharge with dust particles

    NARCIS (Netherlands)

    Chutov, Y. I.; W. J. Goedheer,; Kravchenko, O. Y.; Zuz, V. M.; Yan, M.; Martins, R.; Ferreira, I.; Fortunato, E.; Kroesen, G.

    2000-01-01

    A 1D PIC/MCC method has been developed for computer simulations of low-pressure RF discharges with dust particles using the method for dust-free discharges. A RF discharge in argon with dust particles distributed uniformly in the interelectrode gap is simulated at parameters providing a possibility

  14. 32 CFR 724.117 - Discharge review.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Discharge review. 724.117 Section 724.117 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL NAVAL DISCHARGE REVIEW BOARD Definitions § 724.117 Discharge review. A nonadversary administrative reappraisal at the level of...

  15. Expansion of a nitrogen discharge by sound

    International Nuclear Information System (INIS)

    Antinyan, M.A.; Galechyan, G.A.; Tavakalyan, L.B.

    1992-01-01

    When the background pressure and the discharge current in a gas discharge are raised the plasma column is tightened up into a filament. Then the discharge occupies a region of the discharge tube whose transverse dimensions are substantially less than those of the tube. This contraction phenomenon in discharges restricts the range of parameters used in various devices to the range of relatively low discharge currents and low gas pressures. This contraction interferes with creating high-power gas lasers, since it acts destructively on the lasing process. In order to suppress filamentation of discharges the working gas has been pumped through the system at high speed, with considerable success. The turbulent mixing in the stream plays an important role in creating an uncontracted discharge at high pressures. The purpose of the present work is to study the possibility of undoing the contraction of a nitrogen discharge, which is one of the main components in the operation of a CO 2 laser, by introducing an intense sound wave in the discharge tube. Discharge contraction and the effect of a sound wave propagating along the plasma column have been investigated experimentally in nitrogen by studying the current-voltage characteristics of a contracted discharge. 6 refs., 3 figs

  16. On regulation of radioactive airborne discharge

    International Nuclear Information System (INIS)

    Stroganov, A.A.; Kuryndin, A.V.; Shapovalov, A.S.; Orlov, M.Yu.

    2013-01-01

    Authors present the Russian regulatory basis of radioactive airborne discharges which was updated after enactment of the Methodology for airborne discharge limits development. Criteria for establishing of airborne discharge limits, scope and other features of methodology are also considered in the article [ru

  17. Resilience of developing brain networks to interictal epileptiform discharges is associated with cognitive outcome.

    Science.gov (United States)

    Ibrahim, George M; Cassel, Daniel; Morgan, Benjamin R; Smith, Mary Lou; Otsubo, Hiroshi; Ochi, Ayako; Taylor, Margot; Rutka, James T; Snead, O Carter; Doesburg, Sam

    2014-10-01

    The effects of interictal epileptiform discharges on neurocognitive development in children with medically-intractable epilepsy are poorly understood. Such discharges may have a deleterious effect on the brain's intrinsic connectivity networks, which reflect the organization of functional networks at rest, and in turn on neurocognitive development. Using a combined functional magnetic resonance imaging-magnetoencephalography approach, we examine the effects of interictal epileptiform discharges on intrinsic connectivity networks and neurocognitive outcome. Functional magnetic resonance imaging was used to determine the location of regions comprising various intrinsic connectivity networks in 26 children (7-17 years), and magnetoencephalography data were reconstructed from these locations. Inter-regional phase synchronization was then calculated across interictal epileptiform discharges and graph theoretical analysis was applied to measure event-related changes in network topology in the peri-discharge period. The magnitude of change in network topology (network resilience/vulnerability) to interictal epileptiform discharges was associated with neurocognitive outcomes and functional magnetic resonance imaging networks using dual regression. Three main findings are reported: (i) large-scale network changes precede and follow interictal epileptiform discharges; (ii) the resilience of network topologies to interictal discharges is associated with stronger resting-state network connectivity; and (iii) vulnerability to interictal discharges is associated with worse neurocognitive outcomes. By combining the spatial resolution of functional magnetic resonance imaging with the temporal resolution of magnetoencephalography, we describe the effects of interictal epileptiform discharges on neurophysiological synchrony in intrinsic connectivity networks and establish the impact of interictal disruption of functional networks on cognitive outcome in children with epilepsy. The

  18. Narrow gap electronegative capacitive discharges

    Energy Technology Data Exchange (ETDEWEB)

    Kawamura, E.; Lieberman, M. A.; Lichtenberg, A. J. [Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California 94720 (United States)

    2013-10-15

    Narrow gap electronegative (EN) capacitive discharges are widely used in industry and have unique features not found in conventional discharges. In this paper, plasma parameters are determined over a range of decreasing gap length L from values for which an electropositive (EP) edge exists (2-region case) to smaller L-values for which the EN region connects directly to the sheath (1-region case). Parametric studies are performed at applied voltage V{sub rf}=500 V for pressures of 10, 25, 50, and 100 mTorr, and additionally at 50 mTorr for 1000 and 2000 V. Numerical results are given for a parallel plate oxygen discharge using a planar 1D3v (1 spatial dimension, 3 velocity components) particle-in-cell (PIC) code. New interesting phenomena are found for the case in which an EP edge does not exist. This 1-region case has not previously been investigated in detail, either numerically or analytically. In particular, attachment in the sheaths is important, and the central electron density n{sub e0} is depressed below the density n{sub esh} at the sheath edge. The sheath oscillations also extend into the EN core, creating an edge region lying within the sheath and not characterized by the standard diffusion in an EN plasma. An analytical model is developed using minimal inputs from the PIC results, and compared to the PIC results for a base case at V{sub rf}=500 V and 50 mTorr, showing good agreement. Selected comparisons are made at the other voltages and pressures. A self-consistent model is also developed and compared to the PIC results, giving reasonable agreement.

  19. Double discharges in unipolar-pulsed dielectric barrier discharge xenon excimer lamps

    International Nuclear Information System (INIS)

    Liu Shuhai; Neiger, Manfred

    2003-01-01

    Excitation of dielectric barrier discharge xenon excimer lamps by unipolar short square pulses is studied in this paper. Two discharges with different polarity are excited by each voltage pulse (double discharge phenomenon). The primary discharge occurs at the top or at the rising flank of the applied unipolar square pulse, which is directly energized by the external circuit. The secondary discharge with the reversed polarity occurs at the falling flank or shortly after the falling flank end (zero external voltage) depending on the pulse width, which is energized by the energy stored by memory charges deposited by the primary discharge. Fast-speed ICCD imaging shows the primary discharge has a conic discharge appearance with a channel broadening on the anode side. This channel broadening increases with increasing the pulse top level. Only the anode-side surface discharge is observed in the primary discharge. The surface discharge on the cathode side which is present in bipolar sine voltage excitation is not observed. On the contrary, the secondary discharge has only the cathode-side surface discharge. The surface discharge on the anode side is not observed. The secondary discharge is much more diffuse than the primary discharge. Time-resolved emission measurement of double discharges show the secondary discharge emits more VUV xenon excimer radiation but less infrared (IR) xenon atomic emission than the primary discharge. It was found that the IR xenon atomic emission from the secondary discharge can be reduced by shortening the pulse width. The energy efficiency of unipolar-pulsed xenon excimer lamps (the overall energy efficiency of double discharges) is much higher than that obtained under bipolar sine wave excitation. The output VUV spectrum under unipolar pulse excitation is found to be identical to that under sine wave excitation and independent of injected electric power

  20. Using computerized provider order entry to enforce documentation of tests with pending results at hospital discharge.

    Science.gov (United States)

    Cadwallader, J; Asirwa, C; Li, X; Kesterson, J; Tierney, W M; Were, M C

    2012-01-01

    Small numbers of tests with pending results are documented in hospital discharge summaries leading to breakdown in communication and medical errors due to inadequate followup. Evaluate effect of using a computerized provider order entry (CPOE) system to enforce documentation of tests with pending results into hospital discharge summaries. We assessed the percent of all tests with pending results and those with actionable results that were documented before (n = 182 discharges) and after (n = 203 discharges) implementing the CPOE-enforcement tool. We also surveyed providers (n = 52) about the enforcement functionality. Documentation of all tests with pending results improved from 12% (87/701 tests) before to 22% (178/812 tests) (p = 0.02) after implementation. Documentation of tests with eventual actionable results increased from 0% (0/24) to 50% (14/28)(ppending results into discharge summaries significantly increased documentation rates, especially of actionable tests. However, gaps in documentation still exist.

  1. "I don't know what I was expecting": Home visits by neonatology fellows for infants discharged from the NICU.

    Science.gov (United States)

    Hobbs, Janice E; Tschudy, Megan M; Hussey-Gardner, Brenda; Jennings, Jacky M; Boss, Renee D

    2017-12-01

    When families transition from the neonatal intensive care unit (NICU) to the home, they become responsible for their infant's daily medical needs. Though neonatology physicians prepare families for hospital discharge, it is unclear how much clinicians understand about how their teaching and instructions translate into home care. The goal of this study was to evaluate the influence of a home visiting program on neonatology fellows' understanding of family needs soon after hospital discharge. Neonatology fellows conducted a home visit for an infant recently discharged. Before the visit, fellows reviewed their original discharge instructions, along with information about the family's neighborhood. During the home visit, fellows reviewed their discharge planning with families and discussed any challenges experienced. Afterwards, fellows completed a semi-structured interview; these transcriptions were manually coded for themes. Fellows identified several common women/family discharge challenges. These challenges fall into four domains: (1) inadequate discharge preparation, (2) medicalization of the home, (3) family adjustment to new "normal," and (4) the relevance of social context to discharge planning. Most (90%) fellows reported the home visit experience would affect their future NICU discharge practices and all agreed that home visits should be a part of neonatology training. Home visits allowed neonatology fellows to examine how their discharge preparation did, or did not, meet the family's needs. Incorporating home visits into neonatology training could help fellows learn about the relevance of social and community factors that are difficult to assess in the inpatient setting. © 2017 Wiley Periodicals, Inc.

  2. State waste discharge permit application for cooling water and condensate discharges

    Energy Technology Data Exchange (ETDEWEB)

    Haggard, R.D.

    1996-08-12

    The following presents the Categorical State Waste Discharge Permit (SWDP) Application for the Cooling Water and Condensate Discharges on the Hanford Site. This application is intended to cover existing cooling water and condensate discharges as well as similar future discharges meeting the criteria set forth in this document.

  3. Discharge residence of TLD tagged fish

    International Nuclear Information System (INIS)

    Romberg, G.P.; Prepejchal, W.

    1974-01-01

    Although visual observations suggested that fish remained in the discharge for considerable periods, temperature-sensitive tags indicated the majority of fish spend less than 50 hr or 10 percent of the time at discharge temperatures. During 1974 a second fish tagging study was conducted, using temperature-sensitive tags to yield discharge residence times of Lake Michigan salmonids at Point Beach thermal discharge. Preliminary results revealed that many fish tag values were close to Unit I line indicating that calculated maximum discharge residence times for these fish will be nearly 100 percent of the elapsed time

  4. Prepubertal vaginal discharge: Vaginoscopy to rule out foreign body.

    Science.gov (United States)

    Ekinci, Saniye; Karnak, İbrahim; Tanyel, Feridun Cahit; Çiftçi, Arbay Özden

    2016-01-01

    Medical records of all prepubertal patients who underwent vaginoscopy to rule out vaginal foreign body between 2004 and 2013 were reviewed retrospectively. All patients were evaluated by pediatricians prior to surgical consultation. Vaginoscopy is performed in the operating room under general anesthesia. During the study period, 20 girls with persistent vaginal discharge with a mean age of 6.8 years (1-13 years) underwent vaginoscopy to rule out vaginal foreign body. Six patients had bloody vaginal discharge and 4 had recurrent vaginal bleeding lasting for more than one month. Ten patients had purulent vaginal discharge lasting for 1-7 months. None of vaginal cultures revealed pathological bacteria or candida species. Preoperative imaging techniques revealed vaginal foreign body in one patient only. Vaginoscopy demonstrated vaginal foreign bodies in four patients. Foreign bodies were grass inflorescence, safety pin and undefined brownish particles (n=2), which may be pieces of toilet paper or feces. There was no complication related to vaginoscopy and removal of foreign body. Hymen integrity was preserved in all patients. Persistent or recurrent vaginal discharge in prepubertal girls should raise the suspect of vaginal foreign body. Continuous flow vaginoscopy is mandatory to detect and remove any vaginal foreign body. Early diagnosis would prevent complications secondary to long-standing foreign bodies.

  5. Following up patients with depression after hospital discharge: a mixed methods approach

    OpenAIRE

    Desplenter, Franciska A; Laekeman, Gert J; Simoens, Steven R

    2011-01-01

    Abstract Background A medication information intervention was delivered to patients with a major depressive episode prior to psychiatric hospital discharge. Methods The objective of this study was to explore how patients evolved after hospital discharge and to identify factors influencing this evolution. Using a quasi-experimental longitudinal design, the quantitative analysis measured clinical (using the Hospital Anxiety and Depression Scale, the somatic dimension of the Symptom Checklist 90...

  6. [Severe vaginal discharge following rectal surgery].

    Science.gov (United States)

    Burg, L C; Bremers, A J A; Heesakkers, J P F A; Kluivers, K B

    2018-01-01

    Almost 50% of women who have had rectal surgery subsequently develop vaginal discharge. Due to the recurrent and unexpected nature of this heavy discharge, they often experience it as very distressing. Many of these women undergo extensive diagnostic tests that are mainly focused on identifying fistula formation. If no fistula is found, in most cases no other cause for severe vaginal discharge can be demonstrated. In our practice, we saw three patients (49-, 54- and 74-years-old, respectively) with similar severe vaginal discharge after rectal surgery and in whom no explanation for the vaginal discharge could be found. For this reason we conducted a literature search into this condition. Anatomical changes appear to be responsible for heavy vaginal discharge following rectal surgery. Changes in pelvic floor muscles and compression of the distal part of the vagina may lead to pooling of fluid in the proximal part of the vagina, resulting in severe discharge. Symptomatic treatment may reduce the symptoms.

  7. Anisotropic Percolation Analysis of Discharge

    Science.gov (United States)

    Matsumoto, Shogo; Odagaki, Takashi

    2014-03-01

    Exploiting a nonlinear resistor network on a square lattice in two dimensions, we investigate discharge when two opposite sides of the lattice are subjected to a constant voltage difference. Each site is ionized randomly with a probability in proportion to the square of the strength of the electric field, and the resistivity between two ionized sites is assumed to be 10-6 times smaller than the original resistivity. Using Monte Carlo simulation, we obtain the current and distribution of clusters of ionized sites as functions of the fraction of ionized sites. It is found that a wall of potential drop is formed as the fraction approaches a critical value, which is followed by discharge. The critical value is much smaller than the critical percolation probability of the standard site percolation on the square lattice. We also find that a singular behavior of the cluster distribution is expected at a critical fraction differently from that for the current, and that the critical exponents characterizing the cluster distribution satisfy the scaling relation known for two-dimensional percolation, while the critical exponent of the percolation probability is close to the value reported for a directed percolation.

  8. Electrostatic discharge concepts and definitions

    Energy Technology Data Exchange (ETDEWEB)

    Borovina, Dan L [Los Alamos National Laboratory

    2008-01-01

    Many objects -like a human body, plastic wrap, or a rolling cart -that are electrically neutral, overall, can gain a net electrostatic charge by means of one of three methods: induction, physical transfer, or triboelectric charging (separation of conductive surfaces). The result is a voltage difference between the charged object and other objects, creating a situation where current flow is likely if two objects come into contact or close proximity. This current flow is known as electrostatic discharge, or ESD. The energy and voltage of the discharge can be influenced by factors such as the temperature and humidity in the room, the types of materials or flooring involved, or the clothing and footwear a person uses. Given the possible ranges of the current and voltage characteristic of an ESD pulse, it is important to consider the safety risks associated with detonator handling, assembly and disassembly, transportation and maintenance. For main charge detonators, these safety risks include high explosive violent reactions (HEVR) as well as inadvertent nuclear detonations (lND).

  9. A rare case of foreign body causing recurrent vaginal discharge in prepubertal child.

    Science.gov (United States)

    Gobbur, Vijayalakshmi R; Gobbur, Raghavendra H; Patil, Ashwini G; Endigeri, Preetish

    2015-01-01

    Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. Here, we report a 3 -year -old girl with complaint of recurrent vaginal discharge occasionally blood stained not relieved despite few antibiotics courses. On X -ray pelvis, a radioopaque foreign body hair clip was seen. Under sedation foreign body was removed by forceps following which child became asymptomatic.

  10. Premenarchal, recurrent vaginal discharge associated with an incomplete obstructing longitudinal vaginal septum.

    Science.gov (United States)

    Hansen, Keith A; DeWitt, Jason

    2005-12-01

    To describe an unusual, premenarchal presentation of an obstructive vaginal anomaly. Case Report. University Medical Center. Premenarchal subject Vaginogram, vaginal septum resection. Vaginal septum resection with resolution of vaginal discharge. This case demonstrates some of the typical features of uterus didelphys bicollis with incomplete obstructing hemivagina, but had a unique presentation with premenarchal, recurrent vaginal discharge. Typically, patients with an obstructing mullerian anomaly present after menarche with pelvic pain and a mass. The vaginogram assists in the preoperative definition of abnormal anatomy which allows the surgeon to develop the most appropriate surgical approach. Resection of this incompletely obstructing vaginal septum resulted in resolution of the recurrent vaginal discharge.

  11. A Rare Case of Foreign Body Causing Recurrent Vaginal Discharge in Prepubertal Child

    Science.gov (United States)

    Gobbur, Raghavendra.H.; Patil, Ashwini.G; Endigeri, Preetish

    2015-01-01

    Vaginal discharge in prepubertal children is mainly due to hypoestrogenic state of vaginal mucosa making it thin and alkaline leading to mucosal invasion by pathogen. In a paediatric case with persistent foul smelling , blood stained vaginal discharge not responding to medical therapy, vaginal foreign body should always be ruled out. Here, we report a 3 -year -old girl with complaint of recurrent vaginal discharge occasionally blood stained not relieved despite few antibiotics courses. On X -ray pelvis, a radioopaque foreign body hair clip was seen. Under sedation foreign body was removed by forceps following which child became asymptomatic. PMID:25738041

  12. Temperature and Nitric Oxide Generation in a Pulsed Arc Discharge Plasma

    International Nuclear Information System (INIS)

    Namihira, T.; Sakai, S.; Matsuda, M.; Wang, D.; Kiyan, T.; Akiyama, H.; Okamoto, K.; Toda, K.

    2007-01-01

    Nitric oxide (NO) is increasingly being used in medical treatments of high blood pressure, acute respiratory distress syndrome and other illnesses related to the lungs. Currently a NO inhalation system consists of a gas cylinder of N 2 mixed with a high concentration of NO. This arrangement is potentially risky due to the possibility of an accidental leak of NO from the cylinder. The presence of NO in the air leads to the formation of nitric dioxide (NO 2 ), which is toxic to the lungs. Therefore, an on-site generator of NO would be highly desirable for medical doctors to use with patients with lung disease. To develop the NO inhalation system without a gas cylinder, which would include a high concentration of NO, NAMIHIRA et al have recently reported on the production of NO from room air using a pulsed arc discharge. In the present work, the temperature of the pulsed arc discharge plasma used to generate NO was measured to optimize the discharge condition. The results of the temperature measurements showed the temperature of the pulsed arc discharge plasma reached about 10,000 K immediately after discharge initiation and gradually decreased over tens of microseconds. In addition, it was found that NO was formed in a discharge plasma having temperatures higher than 9,000 K and a smaller input energy into the discharge plasma generates NO more efficiently than a larger one

  13. Current discharge management of acute coronary syndromes: data from the Rijnmond Collective Cardiology Research (CCR) study.

    Science.gov (United States)

    Yetgin, T; van der Linden, M M J M; de Vries, A G; Smits, P C; van Mechelen, R; Yap, S C; Boersma, E; Zijlstra, F; van Geuns, R-J M

    2014-01-01

    Medical discharge management of acute coronary syndromes (ACS) remains suboptimal outside randomised trials and constitutes an essential quality benchmark for ACS. We sought to evaluate the rates of key guideline-recommended pharmacological agents after ACS and characteristics associated with optimal treatment at discharge. The Rijnmond Collective Cardiology Research (CCR) registry is an ongoing prospective, observational study in the Netherlands that aims to enrol 4000 patients with ACS. We examined discharge and 1-month follow-up medication use among the first 1000 patients enrolled in the CCR registry. Logistic regression was performed to identify patient and hospital characteristics associated with collective guideline-recommended pharmacotherapy at hospital discharge. At discharge, 94 % of patients received aspirin, 100 % thienopyridines, 80 % angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers, 87 % β-blockers, 96 % statins, and 65 % the combination of all 5 agents. ST-segment elevation myocardial infarction, hypertension, hypercholesterolaemia, and enrolment in an interventional centre were positive independent predictors of 5-drug combination therapy at discharge. Negative independent predictors were unstable angina and advanced age. Current data from the CCR registry reflect a high quality of care for ACS discharge management in the Rotterdam-Rijnmond region. However, potential still remains for further optimisation.

  14. Regulation, proportionality and discharges of radioactive wastes: UK perspective

    International Nuclear Information System (INIS)

    Morley, Bob; Butler, Gregg; Mc Glynn, Grace

    2008-01-01

    In recent years, the UK Government and the Regulators have made a commitment to further improve the operation of the regulatory regime and to its operating within the principles of proportionality, transparency, consistency and accountability which underpin the Government's approach to regulation in general. Particular emphasis was to be placed upon ensuring that there is greater consistency in the treatment of risk and hazard; proportionate and cost effective delivery of public, worker and environmental protection; and an open and transparently applied regulatory system. It is noteworthy that with regard to radiation protection, there are different limits for public doses and workforce doses, with the latter 15 times greater. Allowable doses for medical patients are higher still. This discrepancy raises a question in itself. This presentation focuses on the practical application of the regulatory regime with particular regard to environmental discharges and disposals. Under the Radioactive Substances Act 1993, Operators within the UK nuclear industry are required to employ Best Practicable Means (BPM) to control and minimise radioactive discharges to ensure that doses from discharges are As Low As Reasonably Achievable (ALARA). Scientific assessments to date indicate that there are no expectations of environmental harm from discharges at Sellafield (and hence likewise at other UK nuclear sites where the discharges are lower), even where those discharges have historically been up to two orders of magnitude higher than current levels. Current discharges result in doses which are a small fraction of those received by the UK population due to natural background radiation. In addition, there is no proven environmental harm from foreseeable future discharges from Sellafield or other UK nuclear sites. This is supported by independent work which illustrates that the public collective dose from Sellafield discharges is almost all delivered at risks of less that one in a

  15. Galactography in non-lactating nipple discharge

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Myung Ok; Lee, Joo Mi; Moon, Jang Ho; Kang, Ik Won; Chung, Soo Young; Bae, Sang Hoon; Park, Soo Sung [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1988-08-15

    Nipple discharge in non-lactating breast is classified as 2 groups. The first group is stagnation discharge which is determined by an apocrino-like exfoliation and stagnation within the ductal system. The second group is hyperplastic or neoplastic group. The secretory breast disease combined with nipple discharge can not be diagnosed by simple X-ray mammography of ultrasonography. For differential diagnosis of secretory breast disease and for localization of lesions, the galactography is necessary. We analysed 49 cases of galactography is non-lactating breat and obtained following results. 1. The most common cause of discharge was duct ectasis (39%) in stagnation discharge group and papilloma (23%) in hyperplastic discharge group. 2. Hyperplastic discharge group occurred most frequently in 5th decade of age and was discovered more frequently in fatty parenchymal pattern on simple mammography. 3. The most frequent type of nipple discharge was cloudy-milky type in stagnation group and bloody nature in hyperplastic group. 4. The most common cause of bloody discharge was papilloma (58%). 5. The bloody nipple discharge among 56 cases of breast cancer during 4 years occurred only in 5 cases (9%)

  16. Ambulatory care of children treated with anticonvulsants - pitfalls after discharge from hospital.

    Science.gov (United States)

    Bertsche, A; Dahse, A-J; Neininger, M P; Bernhard, M K; Syrbe, S; Frontini, R; Kiess, W; Merkenschlager, A; Bertsche, T

    2013-09-01

    Anticonvulsants require special consideration particularly at the interface from hospital to ambulatory care. Observational study for 6 months with prospectively enrolled consecutive patients in a neuropediatric ward of a university hospital (age 0-anticonvulsant. Assessment of outpatient prescriptions after discharge. Parent interviews for emergency treatment for acute seizures and safety precautions. We identified changes of the brand in 19/82 (23%) patients caused by hospital's discharge letters (4/82; 5%) or in ambulatory care (15/82; 18%). In 37/76 (49%) of patients who were deemed to require rescue medication, no recommendation for such a medication was included in the discharge letters. 17/76 (22%) of the respective parents stated that they had no immediate access to rescue medication. Safety precautions were applicable in 44 epilepsy patients. We identified knowledge deficits in 27/44 (61%) of parents. Switching of brands after discharge was frequent. In the discharge letters, rescue medications were insufficiently recommended. Additionally, parents frequently displayed knowledge deficits in risk management. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Medical slang and its functions.

    Science.gov (United States)

    Coombs, R H; Chopra, S; Schenk, D R; Yutan, E

    1993-04-01

    Medical slang is analyzed in the developmental perspective of the physician's career. More than 300 terms gathered by ethnographic methods are classified by social categories: (1) the setting--various types of hospitals and facilities, (2) the players--care-givers and care-receivers, (3) the social processes--patient admission, diagnosis, treatment and discharge, and (4) death and dying. Slang usage generally begins during the third year of medical school when students rotate among clinical services and peaks during the internship year. Male and female clinicians are similar in slang usage. Five psychosocial functions of medical slang are discussed.

  18. Abortion - medical

    Science.gov (United States)

    Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...

  19. CMS proposes prioritizing patient preferences, linking patients to follow-up care in discharge planning process.

    Science.gov (United States)

    2016-03-01

    Hospital providers voice concerns about a proposed rule by the Centers for Medicare and Medicaid Services (CMS) that would require providers to devote more resources to discharge planning. The rule would apply to inpatients as well as emergency patients requiring comprehensive discharge plans as opposed to discharge instructions. CMS states that the rule would ensure the prioritization of patient preferences and goals in the discharge planning process, and also would prevent avoidable complications and readmissions. However, hospital and emergency medicine leaders worry that community resources are not yet in place to facilitate the links and follow-up required in the proposed rule, and that the costs associated with implementation would be prohibitive. The proposed rule would apply to acute care hospitals, EDs, long-term care facilities, inpatient rehabilitation centers, and home health agencies. Regardless of the setting, though, CMS is driving home the message that patient preferences should be given more weight during the discharge planning process. Under the rule, hospitals or EDs would need to develop a patient-centered discharge plan within 24 hours of admission or registration, and complete the plan prior to discharge or transfer to another facility. Under the rule, emergency physicians would determine which patients require a comprehensive discharge plan. Both the American Hospital Association and the American College of Emergency Physicians worry that hospitals will have to take on more staff, invest in training, and make changes to their electronic medical record systems to implement the provisions in the proposed rule.

  20. Utility of functional status for classifying community versus institutional discharges after inpatient rehabilitation for stroke.

    Science.gov (United States)

    Reistetter, Timothy A; Graham, James E; Deutsch, Anne; Granger, Carl V; Markello, Samuel; Ottenbacher, Kenneth J

    2010-03-01

    To evaluate the ability of patient functional status to differentiate between community and institutional discharges after rehabilitation for stroke. Retrospective cross-sectional design. Inpatient rehabilitation facilities contributing to the Uniform Data System for Medical Rehabilitation. Patients (N=157,066) receiving inpatient rehabilitation for stroke from 2006 and 2007. Not applicable. Discharge FIM rating and discharge setting (community vs institutional). Approximately 71% of the sample was discharged to the community. Receiver operating characteristic curve analyses revealed that FIM total performed as well as or better than FIM motor and FIM cognition subscales in differentiating discharge settings. Area under the curve for FIM total was .85, indicating very good ability to identify persons discharged to the community. A FIM total rating of 78 was identified as the optimal cut point for distinguishing between positive (community) and negative (institution) tests. This cut point yielded balanced sensitivity and specificity (both=.77). Discharge planning is complex, involving many factors. Identifying a functional threshold for classifying discharge settings can provide important information to assist in this process. Additional research is needed to determine if the risks and benefits of classification errors justify shifting the cut point to weight either sensitivity or specificity of FIM ratings. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Numerical Modelling of Electrical Discharges

    International Nuclear Information System (INIS)

    Durán-Olivencia, F J; Pontiga, F; Castellanos, A

    2014-01-01

    The problem of the propagation of an electrical discharge between a spherical electrode and a plane has been solved by means of finite element methods (FEM) using a fluid approximation and assuming weak ionization and local equilibrium with the electric field. The numerical simulation of this type of problems presents the usual difficulties of convection-diffusion-reaction problems, in addition to those associated with the nonlinearities of the charged species velocities, the formation of steep gradients of the electric field and particle densities, and the coexistence of very different temporal scales. The effect of using different temporal discretizations for the numerical integration of the corresponding system of partial differential equations will be here investigated. In particular, the so-called θ-methods will be used, which allows to implement implicit, semi-explicit and fully explicit schemes in a simple way

  2. DISCHARGE VALVE FOR GRANULAR MATERIAL

    Science.gov (United States)

    Stoughton, L.D.; Robinson, S.T.

    1962-05-15

    A gravity-red dispenser or valve is designed for discharging the fueled spherical elements used in a pebble bed reactor. The dispenser consists of an axially movable tube terminating under a hood having side walls with openings. When the tube is moved so that its top edge is above the tops of the side openings the elements will not flow. As the tube is moved downwardly, the elements flow into the hood through the side openings and over the top edge into the tube at an increasing rate as the tube is lowered further. The tube is spaced at all times from the hood and side walls a distance greater than the diameter of the largest element to prevent damaging of the elements when the dispenser is closed to flow. (AEC)

  3. Automatic Regulation of Wastewater Discharge

    Directory of Open Access Journals (Sweden)

    Bolea Yolanda

    2017-01-01

    Full Text Available Wastewater plants, mainly with secondary treatments, discharge polluted water to environment that cannot be used in any human activity. When those dumps are in the sea it is expected that most of the biological pollutants die or almost disappear before water reaches human range. This natural withdrawal of bacteria, viruses and other pathogens is due to some conditions such as the salt water of the sea and the sun effect, and the dumps areas are calculated taking into account these conditions. However, under certain meteorological phenomena water arrives to the coast without the full disappearance of pollutant elements. In Mediterranean Sea there are some periods of adverse climatic conditions that pollute the coast near the wastewater dumping. In this paper, authors present an automatic control that prevents such pollution episodes using two mathematical models, one for the pollutant transportation and the other for the pollutant removal in wastewater spills.

  4. Thermal discharge residence by Lake Michigan Salmonids

    International Nuclear Information System (INIS)

    Romberg, G.P.; Prepejchal, W.

    1975-01-01

    Lake Michigan salmon and trout were tagged with a thermoluminescent dosimeter (TLD) temperature tag to estimate their thermal exposure and residence time at a warm water discharge. Fish were collected, tagged, and released at the Point Beach Nuclear Plant, Two Rivers, Wisconsin, in the fall of 1973 and 1974. Tags were recovered during the same season, primarily from fish recaptured at Point Beach. Average uniform temperature exposure and maximum possible discharge residence time were determined. Appropriate hourly intake and discharge temperatures were averaged to calculate mean temperature exposure for the case of maximum discharge residence. Lowest discharge temperature not included within the period of maximum residence was identified to serve as a possible indicator of avoidance temperature. Mean values for the above parameters were calculated for fish species for each tagging year and are reported with the accompanying range of intake and discharge temperatures

  5. Development of Partial Discharging Simulation Test Equipment

    Science.gov (United States)

    Kai, Xue; Genghua, Liu; Yan, Jia; Ziqi, Chai; Jian, Lu

    2017-12-01

    In the case of partial discharge training for recruits who lack of on-site work experience, the risk of physical shock and damage of the test equipment may be due to the limited skill level and improper operation by new recruits. Partial discharge simulation tester is the use of simulation technology to achieve partial discharge test process simulation, relatively true reproduction of the local discharge process and results, so that the operator in the classroom will be able to get familiar with and understand the use of the test process and equipment.The teacher sets up the instrument to display different partial discharge waveforms so that the trainees can analyze the test results of different partial discharge types.

  6. Early hospital discharge of the healthy term neonate: the Italian perspective.

    Science.gov (United States)

    Petrone, E; Mansi, G; Tosco, A; Capasso, L; Migliaro, F; Umbaldo, A; Romano, A; Paludetto, R; Raimondi, F

    2008-06-01

    An appropriate timing of hospital discharge of the healthy, term neonate represents a balance between birth medicalization and surveillance of immediate health hazards. In the absence of European recommendations, the authors have conducted a broad national survey on the current policies of neonatal discharge. A 13-item questionnaire was sent to 136 Italian birth centers. Quantitative variables were expressed as mean+/-range. Qualitative variables were expressed as frequencies. chi squared test was used for variables comparison. Mean age at discharge for a vaginally delivered neonate was 72 hours. Twelve percent of centres would not schedule a follow-up appointment. Neonates born after a cesarean section were discharged at a mean age of 97 hours. Almost all centres (95/98) would discharge an healthy infant without risk factors for hyperbilirubinemia with a total serum bilirubin (TSB) of 13 mg/dL at 72 hours but 14.7% of these centers would not recheck TSB. The same healthy neonate would be discharged at the age of 45 hours with a TSB=10 mg/dL in 67/98 centers and in 11.9% of cases would not be rechecked. Most Italian hospitals discharge healthy, term neonates born after spontaneous vaginal delivery (SVD) at over 72 hours of age. This policy should protect from missed diagnoses of clinical importance (e.g. hyperbilirubinemia). On the other hand, a prolonged hospitalization tends to increase maternal discomfort and medical costs. Implementing a protocol of home visits/clinic follow-up appointments after an earlier discharge may minimize health hazards and medical costs and optimizing the patient's feedback.

  7. Role of secondary emission on discharge dynamics in an atmospheric pressure dielectric barrier discharge

    Energy Technology Data Exchange (ETDEWEB)

    Tay, W. H.; Kausik, S. S.; Yap, S. L.; Wong, C. S., E-mail: cswong@um.edu.my [Plasma Technology Research Centre, Department of Physics, Faculty of Science, University of Malaya, 50603 Kuala Lumpur (Malaysia)

    2014-04-15

    The discharge dynamics in an atmospheric pressure dielectric barrier discharge (DBD) is studied in a DBD reactor consisting of a pair of stainless steel parallel plate electrodes. The DBD discharge has been generated by a 50 Hz ac high voltage power source. The high-speed intensified charge coupled device camera is used to capture the images of filaments occurring in the discharge gap. It is observed that frequent synchronous breakdown of micro discharges occurs across the discharge gap in the case of negative current pulse. The experimental results reveal that secondary emissions from the dielectric surface play a key role in the synchronous breakdown of plasma filaments.

  8. Model of discharge lamps with magnetic ballast

    OpenAIRE

    Molina, Julio; Sainz Sapera, Luis; Mesas García, Juan José; Bergas Jané, Joan Gabriel

    2013-01-01

    Magnetic ballast discharge lamp modeling has been extensively studied because these lamps can be an important source of harmonics. Discharge lamp models usually represent the arc voltage by a square waveform. However, this waveform can be far from actual arc voltages, which affects the accuracy of the lamp models. This paper investigates the actual arc voltage behavior of discharge lamps from laboratory measurements and proposes a novel characterization of these voltages to reformulate the co...

  9. Discharge characteristics of copper vapor laser

    International Nuclear Information System (INIS)

    Nemoto, Koshichi; Fujii, Takashi

    1988-01-01

    This report describes about the copper vapor laser and experimental results of it's discharge characteristics. We measured time varing of plasma regist, and analyzed electron density. (1) The plasma regist is larger than 100Ω at the beginning of discharge, and is rapidly reduced to about 10Ω. (2) The electron density is estimated about 1∼2 x 10 12 /cc at the begining of discharge. (author)

  10. Discharge models through the pressurizer valves

    International Nuclear Information System (INIS)

    Madeira, A.A.

    1985-01-01

    A reliable estimate of discharge through the pressurizer relief and safety valves is of concern to adequately predict the behaviour of RCS pressure during transients. It's investigated the discharge models used by the ALMOD code, and to implement alternative models from the available literature, which are recommended for different conditions of flow that shall exist during transients requiring discharge through the relief and safety valves. (Author) [pt

  11. Fundamental Study on Electrical Discharge Machining

    OpenAIRE

    Uno, Yoshiyuki; Nakajima, Toshikatsu; Endo, Osamu

    1989-01-01

    The generation mechanism of crater in electrical discharge machining is analyzed with a single pulse discharge device for alloy tool steel, black alumina ceramics, cermet and cemented carbide, investigating the gap voltage, the discharge current, the shape of crater, the wear of electrode and so on. The experimental analysis makes it clear that the shape of crater has a characteristic feature for the kind of workpiece. The shape of electrode, which changes with the wear by an electric spark, ...

  12. Secondary mechanisms in a gas discharge

    International Nuclear Information System (INIS)

    Fletcher, J.; Blevin, H.A.

    1978-05-01

    The technique for studying swarms of electrons in a gas discharge by observing the photon flux from the discharge has been adapted to investigate the role of the secondary mechanisms. First results, reported here, show that, contrary to previous indications, ion bombardment of the cathode plays only a negligible, if any, part in the low pressure discharge in hydrogen at E/N approx. less than 200Td

  13. Patient participation in medication safety during an acute care admission.

    Science.gov (United States)

    McTier, Lauren; Botti, Mari; Duke, Maxine

    2015-10-01

    Patient participation in medication management during hospitalization is thought to reduce medication errors and, following discharge, improve adherence and therapeutic use of medications. There is, however, limited understanding of how patients participate in their medication management while hospitalized. To explore patient participation in the context of medication management during a hospital admission for a cardiac surgical intervention of patients with cardiovascular disease. Single institution, case study design. The unit of analysis was a cardiothoracic ward of a major metropolitan, tertiary referral hospital in Melbourne, Australia. Multiple methods of data collection were used including pre-admission and pre-discharge patient interviews (n = 98), naturalistic observations (n = 48) and focus group interviews (n = 2). All patients had changes made to their pre-operative cardiovascular medications as a consequence of surgery. More patients were able to list and state the purpose and side-effects of their cardiovascular medications at pre-admission than prior to discharge from hospital. There was very little evidence that nurses used opportunities such as medication administration times to engage patients in medication management during hospital admission. Failure to engage patients in medication management and provide opportunities for patients to learn about changes to their medications has implications for the quality and safety of care patients receive in hospital and when managing their medications once discharged. To increase the opportunity for patients to participate in medication management, a fundamental shift in the way nurses currently provide care is required. © 2013 John Wiley & Sons Ltd.

  14. Effects of electric discharges on polymers

    International Nuclear Information System (INIS)

    Bagirov, M.A.

    2002-01-01

    Full text: One of the reasons for the worsening of electrical properties of polymeric isolation in use in the effect of the electric discharges which developing in the gas inclusions and in the interlayer inside the isolation itself. The electrical discharges in the gas gap lead to the electrical growing old and the worsening of its electro physical qualities. We have learned the changes of electrical properties (dielectrical permeability and dielectrical loss, and electrical conductivity, electrical strength) of polymer films under the influence of electrical discharges. This paper shows the ways of increase of stability of polymers to the electrical discharges

  15. Recent trends on electrical discharge technologies

    International Nuclear Information System (INIS)

    Nakano, Toshiki

    2007-01-01

    Recent trends on the research activities of electrical-discharge-related technologies are summarized as well as the policies of the technical committee on electrical discharges (TC-ED) of IEEJ. First, the present situation of electrical discharge research is mentioned by referring to the major subjects which TC-ED is responsible to cover. As an example of the increasingly widespread use of electrical discharge technologies, vacuum electrical insulation in a neutral beam injection system of the International Thermonuclear Experimental Reactor (ITER) device is presented. (author)

  16. Investigations into electrical discharges in gases

    CERN Document Server

    Klyarfel'D, B N

    2013-01-01

    Investigations into Electrical Discharges in Gases is a compilation of scientific articles that covers the advances in the investigation of the fundamental processes occurring in electrical discharges in gases and vapors. The book details the different aspects of the whole life cycle of an arc, which include the initiation of a discharge, its transition into an arc, the lateral spread of the arc column, and the recovery of electric strength after extinction of an arc. The text also discusses the methods for the dynamic measurement of vapor density in the vicinity of electrical discharges, alon

  17. Readiness for hospital discharge: A concept analysis.

    Science.gov (United States)

    Galvin, Eileen Catherine; Wills, Teresa; Coffey, Alice

    2017-11-01

    To report on an analysis on the concept of 'readiness for hospital discharge'. No uniform operational definition of 'readiness for hospital discharge' exists in the literature; therefore, a concept analysis is required to clarify the concept and identify an up-to-date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research. Literature review and concept analysis. A review of literature was conducted in 2016. Databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied. Identification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to 'readiness for hospital discharge' were extracted from the literature: physical stability, adequate support, psychological ability, and adequate information and knowledge. This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital. © 2017 John Wiley & Sons Ltd.

  18. Risks predicting prolonged hospital discharge boarding in a regional acute care hospital.

    Science.gov (United States)

    Shaikh, Sajid A; Robinson, Richard D; Cheeti, Radhika; Rath, Shyamanand; Cowden, Chad D; Rosinia, Frank; Zenarosa, Nestor R; Wang, Hao

    2018-01-30

    Prolonged hospital discharge boarding can impact patient flow resulting in upstream Emergency Department crowding. We aim to determine the risks predicting prolonged hospital discharge boarding and their direct and indirect effects on patient flow. Retrospective review of a single hospital discharge database was conducted. Variables including type of disposition, disposition boarding time, case management consultation, discharge medications prescriptions, severity of illness, and patient homeless status were analyzed in a multivariate logistic regression model. Hospital charges, potential savings of hospital bed hours, and whether detailed discharge instructions provided adequate explanations to patients were also analyzed. A total of 11,527 admissions was entered into final analysis. The median discharge boarding time was approximately 2 h. Adjusted Odds Ratio (AOR) of patients transferring to other hospitals was 7.45 (95% CI 5.35-10.37), to court or law enforcement custody was 2.51 (95% CI 1.84-3.42), and to a skilled nursing facility was 2.48 (95% CI 2.10-2.93). AOR was 0.57 (95% CI 0.47-0.71) if the disposition order was placed during normal office hours (0800-1700). AOR of early case management consultation was 1.52 (95% CI 1.37-1.68) versus 1.73 (95% CI 1.03-2.89) for late consultation. Eighty-eight percent of patients experiencing discharge boarding times within 2 h of disposition expressed positive responses when questioned about the quality of explanations of discharge instructions and follow-up plans based on satisfaction surveys. Similar results (86% positive response) were noted among patients whose discharge boarding times were prolonged (> 2 h, p = 0.44). An average charge of $6/bed/h was noted in all hospital discharges. Maximizing early discharge boarding (≤ 2 h) would have resulted in 16,376 hospital bed hours saved thereby averting $98,256.00 in unnecessary dwell time charges in this study population alone. Type of disposition, case

  19. Genital tuberculosis: A rare cause of vulvovaginal discharge and swelling

    Directory of Open Access Journals (Sweden)

    Malak Alhakeem

    2013-09-01

    Full Text Available Herein, we report a patient with vulvovaginal tuberculosis (TB presented with a vulvovaginal mass and vaginal discharge.The diagnosis was made by both histopathological examination of the excised specimen which was clinicallysuspected to be a malignant lesion and cervical smear culture positivity for Mycobacterium tuberculosis. The patientwas prescribed a full course of anti-tuberculous drugs. In this report, we discuss the genital TB and its gynecologicaleffects in the light of medical literature. J Microbiol Infect Dis 2013; 3(3: 140-142Key words: Genital tuberculosis, vulvovaginal swelling

  20. What Controls Submarine Groundwater Discharge?

    Science.gov (United States)

    Martin, J. B.; Cable, J. E.; Cherrier, J.; Roy, M.; Smith, C. G.; Dorsett, A.

    2008-05-01

    Numerous processes have been implicated in controlling submarine groundwater discharge (SGD) to coastal zones since Ghyben, Herzberg and Dupuit developed models of fresh water discharge from coastal aquifers at the turn of the 19th century. Multiple empirical and modeling techniques have also been applied to these environments to measure the flow. By the mid-1950's, Cooper had demonstrated that dispersion across the fresh water-salt water boundary required salt water entrained into fresh water flow be balanced by recharge of salt water across the sediment-water interface seaward of the outflow face. Percolation of water into the beach face from wind and tidal wave run up and changes in pressure at the sediment-water interface with fluctuating tides have now been recognized, and observed, as processes driving seawater into the sediments. Within the past few years, variations in water table levels and the 1:40 amplification from density difference in fresh water and seawater have been implicated to pump salt water seasonally across the sediment- water interface. Salt water driven by waves, tides and seasonal water table fluctuations is now recognized as a component of SGD when it flows back to overlying surface waters. None of these processes are sufficiently large to provide measured volumes of SGD in Indian River Lagoon, Florida, however, because minimal tides and waves exist, flat topography and transmissive aquifers minimize fluctuations of the water table, and little water is entrained across the salt water-fresh water boundary. Nonetheless, the saline fraction of SGD represents more than 99% of the volume of total SGD in the Indian River Lagoon. This volume of saline SGD can be driven by the abundance of burrowing organisms in the lagoon, which pump sufficient amounts of water through the sediment- water interface. These bioirrigating organisms are ubiquitous at all water depths in sandy sediment and thus may provide one of the major sources of SGD world wide