WorldWideScience

Sample records for safe home oxygen

  1. Dementia - keeping safe in the home

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000031.htm Dementia - keeping safe in the home To use the ... make sure the homes of people who have dementia are safe for them. Safety Tips for the ...

  2. The safe home project.

    Science.gov (United States)

    Arphorn, Sara; Jiraniratisai, Sopaphan; Rungtakul, Rungsri; Phutta, Nikom

    2011-12-01

    The Thai Health Promotion Foundation supported the Improvement of Quality of Life of Informal Workers project in Ban Luang District, Amphur Photaram, Ratchaburi Province. There were many informal workers in Ban Luang District. Sweet-crispy fish producers in Ban Luang were the largest group among the sweet-crispy fish producers in Thailand. This project was aimed at improving living and working conditions of informal workers, with a focus on the sweet-crispy fish group. Good practices of improved living and working conditions were used to help informal workers build safe, healthy and productive work environments. These informal workers often worked in substandard conditions and were exposed to various hazards in the working area. These hazards included risk of exposure to hot work environment, ergonomics-related injuries, chemical hazards, electrical hazards etc. Ergonomics problems were commonly in the sweet-crispy fish group. Unnatural postures such as prolonged sitting were performed dominantly. One hundred and fifty informal workers participated in this project. Occupational health volunteers were selected to encourage occupational health and safety in four groups of informal workers in 2009. The occupational health volunteers trained in 2008 were farmers, beauty salon workers and doll makers. The occupational health and safety knowledge is extended to a new informal worker group: sweet-crispy fish producer, in 2009. The occupational health and safety training for sweet-crispy fish group is conducted by occupational health volunteers. The occupational health volunteers increased their skills and knowledge assist in to make safe home and safe community through participatory oriented training. The improvement of living and working condition is conducted by using a modified WISH, Work Improvement for Safe Home, checklist. The plans of improvement were recorded. The informal workers showed improvement mostly on material handling and storage. The safe uses and safe

  3. Using oxygen at home

    Science.gov (United States)

    ... at Home Tell your local fire department, electric company, and telephone company that you use oxygen in your home. They ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  4. Saving our backs: safe patient handling and mobility for home care.

    Science.gov (United States)

    Beauvais, Audrey; Frost, Lenore

    2014-01-01

    Predicted work-related injuries for nurses and home healthcare workers are on the rise given the many risk factors in the home environment and the escalating demands for home healthcare workers in the United States. Fortunately, safe patient handling and mobility programs can dramatically decrease injuries. Despite strides being made to promote safe patient handling and mobility programs in acute care, more can be done to establish such initiatives in the home care setting.

  5. Is home delivery safe for all involved? A new arrival breaks grandma's heart. Literally.

    Science.gov (United States)

    Doolub, Gemina; Daniels, Matthew J; Ormerod, Oliver

    2011-12-01

    Home birth is becoming increasingly popular. Labour in the privacy and comfort of a familiar environment has clear appeal. Home birth is usually as safe for low-risk women with appropriate prenatal care. Yet events during delivery can be unpredictable and may be stressful for unprepared family members. Here we report a case of Tako-tsubo cardiomyopathy, also known as broken-heart syndrome, in a relative attending an impromptu home delivery. Thus, while home delivery is generally safe for the mother we ask: is it safe for everyone involved?

  6. High output stomas: ensuring safe discharge from hospital to home.

    Science.gov (United States)

    Smith, Lisa

    High-output stomas are a challenge for the patient and all health professionals involved. This article discusses safe discharge home for this patient group, encouraging collaborative working practices between acute care trust and the community services. The authors also discuss the management of a high-output stoma and preparation and education of the patient before discharge home.

  7. Home Safe Home: Appliances, Tools, and Small Equipment. Proceed with Caution: Consumer Safety in the Home, III.

    Science.gov (United States)

    Saskatchewan Consumer and Commercial Affairs, Regina.

    Many accidents in the home are caused by faulty, defective or improperly designed tools, appliances, and equipment. Government, non-governmental organizations, and industries cooperate to develop and implement standards for the safe design and manufacture of consumer products. This booklet provides information to help consumers select products,…

  8. Being safe: making the decision to have a planned home birth in the United States.

    Science.gov (United States)

    Lothian, Judith A

    2013-01-01

    Although there is evidence that supports the safety of planned home birth for healthy women, less than 1 percent of women in the United States choose to have their baby at home. An ethnographic study of the experience of planned home birth provided rich descriptions of women's experiences planning, preparing for, and having a home birth.This article describes findings related to how women make the decision to have a planned home birth. For these women, being safe emerged as central in making the decision. For them, being safe included four factors: avoiding technological birth interventions, knowing the midwife and the midwife knowing them, feeling comfortable and protected at home, and knowing that backup hospital medical care was accessible if needed.

  9. Safe medication management in specialized home healthcare - an observational study.

    Science.gov (United States)

    Lindblad, Marléne; Flink, Maria; Ekstedt, Mirjam

    2017-08-24

    Medication management is a complex, error-prone process. The aim of this study was to explore what constitutes the complexity of the medication management process (MMP) in specialized home healthcare and how healthcare professionals handle this complexity. The study is theoretically based in resilience engineering. Data were collected during the MMP at three specialized home healthcare units in Sweden using two strategies: observation of workplaces and shadowing RNs in everyday work, including interviews. Transcribed material was analysed using grounded theory. The MMP in home healthcare was dynamic and complex with unclear boundaries of responsibilities, inadequate information systems and fluctuating work conditions. Healthcare professionals adapted their everyday clinical work by sharing responsibility and simultaneously being authoritative and preserving patients' active participation, autonomy and integrity. To promote a safe MMP, healthcare professionals constantly re-prioritized goals, handled gaps in communication and information transmission at a distance by creating new bridging solutions. Trade-offs and workarounds were necessary elements, but also posed a threat to patient safety, as these interim solutions were not systematically evaluated or devised learning strategies. To manage a safe medication process in home healthcare, healthcare professionals need to adapt to fluctuating conditions and create bridging strategies through multiple parallel activities distributed over time, space and actors. The healthcare professionals' strategies could be integrated in continuous learning, while preserving boundaries of safety, instead of being more or less interim solutions. Patients' and family caregivers' as active partners in the MMP may be an underestimated resource for a resilient home healthcare.

  10. 75 FR 20854 - Medical Device Use in the Home Environment: Implications for the Safe and Effective Use of...

    Science.gov (United States)

    2010-04-21

    ...] Medical Device Use in the Home Environment: Implications for the Safe and Effective Use of Medical Device... related to the safe and effective use of medical device technology in the home environment. The workshop... the home environment. FDA will solicit feedback on: 1. The agency's current working definition of...

  11. Home safe home: Evaluation of a childhood home safety program.

    Science.gov (United States)

    Stewart, Tanya Charyk; Clark, Andrew; Gilliland, Jason; Miller, Michael R; Edwards, Jane; Haidar, Tania; Batey, Brandon; Vogt, Kelly N; Parry, Neil G; Fraser, Douglas D; Merritt, Neil

    2016-09-01

    The London Health Sciences Centre Home Safety Program (HSP) provides safety devices, education, a safety video, and home safety checklist to all first-time parents for the reduction of childhood home injuries. The objective of this study was to evaluate the HSP for the prevention of home injuries in children up to 2 years of age. A program evaluation was performed with follow-up survey, along with an interrupted time series analysis of emergency department (ED) visits for home injuries 5 years before (2007-2013) and 2 years after (2013-2015) implementation. Spatial analysis of ED visits was undertaken to assess differences in home injury rates by dissemination areas controlling differences in socioeconomic status (i.e., income, education, and lone-parent status) at the neighborhood level. A total of 3,458 first-time parents participated in the HSP (a 74% compliance rate). Of these, 20% (n = 696) of parents responded to our questionnaire, with 94% reporting the program to be useful (median, 6; interquartile range, 2 on a 7-point Likert scale) and 81% learning new strategies for preventing home injuries. The median age of the respondent's babies were 12 months (interquartile range, 1). The home safety check list was used by 87% of respondents to identify hazards in their home, with 95% taking action to minimize the risk. The time series analysis demonstrated a significant decline in ED visits for home injuries in toddlers younger than2 years of age after HSP implementation. The declines in ED visits for home injuries remained significant over and above each socioeconomic status covariate. Removing hazards, supervision, and installing safety devices are key facilitators in the reduction of home injuries. Parents found the HSP useful to identify hazards, learn new strategies, build confidence, and provide safety products. Initial finding suggests that the program is effective in reducing home injuries in children up to 2 years of age. Therapeutic/care management study

  12. Recommendations for long-term home oxygen therapy in children and adolescents

    Directory of Open Access Journals (Sweden)

    Fabíola V. Adde

    2013-01-01

    Conclusions: Long-term home oxygen therapy is increasingly common in pediatrics and has many indications. There are relevant particularities when compared to its use in adults, regarding indications, directions for use, and monitoring.

  13. Getting home safe and sound: occupational safety and health administration at 38.

    Science.gov (United States)

    Silverstein, Michael

    2008-03-01

    The Occupational Safety and Health Act of 1970 (OSHAct) declared that every worker is entitled to safe and healthful working conditions, and that employers are responsible for work being free from all recognized hazards. Thirty-eight years after these assurances, however, it is difficult to find anyone who believes the promise of the OSHAct has been met. The persistence of preventable, life-threatening hazards at work is a failure to keep a national promise. I review the history of the Occupational Safety and Health Administration and propose measures to better ensure that those who go to work every day return home safe and sound. These measures fall into 6 areas: leverage and accountability, safety and health systems, employee rights, equal protection, framing, and infrastructure.

  14. Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention.

    Science.gov (United States)

    Markkanen, Pia; Galligan, Catherine; Laramie, Angela; Fisher, June; Sama, Susan; Quinn, Margaret

    2015-04-11

    . Manufacturers and insurance providers can improve safety with more affordable and accessible sharps with injury prevention features for home users. Sharps disposal campaigns, free-of-charge disposal containers, and convenient disposal options remain essential. Sharps injuries are preventable through public health actions that promote needleless treatment methods, sharps with injury prevention features, and safe disposal practices. Communication about hazards regarding sharps is needed for all home healthcare stakeholders.

  15. High Flow Nasal Cannula Oxygen Therapy can be used safely in the general paediatric ward using Paediatric Early Warning Scores

    NARCIS (Netherlands)

    Morsing, IE; Tinnevelt, Marcel; Jansen, Nicolaas J.G.; Koomen, E

    2015-01-01

    High Flow Nasal Cannula oxygen therapy (HFNC) is nowadays widely used at paediatric intensive care units (PICU) to provide a safe and comfortable (warm and humidified) oxygen delivery in children with respiratory distress. At general paediatric wards HFNC is hardly used because intensive observation

  16. Map of Water Infrastructure and Homes Without Access to Safe Drinking Water and Basic Sanitation on the Navajo Nation - October 2010

    Science.gov (United States)

    This document presents the results of completed work using existing geographic information system (GIS) data to map existing water and sewer infrastructure and homes without access to safe drinking water and basic sanitation on the Navajo Nation.

  17. Clinical Inquiry: Is megestrol acetate safe and effective for malnourished nursing home residents?

    Science.gov (United States)

    Wen, Frances K; Millar, James; Oberst-Walsh, Linda; Nashelsky, Joan

    2018-02-01

    No. Megestrol acetate (MA) is neither safe nor effective for stimulating appetite in malnourished nursing home residents. It increases the risk of deep vein thrombosis (strength of recommendation [SOR]: C, 2 retrospective chart reviews), but isn't associated with other new or worsening events or disorders (SOR: B, single randomized controlled trial [RCT]). Over a 25-week period, MA wasn't associated with increased mortality (SOR: B, single RCT). After 44 months, however, MA-treated patients showed decreased median survival (SOR: B, single case-control study). Consistent, meaningful weight gain was not observed with MA treatment (SOR: B, single case-control study, single RCT, 2 retrospective chart reviews, single prospective case-series).

  18. Home Oxygen Therapy

    Science.gov (United States)

    ... cold it can hurt your skin. Keep a fire extinguisher close by, and let your fire department know that you have oxygen in your ... any symptoms of illness. Medicare, Medicaid, and Commercial Insurance Certain insurance policies may pay for all your ...

  19. The SafeBoosC Phase II Randomised Clinical Trial : A Treatment Guideline for Targeted Near-Infrared-Derived Cerebral Tissue Oxygenation versus Standard Treatment in Extremely Preterm Infants

    NARCIS (Netherlands)

    Pellicer, Adelina; Greisen, Gorm; Benders, Manon; Claris, Olivier; Dempsey, Eugene; Fumagalli, Monica; Gluud, Christian; Hagmann, Cornelia; Hellstroem-Westas, Lena; Hyttel-Sorensen, Simon; Lemmers, Petra; Naulaers, Gunnar; Pichler, Gerhard; Roll, Claudia; van Bel, Frank; van Oeveren, Wim; Skoog, Maria; Wolf, Martin; Austin, Topun

    2013-01-01

    Near-infrared spectroscopy-derived regional tissue oxygen saturation of haemoglobin (rSto(2)) reflects venous oxygen saturation. If cerebral metabolism is stable, rSto(2) can be used as an estimate of cerebral oxygen delivery. The SafeBoosC phase II randomised clinical trial hypothesises that the

  20. The importance of understanding epidemiology in order to inform financial decisions: a lesson from the Scottish Home Oxygen Service.

    Science.gov (United States)

    Wood, R; Grant, I; Bain, M

    2012-11-01

    To ensure that decisions on the future planning of the Scottish Home Oxygen Service reflect population needs by examining the epidemiology of the main conditions that require home oxygen therapy and trends in their management. Analysis of routinely available vital event and health service data supplemented by published literature. Use of linked data to provide person-based analyses. Consideration of trends in key risk factors, disease incidence, prevalence and mortality for chronic neonatal lung disease, cystic fibrosis, chronic interstitial lung disease in adults and chronic obstructive pulmonary disease. Examination of trends in management of these conditions including hospital admissions, length of stay and re-admissions. The prevalence of all the conditions studied has increased in Scotland over recent years due to a combination of increased incidence, increased survival, more active case finding and demographic changes. There have been changes in management with trends towards shorter hospital stays. The clinical need for home oxygen therapy is likely to continue to increase over the next 10-20 years. It will encompass all age groups and a complex range of conditions. Public health needs to be proactive in providing relevant needs assessment information to ensure that planning within financial constraints is appropriately informed on population needs. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  1. Removing Hair Safely

    Science.gov (United States)

    ... For Consumers Home For Consumers Consumer Updates Removing Hair Safely Share Tweet Linkedin Pin it More sharing ... related to common methods of hair removal. Laser Hair Removal In this method, a laser destroys hair ...

  2. Feeling safe and motivated to achieve better health: Experiences with a partnership-based nursing practice programme for in-home patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Leine, Marit; Wahl, Astrid Klopstad; Borge, Christine Råheim; Hustavenes, Magne; Bondevik, Hilde

    2017-09-01

    To explore chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme in the home setting. Patients with chronic obstructive pulmonary disease suffer from psychological and physiological problems, especially when they return home after hospitalisation from exacerbation. Many express a need for information and knowledge about chronic obstructive pulmonary disease. Partnership as practice is a patient-centred framework providing an individualised practice for each patient. This study intends to achieve a nuanced and improved understanding of chronic obstructive pulmonary disease patients' experiences with a partnership-based nursing practice programme comprising home visits from a respiratory nurse after hospital discharge, alongside interdisciplinary collaboration. This study has a qualitative design with interviews. Six individual semi-structured interviews collected in 2012-2013 constitute the material. Interviews were recorded, transcribed to written text and analysed using systematic text condensation. Three key themes were identified: to be seen, talked with and understood; healthcare support at home-continuity, practical support and facilitation; and exchange of knowledge. However, there were two generic themes that permeated the material: feeling safe and comforted, and motivation to achieve better health. Patients with chronic obstructive pulmonary disease can experience feeling safe and comforted, and be motivated to make changes in order to achieve better health after participating in a partnership-based nursing practice programme that includes home visits from a respiratory nurse and interdisciplinary cooperation after hospital discharge. To feel safe is of great importance, and how this relates to the patient's ability to cope with illness should be explored in further research. The results suggest that the partnership-based nursing practice programme that includes home visits and interdisciplinary

  3. Cooking and oxygen. An explosive recipe.

    Science.gov (United States)

    Burns, H L; Ralston, D; Muller, M; Pegg, S

    2001-02-01

    Home oxygen therapy is commonly prescribed for the treatment of chronic obstructive pulmonary disease (COPD). The risks of smoking while using this therapy have been well described. To discuss the Royal Brisbane Hospital Burns Unit's experience and present case studies which illustrate the danger of alternative ignition sources while using home oxygen. The dangers of home oxygen therapy can be minimised by careful patient selection, education and ongoing monitoring.

  4. A safe procedure for connecting a continuous renal replacement therapy device into an extracorporeal membrane oxygenation circuit.

    Science.gov (United States)

    Suga, Natsumi; Matsumura, Yosuke; Abe, Ryuzo; Hattori, Noriyuki; Nakada, Taka-Aki; Oda, Shigeto

    2017-06-01

    Patients receiving extracorporeal membrane oxygenation (ECMO) often require continuous renal replacement therapy (CRRT). The intra-circuit pressure of adult ECMO usually deviates from the physiological range. We investigated the use of CRRT connected to an ECMO circuit with physiological intra-circuit pressures (0-150 mmHg, defined as the "safety range") using an in vitro experiment involving a water-filled ECMO circuit. The intra-circuit pressure pre-pump, post-pump, and post-oxygenator were measured while varying the height of the pump or ECMO flow. The bypass conduit pressure and distance from the post-oxygenator port were measured to find the "safety point", where the bypass pressure remained within the safety range. Both drainage and return limbs of the CRRT machine were connected to the safety point and the inlet and outlet pressures of the hemofilter were recorded while varying the ECMO and CRRT flow. The pre-pump pressure only remained within the safety range for heights >75 cm (ECMO flow = 4 L/min) or ECMO flow machine safely under physiological pressures in adult patients receiving ECMO.

  5. Respiratory Home Health Care

    Science.gov (United States)

    ... Us Home > Healthy Living > Living With Lung Disease > Respiratory Home Health Care Font: Aerosol Delivery Oxygen Resources ... Teenagers Living With Lung Disease Articles written by Respiratory Experts Respiratory Home Health Care Respiratory care at ...

  6. Everything safe? – Risk situations in advanced home care from the point of view of ventilated patients and their relatives

    Science.gov (United States)

    Ewers, Michael; Schaepe, Christiane; Lehmann, Yvonne

    2017-01-01

    Background: The number of home mechanically ventilated (HMV) patients has been growing for years. However, little is known about requirements, processes and effects of advanced home care, provided in distance from clinics and doctors. To date, safety related aspects of the above mentioned issues have scarcely been examined. Aim: Users of advanced home care were asked about their experiences and about situations in which they felt safe or unsafe. The aim was to gain insights into the daily care provision, explore safety risks from the users’ point of view, and to develop new approaches to enhance patient safety in home care for the severely ill. Method: A qualitative explorative study has been carried out, based on semi-structured interviews (ventilated patients N = 21; relatives N = 15). Sampling, data collecting and data analysis were guided by principles of Grounded Theory. Results: Risk situations occur when (non-)verbal communication offers of HMV patients are overseen or misunderstood, patient- or technology related monitoring tasks are neglected, if coordination and collaboration requirements are undervalued and if negotiation processes as well as education and supervision needs are disregarded. Furthermore, nurses’ lack of competence, self-confidence and professionalism may produce risk situations. Conclusion: Listen carefully to patients and relatives can help to identify quality shortcomings in advanced home care, to prevent risk situations and to develop patient-centered safety concepts for this particular setting.

  7. Home Improvements Prevent Falls

    Science.gov (United States)

    ... turn JavaScript on. Feature: Falls and Older Adults Home Improvements Prevent Falls Past Issues / Winter 2014 Table ... and ensure your safety. "Safe-ty-fy" Your Home Some Questions for Your Provider Will my medicines ...

  8. Home Canning and Botulism

    Science.gov (United States)

    ... this? Submit What's this? Submit Button Past Emails Home Canning and Botulism Language: English (US) Español (Spanish) ... myself and others safe when it comes to home-canned foods? Many cases of foodborne botulism have ...

  9. Awareness of the need for safe storage of Methadone at home is not improved by the use of protocols on recording information giving

    Directory of Open Access Journals (Sweden)

    Crome Ilana B

    2008-04-01

    Full Text Available Abstract Background Methadone is a synthetic, narcotic analgesic used in the treatment of drug misuse. Tragedies involving children being poisoned by the accidental ingestion of methadone are no longer a rare occurrence. Following an audit of the effectiveness of the provision and recall of information to patients attending an NHS Methadone Clinic a protocol was introduced to ensure that staff documented the provision of such information and patients gave a written confirmation that they had received the information. Methods The study was undertaken in the setting of an NHS methadone clinic with the aim of re- auditing the storage of methadone at home following the introduction of the new protocols. 174 patients completed an anonymous questionnaire regarding where they store methadone at home and whether they recall being given advice about safe storage. Community pharmacists were contacted by telephone to assess the level of advice given to methadone patients regarding safety. Results Only 49 (28.2% patients recalled being given advice about safe storage, 24 (13.8% recalled that information was provided by clinic staff. 170 (97.7% patients regard methadone as being dangerous. (28.2%. Methadone is most commonly stored in a cupboard (37.9%. All methadone is dispensed in a bottle with a child resistant cap on it. All patients reported they stored their methadone in the original bottle provided by the pharmacist. Conclusion Recall of information on safety issues is very poor. Provision of written as well as verbal information is needed. The use of printed safety information cards which patients can take away for future reference may be of use. It is the responsibility of health professionals to ensure they provide information and advice to methadone users on the safe storage of their methadone at home.

  10. Use of the Home Safety Self-Assessment Tool (HSSAT) within Community Health Education to Improve Home Safety.

    Science.gov (United States)

    Horowitz, Beverly P; Almonte, Tiffany; Vasil, Andrea

    2016-10-01

    This exploratory research examined the benefits of a health education program utilizing the Home Safety Self-Assessment Tool (HSSAT) to increase perceived knowledge of home safety, recognition of unsafe activities, ability to safely perform activities, and develop home safety plans of 47 older adults. Focus groups in two senior centers explored social workers' perspectives on use of the HSSAT in community practice. Results for the health education program found significant differences between reported knowledge of home safety (p = .02), ability to recognize unsafe activities (p = .01), safely perform activities (p = .04), and develop a safety plan (p = .002). Social workers identified home safety as a major concern and the HSSAT a promising assessment tool. Research has implications for reducing environmental fall risks.

  11. Differences among nursing homes in outcomes of a safe resident handling program.

    Science.gov (United States)

    Kurowski, Alicia; Gore, Rebecca; Buchholz, Bryan; Punnett, Laura

    2012-01-01

    A large nursing home corporation implemented a safe resident handling program (SRHP) in 2004-2007. We evaluated its efficacy over a 2-year period by examining differences among 5 centers in program outcomes and potential predictors of those differences. We observed nursing assistants (NAs), recording activities and body postures at 60-second intervals on personal digital assistants at baseline and at 3-month, 12-month, and 24-month follow-ups. The two outcomes computed were change in equipment use during resident handling and change in a physical workload index that estimated spinal loading due to body postures and handled loads. Potential explanatory factors were extracted from post-observation interviews, investigator surveys of the workforce, from administrative data, and employee satisfaction surveys. The facility with the most positive outcome measures was associated with many positive changes in explanatory factors and the facility with the fewest positive outcome measures experienced negative changes in the same factors. These findings suggest greater SRHP benefits where there was lower NA turnover and agency staffing; less time pressure; and better teamwork, staff communication, and supervisory support. © 2012 American Society for Healthcare Risk Management of the American Hospital Association.

  12. The SafeBoosC Phase II Randomised Clinical Trial

    DEFF Research Database (Denmark)

    Pellicer, Adelina; Greisen, Gorm; Benders, Manon

    2013-01-01

    Near-infrared spectroscopy-derived regional tissue oxygen saturation of haemoglobin (rStO2) reflects venous oxygen saturation. If cerebral metabolism is stable, rStO2 can be used as an estimate of cerebral oxygen delivery. The SafeBoosC phase II randomised clinical trial hypothesises that the bur...

  13. Staying Safe in Your Home During a Hurricane

    Centers for Disease Control (CDC) Podcasts

    2006-08-10

    If you are not ordered to evacuate, and you stay in your home through a hurricane, there are things you can do to protect yourself and your family.  Created: 8/10/2006 by Emergency Communications System.   Date Released: 8/13/2008.

  14. The SafeBoosC phase II clinical trial

    DEFF Research Database (Denmark)

    Riera, Joan; Hyttel-Sorensen, Simon; Bravo, María Carmen

    2016-01-01

    BACKGROUND: The SafeBoosC phase II randomised clinical trial recently demonstrated the benefits of a combination of cerebral regional tissue oxygen saturation (rStO2) by near-infrared spectroscopy (NIRS) and a treatment guideline to reduce the oxygen imbalance in extremely preterm infants. AIMS: ...

  15. Travellers and Home Education: Safe Spaces and Inequality

    Science.gov (United States)

    D'Arcy, Kate

    2014-01-01

    Elective home education (EHE) is a legal alternative to school in England but the statutory requirements for provision are remarkably vague. This book explores the use of EHE by Gypsy and Traveller families. The accounts of their experiences and their views about education spaces reveal the racism and discrimination their children encounter in…

  16. Large arteriolar component of oxygen delivery implies a safe margin of oxygen supply to cerebral tissue.

    Science.gov (United States)

    Sakadžić, Sava; Mandeville, Emiri T; Gagnon, Louis; Musacchia, Joseph J; Yaseen, Mohammad A; Yucel, Meryem A; Lefebvre, Joel; Lesage, Frédéric; Dale, Anders M; Eikermann-Haerter, Katharina; Ayata, Cenk; Srinivasan, Vivek J; Lo, Eng H; Devor, Anna; Boas, David A

    2014-12-08

    What is the organization of cerebral microvascular oxygenation and morphology that allows adequate tissue oxygenation at different activity levels? We address this question in the mouse cerebral cortex using microscopic imaging of intravascular O2 partial pressure and blood flow combined with numerical modelling. Here we show that parenchymal arterioles are responsible for 50% of the extracted O2 at baseline activity, and the majority of the remaining O2 exchange takes place within the first few capillary branches. Most capillaries release little O2 at baseline acting as an O2 reserve that is recruited during increased neuronal activity or decreased blood flow. Our results challenge the common perception that capillaries are the major site of O2 delivery to cerebral tissue. The understanding of oxygenation distribution along arterio-capillary paths may have profound implications for the interpretation of blood-oxygen-level dependent (BOLD) contrast in functional magnetic resonance imaging and for evaluating microvascular O2 delivery capacity to support cerebral tissue in disease.

  17. SMS security system for smart home detectors

    OpenAIRE

    Cekova, Katerina; Gelev, Saso

    2016-01-01

    Security has always been an important problem everywhere. Home security has been a major issue where crime is increasing and everybody wants home security to protect the home. Safety from theft and flame are the most important requirements of a home security system for people. A remote home security system offers many benefits from keeping homeowners, and their property safe. This paper present controlling of the home security system remotely from Android Application. Owners can turn on or...

  18. Early biomarkers of brain injury and cerebral hypo- and hyperoxia in the SafeBoosC II trial

    DEFF Research Database (Denmark)

    Plomgaard, Anne M.; Alderliesten, Thomas; Austin, Topun

    2017-01-01

    Background The randomized clinical trial, SafeBoosC II, examined the effect of monitoring of cerebral oxygenation by near-infrared spectroscopy combined with a guideline on treatment when cerebral oxygenation was out of the target range. Data on cerebral oxygenation was collected in both the inte......Background The randomized clinical trial, SafeBoosC II, examined the effect of monitoring of cerebral oxygenation by near-infrared spectroscopy combined with a guideline on treatment when cerebral oxygenation was out of the target range. Data on cerebral oxygenation was collected in both......, and the biomarkers of brain injury from birth till term equivalent age that was collected as secondary and explorative outcomes in the SafeBoosC II trial. Methods Cerebral oxygenation was continuously monitored during the first 72h of life in 166 extremely preterm infants. Cranial ultrasound was performed at day 1...

  19. Facilitating home birth.

    Science.gov (United States)

    Finigan, Valerie; Chadderton, Diane

    2015-06-01

    The birth of a baby is a family experience. However, in the United Kingdom birth often occurs outside the family environment, in hospital. Both home and hospital births have risks and benefits, but research shows that, for most women, it is as safe to give birth at home as it is in hospital. Women report home-birth to be satisfying with lowered risks of intervention and less likelihood of being separated from their family. It is also more cost effective for the National Health Service. Yet, whilst midwives are working hard to promote home birth as an option, it remains controversial. The aim of this paper is to raise awareness of the safety of home birth and the needs of women and midwives when a home birth is chosen. It provides an overview of care required and the role of the midwife in the ensuring care is woman-centred and personalised.

  20. [Domiciliary oxygen therapy].

    Science.gov (United States)

    Abdel Kafi, S

    2010-09-01

    In Belgium, oxygen therapy is becoming more and more accessible. When oxygen is needed for short periods or for special indications as palliative care, an agreement between mutual insurance companies and pharmacists allows the practitioner the home installation of gazeous oxygen cylinder or of oxygen concentrator. When long term oxygen therapy (LTOT) is indicated for patients with respiratory insufficiency, the pneumologist must first ask the INAMI the authorization to install one of the following modalities: oxygen concentrator with or without demand oxygen delivery cylinder and liquid oxygen. The goal of LTOT is to increase survival and quality of life. The principal and well accepted indication for LTOT is severe hypoxemia. The beneficial effects of oxygen therapy limited at night or on exertion are controversial. In order to increase patient's autonomy, oxygen can be prescribed for ambulation, respecting prescription's rules. At each step of oxygen therapy implementing (indication, choice of the device and follow-up) the patient under oxygen may benefit from a joint approach between the general practitioner and the chest specialist.

  1. Keeping It Safe: Aging in Place among Rural Older Adults

    Science.gov (United States)

    Peek, Gina G.; Bishop, Alex J.

    2016-01-01

    The purpose of the study addressed in this article was to identify ways to reduce risk and improve safe aging in place among rural older adults. Resident and Extension faculty and county educators visited study participants at home to assess functional capacity and the home environment. Extension professionals may be uniquely positioned to provide…

  2. Predictors of low back pain in nursing home workers after implementation of a safe resident handling programme.

    Science.gov (United States)

    Gold, Judith E; Punnett, Laura; Gore, Rebecca J

    2017-06-01

    Healthcare workers have high rates of low back pain (LBP) related to handling patients. A large chain of nursing homes experienced reduced biomechanical load, compensation claims and costs following implementation of a safe resident handling programme (SRHP). The aim of this study was to examine whether LBP similarly declined and whether it was associated with relevant self-reported occupational exposures or personal health factors. Worker surveys were conducted on multiple occasions beginning with the week of first SRHP introduction (baseline). In each survey, the outcome was LBP during the prior 3 months with at least mild severity during the past week. Robust Poisson multivariable regression models were constructed to examine correlates of LBP cross-sectionally at 2 years (F3) and longitudinally at 5-6 years (F5) post-SRHP implementation among workers also in at least one prior survey. LBP prevalence declined minimally between baseline and F3. The prevalence was 37% at F3 and cumulative incidence to F5 was 22%. LBP prevalence at F3 was positively associated with combined physical exposures, psychological job demands and prior back injury, while frequent lift device usage and 'intense' aerobic exercise frequency were protective. At F5, the multivariable model included frequent lift usage at F3 (relative risk (RR) 0.39 (0.18 to 0.84)) and F5 work-family imbalance (RR=1.82 (1.12 to 2.98)). In this observational study, resident lifting device usage predicted reduced LBP in nursing home workers. Other physical and psychosocial demands of nursing home work also contributed, while frequent intense aerobic exercise appeared to reduce LBP risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Oxygen safety

    Science.gov (United States)

    ... sure you have working smoke detectors and a working fire extinguisher in your home. If you move around the house with your oxygen, you may need more than one fire extinguisher in different locations. Smoking can be very dangerous. No one should smoke ...

  4. Pharmaceutical preparation of oxygen-15 labelled molecular oxygen and carbon monoxide gasses in a hospital setting.

    NARCIS (Netherlands)

    Luurtsema, Geert; Boellaard, Ronald; Greuter, Henri; Rijbroek, Abraham; Takkenkamp, Kevin; de Geest, Frank; Buijs, Fred; Hendrikse, NH; Franssen, Eric; van Lingen, Arthur; Lammertsma, Adriaan A.

    BACKGROUND: Clinical positron emission tomography (PET) requires safe and effective PET radiopharmaceuticals. Tracers used for measuring oxygen consumption and blood volume are [(15)O]O(2) and [(15)O]CO, respectively. In general, these oxygen-15 labelled tracers are produced using a cyclotron that

  5. Polysomnography for the management of oxygen supplementation therapy in infants with chronic lung disease of prematurity.

    Science.gov (United States)

    Kulkarni, Gaurav; de Waal, Koert; Grahame, Sally; Collison, Adam; Roddick, Laurence; Hilton, Jodi; Gulliver, Tanya; Whitehead, Bruce; Mattes, Joerg

    2018-04-25

    Some infants with bronchopulmonary dysplasia (BPD) may require oxygen supplementation at home but a role for overnight polysomnography (PSG) in the management of home oxygen therapy has been rarely described. Forty-one infants with BPD born at less than 30 weeks gestational age were discharged with continuous home oxygen supplementation therapy between 2010 and 2013. PSG data were recorded on oxygen supplementation versus room air at median post conceptual age of 2 months (range 1-5.5 months) (first PSG after discharge to home). Those infants who continued oxygen supplementation therapy at home had at least one more PSG before oxygen therapy was discontinued (last PSG). We also collected PSG data in 10 healthy term infants (median age 3.5 months; range 2-4 months). In infants with BPD in room air, increased numbers of central apnoeas, hypopnoeas and SaO 2 desaturations were the predominant PSG features with a median apnoea-hypopnoea index (AHI) of 16.8 events per hour (range 0-155). On oxygen supplementation therapy, median AHI dramatically improved (2.2, range 0-22; p < 0.001) and was not different from control infants (2.0, range 0-3.9; p = 0.31). AHI on room air at the last PSG when home oxygen was ceased was 4.1 per hour (range 0-13.8) slightly higher than in healthy infants. Central sleep disordered breathing in infants with BPD dramatically normalises with low flow nasal cannula home oxygen therapy and improves with age. Mild central sleep disordered breathing remains detectable, although much improved, when compared to healthy infants at the time when the decision to cease home oxygen therapy was made by the physician.

  6. Planned home birth: the professional responsibility response.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit

    2013-01-01

    This article addresses the recrudescence of and new support for midwife-supervised planned home birth in the United States and the other developed countries in the context of professional responsibility. Advocates of planned home birth have emphasized patient safety, patient satisfaction, cost effectiveness, and respect for women's rights. We provide a critical evaluation of each of these claims and identify professionally appropriate responses of obstetricians and other concerned physicians to planned home birth. We start with patient safety and show that planned home birth has unnecessary, preventable, irremediable increased risk of harm for pregnant, fetal, and neonatal patients. We document that the persistently high rates of emergency transport undermines patient safety and satisfaction, the raison d'etre of planned home birth, and that a comprehensive analysis undermines claims about the cost-effectiveness of planned home birth. We then argue that obstetricians and other concerned physicians should understand, identify, and correct the root causes of the recrudescence of planned home birth; respond to expressions of interest in planned home birth by women with evidence-based recommendations against it; refuse to participate in planned home birth; but still provide excellent and compassionate emergency obstetric care to women transported from planned home birth. We explain why obstetricians should not participate in or refer to randomized clinical trials of planned home vs planned hospital birth. We call on obstetricians, other concerned physicians, midwives and other obstetric providers, and their professional associations not to support planned home birth when there are safe and compassionate hospital-based alternatives and to advocate for a safe home-birth-like experience in the hospital. Copyright © 2013 Mosby, Inc. All rights reserved.

  7. Primary caregivers of in-home oxygen-dependent children: predictors of stress based on characteristics, needs and social support.

    Science.gov (United States)

    Wang, Kai-Wei K; Lin, Hung-Ching; Lee, Chin-Ting; Lee, Kuo-Sheng

    2016-07-01

    To identify the predictors of primary caregivers' stress in caring for in-home oxygen-dependent children by examining the association between their levels of stress, caregiver needs and social support. Increasing numbers of primary caregivers of oxygen-dependent children experience caregiving stress that warrants investigation. The study used a cross-sectional design with three psychometric scales - Modified-Parenting Stress Index, Caregiver Needs Scale and Social Support Index. The data collected during 2010-2011 were from participants who were responsible for their child's care that included oxygen therapy for ≧6 hours/day; the children's ages ranged from 3 months-16 years. Descriptive statistics and multivariable linear regression were used. A total of 104 participants (M = 34, F = 70) were recruited, with an average age of 39·7 years. The average age of the oxygen-dependent children was 6·68 years and their daily use of oxygen averaged 11·39 hours. The caregivers' overall levels of stress were scored as high and information needs were scored as the highest. The most available support from family and friends was emotional support. Informational support was mostly received from health professionals, but both instrumental and emotional support were important. Levels of stress and caregiver needs were significantly correlated. Multivariable linear regression analyses identified three risk factors predicting stress, namely, the caregiver's poor health status, the child's male gender and the caregiver's greater financial need. To support these caregivers, health professionals can maintain their health status and provide instrumental, emotional, informational and financial support. © 2016 John Wiley & Sons Ltd.

  8. The SafeBoosC II randomized trial

    DEFF Research Database (Denmark)

    Plomgaard, Anne M; van Oeveren, Wim; Petersen, Tue Hvass

    2016-01-01

    BACKGROUND: The SafeBoosC phase II multicentre randomized clinical trial investigated the benefits and harms of monitoring cerebral oxygenation by near-infrared spectroscopy (NIRS) combined with an evidence-based treatment guideline vs. no NIRS data and treatment as usual in the control group...

  9. Home Network Security

    NARCIS (Netherlands)

    Scholten, Hans; van Dijk, Hylke

    2008-01-01

    Service discovery and secure and safe service usage are essential elements in the deployment of home and personal networks. Because no system administrator is present, setup and daily operation of such a network has to be automated as much as possible with a high degree of user friendliness. To

  10. VegeSafe: A community science program measuring soil-metal contamination, evaluating risk and providing advice for safe gardening.

    Science.gov (United States)

    Rouillon, Marek; Harvey, Paul J; Kristensen, Louise J; George, Steven G; Taylor, Mark P

    2017-03-01

    The extent of metal contamination in Sydney residential garden soils was evaluated using data collected during a three-year Macquarie University community science program called VegeSafe. Despite knowledge of industrial and urban contamination amongst scientists, the general public remains under-informed about the potential risks of exposure from legacy contaminants in their home garden environment. The community was offered free soil metal screening, allowing access to soil samples for research purposes. Participants followed specific soil sampling instructions and posted samples to the University for analysis with a field portable X-ray Fluorescence (pXRF) spectrometer. Over the three-year study period, >5200 soil samples, primarily from vegetable gardens, were collected from >1200 Australian homes. As anticipated, the primary soil metal of concern was lead; mean concentrations were 413 mg/kg (front yard), 707 mg/kg (drip line), 226 mg/kg (back yard) and 301 mg/kg (vegetable garden). The Australian soil lead guideline of 300 mg/kg for residential gardens was exceeded at 40% of Sydney homes, while concentrations >1000 mg/kg were identified at 15% of homes. The incidence of highest soil lead contamination was greatest in the inner city area with concentrations declining towards background values of 20-30 mg/kg at 30-40 km distance from the city. Community engagement with VegeSafe participants has resulted in useful outcomes: dissemination of knowledge related to contamination legacies and health risks; owners building raised beds containing uncontaminated soil and in numerous cases, owners replacing all of their contaminated soil. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Care home manager attitudes to balancing risk and autonomy for residents with dementia.

    Science.gov (United States)

    Evans, Elizabeth A; Perkins, Elizabeth; Clarke, Pam; Haines, Alina; Baldwin, Ashley; Whittington, Richard

    2018-02-01

    To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach. There were three areas in which care home staff reported balancing safety and risk against the individual needs of residents. First, the physical environment created a tension between safety and accessibility to the outside world, which meant that care homes provided highly structured or limited access to outdoor space. Second, care home managers reflected a balancing act between an individual's autonomy and the need to protect their residents' dignity. Finally, care home managers highlighted the ways in which an individual's needs were framed by the needs of other residents to the extent that on some occasions an individual's needs were subjugated to the needs of the general population of a home. There was a strong, even dominant, ethos of risk management and keeping people safe. Managing individual needs while maintaining a safe care home environment clearly is a constant dynamic interpersonal process of negotiating and balancing competing interests for care home managers.

  12. Safe practices and financial considerations in using oral chemotherapeutic agents.

    Science.gov (United States)

    Bartel, Sylvia B

    2007-05-01

    Safe handling practices and financial concerns associated with oral chemotherapy in non-traditional settings are discussed. Oral chemotherapy may pose a risk to patients because of a narrow therapeutic index, complex dosing regimen, dispensing by community pharmacists without prescription order review by an oncology pharmacist or nurse, or self-administration in the home or another nontraditional setting, where patient monitoring is infrequent. Errors in prescribing, dispensing, and administration and patient or caregiver misunderstandings are potential problems with the use of oral chemotherapy that need to be addressed when developing safe practices. Changes in Medicare pharmaceutical reimbursement rates and rules need to be monitored because they have the potential to affect patient care and outcomes. Patient assistance programs and advocacy groups can help alleviate financial concerns associated with oral chemotherapy. Consensus guidelines specific to safe handling of oral chemotherapy in the home or other nontraditional setting need to be developed. Also, healthcare providers must understand reimbursement and provide direction to patients when patient assistance programs or advocacy groups can assist with the financial challenges of oral chemotherapy.

  13. Microcontroller Based Home Security and Load Controlling Using Gsm Technology

    OpenAIRE

    Mustafijur Rahman; A.H.M Zadidul Karim; Sultanur Nyeem; Faisal Khan; Golam Matin

    2015-01-01

    "Home automation" referred to as 'Intelligent home' or 'automated home', indicates the automation of daily tasks with electrical devices used in homes. This could be the control of lights or more complex chores such as remote viewing of the house interiors for surveillance purposes. The emerging concept of smart homes offers a comfortable, convenient and safe and secure environment for occupants. These include automatic load controlling, fire detection, temperature sensing, and motion detecti...

  14. Oxygen Handling and Cooling Options in High Temperature Electrolysis Plants

    Energy Technology Data Exchange (ETDEWEB)

    Manohar S. Sohal; J. Stephen Herring

    2008-07-01

    Idaho National Laboratory is working on a project to generate hydrogen by high temperature electrolysis (HTE). In such an HTE system, safety precautions need to be taken to handle high temperature oxygen at ~830°C. This report is aimed at addressing oxygen handling in a HTE plant.. Though oxygen itself is not flammable, most engineering material, including many gases and liquids, will burn in the presence of oxygen under some favorable physicochemical conditions. At present, an absolute set of rules does not exist that can cover all aspects of oxygen system design, material selection, and operating practices to avoid subtle hazards related to oxygen. Because most materials, including metals, will burn in an oxygen-enriched environment, hazards are always present when using oxygen. Most materials will ignite in an oxygen-enriched environment at a temperature lower than that in air, and once ignited, combustion rates are greater in the oxygen-enriched environment. Even many metals, if ignited, burn violently in an oxygen-enriched environment. However, these hazards do not preclude the operations and systems involving oxygen. Oxygen can be safely handled and used if all the materials in a system are not flammable in the end-use environment or if ignition sources are identified and controlled. In fact, the incidence of oxygen system fires is reported to be low with a probability of about one in a million. This report is a practical guideline and tutorial for the safe operation and handling of gaseous oxygen in high temperature electrolysis system. The intent is to provide safe, practical guidance that permits the accomplishment of experimental operations at INL, while being restrictive enough to prevent personnel endangerment and to provide reasonable facility protection. Adequate guidelines are provided to govern various aspects of oxygen handling associated with high temperature electrolysis system to generate hydrogen. The intent here is to present acceptable

  15. Home drinking-water purifiers

    International Nuclear Information System (INIS)

    Pizzichini, Massimo; Pozio, Alfonso; Russo, Claudio

    2005-01-01

    To salve the widespread problem of contaminated drinking water, home purifiers are now sold in Italy as well as other countries. This article describes how these devices work, how safe they are to use and how safe the water they produce, in the broad context of regulations on drinking water and mineral water. A new device being developed by ENEA to treat municipal water and ground water could provide greater chemical and bacteriological safety. However, the appearance of these new systems makes it necessary to update existing regulations [it

  16. Balance of power shifts when providing care in patients' homes.

    Science.gov (United States)

    Sander, Ruth

    2011-06-01

    Nursing practice at home involves entering a place where the patient's and family's values and habits predominate. In hospital, nurses work in safe territory with the aid of conferred authority but this manner might not be suitable in a patient's own home. When people need nursing care, the meaning of home is at risk of changing.

  17. The implementation of intelligent home controller

    Science.gov (United States)

    Li, Biqing; Li, Zhao

    2018-04-01

    This paper mainly talks about the working way of smart home terminal controller and the design of hardware and software. Controlling the lights and by simulating the lamp and the test of the curtain, destroy the light of lamp ON-OFF and the curtain's UP-DOWN by simulating the lamp and the test of the cuetain. Through the sensor collects the ambient information and sends to the network, such as light, temperature and humidity. Besides, it can realise the control of intelligent home control by PCS. Terminal controller of intelligent home which is based on ZiBee technology has into the intelligent home system, it provides people with convenient, safe and intelligent household experience.

  18. Oxygen treatment of cluster headache

    DEFF Research Database (Denmark)

    Petersen, Anja S; Barloese, Mads C J; Jensen, Rigmor H

    2014-01-01

    PURPOSE: Our aim was to review the existing literature to document oxygen's therapeutic effect on cluster headache. METHOD: A PubMed search resulted in 28 hits, and from these and their references we found in total 11 relevant studies. We included six studies that investigated the efficacy......, but not a prophylactic effect. Despite the fact that only a few high-quality RCT studies are available, oxygen treatment is close to an ideal treatment because it is effective and safe. However, sufferers of cluster headache do not always have access to oxygen because of logistic and financial concerns....

  19. Recomendações para oxigenoterapia domiciliar prolongada em crianças e adolescentes Recommendations for long-term home oxygen therapy in children and adolescents

    Directory of Open Access Journals (Sweden)

    Fabíola V. Adde

    2013-02-01

    monitorização.OBJECTIVE: To advise pediatricians, neonatologists, pulmonologists, pediatric pulmonologists, and other professionals in the area on the main indications and characteristics of long-term home oxygen therapy in children and adolescents. DATA SOURCE: A literature search was carried out in the MEDLINE/PubMed database (1990 to 2011. Additionally, references from selected studies were included. As consistent scientific evidence does not exist for many aspects, some of the recommendations were based on clinical experience. DATA SYNTHESIS: Long-term home oxygen therapy has been a growing practice in pediatric patients and is indicated in bronchopulmonary dysplasia, cystic fibrosis, bronchiolitis obliterans, interstitial lung diseases, and pulmonary hypertension, among others. The benefits are: decrease in hospitalizations, optimization of physical growth and neurological development, improvement of exercise tolerance and quality of sleep, and prevention of pulmonary hypertension/cor pulmonale. The levels of oxygen saturation indicative for oxygen therapy differ from those established for adults with chronic obstructive pulmonary disease, and vary according to age and disease. Pulse oximetry is used to evaluate oxygen saturation; arterial blood gas is unnecessary. There are three available sources of oxygen: gas cylinders, liquid oxygen, and oxygen concentrators. The flows used are usually smaller, as are the number of hours/day needed when compared to the use in adults. Some diseases show improvement and oxygen therapy discontinuation is possible. CONCLUSIONS: Long-term home oxygen therapy is increasingly common in pediatrics and has many indications. There are relevant particularities when compared to its use in adults, regarding indications, directions for use, and monitoring.

  20. Smart Home : A Social, Technological and Virtual Learning and Development Environment

    OpenAIRE

    Heimovaara-Kotonen, Essi (ed.)

    2014-01-01

    All people have the right to good housing regardless of their age or functional capacity. The objective of the Smart Home environment is to present solutions that enable accessible and safe housing and promote meaningful assistance and life at home. The goal of building the Smart Home environment was to find a useroriented, comprehensive solution for the client, which maintains the client’s own control over his or her home environment. The Smart Home was also built to serve the developme...

  1. Development of Safe Food Handling Guidelines for Korean Consumers.

    Science.gov (United States)

    Kang, Hee-Jin; Lee, Min-Woo; Hwang, In-Kyeong; Kim, Jeong-Weon

    2015-08-01

    The purpose of this study was to develop guidelines for Korean consumers with regard to safe food handling practices at home by identifying current food handling issues. Korean consumers' behaviors regarding their safe food handling were identified via survey questionnaires that included items on individual hygiene practices, prepreparation steps when cooking, the cooking process, and the storage of leftover foods. The subjects were 417 Korean parents with elementary school children living in Seoul and Gyeonggi Province in the central area of Korea. The survey results revealed gaps between the knowledge or practices of Korean consumers and scientific evidence pertaining to safe food handling practices. Based on these findings, a leaflet on safe food handling guidelines was developed in accordance with Korean food culture. These guidelines suggest personal hygiene practices as well as fundamental principles and procedures for safe food handling from the stage of food purchase to that of keeping leftover dishes. A pilot application study with 50 consumers revealed that the guidelines effectively improved Korean consumers' safe food handling practices, suggesting that they can serve as practical educational material suitable for Korean consumers.

  2. On-line hemodiafiltration at home.

    Science.gov (United States)

    Vega, Almudena; Abad, Soraya; Macías, Nicolás; Aragoncillo, Inés

    2018-04-01

    Survival with online hemodiafiltration (OL-HDF) is higher than with hemodialysis; frequent hemodialysis has also improved survival and quality of life. Home hemodialysis facilitates frequent therapy. We report our experience with 2 patients with stage 5 CKD who started home hemodialysis with OL-HDF in November 2016. After a training period at the hospital, they started home hemodialysis with OL-HDF after learning how to manage dialysis monitors and how to administer water treatment. We used the "5008-home" (FMC © ) monitor, and the Acqua C © (Fresenius Medical Care) for water treatment. Water conductivity was always checked before and during dialysis sessions and was always 2.5 to 3 mS/cm. Water cultures always fulfilled the criteria for ultrapurity. As far as we know, this is the first report on patients receiving OL-HDF at home. The technique proved to be safe and valid for renal replacement therapy and transfers the benefits of hospital convective therapy to the home setting. Future data will enable us to determine whether survival has also improved. © 2017 International Society for Hemodialysis.

  3. Ohio Department of Health Home

    Science.gov (United States)

    Business Award Flu Season Media button unselected Media button selected Data Stats button unselected Data unselected Contact Us button selected Start Talking Help Me Grow WIC (Women, Infants & Children) Office , sleep-related deaths and birth defects. Makes it easier for Ohio families to identify lead-safe homes

  4. Changes in Oxygen Partial Pressure in the Vitreous Body and Arterial Blood of Rabbits Depending on Oxygen Concentration in Inspired Mixture.

    Science.gov (United States)

    Amkhanitskaya, L I; Nikolaeva, G V; Sokolova, N A

    2015-07-01

    We demonstrated that the vitreous body of one-month-old rabbits becomes a "reservoir" for storage and accumulation of oxygen after exposure to additional oxygenation of the organism (O2 concentrations in inspired gas mixture were 40, 60, 85, and 99%). The higher was O2 concentration in inspired mixture, the higher was oxygen saturation of the blood and vitreous body. O2 concentration of 40% was relatively safe for eye tissues. O2 concentration >60% induced oxygen accumulation in the vitreous body, which can be a provoking factor for the development of oxygen-induced pathologies.

  5. Safe delivery practices: experience from cross-sectional data of Bangladeshi women.

    Science.gov (United States)

    Kabir, M A; Goh, Kim-Leng; Khan, M M H; Al-Amin, Abul Quasem; Azam, Mohammad Nurul

    2015-03-01

    This study examines the safe delivery practices of Bangladeshi women using data on 4905 ever-married women aged 15 to 49 years from the 2007 Bangladesh Demographic and Health Survey. Variables that included age, region of origin, education level of respondent and spouse, residence, working status, religion, involvement in NGOs, mass media exposure, and wealth index were analyzed to find correlates of safe delivery practices. More than 80% of the deliveries took place at home, and only 18% were under safe and hygienic conditions. The likelihood of safe deliveries was significantly lower among younger and older mothers than middle-aged mothers and higher among educated mothers and those living in urban areas. Economically better-off mothers and those with greater exposure to mass media had a significantly higher incidence of safe delivery practices. A significant association with religion and safe delivery practices was revealed. Demographic, socioeconomic, cultural, and programmatic factors that are strongly associated with safe delivery practices should be considered in the formulation of reproductive health policy. © 2012 APJPH.

  6. Recovery After Stroke: Managing Life at Home

    Science.gov (United States)

    ... be made before you go home. Staying Safe Connected and  Write out emergency phone numbers in large ... learn how to manage many sharp or hot objects that pose serious dangers in the kitchen. To ...

  7. Oxygen therapy in acute exacerbations of chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Ringbaek, T.; Lange, P.; Mogensen, T.

    2008-01-01

    Acute exacerbation of COPD is a major cause of hospitalisation in Denmark. Most of the patients require supplemental oxygen in the acute phase and some patients continue oxygen therapy at home after discharge. In this paper we discuss the physiological mechanisms of respiratory failure seen...... in acute exacerbations of COPD. The principles for oxygen therapy in the acute phase are described and recommendations for oxygen therapy are suggested Udgivelsesdato: 2008/5/5...

  8. Use of Palliative Care in Patients With End-Stage COPD and Receiving Home Oxygen: National Trends and Barriers to Care in the United States.

    Science.gov (United States)

    Rush, Barret; Hertz, Paul; Bond, Alexandra; McDermid, Robert C; Celi, Leo Anthony

    2017-01-01

    To investigate the use of palliative care (PC) in patients with end-stage COPD receiving home oxygen hospitalized for an exacerbation. A retrospective nationwide cohort analysis was performed, using the Nationwide Inpatient Sample. All patients ≥ 18 years of age with a diagnosis of COPD, receiving home oxygen, and admitted for an exacerbation were included. A total of 55,208,382 hospitalizations from the 2006-2012 Nationwide Inpatient Sample were examined. There were 181,689 patients with COPD, receiving home oxygen, and admitted for an exacerbation; 3,145 patients (1.7%) also had a PC contact. There was a 4.5-fold relative increase in PC referral from 2006 (0.45%) to 2012 (2.56%) (P < .01). Patients receiving PC consultations compared with those who did not were older (75.0 years [SD 10.9] vs 70.6 years [SD 9.7]; P < .01), had longer hospitalizations (4.9 days [interquartile range, 2.6-8.2] vs 3.5 days [interquartile range, 2.1-5.6]), and more likely to die in hospital (32.1% vs 1.5%; P < .01). Race was significantly associated with referral to palliative care, with white patients referred more often than minorities (P < .01). Factors associated with PC referral included age (OR, 1.03; 95% CI, 1.02-1.04; P < .01), metastatic cancer (OR, 2.40; 95% CI, 2.02-2.87; P < .01), nonmetastatic cancer (OR, 2.75; 95% CI, 2.43-3.11; P < .01), invasive mechanical ventilation (OR, 4.89; 95% CI, 4.31-5.55; P < .01), noninvasive mechanical ventilation (OR, 2.84; 95% CI, 2.58-3.12; P < .01), and Do Not Resuscitate status (OR, 7.95; 95% CI, 7.29-8.67; P < .01). The use of PC increased dramatically during the study period; however, PC contact occurs only in a minority of patients with end-stage COPD admitted with an exacerbation. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  9. The impact of state fire safe cigarette policies on fire fatalities, injuries, and incidents.

    Science.gov (United States)

    Folz, David H; Shults, Chris

    Cigarettes are a leading cause of civilian deaths in home fires. Over the last decade, state fire service leaders and allied interest groups succeeded in persuading state lawmakers to require manufacturers to sell only low-ignition strength or "fire safe" cigarettes as a strategy to reduce these fatalities and the injuries and losses that stem from them. This article examines whether the states' fire safe cigarette laws actually helped to save lives, prevent injuries, and reduce the incidence of home fires ignited by cigarettes left unattended by smokers. Controlling for the effects of key demographic, social, economic, and housing variables, this study finds that the states' fire-safe cigarette policies had significant impacts on reducing the rate of smoking-related civilian fire deaths and the incidence of fires started by tobacco products. The findings also suggest that the states' fire safe cigarette policies may have helped to reduce the rate of smoking-related fire injuries. The study shows that collective actions by leaders in the fire service across the states can result in meaningful policy change that protects lives and advances public safety even when a political consensus for action is absent at the national level.

  10. Not all food additive related reactions originate from commercial foods: chronic urticaria due to home-made canned tomato.

    Science.gov (United States)

    Ozturk, S; Karaayvaz, M; Caliskaner, Z; Gulec, M

    2005-01-01

    Additives and preservatives in commercial foods have been implicated in the etiology of chronic urticaria, but such foods have not been widely accepted. In some countries, as in ours, people prefer to use home-made foodstuffs to avoid potentially hazardous commercial additives. However, not all home-made foodstuffs are safe, especially regarding allergies. In this report, we describe a patient with chronic urticaria due to home-made canned tomato prepared using "tomato drug" as a "safe (!)" additive.

  11. Guiding people with early dementia home with the talkmehome service

    NARCIS (Netherlands)

    Christian Hesselman; Martine de Jong; Marcel Roest; Marike Hettinga; Matti Groot; Lammie van den Bosch; Jeffrey Brangert; Jan M. Nauta

    2012-01-01

    People suffering from mild dementia may get lost during a walk, which can be dangerous for them and adds to the anxiety felt by their informal caregivers. TalkMeHome is a new service that allows these people to get home safely in such situations using their mobile phone. They can call a remote care

  12. Vascular access for home haemodialysis.

    Science.gov (United States)

    Al Shakarchi, Julien; Day, C; Inston, N

    2018-03-01

    Home haemodialysis has been advocated due to improved quality of life. However, there are very little data on the optimum vascular access for it. A retrospective cohort study was carried on all patients who initiated home haemodialysis between 2011 and 2016 at a large university hospital. Access-related hospital admissions and interventions were used as primary outcome measures. Our cohort consisted of 74 patients. On initiation of home haemodialysis, 62 individuals were using an arteriovenous fistula as vascular access, while the remaining were on a tunnelled dialysis catheter. Of the 12 patients who started on a tunnelled dialysis catheter, 5 were subsequently converted to either an arteriovenous fistula ( n = 4) or an arteriovenous graft ( n = 1). During the period of home haemodialysis use, four arteriovenous fistula failed or thrombosed with patients continuing on home haemodialysis using an arteriovenous graft ( n = 3) or a tunnelled dialysis catheter ( n = 1). To maintain uninterrupted home haemodialysis, interventional rates were 0.32 per arteriovenous fistula/arteriovenous graft access-year and 0.4 per tunnelled dialysis catheter access-year. Hospital admission rates for patients on home haemodialysis were 0.33 per patient-year. Our study has shown that home haemodialysis can be safely and independently performed at home within a closely managed home haemodialysis programme. The authors also advocate the use of arteriovenous fistulas for this cohort of patients due to both low complication and intervention rates.

  13. Safe discharge: an irrational, unhelpful and unachievable concept

    OpenAIRE

    Goodacre, S

    2006-01-01

    Emergency doctors often decide whether to advise hospital admission or discharge by assessing whether a decision to discharge home is considered safe. This implies that hospital admission may be recommended on the basis of exceeding an arbitrarily defined risk of adverse outcome, rather than weighing the potential benefits, risks and costs of hospital admission. This approach is likely to lead to irrational decision making, unnecessary hospitalisation and unrealistic expectations regarding ri...

  14. Setting priorities for safe motherhood interventions in resource-scarce settings.

    Science.gov (United States)

    Prata, Ndola; Sreenivas, Amita; Greig, Fiona; Walsh, Julia; Potts, Malcolm

    2010-01-01

    Guide policy-makers in prioritizing safe motherhood interventions. Three models (LOW, MED, HIGH) were constructed based on 34 sub-Saharan African countries to assess the relative cost-effectiveness of available safe motherhood interventions. Cost and effectiveness data were compiled and inserted into the WHO Mother Baby Package Costing Spreadsheet. For each model we assessed the percentage in maternal mortality reduction after implementing all interventions, and optimal combinations of interventions given restricted budgets of US$ 0.50, US$ 1.00, US$ 1.50 per capital maternal health expenditures respectively for LOW, MED, and HIGH models. The most cost-effective interventions were family planning and safe abortion (fpsa), antenatal care including misoprostol distribution for postpartum hemorrhage prevention at home deliveries (anc-miso), followed by sepsis treatment (sepsis) and facility-based postpartum hemorrhage management (pph). The combination of interventions that avert the greatest number of maternal deaths should be prioritized and expanded to cover the greatest number of women at risk. Those which save the most number of lives in each model are 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for LOW; 'fpsa, anc-miso' and 'fpsa, sepsis, safe delivery' for MED; and 'fpsa, anc-miso, sepsis, eclampsia treatment, safe delivery' for HIGH settings. Safe motherhood interventions save a significant number of newborn lives.

  15. Oxygen from Hydrogen Peroxide. A Safe Molar Volume-Molar Mass Experiment.

    Science.gov (United States)

    Bedenbaugh, John H.; And Others

    1988-01-01

    Describes a molar volume-molar mass experiment for use in general chemistry laboratories. Gives background technical information, procedures for the titration of aqueous hydrogen peroxide with standard potassium permanganate and catalytic decomposition of hydrogen peroxide to produce oxygen, and a discussion of the results obtained in three…

  16. Make Yourself At Home! Adolescents in Search of the Queer Spaces of Home

    Directory of Open Access Journals (Sweden)

    Kokkola, Lydia

    2014-09-01

    Full Text Available Home is often assumed to be a safe place, a place to which children can return after their adventures Away. For many gay and lesbian teens, both fictional and in real life, however, the space they share with their family of origin is not a place where they can feel at home. The heterosexual family home is often so hostile to queerly desiring teens that they are forced to leave in search of a place where they can feel at home. The queer spaces they enter in their search are usually considered risky spaces – public spaces, urban spaces, the bar and the street – unhomely spaces. In these temporary, in-between spaces, the queerly desiring teens in the novels examined in this paper form new family structures. Although all the Anglophone novels discussed in this article end on moments of up-lift and hope for the future, the association of the queerly desiring youngster with risky spaces suggests that the queer teens are themselves unheimlich (uncanny..

  17. Measuring safety climate in elderly homes.

    Science.gov (United States)

    Yeung, Koon-Chuen; Chan, Charles C

    2012-02-01

    Provision of a valid and reliable safety climate dimension brings enormous benefits to the elderly home sector. The aim of the present study was to make use of the safety climate instrument developed by OSHC to measure the safety perceptions of employees in elderly homes such that the factor structure of the safety climate dimensions of elderly homes could be explored. In 2010, surveys by mustering on site method were administered in 27 elderly homes that had participated in the "Hong Kong Safe and Healthy Residential Care Home Accreditation Scheme" organized by the Occupational Safety and Health Council. Six hundred and fifty-one surveys were returned with a response rate of 54.3%. To examine the factor structure of safety climate dimensions in our study, an exploratory factor analysis (EFA) using principal components analysis method was conducted to identify the underlying factors. The results of the modified seven-factor's safety climate structure extracted from 35 items better reflected the safety climate dimensions of elderly homes. The Cronbach alpha range for this study (0.655 to 0.851) indicated good internal consistency among the seven-factor structure. Responses from managerial level, supervisory and professional level, and front-line staff were analyzed to come up with the suggestion on effective ways of improving the safety culture of elderly homes. The overall results showed that managers generally gave positive responses in the factors evaluated, such as "management commitment and concern to safety," "perception of work risks and some contributory influences," "safety communication and awareness," and "safe working attitude and participation." Supervisors / professionals, and frontline level staff on the other hand, have less positive responses. The result of the lowest score in the factors - "perception of safety rules and procedures" underlined the importance of the relevance and practicability of safety rules and procedures. The modified OSHC

  18. 76 FR 56784 - Safe and Healthy Homes Investment Partnerships: Request for Comments

    Science.gov (United States)

    2011-09-14

    ... the attention of the Rules Docket Clerk. Due to security measures at all federal agencies, submission... multiple intervention strategies, pilot initiatives in several cities and counties began to formalize... HUD Healthy Homes Rating Tool (HHRT), c. Supporting common multi-disciplinary workforce training, d...

  19. Making home visits: Creativity and the embodied practices of home visiting in social work and child protection.

    Science.gov (United States)

    Ferguson, Harry

    2018-01-01

    Although the home is the most common place where social work goes on, research has largely ignored the home visit. Drawing on a participant observation study of child protection work, this article reveals the complex hidden practices of social work on home visits. It is argued that home visits do not simply involve an extension of the social work organisation, policies and procedures into the domestic domain but the home constitutes a distinct sphere of practice and experience in its own right. Home visiting is shown to be a deeply embodied practice in which all the senses and emotions come into play and movement is central. Through the use of creativity, craft and improvisation practitioners 'make' home visits by skilfully enacting a series of transitions from the office to the doorstep, and into the house, where complex interactions with service users and their domestic space and other objects occur. Looking around houses and working with children alone in their bedrooms were common. Drawing upon sensory and mobile methods and a material culture studies approach, the article shows how effective practice was sometimes blocked and also how the home was skilfully negotiated, moved around and creatively used by social workers to ensure parents were engaged with and children seen, held and kept safe.

  20. Planned hospital birth versus planned home birth

    DEFF Research Database (Denmark)

    Olsen, O.; Clausen, J.A.

    2012-01-01

    Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998....

  1. Newborn care practices and home-based postnatal newborn care programme – Mewat, Haryana, India, 2013

    Directory of Open Access Journals (Sweden)

    Latika Nath Sinha

    2014-09-01

    Full Text Available Background: In India, the Home Based Postnatal Newborn Care programme by Accredited Social Health Activists (ASHAs under the National Rural Health Mission was initiated in 2011 to reduce neonatal mortality rates (NMRs. ASHAs get cash incentives for six postnatal home visits for newborn care. We studied newborn care practices among mothers in Mewat, Haryana, having a high NMR and determined risk factors for unsafe practices and described the knowledge and skills of ASHAs during home visits. Methods: A cross-sectional survey was conducted among mothers who had delivered a child during the previous seven months using cluster sampling. We interviewed mothers and ASHAs in the selected subcentres using semi–structured questionnaires on the six safe newborn care practices, namely safe breastfeeding, keeping cord and eyes clean, wrapping baby, kangaroo care, delayed bathing and hand washing. Results: We interviewed 320 mothers, 61 ASHAs and observed 19 home visits. Overall, 60% of mothers adopted less than three safe practices. Wrapping newborns (96% and delayed bathing (64% were better adopted than cord care (49%, safe breastfeeding (48%, hand washing (30%, kangaroo care (20% and eye care (9%. Cultural beliefs and traditional birth attendants influenced the mother’s practices. The lack of supervision by auxiliary nurse midwives (ANM, delayed referral and transportation were the other challenges. Conclusion: Knowledge–practice gaps existed among mothers counselled by ASHAs. Poor utilization of reproductive and child health services decreased opportunities for ASHA–mother dialogue on safe practices. Recommendations included training ANMs, training TBAs as ASHAs, innovative communication strategies for ASHAs and improved referral system.

  2. Teaching Family Caregivers to Assist Safely with Mobility.

    Science.gov (United States)

    Powell-Cope, Gail; Pippins, Karla M; Young, Heather M

    2017-12-01

    : This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series explain principles for promoting safe mobility that nurses should reinforce with family caregivers. Each article also includes an informational tear sheet-Information for Family Caregivers-that contains links to instructional videos. To use this series, nurses should read the article first, so they understand how best to help family caregivers, and then encourage the caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.

  3. Effect of Electroacupuncture on Transcutaneous Oxygen Partial Pressure During Hyperbaric Oxygen Therapy in Healthy Individuals.

    Science.gov (United States)

    Qu, Lan; Ye, Yong; Li, Chunfeng; Gao, Guangkai

    2015-01-01

    The goal of hyperbaric oxygen therapy (HBOT) is to increase the oxygen (O₂) supply to the body significantly. Because of the toxic side effects and complications of hyperbaric oxygen (HBO₂), the environmental pressure and treatment time must be restricted. The research team hypothesized that other therapies administered during HBOT could safely improve the value of the arterial oxygen partial pressure (PaO₂) during HBOT and improve its therapeutic effect. The study intended to investigate whether electroacupuncture (EA) while receiving HBOT had a greater effect for healthy individuals than HBOT or EA alone or EA combined with normobaric pure oxygen (pure O₂). The research team designed a randomized, controlled trial. The study was performed in the Department of Hyperbaric Medicine at the No. 401 Hospital of the People's Liberation Army in Qingdao, China. A total of 81 volunteers were recruited. After thorough physical examination and laboratory testing, 21 volunteers were excluded from the study. Participants included 60 healthy volunteers. Participants were randomly assigned to 1 of 4 groups of 15 participants each: (1) an HBOT group, (2) an EA group, (3) an EA During HBOT group, and (4) an EA Combined With Pure O₂group. Because at the current technology level a blood gas analyzer cannot test PaO₂during HBOT, transcutaneous oxygen partial pressure (PtcO₂) of the participants was tested instead. Before, during, and after EA, variations in PtcO₂were monitored in each group. For the EA During HBOT group, (1) the increase in PtcO₂during EA was significantly greater than that observed for the other 3 groups (P > .05). The EA During HBOT method provided improvements in the efficacy, safety, and tolerability of HBOT, and the study's results partially demonstrated the accuracy of the research team's hypothesis that EA therapy applied during HBOT could safely improve the value of PtcO₂(PaO₂) during HBOT and produce a greater therapeutic effect.

  4. Law, Ethics, and Conversations between Physicians and Patients about Firearms in the Home.

    Science.gov (United States)

    McCourt, Alexander D; Vernick, Jon S

    2018-01-01

    Firearms in the home pose a risk to household members, including homicide, suicide, and unintentional deaths. Medical societies urge clinicians to counsel patients about those risks as part of sound medical practice. Depending on the circumstances, clinicians might recommend safe firearm storage, temporary removal of the firearm from the home, or other measures. Certain state firearm laws, however, might present legal and ethical challenges for physicians who counsel patients about guns in the home. Specifically, we discuss state background check laws for gun transfers, safe gun storage laws, and laws forbidding physicians from engaging in certain firearm-related conversations with their patients. Medical professionals should be aware of these and other state gun laws but should offer anticipatory guidance when clinically appropriate. © 2018 American Medical Association. All Rights Reserved.

  5. Development of safe routes for children in urban environment

    Science.gov (United States)

    Koryagin, M. E.; Medvedev, V. I.; Strykov, P. G.

    2018-01-01

    The matter of development of safe travel routes for children between school and home is analyzed. The availability of various applications and devices to identify the location of the child and his/her travel routes is noted. The main factors to be taken into account when planning children travel routes are described. The most popular Russian services for route planning, Google, Yandex, and 2GIS, are discussed. These services are shown to have a number of shortcomings which does not allow them to choose really safe routes. A decision on making the route selection by two criteria (the travel time and the probability of an accident) is obtained. As a numerical example, the Pareto area for possible routes is constructed.

  6. Safe current in home and spare time. Sicherer Strom in Heim und Freizeit. Vortraege

    Energy Technology Data Exchange (ETDEWEB)

    1982-01-01

    The papers read at the meeting of the Association of Electrical Engineers (VDE) in May 1982 are intended on the one hand to create awareness of sources of danger and, on the other hand, to demonstrate and discuss how safety can be further enhanced by consistent use of standardization and enlightenment. They are titled as follows: Power accidents in home and spare time; Physiological aspects of accidents; Tasks of the state in consumer protection; Consumer protection through laws and standards; Test institutions and test-marks; Installation technology at home and abroad; Protective measures; Teaching and learning safety; Training for electricians and continuation training.

  7. A physical workload index to evaluate a safe resident handling program for nursing home personnel.

    Science.gov (United States)

    Kurowski, Alicia; Buchholz, Bryan; Punnett, Laura

    2014-06-01

    The aim of this study was to obtain a comprehensive analysis of the physical workload of clinical staff in long-term care facilities, before and after a safe resident handling program (SRHP). Ergonomic exposures of health care workers include manual handling of patients and many non-neutral postures. A comprehensive assessment requires the integration of loads from these varied exposures into a single metric. The Postures, Activities, Tools, and Handling observational protocol, customized for health care, was used for direct observations of ergonomic exposures in clinical jobs at 12 nursing homes before the SRHP and 3, 12, 24, and 36 months afterward. Average compressive forces on the spine were estimated for observed combinations of body postures and manual handling and then weighted by frequencies of observed time for the combination. These values were summed to obtain a biomechanical index for nursing assistants and nurses across observation periods. The physical workload index (PWI) was much higher for nursing assistants than for nurses and decreased more after 3 years (-24% versus -2.5%). Specifically during resident handling, the PWI for nursing assistants decreased by 41% of baseline value. Spinal loading was higher for nursing assistants than for nurses in long-term care centers. Both job groups experienced reductions in physical loading from the SRHP, especially the nursing assistants and especially while resident handling. The PWI facilitates a comprehensive investigation of physical loading from both manual handling and non-neutral postures. It can be used in any work setting to identify high-risk tasks and determine whether reductions in one exposure are offset by increases in another.

  8. Oxygen deficiency at CERN: Hazards, risks & mitigation measures

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    Compressed and liquified gases are used at many places at CERN. If they are introduced to the atmosphere, they can present an oxygen deficiency hazard (ODH) and lead to reduced abilities, unconsciousness or even death. The CERN method for ODH risk assessments is done on a case-by-case basis as each situation is unique. It is crucial to make sure the personnel can evacuate safely in case of an ODH situation. My talk will explain human reactions to reduced oxygen levels and I will give some practical examples on how one can assess and control the hazards from a possible oxygen deficient atmosphere. Some real accidents involving oxygen deficiency will also be mentioned.

  9. 77 FR 5186 - Medical Foster Homes

    Science.gov (United States)

    2012-02-02

    ... have a posted ``No Smoking'' sign. Oxygen cylinders must be adequately secured or protected to prevent... living areas of the home. (n) Smoking. Smoking must be prohibited in all sleeping rooms, including... not limited to prohibiting smoking or use of a fireplace. However, each veteran resident who is...

  10. A bench evaluation of fraction of oxygen in air delivery and tidal volume accuracy in home care ventilators available for hospital use

    Science.gov (United States)

    Baboi, Loredana; Subtil, Fabien

    2016-01-01

    Background Turbine-powered ventilators are not only designed for long-term ventilation at home but also for hospital use. It is important to verify their capabilities in delivering fraction of oxygen in air (FIO2) and tidal volume (VT). Methods We assessed the FIO2 accuracy and the VT delivery in four home care ventilators (HCV) on the bench. The four HCV were Astral 150, Elisée 150, Monnal T50 and Trilogy 200 HCV, which were connected to a lung model (ASL 5000). For assessing FIO2 accuracy, lung model was set to mimic an obstructive lung and HCV were set in volume controlled mode (VC). They supplied with air, 3 or 15 L/min oxygen and FIO2 was measured by using a ventilator tester (Citrex H4TM). For the VT accuracy, the lung model was set in a way to mimic three adult configurations (normal, obstructive, or restrictive respiratory disorder) and one pediatric configuration. Each HCV was set in VC. Two VT (300 and 500 mL) in adult lung configuration and one 50 mL VT in pediatric lung configuration, at two positive end expiratory pressures 5 and 10 cmH2O, were tested. VT accuracy was measured as volume error (the relative difference between set and measured VT). Statistical analysis was performed by suing one-factor ANOVA with a Bonferroni correction for multiple tests. Results For Astral 150, Elisée 150, Monnal T50 and Trilogy 200, FIO2 averaged 99.2%, 93.7%, 86.3%, and 62.1%, respectively, at 15 L/min oxygen supplementation rate (P<0.001). Volume error was 0.5%±0%, −38%±0%, −9%±0%, −29%±0% and −36%±0% for pediatric lung condition (P<0.001). In adult lung configurations, Monnal T50 systematically over delivered VT and Trilogy 150 was sensitive to lung configuration when VT was set to 300 mL at either positive end-expiratory pressure (PEEP). Conclusions HCV are different in terms of FIO2 efficiency and VT delivery. PMID:28149559

  11. Performance House -- A Cold Climate Challenge Home

    Energy Technology Data Exchange (ETDEWEB)

    Puttagunta, S.; Grab, J.; Williamson, J.

    2013-08-01

    Working with builder partners on a test homes allows for vetting of whole-house building strategies to eliminate any potential unintended consequences prior to implementing these solution packages on a production scale. To support this research, CARB partnered with Preferred Builders Inc. on a high-performance test home in Old Greenwich, CT. The philosophy and science behind the 2,700 ft2 'Performance House' was based on the premise that homes should be safe, healthy, comfortable, durable, efficient, and adapt with the homeowners. The technologies and strategies used in the 'Performance House' were not cutting-edge, but simply 'best practices practiced'. The focus was on simplicity in construction, maintenance, and operation. When seeking a 30% source energy savings targets over a comparable 2009 IECC code-built home in the cold climate zone, nearly all components of a home must be optimized. Careful planning and design are critical. To help builders and architects seeking to match the performance of this home, a step-by-step guide through the building shell components of DOE's Challenge Home are provided in a pictorial story book. The end result was a DOE Challenge Home that achieved a HERS Index Score of 20 (43 without PV, the minimum target was 55 for compliance). This home was also awarded the 2012 HOBI for Best Green Energy Efficient Home from the Home Builders & Remodelers Association of Connecticut.

  12. [Outcomes after planned home births].

    Science.gov (United States)

    Blix, Ellen; Øian, Pål; Kumle, Merethe

    2008-11-06

    About 150 planned home births take place in Norway annually. Professionals have different opinions on whether such births are safe or not. The aim of the present study was to perform a systematic literature review on maternal and neonatal outcomes after planned home births. A review was performed of literature retrieved from searches in MEDLINE, PubMed, Embase, Cinahl and The Cochrane Library and relevant references found in the articles. The searches were limited to studies published in 1985 and later. 10 studies with data from 30 204 women who had planned and were selected to home birth at the onset of labour were included. Three of the studies had control groups including women with planned hospital births. All included studies were assessed to be of medium quality. Between 9.9 and 23.1 % of women and infants were transferred to hospital during labour or after birth. There were few caesarean sections, other interventions or complications in the studies assessed; the total perinatal mortality rate was 2.9/1000 and the intrapartum mortality rate 0.8/1000. There is no sound basis for discouraging low-risk women from planning a home birth. Results from the included studies do not directly apply to Norwegian conditions. Outcomes and transfers after planned home births should be systematically registered.

  13. Low-Flammability PTFE for High-Oxygen Environments

    Science.gov (United States)

    Walle, E.; Fallon, B.; Sheppard, A.

    1986-01-01

    Modified forming process removes volatile combustible materials. Flammability of cable-wrapping tape reduced by altering tape-manufacturing process. In new manufacturing process, tape formed by proprietary process of screw extrusion, followed by washing in solvent and drying. Tape then wrapped as before. Spectrogram taken after extrusion, washing, and drying shows lower hydrocarbon content. PTFE formed by new process suited to oxygen-rich environments. Safe in liquid oxygen of Space Shuttle tank and in medical uses; thin-wall shrinkable tubing in hospital test equipment, surgical instruments, and implants.

  14. Health and Safety Guide for Home Performance Contractors

    Energy Technology Data Exchange (ETDEWEB)

    Stratton, Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walker, Iain S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-02-15

    This report is intended to provide home performance contractor trainers with a resource to keep both their workers and home residents safe and healthy. This document is an attempt to describe what we currently believe is safe, what we believe is unsafe, and what we’re unsure about. It is intended to identify health and safety issues and provide historical context and current understanding of both risks and mitigation strategies. In addition, it provides links to more in-depth resources for each issue. When we tighten the thermal envelope of a house to improve comfort and reduce energy use, we have to be sure that we are not compromising the indoor air quality of the home. This means identifying and mitigating or eliminating pollution sources before and after you make changes to the home. These sources can include materials and finishes in the home, exhaust gasses from combustion appliances, soil gasses such as radon, and moisture from a bathroom, kitchen, or unvented clothes dryer. Our first responsibility is to do no harm — this applies both to our clients and to our employees. Currently, there are many new products that are widely used but whose health effects are not well understood. Our in ability to have perfect information means the directive to do no harm can be difficult to obey. Each home is a little bit different, and in the face of a situation you’ve never encountered, it’s important to have a solid grasp of the fundamental concepts of building science when the hard and fast rules don’t apply . The home performance industry is gaining momentum, and has the potential to expand greatly as energy costs continue to rise. It is imperative that we remain vigilant about protecting the health and safety of our workers and our customers. It only takes a few news stories about a family that got sick after their home was tightened by a home performance contractor to scare off potential customers and taint the reputation of the entire industry. Good

  15. The effects of home oxygen therapy on energy metabolism in patients with COPD

    Science.gov (United States)

    Kırıcı Berber, Nurcan; Yetkin, Özkan; Kılıç, Talat; Berber, Ilhami; Özgel, Mehmet

    2018-01-01

    Background COPD is preventable and treatable and is characterized by completely nonreversible airflow obstruction. In this study, we aimed to investigate the effect of long-term oxygen therapy on patients with stage 4 COPD who were followed up and treated at the polyclinic or clinic service. We evaluated the effects of oxygen therapy on energy metabolism and physical activity in patients with COPD. Methods Nineteen patients with COPD (16 male/3 female), treated with oxygen therapy for the first time, were included in this study. Analysis of arterial blood gases and pulmonary function test was performed. Metabolic Holter device (SenseWear® Armband) was placed pre- and post-oxygen therapy on the patients’ arm for at least 3 days. This device captures Holter data in a digitized electronic system, and the daily average value was calculated from the data. Results Post-oxygen treatment showed a significant increase in energy expenditure by patients with COPD (pretreatment, 1,497±596 joule; posttreatment, 2,977±5,985 joule; P=0.044). Moreover, number of steps during walking (pretreatment, 2,056±256; posttreatment, 2,120±195; P=0.03), resting (pretreatment, 6.36±3.31 hours; posttreatment, 3.47±2.19 hours; P<0.03), and sleeping (pretreatment, 4.23±2.13 hours; posttreatment, 2.33±1.42 hours; P<0.00) showed significant differences. Increased daily energy expenditure in patients with respiratory failure was detected with long-term oxygen therapy. In addition, the immobility of patients decreased and duration of physical activity increased in patients with COPD. Conclusion In this study, positive effects of long-term oxygen therapy have been demonstrated with respect to energy metabolism and physical activity of patients with COPD. Thus, we recommend that medication adherence and long-term oxygen therapy should begin early in patients with COPD.

  16. Role of environmental cleanliness and decontamination in care homes.

    Science.gov (United States)

    Cousins, Gary

    2016-01-06

    While it is widely accepted that the environment has an important role in transmission of healthcare-associated infections, there has been a paucity of empirical investigation in this area to date, and the majority of published literature relates to acute settings. People living in care homes come into contact with a communally used environment and communally used equipment daily. Equipment may include hoists, hoist slings, clinical monitoring equipment, commodes and shower chairs. In care homes, primary responsibility for decontamination lies with the healthcare team, most of whom are not nurses. The challenge for nurses working in care homes is their accountability for the provision of safe and effective care.

  17. The Performance House - A Cold Climate Challenge Home

    Energy Technology Data Exchange (ETDEWEB)

    Puttagunta, S. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Grab, J. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States); Williamson, J. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2013-08-01

    Working with builder partners on test homes allows for vetting of whole-house building strategies to eliminate any potential unintended consequences prior to implementing these solution packages on a production scale. To support this research, CARB partnered with Preferred Builders Inc. on a high-performance test home in Old Greenwich, CT. The philosophy and science behind the 2,700 ft2 "Performance House" was based on the premise that homes should be safe, healthy, comfortable, durable, efficient, and adapt with the homeowners. The technologies and strategies used in the "Performance House" were not cutting-edge, but simply "best practices practiced". The focus was on simplicity in construction, maintenance, and operation. When seeking a 30% source energy savings targets over a comparable 2009 IECC code-built home in the cold climate zone, nearly all components of a home must be optimized. Careful planning and design are critical. To help builders and architects seeking to match the performance of this home, a step-by-step guide through the building shell components of DOE's Challenge Home are provided in a pictorial story book. The end result was a DOE Challenge Home that achieved a HERS Index Score of 20 (43 without PV, the minimum target was 55 for compliance). This home was also awarded the 2012 HOBI for Best Green Energy Efficient Home from the Home Builders & Remodelers Association of Connecticut.

  18. Therapeutic home adaptations for older adults with disabilities.

    Science.gov (United States)

    Unwin, Brian K; Andrews, Christopher M; Andrews, Patrick M; Hanson, Janice L

    2009-11-01

    Family physicians commonly care for older patients with disabilities. Many of these patients need help maintaining a therapeutic home environment to preserve their comfort and independence. Patients often have little time to decide how to address the limitations of newly-acquired disabilities. Physicians can provide patients with general recommendations in home modification after careful history and assessment. Universal design features, such as one-story living, no-step entries, and wide hallways and doors, are key adaptations for patients with physical disabilities. Home adaptations for patients with dementia include general safety measures such as grab bars and door alarms, and securing potentially hazardous items, such as cleaning supplies and medications. Improved lighting and color contrast, enlarged print materials, and vision aids can assist patients with limited vision. Patients with hearing impairments may benefit from interventions that provide supplemental visual and vibratory cues and alarms. Although funding sources are available, home modification is often a nonreimbursed expense. However, sufficient home modifications may allow the patient and caregivers to safely remain in the home without transitioning to a long-term care facility.

  19. On Using TPM for Secure Identities in Future Home Networks

    Directory of Open Access Journals (Sweden)

    Georg Carle

    2011-01-01

    Full Text Available Security should be integrated into future networks from the beginning, not as an extension. Secure identities and authentication schemes are an important step to fulfill this quest. In this article, we argue that home networks are a natural trust anchor for such schemes. We describe our concept of home networks as a universal point of reference for authentication, trust and access control, and show that our scheme can be applied to any next generation network. As home networks are no safe place, we apply Trusted Computing technology to prevent the abuse of identities, i.e., identity theft.

  20. Why Do Parents with Toddlers Store Poisonous Products Safely?

    Directory of Open Access Journals (Sweden)

    Tinneke M. J. Beirens

    2010-01-01

    Full Text Available Unintentional poisoning is a major cause of nonfatal injuries in children aged 0–24 months. Associations between self-reported habits on the child safe storage of medication and cleaning products and family, and psychosocial factors were assessed, using a model based on the Protection Motivation Theory. By identifying correlates of safety behavior in this manner, more insight in factors which influence this behavior is obtained. Health promotion activities in order to promote safety behavior should address these factors in order to increase the effectiveness of the health message. Data were gathered from a cross-sectional survey using self-administered questionnaires, mailed to a population sample of 2470 parents with toddlers. The results indicate that the promotion of safe storage of medication and cleaning products should address the family situation, personal cognitive factors as well as social factors. Interventions should particularly focus on parents' self-efficacy of storing poisonous products in a child safe manner and on the vulnerability of their child in their home concerning an unintentional poisoning incident.

  1. Committee Opinion No. 697: Planned Home Birth.

    Science.gov (United States)

    2017-04-01

    In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes. These factors include the appropriate selection of candidates for home birth; the availability of a certified nurse-midwife, certified midwife or midwife whose education and licensure meet International Confederation of Midwives' Global Standards for Midwifery Education, or physician practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals. The Committee on Obstetric Practice considers fetal malpresentation, multiple gestation, or prior cesarean delivery to be an absolute contraindication to planned home birth.

  2. Committee Opinion No. 669: Planned Home Birth.

    Science.gov (United States)

    2016-08-01

    In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes. These factors include the appropriate selection of candidates for home birth; the availability of a certified nurse-midwife, certified midwife or midwife whose education and licensure meet International Confederation of Midwives' Global Standards for Midwifery Education, or physician practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals. The Committee on Obstetric Practice considers fetal malpresentation, multiple gestation, or prior cesarean delivery to be an absolute contraindication to planned home birth.

  3. A study investigating patients' experience of hospital and home iontophoresis for hyperhidrosis.

    LENUS (Irish Health Repository)

    McAleer, Maeve Aine

    2014-08-01

    Iontophoresis is an effective and safe treatment for hyperhidrosis. We investigated patients\\' experiences with the Idrostar® home iontophoresis unit (STD Pharmaceuticals, Hereford, UK) considering compliance and efficacy.

  4. How do you know if your food is safe to sell?

    OpenAIRE

    Boyer, Renee Raiden

    2001-01-01

    When preparing foods at home to sell, you must still practice good sanitation and proper food safety techniques. Microbial growth is affected by the following six factors: Food, Acidity, Time, Temperature, Oxygen and Moisture, also known as FAT TOM. Controlling one or more FAT TOM factors prevents microorganisms from growing to dangerous levels that might make someone sick.

  5. Safe motherhood at risk?

    Science.gov (United States)

    Thompson, A

    1996-12-01

    Health professionals' negative attitudes toward clients often exacerbate the problems women face in terms of health status and access to health care. Thus, the health professionals can themselves be obstacles to women seeking the health care they need. A key challenge to midwives, in addition to providing technically competent services, is gaining insight into the people for whom they are responsible so that childbirth traditions are treated with respect and women are offered dignity. Safe motherhood requires intersectoral collaboration. Many innovative approaches to safe motherhood are based on the community's participation in planning services that meet the needs of women. Other approaches are based on decentralization of services. For example, a large university teaching hospital in Lusaka, Zambia, set up birthing centers around the city to take the pressure off the hospital. Midwives head up these centers, which are close to the women's homes. Decentralization of delivery services has improved the physical and emotional outcomes for mothers and newborns. Midwives must be prepared to articulate concerns about inequalities and deficiencies in the health care system in order to persuade the government to change. Women, including midwives, need to form multidisciplinary alliances to work together to effect change. The front-line workers in maternity care are midwives. They should adopt the following strategies to become even more effective in their efforts to make motherhood safer. They should listen to what women say about their needs. They should scale services to a manageable, human scale. They should learn the skills to become politically active advocates. They should work with other midwives, women, leaders, and other professional groups. Motherhood can be safe when women have more control over their own decision making, the education to liberate themselves to make their own decisions, and access to skilled care.

  6. Safe sex

    Science.gov (United States)

    ... sex; Sexually transmitted - safe sex; GC - safe sex; Gonorrhea - safe sex; Herpes - safe sex; HIV - safe sex; ... contact. STIs include: Chlamydia Genital herpes Genital warts Gonorrhea Hepatitis HIV HPV Syphilis STIs are also called ...

  7. Considerations for the design of safe and effective consumer health IT applications in the home.

    Science.gov (United States)

    Zayas-Cabán, Teresa; Dixon, Brian E

    2010-10-01

    Consumer health IT applications have the potential to improve quality, safety and efficiency of consumers' interactions with the healthcare system. Yet little attention has been paid to human factors and ergonomics in the design of consumer health IT, potentially limiting the ability of health IT to achieve these goals. This paper presents the results of an analysis of human factors and ergonomics issues encountered by five projects during the design and implementation of home-based consumer health IT applications. Agency for Healthcare Research and Quality-funded consumer health IT research projects, where patients used the IT applications in their homes, were reviewed. Project documents and discussions with project teams were analysed to identify human factors and ergonomic issues considered or addressed by project teams. The analysis focused on system design and design processes used as well as training, implementation and use of the IT intervention. A broad range of consumer health IT applications and diverse set of human factors and ergonomics issues were identified. The design and implementation processes used resulted in poor fit with some patients' healthcare tasks and the home environment and, in some cases, resulted in lack of use. Clinician interaction with patients and the information provided through health IT applications appeared to positively influence adoption and use. Consumer health IT application design would benefit from the use of human factors and ergonomics design and evaluation methods. Considering the context in which home-based consumer health IT applications are used will likely affect the ability of these applications to positively impact the quality, safety and efficiency of patient care.

  8. Nurses' reflections on pain management in a nursing home setting.

    Science.gov (United States)

    Clark, Lauren; Fink, Regina; Pennington, Karen; Jones, Katherine

    2006-06-01

    Achieving optimal and safe pain-management practices in the nursing home setting continues to challenge administrators, nurses, physicians, and other health care providers. Several factors in nursing home settings complicate the conduct of clinical process improvement research. The purpose of this qualitative study was to explore the perceptions of a sample of Colorado nursing home staff who participated in a study to develop and evaluate a multifaceted pain-management intervention. Semistructured interviews were conducted with 103 staff from treatment and control nursing homes, audiotaped, and content analyzed. Staff identified changes in their knowledge and attitudes about pain and their pain-assessment and management practices. Progressive solutions and suggestions for changing practice include establishing an internal pain team and incorporating nursing assistants into the care planning process. Quality improvement strategies can accommodate the special circumstances of nursing home care and build the capacity of the nursing homes to initiate and monitor their own process-improvement programs using a participatory research approach.

  9. Episodic medical home interventions in severe bedridden chronic respiratory failure patients: a 4 year retrospective study.

    Science.gov (United States)

    Barbano, L; Bertella, E; Vitacca, M

    2009-09-01

    Home care for respiratory patients includes a complex array of services delivered in an uncontrolled setting. The role of a respiratory specialist inside the home healthcare team has been scarcely studied up to now. Our aims were to analyse the number and quality of episodic home visits performed by respiratory physicians to severe bedridden Chronic Respiratory Failure (CRF) patients, and also to evaluate the safety of tracheotomy tube substitutions at home. 231 home interventions (59.8/year) in 123 CRF patients (59 males; age 63 +/- 17 y, 24 on oxygen therapy, 35 under non invasive mechanical ventilation, 46 under invasive ventilation, 74 with tracheostomy) located 35 +/- 16 km far from referred hospital, were revised in a period of 4 years (2005-2008). Chronic Obstructive Pulmonary Disease (COPD) (31%) and amyotrophic lateral sclerosis (ALS) (28%) were the more frequent diagnoses. Interventions were: tracheotomy tube substitution (64%) presenting 22% of minor adverse events and 1.4% of major adverse events; change or new oxygen prescription (37%); nocturnal pulsed saturimetric trend prescription (24%); change in mechanical ventilation (MV) setting (4%); new MV adaptation (7%). After medical intervention, new home medical equipment devices (oxygen and MV) were prescribed in 36% of the cases while rehabilitative hospital admission and home respiratory physiotherapy prescription was proposed in 9% and 6% of the cases respectively. Patient/caregiver's satisfaction was reported on average 8.48 +/- 0.79 (1 = the worst; 10 = the higher). The local health care system (HCS) reimbursed 70 euros for each home intervention. Families saved 42 +/- 20 euros per visit for ambulance transportation. Home visits performed by a respiratory physician to bedridden patients with chronic respiratory failure: 1. include predominantly patients affected by COPD and ALS; 2. determine a very good satisfaction to patients/caregivers; 3. allow money saving to caregivers; 4. are predominantly

  10. Pulmonary Effects of Submerged Breathing of Air or Oxygen

    National Research Council Canada - National Science Library

    Shykoff, B

    2002-01-01

    ...). The risks of developing PO2T are poorly characterized. The current shallow-water exposure limit, four hours breathing oxygen at 25 fsw or less in any 24-hour period, was established somewhat arbitrarily as a known "safe" exposure...

  11. Patient Safety Culture and the Association with Safe Resident Care in Nursing Homes

    Science.gov (United States)

    Thomas, Kali S.; Hyer, Kathryn; Castle, Nicholas G.; Branch, Laurence G.; Andel, Ross; Weech-Maldonado, Robert

    2012-01-01

    Purpose of the study: Studies have shown that patient safety culture (PSC) is poorly developed in nursing homes (NHs), and, therefore, residents of NHs may be at risk of harm. Using Donabedian's Structure-Process-Outcome (SPO) model, we examined the relationships among top management's ratings of NH PSC, a process of care, and safety outcomes.…

  12. Safe Handling of Oral Antineoplastic Medications: Focus on Targeted Therapeutics in the Home Setting

    Science.gov (United States)

    Cass, Yaakov; Connor, Thomas H.; Tabachnik, Alexander

    2017-01-01

    Introduction With the growing number of oral targeted therapies being approved for use in cancer therapy, the potential for long-term administration of these drugs to cancer patients is expanding. The use of these drugs in the home setting has the potential to expose family members and caregivers to them either through direct contact with the drugs or indirectly by exposure to the parent compounds and/or their active metabolites in contaminated patient's waste. Methods A systematic literature review was performed and the known adverse health effect of 32 oral targeted therapeutics is summarized. In particular, the carcinogenicity, genotoxicity, and embryo-foetal toxicity, along with the route of excretion were evaluated. Results Carcinogenicity testing has not been performed on most of the oral targeted therapeutics and the genotoxicity data are mixed. However, the majority of these drugs exhibit adverse reproductive effects, some of which are severe. Currently available data does not permit the possibility of a health hazard from inappropriate handling of drugs and contaminated patients waste to be ignored, especially in a long-term home setting. Further research is needed to understand these issues. Conclusions With the expanding use of targeted therapies in the home setting, family members and caregivers, especially those of reproductive risk age, are, potentially at risk. Overall basic education and related precautions should be taken to protect family members and caregivers from indirect or direct exposure from these drugs. Further investigations and discussion on this subject is warranted. PMID:27009803

  13. Committee Opinion No. 669 Summary: Planned Home Birth.

    Science.gov (United States)

    2016-08-01

    In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes. These factors include the appropriate selection of candidates for home birth; the availability of a certified nurse-midwife, certified midwife or midwife whose education and licensure meet International Confederation of Midwives' Global Standards for Midwifery Education, or physician practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals. The Committee on Obstetric Practice considers fetal malpresentation, multiple gestation, or prior cesarean delivery to be an absolute contraindication to planned home birth.

  14. Committee Opinion No 697 Summary: Planned Home Birth.

    Science.gov (United States)

    2017-04-01

    In the United States, approximately 35,000 births (0.9%) per year occur in the home. Approximately one fourth of these births are unplanned or unattended. Although the American College of Obstetricians and Gynecologists believes that hospitals and accredited birth centers are the safest settings for birth, each woman has the right to make a medically informed decision about delivery. Importantly, women should be informed that several factors are critical to reducing perinatal mortality rates and achieving favorable home birth outcomes. These factors include the appropriate selection of candidates for home birth; the availability of a certified nurse-midwife, certified midwife or midwife whose education and licensure meet International Confederation of Midwives' Global Standards for Midwifery Education, or physician practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals. The Committee on Obstetric Practice considers fetal malpresentation, multiple gestation, or prior cesarean delivery to be an absolute contraindication to planned home birth.

  15. Safe delivery care practices in western Nepal: Does women's autonomy influence the utilization of skilled care at birth?

    Science.gov (United States)

    Bhandari, Tulsi Ram; Kutty, V Raman; Sarma, P Sankara; Dangal, Ganesh

    2017-01-01

    Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives-women's autonomy-plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women's autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women's autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women's education had a strong positive association (odds ratio = 24.11, CI = 9.43-61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women's education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband's education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women's autonomy may be an important mediating factor in this pathway.

  16. Toward Hazardless Waste: A Guide for Safe Use and Disposal of Hazardous Household Products.

    Science.gov (United States)

    Toteff, Sally; Zehner, Cheri

    This guide is designed to help individuals make responsible decisions about safe use and disposal of household products. It consists of eight sections dealing with: (1) hazardous chemicals in the home, how hazaradous products become hazardous waste, and whether a hazardous waste problem exists in Puget Sound; (2) which household wastes are…

  17. Estimation of maximal oxygen uptake via submaximal exercise testing in sports, clinical, and home settings.

    Science.gov (United States)

    Sartor, Francesco; Vernillo, Gianluca; de Morree, Helma M; Bonomi, Alberto G; La Torre, Antonio; Kubis, Hans-Peter; Veicsteinas, Arsenio

    2013-09-01

    Assessment of the functional capacity of the cardiovascular system is essential in sports medicine. For athletes, the maximal oxygen uptake [Formula: see text] provides valuable information about their aerobic power. In the clinical setting, the (VO(2max)) provides important diagnostic and prognostic information in several clinical populations, such as patients with coronary artery disease or heart failure. Likewise, VO(2max) assessment can be very important to evaluate fitness in asymptomatic adults. Although direct determination of [VO(2max) is the most accurate method, it requires a maximal level of exertion, which brings a higher risk of adverse events in individuals with an intermediate to high risk of cardiovascular problems. Estimation of VO(2max) during submaximal exercise testing can offer a precious alternative. Over the past decades, many protocols have been developed for this purpose. The present review gives an overview of these submaximal protocols and aims to facilitate appropriate test selection in sports, clinical, and home settings. Several factors must be considered when selecting a protocol: (i) The population being tested and its specific needs in terms of safety, supervision, and accuracy and repeatability of the VO(2max) estimation. (ii) The parameters upon which the prediction is based (e.g. heart rate, power output, rating of perceived exertion [RPE]), as well as the need for additional clinically relevant parameters (e.g. blood pressure, ECG). (iii) The appropriate test modality that should meet the above-mentioned requirements should also be in line with the functional mobility of the target population, and depends on the available equipment. In the sports setting, high repeatability is crucial to track training-induced seasonal changes. In the clinical setting, special attention must be paid to the test modality, because multiple physiological parameters often need to be measured during test execution. When estimating VO(2max), one has

  18. Brain injury in the international multicenter randomized SafeBoosC phase II feasibility trial

    DEFF Research Database (Denmark)

    Plomgaard, Anne M; Hagmann, Cornelia; Alderliesten, Thomas

    2016-01-01

    BACKGROUND: Abnormal cerebral perfusion during the first days of life in preterm infants is associated with higher grades of intraventricular hemorrhages and lower developmental score. In SafeBoosC II, we obtained a significant reduction of cerebral hypoxia by monitoring cerebral oxygenation in c...

  19. Sixty Girls, Three Nuns, One Home.

    Science.gov (United States)

    Smeltzer, Carolyn Hope

    2016-04-01

    This article describes the experience of a nurse volunteer working with girls in India who had been trafficked and/or were children of mothers who were (are) prostitutes. The article describes how nuns who care, provide values and a safe home give the girls opportunities. The article illustrates how, with little recourse, three nuns care for 60 girls living in one home. The girls range in age from 4 to 18 years. The girls are motivated to live happily, work hard, study often, and play together. Lessons learned from the nurse volunteer who worked and lived with the girls are described. This article illustrates how nurses in retirement can still fulfill their passion of helping others. © 2015 Wiley Periodicals, Inc.

  20. Creative Arts Therapies as Temporary Home for Refugees: Insights from Literature and Practice

    Directory of Open Access Journals (Sweden)

    Rebekka Dieterich-Hartwell

    2017-10-01

    Full Text Available One of the frequently overlooked psychosocial problems of refugees is the phenomenon of homesickness. Being forced into exile and unable to return home may cause natural feelings of nostalgia but may also result in emotional, cognitive, behavioral and physical adversities. According to the literature, the creative arts therapies with their attention to preverbal language—music, imagery, dance, role play, and movement—are able to reach individuals through the senses and promote successive integration, which can lead to transformation and therapeutic change. These forms of therapy can be a temporary home for refugees in the acculturation process, by serving as a safe and enactive transitional space. More specifically, working with dance and movement can foster the experience of the body as a home and thus provide a safe starting place, from which to regulate arousal, increase interoception, and symbolize trauma- and resource-related processes. Hearing, playing, and singing music from the home culture may assist individuals in maintaining their cultural and personal individuality. Creating drawings, paintings, or sculpturing around the topics of houses and environments from the past can help refugees to retain their identity through art, creating safe spaces for the future helps to look ahead, retain resources, and regain control. This article provides a literature review related to home and homesickness, and the role the arts therapies can play for refugees in transition. It further reports selected interview data on adverse life events and burdens in the host country from a German study. We propose that the creative arts therapies are not only a container that offers a temporary home, but can also serve as a bridge that gently guides refugees to a stepwise integration in the host country. Several clinical and research examples are presented suggesting that the support and affirmation through the creative arts can strengthen individuals in

  1. The use of technology to transform the home into a safe-haven.

    Science.gov (United States)

    Kun, Luis

    2007-01-01

    On June 14, 2006 three reports were published by the Institute of Medicine (IOM) in regards to "THE FUTURE OF EMERGENCY CARE IN THE UNITED STATES HEALTH SYSTEM". The three combined reports: Hospital-Based Emergency Care at the Breaking Point, Emergency Medical Services at the Crossroads and Emergency Care for Children Growing Pains, are a clear reflection of the state we currently face, even without a major disaster. Some key findings drawn from all three reports showed that the emergency care system is ill-prepared to handle a major one. For example, many of the 41 million citizens who do not have medical insurance end up using the Emergency Departments (ED) as their source of "regular" care and many of these EDs are at or over capacity, there is little surge capacity for a major event, whether it takes the form of a natural disaster, disease outbreak, or terrorist attack. If we had during the major disaster event, a "contagion" element, i.e. pandemic flu, then the problem would be even more complicated, since the "regular" hospital patient population would need to be isolated from these patients. If we add to this equation the length of time involved in the "current" process of vaccine creation and production (i.e. the volume of vaccines that would be required to be provided to the citizens of the world), the scenario does not look to promising. A new model is needed then to address these requirements. In the developed world we have a number of devices (e.g., radio, TV, Computers, telephones, mobile devices, etc.) and infrastructure (e.g., cable, wireless networks, etc.) that are already supplying the homes and the individuals with a large number of independent applications and different types of information. These stovepipes or independently developed family that include: tele-banking, Telehealth, tele-education, e-commerce, entertainment on demand, etc. when "connected" as an integrated set, may provide an ideal environment, where families may stay at home for

  2. Occupational health of home care aides: results of the safe home care survey

    Science.gov (United States)

    Quinn, Margaret M; Markkanen, Pia K; Galligan, Catherine J; Sama, Susan R; Kriebel, David; Gore, Rebecca J; Brouillette, Natalie M; Okyere, Daniel; Sun, Chuan; Punnett, Laura; Laramie, Angela K; Davis, Letitia

    2016-01-01

    Objectives In countries with ageing populations, home care (HC) aides are among the fastest growing jobs. There are few quantitative studies of HC occupational safety and health (OSH) conditions. The objectives of this study were to: (1) assess quantitatively the OSH hazards and benefits for a wide range of HC working conditions, and (2) compare OSH experiences of HC aides who are employed via different medical and social services systems in Massachusetts, USA. Methods HC aides were recruited for a survey via agencies that employ aides and schedule their visits with clients, and through a labour union of aides employed directly by clients or their families. The questionnaire included detailed questions about the most recent HC visits, as well as about individual aides’ OSH experiences. Results The study population included 1249 HC aides (634 agency-employed, 615 client-employed) contributing information on 3484 HC visits. Hazards occurring most frequently related to musculoskeletal strain, exposure to potentially infectious agents and cleaning chemicals for infection prevention and experience of violence. Client-hired and agency-hired aides had similar OSH experiences with a few exceptions, including use of sharps and experience of verbal violence. Conclusions The OSH experience of HC aides is similar to that of aides in institutional healthcare settings. Despite OSH challenges, HC aides enjoy caring for others and the benefits of HC work should be enhanced. Quantification of HC hazards and benefits is useful to prioritise resources for the development of preventive interventions and to provide an evidence base for policy-setting. PMID:26209318

  3. Benefits and implementation of home hemodialysis: A narrative review

    Directory of Open Access Journals (Sweden)

    Ayman Karkar

    2015-01-01

    Full Text Available Home hemodialysis (HD is a modality of renal replacement therapy that can be safely and independently performed at home by end-stage renal disease (ESRD patients. Home HD can be performed at the convenience of the patients on a daily basis, every other day and overnight (nocturnal. Despite the great and many perceived benefits of home HD, including the significant improvements in health outcomes and resource utilization, the adoption of home HD has been limited; lack or inadequate pre-dialysis education and training constitute a major barrier. The lack of self-confidence and/or self-efficacy to manage own therapy, lack of family and/or social support, fear of machine and cannulation of blood access and worries of possible catastrophic events represent other barriers for the implementation of home HD besides inadequate competence and/or expertise in caring for home HD patients among renal care providers (nephrologists, dialysis nurses, educators. A well-studied, planned and prepared and carefully implemented central country program supported by adequate budget can play a positive role in overcoming the challenges to home HD. Healthcare authorities, with the increasingly financial and logistic demands and the relatively higher mortality and morbidity rates of the conventional in-center HD, should tackle home HD as an attractive and cost-effective modality with more freedom, quality of life and improvement of clinical outcomes for the ESRD patients.

  4. Maternal worries, home safety behaviors, and perceived difficulties.

    Science.gov (United States)

    Hendrickson, Sherry Garrett

    2008-01-01

    The aim of the study was to explore the worries, safety behaviors, and perceived difficulties in keeping children safe at home in a purposive sample of low-income, predominantly non-English speaking mothers as a foundation for later nursing interventions. This study was a qualitative, descriptive design with content analysis to identify maternal concerns, behaviors, and perceptions of home safety as part of a larger study. Eighty-two mothers, 64% of whom were monolingual Spanish-speakers, responded in writing to three semistructured interview questions. When mothers were unable to read and write the researcher wrote the responses, then read the content aloud for verification. A standardized probe for each question was posed to obtain richer responses. Data management included use of the software program NUD*IST and coding analyses following the Miles and Huberman guidelines (1994). Interpretations were translated into English for this report. The major worries were falling, health, kidnapping, and being hit by a car. The leading maternal behaviors were coded as being physically, verbally, and environmentally preventive. Mothers said that it was their role to provide safety, and that this role could be wearisome, such that constant supervision was difficult. Low-income mothers described their worries for their 1 to 4 year-old children, explored their behaviors for preventing injury, and discussed what made keeping children from harm difficult. Understanding how mothers keep children safe, the barriers to home safety, and effective safety behaviors are important to the health of children. The clinical relevance of this study includes building trust as clinicians plan assessment, intervention and evaluation of home safety to encourage dialog about concerns, safety behaviors, and barriers to keeping children from injury.

  5. Randomized Trial of a Children's Book Versus Brochures for Safe Sleep Knowledge and Adherence in a High-Risk Population.

    Science.gov (United States)

    Hutton, John S; Gupta, Resmi; Gruber, Rachel; Berndsen, Jennifer; DeWitt, Thomas; Ollberding, Nicholas J; Van Ginkel, Judith B; Ammerman, Robert T

    Sleep-related infant deaths have plateaued in the past decade, disproportionately affecting low socioeconomic status (SES) families. Printed materials are widely used for anticipatory guidance, yet none for safe sleep has been studied. We tested the efficacy of a specially designed children's book compared to brochures for safe sleep knowledge and adherence, which we hypothesized would be greater due to superior readability and engagement. This randomized controlled trial involved low-SES mothers (n = 282) enrolled in a home visiting program. Home visitors (n = 56) were randomly assigned to perform safe sleep teaching and assessments during 3 visits: third trimester, 1 week old, and 2 months old, exclusively utilizing a specially designed children's book or brochures, and surveys incorporating the American Academy of Pediatrics' safe sleep recommendations. Outcomes were safe sleep knowledge, adherence, and usefulness of materials, controlling for maternal health literacy. Safe sleep knowledge increased across all time points with no overall group difference, though gains for sleep-evocative and general health items varied. Odds of bed sharing were higher and exclusive crib use lower for the brochure group (P book and mothers in the book group reported more book sharing with their baby. While a specially designed children's book and brochures were equally effective conveying aggregate safe sleep knowledge in low-SES mothers, adherence to exclusive crib use and avoiding bed sharing were greater in the book group, attributable to enhanced dialogue, readability and emotional engagement. Children's books are a promising mode of anticipatory guidance, warranting further investigation. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  6. SafeMed: Using pharmacy technicians in a novel role as community health workers to improve transitions of care.

    Science.gov (United States)

    Bailey, James E; Surbhi, Satya; Bell, Paula C; Jones, Angel M; Rashed, Sahar; Ugwueke, Michael O

    2016-01-01

    To describe the design, implementation, and early experience of the SafeMed program, which uses certified pharmacy technicians in a novel expanded role as community health workers (CPhT-CHWs) to improve transitions of care. A large nonprofit health care system serving the major medically underserved areas and geographic hotspots for readmissions in Memphis, TN. The SafeMed program is a care transitions program with an emphasis on medication management designed to use low-cost health workers to improve transitions of care from hospital to home for superutilizing patients with multiple chronic conditions and polypharmacy. CPhT-CHWs were given primary responsibility for patient outreach after hospital discharge with the use of home visits and telephone follow-up. SafeMed program CPhT-CHWs served as pharmacist extenders, obtaining medication histories, assisting in medication reconciliation and identification of potential drug therapy problems (DTPs), and reinforcing medication education previously provided by the pharmacist per protocol. CPhT-CHW training included patient communication skills, motivational interviewing, medication history taking, teach-back techniques, drug disposal practices, and basic disease management. Some CPhT-CHWs experienced difficulties adjusting to an expanded scope of practice. Nonetheless, once the Tennessee Board of Pharmacy affirmed that envisioned SafeMed CPhT-CHW roles were consistent with Board rules, additional responsibilities were added for CPhT-CHWs to enhance their effectiveness. Patient outreach teams including CPhT-CHWs achieved increases in home visit and telephone follow-up rates and were successful in helping identify potential DTPs. The early experience of the SafeMed program demonstrates that CPhT-CHWs are well suited for novel expanded roles to improve care transitions for superutilizing populations. CPhT-CHWs can identify and report potential DTPs to the pharmacist to help target medication therapy management. Critical

  7. [Relationship among the Oxygen Concentration, Reactive Oxygen Species and the Biological Characteristics of Mouse Bone Marrow Hematopoietic Stem Cells].

    Science.gov (United States)

    Ren, Si-Hua; He, Yu-Xin; Ma, Yi-Ran; Jin, Jing-Chun; Kang, Dan

    2016-02-01

    To investigate the effects of oxygen concentration and reactive oxygen species (ROS) on the biological characteristics of hematopoietic stem cells (HSC) and to analyzed the relationship among the oxygen concentration, ROS and the biological characteristics of mouse HSC through simulation of oxygen environment experienced by PB HSC during transplantation. The detection of reactive oxygen species (ROS), in vitro amplification, directional differentiation (BFU-E, CFU-GM, CFU-Mix), homing of adhesion molecules (CXCR4, CD44, VLA4, VLA5, P-selectin), migration rate, CFU-S of NOD/SCID mice irradiated with sublethal dose were performed to study the effect of oxgen concentration and reactive oxygen species on the biological characteristics of mouse BM-HSC and the relationship among them. The oxygen concentrations lower than normal oxygen concentration (especially hypoxic oxygen environment) could reduce ROS level and amplify more Lin(-) c-kit(+) Sca-1(+) BM HSC, which was more helpful to the growth of various colonies (BFU-E, CFU-GM, CFU-Mix) and to maintain the migratory ability of HSC, thus promoting CFU-S growth significantly after the transplantation of HSC in NOD/SCID mice irradiated by a sublethal dose. BM HSC exposed to oxygen environments of normal, inconstant oxygen level and strenuously thanging of oxygen concentration could result in higher level of ROS, at the same time, the above-mentioned features and functional indicators were relatively lower. The ROS levels of BM HSC in PB HSCT are closely related to the concentrations and stability of oxygen surrounding the cells. High oxygen concentration results in an high level of ROS, which is not helpful to maintain the biological characteristics of BM HSC. Before transplantation and in vitro amplification, the application of antioxidancs and constant oxygen level environments may be beneficial for transplantation of BMMSC.

  8. TED-Time and life saving External Defibrillator for home-use.

    Science.gov (United States)

    Weiss, Teddy A; Rosenheck, Shimon; Gorni, Shraga; Katz, Ioni; Mendelbaum, Mendel; Gilon, Dan

    2014-06-01

    Sudden Cardiac Death--SCD --is a major unmet health problem that needs urgent and prompt solution. AICDs are very expensive, risky and indicated for a small group of patients, at the highest risk. AEDs--Automatic External Defibrillators--are designed for public places and although safe, cannot enter the home-market due to their cost and need for constant, high-cost maintenance. We developed TED, a low-cost AED that derives its energy off the mains, designed for home-use, to save SCD victims' lives. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Willingness to pay for safe drinking water: Evidence from Parral, Mexico.

    Science.gov (United States)

    Vásquez, William F; Mozumder, Pallab; Hernández-Arce, Jesús; Berrens, Robert P

    2009-08-01

    A referendum-format contingent valuation (CV) survey is used to elicit household willingness to pay responses for safe and reliable drinking water in Parral, Mexico. Households currently adopt a variety of averting and private investment choices (e.g., bottled water consumption, home-based water treatment, and installation of water storage facilities) to adapt to the existing water supply system. These revealed behaviors indicate the latent demand for safer and more reliable water services, which is corroborated by the CV survey evidence. Validity findings include significant scope sensitivity in WTP for water services. Further, results indicate that households are willing to pay from 1.8% to 7.55% of reported household income above their current water bill for safe and reliable drinking water services, depending upon the assumptions about response uncertainty.

  10. Optimizing Oxygenation in the Mechanically Ventilated Patient: Nursing Practice Implications.

    Science.gov (United States)

    Barton, Glenn; Vanderspank-Wright, Brandi; Shea, Jacqueline

    2016-12-01

    Critical care nurses constitute front-line care provision for patients in the intensive care unit (ICU). Hypoxemic respiratory compromise/failure is a primary reason that patients require ICU admission and mechanical ventilation. Critical care nurses must possess advanced knowledge, skill, and judgment when caring for these patients to ensure that interventions aimed at optimizing oxygenation are both effective and safe. This article discusses fundamental aspects of respiratory physiology and clinical indices used to describe oxygenation status. Key nursing interventions including patient assessment, positioning, pharmacology, and managing hemodynamic parameters are discussed, emphasizing their effects toward mitigating ventilation-perfusion mismatch and optimizing oxygenation. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Replacement of HCFC-225 Solvent for Cleaning NASA Propulsion Oxygen Systems

    Science.gov (United States)

    Mitchell, Mark A.; Lowrey, Nikki M.

    2015-01-01

    Since the 1990's, when the Class I Ozone Depleting Substance (ODS) chlorofluorocarbon-113 (CFC-113) was banned, NASA's rocket propulsion test facilities at Marshall Space Flight Center (MSFC) and Stennis Space Center (SSC) have relied upon hydrochlorofluorocarbon-225 (HCFC-225) to safely clean and verify the cleanliness of large scale propulsion oxygen systems. Effective January 1, 2015, the production, import, export, and new use of HCFC-225, a Class II ODS, was prohibited by the Clean Air Act. In 2012 through 2014, leveraging resources from both the NASA Rocket Propulsion Test Program and the Defense Logistics Agency - Aviation Hazardous Minimization and Green Products Branch, test labs at MSFC, SSC, and Johnson Space Center's White Sands Test Facility (WSTF) collaborated to seek out, test, and qualify a replacement for HCFC-225 that is both an effective cleaner and safe for use with oxygen systems. Candidate solvents were selected and a test plan was developed following the guidelines of ASTM G127, Standard Guide for the Selection of Cleaning Agents for Oxygen Systems. Solvents were evaluated for materials compatibility, oxygen compatibility, cleaning effectiveness, and suitability for use in cleanliness verification and field cleaning operations. Two solvents were determined to be acceptable for cleaning oxygen systems and one was chosen for implementation at NASA's rocket propulsion test facilities. The test program and results are summarized. This project also demonstrated the benefits of cross-agency collaboration in a time of limited resources.

  12. [Recent technical advances in portable oxygen delivery systems].

    Science.gov (United States)

    Machida, K; Kawabe, Y; Mori, M; Haga, T

    1992-08-01

    According to a Japanese national survey (June 30, 1990), the number of patients receiving home oxygen therapy (HOT) has been greater than 18,000 since March 1985, when HOT was first covered by health insurance. The oxygen concentrator, especially the molecular sieve type, is the most common method of delivery (more than 90%). In April 1988, the portable oxygen cylinder was acknowledged by health insurance, and the liquid oxygen supply system in April 1990. Three types of portable oxygen delivery systems are available; oxygen cyclinder, liquid oxygen system, and oxygen concentrator (membrane type), of which the oxygen cylinder is most commonly used. In our hospital, portable oxygen supply systems were used in 80% of 168 HOT cases in 1990, and the use of 400 L aluminum oxygen cylinders at a flow rate of 1-2 L/min has been most popular. There is an strong desire from patients for lighter portable oxygen supply system of longer duration. In 19 patients with chronic respiratory failure, we evaluated a newly designed demand oxygen delivery system (DODS), which weighs 2.4 kg including the DOD device (TER-20 Teijin), 1.1 L oxygen cylinder made of ultressor, nasal cannula, and carrier. Arterial blood gases at rest (room air) were PaO2 61.9 +/- 6.3 torr, PaCO2 63.8 +/- 9.4 torr and pH 7.40 +/- 0.04. A crossover trial was performed under three conditions; breathing room air with no weight, and pulse oxygen flow and continuous oxygen flow each carrying 2.4 kg of weight. Both 6 minute walking (E1) and walking on a slow speed treadmill (E2) were studied.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Safe delivery care practices in western Nepal: Does women’s autonomy influence the utilization of skilled care at birth?

    Science.gov (United States)

    Kutty, V. Raman; Sarma, P. Sankara; Dangal, Ganesh

    2017-01-01

    Despite various efforts to increase the utilization of skilled birth attendants (SBA), nearly two-thirds of deliveries take place at home without the assistance of SBAs in Nepal. We hypothesized that the ability of women to take decisions about their own lives—women’s autonomy—plays an important part in birth choices. To know this, we conducted a community-based cross-sectional study for assessing women’s autonomy and utilization of safe delivery care service in Kapilvastu district of Nepal from June to October 2014. We used multivariate modeling to associate socioeconomic factors and women’s autonomy with the utilization of safe delivery care services. Just over one-third of women sought institutional delivery care during the birth of their last child. Out of the total deliveries at health facilities, nearly 58% women visited health facility for self-reported emergency obstructive care. Only 6.2% home deliveries were handled by health workers and 14.7% women used the safe delivery kit for home delivery care. Higher levels of women’s education had a strong positive association (odds ratio = 24.11, CI = 9.43–61.64) with institutional delivery care. Stratified analysis showed that when the husband is educated, women’s education seems to work partly through their autonomy in decision making. Educational status of women emerged as one of the key predictors of the utilization of delivery care services in Kapilvastu district. Economic status of household and husband’s education are other dominant predictors of the utilization of safe delivery care services. Improving the economic and educational status may be the way out for improving the proportion of institutional deliveries. Women’s autonomy may be an important mediating factor in this pathway. PMID:28771579

  14. Home parenteral nutrition in children: the Polish experience.

    Science.gov (United States)

    Ksiazyk, J; Lyszkowska, M; Kierkus, J; Bogucki, K; Ratyńska, A; Tondys, B; Socha, J

    1999-02-01

    Home parenteral nutrition has become routine for management of intestinal failure in patients. In Poland the main obstacle to widespread use of home parenteral nutrition is the lack of interest of commercial companies in delivering feedings and ancillaries to patients. Twenty-five home parenteral nutrition patients aged from 4 months to more than 13 years were reviewed. The mother or both parents were trained in home parenteral nutrition techniques for 4 to 6 weeks and compounded the nutrients themselves at home. The mean duration of home parenteral nutrition was 10,117 patient days. Hospital stays of patients receiving parenteral feedings were significantly shorter than the duration of administration of home parenteral nutrition (p rate of catheter occlusion decreased within the observation period, and in 1997 not one case of occlusion was observed. In 1997 only three catheters were removed during 7.8 patient years, and the overall incidence of catheter-related complications was 0.38 per patient year. The overall occurrence of septicemia was one case in 516 days and of catheter infection was one in 459 days. In 1997 a catheter was infected on average of once every 1419 days. There was significant improvement in the z score for weight during therapy. The average monthly cost of nutrients and ancillary items was approximately $1200 (4200 Polish zlotys [PLN]). These costs are 1.6 to 3 times lower than those recorded in other studies. Home parenteral nutrition in children with nutrients mixed by caregivers in the home setting is a safe and appropriate method of treatment that can be used in countries where home parenteral nutrition solutions are not manufactured or where commercial home parenteral nutrition is not economically feasible.

  15. An In-home Advanced Robotic System to Manage Elderly Home-care Patients' Medications: A Pilot Safety and Usability Study.

    Science.gov (United States)

    Rantanen, Pekka; Parkkari, Timo; Leikola, Saija; Airaksinen, Marja; Lyles, Alan

    2017-05-01

    We examined the safety profile and usability of an integrated advanced robotic device and telecare system to promote medication adherence for elderly home-care patients. There were two phases. Phase I aimed to verify under controlled conditions in a single nursing home (n = 17 patients) that no robotic malfunctions would hinder the device's safe use. Phase II involved home-care patients from 3 sites (n = 27) who were on long-term medication. On-time dispensing and missed doses were recorded by the robotic system. Patients' and nurses' experiences were assessed with structured interviews. The 17 nursing home patients had 457 total days using the device (Phase I; mean, 26.9 per patient). On-time sachet retrieval occurred with 97.7% of the alerts, and no medication doses were missed. At baseline, Phase II home-dwelling patients reported difficulty remembering to take their medicines (23%), and 18% missed at least 2 doses per week. Most Phase II patients (78%) lived alone. The device delivered and patients retrieved medicine sachets for 99% of the alerts. All patients and 96% of nurses reported the device was easy to use. This trial demonstrated the safety profile and usability of an in-home advanced robotic device and telecare system and its acceptability to patients and nurses. It supports individualized patient dosing schedules, patient-provider communications, and on-time, in-home medication delivery to promote adherence. Real time dose-by-dose monitoring and communication with providers if a dose is missed provide oversight generally not seen in home care. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. Incremental short daily home hemodialysis: a case series.

    Science.gov (United States)

    Toth-Manikowski, Stephanie M; Mullangi, Surekha; Hwang, Seungyoung; Shafi, Tariq

    2017-07-05

    Patients starting dialysis often have substantial residual kidney function. Incremental hemodialysis provides a hemodialysis prescription that supplements patients' residual kidney function while maintaining total (residual + dialysis) urea clearance (standard Kt/Vurea) targets. We describe our experience with incremental hemodialysis in patients using NxStage System One for home hemodialysis. From 2011 to 2015, we initiated 5 incident hemodialysis patients on an incremental home hemodialysis regimen. The biochemical parameters of all patients remained stable on the incremental hemodialysis regimen and they consistently achieved standard Kt/Vurea targets. Of the two patients with follow-up >6 months, residual kidney function was preserved for ≥2 years. Importantly, the patients were able to transition to home hemodialysis without automatically requiring 5 sessions per week at the outset and gradually increased the number of treatments and/or dialysate volume as the residual kidney function declined. An incremental home hemodialysis regimen can be safely prescribed and may improve acceptability of home hemodialysis. Reducing hemodialysis frequency by even one treatment per week can reduce the number of fistula or graft cannulations or catheter connections by >100 per year, an important consideration for patient well-being, access longevity, and access-related infections. The incremental hemodialysis approach, supported by national guidelines, can be considered for all home hemodialysis patients with residual kidney function.

  17. Flexible technologies and smart clothing for citizen medicine, home healthcare, and disease prevention.

    Science.gov (United States)

    Axisa, Fabrice; Schmitt, Pierre Michael; Gehin, Claudine; Delhomme, Georges; McAdams, Eric; Dittmar, André

    2005-09-01

    Improvement of the quality and efficiency of healthcare in medicine, both at home and in hospital, is becoming more and more important for patients and society at large. As many technologies (micro technologies, telecommunication, low-power design, new textiles, and flexible sensors) are now available, new user-friendly devices can be developed to enhance the comfort and security of the patient. As clothes and textiles are in direct contact with about 90% of the skin surface, smart sensors and smart clothes with noninvasive sensors are an attractive solution for home-based and ambulatory health monitoring. Moreover, wearable devices or smart homes with exosensors are also potential solutions. All these systems can provide a safe and comfortable environment for home healthcare, illness prevention, and citizen medicine.

  18. The role of Aboriginal family workers in delivering a child safety focused home visiting program for Aboriginal families in an urban region of NSW.

    Science.gov (United States)

    Clapham, Kathleen; Bennett-Brook, Keziah; Hunter, Kate

    2018-05-09

    Aboriginal Australian children experience higher rates of injury than other Australian children. However few culturally acceptable programs have been developed or evaluated. The Illawarra Aboriginal Medical Service (IAMS) developed the Safe Homes Safe Kids program as an injury prevention program targeting disadvantaged Aboriginal families with children aged 0-5 in an urban region of NSW. Delivered by Aboriginal Family Workers the program aims to reduce childhood injury by raising awareness of safety in the home. A program evaluation was conducted to determine the effectiveness of the home visiting model as an injury prevention program. This paper reports on the qualitative interviews which explored the ways in which clients, IAMS staff, and external service providers experienced the program and assessed its delivery by the Aboriginal Family Workers. A qualitative program evaluation was conducted between January 2014 and June 2015. We report here on the semi-structured interviews undertaken with 34 individuals. The results show increased client engagement in the program; improved child safety knowledge and skills; increased access to services; improved attitudes to home and community safety; and changes in the home safety environment. Safe Homes Safe Kids provides a culturally appropriate child safety program delivered by Aboriginal Family Workers to vulnerable families. Clients, IAMS staff, and external service were satisfied with the family workers' delivery of the program and the holistic model of service provision. SO WHAT?: This promising program could be replicated in other Aboriginal health services to address unintentional injury to vulnerable Aboriginal children. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. Arkansas People Participating in Lead Education (APPLE): results of a lead-safe training program.

    Science.gov (United States)

    Ferguson, Alesia; Bursac, Zoran; Kern, David F

    2011-06-01

    Lead is still seen as one of the most harmful environmental toxins for young children, with the predominant source being deteriorating lead-based paint. Those at continued risk include those living in homes built before 1978, renovators and remodelers, and especially those with limited access to proper healthcare and diets. Proper training on lead-safe work practices focused on preventing and reducing the spread of lead dust can help reduce lead exposure. Presented in this paper are experiences in delivering lead-safe work practices training in six Arkansas cities, and results from pre- and post- surveys delivered before and immediately after the training. Pre- and post-surveys assess strong and weak areas of training. Participants demonstrated positive shifts in attitude and behavior towards lead-safe work practices following training. However, our research found that more emphasis should be focused on clarifying current lead exposure sources and routes for children.

  20. Investigation, Analysis, and Testing of Self-contained Oxygen Generators

    Science.gov (United States)

    Keddy, Christopher P.; Haas, Jon P.; Starritt, Larry

    2008-01-01

    Self Contained Oxygen Generators (SCOGs) have widespread use in providing emergency breathing oxygen in a variety of environments including mines, submarines, spacecraft, and aircraft. These devices have definite advantages over storing of gaseous or liquid oxygen. The oxygen is not generated until a chemical briquette containing a chlorate or perchlorate oxidizer and a solid metallic fuel such as iron is ignited starting a thermal decomposition process allowing gaseous oxygen to be produced. These devices are typically very safe to store, easy to operate, and have primarily only a thermal hazard to the operator that can be controlled by barriers or furnaces. Tens of thousands of these devices are operated worldwide every year without major incident. This report examines the rare case of a SCOG whose behavior was both abnormal and lethal. This particular type of SCOG reviewed is nearly identical to a flight qualified version of SCOG slated for use on manned space vehicles. This Investigative Report is a compilation of a NASA effort in conjunction with other interested parties including military and aerospace to understand the causes of the particular SCOG accident and what preventative measures can be taken to ensure this incident is not repeated. This report details the incident and examines the root causes of the observed SCOG behavior from forensic evidence. A summary of chemical and numerical analysis is provided as a background to physical testing of identical SCOG devices. The results and findings of both small scale and full scale testing are documented on a test-by-test basis along with observations and summaries. Finally, conclusions are presented on the findings of this investigation, analysis, and testing along with suggestions on preventative measures for any entity interested in the safe use of these devices.

  1. "Is there a gun in the home?" Assessing the risks of gun ownership in older adults.

    Science.gov (United States)

    Pinholt, Ellen M; Mitchell, Joshua D; Butler, Jane H; Kumar, Harjinder

    2014-06-01

    An important ethical and safety concern that geriatricians, primary care providers, and home health professionals need to address is gun ownership by elderly adults. Those aged 65 and older now have the highest rate of gun ownership in America, and they also have a high prevalence of depression and suicide. Dementia can add additional layers of risk. Even older gun owners who are otherwise intellectually intact may benefit from information about gun safety with the increasing numbers of children being cared for by grandparents. Health professionals should ask patients, "Is there a gun in the home?" in the clinic and during home visits. Healthcare professionals must have knowledge and skills to address safe gun ownership in elderly adults. The 5 L's (Locked, Loaded, Little children, feeling Low, Learned owner) will assist professionals in addressing all aspects of safe ownership. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  2. Home care patients in four Nordic capitals – predictors of nursing home admission during one-year followup

    Directory of Open Access Journals (Sweden)

    Liv W Sørbye

    2010-03-01

    Full Text Available Liv W Sørbye1, Torunn Hamran2, Nils Henriksen2, Astrid Norberg2,31Diakonhjemmet University College, Oslo, Norway; 2Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, Norway; 3Umeå University, Umeå, Ersta Sköndal University College, Stockholm, SwedenAbstract: The aim was to predict nursing home admission (NHA for home care patients after a 12-month follow-up study. This Nordic study is derived from the aged in home care (AdHOC project conducted in 2001–2003 with patients at 11 sites in Europe. The participants in the cohort study were randomly selected individuals, aged 65 years or older, receiving homecare in Oslo, Stockholm, Copenhagen, and Reykjavik. The Resident Assessment Instrument for Home Care (version 2.0 was used. Epidemiological and medical characteristics of patients and service utilization were recorded for 1508 home care patients (participation rate 74%. In this sample 75% were female. The mean age was 82.1 (6.9 years for men and 84.0 (6.6 for women. The most consistent predictor of NHA was receiving skilled nursing procedures at baseline (help with medication and injections, administration or help with oxygen, intravenous, catheter and stoma care, wounds and skin care (adjusted odds ratio = 3.7, 95% confidence interval: 1.7–7.8; P < 0.001. In this Nordic material, stronger emphasizing on higher qualified nurses in a home care setting could prevent or delay NHA.Keywords: aged, home care, cross-sectional study, self-rated health, level of care, care burden, comprehensive assessment, RAI, Nordic

  3. 76 FR 12719 - Safe Schools/Healthy Students Program; Office of Safe and Drug-Free Schools; Safe Schools/Healthy...

    Science.gov (United States)

    2011-03-08

    ... DEPARTMENT OF EDUCATION Safe Schools/Healthy Students Program; Office of Safe and Drug- Free Schools; Safe Schools/Healthy Students Program; Catalog of Federal Domestic Assistance (CFDA) Numbers: 84... priorities, requirements, and definitions under the Safe Schools/Healthy Students (SS/HS) program. Since...

  4. Health smart home for elders - a tool for automatic recognition of activities of daily living.

    Science.gov (United States)

    Le, Xuan Hoa Binh; Di Mascolo, Maria; Gouin, Alexia; Noury, Norbert

    2008-01-01

    Elders live preferently in their own home, but with aging comes the loss of autonomy and associated risks. In order to help them live longer in safe conditions, we need a tool to automatically detect their loss of autonomy by assessing the degree of performance of activities of daily living. This article presents an approach enabling the activities recognition of an elder living alone in a home equipped with noninvasive sensors.

  5. Working safely with electronics racks

    CERN Document Server

    Simon Baird, HSE Unit Head

    2016-01-01

    Think of CERN and you’ll probably think of particle accelerators and detectors. These are the tools of the trade in particle physics, but behind them are the racks of electronics that include power supplies, control systems and data acquisition networks.   Inside an electronics rack: danger could be lurking if the rack is not powered off. In routine operation, these are no more harmful than the home entertainment system in your living room. But unscrew the cover and it’s a different matter. Even after following appropriate training, and with formal authorisation from your group leader or equivalent to carry out electrical work or any work in the vicinity of electrical hazards, and even with extensive experience of carrying out such operations, it’s important to incorporate safe working practices into your routine. At CERN, before the racks of electronics reach their operational configurations for the accelerators and detectors, they play a vital role in test set-ups ...

  6. Sensing performances of ZnO nanostructures grown under different oxygen pressures to hydrogen

    International Nuclear Information System (INIS)

    Chu, Jin; Peng, Xiaoyan; Wang, Zhenbo; Feng, Peter

    2012-01-01

    Graphical abstract: Display Omitted Highlights: ► Surface morphology depends on the oxygen pressure. ► Structural degradation was observed for the ZnO samples when oxygen pressure was overhigh. ► The sensitivity of the ZnO-based sensors increase with grown oxygen pressure. -- Abstract: For extensive use in an industrialized process of individual ZnO nanostructures applied in gas sensors, a simple, inexpensive, and safe synthesis process is required. Here, nanostructured ZnO films were grown by a pulsed laser deposition technique under different oxygen pressures. Scanning electron microscopy images show nanopores, nanotips, and nanoparticles are obtained and energy dispersive X-ray spectroscopy data indicate oxygen concentration of the synthesized samples increases monotonously with oxygen pressure. The sensor based on ZnO with high oxygen concentration has high sensitivity, rapid response (9 s) and recovery (80 s) behavior to 500 ppm hydrogen below 150 °C. Experimental data indicate that high oxygen concentration effectively improves the sensing properties of nanostructured ZnO.

  7. Pilot study of a new device to titrate oxygen flow in hypoxic patients on long-term oxygen therapy.

    Science.gov (United States)

    Cirio, Serena; Nava, Stefano

    2011-04-01

    The O(2) Flow Regulator (Dima, Bologna, Italy) is a new automated oxygen regulator that titrates the oxygen flow based on a pulse-oximetry signal to maintain a target S(pO(2)). We tested the device's safety and efficacy. We enrolled 18 subjects with chronic lung disease, exercise-induced desaturation, and on long-term oxygen therapy, in a randomized crossover study with 2 constant-work-load 15-min cycling exercise tests, starting with the patient's previously prescribed usual oxygen flow. In one test the oxygen flow was titrated manually by the respiratory therapist, and in the other test the oxygen flow was titrated by the O(2) Flow Regulator, to maintain an S(pO(2)) of 94%. We measured S(pO(2)) throughout each test, the time spent by the respiratory therapist to set the device or to manually regulate the oxygen flow, and the total number of respiratory-therapist titration interventions during the trial. There were no differences in symptoms or heart rate between the exercise tests. Compared to the respiratory-therapist-controlled tests, during the O(2) Flow Regulator tests S(pO(2)) was significantly higher (95 ± 2% vs 93 ± 3%, P = .04), significantly less time was spent below the target S(pO(2)) (171 ± 187 s vs 340 ± 220 s, P less respiratory therapist time (5.6 ± 3.7 min vs 2.0 ± 0.1 min, P = .005). The O(2) Flow Regulator may be a safe and effective alternative to manual oxygen titration during exercise in hypoxic patients. It provided stable S(pO(2)) and avoided desaturations in our subjects.

  8. Safe Cockroach Control: A Guide to Setting Up an Integrated Pest Management Program within a School System.

    Science.gov (United States)

    Cowles, Kathleen Letcher; And Others

    Integrated Pest Management (IPM) is a decision-making approach to pest control that has been used successfully on farms, city parks, offices, homes, and schools. IPM programs help individuals decide when treatments are necessary, where treatment would be most helpful, and what combinations of tactics would be most effective, safe, and inexpensive…

  9. Cool and Safe: Multiplicity in Safe Innovation at Unilever

    Science.gov (United States)

    Penders, Bart

    2011-01-01

    This article presents the making of a safe innovation: the application of ice structuring protein (ISP) in edible ices. It argues that safety is not the absence of risk but is an active accomplishment; innovations are not "made safe afterward" but "safe innovations are made". Furthermore, there are multiple safeties to be accomplished in the…

  10. Oxygen Compatibility of Brass-Filled PTFE Compared to Commonly Used Fluorinated Polymers for Oxygen Systems

    Science.gov (United States)

    Herald, Stephen D.; Frisby, Paul M.; Davis, Samuel Eddie

    2009-01-01

    Safe and reliable seal materials for high-pressure oxygen systems sometimes appear to be extinct species when sought out by oxygen systems designers. Materials that seal well are easy to find, but these materials are typically incompatible with oxygen, especially in cryogenic liquid form. This incompatibility can result in seals that leak, or much worse, seals that easily ignite and burn during use. Materials that are compatible with oxygen are easy to find, such as the long list of compatible metals, but these metallic materials are limiting as seal materials. A material that seals well and is oxygen compatible has been the big game in the designer's safari. Scientists at the Materials Combustion Research Facility (MCRF), part of NASA/Marshall Space Flight Center (MSFC), are constantly searching for better materials and processes to improve the safety of oxygen systems. One focus of this effort is improving the characteristics of polymers used in the presence of an oxygen enriched environment. Very few systems can be built which contain no polymeric materials; therefore, materials which have good impact resistance, low heat of combustion, high auto-ignition temperature and that maintain good mechanical properties are essential. The scientists and engineers at the Materials Combustion Research Facility, in cooperation with seal suppliers, are currently testing a new formulation of polytetrafluoroethylene (PTFE) with Brass filler. This Brass-filled PTFE is showing great promise as a seal and seat material for high pressure oxygen systems. Early research has demonstrated very encouraging results, which could rank this material as one of the best fluorinated polymers ever tested. This paper will compare the data obtained for Brass-filled PTFE with other fluorinated polymers, such as TFE-Teflon (PTFE) , Kel-F 81, Viton A, Viton A-500, Fluorel , and Algoflon . A similar metal filled fluorinated polymer, Salox-M , was tested in comparison to Brass-filled PTFE to

  11. Malpractice paid losses and financial performance of nursing homes.

    Science.gov (United States)

    Zhao, Mei; Haley, D Rob; Oetjen, Reid M; Carretta, Henry J

    2011-01-01

    Florida's nursing home industry has experienced significant financial pressure over the past decade. One of the primary reasons is the dramatic increase in litigation activity for nursing home providers claiming negligent care and abuse. Although anecdotal reports indicate a higher cost because of malpractice in nursing facilities, few studies have examined the extent of malpractice paid losses and their effect on the financial performance of nursing homes. The purpose of this study was to examine the impact of malpractice paid losses on the financial performance of nursing homes. Medicare Cost Report data and Online Survey, Certification, and Reporting data for Florida skilled nursing facilities over the 6-year period from 2001 to 2006 were used to calculate the malpractice paid losses and the financial performance indicators as well as the nursing home organizational and market factors. Descriptive analysis and multivariate regression analysis were used to examine the effect of paid loss on financial performance. The paid loss for malpractice claims was strongly associated with financial performance. Nursing facilities with malpractice paid losses had consistently lower total margins over the study period. The threat of nursing home litigation may create an incentive for nursing homes to improve quality of care; however, large paid claims can also force nursing homes into a financial situation where the organization no longer has the resources to improve quality. Nursing home managers must assess their malpractice litigation risk and identify tactics to mitigate these risks to better provide a safe and secure environment for the older persons. In addition, this research offers support for local, state, and federal policymakers to revisit the issue of malpractice litigation and the nursing home industry through its insight on the relationship of nursing home margins and litigation.

  12. Tubing length for long-term oxygen therapy.

    Science.gov (United States)

    Aguiar, Carolina; Davidson, Josy; Carvalho, Andréa K; Iamonti, Vinícius C; Cortopassi, Felipe; Nascimento, Oliver A; Jardim, José R

    2015-02-01

    Most patients on long-term oxygen therapy use stationary oxygen delivery systems. It is not uncommon for guidelines to instruct patients to use tubing lengths no longer than 19.68 ft (6 m) when using an oxygen concentrator and 49.21 ft (15 m) when using cylinders. However, these concepts are not based on sufficient evidence. Thus, our objective was to evaluate whether a 98.42-ft (30-m) tubing length affects oxygen flow and FIO2 delivery from 1 cylinder and 2 oxygen concentrators. The 3 oxygen delivery systems were randomly selected, and 1, 3, and 5 L/min flows and FIO2 were measured 5 times at each flow at the proximal and distal outlets of the tubing by a gas-flow analyzer. Paired Student t test was used to analyze the difference between flows and FIO2 at proximal and distal outlets of tubing length. A total of 45 flows were measured between proximal and distal outlets of the 98.42-ft (30-m) tubing. Flows were similar for 1 and 3 L/min, but distal flow was higher than proximal flow at 5 L/min (5.57×5.14 L/min, Ptubing at flows 1, 3, and 5 L/min, but the mean difference between measurements was less than 1%. Tubing length of 98.42 ft (30 m) may be used by patients for home delivery oxygen with flows up to 5 L/min, as there were no important changes in flows or FIO2. Copyright © 2015 by Daedalus Enterprises.

  13. Percutaneous treatment of lumbar disc herniation by oxygen-ozone injection -clinical study with indication

    International Nuclear Information System (INIS)

    Wang Zhuying; Jiang Caimei; Wang Zhimin

    2006-01-01

    Objective: To study the clinical effect and the range of indications of oxygen-ozone treatment for lumber disc herniation. Methods: 6-15 ml of oxygen-ozone (35-45 μg/ml) were injected percutaneously into lumbar disc. In case of multiple disc herniations, the procedure could be taken with two discs for once. Results: 323 patients with 433 discs were treated by oxygen-ozone injection procedure. Total effective rate was 77.7%. Conclusions: The treatment of lumber disc herniation by oxygen-ozone injection is simple, safe and effective with mild trauma. Oxygen-ozone not only can oxidize the proteoglycan in the nucleus leading to the contraction of nucleus, but also provide anti-inflammation effect with pain relief and without complication yet. (authors)

  14. Barriers and Facilitators to Safe Food Handling among Consumers: A Systematic Review and Thematic Synthesis of Qualitative Research Studies.

    Directory of Open Access Journals (Sweden)

    Ian Young

    Full Text Available Foodborne illness has a substantial health and economic burden on society, and most cases are believed to be due to unsafe food handling practices at home. Several qualitative research studies have been conducted to investigate consumers' perspectives, opinions, and experiences with safe food handling at home, and these studies provide insights into the underlying barriers and facilitators affecting their safe food handling behaviours. We conducted a systematic review of previously published qualitative studies in this area to synthesize the main across-study themes and to develop recommendations for future consumer interventions and research. The review was conducted using the following steps: comprehensive search strategy; relevance screening of abstracts; relevance confirmation of articles; study quality assessment; thematic synthesis of the results; and quality-of-evidence assessment. A total of 39 relevant articles reporting on 37 unique qualitative studies were identified. Twenty-one barriers and 10 facilitators to safe food handling were identified, grouped across six descriptive themes: confidence and perceived risk; knowledge-behaviour gap; habits and heuristics; practical and lifestyle constraints; food preferences; and societal and social influences. Our overall confidence that each barrier and facilitator represents the phenomenon of interest was rated as high (n = 11, moderate (11, and low (9. Overarching analytical themes included: 1 safe food handling behaviours occur as part of a complex interaction of everyday consumer practices and habituation; 2 most consumers are not concerned about food safety and are generally not motivated to change their behaviours based on new knowledge about food safety risks; and 3 consumers are amenable to changing their safe food handling habits through relevant social pressures. Key implications and recommendations for research, policy and practice are discussed.

  15. Barriers and Facilitators to Safe Food Handling among Consumers: A Systematic Review and Thematic Synthesis of Qualitative Research Studies

    Science.gov (United States)

    Young, Ian; Waddell, Lisa

    2016-01-01

    Foodborne illness has a substantial health and economic burden on society, and most cases are believed to be due to unsafe food handling practices at home. Several qualitative research studies have been conducted to investigate consumers’ perspectives, opinions, and experiences with safe food handling at home, and these studies provide insights into the underlying barriers and facilitators affecting their safe food handling behaviours. We conducted a systematic review of previously published qualitative studies in this area to synthesize the main across-study themes and to develop recommendations for future consumer interventions and research. The review was conducted using the following steps: comprehensive search strategy; relevance screening of abstracts; relevance confirmation of articles; study quality assessment; thematic synthesis of the results; and quality-of-evidence assessment. A total of 39 relevant articles reporting on 37 unique qualitative studies were identified. Twenty-one barriers and 10 facilitators to safe food handling were identified, grouped across six descriptive themes: confidence and perceived risk; knowledge-behaviour gap; habits and heuristics; practical and lifestyle constraints; food preferences; and societal and social influences. Our overall confidence that each barrier and facilitator represents the phenomenon of interest was rated as high (n = 11), moderate (11), and low (9). Overarching analytical themes included: 1) safe food handling behaviours occur as part of a complex interaction of everyday consumer practices and habituation; 2) most consumers are not concerned about food safety and are generally not motivated to change their behaviours based on new knowledge about food safety risks; and 3) consumers are amenable to changing their safe food handling habits through relevant social pressures. Key implications and recommendations for research, policy and practice are discussed. PMID:27907161

  16. Development of a Health Care Information System for the Elderly at Home

    Directory of Open Access Journals (Sweden)

    Wang Dong

    2016-01-01

    Full Text Available The growing population aging is a serious social problem in the world today. Accidental death at home is increasing because abnormal conditions can not be discovered in time, especially to the elderly who live alone. Besides, according to statistics, over 80 percent of the elderly need the service of home care in China. A health care information system for the elderly at home is developed to monitor the real–time state of the elderly remotely in this thesis. The system can show the current positions of the elderly in the house and judge whether they are in dangerous locations or have dangerous activities. In the case of emergency, the elderly can press the emergency button. The system also provides some help for the elderly’s daily life. The system offers the advantage for living at home more safely and more comfortably, and has better application prospect

  17. Paediatric tracheostomy and ventilation home care with challenging socio-economic circumstances in South Africa.

    Science.gov (United States)

    Groenendijk, Ilse; Booth, Jane; van Dijk, Monique; Argent, Andrew; Zampoli, Marco

    2016-05-01

    Children discharged home with a tracheostomy need a safe home environment and access to health care. We described the indications, clinical characteristics, socio-economic circumstances and outcomes of children enroled in a tracheostomy home care programme in South Africa. We performed a retrospective chart review of children receiving a tracheostomy and enroled in the Breatheasy programme at the Red Cross War Memorial Children's Hospital, Cape Town. Medical and background characteristics were recorded. Influences of socio-economic variables and underlying medical conditions on length of hospital stay, unplanned readmissions and mortality in the first year after discharge were evaluated. In the period 2008-2012, 157 patients were discharged home with a tracheostomy. Median hospital stay after tracheostomy insertion was significantly longer when parents had incomplete schooling compared to completed secondary school or higher education; 30 days (IQR 21-53) versus 23 days (IQR 16-33), respectively. Unplanned readmissions in the first year were documented for 72 patients (45.9%). The risk for unplanned readmission was 2.6 times higher in families with substance abuse the risk of respiratory infections was two-fold in case of household cigarette smoke exposure (OR 2.3.) Tracheostomy-related mortality was low (1.2%). An underlying medical condition was the only independent significant risk factor for mortality (OR 5.1, 95% CI 1.8-14.3). This study demonstrates that despite difficult socio-economic circumstances, home ventilation of children with a tracheostomy is safe, provided caregivers are adequately trained and supported. Copyright © 2016. Published by Elsevier Ireland Ltd.

  18. Extracorporeal membrane oxygenation in near-drowning patients with cardiac or pulmonary failure.

    Science.gov (United States)

    Kim, Kun Il; Lee, Won Yong; Kim, Hyoung Soo; Jeong, Jae Han; Ko, Ho Hyun

    2014-12-12

    The aim of this study was to determine the early outcomes of using extracorporeal membrane oxygenation (ECMO) in near-drowning patients with cardiac or pulmonary failure. This study was based on data from 9 patients including 2 children (mean age 33; 8 males, 1 female) who received ECMO after near-drowning between 2008 and 2013. Veno-arterial or veno-arteriovenous ECMO was used in 2 patients with sustained cardiac arrest and veno-venous ECMO was used in 7 patients with severe acute respiratory distress syndrome (ARDS). The means of the partial arterial oxygen pressure (PaO2), Murray score, sequential organ failure assessment (SOFA) score, and simplified acute physiology score II (SAPS-II) prior to ECMO were 59.7 ± 9.9 mmHg on 100% oxygen, 3.5 ± 0.6, 11.4 ± 1.9, and 73.0 ± 9.2, respectively. The PaO2 mean improved to 182 ± 152 mmHg within 2 h post-ECMO. The mean of SOFA score and SAPS-II decreased significantly to 8.6 ± 3.2 (p = 0.013) and 46.4 ± 5.1 (p = 0.008), respectively, at 24 h post-ECMO with mean flow rate of 3.9 ± 0.8 l/min. ECMO was weaned at a mean duration of 188 (range, 43-672) h in all patients. Seven patients were discharged home without neurological sequelae, while 2 patients who had hypoxic brain damage died after further referral. The overall survival with favourable neurological outcomes at 3 months was 77.8%. There were no complications related to ECMO. ECMO was safe and effective for patients with ongoing cardiac arrest or ARDS after a near-drowning incident and can be used as a resuscitative strategy in near-drowning patients with cardiac or pulmonary failure resistant to conventional ventilator therapy.

  19. Special Needs Adoption and Foster Exigencies (SAFE: A Model for Case Managers

    Directory of Open Access Journals (Sweden)

    Kristen Linton

    2014-05-01

    Full Text Available Children with special needs disproportionately receive child welfare services in out-of-home placements, such as foster and adoptive homes. This theoretical model has been developed to describe or explain exigencies of adoptive and foster families of children with special needs (n = 82. A web content analysis, including theme, feature, link, exchange, and language analyses, of online discussion forums of adoptive and foster parents of children with special needs using a phenomenological framework was conducted. Inductive and quantitative web content analyses were conducted on themes. Parenting concerns were clustered into two main themes, disability and placement issues, and focused on children’s pre and post placement needs. A phenomenological analysis resulted in the development of the Special Needs Adoption and Foster Exigencies (SAFE, which outlines exigencies of adoptive and foster parents of children with special needs during engagement, assessment, and intervention phases of case management.

  20. The interrater and test-retest reliability of the Home Falls and Accidents Screening Tool (HOME FAST) in Malaysia: Using raters with a range of professional backgrounds.

    Science.gov (United States)

    Romli, Muhammad Hibatullah; Mackenzie, Lynette; Lovarini, Meryl; Tan, Maw Pin; Clemson, Lindy

    2017-06-01

    Falls can be a devastating issue for older people living in the community, including those living in Malaysia. Health professionals and community members have a responsibility to ensure that older people have a safe home environment to reduce the risk of falls. Using a standardised screening tool is beneficial to intervene early with this group. The Home Falls and Accidents Screening Tool (HOME FAST) should be considered for this purpose; however, its use in Malaysia has not been studied. Therefore, the aim of this study was to evaluate the interrater and test-retest reliability of the HOME FAST with multiple professionals in the Malaysian context. A cross-sectional design was used to evaluate interrater reliability where the HOME FAST was used simultaneously in the homes of older people by 2 raters and a prospective design was used to evaluate test-retest reliability with a separate group of older people at different times in their homes. Both studies took place in an urban area of Kuala Lumpur. Professionals from 9 professional backgrounds participated as raters in this study, and a group of 51 community older people were recruited for the interrater reliability study and another group of 30 for the test-retest reliability study. The overall agreement was moderate for interrater reliability and good for test-retest reliability. The HOME FAST was consistently rated by different professionals, and no bias was found among the multiple raters. The HOME FAST can be used with confidence by a variety of professionals across different settings. The HOME FAST can become a universal tool to screen for home hazards related to falls. © 2017 John Wiley & Sons, Ltd.

  1. Maternity waiting homes in Southern Lao PDR: the unique 'silk home'.

    Science.gov (United States)

    Eckermann, Elizabeth; Deodato, Giovanni

    2008-10-01

    The concept of maternity waiting homes (MWH) has a long history spanning over 100 years. The research reported here was conducted in the Thateng District of Sekong Province in southern Lao People's Democratic Republic (PDR) to establish whether the MWH concept would be affordable, accessible, and most importantly acceptable, as a strategy to improve maternal outcomes in the remote communities of Thateng with a high proportion of the population from ethnic minority groups. The research suggested that there were major barriers to minority ethnic groups using existing maternal health services (reflected in very low usage of trained birth attendants and hospitals and clinics) in Thateng. Unless MWH are adapted to overcome these potential barriers, such initiatives will suffer the same fate as existing maternal facilities. Consequently, the Lao iteration of the concept, as operationalized in the Silk Homes project in southern Lao PDR is unique in combining maternal and infant health services with opportunities for micro credit and income generating activities and allowing non-harmful traditional practices to co-exist alongside modern medical protocols. These innovative approaches to the MWH concept address the major economic, social and cultural barriers to usage of safe birthing options in remote communities of southern Lao PDR.

  2. A Water-/Fireproof Flexible Lithium-Oxygen Battery Achieved by Synergy of Novel Architecture and Multifunctional Separator.

    Science.gov (United States)

    Yin, Yan-Bin; Yang, Xiao-Yang; Chang, Zhi-Wen; Zhu, Yun-Hai; Liu, Tong; Yan, Jun-Min; Jiang, Qing

    2018-01-01

    To meet the increasing demands for portable and flexible devices in a rapidly developing society, it is urgently required to develop highly safe and flexible electrochemical energy-storage systems. Flexible lithium-oxygen batteries with high theoretical specific energy density are promising candidates; however, the conventional half-open structure design prevents it from working properly under water or fire conditions. Herein, as a proof-of-concept experiment, a highly safe flexible lithium-oxygen battery achieved by the synergy of a vital multifunctional structure design and a unique composite separator is proposed and fabricated. The structure can effectively prevent the invasion of water from the environment and combustion, which is further significantly consolidated with the help of a polyimide and poly(vinylidene fluoride-co-hexafluoropropylene) composite separator, which holds good water resistance, thermal stability, and ionic conductivity. Unexpectedly, the obtained lithium-oxygen battery exhibits superior flexibility, water resistance, thermal resistance, and cycling stability (up to 218 cycles; at a high current of 1 mA and capacity of 4 mA h). This novel water/fireproof, flexible lithium-oxygen battery is a promising candidate to power underwater flexible electronics. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Health-illness transition among persons using advanced medical technology at home.

    Science.gov (United States)

    Fex, Angelika; Flensner, Gullvi; Ek, Anna-Christina; Söderhamn, Olle

    2011-06-01

    This study aimed to elucidate meanings of health-illness transition experiences among adult persons using advanced medical technology at home. As an increasing number of persons perform self-care while using different sorts of advanced medical technology at home, knowledge about health-illness transition experiences in this situation may be useful to caregivers in supporting these patients. A qualitative design was used. Five women and five men, all of whom performed self-care at home, either using long-term oxygen therapy from a ventilator or oxygen cylinder, or performing peritoneal or haemodialysis, were interviewed. Ethics committee approval was obtained. Informed consent was received from all participants, and ethical issues concerning their rights in research were raised. The interviews were analysed using a phenomenological hermeneutical methodology, including both an inductive and a deductive structural analysis. This method offers possibilities to obtain an increased understanding by uncovering a deeper meaning of lived experiences through interviews transcribed as texts. The health-illness transition for adult persons in this context was found to mean a learning process of accepting, managing, adjusting and improving daily life with technology, facilitated by realizing the gain from technology at home. Further, the meaning of the health-illness transition experience was interpreted as contentment with being part of the active and conscious process towards transcending into a new state of living, in which the individual and the technology were in tune. The healthy transition experience was characterized by human growth and becoming. This study elucidates one meaning of health-illness transition experiences in relation to the use of advanced medical technology on a more generic level, independent of the specific type of technology used. A positive attitude towards technology at home facilitates the transition. © 2010 The Authors. Scandinavian Journal of

  4. Improving quality and safety in nursing homes and home care: the study protocol of a mixed-methods research design to implement a leadership intervention

    Science.gov (United States)

    Wiig, Siri; Ree, Eline; Johannessen, Terese; Strømme, Torunn; Storm, Marianne; Aase, Ingunn; Ullebust, Berit; Holen-Rabbersvik, Elisabeth; Hurup Thomsen, Line; Sandvik Pedersen, Anne Torhild; van de Bovenkamp, Hester; Bal, Roland; Aase, Karina

    2018-01-01

    Introduction Nursing homes and home care face challenges across different countries as people are living longer, often with chronic conditions. There is a lack of knowledge regarding implementation and impact of quality and safety interventions as most research evidence so far is generated in hospitals. Additionally, there is a lack of effective leadership tools for quality and safety improvement work in this context. Methods and analysis The aim of the ‘Improving Quality and Safety in Primary Care—Implementing a Leadership Intervention in Nursing Homes and Homecare’ (SAFE-LEAD) study is to develop and evaluate a research-based leadership guide for managers to increase quality and safety competence. The project applies a mixed-methods design and explores the implications of the leadership guide on managers’ and staffs’ knowledge, attitudes and practices. Four nursing homes and four home care services from different Norwegian municipalities will participate in the intervention. Surveys, process evaluation (interviews, observations) and document analyses will be conducted to evaluate the implementation and impact of the leadership intervention. A comparative study of Norway and the Netherlands will establish knowledge of the context dependency of the intervention. Ethics and dissemination The study is approved by the Norwegian Centre for Research Data (2017/52324 and 54855). The results will be disseminated through scientific articles, two PhD dissertations, an anthology, presentations at national and international conferences, and in social media, newsletters and in the press. The results will generate knowledge to inform leadership practices in nursing homes and home care. Moreover, the study will build new theory on leadership interventions and the role of contextual factors in nursing homes and home care. PMID:29599394

  5. Comparison of the OxyMask and Venturi mask in the delivery of supplemental oxygen: Pilot study in oxygen-dependent patients

    Science.gov (United States)

    Beecroft, Jaime M; Hanly, Patrick J

    2006-01-01

    BACKGROUND: The OxyMask (Southmedic Inc, Canada) is a new face mask for oxygen delivery that uses a small ‘diffuser’ to concentrate and direct oxygen toward the mouth and nose. The authors hypothesized that this unique design would enable the OxyMask to deliver oxygen more efficiently than a Venturi mask (Hudson RCI, USA) in patients with chronic hypoxemia. METHODS: Oxygen-dependent patients with chronic, stable respiratory disease were recruited to compare the OxyMask and Venturi mask in a randomized, single-blind, cross-over design. Baseline blood oxygen saturation (SaO2) was established breathing room air, followed in a random order by supplemental oxygen through the OxyMask or Venturi mask. Oxygen delivery was titrated to maintain SaO2 4% to 5% and 8% to 9% above baseline for two separate 30 min periods of stable breathing. Oxygen flow rate, partial pressure of inspired and expired oxygen (PO2) and carbon dioxide (PCO2), minute ventilation, heart rate, nasal and oral breathing, SaO2 and transcutaneous PCO2 were collected continuously. The study was repeated following alterations to the OxyMask design, which improved clearance of carbon dioxide. RESULTS: Thirteen patients, aged 28 to 79 years, were studied initially using the original OxyMask. Oxygen flow rate was lower, inspired PO2 was higher and expired PO2 was lower while using the OxyMask. Minute ventilation and inspired and expired PCO2 were significantly higher while using the OxyMask, whereas transcutaneous PCO2, heart rate and the ratio of nasal to oral breathing did not change significantly throughout the study. Following modification of the OxyMask, 13 additional patients, aged 18 to 79 years, were studied using the same protocol. The modified OxyMask provided a higher inspired PO2 at a lower flow rate, without evidence of carbon dioxide retention. CONCLUSIONS: Oxygen is delivered safely and more efficiently by the OxyMask than by the Venturi mask in stable oxygen-dependent patients. PMID:16896425

  6. The SafeCOP ECSEL Project: Safe Cooperating Cyber-Physical Systems Using Wireless Communication

    DEFF Research Database (Denmark)

    Pop, Paul; Scholle, Detlef; Hansson, Hans

    2016-01-01

    This paper presents an overview of the ECSEL project entitled "Safe Cooperating Cyber-Physical Systems using Wireless Communication" (SafeCOP), which runs during the period 2016 -- 2019. SafeCOP targets safety-related Cooperating Cyber-Physical Systems (CO-CPS) characterised by use of wireless...... detection of abnormal behaviour, triggering if needed a safe degraded mode. SafeCOP will also develop methods and tools, which will be used to produce safety assurance evidence needed to certify cooperative functions. SafeCOP will extend current wireless technologies to ensure safe and secure cooperation...

  7. Home Water Treatment Habits and Effectiveness in a Rural Arizona Community.

    Science.gov (United States)

    Lothrop, Nathan; Wilkinson, Sarah T; Verhougstraete, Marc; Sugeng, Anastasia; Loh, Miranda M; Klimecki, Walter; Beamer, Paloma I

    Drinking water quality in the United States (US) is among the safest in the world. However, many residents, often in rural areas, rely on unregulated private wells or small municipal utilities for water needs. These utilities may violate the Safe Drinking Water Act contaminant guidelines, often because they lack the required financial resources. Residents may use alternative water sources or install a home water treatment system. Despite increased home water treatment adoption, few studies have examined their use and effectiveness in the US. Our study addresses this knowledge gap by examining home water treatment in a rural Arizona community. Water samples were analyzed for metal(loid)s, and home treatment and demographic data were recorded in 31 homes. Approximately 42% of homes treated their water. Independent of source water quality, residents with higher income (OR = 1.25; 95%CI (1.00 - 1.64)) and education levels (OR = 1.49; 95%CI (1.12 - 2.12)) were more likely to treat their water. Some contaminant concentrations were effectively reduced with treatment, while some were not. We conclude that increased educational outreach on contaminant testing and treatment, especially to rural areas with endemic water contamination, would result in a greater public health impact while reducing rural health disparities.

  8. Safe Kids Worldwide

    Science.gov (United States)

    ... Blog Videos Newsletter facebook twitter instagram pinterest gplus youtube Search Menu Why It Matters Who We Are What We Do Find Your Safe Kids Safe Kids Day Main menu Keeping All Kids Safe Safety Tips Get Involved 4 Star Charity Donate Text Burns and Scalds 4 tips ...

  9. Safe management of cesarean section in a patient of Eisenmenger syndrome

    Directory of Open Access Journals (Sweden)

    Silvia Minicucci

    2012-01-01

    Full Text Available We report our experience of a 29-year-old female with a complete atrio-ventricular septal defect leading to a single ventricle physiology and Eisenmenger syndrome. The patient successfully underwent spinal anesthesia for cesarean section in the 31 st week of pregnancy. A multidisciplinary approach involving cardiologist, cardiac surgeon, obstetrician, and anesthesiologist was utilized to achieve a safe pregnancy and cesarean for the delivery of the baby. A close clinical assessment is required, especially during the third trimester when the risk of acute right ventricular dysfunction increases. The use of extracorporeal membrane oxygenation (ECMO (as a bridge to recovery or bridge to salvage was planned to support oxygenation and circulation in case of acute biventricular dysfunction. The delivery/cesarean section was performed in a cardiac surgery operating room, and to reduce the time-frame for ECMO institution the femoral vessels were exposed surgically before the cesarean section.

  10. SCI Hospital in Home Program: Bringing Hospital Care Home for Veterans With Spinal Cord Injury.

    Science.gov (United States)

    Madaris, Linda L; Onyebueke, Mirian; Liebman, Janet; Martin, Allyson

    2016-01-01

    The complex nature of spinal cord injury (SCI) and the level of care required for health maintenance frequently result in repeated hospital admissions for recurrent medical complications. Prolonged hospitalizations of persons with SCI have been linked to the increased risk of hospital-acquired infections and development or worsening pressure ulcers. An evidence-based alternative for providing hospital-level care to patients with specific diagnoses who are willing to receive that level of care in the comfort of their home is being implemented in a Department of Veterans Affairs SCI Home Care Program. The SCI Hospital in Home (HiH) model is similar to a patient-centered interdisciplinary care model that was first introduced in Europe and later tested as part of a National Demonstration and Evaluation Study through Johns Hopkins School of Medicine and School of Public Health. This was funded by the John A. Hartford Foundation and the Department of Veterans Affairs. The objectives of the program are to support veterans' choice and access to patient-centered care, reduce the reliance on inpatient medical care, allow for early discharge, and decrease medical costs. Veterans with SCI who are admitted to the HiH program receive daily oversight by a physician, daily visits by a registered nurse, access to laboratory services, oxygen, intravenous medications, and nursing care in the home setting. In this model, patients may typically access HiH services either as an "early discharge" from the hospital or as a direct admit to the program from the emergency department or SCI clinic. Similar programs providing acute hospital-equivalent care in the home have been previously implemented and are successfully demonstrating decreased length of stay, improved patient access, and increased patient satisfaction.

  11. Evaluation of five years of nursing home inspection forms: structural and hygiene-related violation trends.

    Science.gov (United States)

    Avery, Chris; Humphrey, Charles; Balany, Jo Anne

    2014-11-01

    Health inspections are performed at nursing homes to identify and reduce risk and to help maintain a safe environment for nursing home residents. The study described in this article aimed to identify the most frequent violations, types of violations (hygiene or structural), and repeat violations in nursing home facilities during health inspections; and to determine if the age of the facility influenced inspection scores. Nursing home health inspection forms (N = 131) completed between 2005 and 2011 in Pitt County, North Carolina, were analyzed. Results indicated that 60% of all violations were hygiene-related and could possibly be corrected without significant financial investments by management. Significant correlations occurred between the total number of violations and the facility age (p = .003) and between the number of repeat violations and total violations (p < .001). The average inspection score for nursing homes could be increased by more than three points if sanitation practices were improved.

  12. Hypercapnic Respiratory Acidosis During An In-Flight Oxygen Assessment.

    Science.gov (United States)

    Spurling, Kristofer J; Moonsie, Ian K; Perks, Joseph L

    2016-02-01

    Patients with respiratory disease are at risk of excessive hypoxemia in the hypobaric commercial aircraft cabin environment, and the consensus is that this is easily corrected with supplementary oxygen. However, despite the risks of hypercapnia with increasing inspired oxygen in some patients being well established, this issue is not currently addressed in medical guidelines for air travel. A 76-yr-old woman with chronic type 2 respiratory failure underwent hypoxic challenge testing (HCT) to assess in-flight oxygen requirements. She is stable on home ventilation, and baseline arterial blood gases showed mild hypoxemia (Pao2 9.12 kPa), normal P(a)co(2) (5.64 kPa) and pH (7.36) with 98% S(p)O(2). HCT was performed delivering 15% FIo(2) via a mask, and the patient desaturated to respiratory acidosis (pH 7.25). The patient was advised against flying due to hypoxemia during HCT and the precipitous drop in pH on oxygen. It is possible to hyperoxygenate patients with type 2 respiratory failure in flight with the minimum level of supplementary oxygen available on many aircraft. In these cases P(a)co(2) and pH should be scrutinized during HCT before recommending in-flight oxygen. No current guidelines discuss the risk of hypercapnia from in-flight oxygen; it is therefore recommended that this be addressed in future revisions of medical air travel guidelines, should further research indicate it.

  13. Public education in safe use of artificial UV radiation sources by the consumer safety institute in the Netherlands

    International Nuclear Information System (INIS)

    Bruggers, J.H.A.

    1987-01-01

    The Consumer Safety Institute in the Netherlands is a national institute which operates entirely in the field of home safety. Its main aim exists in reducing the possibility and severity of accidents happening in and around the home, at school and recreational areas. To attain this aim the institute is active in research, handling consumer complaints, education, and advising. To inform and educate consumers about product safety, special leaflets and brochures are published. One of these brochures deals with safety and safe use of artificial UV radiation sources, e.g. UV lamps, UV couches etc. This brochure about suntanning equipment and safety was published recently

  14. Carbon dioxide narcosis due to inappropriate oxygen delivery: a case report.

    Science.gov (United States)

    Herren, Thomas; Achermann, Eva; Hegi, Thomas; Reber, Adrian; Stäubli, Max

    2017-07-28

    Oxygen delivery to patients with chronic obstructive pulmonary disease may be challenging because of their potential hypoxic ventilatory drive. However, some oxygen delivery systems such as non-rebreathing face masks with an oxygen reservoir bag require high oxygen flow for adequate oxygenation and to avoid carbon dioxide rebreathing. A 72-year-old Caucasian man with severe chronic obstructive pulmonary disease was admitted to the emergency department because of worsening dyspnea and an oxygen saturation of 81% measured by pulse oximetry. Oxygen was administered using a non-rebreathing mask with an oxygen reservoir bag attached. For fear of removing the hypoxic stimulus to respiration the oxygen flow was inappropriately limited to 4L/minute. The patient developed carbon dioxide narcosis and had to be intubated and mechanically ventilated. Non-rebreathing masks with oxygen reservoir bags must be fed with an oxygen flow exceeding the patient's minute ventilation (>6-10 L/minute.). If not, the amount of oxygen delivered will be too small to effectively increase the arterial oxygen saturation. Moreover, the risk of carbon dioxide rebreathing dramatically increases if the flow of oxygen to a non-rebreathing mask is lower than the minute ventilation, especially in patients with chronic obstructive pulmonary disease and low tidal volumes. Non-rebreathing masks (with oxygen reservoir bags) must be used cautiously by experienced medical staff and with an appropriately high oxygen flow of 10-15 L/minute. Nevertheless, arterial blood gases must be analyzed regularly for early detection of a rise in partial pressure of carbon dioxide in arterial blood in patients with chronic obstructive pulmonary disease and a hypoxic ventilatory drive. These patients are more safely managed using a nasal cannula with an oxygen flow of 1-2L/minute or a simple face mask with an oxygen flow of 5L/minute.

  15. The Blue Dog: evaluation of an interactive software program to teach young children how to interact safely with dogs.

    Science.gov (United States)

    Schwebel, David C; Morrongiello, Barbara A; Davis, Aaron L; Stewart, Julia; Bell, Melissa

    2012-04-01

    Pre-post-randomized design evaluated The Blue Dog, a dog safety software program. 76 children aged 3.5-6 years completed 3 tasks to evaluate dog safety pre- and postintervention: (a) pictures (recognition of safe/risky behavior), (b) dollhouse (recall of safe behavior via simulated dollhouse scenarios), and (c) live dog (actual behavior with unfamiliar live dog). Following preintervention evaluation, children were randomly assigned to dog or fire safety conditions, each involving 3 weeks of home computer software use. Children using Blue Dog had greater change in recognition of risky dog situations than children learning fire safety. No between-group differences emerged in recall (dollhouse) or engagement (live-dog) in risky behavior. Families enjoyed using the software. Blue Dog taught children knowledge about safe engagement with dogs, but did not influence recall or implementation of safe behaviors. Dog bites represent a significant pediatric injury concern and continued development of effective interventions is needed.

  16. Improving quality and safety in nursing homes and home care: the study protocol of a mixed-methods research design to implement a leadership intervention.

    Science.gov (United States)

    Wiig, Siri; Ree, Eline; Johannessen, Terese; Strømme, Torunn; Storm, Marianne; Aase, Ingunn; Ullebust, Berit; Holen-Rabbersvik, Elisabeth; Hurup Thomsen, Line; Sandvik Pedersen, Anne Torhild; van de Bovenkamp, Hester; Bal, Roland; Aase, Karina

    2018-03-28

    Nursing homes and home care face challenges across different countries as people are living longer, often with chronic conditions. There is a lack of knowledge regarding implementation and impact of quality and safety interventions as most research evidence so far is generated in hospitals. Additionally, there is a lack of effective leadership tools for quality and safety improvement work in this context. The aim of the 'Improving Quality and Safety in Primary Care-Implementing a Leadership Intervention in Nursing Homes and Homecare' (SAFE-LEAD) study is to develop and evaluate a research-based leadership guide for managers to increase quality and safety competence. The project applies a mixed-methods design and explores the implications of the leadership guide on managers' and staffs' knowledge, attitudes and practices. Four nursing homes and four home care services from different Norwegian municipalities will participate in the intervention. Surveys, process evaluation (interviews, observations) and document analyses will be conducted to evaluate the implementation and impact of the leadership intervention. A comparative study of Norway and the Netherlands will establish knowledge of the context dependency of the intervention. The study is approved by the Norwegian Centre for Research Data (2017/52324 and 54855). The results will be disseminated through scientific articles, two PhD dissertations, an anthology, presentations at national and international conferences, and in social media, newsletters and in the press. The results will generate knowledge to inform leadership practices in nursing homes and home care. Moreover, the study will build new theory on leadership interventions and the role of contextual factors in nursing homes and home care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. "Same Room, Safe Place".

    Science.gov (United States)

    Keene Woods, Nikki

    2017-04-01

    There are many different professional stances on safe sleep and then there is the reality of caring for a newborn. There is a debate among professionals regarding safe sleep recommendations. The continum of recommendations vary from the American Academy of Pediatrics (AAP) Safe Sleep Guidelines to the bed-sharing recommendations from the Mother-Baby Behavioral Sleep Laboratory. The lack of consistent and uniform safe sleep recommendations from health professionals has been confusing for families but has more recently raised a real professional ethical dilemma. Despite years of focused safe sleep community education and interventions, sleep-related infant deaths are on the rise in many communities. This commentary calls for a united safe sleep message from all health professionals to improve health for mothers and infants most at-risk, "Same Room, Safe Place."

  18. Oxygen Exposure Resulting in Arterial Oxygen Tensions Above the Protocol Goal Was Associated With Worse Clinical Outcomes in Acute Respiratory Distress Syndrome.

    Science.gov (United States)

    Aggarwal, Neil R; Brower, Roy G; Hager, David N; Thompson, B Taylor; Netzer, Giora; Shanholtz, Carl; Lagakos, Adrian; Checkley, William

    2018-04-01

    High fractions of inspired oxygen may augment lung damage to exacerbate lung injury in patients with acute respiratory distress syndrome. Participants enrolled in Acute Respiratory Distress Syndrome Network trials had a goal partial pressure of oxygen in arterial blood range of 55-80 mm Hg, yet the effect of oxygen exposure above this arterial oxygen tension range on clinical outcomes is unknown. We sought to determine if oxygen exposure that resulted in a partial pressure of oxygen in arterial blood above goal (> 80 mm Hg) was associated with worse outcomes in patients with acute respiratory distress syndrome. Longitudinal analysis of data collected in these trials. Ten clinical trials conducted at Acute Respiratory Distress Syndrome Network hospitals between 1996 and 2013. Critically ill patients with acute respiratory distress syndrome. None. We defined above goal oxygen exposure as the difference between the fraction of inspired oxygen and 0.5 whenever the fraction of inspired oxygen was above 0.5 and when the partial pressure of oxygen in arterial blood was above 80 mm Hg. We then summed above goal oxygen exposures in the first five days to calculate a cumulative above goal oxygen exposure. We determined the effect of a cumulative 5-day above goal oxygen exposure on mortality prior to discharge home at 90 days. Among 2,994 participants (mean age, 51.3 yr; 54% male) with a study-entry partial pressure of oxygen in arterial blood/fraction of inspired oxygen that met acute respiratory distress syndrome criteria, average cumulative above goal oxygen exposure was 0.24 fraction of inspired oxygen-days (interquartile range, 0-0.38). Participants with above goal oxygen exposure were more likely to die (adjusted interquartile range odds ratio, 1.20; 95% CI, 1.11-1.31) and have lower ventilator-free days (adjusted interquartile range mean difference of -0.83; 95% CI, -1.18 to -0.48) and lower hospital-free days (adjusted interquartile range mean difference of -1.38; 95

  19. Sterilization by oxygen plasma

    Energy Technology Data Exchange (ETDEWEB)

    Moreira, Adir Jose; Mansano, Ronaldo Domingues; Andreoli Pinto, Terezinha de Jesus; Ruas, Ronaldo; Silva Zambon, Luis da; Silva, Monica Valero da; Verdonck, Patrick Bernard

    2004-07-31

    The use of polymeric medical devices has stimulated the development of new sterilization methods. The traditional techniques rely on ethylene oxide, but there are many questions concerning the carcinogenic properties of the ethylene oxide residues adsorbed on the materials after processing. Another common technique is the gamma irradiation process, but it is costly, its safe operation requires an isolated site and it also affects the bulk properties of the polymers. The use of a gas plasma is an elegant alternative sterilization technique. The plasma promotes an efficient inactivation of the micro-organisms, minimises the damage to the materials and presents very little danger for personnel and the environment. Pure oxygen reactive ion etching type of plasmas were applied to inactivate a biologic indicator, the Bacillus stearothermophilus, to confirm the efficiency of this process. The sterilization processes took a short time, in a few minutes the mortality was complete. In situ analysis of the micro-organisms' inactivating time was possible using emission spectrophotometry. The increase in the intensity of the 777.5 nm oxygen line shows the end of the oxidation of the biologic materials. The results were also observed and corroborated by scanning electron microscopy.

  20. Method for the safe disposal of alkali metal

    International Nuclear Information System (INIS)

    Johnson, T.R.

    1977-01-01

    Alkali metals such as those employed in liquid metal coolant systems can be safely reacted to form hydroxides by first dissolving the alkali metal in relatively inert metals such as lead or bismuth. The alloy thus formed is contacted with a molten salt including the alkali metal hydroxide and possibly the alkali metal carbonate in the presence of oxygen. This oxidizes the alkali metal to an oxide which is soluble within the molten salt. The salt is separated and contacted with steam or steam--CO 2 mixture to convert the alkali metal oxide to the hydroxide. These reactions can be conducted with minimal hydrogen evolution and with the heat of reaction distributed between the several reaction steps. 5 claims, 1 figure

  1. An Elementary Overview of the Selection of Materials for Service in Oxygen-Enriched Environments

    Science.gov (United States)

    Davis, Samuel Eddie

    2012-01-01

    The process for selecting materials for use in oxygen or oxygen-enriched environments is one that continues to be investigated by many industries due to the importance to those industries of oxygen systems. There are several excellent resources available to assist oxygen systems design engineers and end-users, with the most comprehensive being ASTM MNL-36, Safe Use of Oxygen and Oxygen Systems: Handbook for Design, Operation and Maintenance, 2nd Edition. ASTM also makes available several standards for oxygen systems. However, the ASTM publications are extremely detailed, and typically designed for professionals who already possess a working knowledge of oxygen systems. No notable resource exists, whether an ASTM or other organizational publication, which can be used to educate engineers or technicians who have no prior knowledge of the nuances of oxygen system design and safety. This paper will fill the void for information needed by organizations that design or operate oxygen systems. The information in this paper is not new information, but is a concise and easily understood summary of selecting materials for oxygen systems. This paper will serve well as an employee s first introduction to oxygen system materials selection, and probably the employee s first introduction to ASTM.

  2. Pulse Oximetry Screening Adapted to a System with Home Births: The Dutch Experience

    Directory of Open Access Journals (Sweden)

    Ilona C. Narayen

    2018-03-01

    Full Text Available Neonatal screening for critical congenital heart defects is proven to be safe, accurate, and cost-effective. The screening has been implemented in many countries across all continents in the world. However, screening for critical congenital heart defects after home births had not been studied widely yet. The Netherlands is known for its unique perinatal care system with a high rate of home births (18% and early discharge after an uncomplicated delivery in hospital. We report a feasibility, accuracy, and acceptability study performed in the Dutch perinatal care system. Screening newborns for critical congenital heart defects using pulse oximetry is feasible after home births and early discharge, and acceptable to mothers. The accuracy of the test is comparable to other early-screening settings, with a moderate sensitivity and high specificity.

  3. Age, gender, will, and use of home-visit nursing care are critical factors in home care for malignant diseases; a retrospective study involving 346 patients in Japan

    Science.gov (United States)

    2011-01-01

    Background We aimed to clarify the factors affecting outcomes of home care for patients with malignant diseases. Methods Of 607 patients who were treated in 10 clinics specialized in home care between January and December 2007 at Chiba, Fukuoka, Iwate, Kagoshima, Tochigi and Tokyo prefectures across Japan, 346 (57%; 145 men and 201 women) had malignant diseases. We collected information on medical and social backgrounds, details of home care, and its outcomes based on their medical records. Results Median age of the patients was 77 years (range, 11-102), and 335 patients were economically self-sufficient. Their general condition was poor; advanced cancer (n = 308), performance status of 3-4 (n = 261), and dementia (n = 121). At the beginning of home care, 143 patients and 174 family members expressed their wish to die at home. All the patients received supportive treatments including fluid replacement and oxygenation. Median duration of home care was 47 days (range, 0-2,712). 224 patients died at home. For the remaining 122, home care was terminated due to complications (n = 109), change of attending physicians (n = 8), and others (n = 5). The factors which inhibited the continuity of home care were the non-use of home-visit nursing care (hazard ratio [HR] = 1.78, 95% confidence interval [CI]: 1.05-3.00, p = 0.03), the fact that the patients themselves do not wish to die at home (HR = 1.83, CI: 1.09-3.07, p = 0.02), women (HR = 1.81, CI: 1.11-2.94, p = 0.02), and age (HR = 0.98, CI: 0.97-1.00, p = 0.02). Conclusions Continuation of home care is influenced by patients' age, gender, will, and use of home-visit nursing. PMID:22044683

  4. Monetary benefits of preventing childhood lead poisoning with lead-safe window replacement.

    Science.gov (United States)

    Nevin, Rick; Jacobs, David E; Berg, Michael; Cohen, Jonathan

    2008-03-01

    Previous estimates of childhood lead poisoning prevention benefits have quantified the present value of some health benefits, but not the costs of lead paint hazard control or the benefits associated with housing and energy markets. Because older housing with lead paint constitutes the main exposure source today in the US, we quantify health benefits, costs, market value benefits, energy savings, and net economic benefits of lead-safe window replacement (which includes paint stabilization and other measures). The benefit per resident child from improved lifetime earnings alone is $21,195 in pre-1940 housing and $8685 in 1940-59 housing (in 2005 dollars). Annual energy savings are $130-486 per housing unit, with or without young resident children, with an associated increase in housing market value of $5900-14,300 per housing unit, depending on home size and number of windows replaced. Net benefits are $4490-5,629 for each housing unit built before 1940, and $491-1629 for each unit built from 1940-1959, depending on home size and number of windows replaced. Lead-safe window replacement in all pre-1960 US housing would yield net benefits of at least $67 billion, which does not include many other benefits. These other benefits, which are shown in this paper, include avoided Attention Deficit Hyperactivity Disorder, other medical costs of childhood lead exposure, avoided special education, and reduced crime and juvenile delinquency in later life. In addition, such a window replacement effort would reduce peak demand for electricity, carbon emissions from power plants, and associated long-term costs of climate change.

  5. Marine turtles use geomagnetic cues during open-sea homing.

    Science.gov (United States)

    Luschi, Paolo; Benhamou, Simon; Girard, Charlotte; Ciccione, Stephane; Roos, David; Sudre, Joël; Benvenuti, Silvano

    2007-01-23

    Marine turtles are renowned long-distance navigators, able to reach remote targets in the oceanic environment; yet the sensory cues and navigational mechanisms they employ remain unclear [1, 3]. Recent arena experiments indicated an involvement of magnetic cues in juvenile turtles' homing ability after simulated displacements [4, 5], but the actual role of geomagnetic information in guiding turtles navigating in their natural environment has remained beyond the reach of experimental investigations. In the present experiment, twenty satellite-tracked green turtles (Chelonia mydas) were transported to four open-sea release sites 100-120 km from their nesting beach on Mayotte island in the Mozambique Channel; 13 of them had magnets attached to their head either during the outward journey or during the homing trip. All but one turtle safely returned to Mayotte to complete their egg-laying cycle, albeit with indirect routes, and showed a general inability to take into account the deflecting action of ocean currents as estimated through remote-sensing oceanographic measurements [7]. Magnetically treated turtles displayed a significant lengthening of their homing paths with respect to controls, either when treated during transportation or when treated during homing. These findings represent the first field evidence for the involvement of geomagnetic cues in sea-turtle navigation.

  6. Air-to-Water Heat Pumps With Radiant Delivery in Low-Load Homes

    Energy Technology Data Exchange (ETDEWEB)

    Backman, C. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); German, A. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Dakin, B. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States); Springer, D. [Alliance for Residential Building Innovation (ARBI), Davis, CA (United States)

    2013-12-01

    Space conditioning represents nearly 50% of average residential household energy consumption, highlighting the need to identify alternative cost-effective, energy-efficient cooling and heating strategies. As homes are better built, there is an increasing need for strategies that are particularly well suited for high performance, low load homes. ARBI researchers worked with two test homes in hot-dry climates to evaluate the in-situ performance of air-to-water heat pump systems, an energy efficient space conditioning solution designed to cost-effectively provide comfort in homes with efficient, safe, and durable operation. Two monitoring projects of test houses in hot-dry climates were initiated in 2010 to test this system. Both systems were fully instrumented and have been monitored over one year to capture complete performance data over the cooling and heating seasons. Results are used to quantify energy savings, cost-effectiveness, and system performance using different operating modes and strategies. A calibrated TRNSYS model was developed and used to evaluate performance in various climate regions. This strategy is most effective in tight, insulated homes with high levels of thermal mass (i.e. exposed slab floors).

  7. Air-to-Water Heat Pumps With Radiant Delivery in Low-Load Homes

    Energy Technology Data Exchange (ETDEWEB)

    Backman, C. [Alliance for Residential Building Innovation, Davis, CA (United States). Davis Energy Group; German, A. [Alliance for Residential Building Innovation, Davis, CA (United States). Davis Energy Group; Dakin, B. [Alliance for Residential Building Innovation, Davis, CA (United States). Davis Energy Group; Springer, D. [Alliance for Residential Building Innovation, Davis, CA (United States). Davis Energy Group

    2013-12-01

    Space conditioning represents nearly 50% of average residential household energy consumption, highlighting the need to identify alternative cost-effective, energy-efficient cooling and heating strategies. As homes are better built, there is an increasing need for strategies that are particularly well suited for high performance, low load homes. ARBI researchers worked with two test homes in hot-dry climates to evaluate the in-situ performance of air-to-water heat pump (AWHP) systems, an energy efficient space conditioning solution designed to cost-effectively provide comfort in homes with efficient, safe, and durable operation. Two monitoring projects of test houses in hot-dry climates were initiated in 2010 to test this system. Both systems were fully instrumented and have been monitored over one year to capture complete performance data over the cooling and heating seasons. Results are used to quantify energy savings, cost-effectiveness, and system performance using different operating modes and strategies. A calibrated TRNSYS model was developed and used to evaluate performance in various climate regions. This strategy is most effective in tight, insulated homes with high levels of thermal mass (i.e. exposed slab floors).

  8. Patterns of 'at-home' alcohol-related injury presentations to emergency departments.

    Science.gov (United States)

    Bunker, Naomi; Woods, Cindy; Conway, Jane; Barker, Ruth; Usher, Kim

    2017-01-01

    This study aimed to establish the scale of alcohol-related injuries originating in the home. Despite recent media and public attention on alcohol-related injuries occurring at licensed venues, many occur in other locations including the home. A retrospective observational study. Emergency department surveillance data sourced from the Queensland Injury Surveillance Unit were interrogated for alcohol-related emergency department presentations from 2003-2012 (n = 12,296). Descriptive analysis was undertaken to assess alcohol involvement in injury, and analysis of variance was used to determine the differences among group means and their associated presentations. The relationship between demographic variables and injury location was assessed using p value of domestic violence by spouse or partner (n = 510), 59·5% occurred 'at home'. This is the first study to investigate alcohol-related injuries occurring at home. The home accounts for a greater proportion of injuries than the frequently assessed licensed premises location. Further research is required to validate these findings in a wider setting. A public health campaign is required to minimise harm associated with alcohol-related injuries in the home, and nurses are positioned to inform health policy makers around this issue. Furthermore, emergency department nurses are in a unique position to provide brief interventions around safe alcohol consumption and injury prevention. © 2016 John Wiley & Sons Ltd.

  9. Nasal Cannula Apneic Oxygenation Prevents Desaturation During Endotracheal Intubation: An Integrative Literature Review

    Directory of Open Access Journals (Sweden)

    Bill R. Christian

    2018-02-01

    Full Text Available Patients requiring emergency airway management may be at greater risk of acute hypoxemic events because of underlying lung pathology, high metabolic demands, insufficient respiratory drive, obesity, or the inability to protect their airway against aspiration. Emergency tracheal intubation is often required before complete information needed to assess the risk of procedural hypoxia is acquired (i.e., arterial blood gas level, hemoglobin value, or chest radiograph. During pre-oxygenation, administering high-flow nasal oxygen in addition to a non-rebreather face mask can significantly boost the effective inspired oxygen. Similarly, with the apnea created by rapid sequence intubation (RSI procedures, the same high-flow nasal cannula can help maintain or increase oxygen saturation during efforts to secure the tube (oral intubation. Thus, the use of nasal oxygen during pre-oxygenation and continued during apnea can prevent hypoxia before and during intubation, extending safe apnea time, and improve first-pass success attempts. We conducted a literature review of nasal-cannula apneic oxygenation during intubation, focusing on two components: oxygen saturation during intubation, and oxygen desaturation time. We performed an electronic literature search from 1980 to November 2017, using PubMed, Elsevier, ScienceDirect, and EBSCO. We identified 14 studies that pointed toward the benefits of using nasal cannula during emergency intubation.

  10. Microbes safely, effectively bioremediate oil field pits

    International Nuclear Information System (INIS)

    Shaw, B.; Block, C.S.; Mills, C.H.

    1995-01-01

    Natural and augmented bioremediation provides a safe, environmental, fast, and effective solution for removing hydrocarbon stains from soil. In 1992, Amoco sponsored a study with six bioremediation companies, which evaluated 14 different techniques. From this study, Amoco continued using Environmental Protection Co.'s (EPC) microbes for bioremediating more than 145 sites near Farmington, NM. EPC's microbes proved effective on various types of hydrocarbon molecules found in petroleum stained soils from heavy crude and paraffin to volatiles such as BTEX (benzene, toluene, ethylbenzene, xylene) compounds. Controlled laboratory tests have shown that these microbes can digest the hydrocarbon molecules with or without free oxygen present. It is believed that this adaptation gives these microbes their resilience. The paper describes the bioremediation process, environmental advantages, in situ and ex situ bioremediation, goals of bioremediation, temperature effects, time, cost, and example sites that were treated

  11. Determining the Source of Water Vapor in a Cerium Oxide Electrochemical Oxygen Separator to Achieve Aviator Grade Oxygen

    Science.gov (United States)

    Graf, John; Taylor, Dale; Martinez, James

    2014-01-01

    More than a metric ton of water is transported to the International Space Station (ISS) each year to provide breathing oxygen for the astronauts. Water is a safe and compact form of stored oxygen. The water is electrolyzed on ISS and ambient pressure oxygen is delivered to the cabin. A much smaller amount of oxygen is used each year in spacesuits to conduct Extra Vehicular Activities (EVAs). Space suits need high pressure (>1000 psia) high purity oxygen (must meet Aviator Breathing Oxygen "ABO" specifications, >99.5% O2). The water / water electrolysis system cannot directly provide high pressure, high purity oxygen, so oxygen for EVAs is transported to ISS in high pressure gas tanks. The tanks are relatively large and heavy, and the majority of the system launch weight is for the tanks and not the oxygen. Extracting high purity oxygen from cabin air and mechanically compressing the oxygen might enable on-board production of EVA grade oxygen using the existing water / water electrolysis system. This capability might also benefit human spaceflight missions, where oxygen for EVAs could be stored in the form of water, and converted into high pressure oxygen on-demand. Cerium oxide solid electrolyte-based ion transport membranes have been shown to separate oxygen from air, and a supported monolithic wafer form of the CeO2 electrolyte membrane has been shown to deliver oxygen at pressures greater than 300 psia. These supported monolithic wafers can withstand high pressure differentials even though the membrane is very thin, because the ion transport membrane is supported on both sides (Fig 1). The monolithic supported wafers have six distinct layers, each with matched coefficients of thermal expansion. The wafers are assembled into a cell stack which allows easy air flow across the wafers, uniform current distribution, and uniform current density (Fig 2). The oxygen separation is reported to be "infinitely selective" to oxygen [1] with reported purity of 99.99% [2

  12. Home Reading Environment and Brain Activation in Preschool Children Listening to Stories.

    Science.gov (United States)

    Hutton, John S; Horowitz-Kraus, Tzipi; Mendelsohn, Alan L; DeWitt, Tom; Holland, Scott K

    2015-09-01

    Parent-child reading is widely advocated to promote cognitive development, including in recommendations from the American Academy of Pediatrics to begin this practice at birth. Although parent-child reading has been shown in behavioral studies to improve oral language and print concepts, quantifiable effects on the brain have not been previously studied. Our study used blood oxygen level-dependent functional magnetic resonance imaging to examine the relationship between home reading environment and brain activity during a story listening task in a sample of preschool-age children. We hypothesized that while listening to stories, children with greater home reading exposure would exhibit higher activation of left-sided brain regions involved with semantic processing (extraction of meaning). Nineteen 3- to 5-year-old children were selected from a longitudinal study of normal brain development. All completed blood oxygen level-dependent functional magnetic resonance imaging using an age-appropriate story listening task, where narrative alternated with tones. We performed a series of whole-brain regression analyses applying composite, subscale, and individual reading-related items from the validated StimQ-P measure of home cognitive environment as explanatory variables for neural activation. Higher reading exposure (StimQ-P Reading subscale score) was positively correlated (P eco-bio-developmental models of emergent literacy. Copyright © 2015 by the American Academy of Pediatrics.

  13. DroidSafe

    Science.gov (United States)

    2016-12-01

    Massachusetts Avenue, Build E19-750 Cambridge , MA 02139-4307 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS...Activity objects illustrating the challenges of points-to and information flow analysis...measure how many malicious flows Droid- Safe was able to detect). As these results illustrate , DroidSafe implements an analysis of unprece- dented

  14. Welcoming Home the Patient with a New Ostomy.

    Science.gov (United States)

    Walker, Cynthia A; Rau, Lou Ann; Green, Mary Phyllis

    2015-01-01

    The 5-day average inpatient hospital length-of-stay postostomy limits opportunities for patients and family members to master self-care of the new ostomy prior to discharge. The literature suggests premature discharge, poor care coordination, lack of symptom reporting and follow-up as the primary factors supporting causes of readmissions. Home care nurses are faced with failed handoffs, limited resources, poor care coordination, payor restrictions, and knowledge and skill deficits that negatively impact safe and effective discharge practices of patients with a new ostomy. This article describes an evolving community standard related to nursing care of the patient with a new ostomy as identified by the Baltimore Wound, Ostomy, Continence (WOC) Nursing Affiliate. Case managers, discharge planners, intake team members, and home care nurses benefit from ongoing education from WOC nurse experts to master the skills needed to care for patients with ostomies.

  15. Staying safe at home

    Science.gov (United States)

    ... the chimney or flu, which can cause chimney fires. Use a glass or metal screen in front of your fireplace to keep sparks from popping out and starting a fire. Make sure the door latch on the wood ...

  16. Autonomous rehabilitation at stroke patients home for balance and gait: safety, usability and compliance of a virtual reality system.

    Science.gov (United States)

    Held, Jeremia P; Ferrer, Begoña; Mainetti, Renato; Steblin, Alexander; Hertler, Benjamin; Moreno-Conde, Alberto; Dueñas, Alvaro; Pajaro, Marta; L-Parra-Calderón, Carlos; Vargiu, Eloisa; Zarco, Maria J; Barrera, Maria; Echevarria, Carmen; Jódar-Sánchez, Francisco; Luft, Andreas R; Borghese, Nunzio A

    2017-09-25

    New technologies, such as telerehabilitation and gaming devices offer the possibility for patients to train at home. This opens the challenge of safety for the patient as he is called to exercise neither with a therapist on the patients' side nor with a therapist linked remotely to supervise the sessions. To study the safety, usability and patient acceptance of an autonomous telerehabilitation system for balance and gait (the REWIRE platform) in the patients home. Cohort study. Community, in the stroke patients' home. 15 participants with first-ever stroke, with a mild to moderate residual deficit of the lower extremities. Autonomous rehabilitation based on virtual rehabilitation was provided at the participants' home for twelve weeks. The primary outcome was compliance (the ratio between days of actual and scheduled training), analysed with the two-tailed Wilcoxon Mann- Whitney test. Furthermore safety is defined by adverse events. The secondary endpoint was the acceptance of the system measured with the Technology Acceptance Model. Additionally, the cumulative duration of weekly training was analysed. During the study there were no adverse events related to the therapy. Patients performed on average 71% (range 39 to 92%) of the scheduled sessions. The Technology Acceptance Model Questionnaire showed excellent values for stroke patients after the training. The average training duration per week was 99 ±53min. Autonomous telerehabilitation for balance and gait training with the REWIRE-system is safe, feasible and can help to intensive rehabilitative therapy at home. Telerehabilitation enables safe training in home environment and supports of the standard rehabilitation therapy.

  17. Safe havens in Europe

    DEFF Research Database (Denmark)

    Paldam, Martin

    2013-01-01

    Eleven safe havens exist in Europe providing offshore banking and low taxes. Ten of these states are very small while Switzerland is moderately small. All 11 countries are richer than their large neighbors. It is shown that causality is from small to safe haven to wealth, and that theoretically...... equilibriums are likely to exist where a certain regulation is substantially lower in a small country than in its big neighbor. This generates a large capital inflow to the safe havens. The pool of funds that may reach the safe havens is shown to be huge. It is far in excess of the absorptive capacity...... of the safe havens, but it still explains, why they are rich. Microstates offer a veil of anonymity to funds passing through, and Switzerland offers safe storage of funds....

  18. Hydrogen and oxygen concentrations in IXCs: A compilation

    International Nuclear Information System (INIS)

    Liljegren, L.M.; Terrones, G.T.; Melethil, P.K.

    1996-06-01

    This paper contains four reports and two internal letters that address the estimation of hydrogen and oxygen concentrations in ion exchange columns that treat the water of the K-East and K-West Basins at Hanford. The concern is the flammability of this mixture of gases and planning for safe transport during decommissioning. A transient will occur when the hydrogen filter is temporarily blocked by a sandbag. Analyses are provided for steady-state, transients, and for both wet and dry resins

  19. The patient-centered medical home neighbor: A primary care physician's view.

    Science.gov (United States)

    Sinsky, Christine A

    2011-01-04

    The American College of Physicians' position paper on the patient-centered medical home neighbor (PCMH-N) extends the work of the patient-centered medical home (PCMH) as a means of improving the delivery of health care. Recognizing that the PCMH does not exist in isolation, the PCMH-N concept outlines expectations for comanagement, communication, and care coordination and broadens responsibility for safe, effective, and efficient care beyond primary care to include physicians of all specialties. As such, it is a fitting follow-up to the PCMH and moves further down the road toward improved care for complex patients. Yet, there is more work to be done. Truly transforming the U.S. health care system around personalized medical homes embedded in highly functional medical neighborhoods will require better staffing models; more robust electronic information tools; aligned incentives for quality and efficiency within payment and regulatory policies; and a culture of greater engagement of patients, their families, and communities.

  20. The Effect of a High-Fidelity Home Health Simulations on Nursing Students' Clinical Performance

    Science.gov (United States)

    Crytzer, Michele Leigh

    2011-01-01

    With an increasing number of patients receiving nursing care in outpatient settings, it is the responsibility of nursing education programs to provide students with adequate training to enable them to develop the skills necessary to provide safe, effective care in diverse environments, including the home. Providing care to patients in their own…

  1. Traveling Safely with Medicines

    Science.gov (United States)

    ... Medications Safely My Medicine List How to Administer Traveling Safely with Medicines Planes, trains, cars – even boats ... your trip, ask your pharmacist about how to travel safely with your medicines. Make sure that you ...

  2. Ordered oxygen deficient '112'perovskites, LnBaCo2 O5⋅ 50 ...

    Indian Academy of Sciences (India)

    ... Refresher Courses · Symposia · Live Streaming. Home; Journals; Bulletin of Materials Science; Volume 32; Issue 3. Ordered oxygen deficient '112' perovskites, LnBaCo2O5.50+: complex magnetism and transport properties. B Raveau Md Motin Seikh V Pralong V Caignaert. Volume 32 Issue 3 June 2009 pp 305-312 ...

  3. Aflatoxins & Safe Storage

    Directory of Open Access Journals (Sweden)

    Philippe eVillers

    2014-04-01

    Full Text Available The paper examines both field experience and research on the prevention of the exponential growth of aflatoxins during multi-month post harvest storage in hot, humid countries. The approach described is the application of modern safe storage methods using flexible, Ultra Hermetic™ structures that create an unbreatheable atmosphere through insect and microorganism respiration alone, without use of chemicals, fumigants, or pumps. Laboratory and field data are cited and specific examples are given describing the uses of Ultra Hermetic storage to prevent the growth of aflatoxins with their significant public health consequences. Also discussed is the presently limited quantitative information on the relative occurrence of excessive levels of aflatoxin (>20 ppb before versus after multi-month storage of such crops as maize, rice and peanuts when under high humidity, high temperature conditions and, consequently, the need for further research to determine the frequency at which excessive aflatoxin levels are reached in the field versus after months of post-harvest storage. The significant work being done to reduce aflatoxin levels in the field is mentioned, as well as its probable implications on post harvest storage. Also described is why, with some crops such as peanuts, using Ultra Hermetic storage may require injection of carbon dioxide or use of an oxygen absorber as an accelerant. The case of peanuts is discussed and experimental data is described.

  4. Upon a Home Assistant Solution Based on Raspberry Pi Platform

    Directory of Open Access Journals (Sweden)

    Alexandru Florentin IFTIMIE

    2017-01-01

    Full Text Available Our ongoing research on Internet of Things (IoT has been focused on a project aiming to creating a proof of concept for a distributed system capable of controlling common devices found in a house such as TVs, air conditioning units, and other electrical devices. In order to automate these devices, the system integrates various sensors and actuators and, depending of user’s needs and creativity in conceiving and implementing new commands, the system is able to take care and execute the respective commands in a safe and secure manner. This paper presents our current research results upon a personal home assistant solution designed and built around Raspberry Pi V3 platform. The distributed, client-server approach enables users to control home electric and electronic devices from an Android based mobile application.

  5. Teaching minority children hygiene: investigating hygiene education in kindergartens and homes of ethnic minority children in northern Vietnam.

    Science.gov (United States)

    Rheinländer, Thilde; Samuelsen, Helle; Dalsgaard, Anders; Konradsen, Flemming

    2015-01-01

    Ethnic minority children in Vietnam experience high levels of hygiene- and sanitation-related diseases. Improving hygiene for minority children is therefore vital for improving child health. The study objective was to investigate how kindergarten and home environments influence the learning of hygiene of pre-school ethnic minority children in rural Vietnam. Eight months of ethnographic field studies were conducted among four ethnic minority groups living in highland and lowland communities in northern Vietnam. Data included participant observation in four kindergartens and 20 homes of pre-school children, together with 67 semi-structured interviews with caregivers and five kindergarten staff. Thematic analysis was applied and concepts of social learning provided inputs to the analysis. This study showed that poor living conditions with lack of basic sanitation infrastructures were important barriers for the implementation of safe home child hygiene. Furthermore, the everyday life of highland villages, with parents working away from the households resulted in little daily adult supervision of safe child hygiene practices. While kindergartens were identified as potentially important institutions for improving child hygiene education, essential and well-functioning hygiene infrastructures were lacking. Also, hygiene teaching relied on theoretical and non-practice-based learning styles, which did not facilitate hygiene behaviour change in small children. Minority children were further disadvantaged as teaching was only provided in non-minority language. Kindergartens can be important institutions for the promotion of safe hygiene practices among children, but they must invest in the maintenance of hygiene and sanitation infrastructures and adopt a strong practice-based teaching approach in daily work and in teacher's education. To support highland minority children in particular, teaching styles must take local living conditions and caregiver structures into account

  6. Joseph Priestley, oxygen, and the enlightenment.

    Science.gov (United States)

    West, John B

    2014-01-01

    Joseph Priestley (1733–1804) was the first person to report the discovery of oxygen and describe some of its extraordinary properties. As such he merits a special place in the history of respiratory physiology. In addition his descriptions in elegant 18th-century English were particularly arresting, and rereading them never fails to give a special pleasure. The gas was actually first prepared by Scheele (1742–1786) but his report was delayed. Lavoisier (1743–1794) repeated Priestley's initial experiment and went on to describe the true nature of oxygen that had eluded Priestley, who never abandoned the erroneous phlogiston theory. In addition to oxygen, Priestley isolated and characterized seven other gases. However, most of his writings were in theology because he was a conscientious clergyman all his life. Priestley was a product of the Enlightenment and argued that all beliefs should be able to stand the scientific scrutiny of experimental investigations. As a result his extreme liberal views were severely criticized by the established Church of England. In addition he was a supporter of both the French and American Revolutions. Ultimately his political and religious attitudes provoked a riot during which his home and his scientific equipment were destroyed. He therefore emigrated to America in 1794 where his friends included Thomas Jefferson and Benjamin Franklin. He settled in Northumberland, Pennsylvania although his scientific work never recovered from his forced departure. But the descriptions of his experiments with oxygen will always remain a high point in the history of respiratory physiology.

  7. Optoacoustic monitoring of central and peripheral venous oxygenation during simulated hemorrhage

    Science.gov (United States)

    Petrov, Andrey; Kinsky, Michael; Prough, Donald S.; Petrov, Yuriy; Petrov, Irene Y.; Henkel, S. Nan; Seeton, Roger; Salter, Michael G.; Khan, Muzna N.; Esenaliev, Rinat O.

    2014-03-01

    Circulatory shock may be fatal unless promptly recognized and treated. The most commonly used indicators of shock (hypotension and tachycardia) lack sensitivity and specificity. In the initial stages of shock, the body compensates by reducing blood flow to the peripheral (skin, muscle, etc.) circulation in order to preserve vital organ (brain, heart, liver) perfusion. Characteristically, this can be observed by a greater reduction in peripheral venous oxygenation (for instance, the axillary vein) compared to central venous oxygenation (the internal jugular vein). While invasive measurements of oxygenation are accurate, they lack practicality and are not without complications. We have developed a novel optoacoustic system that noninvasively determines oxygenation in specific veins. In order to test this application, we used lower body negative pressure (LBNP) system, which simulates hemorrhage by exerting a variable amount of suction on the lower body, thereby reducing the volume of blood available for central circulation. Restoration of normal blood flow occurs promptly upon cessation of LBNP. Using two optoacoustic probes, guided by ultrasound imaging, we simultaneously monitored oxygenation in the axillary and internal jugular veins (IJV). LBNP began at -20 mmHg, thereafter was reduced in a step-wise fashion (up to 30 min). The optoacoustically measured axillary oxygenation decreased with LBNP, whereas IJV oxygenation remained relatively constant. These results indicate that our optoacoustic system may provide safe and rapid measurement of peripheral and central venous oxygenation and diagnosis of shock with high specificity and sensitivity.

  8. The critical role of social workers in home-based primary care.

    Science.gov (United States)

    Reckrey, Jennifer M; Gettenberg, Gabrielle; Ross, Helena; Kopke, Victoria; Soriano, Theresa; Ornstein, Katherine

    2014-01-01

    The growing homebound population has many complex biomedical and psychosocial needs and requires a team-based approach to care (Smith, Ornstein, Soriano, Muller, & Boal, 2006). The Mount Sinai Visiting Doctors Program (MSVD), a large interdisciplinary home-based primary care program in New York City, has a vibrant social work program that is integrated into the routine care of homebound patients. We describe the assessment process used by MSVD social workers, highlight examples of successful social work care, and discuss why social workers' individualized care plans are essential for keeping patients with chronic illness living safely in the community. Despite barriers to widespread implementation, such social work involvement within similar home-based clinical programs is essential in the interdisciplinary care of our most needy patients.

  9. Family carers/next-of-kin perceptions of home-care technology: a review

    Directory of Open Access Journals (Sweden)

    Smithard DG

    2014-05-01

    Full Text Available David G Smithard1,2 1Royal Victoria Hospital, Kent Community Health NHS Trust, Folkestone, UK; 2Department of Electronics and Digital Arts, University of Kent, Canterbury, UK Abstract: As the global population increases in age and the pressures on hospital resources increase, with a defined budget, the management of people in their own home environment is increasingly being accepted as a viable alternative to hospital admission. Evidence from the US and Australian health care systems has shown that acute care at home for older people is safe and the outcomes are at times better than when older people are admitted. Caring of people at home, particularly older people, puts an increased burden of expectation on the next of kin (family members; however, this burden appears to be offset by the reduction in the inconvenience that admission to hospital brings. In many cases, family members highlight the positives of home-based care, such as the convenience, increased contact, and in the case of people with long-term conditions, return of independence and socialization. However, we know little about the perceptions of family members to the ever-increasing possibilities of medically managing people at home, and future research needs to take this into account and to consider their views, as well as those of the people in receipt of care. Keywords: telehealth, health care, acute care, hospital at home

  10. Home cervical ripening with dinoprostone gel in nulliparous women with singleton pregnancies.

    Science.gov (United States)

    Stock, Sarah J; Taylor, Rebecca; Mairs, Rebecca; Azaghdani, Abdulhamid; Hor, Kahyee; Smith, Imogen; Dundas, Kirsty; Kissack, Chris; Norman, Jane E; Denison, Fiona

    2014-08-01

    To evaluate whether home cervical ripening is safe and results in shorter hospital stay. This was a retrospective cohort study of women with singleton pregnancies having induction of labor for postmaturity at a single center between January 2007 and June 2010. Women were offered home cervical ripening with 1 mg dinoprostone gel if they were nulliparous, had uncomplicated singleton pregnancies, and the indication for induction was postmaturity. Nine hundred seven of 1,536 (59.1%) nulliparous women having induction of labor for postmaturity were eligible for home cervical ripening. The median number of hours at home was 11.76 hours (range 0-24.82 hours). There were no cases of birth outside of the hospital, uterine rupture, or significant neonatal morbidity or neonatal death related to home cervical ripening. Eighty-five (5.5%) women who underwent hospital cervical ripening because of maternal preference or social issues formed a hospital cervical ripening comparison group. There was no significant difference in the total number of hours before delivery spent in the hospital between the two groups (26.25; 95% confidence interval [CI] 25.27-27.23 in home cervical ripening group compared with 24.28; 95% CI 22.5-26.0 in the hospital group; P=.26). Clinical outcomes are comparable in nulliparous women who receive a single dose of dinoprostone gel for home cervical ripening compared with those who undergo hospital cervical ripening. However, preadmission home cervical ripening with 1 mg dinoprostone does not decrease the number of hours women spend in the hospital. II.

  11. Obstetrician Attitudes, Experience, and Knowledge of Planned Home Birth: An Exploratory Study.

    Science.gov (United States)

    Leone, Jennifer; Mostow, Jackie; Hackney, David; Gokhale, Priyanka; Janata, Jeffrey; Greenfield, Marjorie

    2016-09-01

    The incidence of planned home birth is increasing in the United States. The American College of Obstetricians and Gynecologists acknowledges a woman's right to make an informed choice about place of delivery, including home birth. This exploratory study measures obstetricians' attitudes, experiences, and knowledge about planned home birth, identifies associations between these factors, and compares obstetricians' responses in Ohio to those in Arizona and New Mexico. A survey about attitudes, experiences, and knowledge of planned home birth was distributed to obstetricians in Ohio, Arizona, and New Mexico. Attitude and knowledge scores were calculated for each respondent and used to evaluate associations through linear regression. Attitude and knowledge scores in states that have regulation of direct entry midwives (Arizona and New Mexico) were compared to a state which does not (Ohio). Obstetricians in all three states reported little experience and knowledge of planned home birth and overall negative attitudes. Obstetricians with stronger knowledge did not differ in their attitudes from those with less knowledge. No statistically significant differences were found when comparing attitude and knowledge scores in Ohio to Arizona and New Mexico, but Ohio obstetricians responded most negatively to the attitude questions. Obstetricians have limited knowledge and experience and hold very negative attitudes about planned home birth. Research is necessary to determine: 1) whether negative obstetrician attitudes would be modified by exposure to home birth education and experience, and, 2) whether negative obstetrician beliefs deter safe and timely transfer from home or compromise hospital care for transferred parturients. © 2016 Wiley Periodicals, Inc.

  12. Safety in home care: A research protocol for studying medication management

    Directory of Open Access Journals (Sweden)

    Easty Anthony

    2010-06-01

    Full Text Available Abstract Background Patient safety is an ongoing global priority, with medication safety considered a prevalent, high-risk area of concern. Yet, we have little understanding of the supports and barriers to safe medication management in the Canadian home care environment. There is a clear need to engage the providers and recipients of care in studying and improving medication safety with collaborative approaches to exploring the nature and safety of medication management in home care. Methods A socio-ecological perspective on health and health systems drives our iterative qualitative study on medication safety with elderly home care clients, family members and other informal caregivers, and home care providers. As we purposively sample across four Canadian provinces: Alberta (AB, Ontario (ON, Quebec (QC and Nova Scotia (NS, we will collect textual and visual data through home-based interviews, participant-led photo walkabouts of the home, and photo elicitation sessions at clients' kitchen tables. Using successive rounds of interpretive description and human factors engineering analyses, we will generate robust descriptions of managing medication at home within each provincial sample and across the four-province group. We will validate our initial interpretations through photo elicitation focus groups with home care providers in each province to develop a refined description of the phenomenon that can inform future decision-making, quality improvement efforts, and research. Discussion The application of interpretive and human factors lenses to the visual and textual data is expected to yield findings that advance our understanding of the issues, challenges, and risk-mitigating strategies related to medication safety in home care. The images are powerful knowledge translation tools for sharing what we learn with participants, decision makers, other healthcare audiences, and the public. In addition, participants engage in knowledge exchange

  13. MotionTherapy@Home - First results of a clinical study with a novel robotic device for automated locomotion therapy at home.

    Science.gov (United States)

    Rupp, Rüdiger; Plewa, Harry; Schuld, Christian; Gerner, Hans Jürgen; Hofer, Eberhard P; Knestel, Markus

    2011-02-01

    In incomplete spinal cord injured subjects, task-oriented training regimes are applied for enhancement of neuroplasticity to improve gait capacity. However, a sufficient training intensity can only be achieved during the inpatient phase, which is getting shorter and shorter due to economic restrictions. In the clinical environment, complex and expensive robotic devices have been introduced to maintain the duration and the intensity of the training, but up to now only a few exist for continuation of automated locomotion training at home. For continuation of the automated locomotion training at home prototypes of the compact, pneumatically driven orthosis MoreGait have been realized, which generate the key afferent stimuli for activation of the spinal gait pattern generator. Artificial pneumatic muscles with excellent weight-to-force ratio and safety characteristics have been integrated as joint actuators. Additionally, a Stimulative Shoe for generation of the appropriate foot loading pattern has been developed without the need for verticalization of the user. The first results of the pilot study in eight chronic incomplete spinal cord injured subjects indicate that the home-based therapy is safe and feasible. The therapy related improvements of the walking capacity are in the range of locomotion robots used in clinical settings.

  14. Qualitative assessment of home environment across the different educational status of parents.

    Science.gov (United States)

    Sharma, S

    1997-01-01

    This study examined the home environment of preschool children among 6 villages in Ludhiana district in Punjab state, India. The sample included 120 children aged 3-5 years. Eight composite scales were used to measure the home environment: learning stimulation, language stimulation, physical environment, warmth and affection, academic stimulation, role modeling, variety of experience, and acceptance. The sample reflected four educational groups for the father (illiterate, primary, matric, and graduate) and three educational groups for the mother (illiterate, primary, and matric). Findings clearly indicate that graduate level parents provided a more enriched home environment than less educated and illiterate parents. Education was unrelated to warmth and affection or acceptance between parents and children. Educated mothers showed slightly more warmth and affection. The stimulation in the growth of language and learning stimulation was significantly greater among graduate parents. Mothers encouraged their children to speak correctly, whereas illiterate mothers did not realize the importance. The lesser physical environment among lower educated parents supports findings of R.K. Srivastava (1974) on the association between lower scholastic achievement and overcrowding in the home. The study included homes where parents had sufficient financial resources to provide a safe and adequate physical environment but did not do so.

  15. Perceptions of health and risk management among home care workers in Sweden.

    Science.gov (United States)

    Larsson, A; Karlqvist, L; Westerberg, M; Gard, G

    2013-10-01

    Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid priority-making among both employers and employees to ensure that the work can be performed in a safe way. This study aims to examine home care workers' perceptions of health, risks, working conditions, and risk management within their organization. The study was based on cross-sectional data collected from home care service staff in a municipality in the north of Sweden. Nursing assistants and care aides ( n  = 133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulty in performing risk assessments and following safety regulations due to lack of time, equipment, and information were identified. There is a need to increase participation in risk assessments among the staff, improve management support, structures, and cooperation with other divisions of the social services and the medical care organizations.

  16. Pregnancy and Village Outreach Tibet: a descriptive report of a community- and home-based maternal-newborn outreach program in rural Tibet.

    Science.gov (United States)

    Dickerson, Ty; Crookston, Benjamin; Simonsen, Sara E; Sheng, Xiaoming; Samen, Arlene; Nkoy, Flory

    2010-01-01

    The Pregnancy and Village Outreach Tibet (PAVOT) program, a model for community- and home-based maternal-newborn outreach in rural Tibet, is presented. This article describes PAVOT, including the history, structure, content, and activities of the program, as well as selected program outcome measures and demographic characteristics, health behaviors, and pregnancy outcomes of women who recently participated in the program. The PAVOT program was developed to provide health-related services to pregnant rural Tibetan women at risk of having an unattended home birth. The program involves training local healthcare workers and laypersons to outreach pregnant women and family members. Outreach includes basic maternal-newborn health education and simple obstetric and neonatal life-saving skills training. In addition, the program distributes safe and clean birth kits, newborn hats, blankets, and maternal micronutrient supplements (eg, prenatal vitamins and minerals). More than 980 pregnant women received outreach during the study period. More than 92% of outreach recipients reported receiving safe pregnancy and birth education, clean birthing and uterine massage skills instruction, and clean umbilical cord care training. Nearly 80% reported basic newborn resuscitation skills training. Finally, nearly 100% of outreach recipients received maternal micronutrient supplements and safe and clean birth kits. The PAVOT program is a model program that has been proven to successfully provide outreach to rural-living Tibetans by delivering maternal-newborn health education, skills training, and resources to the home.

  17. Transnasal humidified rapid insufflation ventilatory exchange for oxygenation of children during apnoea: a prospective randomised controlled trial.

    Science.gov (United States)

    Riva, T; Pedersen, T H; Seiler, S; Kasper, N; Theiler, L; Greif, R; Kleine-Brueggeney, M

    2018-03-01

    Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) comprises the administration of heated, humidified, and blended air/oxygen mixtures via nasal cannula at rates of ≥2 litres kg -1  min -1 . The aim of this randomized controlled study was to evaluate the length of the safe apnoea time using THRIVE with two different oxygen concentrations (100% vs 30% oxygen) compared with standard low-flow 100% oxygen administration. Sixty patients, aged 1-6 yr, weighing 10-20 kg, undergoing general anaesthesia for elective surgery, were randomly allocated to receive one of the following oxygen administration methods during apnoea: 1) low-flow 100% oxygen at 0.2 litres kg -1  min -1 ; 2) THRIVE 100% oxygen at 2 litres kg -1  min -1 ; and 3) THRIVE 30% oxygen at 2 litres kg -1  min -1 . Primary outcome was time to desaturation to 95%. Termination criteria included SpO 2 decreased to 95%, transcutaneous CO 2 increased to 65 mmHg, or apnoea time of 10 min. The median (interquartile range) [range] apnoea time was 6.9 (5.7-7.8) [2.8-10.0] min for low-flow 100% oxygen, 7.6 (6.2-9.1) [5.2-10.0] min for THRIVE 100% oxygen, and 3.0 (2.4-3.7) [0.2-5.3] min for THRIVE 30% oxygen. No significant difference was detected between apnoea times with low-flow and THRIVE 100% oxygen administration (P=0.15). THRIVE with 30% oxygen demonstrated significantly shorter apnoea times (Prate of transcutaneous CO 2 increase was 0.57 (0.49-0.63) [0.29-8.92] kPa min -1 without differences between the 3 groups (P=0.25). High-flow 100% oxygen (2 litres kg -1  min -1 ) administered via nasal cannulas did not extend the safe apnoea time for children weighing 10-20 kg compared with low-flow nasal cannula oxygen (0.2 litres kg -1  min -1 ). No ventilatory effect was observed with THRIVE at 2.0 litres kg -1  min -1 . NCT02979067. Copyright © 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

  18. Safe and Secure Services Based on NGN

    Science.gov (United States)

    Fukazawa, Tomoo; Nisase, Takemi; Kawashima, Masahisa; Hariu, Takeo; Oshima, Yoshihito

    Next Generation Network (NGN), which has been undergoing standardization as it has developed, is expected to create new services that converge the fixed and mobile networks. This paper introduces the basic requirements for NGN in terms of security and explains the standardization activities, in particular, the requirements for the security function described in Y.2701 discussed in ITU-T SG-13. In addition to the basic NGN security function, requirements for NGN authentication are also described from three aspects: security, deployability, and service. As examples of authentication implementation, three profiles-namely, fixed, nomadic, and mobile-are defined in this paper. That is, the “fixed profile” is typically for fixed-line subscribers, the “nomadic profile” basically utilizes WiFi access points, and the “mobile profile” provides ideal NGN mobility for mobile subscribers. All three of these profiles satisfy the requirements from security aspects. The three profiles are compared from the viewpoint of requirements for deployability and service. After showing that none of the three profiles can fulfill all of the requirements, we propose that multiple profiles should be used by NGN providers. As service and application examples, two promising NGN applications are proposed. The first is a strong authentication mechanism that makes Web applications more safe and secure even against password theft. It is based on NGN ID federation function. The second provides an easy peer-to-peer broadband virtual private network service aimed at safe and secure communication for personal/SOHO (small office, home office) users, based on NGN SIP (session initiation protocol) session control.

  19. Association of apneic oxygenation with decreased desaturation rates during rapid sequence intubation by a Chinese emergency medicine service.

    Science.gov (United States)

    Mao, Yong; Qin, Zong-He

    2015-01-01

    Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The achievement rate of emergency medicine inhabitants in airway management improved enhanced essentially subsequent to finishing anaesthesiology turn. There was a slightly higher rate of quick sequence intubation in the postapneic oxygenation groups (preapneic oxygenation 6.4%; postapneic oxygenation 9.1%). The majority of patients intubated in both groups were men (preapneic oxygenation 72.3%; postapneic oxygenation 63.5%). A higher percentage of patients in the preapneic oxygenation group had a Cormack-Lehane grade III or worse view (23.2% versus 11.8%). Anaesthesiology turns should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

  20. Endoscopic Resection of Tracheal Tumor in an Elderly Woman Under Extracorporeal Membrane Oxygenation

    Directory of Open Access Journals (Sweden)

    Yi-Ying Chiang

    2011-03-01

    Full Text Available Anesthetic management of patients with difficult airway is challenging, especially in patients who present with near total occlusion of the airway. Tracheal tumors occur more frequently in elderly patients who are more prone to hypoxic injury. Reliable ventilation and oxygenation are mandatory for a safe and sound intervention. Herein, we report on a 71-year-old woman with a large tracheal tumor occluding approximately 90% of the tracheal lumen. Extracorporeal membrane oxygenation under local anesthesia was used during electrocautery resection of the tumor because of the possibility of fatal airway collapse due to the degree of occlusion and location of the tumor. After the tumor had been successfully resected by means of bronchoscopy, an endotracheal tube was inserted, and the patient was weaned from extracorporeal membrane oxygenation.

  1. Use of telehealth technology for home spirometry after lung transplantation: a randomized controlled trial.

    Science.gov (United States)

    Sengpiel, Juliane; Fuehner, Thomas; Kugler, Christiane; Avsar, Murat; Bodmann, Isabelle; Boemke, Annelies; Simon, Andre; Welte, Tobias; Gottlieb, Jens

    2010-12-01

    Complications often occur during the early phase after lung transplantation, and rapid diagnosis is vital. Home spirometry is used to detect early changes in graft function. Bluetooth-equipped cell phones are easy to use and facilitate data transfer from home spirometry. To explore use of home spirometry with Bluetooth data transfer in outpatient lung transplant recipients. Single-center prospective randomized controlled trial. Intervention-Fifty-six patients were randomized either to home spirometry with data transfer via Bluetooth-equipped cell phones or to home spirometry alone before discharge after lung transplantation. In the Bluetooth group, results were transferred to a database capable of generating alarm messages. Time from onset of symptoms to physician consultation during the first 6 months after lung transplantation was the primary end point. Adherence to home spirometry was 97.2% in the Bluetooth group and 95.3% in the home spirometry alone group (P = .73). Median time to first consultation (P = .60) and frequency of consultation (P = .06) did not differ significantly in the 2 groups. Mean scores on the Hospital Anxiety and Depression Scale were lower in patients in the Bluetooth group (1.5; range, 0.0-4.0) than in the home spirometry alone group (4.0; range, 2.0-6.0; P = .04). Home spirometry with data transfer is feasible and safe in lung transplant recipients. Compared with home spirometry alone, additional data transfer was equally effective regarding the time interval from symptom onset to consultation. Patients in the Bluetooth group reported less anxiety, which may improve emotional well-being.

  2. At-home palliative sedation for end-of-life cancer patients.

    Science.gov (United States)

    Alonso-Babarro, Alberto; Varela-Cerdeira, Maria; Torres-Vigil, Isabel; Rodríguez-Barrientos, Ricardo; Bruera, Eduardo

    2010-07-01

    Using a decision-making and treatment checklist developed to facilitate the at-home palliative sedation process, we assessed the incidence and efficacy of palliative sedation for end-of-life cancer patients with intractable symptoms who died at home. We retrospectively reviewed the medical records of 370 patients who were followed by a palliative home care team. Twenty-nine of 245 patients (12%) who died at home had received palliative sedation. The mean age of the patients who received palliative sedation was 58 +/- 17 years, and the mean age of the patients who did not receive palliative sedation was 69 +/- 15 years (p = 0.002). No other differences were detected between patients who did or did not receive palliative sedation. The most common indications for palliative sedation were delirium (62%) and dyspnea (14%). Twenty-seven patients (93%) received midazolam for palliative sedation (final mean dose of 74 mg), and two (7%) received levomepromazine (final mean dose of 125 mg). The mean time between palliative sedation initiation and time of death was 2.6 days. In 13 of the cases (45%), the palliative sedation decision was made with the patient and his or her family members, and in another 13 patients (45%), the palliative sedation decision was made only with the patient's family members. We concluded that palliative sedation may be used safely and efficaciously to treat dying cancer patients with refractory symptoms at home.

  3. Test Methods and Protocols for Environmental and Safety Hazards Associated with Home Energy Retrofits

    Energy Technology Data Exchange (ETDEWEB)

    Cautley, D. [NorthernSTAR Building America Partnership, St. Paul, MN (United States); Viner, J. [NorthernSTAR Building America Partnership, St. Paul, MN (United States); Lord, M. [NorthernSTAR Building America Partnership, St. Paul, MN (United States); Pearce, M. [NorthernSTAR Building America Partnership, St. Paul, MN (United States)

    2012-12-01

    A number of health hazards and hazards to the durability of homes may be associated with energy retrofitting and home renovation projects. Among the hazards associated with energy retrofit work, exposure to radon is thought to cause more than 15,000 deaths per year in the U.S., while carbon monoxide poisoning results in about 20,000 injuries and 450 deaths per year. Testing procedures have been developed for identifying and quantifying hazards during retrofitting. These procedures commonly include a battery of tests to screen combustion appliances for safe operation, including worst case depressurization measurement, backdrafting (spillage) under depressurized or normal conditions, and carbon monoxide production.

  4. Ergonomic evaluation of slide boards used by home care aides to assist client transfers.

    Science.gov (United States)

    Sun, Chuan; Buchholz, Bryan; Quinn, Margaret; Punnett, Laura; Galligan, Catherine; Gore, Rebecca

    2018-07-01

    Home care aides risk musculoskeletal injury because they lift and move clients; the body weight of most adults exceeds the NIOSH recommended limit for lifting. Methods to reduce manual patient lifting in institutional settings are often technically or economically infeasible in home care. Our goal was to identify suitable, safe, low-technology transfer devices for home care use. Sixteen experienced home care aides performed client transfers from wheelchair to bed (upward) and bed to wheelchair (downward) in a simulated home care environment (laboratory), using four different slide boards and by hand without a device. Aides' hand forces were measured during client transfers; aides also evaluated usability of each board. Hand forces exerted while using slide boards were mostly lower than in manual transfer, and forces were lower in downward versus upward transfers. Aides judged a board with a sliding mechanism easier to use than boards without a sliding mechanism. Practitioner Summary: This paper provides quantitative biomechanical measurements showing that slide boards reduced the hand forces needed by home care aides to transfer clients from bed to wheel chair and vice versa, compared to manual lifting. Using a semi-quantitative usability survey, aides identified boards with a sliding mechanism easiest to use.

  5. Adverse reactions of hyperbaric oxygen therapy - case description of a generalised seizure

    Directory of Open Access Journals (Sweden)

    Grobelska Kinga

    2016-03-01

    Full Text Available Hyperbaric oxygen therapy (HBOT is a safe treatment, provided fulfilling certain rules of patient qualifications to treatment, as well as supervision over the course of therapy by qualified medical staff. Side effects reported in the literature are rare, and are usually mild and transient. Professional medical staff allows minimising the adverse events occurrence. The scale of complications is unknown, especially in Polish hyperbaric center. Careful analysis could be used to develop prevention procedures for patients of hyperbaric oxygen therapy. Hyperbaric Oxygen Centre and Wound Treatment in Bydgoszcz during 28 months performed hyperbaric oxygen therapy (HBOT in case of 423 patients. During this period, adverse events occurred occasionally. 17 cases have been reported. Authors described study case 77 year-old patient who was admitted due to non-healing wound-left lower abdomen (state after radiotherapy. During the fourth session, on decompression phase patient have had a generalized seizure (tonic-clonic. The decompression was stopped, the oxygen supply was disconnected but only after the drug administration seizures terminated. The most likely causative agent of the adverse reactions of the patient treated with HBOT was the oxygen toxic effect on the brain tissue. However, analyzing the circumstances of the seizure termination: phase of decompression at the pressure 2ATA and lack of oxygen disconnection response, it cannot be excluded other causes of this complication.

  6. SAFE Newsletter

    OpenAIRE

    2013-01-01

    The Center of Excellence SAFE – “Sustainable Architecture for Finance in Europe” – is a cooperation of the Center for Financial Studies and Goethe University Frankfurt. It is funded by the LOEWE initiative of the State of Hessen (Landes-Offensive zur Entwicklung wissenschaftlich-ökonomischer Exzellenz). SAFE brings together more than 40 professors and just as many junior researchers who are all dedicated to conducting research in support of a sustainable financial architecture. The Center has...

  7. Robotics to Enable Older Adults to Remain Living at Home

    OpenAIRE

    Pearce, Alan J.; Adair, Brooke; Miller, Kimberly; Ozanne, Elizabeth; Said, Catherine; Santamaria, Nick; Morris, Meg E.

    2012-01-01

    Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1) what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2) what is the evidence demonstrating that robotic devices are effec...

  8. 'Fiber 7' supplement as an alternative to laxatives in a nursing home.

    Science.gov (United States)

    Khaja, M; Thakur, C S; Bharathan, T; Baccash, E; Goldenberg, G

    2005-06-01

    Chronic constipation is a common and bothersome problem in elderly nursing home patients. Although fibre has a known role in the treatment of constipation, laxatives are still widely used in nursing home patients. To determine whether the addition of a fibre supplement to oral diet can reduce the use of laxatives in a long-term care facility. Oral diet of 92 nursing home residents (all older than 65) on chronic laxatives (docusate, milk of magnesia with Cascara, psyllium) was supplemented with 'Fiber 7', a natural powder fibre (7 g per meal twice a day). During the next 2.5 years discontinuation of laxatives was attempted. Laxatives were successfully discontinued in 63 of the 92 patients (68.5%, 95% confidence interval 59-78%). The fibre supplement was well tolerated. The cost of care was decreased by dollar 3.5 per patient every month or by dollar 220/month for the 63 patients. Use of 'Fiber 7' allowed discontinuation of laxatives in 63 of 92 nursing home residents. The fibre supplement was a safe and convenient alternative to laxatives and decreased the cost of medical care.

  9. The potential of smart homes for injury prevention among the elderly.

    Science.gov (United States)

    Eriksson, Henrik; Timpka, Toomas

    2002-06-01

    Smart homes promise to make the lives of elderly people more comfortable and safe. Today, there is a significant interest from industry and policy makers in developing these technologies. In theory, the emerging technologies make it possible to provide a new range of services. So far, however, the goal has often been to develop new services for young people rather than assisting old people to improve their quality of life. Especially important is the potential for using these technologies to promote safety and prevent injury among old people because this group is at home more than the other age groups. Networked devices can collect data from sensors and aid decision-making on intervention and other measures. Furthermore, these devices can instruct and remind individuals about safety-related issues.

  10. Deliveries in maternity homes in Norway: results from a 2-year prospective study.

    Science.gov (United States)

    Schmidt, Nina; Abelsen, Birgit; Øian, Pål

    2002-08-01

    The study aims to report the short-term outcome for the mothers and newborns for all pregnancies accepted for birth at maternity homes in Norway. A 2-year prospective study of all mothers in labor in maternity homes, i.e. all births including women and newborns transferred to hospital intra partum or the first week post partum. The study included 1275 women who started labor in the maternity homes in Norway; 1% of all births in Norway during this period. Of those who started labor in a maternity home, 1217 (95.5%) also delivered there while 58 (4.5%) women were transferred to hospital during labor. In the post partum period there were 57 (4.7%) transferrals of mother and baby. Nine women had a vacuum extraction, one had a forceps and three had a vaginal breech (1.1% operative vaginal births in the maternity homes). Five babies (0.4%) had an Apgar score below 7 at 5 min. There were two (0.2%) neonatal deaths; both babies were born with a serious group B streptococcal infection. Midwives and general practitioners working in the districts can identify a low-risk population (estimated at 35%) of all pregnant women in the catchment areas who can deliver safely at the maternity homes in Norway. Only 4.5% of those who started labor in the maternity homes had to be transferred to hospital during labor.

  11. A reconsideration of home birth in the United States.

    Science.gov (United States)

    Minkoff, Howard; Ecker, Jeffrey

    2013-01-01

    Home births continue to constitute only a small percentage of all deliveries in the United States, in part because of concerns about their safety. While the literature is decidedly mixed in regard to the degree of risk, there are several studies that report that home birth may at times entail a small absolute increase in perinatal risks in circumstances that cannot always be anticipated prior to the onset of labor. While the definition of "small" will vary between individuals, and publications vary in the level of risk they ascribe to birth at home, studies with the least methodological flaws and with adequate power often cite an excess death rate in the range of one per thousand. Home birth is, in that regard, but one example of patients' choices and plans that sometimes carry increased risk or include alternatives that individual physicians feel uncomfortable supporting or recommending. Our intention in this opinion piece is not to advocate for or against home birth. Rather, we recognize that home birth is but one example of a patient choice that might differ from what a provider feels is in a woman's best interests. In this article we will discuss ethical considerations in such circumstances using home birth as an example. We consider in this article how the ethical principles of respect for autonomy and non-maleficence can be balanced using, among other examples, the choice by some for a home birth. We discuss how absolute rather than relative risk should guide individuals' evaluation of patient choices. We also consider how in some circumstances, the value and safety added by a physician's participation may outweigh a potentially small increment in absolute risk that might result from a patient's decision to deliver at home because of a perceived physician endorsement. We recognize, however, that doctors and midwives participating in choices they have not recommended, or may even believe will lead to or increase risk for adverse outcomes, presents dilemmas and

  12. Land of California?: The ambiguities of sweet home Chicago.

    Science.gov (United States)

    Kimsey, John

    2005-01-01

    This essay examines some historical questions and cultural constructions surrounding the song Sweet Home Chicago and its composer Robert Johnson. Noting that while the song has enjoyed long life, Johnson's lyric (describing Chicago as a land of California) has not, the essay critiques primitivist readings of Johnson while posing an African American cultural myth-Chicago as promised land of the Great Migration-as the subtext of his puzzling line. Finally, it considers whether mundane-sounding revisions of Johnson's lyric indicate a reduction in Chicago's mythic status, from safe haven to same old place.

  13. Home versus hospital immunoglobulin treatment for autoimmune neuropathies: A cost minimization analysis.

    Science.gov (United States)

    Le Masson, Gwendal; Solé, Guilhem; Desnuelle, Claude; Delmont, Emilien; Gauthier-Darnis, Marc; Puget, Sophie; Durand-Zaleski, Isabelle

    2018-02-01

    Prior clinical trials have suggested that home-based Ig treatment in multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and its variant Lewis-Sumner syndrome (LSS) is safe and effective and is less costly than hospital-administered intravenous immunoglobulin (IVIg). A French prospective, dual-center, cost minimization analysis was carried out to evaluate IVIg administration (5% concentrated) at home versus in hospital with regard to costs, patients' autonomy, and patients' quality of life. The primary endpoint was the overall cost of treatment, and we adopted the perspective of the payer (French Social Health Insurance). Twenty-four patients aged 52.3 (12.2) years were analyzed: nine patients with MMN, eight with CIDP, and seven with LSS. IVIg (g/kg) dosage was 1.51 ± 0.43 in hospital and 1.52 ± 0.4 at home. Nine-month total costs per patient extrapolated to 1 year of treatment were €48,189 ± 26,105 versus €91,798 ± 51,125 in the home and hospital groups, respectively ( p  home treatment were the good tolerance and absence of side effects of IVIg administration, as well as a good understanding of the advantages and drawbacks of home treatment (75% of respondents). The mRankin scores before and after switch to home treatment were 1.61 ± 0.72 and 1.36 ± 0.76, respectively ( p  =   .027). The switch from hospital-based to home-based IVIg treatment for patients with immune neuropathy represents potentially significant savings in the management of the disease.

  14. Physiological closed-loop control in intelligent oxygen therapy: A review.

    Science.gov (United States)

    Sanchez-Morillo, Daniel; Olaby, Osama; Fernandez-Granero, Miguel Angel; Leon-Jimenez, Antonio

    2017-07-01

    Oxygen therapy has become a standard care for the treatment of patients with chronic obstructive pulmonary disease and other hypoxemic chronic lung diseases. In current systems, manually continuous adjustment of O 2 flow rate is a time-consuming task, often unsuccessful, that requires experienced staff. The primary aim of this systematic review is to collate and report on the principles, algorithms and accuracy of autonomous physiological close-loop controlled oxygen devices as well to present recommendations for future research and studies in this area. A literature search was performed on medical database MEDLINE, engineering database IEEE-Xplore and wide-raging scientific databases Scopus and Web of Science. A narrative synthesis of the results was carried out. A summary of the findings of this review suggests that when compared to the conventional manual practice, the closed-loop controllers maintain higher saturation levels, spend less time below the target saturation, and save oxygen resources. Nonetheless, despite of their potential, autonomous oxygen therapy devices are scarce in real clinical applications. Robustness of control algorithms, fail-safe mechanisms, limited reliability of sensors, usability issues and the need for standardized evaluating methods of assessing risks can be among the reasons for this lack of matureness and need to be addressed before the wide spreading of a new generation of automatic oxygen devices. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Guidelines on the safety of light-based home-use hair removal devices from the European Society for Laser Dermatology

    DEFF Research Database (Denmark)

    Town, Graham; Ash, C; Dierickx, C

    2012-01-01

    . These guidelines provide a definition of light-based home-use technology, to inform healthcare professionals about home-use light-based technology and encourage manufacturers wishing to sell in Europe to adopt 'best practice'. The review presents the current status on standards and regulation issues and considers...... home-use safety issues, encompassing human, device and electrical safety, given risks to the eyes and skin from optical radiation both to the consumer and persons in the vicinity. Proposed technical measurement methodology is considered with focus on recognized critical parameters for the safe use...... of light-based hair removal technology including recording the technical performance and safety claims of a range of home-use hair removal devices. The literature review emphasizes potential adverse incidents and safety aspects of treating cosmetic conditions, such as unwanted hair growth. Although some...

  16. Quality of human milk expressed in a human milk bank and at home.

    Science.gov (United States)

    Borges, Mayla S; Oliveira, Angela M de M; Hattori, Wallisen T; Abdallah, Vânia O S

    2017-08-30

    To evaluate the quality of the human milk expressed at home and at a human milk bank. This a retrospective, analytical, and observational study, performed by assessing titratable acidity records and the microbiological culture of 100 human milk samples expressed at home and at a human milk bank, in 2014. For the statistical analysis, generalized estimating equations (GEE) and the chi-squared test were used. When comparing the two sample groups, no significant difference was found, with 98% and 94% of the samples being approved among those collected at the milk bank and at home, respectively. No main interaction effect between local and titratable acidity records (p=0.285) was observed, and there was no statistically significant difference between the expected and observed values for the association between the collection place and the microbiological culture results (p=0.307). The quality of human milk expressed at home and at the milk bank are in agreement with the recommended standards, confirming that the expression of human milk at home is as safe as expression at the human milk bank, provided that the established hygiene, conservation, storage, and transport standards are followed. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  17. Effect of Safe Water on Arsenicosis: A Follow-up Study.

    Science.gov (United States)

    Majumdar, Kunal K; Ghose, Aloke; Ghose, Nilima; Biswas, Anirban; Mazumder, D N Guha

    2014-04-01

    Arsenic pollution in groundwater, used for drinking purposes, has been envisaged as a problem of global concern. Treatment options for the management symptoms of chronic arsenicosis are limited. Mitigation option available for dealing with the health problem of ground water arsenic contamination rests mainly on supply of arsenic safe water in arsenic-endemic region of Indo-Bangladesh subcontinent. Limited information is available regarding the long-term effect of chronic arsenic toxicity after stoppage of consumption of arsenic-containing water. The current study was, therefore, done to assess, objectively, the effect of drinking arsenic safe water (water source in their houses were supplied with arsenic removal filters for getting arsenic-free water during the follow-up period. In participants belonging to Cohort-I, the skin score was found to improve significantly at the end of each year, and it was found to be reduced significantly from 2.17 ± 1.09 to 1.23 ± 1.17; P water on skin lesions. The systemic disease symptom score was also found to improve, but less significantly, at the end of 3 years in both the cohorts. Most important observation during the follow-up study was persistence of severe symptoms of chronic lung disease and severe skin lesion including Bowen's disease in spite of taking arsenic-safe water. Further, death could not be prevented to occur because of lung cancer and severe lung disease. It is, therefore, an urgent need to make arrangement for availability of safe water source among the arsenic-affected people in the district. Many of the people in the affected villages are not aware of contamination of their home tube wells with arsenic. Awareness generation and motivation of the people for testing their drinking water sources for arsenic and environmental interventions like rain water harvesting, ground water recharge, and restricting excessive use of ground water for domestic and agricultural purposes are also important to prevent further

  18. Interactive CaringTV® supporting elderly living at home.

    Science.gov (United States)

    Lehto, Paula

    2013-01-01

    Interactive CaringTV® is a Finnish innovation that was developed by Laurea University of Applied Sciences in 2006. CaringTV was developed through action research during three research projects. The aim of interactive CaringTV is to support the health and well-being of elderly people living in their own homes. The Safe Home project was based on action research, userdriven methods, and a case study. User-driven methods were applied in planning, implementing and evaluating the programme and eServices e.g. testing and evaluating peer support, including eConsultation as the methods for supporting clients´ coping with life in their own homes. Costeffectiveness and process modelling were studied through the case study. The user-driven approach and the collected data formed the basis for the interactive programme. The online CaringTV programme included content to: support everyday life for the elderly, safety, and activities of daily living, support social relationships, participate in rehabilitation and physical exercises, manage self-care, and health issues. Active participation in the CaringTV programme provided functional ability and everyday coping as well as a meaningful activity in everyday life. CaringTV is an interactive platform to support elderly in their everyday life and help them cope at home. User-driven methods enable participants´ active involvement in planning interactive and online programmes and eServices via CaringTV. The ultimate goal of the CaringTV is to support elderly´s health, wellbeing and interaction. CaringTV empowers elderly people to take responsibility for their own health care as part of healthy ageing.

  19. Safe Grid

    Science.gov (United States)

    Chow, Edward T.; Stewart, Helen; Korsmeyer, David (Technical Monitor)

    2003-01-01

    The biggest users of GRID technologies came from the science and technology communities. These consist of government, industry and academia (national and international). The NASA GRID is moving into a higher technology readiness level (TRL) today; and as a joint effort among these leaders within government, academia, and industry, the NASA GRID plans to extend availability to enable scientists and engineers across these geographical boundaries collaborate to solve important problems facing the world in the 21 st century. In order to enable NASA programs and missions to use IPG resources for program and mission design, the IPG capabilities needs to be accessible from inside the NASA center networks. However, because different NASA centers maintain different security domains, the GRID penetration across different firewalls is a concern for center security people. This is the reason why some IPG resources are been separated from the NASA center network. Also, because of the center network security and ITAR concerns, the NASA IPG resource owner may not have full control over who can access remotely from outside the NASA center. In order to obtain organizational approval for secured remote access, the IPG infrastructure needs to be adapted to work with the NASA business process. Improvements need to be made before the IPG can be used for NASA program and mission development. The Secured Advanced Federated Environment (SAFE) technology is designed to provide federated security across NASA center and NASA partner's security domains. Instead of one giant center firewall which can be difficult to modify for different GRID applications, the SAFE "micro security domain" provide large number of professionally managed "micro firewalls" that can allow NASA centers to accept remote IPG access without the worry of damaging other center resources. The SAFE policy-driven capability-based federated security mechanism can enable joint organizational and resource owner approved remote

  20. An examination of interventions to reduce respiratory health and injury hazards in homes of low-income families

    International Nuclear Information System (INIS)

    Dixon, Sherry L.; Fowler, Cecile; Harris, Judy; Moffat, Sally; Martinez, Yolanda; Walton, Heather; Ruiz, Bernice; Jacobs, David E.

    2009-01-01

    We evaluated whether combining asthma trigger reduction with housing structural repairs, device disbursement and education in low-income households with children would improve self-reported respiratory health and reduce housing-related respiratory health and injury hazards (convenience sample of n=67 homes with 63 asthmatic and 121 non-asthmatic children). At baseline, a visual assessment of the home environment and a structured occupant interview were used to examine 29 potential injury hazards and 7 potential respiratory health hazards. A home-specific intervention was designed to provide the children's parents or caretakers with the knowledge, skills, motivation, supplies, equipment, and minimum housing conditions necessary for a healthy and safe home. The enrolled households were primarily Hispanic and owned their homes. On average, 8 injury hazards were observed in the homes at baseline. Four months following intervention, the average declined to 2.2 hazards per home (p<0.001), with 97% of the parents reporting that their homes were safer following the interventions. An average of 3.3 respiratory health hazards were observed in the homes at baseline. Four months following intervention, the average declined to 0.9 hazards per home (p<0.001), with 96% of parents reporting that the respiratory health of their asthmatic children improved. A tailored healthy homes improvement package significantly improves self-reported respiratory health and safety, reduces respiratory health and injury hazards, and can be implemented in concert with a mobile clinical setting

  1. Home medicine chests and their relationship with self-medication in children and adolescents.

    Science.gov (United States)

    Tourinho, Francis S V; Bucaretchi, Fábio; Stephan, Celso; Cordeiro, Ricardo

    2008-01-01

    To investigate the contents of home medicine chests and their relationship with self-medication in children and adolescents in the towns of Limeira and Piracicaba, SP, Brazil. This is a descriptive population study based on a home survey of a simple random sample from both towns, comprising 705 households from census sectors selected by means of cluster sampling. age medicines kept at home; and having taken at least one medication during the 15 days prior to the interview. The participants were split into two groups based on medication: self-medication (lay advice) and medical prescription. Tests of linear association were performed, in addition to a descriptive analysis of the variables and multiple logistic regression. A total of 3,619 medicines were found (mean = 5.1/household; 79.6% were pharmaceutical preparations). The rooms most commonly used to store medications were bedrooms (47.5%), kitchens (29.9%), and bathrooms (14.6%); 76.5% were in cardboard boxes and within easy reach of 142 children aged medicines at home is a common practice, and it is important to implement campaigns to encourage rational use, reduced waste and safe storage of medicines.

  2. Care relationships at stake? Home healthcare professionals' experiences with digital medicine dispensers - a qualitative study.

    Science.gov (United States)

    Nakrem, Sigrid; Solbjør, Marit; Pettersen, Ida Nilstad; Kleiven, Hanne Hestvik

    2018-01-15

    Although digital technologies can mitigate the burdens of home healthcare services caused by an ageing population that lives at home longer with complex health problems, research on the impacts and consequences of digitalised remote communication between patients and caregivers is lacking. The present study explores how home healthcare professionals had experienced the introduction of digital medicine dispensers and their influence on patient-caregiver relationships. The multi-case study comprised semi-structured interviews with 21 healthcare professionals whose home healthcare service involved using the digital medicine dispensers. The constant comparative method was used for data analyses. Altogether, interviewed healthcare professionals reported three main technology-related impacts upon their patient-caregiver relationships. First, national and local pressure to increase efficiency had troubled their relationships with patients who suspected that municipalities have sought to lower costs by reducing and digitalising services. Participants reported having to consider such worries when introducing technologies into their services. Second, participants reported a shift towards empowering patients. Digital technology can empower patients who value their independence, whereas safety is more important for other patients. Healthcare professionals needed to ensure that replacing care tasks with technology implies safe and improved care. Third, the safety and quality of digital healthcare services continues to depend upon surveillance and control mechanisms that compensate for less face-to-face monitoring. Participants did not consider the possibility that surveillance exposes information about patients' everyday lives to be problematic, but to constitute opportunities for adjusting services to meet patients' needs. Technologies such as digital medicine dispensers can improve the efficiency of healthcare services and enhance patients' independence when introduced in a

  3. A randomized controlled trial to evaluate the Make Safe Happen® app-a mobile technology-based safety behavior change intervention for increasing parents' safety knowledge and actions.

    Science.gov (United States)

    McKenzie, Lara B; Roberts, Kristin J; Clark, Roxanne; McAdams, Rebecca; Abdel-Rasoul, Mahmoud; Klein, Elizabeth G; Keim, Sarah A; Kristel, Orie; Szymanski, Alison; Cotton, Christopher G; Shields, Wendy C

    2018-03-12

    Many unintentional injuries that occur in and around the home can be prevented through the use of safety equipment and by consistently following existing safety recommendations. Unfortunately, uptake of these safety behaviors is unacceptably low. This paper describes the design of the Make Safe Happen® smartphone application evaluation study, which aims to evaluate a mobile technology-based safety behavior change intervention on parents' safety knowledge and actions. Make Safe Happen® app evaluation study is a randomized controlled trial. Participants will be parents of children aged 0-12 years who are recruited from national consumer online survey panels. Parents will complete a pretest survey, and will be randomized to receive the Make Safe Happen® app or a non-injury-related app, and then complete a posttest follow-up survey after 1 week. Primary outcomes are: (1) safety knowledge; (2) safety behaviors; (3) safety device acquisition and use, and (4) behavioral intention to take safety actions. Anticipated study results are presented. Wide-reaching interventions, to reach substantial parent and caregiver audiences, to effectively reduce childhood injuries are needed. This study will contribute to the evidence-base about how to increase safety knowledge and actions to prevent home-related injuries in children. NCT02751203 ; Pre-results.

  4. Scandinavian consumer preference for beef steaks packed with or without oxygen.

    Science.gov (United States)

    Aaslyng, M D; Tørngren, M A; Madsen, N T

    2010-07-01

    Beef steaks retail-packed with (80% O(2), 20% CO(2)) or without oxygen (either skin-packed or gas-packed (69.6% N(2), 30% CO(2), 0.04% CO or 70% N(2), 30% CO(2))) were compared by consumers in Denmark (n=382), Norway (n=316) and Sweden (n=374). Two pairs of two steaks - one steak packed in a high oxygen atmosphere and one packed without oxygen - were given to the consumers. They were instructed to prepare the steaks at home on two consecutive days, and two persons had to taste each steak. In Denmark, the oxygen-free packing was either gas packing with CO (69.6% N(2), 30% CO(2), 0.04% CO) or without CO (70% N(2), 30% CO(2)), in Norway it was either gas packing with CO (69.6% N(2), 30% CO(2), 0.04% CO) or skin packing, and in Sweden it was either skin packing or gas packing without CO (70% N(2), 30% CO(2)). The meat represented animals that were between 17 and 80 months old (Denmark) and young bulls (Norway and Sweden). Consumers in all three countries clearly preferred steaks packed without oxygen, in terms of overall liking, willingness to pay and their preferred choice of one steak. Furthermore, they preferred the oxygen-free steaks in terms of both overall liking and liking of tenderness, juiciness and flavour. In Sweden, many consumers would pay more than usual for the skin-packed steak, and it was more often chosen as the preferred steak out of the four compared with gas-packed without oxygen. No difference was seen between the two oxygen-free packing methods in Denmark and Norway. Copyright 2010 Elsevier Ltd. All rights reserved.

  5. Oxygenated Phosphine Fumigation for Control of Light Brown Apple Moth (Lepidoptera: Tortricidae) Eggs on Cut-Flowers.

    Science.gov (United States)

    Liu, Samuel S; Liu, Yong-Biao; Simmons, Gregory S

    2015-08-01

    Light brown apple moth, Epiphyas postvittana (Walker), eggs were subjected to oxygenated phosphine fumigation treatments under 70% oxygen on cut flowers to determine efficacy and safety. Five cut flower species: roses, lilies, tulips, gerbera daisy, and pompon chrysanthemums, were fumigated in separate groups with 2,500 ppm phosphine for 72 h at 5°C. Egg mortality and postharvest quality of cut flowers were determined after fumigation. Egg mortalities of 99.7-100% were achieved among the cut flower species. The treatment was safe to all cut flowers except gerbera daisy. A 96-h fumigation treatment with 2,200 ppm phosphine of eggs on chrysanthemums cut flowers also did not achieve complete control of light brown apple moth eggs. A simulation of fumigation in hermetically sealed fumigation chambers with gerbera daisy showed significant accumulations of carbon dioxide and ethylene by the end of 72-h sealing. However, oxygenated phosphine fumigations with carbon dioxide and ethylene absorbents did not reduce the injury to gerbera daisy, indicating that it is likely that phosphine may directly cause the injury to gerbera daisy cut flowers. The study demonstrated that oxygenated phosphine fumigation is effective against light brown apple moth eggs. However, it may not be able to achieve the probit9 quarantine level of control and the treatment was safe to most of the cut flower species. Published by Oxford University Press on behalf of Entomological Society of America 2015. This work is written by US Government employees and is in the public domain in the US.

  6. Are Detox Diets Safe?

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Are Detox Diets Safe? KidsHealth / For Teens / Are Detox Diets ... seguras las dietas de desintoxicación? What Is a Detox Diet? The name sounds reassuring — everyone knows that ...

  7. Year-end technical stop: train to work safely

    CERN Multimedia

    Rosaria Marraffino

    2016-01-01

    As mentioned in the previous issue of the Bulletin (see here), the accelerators are currently undergoing maintenance as part of the year-end technical stop (YETS). Hundreds of people are working simultaneously on different machines, and many of them need to be trained in order to work safely underground. From a Safety Training point of view, this has resulted in a significant increase in training requests, most of them at the last minute, which are now being handled – but not without difficulties.     In the LHC mock-up, a helium leak is simulated. In this stressful situation, the trainees learn how to put their mask on in less than 40 seconds.   "The most requested course is the Self-Rescue Mask classroom training,” explains Christoph Balle, Safety Training Section Leader. “In this course, people are trained to face the oxygen deficiency hazards that may occur in CERN's underground areas, learning...

  8. Singlet oxygen quenching by oxygen in tetraphenyl-porphyrin solutions

    International Nuclear Information System (INIS)

    Dedic, Roman; Korinek, Miloslav; Molnar, Alexander; Svoboda, Antonin; Hala, Jan

    2006-01-01

    Time-resolved measurement of singlet oxygen infrared phosphorescence is a powerful tool for determination of quantum yields and kinetics of its photosensitization. This technique was employed to investigate in detail the previously observed effect of singlet oxygen quenching by oxygen. The question whether the singlet oxygen is quenched by oxygen in ground or in excited state was addressed by study of two complementary dependencies of singlet oxygen lifetimes: on dissolved oxygen concentration and on excitation intensity. Oxygen concentration dependence study of meso-tetra(4-sulphonato)phenylporphyrin (TPPS 4 ) phosphorescence kinetics showed linearity of the dependence of TPPS 4 triplet state rate-constant. Corresponding bimolecular quenching constant of (1.5±0.1)x10 9 l/mol s was obtained. On the other hand, rate constants of singlet oxygen depopulation exhibit nonlinear dependence on oxygen concentration. Comparison of zero oxygen concentration-extrapolated value of singlet oxygen lifetime of (6.5±0.4) μs to (3.7±0.1) μs observed under air-saturated conditions indicates importance of the effect of quenching of singlet oxygen by oxygen. Upward-sloping dependencies of singlet oxygen depopulation rate-constant on excitation intensity evidence that singlet oxygen is predominantly quenched by oxygen in excited singlet state

  9. School and Pupil Effects on Secondary Pupils' Feelings of Safety in School, around School, and at Home

    Science.gov (United States)

    Mooij, Ton; Fettelaar, Daan

    2013-01-01

    In line with fear of crime research, schools should be secure places where pupils feel safe in order to function well. Various types of risk and promotive variables at school and pupil level may differently influence a pupil's feelings of safety in school, the school surroundings, and at home. The aim is to elaborate and test a theoretical…

  10. Cardiac function associated with home ventilator care in Duchenne muscular dystrophy.

    Science.gov (United States)

    Lee, Sangheun; Lee, Heeyoung; Eun, Lucy Youngmin; Gang, Seung Woong

    2018-02-01

    Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older (16.25±1.85 years) than those in the nonventilator group (14.73±1.36 years) ( P =0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity (1,038±620.41 mL) than the nonventilator group (1,455±603.12 mL). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio (1.7±0.44) was lower in the home ventilator group than in the nonventilator group (2.02±0.62). The mitral valve annular systolic velocity was higher in the home ventilator group (estimated β, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.

  11. Photoelectrochemical water splitting in separate oxygen and hydrogen cells

    Science.gov (United States)

    Landman, Avigail; Dotan, Hen; Shter, Gennady E.; Wullenkord, Michael; Houaijia, Anis; Maljusch, Artjom; Grader, Gideon S.; Rothschild, Avner

    2017-06-01

    Solar water splitting provides a promising path for sustainable hydrogen production and solar energy storage. One of the greatest challenges towards large-scale utilization of this technology is reducing the hydrogen production cost. The conventional electrolyser architecture, where hydrogen and oxygen are co-produced in the same cell, gives rise to critical challenges in photoelectrochemical water splitting cells that directly convert solar energy and water to hydrogen. Here we overcome these challenges by separating the hydrogen and oxygen cells. The ion exchange in our cells is mediated by auxiliary electrodes, and the cells are connected to each other only by metal wires, enabling centralized hydrogen production. We demonstrate hydrogen generation in separate cells with solar-to-hydrogen conversion efficiency of 7.5%, which can readily surpass 10% using standard commercial components. A basic cost comparison shows that our approach is competitive with conventional photoelectrochemical systems, enabling safe and potentially affordable solar hydrogen production.

  12. Results of the Test Program for Replacement of AK-225G Solvent for Cleaning NASA Propulsion Oxygen Systems

    Science.gov (United States)

    Lowrey, Nikki M.; Mitchell, Mark A.

    2016-01-01

    Since the 1990's, when the Class I Ozone Depleting Substance (ODS) chlorofluorocarbon-113 (CFC-113) was banned, NASA's propulsion test facilities at Marshall Space Flight Center (MSFC) and Stennis Space Center (SSC) have relied upon the solvent AsahiKlin AK-225 (hydrochlorofluorocarbon-225ca/cb or HCFC-225ca/cb) and, more recently AK-225G (the single isomer form, HCFC-225cb) to safely clean and verify the cleanliness of large scale propulsion oxygen systems. Effective January 1, 2015, the production, import, export, and new use of Class II Ozone Depleting Substances, including AK-225G, was prohibited in the United States by the Clean Air Act. In 2012 through 2014, NASA test labs at MSFC, SSC, and Johnson Space Center's White Sands Test Facility (WSTF) collaborated to seek out, test, and qualify a solvent replacement for AK-225G that is both an effective cleaner and safe for use with oxygen systems. This paper summarizes the tests performed, results, and lessons learned.

  13. Location, Location, Location: Characteristics and Services of Long-Stay Home Care Recipients in Retirement Homes Compared to Others in Private Homes and Long-Term Care Homes.

    Science.gov (United States)

    Poss, Jeffrey W; Sinn, Chi-Ling Joanna; Grinchenko, Galina; Blums, Jane; Peirce, Tom; Hirdes, John

    2017-02-01

    We examine recipients of publicly funded ongoing care in a single Ontario jurisdiction who reside in three different settings: long-stay home care patients in private homes and apartments, other patients in retirement homes and residents of long-term care homes, using interRAI assessment instruments. Among home care patients, those in retirement homes have higher proportions of dementia and moderate cognitive impairment, less supportive informal care systems as well as more personal care and nursing services above those provided by the public home care system, more frequent but shorter home support visits and lower than expected public home care expenditures. These lower expenditures may be because of efficiency of care delivery or by retirement homes providing some services otherwise provided by the public home care system. Although persons in each setting are mostly older adults with high degrees of frailty and medical complexity, long-term care home residents show distinctly higher needs. We estimate that 40% of retirement home residents are long-stay home care patients, and they comprise about one in six of this Community Care Access Centre's long-stay patients. Copyright © 2017 Longwoods Publishing.

  14. Safe Anesthesia For Every Tot

    DEFF Research Database (Denmark)

    Weiss, Markus; Vutskits, Laszlo; Hansen, Tom G

    2015-01-01

    PURPOSE OF REVIEW: The term 'safe use of anesthesia in children is ill-defined and requires definition of and focus on the 'safe conduct of pediatric anesthesia'. RECENT FINDINGS: The Safe Anesthesia For Every Tot initiative (www.safetots.org) has been set up during the last year to focus...... on the safe conduct of pediatric anesthesia. This initiative aims to provide guidance on markers of quality anesthesia care. The introduction and implementation of national regulations of 'who, where, when and how' are required and will result in an improved perioperative outcome in vulnerable children....... The improvement of teaching, training, education and supervision of the safe conduct of pediatric anesthesia are the main goals of the safetots.org initiative. SUMMARY: This initiative addresses the well known perioperative risks in young children, perioperative causes for cerebral morbidity as well as gaps...

  15. Hybrid-Aware Model for Senior Wellness Service in Smart Home.

    Science.gov (United States)

    Jung, Yuchae

    2017-05-22

    Smart home technology with situation-awareness is important for seniors to improve safety and security. With the development of context-aware computing, wearable sensor technology, and ubiquitous computing, it is easier for seniors to manage their health problem in smart home environment. For monitoring senior activity in smart home, wearable, and motion sensors-such as respiration rate (RR), electrocardiography (ECG), body temperature, and blood pressure (BP)-were used for monitoring movements of seniors. For context-awareness, environmental sensors-such as gas, fire, smoke, dust, temperature, and light sensors-were used for senior location data collection. Based on senior activity, senior health status can be classified into positive and negative. Based on senior location and time, senior safety is classified into safe and emergency. In this paper, we propose a hybrid inspection service middleware for monitoring elderly health risk based on senior activity and location. This hybrid-aware model for the detection of abnormal status of seniors has four steps as follows: (1) data collection from biosensors and environmental sensors; (2) monitoring senior location and time of stay in each location using environmental sensors; (3) monitoring senior activity using biometric data; finally, (4) expectation-maximization based decision-making step recommending proper treatment based on a senior health risk ratio.

  16. Molecular controls of the oxygenation and redox reactions of hemoglobin.

    Science.gov (United States)

    Bonaventura, Celia; Henkens, Robert; Alayash, Abdu I; Banerjee, Sambuddha; Crumbliss, Alvin L

    2013-06-10

    The broad classes of O(2)-binding proteins known as hemoglobins (Hbs) carry out oxygenation and redox functions that allow organisms with significantly different physiological demands to exist in a wide range of environments. This is aided by allosteric controls that modulate the protein's redox reactions as well as its O(2)-binding functions. The controls of Hb's redox reactions can differ appreciably from the molecular controls for Hb oxygenation and come into play in elegant mechanisms for dealing with nitrosative stress, in the malarial resistance conferred by sickle cell Hb, and in the as-yet unsuccessful designs for safe and effective blood substitutes. An important basic principle in consideration of Hb's redox reactions is the distinction between kinetic and thermodynamic reaction control. Clarification of these modes of control is critical to gaining an increased understanding of Hb-mediated oxidative processes and oxidative toxicity in vivo. This review addresses emerging concepts and some unresolved questions regarding the interplay between the oxygenation and oxidation reactions of structurally diverse Hbs, both within red blood cells and under acellular conditions. Developing methods that control Hb-mediated oxidative toxicity will be critical to the future development of Hb-based blood substitutes.

  17. Evaluation and comparison of safety, convenience and cost of administering intravenous pamidronate infusions to children in the home and ambulatory care settings.

    Science.gov (United States)

    Rush, Eric T; DeHaai, Kristi; Kreikemeier, Rose M; Lutz, Richard E

    2012-01-01

    The use of bisphosphonates in children to treat low bone mineral density has increased. Safety and efficacy of pamidronate has been previously demonstrated. However, little research has been done on pamidronate infusion in the home health setting for patients with metabolic bone disease. Data were collected via a survey to assess satisfaction and convenience of infusions. Adverse events were measured by collecting calcium levels before and after infusions. Infusion costs were estimated from the standard orders from one home health agency and our infusion center. We found no difference in the rates of hypocalcemia between the two groups. The survey results showed high satisfaction for both groups, with higher scores in the home health group for convenience and stress. Home health infusions showed lower cost and less absenteeism from school and work. Home health-based pamidronate infusion appears to be safe, less expensive, and is associated with high patient satisfaction.

  18. Homing oneself

    DEFF Research Database (Denmark)

    Winther, Ida Wentzel

    2009-01-01

    What is home? A building, a physical and mental phenomenon, or a concept?  There are many homes and ways `to home oneself´. Many of us quite often dwell in other places than at home (as professional commuters between two places, as travellers staying in hotels, as children of divorced parents...

  19. Estimation of maximal oxygen uptake via submaximal exercise testing in sports, clinical, and home settings

    NARCIS (Netherlands)

    Sartor, F.; Vernillo, G.; de Morree, H.M.; Bonomi, A.G.; La Torre, A.; Kubis, H.P.; Veicsteinas, A.

    2013-01-01

    Assessment of the functional capacity of the cardiovascular system is essential in sports medicine. For athletes, the maximal oxygen uptake (V˙O2max) provides valuable information about their aerobic power. In the clinical setting, the V˙O2max provides important diagnostic and prognostic information

  20. Regime shifts and ecological catastrophes in a model of plankton-oxygen dynamics under the climate change.

    Science.gov (United States)

    Petrovskii, Sergei; Sekerci, Yadigar; Venturino, Ezio

    2017-07-07

    It is estimated that more than a half of the total atmospheric oxygen is produced in the oceans due to the photosynthetic activity of phytoplankton. Any significant decrease in the net oxygen production by phytoplankton is therefore likely to result in the depletion of atmospheric oxygen and in a global mass mortality of animals and humans. In its turn, the rate of oxygen production is known to depend on water temperature and hence can be affected by the global warming. We address this problem theoretically by considering a model of a coupled plankton-oxygen dynamics where the rate of oxygen production slowly changes with time to account for the ocean warming. We show that, when the temperature rises sufficiently high, a regime shift happens: the sustainable oxygen production becomes impossible and the system's dynamics leads to fast oxygen depletion and plankton extinction. We also consider a scenario when, after a certain period of increase, the temperature is set on a new higher yet apparently safe value, i.e. before the oxygen depletion disaster happens. We show that in this case the system dynamics may exhibit a long-term quasi-sustainable dynamics that can still result in an ecological disaster (oxygen depletion and mass extinctions) but only after a considerable period of time. Finally, we discuss the early warning signals of the approaching regime shift resulting in the disaster. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. The Role of Telehealth to Assist In-Home tDCS: Opportunities, Promising Results and Acceptability

    Directory of Open Access Journals (Sweden)

    Brenton Hordacre

    2018-06-01

    Full Text Available Transcranial direct current stimulation (tDCS has shown great promise as a neuromodulatory intervention capable of improving behavioral outcomes in a range of neurological and psychiatric populations. Evidence indicates that the neuromodulatory effect of stimulation may be cumulative, with greater improvements in behavior observed following multiple treatment sessions. However, the requirement to attend clinical or research departments for multiple treatment sessions may present a barrier for many people, particularly those with greater disability or living remotely. The portability of tDCS suggests that in-home stimulation may become an avenue for further investigation. However, safe and effective use of tDCS by a participant within their home requires a form of monitoring. This review discusses how telehealth may provide real-time visual monitoring to ensure correct tDCS set-up and adherence to stimulation protocols, manage technical issues and monitor adverse events. The combination of telehealth to supplement in-home tDCS use has potential to transform the way tDCS is delivered.

  2. Family and home characteristics correlate with mold in homes.

    Science.gov (United States)

    Reponen, Tiina; Levin, Linda; Zheng, Shu; Vesper, Stephen; Ryan, Patrick; Grinshpun, Sergey A; LeMasters, Grace

    2013-07-01

    Previously, we demonstrated that infants residing in homes with higher Environmental Relative Moldiness Index were at greater risk for developing asthma by age seven. The purpose of this analysis was to identify the family and home characteristics associated with higher moldiness index values in infants' homes at age one. Univariate linear regression of each characteristic determined that family factors associated with moldiness index were race and income. Home characteristics associated with the moldiness index values were: air conditioning, carpet, age of the home, season of home assessment, and house dust mite allergen. Parental history of asthma, use of dehumidifier, visible mold, dog and cat allergen levels were not associated with moldiness index. Results of multiple linear regression showed that older homes had 2.9 units higher moldiness index (95% confidence interval [CI]=0.4, 5.4), whereas homes with central air conditioning had 2.5 units lower moldiness index (95% CI=-4.7, -0.4). In addition, higher dust mite allergen levels and carpeting were positively and negatively associated with higher moldiness index, respectively. Because older homes and lack of air conditioning were also correlated with race and lower income, whereas carpeting was associated with newer homes, the multivariate analyses suggests that lower overall socioeconomic position is associated with higher moldiness index values. This may lead to increased asthma risk in homes inhabited by susceptible, vulnerable population subgroups. Further, age of the home was a surrogate of income, race and carpeting in our population; thus the use of these factors should carefully be evaluated in future studies. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. 24 CFR 982.612 - Group home: State approval of group home.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Group home: State approval of group... Types Group Home § 982.612 Group home: State approval of group home. A group home must be licensed..., Retardation, or Social Services) as a group home for elderly persons or persons with disabilities. ...

  4. ThinkHome Energy Efficiency in Future Smart Homes

    OpenAIRE

    Christian Reinisch; Mario J. Kofler; Félix Iglesias; Wolfgang Kastner

    2011-01-01

    Abstract Smart homes have been viewed with increasing interest by both home owners and the research community in the past few years. One reason for this development is that the use of modern automation technology in the home or building promises considerable savings of energy, therefore, simultaneously reducing the operational costs of the building over its whole lifecycle. However, the full potential of smart homes still lies fallow, due to the complexity and diversity of the systems, badly ...

  5. Efficacy and safety of a new superficial chemical peel using alpha-hydroxy acid, vitamin C and oxygen for melasma.

    Science.gov (United States)

    Kim, Won-Serk

    2013-02-01

    Facial skin pigmentary disorders can be resistant to conventional treatment. Superficial chemical peel is an effective and safe treatment in pigmentary problems including melasma, post-inflammatory hyperpigmentation and aging spots. To assess the efficacy and safety of new superficial chemical peel (Melasma peel, Theraderm®), this is composed of alpha-hydroxy acid (AHAs), vitamin C and oxygen for melasma. Twenty-five ethnic Korean patients (Fitzpatrick skin phototypes IV and V) with moderate to severe melasma were enrolled. The patients underwent four treatments at 1-2-week intervals for 8 weeks. Clinical improvement was evaluated on a 5-point scale by participants and by the same dermatologist, and adverse effects were checked during the study. Improvement in the degree of pigmentation, pores, and evenness were noted. Significant clinical improvement of hyperpigmentation was evident. No adverse effects were reported. New superficial chemical peel using AHAs, vitamin C and oxygen is an effective and very safe treatment for melasma.

  6. SAFE/SNAP application to shipboard security

    International Nuclear Information System (INIS)

    Grady, L.M.; Walker, J.L.; Polito, J.

    1981-11-01

    An application of the combined Safeguards Automated Facility Evaluation/Safeguards Network Analysis Procedure (SAFE/SNAP) modeling technique to a physical protection system (PPS) aboard a generic ship is described. This application was performed as an example of how the SAFE and SNAP techniques could be used. Estimates of probability of interruption and neutralization for the example shipboard PPS are provided by SAFE as well as an adversary scenario, which serves as input to SNAP. This adversary scenario is analyzed by SNAP through four cases which incorporate increasingly detailed security force tactics. Comparisons between the results of the SAFE and SNAP analyses are made and conclusions drawn on the validity of each technique. Feedback from SNAP to SAFE is described, and recommendations for upgrading the ship based on the results of the SAFE/SNAP application are also discussed

  7. Study protocol: home-based telehealth stroke care: a randomized trial for veterans

    Directory of Open Access Journals (Sweden)

    McGee-Hernandez Nancy

    2010-06-01

    Full Text Available Abstract Background Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. Methods We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a TR; or (b Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. Discussion For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and

  8. Home hygiene and environmental sanitation: a country situation analysis for India.

    Science.gov (United States)

    Nath, K J

    2003-06-01

    Problems of the environment and of domestic hygiene are always related to poverty of population and the sanitation of settlements. Most cities and towns in developing countries, like India, are characterised by over-crowding, congestion, inadequate water supply and inadequate facilities of disposal of human excreta, waste water and solid wastes. Inadequacy of housing for most urban poor invariably leads to poor home hygiene. Personal and domestic hygiene practices cannot be improved without improving basic amenities, such as water supply, waste water disposal, solid waste management and the problems of human settlements. But even under the prevailing conditions, there is significant scope of improving hygiene practices at home to prevent infection and cross-infection. Unfortunately, in developing countries, public health concerns are usually raised on the institutional setting, such as municipal services, hospitals, environmental sanitation, etc. There is a reluctance to acknowledge the home as a setting of equal importance along with the public institutions in the chain of disease transmission in the community. Managers of home hygiene and community hygiene must act in unison to optimise return from efforts to promote public health. Current practices and perceptions of domestic and personal hygiene in Indian communities, the existing levels of environmental and peri-domestic sanitation and the 'health risk' these pose will be outlined, as well as the need for an integrated action for improving hygiene behaviour and access to safe water and sanitation.

  9. [Influence of in-home nursing care on the weight of the early discharged preterm newborn].

    Science.gov (United States)

    Alvarez Miró, R; Lluch Canut, M T; Figueras Aloy, J; Esqué Ruiz, M T; Arroyo Gili, L; Bella Rodríguez, J; Carbonell Estrany, X

    2014-12-01

    In-Home nursing care of the preterm newborn helps to bring the family situation to normal, promotes breastfeeding and development of the newborn, and enables the reorganization of health care resources. The purpose of this paper is to demonstrate that in-home nursing care of the preterm newborn leads to an increase in weight and a similar morbidity. A total of 65 cases and 65 controls (matched by weight, age and sex) were studied, all of them preterm newborns born in hospital and weighing less than 2100 g at discharge. In-home nursing care was carried out by a pediatrician neonatologist, as well as two nurses specialized in neonatology who made several visits to the home. Weight gain was calculated as g/day and g/Kg/day, comparing the first week of the study with the week prior to the beginning of the study. The groups were comparable. Weight gain in the group with home nursing care was 38 g per day, significantly higher than the weight gain in the control group (31 g/day). The independent predictive variables of the increase in g/Kg/day during the study were in-home nursing care, male gender, breastfeeding less, and not having suffered from a peri-intraventricular hemorrhage. Neonatal morbidity was similar in both groups. In-home care was associated with a greater weight gain of the newborn at home than during their stay in the hospital, and can be considered safe because neonatal morbidity was not increased. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  10. Development of a smart home simulator for use as a heuristic tool for management of sensor distribution.

    Science.gov (United States)

    Poland, Michael P; Nugent, Chris D; Wang, Hui; Chen, Liming

    2009-01-01

    Smart Homes offer potential solutions for various forms of independent living for the elderly. The assistive and protective environment afforded by smart homes offer a safe, relatively inexpensive, dependable and viable alternative to vulnerable inhabitants. Nevertheless, the success of a smart home rests upon the quality of information its decision support system receives and this in turn places great importance on the issue of correct sensor deployment. In this article we present a software tool that has been developed to address the elusive issue of sensor distribution within smart homes. Details of the tool will be presented and it will be shown how it can be used to emulate any real world environment whereby virtual sensor distributions can be rapidly implemented and assessed without the requirement for physical deployment for evaluation. As such, this approach offers the potential of tailoring sensor distributions to the specific needs of a patient in a non-evasive manner. The heuristics based tool presented here has been developed as the first part of a three stage project.

  11. Improving access to home phototherapy for patients with psoriasis: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Franken SM

    2016-05-01

    Full Text Available Sylvie M Franken, Carlijn L Vierstra, Thomas RustemeyerDepartment of Dermatology, VU University Medical Centre, Amsterdam, the Netherlands Introduction: Although the treatment burden for phototherapy in the outpatient setting is considerable, prescription of home-based phototherapy has not been instigated. Home-based phototherapy seems more patient friendly in terms of avoiding the thrice-weekly hospital visits. So why are most treatments still given in a hospital setting? Is home-based treatment less effective? Are there financial barriers? Is the treatment not available? To answer these questions, a literature search was done. Methods: A literature search of PubMed, Embase, and Cochrane Library databases was performed, using the search terms “psoriasis” and “phototherapy”. Selection was based on two rounds; the first round involved screening the title and abstract of all records and second involved evaluating the full text of the remaining articles for eligibility according to inclusion and exclusion criteria. Results: In total, 23 publications were included with consensus of both researchers. Overall, the patients reported being very satisfied with home-based phototherapy. Results regarding effectivity in terms of improvement from disease severity and in quality of life were variable but generally positive. Reasons for reluctance varied from medicolegal and social aspects to lack of reimbursement and unfamiliarity on the side of the prescriber. Conclusion: In the treatment for psoriasis, home-based phototherapy is as effective and safe as phototherapy in an outpatient setting. Patients were more satisfied with home-based phototherapy. Factors that negatively influence the prescription of or choice for home-based phototherapy can be summarized in terms of lack of control, lack of knowledge, and lack of a good reimbursement system. Keywords: psoriasis, phototherapy, UVB, home-based, effectiveness, burden, costs, access 

  12. Oxygen breathing accelerates decompression from saturation at 40 msw in 70-kg swine.

    Science.gov (United States)

    Petersen, Kyle; Soutiere, Shawn E; Tucker, Kathryn E; Dainer, Hugh M; Mahon, Richard T

    2010-07-01

    Submarine disaster survivors can be transferred from a disabled submarine at a pressure of 40 meters of seawater (msw) to a new rescue vehicle; however, they face an inherently risky surface interval before recompression and an enormous decompression obligation due to a high likelihood of saturation. The goal was to design a safe decompression protocol using oxygen breathing and a trial-and-error methodology. We hypothesized that depth, timing, and duration of oxygen breathing during decompression from saturation play a role to mitigate decompression outcomes. Yorkshire swine (67-75 kg), compressed to 40 msw for 22 h, underwent one of three accelerated decompression profiles: (1) 13.3 h staged air decompression to 18 msw, followed by 1 h oxygen breathing, then dropout; (2) direct decompression to 18 msw followed by 1 h oxygen breathing then dropout; and (3) 1 h oxygen prebreathe at 40 msw followed by 1 h mixed gas breathing at 26 msw, 1 h oxygen breathing at 18 msw, and 1 h ascent breathing oxygen. Animals underwent 2-h observation for signs of DCS. Profile 1 (14.3 h total) resulted in no deaths, no Type II DCS, and 20% Type I DCS. Profile 2 (2.1 h total) resulted in 13% death, 50% Type II DCS, and 75% Type I DCS. Profile 3 (4.5 h total) resulted in 14% death, 21% Type II DCS, and 57% Type I DCS. No oxygen associated seizures occurred. Profile 1 performed best, shortening decompression with no death or severe DCS, yet it may still exceed emergency operational utility in an actual submarine rescue.

  13. Development, evaluation and implementation of video-EEG telemetry at home.

    Science.gov (United States)

    Brunnhuber, Franz; Amin, Devyani; Nguyen, Yan; Goyal, Sushma; Richardson, Mark P

    2014-05-01

    To describe the development and implementation of video EEG telemetry (VT) in the patient's home (home video telemetry, HVT) in a single centre. HVT met the UK Medical Research Council definition of a complex intervention, and we used its guidance to evaluate the process of piloting, evaluating, developing and implementing this new clinical service. The first phase was a feasibility study, comparing inpatient VT (IVT) with HVT in a test-retest design (n=5), to assess data quality and yield of clinically relevant events. The second phase was a pre-implementation study (n=8), to examine acceptability and satisfaction as well as the costs of IVT and HVT. Subsequently, we implemented the service, and reviewed the outcomes of the first 34 patients. The feasibility study found no difference in the quality of recording or clinical yield between IVT and HVT. The pre-implementation study showed excellent patient satisfaction. We also discuss the findings of the main stakeholder survey (consultants and technicians). Our economic modelling demonstrates a clear financial superiority of HVT over IVT. Our findings show that diagnostic HVT for seizure classification and polysomnographies can be carried out safely in the patients' home and poses no security risks for staff. HVT can be effectively integrated into an existing tertiary care service as a routine home or community-based procedure. We hope to encourage other clinical neurophysiology departments and epilepsy centres to take advantage of our experience and consider adopting and implementing HVT, with the aim of a nationwide coverage. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  14. Effect of safe water on arsenicosis: A follow-up study

    Directory of Open Access Journals (Sweden)

    Kunal K Majumdar

    2014-01-01

    prevented to occur because of lung cancer and severe lung disease. Conclusion: It is, therefore, an urgent need to make arrangement for availability of safe water source among the arsenic-affected people in the district. Many of the people in the affected villages are not aware of contamination of their home tube wells with arsenic. Awareness generation and motivation of the people for testing their drinking water sources for arsenic and environmental interventions like rain water harvesting, ground water recharge, and restricting excessive use of ground water for domestic and agricultural purposes are also important to prevent further exposure of arsenic to these people.

  15. Explaining Consumer Safe Food Handling Through Behavior-Change Theories: A Systematic Review.

    Science.gov (United States)

    Young, Ian; Reimer, Danielle; Greig, Judy; Meldrum, Richard; Turgeon, Patricia; Waddell, Lisa

    2017-11-01

    Consumers often engage in unsafe food handling behaviors at home. Previous studies have investigated the ability of behavior-change theories to explain and predict these behaviors. The purpose of this review was to determine which theories are most consistently associated with consumers' safe food handling behaviors across the published literature. A standardized systematic review methodology was used, consisting of the following steps: comprehensive search strategy; relevance screening of identified references; confirmation of relevance and characterization of relevant articles; risk-of-bias assessment; data extraction; and descriptive analysis of study results. A total of 20 relevant studies were identified; they were mostly conducted in Australia (40%) and the United States (35%) and used a cross-sectional design (65%). Most studies targeted young adults (65%), and none focused on high-risk consumer groups. The outcomes of 70% of studies received high overall risk-of-bias ratings, largely due to a lack of control for confounding variables. The most commonly applied theory was the Theory of Planned Behavior (45% of studies), which, along with other investigated theories of behavior change, was frequently associated with consumer safe food handling behavioral intentions and behaviors. However, overall, there was wide variation in the specific constructs found to be significantly associated and in the percentage of variance explained in each outcome across studies. The results suggest that multiple theories of behavior change can help to explain consumer safe food handling behaviors and could be adopted to guide the development of future behavior-change interventions. In these contexts, theories should be appropriately selected and adapted to meet the needs of the specific target population and context of interest.

  16. Formulating evidence-based guidelines for certified nurse-midwives and certified midwives attending home births.

    Science.gov (United States)

    Cook, Elizabeth; Avery, Melissa; Frisvold, Melissa

    2014-01-01

    Implementing national home birth guidelines for certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States may facilitate a common approach to safe home birth practices. Guidelines are evidence-based care recommendations for specified clinical situations that can be modified by individual providers to meet specific client needs. Following a review of home birth guidelines from multiple countries, a set of home birth practices guidelines for US CNMs/CMs was drafted. Fifteen American Midwifery Certification Board, Inc. (AMCB)-certified home birth midwives who participate in the American College of Nurse-Midwives (ACNM) home birth electronic mailing list considered the use of such a document in their practices and reviewed and commented on the guidelines. The proposed guidelines addressed client screening, informed consent, antepartum care, routine intrapartum care, obstetric complications and hospital transports, postpartum care, neonatal care, gynecologic care, primary care, peer reviews, recordkeeping, and physician collaboration. The reviewers had varying assessments as to whether the guidelines reflected international standards and current best evidence. The primary concern expressed was that an adoption of national guidelines could compromise provider autonomy. Incorporation of evidence-based guidelines is an ACNM standard and was recommended by the Home Birth Consensus Summit. Clinical practice guidelines are informed by current evidence and supported by experts in a given discipline. Implementation of guidelines ensures optimal patient care and is becoming increasingly central to reimbursement and to medicolegal support. A set of practice guidelines based on current best evidence and internationally accepted standards was developed and reviewed by an interested group of US CNMs/CMs. Further discussion with home birth midwives and other stakeholders about the development and implementation of home birth guidelines is needed, especially in

  17. Chernobyl new safe confinement

    International Nuclear Information System (INIS)

    Dodd, L.

    2011-01-01

    The author presents the new safe confinement that will be commissioned at Unit 4 of the Chernobyl NPP in 2015. The confinement will ensure that Chernobyl Unit 4 will be placed in an environmentally safe condition for at least next 100 years. The article highlights the current work status, future perspectives and the feasibility of confinement concept [ru

  18. Asymptotically Safe Dark Matter

    DEFF Research Database (Denmark)

    Sannino, Francesco; Shoemaker, Ian M.

    2015-01-01

    We introduce a new paradigm for dark matter (DM) interactions in which the interaction strength is asymptotically safe. In models of this type, the coupling strength is small at low energies but increases at higher energies, and asymptotically approaches a finite constant value. The resulting...... searches are the primary ways to constrain or discover asymptotically safe dark matter....

  19. Effect of esmolol infusion on myocardial oxygen consumption during extubation and quality of recovery in elderly patients undergoing general anesthesia: randomized, double blinded, clinical trial

    Directory of Open Access Journals (Sweden)

    Sherif A. ELokda

    2015-04-01

    Conclusions: Esmolol is a safe, effective and well-tolerated drug that can be used in elderly patients undergoing general anesthesia to reduce the myocardial oxygen consumption and improve the quality of recovery.

  20. Comparative economic evaluation of home-based and hospital-based palliative care for terminal cancer patients.

    Science.gov (United States)

    Kato, Koki; Fukuda, Haruhisa

    2017-11-01

    To quantify the difference between adjusted costs for home-based palliative care and hospital-based palliative care in terminally ill cancer patients. We carried out a case-control study of home-care patients (cases) who had died at home between January 2009 and December 2013, and hospital-care patients (controls) who had died at a hospital between April 2008 and December 2013. Data on patient characteristics were obtained from insurance claims data and medical records. We identified the determinants of home care using a multivariate logistic regression analysis. Cox proportional hazards analysis was used to examine treatment duration in both types of care, and a generalized linear model was used to estimate the reduction in treatment costs associated with home care. The case and control groups comprised 48 and 99 patients, respectively. Home care was associated with one or more person(s) living with the patient (adjusted OR 6.54, 95% CI 1.18-36.05), required assistance for activities of daily living (adjusted OR 3.61, 95% CI 1.12-10.51), non-use of oxygen inhalation therapy (adjusted OR 12.75, 95% CI 3.53-46.02), oral or suppository opioid use (adjusted OR 5.74, 95% CI 1.11-29.54) and transdermal patch opioid use (adjusted OR 8.30, 95% CI 1.97-34.93). The adjusted hazard ratio of home care for treatment duration was not significant (adjusted OR 0.95, 95% CI 0.59-1.53). However, home care was significantly associated with a reduction of $7523 (95% CI $7093-7991, P = 0.015) in treatment costs. Despite similar treatment durations between the groups, treatment costs were substantially lower in the home-care group. These findings might inform the policymaking process for improving the home-care support system. Geriatr Gerontol Int 2017; 17: 2247-2254. © 2017 Japan Geriatrics Society.

  1. Nursing Homes

    Science.gov (United States)

    ... Home › Aging & Health A to Z › Nursing Homes Font size A A A Print Share Glossary Basic ... Reason For Living in A Nursing Home Some type of disability with activities of daily living (ADLs) ...

  2. Hydrogen-Oxygen PEM Regenerative Fuel Cell at NASA Glenn Research Center

    Science.gov (United States)

    Bents, David J.

    2004-01-01

    The NASA Glenn Research Center has constructed a closed-cycle hydrogen-oxygen PEM regenerative fuel cell (RFC) to explore its potential use as an energy storage device for a high altitude solar electric aircraft. Built up over the last 2 years from specialized hardware and off the shelf components the Glenn RFC is a complete "brassboard" energy storage system which includes all the equipment required to (1) absorb electrical power from an outside source and store it as pressurized hydrogen and oxygen and (2) make electrical power from the stored gases, saving the product water for re-use during the next cycle. It consists of a dedicated hydrogen-oxygen fuel cell stack and an electrolyzer stack, the interconnecting plumbing and valves, cooling pumps, water transfer pumps, gas recirculation pumps, phase separators, storage tanks for oxygen (O2) and hydrogen (H2), heat exchangers, isolation valves, pressure regulators, nitrogen purge provisions, instrumentation, and other components. It specific developmental functions include: (1) Test fuel cells and fuel cell components under repeated closed-cycle operation (nothing escapes; everything is used over and over again). (2) Simulate diurnal charge-discharge cycles (3) Observe long-term system performance and identify degradation and loss mechanisms. (4) Develop safe and convenient operation and control strategies leading to the successful development of mission-capable, flight-weight RFC's.

  3. Home Care

    Science.gov (United States)

    ... are part of home healthcare agencies. You may benefit from home care if you are dealing with ... it will trigger an emergency response or checkup phone call. Newer technologies ... or mobile testing technology (home diagnostics), including x-rays and ...

  4. Hyperbaric oxygen as sole treatment for severe radiation - induced haemorrhagic cystitis

    Energy Technology Data Exchange (ETDEWEB)

    Dellis, Athanasios, E-mail: aedellis@gmail.com [Department of Surgery, National and Kapodistrian University of Athens, Aretaieion Academic Hospital, Athens (Greece); Papatsoris, Athanasios; Deliveliotis, Charalambos; Skolarikos, Andreas [Department of Urology, University of Athens, Sismanoglio General Hospital, Athens (Greece); Kalentzos, Vasileios [Department of Diving and Hyperbaric Oxygen, Naval and Veterans Hospital, Athens (Greece)

    2017-05-15

    Purpose: To examine the safety and efficacy of hyperbaric oxygen as the primary and sole treatment for severe radiation-induced haemorrhagic cystitis. Materials and methods: Hyperbaric oxygen was prospectively applied as primary treatment in 38 patients with severe radiation cystitis. Our primary endpoint was the incidence of complete and partial response to treatment, while the secondary endpoints included the duration of response, the correlation of treatment success-rate to the interval between the onset of haematuria and initiation of therapy, blood transfusion need and total radiation dose, the number of sessions to success, the avoidance of surgery and the overall survival. Results: All patients completed therapy without complications with a mean follow-up of 29.33 months. Median number of sessions needed was 33. Complete and partial response rate was 86.8% and 13.2%, respectively. All 33 patients with complete response received therapy within 6 months of the haematuria onset. One patient needed cystectomy, while 33 patients were alive at the end of follow-up. Conclusions: Our study suggests the early primary use of hyperbaric oxygen for radiation-induced severe cystitis as an effective and safe treatment option. (author)

  5. Surface oxygen vacancy and oxygen permeation flux limits of perovskite ion transport membranes

    KAUST Repository

    Hunt, Anton

    2015-09-01

    © 2015 Elsevier B.V. The mechanisms and quantitative models for how oxygen is separated from air using ion transport membranes (ITMs) are not well understood, largely due to the experimental complexity for determining surface exchange reactions at extreme temperatures (>800°C). This is especially true when fuels are present at the permeate surface. For both inert and reactive (fuels) operations, solid-state oxygen surface vacancies (δ) are ultimately responsible for driving the oxygen flux, JO2. In the inert case, the value of δ at either surface is a function of the local PO2 and temperature, whilst the magnitude of δ dictates both the JO2 and the inherent stability of the material. In this study values of δ are presented based on experimental measurements under inert (CO2) sweep: using a permeation flux model and local PO2 measurements, collected by means of a local gas-sampling probe in our large-scale reactor, we can determine δ directly. The ITM assessed was La0.9Ca0.1FeO3-δ (LCF); the relative resistances to JO2 were quantified using the pre-defined permeation flux model and local PO2 values. Across a temperature range from 825°C to 1056°C, δ was found to vary from 0.007 to 0.029 (<1%), safely within material stability limits, whilst the permeate surface exchange resistance dominates. An inert JO2 limit was identified owing to a maximum sweep surface δ, δmaxinert. The physical presence of δmaxinert is attributed to a rate limiting step shift from desorption to associative electron transfer steps on the sweep surface as PO2 is reduced. Permeate surface exchange limitations under non-reactive conditions suggest that reactive (fuel) operation is necessary to accelerate surface chemistry for future work, to reduce flux resistance and push δpast δmaxinert in a stable manner.

  6. Evaluation of nitrous oxide-oxygen and triclofos sodium as conscious sedative agents

    Directory of Open Access Journals (Sweden)

    Priya Subramaniam

    2017-01-01

    Full Text Available Background: Conscious sedation is used in the pediatric dentistry to reduce fear and anxiety in children and promote favorable treatment outcomes. To achieve them, the primary clinical need is for a well-tolerated, effective, and expedient analgesic and sedative agent that is safe to use. Aim: The aim of the present study was to evaluate the efficacy of nitrous oxide-oxygen and triclofos sodium as conscious sedative agents in 5–10-year-old children. Methodology: Sixty children aged 5–10 years showing anxious, uncooperative, and apprehensive behavior were randomly divided and assigned into two groups (Groups A and B such that Group A received 40% nitrous oxide-60% oxygen and Group B received triclofos sodium in the dose of 70 mg/kg body weight, given 30 min before the treatment procedure. During the whole course of sedation procedure, the response of the child was assessed using Houpt's behavior rating scale. The acceptance of route of drug administration by the patient and parent was also assessed. Data obtained were statistically evaluated using the Mann–Whitney U-test and Chi-square test. Results: Children sedated with triclofos sodium were significantly more drowsy and disoriented compared to those sedated with nitrous oxide. The overall behavior of children in both the groups was similar. Good parental acceptance was observed for both the routes of administration. Patients accepted the oral route significantly better than inhalation route. Conclusion: Both nitrous oxide-oxygen and triclofos sodium were observed to be effective sedative agents, for successful and safe use in 5–10-year-old dental patients. Patients showed a good acceptance of the oral route compared to the inhalation route for sedation.

  7. 75 FR 1734 - Children’s Online Privacy Protection Rule Safe Harbor Proposed Self-Regulatory Guidelines; i-SAFE...

    Science.gov (United States)

    2010-01-13

    ... Proposed Self-Regulatory Guidelines; i-SAFE, Inc. Application for Safe Harbor AGENCY: Federal Trade... for public comment concerning proposed self-regulatory guidelines submitted by i-SAFE, Inc. under the... approval self-regulatory guidelines that would implement the Rule's protections.\\3\\ \\1\\ 64 FR 59888 (1999...

  8. Relations among work-home culture, the utilization of work-home arrangements, and work-home interference

    NARCIS (Netherlands)

    Dikkers, J.S.E.; Geurts, S.A.E.; Dulk, L. den; Peper, A.B.; Kompier, M.A.J.

    2004-01-01

    In the present study, we examined the associations among work-home culture (WHC), the utilization of work-home arrangements (WHAs), and work-home interference (WHI) among 638 workers from a Dutch financial consultancy firm. We (a) developed a typology of WHC, (b) examined whether the utilization of

  9. Safeness of radiological machinery

    International Nuclear Information System (INIS)

    Yokoyama, Shun

    1979-01-01

    The human factors affecting the safeness of radiological machinery, which are often very big and complicated machines, are described from the stand point of handling. 20 to 50% of the troubles on equipments seem to be caused by men. This percentage will become even higher in highly developed equipments. Human factors have a great influence on the safeness of radiological equipments. As the human factors, there are sensory factors and knowledge factors as well as psychological factors, and the combination of these factors causes mishandling and danger. Medical services at present are divided in various areas, and consist of the teamwork of the people in various professions. Good human relationship, education and control are highly required to secure the safeness. (Kobatake, H.)

  10. Pilot Implementation of two evidence based programs (SafeCare and IncredibleYears in Child Protection Services in Gipuzkoa (Spain

    Directory of Open Access Journals (Sweden)

    Joaquín de Paul

    2015-08-01

    Full Text Available This paper describes the implementation process of two evidence-based programs in Gipuzko as Child Protection System (Spain: SafeCare and Incredible Years. SafeCare is a home visiting program for high-riskand neglectful families with children under 5 years. Incredible Years is a parenting skills training program for families with children between 4 to 8 years with behavior problems whose parents have significantdifficulties to manage. The paper describes the process by which public institutions responsible for child protection in Gipuzkoa decided to shift from current intervention programs towards more structured, focused, and short-term programs that have shown positive results in previous applications in other countries. Issues related to programs adaptation, selection, and training of professionals and pre- and postresults obtained in the preliminary application of SafeCare and Incredible Years to a limited set of families are presented. Finally, the next step of the implementation process (pilot implementation with a randomized control trial design is described. The paper discusses a significant number of issues that have been important throughout this process and that may be useful for administrations and institutions that wish to undertake a similar process.

  11. Associations Between Home Death and the Use and Type of Care at Home.

    Science.gov (United States)

    McEwen, Rebecca; Asada, Yukiko; Burge, Frederick; Lawson, Beverley

    2018-01-01

    Despite wishes for and benefits of home deaths, a discrepancy between preferred and actual location of death persists. Provision of home care may be an effective policy response to support home deaths. Using the population-based mortality follow-back study conducted in Nova Scotia, we investigated the associations between home death and formal care at home and between home death and the type of formal care at home. We found (1) the use of formal care at home at the end of life was associated with home death and (2) the use of formal home support services at home was associated with home death among those whose symptoms were well managed.

  12. Home

    Science.gov (United States)

    Military Commission Seal VWAP Login Home Go ABOUT US Organization Overview Organizational Chart Families VWAP Login CCTV Sites Travel Media MC News CCTV Sites Travel Today at OMC Home Today at OMC Daily

  13. Home hemodialysis

    DEFF Research Database (Denmark)

    Agar, John W; Perkins, Anthony; Heaf, James G

    2015-01-01

    We describe the infrastructure that is necessary for hemodialysis in the home focusing on physical requirements, the organization of plumbing and water, and the key features that should guide the selection of machines that are suitable for home use.......We describe the infrastructure that is necessary for hemodialysis in the home focusing on physical requirements, the organization of plumbing and water, and the key features that should guide the selection of machines that are suitable for home use....

  14. A case of lung cancer pain relief and safe return home by strontium chloride

    International Nuclear Information System (INIS)

    Motoshima, Kohei; Fukuda, Minoru; On, Yumi

    2013-01-01

    Strontium chloride 89 ( 89 Sr) is used as a systemic radiopharmaceutical therapy for the palliation of pain in patients with metastatic bone cancer. A 64-year-old man had previously undergone an operation to resect his right upper lobe of lung and sixth rib. He was diagnosed with lung cancer (large cell carcinoma, pT3N0M0, stage IIB). Three months later, he was treated with chemoradiotherapy for local recurrence. Ten months later, he could not sit up due to severe pain of the left ilium, although he had been treated with opiate analgesics. Fourteen months later, his hospital stay was prolonged and he was treated with 89 Sr. One week after injection, the pain was almost completed relieved. Two weeks after injection, morphine infusion was stopped and a reduced dose of a fentanyl patch was used. He was also able to eat meals. Three weeks after injection, he started rehabilitation. Two months after the injection of 89 Sr, he could return home from the hospital. Adverse events included grade 2 leukopenia, neutropenia and thrombocytopenia. These peaked 2 months after injection. (author)

  15. HomePort

    DEFF Research Database (Denmark)

    Madsen, Per Printz

    2009-01-01

    In the last couple of year's computer based home control systems are getting more and more common in modern homes. For instance these systems take care of light control, heat control and security systems.  The latest trend is to use wireless communication like Z-Wave and ZigBee to interconnect...... different components in these systems. One of the characteristics is that each system, like for instance heat and light, has their own specific way of using the communication system.   This paper describes a way to connect different home control systems through an intelligent gateway, called a Home......Port. The HomePort consists of a number of Subsystem communication drivers, a virtual communication layer, an interpreter and a PC- based compiler for a high level control language, called GIL (Gateway intelligence language). The focus in this paper will be on the upper two layers in the Home...

  16. DOE Zero Energy Ready Home Case Study: Thrive Home Builders, Lowry Plan

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2017-09-01

    Thrive Home Builders built this 4,119-ft2 home at the Lowry development in Denver, Colorado, to the high-performance criteria of the U.S. Department of Energy’s Zero Energy Ready Home Program. Despite the dense positioning of the homes, mono-plane roof designs afforded plenty of space for the 8.68 kW of photovoltaic panels. With the PV, the home achieves a Home Energy Rating System (HERS) score of 4 and the home owners should enjoy energy bills of about $-11 a year. Without the PV, the home would score a HERS 38 (far lower than the HERS 80 to 100 of typical new homes).

  17. Multidisciplinary nutritional support for undernutrition in nursing home and home-care

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe

    2016-01-01

    Objective To assess the effect of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care identified with the validated Eating Validation Scheme (EVS). Methods An 11 wk cluster randomized trial with a home-care (3 clusters) or nursing home (3 clusters.......3] versus 1.3 [0.5], P = 0.021) was observed. There was a almost significant difference in mortality (2% versus 13%, P = 0.079). Conclusions Multidisciplinary nutritional support in older adults in nursing home and home-care could have a positive effect on quality of life, muscle strength, and oral care....... means of EuroQol-5D-3L), physical performance (30-seconds chair stand), nutritional status (weight and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (participants from home-care), and mortality. Results Respectively, 55 (46 from 2 home...

  18. The Medical Home

    Science.gov (United States)

    ... Videos for Educators Search English Español The Medical Home KidsHealth / For Parents / The Medical Home What's in ... for your child. What Does the Term "Medical Home" Mean? A medical home isn't a place ...

  19. Home Rx: The Health Benefits of Home Performance

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, Jonathan [National Center for Healthy Housing (NCHH), Columbia, MD (United States); Jacobs, David [National Center for Healthy Housing (NCHH), Columbia, MD (United States); Reddy, Amanda [National Center for Healthy Housing (NCHH), Columbia, MD (United States); Tohn, Ellen [Tohn Environmental Strategies, Wayland, MA (United States); Cohen, Jonathan [Dept. of Energy (DOE), Washington DC (United States); Jacobsohn, Ely [Dept. of Energy (DOE), Washington DC (United States)

    2016-12-01

    Evidence in a new, groundbreaking U.S. Department of Energy report, Home Rx: The Health Benefits of Home Performance, shows that home performance upgrades can improve the quality of a home’s indoor environment by reducing the prevalence of harmful indoor air pollutants and contaminants. Until recently, no systematic review of this evidence had been conducted, limiting full understanding of the link between home performance and health. This new report summarizes current knowledge and identifies research gaps. The design characteristics and results of each of the 40 studies considered in the report are summarized in a searchable matrix.

  20. Molecular Controls of the Oxygenation and Redox Reactions of Hemoglobin

    Science.gov (United States)

    Henkens, Robert; Alayash, Abdu I.; Banerjee, Sambuddha; Crumbliss, Alvin L.

    2013-01-01

    Abstract Significance: The broad classes of O2-binding proteins known as hemoglobins (Hbs) carry out oxygenation and redox functions that allow organisms with significantly different physiological demands to exist in a wide range of environments. This is aided by allosteric controls that modulate the protein's redox reactions as well as its O2-binding functions. Recent Advances: The controls of Hb's redox reactions can differ appreciably from the molecular controls for Hb oxygenation and come into play in elegant mechanisms for dealing with nitrosative stress, in the malarial resistance conferred by sickle cell Hb, and in the as-yet unsuccessful designs for safe and effective blood substitutes. Critical Issues: An important basic principle in consideration of Hb's redox reactions is the distinction between kinetic and thermodynamic reaction control. Clarification of these modes of control is critical to gaining an increased understanding of Hb-mediated oxidative processes and oxidative toxicity in vivo. Future Directions: This review addresses emerging concepts and some unresolved questions regarding the interplay between the oxygenation and oxidation reactions of structurally diverse Hbs, both within red blood cells and under acellular conditions. Developing methods that control Hb-mediated oxidative toxicity will be critical to the future development of Hb-based blood substitutes. Antioxid. Redox Signal. 18, 2298–2313. PMID:23198874

  1. Nature works best when allowed to run its course. The experience of midwives promoting normal births in a home birth setting.

    Science.gov (United States)

    Aune, Ingvild; Hoston, Mari A; Kolshus, Nora J; Larsen, Christel E G

    2017-07-01

    to gain a deeper understanding of how midwives promote a normal birth in a home birth setting in Norway. a qualitative approach was chosen for data collection. In-depth interviews were conducted with nine midwives working in a home birth setting in different areas in Norway. The transcribed interviews were analysed with the help of systematic text condensation. the analysis generated two main themes: «The midwife's fundamental beliefs» and «Working in line with one's ideology». The midwives had a fundamental belief that childbirth is a normal event that women are able to manage. It is important that this attitude is transferred to the woman in order for her to believe in her own ability to give birth. The midwives in the study were able to work according to their ideology when promoting a normal birth at home. To avoid disturbing the natural birth process was described as an important factor. Also crucial was to approach the work in a patient manner. Staying at home in a safe environment and establishing a close relationship with the midwife also contributed positively to a normal birth. the midwife's attitude is important when trying to promote a normal birth. Patience was seen as essential to avoid interventions. Being in a safe environment with a familiar midwife provides a good foundation for a normal birth. The attitude of the midwives towards normal childbirth ought to be more emphasised, also in the context of maternity wards. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Oxygen toxicity

    Directory of Open Access Journals (Sweden)

    C. A. van der Westhuizen

    1990-07-01

    Full Text Available Oxygen has been discovered about 200 years ago. Since then the vital physiological involvement of oxygen in various biologi­cal processes, mainly energy production, has been established. However, in the body molecular oxygen can be converted to toxic oxygen metabolites such as superoxide anion, hydrogen peroxide, the hydroxyl radical and singlet oxygen. These toxic metabolites are produced mainly in the mitochondria, plasma membranes and endoplasmic reticulum.

  3. Home Safety

    Science.gov (United States)

    ... Storing Medicine New infographic from Safe Kids shows what parents and caregivers need to know about storing medicine safely in ... medicine while the caregiver wasn't looking. Learn what families and caregivers need to do to keep their children safe: ...

  4. ThinkHome Energy Efficiency in Future Smart Homes

    Directory of Open Access Journals (Sweden)

    Reinisch Christian

    2011-01-01

    Full Text Available Abstract Smart homes have been viewed with increasing interest by both home owners and the research community in the past few years. One reason for this development is that the use of modern automation technology in the home or building promises considerable savings of energy, therefore, simultaneously reducing the operational costs of the building over its whole lifecycle. However, the full potential of smart homes still lies fallow, due to the complexity and diversity of the systems, badly engineered and configured installations, as well as the frequent problem of suboptimal control strategies. Summarized, these problems converge to two undesirable conditions in the "not-so-smart" home: energy consumption is still higher than actually necessary and users are unable to yield full comfort in their automated homes. This work puts its focus on alleviating the current problems by proposing a comprehensive system concept, that shall ensure that smart homes can keep their promise in the future. The system operates on an extensive knowledge base that stores all information needed to fulfill the goals of energy efficiency and user comfort. Its intelligence is implemented as and within a multiagent system that also caters for the system's openness to the outside world. As a first evaluation, a profile-based control strategy for thermal comfort is developed and verified by means of simulation.

  5. Home Health Agency Characteristics and Quality Outcomes for Medicare Beneficiaries With Rehabilitation-Sensitive Conditions.

    Science.gov (United States)

    Mroz, Tracy M; Meadow, Ann; Colantuoni, Elizabeth; Leff, Bruce; Wolff, Jennifer L

    2018-06-01

    To examine associations between organizational characteristics of home health agencies (eg, profit status, rehabilitation therapy staffing model, size, and rurality) and quality outcomes in Medicare beneficiaries with rehabilitation-sensitive conditions, conditions for which occupational, physical, and/or speech therapy have the potential to improve functioning, prevent or slow substantial decline in functioning, or increase ability to remain at home safely. Retrospective analysis. Home health agencies. Fee-for-service beneficiaries (N=1,006,562) admitted to 9250 Medicare-certified home health agencies in 2009. Not applicable. Institutional admission during home health care, community discharge, and institutional admission within 30 days of discharge. Nonprofit (vs for-profit) home health agencies were more likely to discharge beneficiaries to the community (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.13-1.33) and less likely to have beneficiaries incur institutional admissions within 30 days of discharge (OR, .93; 95% CI, .88-.97). Agencies in rural (vs urban) counties were less likely to discharge patients to the community (OR, .83; 95% CI, .77-.90) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.24; 95% CI, 1.18-1.30) and within 30 days of discharge (OR, 1.15; 95% CI, 1.10-1.22). Agencies with contract (vs in-house) therapy staff were less likely to discharge beneficiaries to the community (OR, .79, 95% CI, .70-.91) and more likely to have beneficiaries incur institutional admissions during home health (OR, 1.09; 95% CI, 1.03-1.15) and within 30 days of discharge (OR, 1.17; 95% CI, 1.07-1.28). As payers continue to test and implement reimbursement mechanisms that seek to reward value over volume of services, greater attention should be paid to organizational factors that facilitate better coordinated, higher quality home health care for beneficiaries who may benefit from rehabilitation. Copyright © 2017

  6. Mixed oxygen ion/electron-conducting ceramics for oxygen separation

    Energy Technology Data Exchange (ETDEWEB)

    Stevenson, J.W.; Armstrong, T.R.; Armstrong, B.L. [Pacific Northwest National Lab., Richland, WA (United States)

    1996-08-01

    Mixed oxygen ion and electron-conducting ceramics are unique materials that can passively separate high purity oxygen from air. Oxygen ions move through a fully dense ceramic in response to an oxygen concentration gradient, charge-compensated by an electron flux in the opposite direction. Compositions in the system La{sub 1{minus}x}M{sub x}Co{sub 1{minus}y{minus}z}Fe{sub y}N{sub z}O{sub 3{minus}{delta}}, perovskites where M=Sr, Ca, and Ba, and N=Mn, Ni, Cu, Ti, and Al, have been prepared and their electrical, oxygen permeation, oxygen vacancy equilibria, and catalytic properties evaluated. Tubular forms, disks, and asymmetric membrane structures, a thin dense layer on a porous support of the same composition, have been fabricated for testing purposes. In an oxygen partial gradient, the passive oxygen flux through fully dense structures was highly dependent on composition. An increase in oxygen permeation with increased temperature is attributed to both enhanced oxygen vacancy mobility and higher vacancy populations. Highly acceptor-doped compositions resulted in oxygen ion mobilities more than an order of magnitude higher than yttria-stabilized zirconia. The mixed conducting ceramics have been utilized in a membrane reactor configuration to upgrade methane to ethane and ethylene. Conditions were established to balance selectivity and throughput in a catalytic membrane reactor constructed from mixed conducting ceramics.

  7. Unimaginable homes

    DEFF Research Database (Denmark)

    Møller, Kristian; Klausen, Maja

    2018-01-01

    The chapter draw from critical mediatization theory, critical intimacy theory, and cultural gerontology and asks: How do elderly people practice their mediatized homes? Which roles do media play in constituting and disturbing the flows of bodies into the home? Moreover: how do dominant...... in the making of the mediatized home space. We conclude by returning to the research questions and making explicit how researching flows of bodies that in many ways inhabit homes of the in-between contributes to both gerontological and geomediatization research agendas....

  8. Replacement of Hydrochlorofluorocarbon (HCFC) -225 Solvent for Cleaning and Verification Sampling of NASA Propulsion Oxygen Systems Hardware, Ground Support Equipment, and Associated Test Systems

    Science.gov (United States)

    Mitchell, Mark A.; Lowrey, Nikki M.

    2015-01-01

    Since the 1990's, when the Class I Ozone Depleting Substance (ODS) chlorofluorocarbon-113 (CFC-113) was banned, NASA's rocket propulsion test facilities at Marshall Space Flight Center (MSFC) and Stennis Space Center (SSC) have relied upon hydrochlorofluorocarbon-225 (HCFC-225) to safely clean and verify the cleanliness of large scale propulsion oxygen systems. Effective January 1, 2015, the production, import, export, and new use of HCFC-225, a Class II ODS, was prohibited by the Clean Air Act. In 2012 through 2014, leveraging resources from both the NASA Rocket Propulsion Test Program and the Defense Logistics Agency - Aviation Hazardous Minimization and Green Products Branch, test labs at MSFC, SSC, and Johnson Space Center's White Sands Test Facility (WSTF) collaborated to seek out, test, and qualify a replacement for HCFC-225 that is both an effective cleaner and safe for use with oxygen systems. Candidate solvents were selected and a test plan was developed following the guidelines of ASTM G127, Standard Guide for the Selection of Cleaning Agents for Oxygen Systems. Solvents were evaluated for materials compatibility, oxygen compatibility, cleaning effectiveness, and suitability for use in cleanliness verification and field cleaning operations. Two solvents were determined to be acceptable for cleaning oxygen systems and one was chosen for implementation at NASA's rocket propulsion test facilities. The test program and results are summarized. This project also demonstrated the benefits of cross-agency collaboration in a time of limited resources.

  9. Safe Cooperating Cyber-Physical Systems using Wireless Communication

    DEFF Research Database (Denmark)

    Pop, Paul; Scholle, Detlef; Sljivo, Irfan

    2017-01-01

    This paper presents an overview of the ECSEL project entitled ―Safe Cooperating Cyber-Physical Systems using Wireless Communication‖ (SafeCOP), which runs during the period 2016–2019. SafeCOP targets safety-related Cooperating Cyber-Physical Systems (CO-CPS) characterised by use of wireless...... detection of abnormal behaviour, triggering if needed a safe degraded mode. SafeCOP will also develop methods and tools, which will be used to produce safety assurance evidence needed to certify cooperative functions. SafeCOP will extend current wireless technologies to ensure safe and secure cooperation...

  10. Stroke and Nursing Home care: a national survey of nursing homes.

    LENUS (Irish Health Repository)

    Cowman, Seamus

    2010-01-01

    BACKGROUND: Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. METHODS: A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30) efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. RESULTS: Across all nursing homes (n = 60), 18% (n = 570) of the residents had previously had a stroke. In homes (n = 30), where interviews with residents with stroke (n = 257), only 7% (n = 18) residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239) residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. CONCLUSIONS: This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care) for stroke survivors who reside in nursing homes in Ireland.

  11. Air-To-Water Heat Pumps with Radiant Delivery in Low Load Homes: Tucson, Arizona and Chico, California (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2013-11-01

    Space conditioning represents nearly 50% of average residential household energy consumption, highlighting the need to identify alternative cost-effective, energy-efficient cooling and heating strategies. As homes are better built, there is an increasing need for strategies that are particularly well suited for high performance, low load homes. ARBI researchers worked with two test homes in hot-dry climates to evaluate the in-situ performance of air-to-water heat pump (AWHP) systems, an energy efficient space conditioning solution designed to cost-effectively provide comfort in homes with efficient, safe, and durable operation. Two monitoring projects of test houses in hot-dry climates were initiated in 2010 to test this system. Both systems were fully instrumented and have been monitored over one year to capture complete performance data over the cooling and heating seasons. Results are used to quantify energy savings, cost-effectiveness, and system performance using different operating modes and strategies. A calibrated TRNSYS model was developed and used to evaluate performance in various climate regions. This strategy is most effective in tight, insulated homes with high levels of thermal mass (i.e. exposed slab floors).

  12. The challenge of home discharge with a total artificial heart: the La Pitie Salpetriere experience.

    Science.gov (United States)

    Demondion, Pierre; Fournel, Ludovic; Niculescu, Michaela; Pavie, Alain; Leprince, Pascal

    2013-11-01

    The total artificial heart (TAH) helps to counteract the current decrease in heart donors and is likely to bridge patients to transplant under favourable conditions. Today's mobile consoles facilitate home discharge. The aim of this study was to report on the La Pitie Hospital experience with CardioWest TAH recipients, and more particularly, on generally successful outpatient' management. A retrospective analysis was performed on clinical and biological data from patients implanted with a TAH between December 2006 and July 2010 in a single institution. Morbi-mortality during hospital stay, number and causes of rehospitalizations, quality of life during home discharge, bridge to transplant results and survival have all been analysed. Twenty-seven patients were implanted with the CardioWest. Fifteen patients (55.5%) died during support. Prior to home discharge, the most frequent cause of death was multi-organ failure (46.6%). Twelve patients were discharged home from hospital within a median of 88 days [range 35-152, interquartile range 57] postimplantation. Mean rehospitalization rate was 1.2 by patient, on account of device infection (n = 7), technical problems with the console (n = 3) and other causes (n = 4). Between discharge and transplant, patients spent 87% of their support time out of hospital. All patients who returned home with the TAH were subsequently transplanted, and 1 died in post-transplant. Despite the morbidity and mortality occurring during the postimplantation period, home discharge with a TAH is possible. Portables drivers allow for a safe return home. Aside from some remaining weak points such as infectious complications or noise, CardioWest TAH allows for successful rehabilitation of graft candidates, and assures highly satisfactory transplant results.

  13. Systematic spatial and stoichiometric screening towards understanding the surface of ultrasmall oxygenated silicon nanocrystal

    Energy Technology Data Exchange (ETDEWEB)

    Niaz, Shanawer, E-mail: shanawersi@gmail.com [Department of Physics, Bilkent University, Ankara 06800 (Turkey); Molecular Engineering Laboratory, at the Department of Physics, University of Patras, Patras, GR-26500 (Greece); Zdetsis, Aristides D.; Koukaras, Emmanuel N. [Molecular Engineering Laboratory, at the Department of Physics, University of Patras, Patras, GR-26500 (Greece); Gülseren, Oǧuz [Department of Physics, Bilkent University, Ankara 06800 (Turkey); Sadiq, Imran [Centre of Excellence in Solid State Physics, University of the Punjab, Lahore (Pakistan)

    2016-11-30

    Highlights: • Understanding surface science of oxygenated silicon nanocrystals by means of their composition, stoichiometry and spatial distribution. • Drastic change observed in binding energy, localization of frontier orbitals and HOMO-LUMO gap up to 1.48 eV. • Might be a safe alternative of size dependent bandgap tunability. - Abstract: In most of the realistic ab initio and model calculations which have appeared on the emission of light from silicon nanocrystals, the role of surface oxygen has been usually ignored, underestimated or completely ruled out. We investigate theoretically, by density functional theory (DFT/B3LYP) possible modes of oxygen bonding in hydrogen terminated silicon quantum dots using as a representative case of the Si{sub 29} nanocrystal. We have considered Bridge-bonded oxygen (BBO), Doubly-bonded oxygen (DBO), hydroxyl (OH) and Mix of these oxidizing agents. Due to stoichiometry, all comparisons performed are unbiased with respect to composition whereas spatial distribution of oxygen species pointed out drastic change in electronic and cohesive characteristics of nanocrytals. From an overall perspective of this study, it is shown that bridge bonded oxygenated Si nanocrystals accompanied by Mix have higher binding energies and large electronic gap compared to nanocrystals with doubly bonded oxygen atoms. In addition, it is observed that the presence of OH along with BBO, DBO and mixed configurations further lowers electronic gaps and binding energies but trends in same fashion. It is also demonstrated that within same composition, oxidizing constituent, along with their spatial distribution substantially alters binding energy, highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO) gap (up to 1.48 eV) and localization of frontier orbitals.

  14. Systematic spatial and stoichiometric screening towards understanding the surface of ultrasmall oxygenated silicon nanocrystal

    International Nuclear Information System (INIS)

    Niaz, Shanawer; Zdetsis, Aristides D.; Koukaras, Emmanuel N.; Gülseren, Oǧuz; Sadiq, Imran

    2016-01-01

    Highlights: • Understanding surface science of oxygenated silicon nanocrystals by means of their composition, stoichiometry and spatial distribution. • Drastic change observed in binding energy, localization of frontier orbitals and HOMO-LUMO gap up to 1.48 eV. • Might be a safe alternative of size dependent bandgap tunability. - Abstract: In most of the realistic ab initio and model calculations which have appeared on the emission of light from silicon nanocrystals, the role of surface oxygen has been usually ignored, underestimated or completely ruled out. We investigate theoretically, by density functional theory (DFT/B3LYP) possible modes of oxygen bonding in hydrogen terminated silicon quantum dots using as a representative case of the Si 29 nanocrystal. We have considered Bridge-bonded oxygen (BBO), Doubly-bonded oxygen (DBO), hydroxyl (OH) and Mix of these oxidizing agents. Due to stoichiometry, all comparisons performed are unbiased with respect to composition whereas spatial distribution of oxygen species pointed out drastic change in electronic and cohesive characteristics of nanocrytals. From an overall perspective of this study, it is shown that bridge bonded oxygenated Si nanocrystals accompanied by Mix have higher binding energies and large electronic gap compared to nanocrystals with doubly bonded oxygen atoms. In addition, it is observed that the presence of OH along with BBO, DBO and mixed configurations further lowers electronic gaps and binding energies but trends in same fashion. It is also demonstrated that within same composition, oxidizing constituent, along with their spatial distribution substantially alters binding energy, highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO) gap (up to 1.48 eV) and localization of frontier orbitals.

  15. Home Automation : Smart home technology and template house design

    OpenAIRE

    Zheng, Zeya

    2013-01-01

    In this thesis, home automation’s general knowledge, technology information and each component will be introduced to the reader in the first half of the whole thesis. In the second half, thesis includes the Home Automation template design and market competitiveness analysis. The author assumes that the reader is going to spend lots of money to have a smart home. In this situation, the author introduces the home automation to the reader at each component. So the reader in this thesis actu...

  16. Predictors of Home Care Expenditures and Death at Home for Cancer Patients in an Integrated Comprehensive Palliative Home Care Pilot Program

    Science.gov (United States)

    Howell, Doris M.; Abernathy, Tom; Cockerill, Rhonda; Brazil, Kevin; Wagner, Frank; Librach, Larry

    2011-01-01

    Purpose: Empirical understanding of predictors for home care service use and death at home is important for healthcare planning. Few studies have examined these predictors in the context of the publicly funded Canadian home care system. This study examined predictors for home care use and home death in the context of a “gold standard” comprehensive palliative home care program pilot in Ontario where patients had equal access to home care services. Methods: Secondary clinical and administrative data sources were linked using a unique identifier to examine multivariate factors (predisposing, enabling, need) on total home care expenditures and home death for a cohort of cancer patients enrolled in the HPCNet pilot. Results: Subjects with gastrointestinal symptoms (OR: 1.64; p=0.03) and those with higher income had increased odds of dying at home (OR: 1.14; phome care expenditures. Conclusions: Predictors of home death found in earlier studies appeared less important in this comprehensive palliative home care pilot. An income effect for home death observed in this study requires examination in future controlled studies. Relevance: Access to palliative home care that is adequately resourced and organized to address the multiple domains of issues that patients/families experience at the end of life has the potential to enable home death and shift care appropriately from limited acute care resources. PMID:22294993

  17. InaSAFE applications in disaster preparedness

    Science.gov (United States)

    Pranantyo, Ignatius Ryan; Fadmastuti, Mahardika; Chandra, Fredy

    2015-04-01

    Disaster preparedness activities aim to reduce the impact of disasters by being better prepared to respond when a disaster occurs. In order to better anticipate requirements during a disaster, contingency planning activities can be undertaken prior to a disaster based on a realistic disaster scenario. InaSAFE is a tool that can inform this process. InaSAFE is a free and open source software that estimates the impact to people and infrastructure from potential hazard scenarios. By using InaSAFE, disaster managers can develop scenarios of disaster impacts (people and infrastructures affected) to inform their contingency plan and emergency response operation plan. While InaSAFE provides the software framework exposure data and hazard data are needed as inputs to run this software. Then InaSAFE can be used to forecast the impact of the hazard scenario to the exposure data. InaSAFE outputs include estimates of the number of people, buildings and roads are affected, list of minimum needs (rice and clean water), and response checklist. InaSAFE is developed by Indonesia's National Disaster Management Agency (BNPB) and the Australian Government, through the Australia-Indonesia Facility for Disaster Reduction (AIFDR), in partnership with the World Bank - Global Facility for Disaster Reduction and Recovery (GFDRR). This software has been used in many parts of Indonesia, including Padang, Maumere, Jakarta, and Slamet Mountain for emergency response and contingency planning.

  18. National Survey of Emergency Physicians Concerning Home-Based Care Options as Alternatives to Emergency Department-Based Hospital Admissions.

    Science.gov (United States)

    Stuck, Amy R; Crowley, Christopher; Killeen, James; Castillo, Edward M

    2017-11-01

    Emergency departments (EDs) in the United States play a prominent role in hospital admissions, especially for the growing population of older adults. Home-based care, rather than hospital admission from the ED, provides an important alternative, especially for older adults who have a greater risk of adverse events, such as hospital-acquired infections, falls, and delirium. The objective of the survey was to understand emergency physicians' (EPs) perspectives on home-based care alternatives to hospitalization from the ED. Specific goals included determining how often EPs ordered home-based care, what they perceive as the barriers and motivators for more extensive ordering of home-based care, and the specific conditions and response times most appropriate for such care. A group of 1200 EPs nationwide were e-mailed a six-question survey. Participant response was 57%. Of these, 55% reported ordering home-based care from the ED within the past year as an alternative to hospital admission or observation, with most doing so less than once per month. The most common barrier was an "unsafe or unstable home environment" (73%). Home-based care as a "better setting to care for low-acuity chronic or acute disease exacerbation" was the top motivator (79%). Medical conditions EPs most commonly considered for home-based care were cellulitis, urinary tract infection, diabetes, and community-acquired pneumonia. Results suggest that EPs recognize there is a benefit to providing home-based care as an alternative to hospitalization, provided they felt the home was safe and a process was in place for dispositioning the patient to this setting. Better understanding of when and why EPs use home-based care pathways from the ED may provide suggestions for ways to promote wider adoption. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  19. Eldercare at Home: Choosing a Nursing Home

    Science.gov (United States)

    ... required, these services can be provided by a separate home health agency as directed by a doctor or ... complaints made by or on behalf of nursing home residents and work to resolve the problems. If they are unable ...

  20. Smart Home Hacking

    OpenAIRE

    Kodra, Suela

    2016-01-01

    Smart Home is an intelligent home equipped with devices and communications systems that enables the residents to connect and control their home appliances and systems. This technology has changed the way a consumer interacts with his home, enabling more control and convenience. Another advantage of this technology is the positive impact it has on savings on energy and other resources. However, despite the consumer's excitement about smart home, security and privacy have shown to be the strong...

  1. Safe Minimum Internal Temperature Chart

    Science.gov (United States)

    ... Internal Temperature Chart Safe steps in food handling, cooking, and storage are essential in preventing foodborne illness. You can't see, smell, or taste harmful bacteria that may cause illness. In every step of food preparation, follow the four guidelines to keep food safe: ...

  2. Closed Loop Control of Oxygen Delivery and Oxygen Generation

    Science.gov (United States)

    2017-08-01

    were used for this study and were connected via a USB cable to allow communication. The ventilator was modified to allow closed loop control of oxygen...connected via a USB cable to allow communication. The ventilator was modified to allow closed loop control of oxygen based on the oxygen saturation...2017-4119, 28 Aug 2017. oximetry (SpO2) and intermittent arterial blood sampling for arterial oxygen tension (partial pressure of oxygen [PaO2]) and

  3. Supporting frail seniors through a family physician and Home Health integrated care model in Fraser Health

    Directory of Open Access Journals (Sweden)

    Grace Haeson Park

    2014-03-01

    Full Text Available Background: A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice: An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results: The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased. Conclusion: Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients.

  4. Enhanced safety margins during wet transport of irradiated fuel by catalytic recombination of radiolysis hydrogen and oxygen

    International Nuclear Information System (INIS)

    Spencer, J.T.; Bankhead, M.; Hodge, N.A.

    2004-01-01

    BNFL has developed and tested a new method for use in wet transport of irradiated fuel. The method uses a catalyst to recombine the hydrogen and oxygen produced from radiolysis. The catalyst is installed in the nitrogen ullage gas region. It has twin benefits as it eliminates a gas mixture that could, in principle, exceed the safe target levels set to ensure safety during Transport, and it also reduces overall gas pressure. Pure water radiolysis predictions, from experiment and theory, indicate very low levels of hydrogen and oxygen generation. BNFL's historic experience is that in some transport packages it is possible to produce higher levels of hydrogen and oxygen. This drives the need to improve on our existing ullage gas remediation technology. Our studies of the radiolysis science and our flask data suggest it is the interaction of the liquors and material surfaces that is giving rise to the enhanced levels of hydrogen and/or oxygen. This technical paper demonstrates the performance of the recombiner catalyst under normal and extreme conditions of transport. The paper will present experimental data that shows the recombiner catalyst working to manage the hydrogen and oxygen levels

  5. High-Energy-Density Metal-Oxygen Batteries: Lithium-Oxygen Batteries vs Sodium-Oxygen Batteries.

    Science.gov (United States)

    Song, Kyeongse; Agyeman, Daniel Adjei; Park, Mihui; Yang, Junghoon; Kang, Yong-Mook

    2017-12-01

    The development of next-generation energy-storage devices with high power, high energy density, and safety is critical for the success of large-scale energy-storage systems (ESSs), such as electric vehicles. Rechargeable sodium-oxygen (Na-O 2 ) batteries offer a new and promising opportunity for low-cost, high-energy-density, and relatively efficient electrochemical systems. Although the specific energy density of the Na-O 2 battery is lower than that of the lithium-oxygen (Li-O 2 ) battery, the abundance and low cost of sodium resources offer major advantages for its practical application in the near future. However, little has so far been reported regarding the cell chemistry, to explain the rate-limiting parameters and the corresponding low round-trip efficiency and cycle degradation. Consequently, an elucidation of the reaction mechanism is needed for both lithium-oxygen and sodium-oxygen cells. An in-depth understanding of the differences and similarities between Li-O 2 and Na-O 2 battery systems, in terms of thermodynamics and a structural viewpoint, will be meaningful to promote the development of advanced metal-oxygen batteries. State-of-the-art battery design principles for high-energy-density lithium-oxygen and sodium-oxygen batteries are thus reviewed in depth here. Major drawbacks, reaction mechanisms, and recent strategies to improve performance are also summarized. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Oxygen Therapy

    Directory of Open Access Journals (Sweden)

    Bonnie Solmes

    2000-01-01

    Full Text Available LTOT is prescribed for people with chronic lung disease in whom there is a decrease in the ability of the lungs to supply enough oxygen to the body. The heart is obliged to pump faster to meet the body's oxygen requirements. This may place undue stress on the heart, resulting in palpitations, dizziness and fatigue. A low oxygen level in arterial blood is also harmful to the heart, the brain and the pulmonary blood vessels. Oxygen therapy is used to break this cycle. A person with low blood oxygen will often be able to accomplish more with less fatigue with the help of supplemental oxygen therapy. Shortness of breath is a mechanical problem resulting from the effects of chronic obstructive pulmonary disease. Oxygen therapy may or may not reduce shortness of breath, but it will help the lungs and heart to function with less stress.

  7. Stroke and Nursing Home care: a national survey of nursing homes

    Directory of Open Access Journals (Sweden)

    McGee Hannah

    2010-01-01

    Full Text Available Abstract Background Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. Methods A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30 efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. Results Across all nursing homes (n = 60, 18% (n = 570 of the residents had previously had a stroke. In homes (n = 30, where interviews with residents with stroke (n = 257, only 7% (n = 18 residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239 residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. Conclusions This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care for stroke survivors who reside in nursing homes in Ireland.

  8. Probabilistic assessment of the potential indoor air impacts of vent-free gas heating appliances in energy-efficient homes in the United States.

    Science.gov (United States)

    Whitmyre, Gary K; Pandian, Muhilan D

    2018-06-01

    Use of vent-free gas heating appliances for supplemental heating in U.S. homes is increasing. However, there is currently a lack of information on the potential impact of these appliances on indoor air quality for homes constructed according to energy-efficient and green building standards. A probabilistic analysis was conducted to estimate the impact of vent-free gas heating appliances on indoor air concentrations of carbon monoxide (CO), nitrogen dioxide (NO 2 ), carbon dioxide (CO 2 ), water vapor, and oxygen in "tight" energy-efficient homes in the United States. A total of 20,000 simulations were conducted for each Department of Energy (DOE) heating region to capture a wide range of home sizes, appliance features, and conditions, by varying a number of parameters, e.g., room volume, house volume, outdoor humidity, air exchange rates, appliance input rates (Btu/hr), and house heat loss factors. Predicted airborne levels of CO were below the U.S. Environmental Protection Agency (EPA) standard of 9 ppm for all modeled cases. The airborne concentrations of NO 2 were below the U.S. Consumer Product Safety Commission (CPSC) guideline of 0.3 ppm and the Health Canada benchmark of 0.25 ppm in all cases and were below the World Health Organization (WHO) standard of 0.11 ppm in 99-100% of all cases. Predicted levels of CO 2 were below the Health Canada standard of 3500 ppm for all simulated cases. Oxygen levels in the room of vent-free heating appliance use were not significantly reduced. The great majority of cases in all DOE regions were associated with relative humidity (RH) levels from all indoor water vapor sources that were less than the EPA-recommended 70% RH maximum to avoid active mold and mildew growth. The conclusion of this investigation is that when installed in accordance with the manufacturer's instructions, vent-free gas heating appliances maintain acceptable indoor air quality in tight energy-efficient homes, as defined by the standards referenced in

  9. Safe affordable fission engine (SAFE 30) module conductivity test thermal model correlation

    International Nuclear Information System (INIS)

    Roman, Jose

    2001-01-01

    The SAFE 30 is a simple, robust space fission power system that is comprised of several independent modules. Each module contains 4 fuel tubes bonded to a central heatpipe. Fission energy is conducted from the fuel tubes to the heatpipe, which in turn transfers the energy to a power conversion system. This paper benchmarks a thermal model of the SAFE 30 with actual test data from simulated SAFE 30 module tests. Two 'dummy' SAFE 30 modules were fabricated - each consisted of 4 1-inch dia. tubes (simulating the fuel tubes) bonded to a central '1' dia. tube (simulating the heatpipe). In the first module the fuel tubes were simply brazed to the heatpipe along the line of contact (leaving void space in the interstices), and in the second module the tubes and heatpipe were brazed via tri-cusps that completely fill the interstices between the tubes. In these tests, fission energy is simulated by placing resistance heaters within each of the 4 fuel tubes. The tests were conducted in a vacuum chamber in 4 configurations: tri-cusps filled with and without an outer insulation wrap, and no tri-cusps with and without an outer insulation wrap. The baseline SAFE 30 configuration uses the brazed tri-cusps. During the tests, the power applied to the heaters was varied in a stepwise fashion, until a steady-state temperature profile was reached. These temperature levels varied between 773 K and 1073 K. To benchmark the thermal model, the input energy and chamber surface temperature were used as boundary conditions for the model. The analytical results from the nodes at the same location as the test thermocouples were plotted again test data to determinate the accuracy of the analysis. The unknown variables on the analysis are the radiation emissivity of the pipe and chamber and the radiation view factor between the module and the chamber. A correlation was determined using a parametric analysis by varying the surface emissivity and view factor until a good match was reached. This

  10. Medicare home health utilization as a function of nursing home market factors.

    OpenAIRE

    Swan, J H; Benjamin, A E

    1990-01-01

    Rapid increases in the size and costs of the home health market, unknown impacts of Medicare's DRG hospital reimbursement on the posthospital market, and general lack of knowledge about factors that explain interstate variation in home health utilization all suggest the importance of developing and testing models of Medicare home health use. This article proposes and tests a model of state home health utilization as a function of the nursing home market. This model proposes that home health u...

  11. A study on characterization and evaluation methodologies of radioactive waste forms for safe disposal

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Y. C.; Lee, G. S.; Kim, G. J.; Nam, H.; Seok, J. H. [Yonsei Univ., Seoul (Korea, Republic of)

    2004-02-15

    The contents and scope of the study are summarized as follows : elicitation of significant items for characteristic assessment about stability analysis of radioactive waste forms for safe disposal, compressive strength, free water, leaching rate, and weatherability. Suggestion of assessment methods through the characteristic test of waste forms, comparison of assessment methods and suggestion of suitable testing methods about the above stated 4 items. Assessment modeling development for long-term stability of radioactive waste forms, weatherometric test of waste forms, expectation modeling development through VOM(Valance-Oxygen Model). Suggestion of determination standard together assessment testing methods and description about the standard. Explanation to be suitable guideline and regulation of waste handling and acceptance.

  12. Steering teens safe: a randomized trial of a parent-based intervention to improve safe teen driving.

    Science.gov (United States)

    Peek-Asa, Corinne; Cavanaugh, Joseph E; Yang, Jingzhen; Chande, Vidya; Young, Tracy; Ramirez, Marizen

    2014-07-31

    Crashes are the leading cause of death for teens, and parent-based interventions are a promising approach. We assess the effectiveness of Steering Teens Safe, a parent-focused program to increase safe teen driving. Steering Teens Safe aimed to improve parental communication with teens about safe driving using motivational interviewing techniques in conjunction with 19 safe driving lessons. A randomized controlled trial involved 145 parent-teen dyads (70 intervention and 75 control). Intervention parents received a 45-minute session to learn the program with four follow-up phone sessions, a DVD, and a workbook. Control parents received a standard brochure about safe driving. Scores were developed to measure teen-reported quantity and quality of parental communication about safe driving. The main outcome measure was a previously validated Risky Driving Score reported by teens. Because the Score was highly skewed, a generalized linear model based on a gamma distribution was used for analysis. Intervention teens ranked their parent's success in talking about driving safety higher than control teens (p = 0.035) and reported that their parents talked about more topics (non-significant difference). The Risky Driving Score was 21% lower in intervention compared to control teens (85% CI = 0.60, 1.00). Interaction between communication quantity and the intervention was examined. Intervention teens who reported more successful communication had a 42% lower Risky Driving Score (95% CI = 0.37, 0.94) than control parents with less successful communication. This program had a positive although not strong effect, and it may hold the most promise in partnership with other programs, such as Driver's Education or Graduated Driver's License policies. ClinicalTrials.gov NCT01014923. Registered Nov. 16, 2009.

  13. Staying Safe in the Water

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Julie Gilchrist, a pediatrician and medical epidemiologist from CDC’s Injury Center, talks about staying safe in the water. Tips are for all audiences, with a focus on preventing drownings and keeping children safe in and around the pool, lake, or ocean.

  14. Oxygen therapy - infants

    Science.gov (United States)

    ... breathe increased amounts of oxygen to get normal levels of oxygen in their blood. Oxygen therapy provides babies with the extra oxygen. Information Oxygen is a gas that the cells in your body need to work properly. The ...

  15. Safe biodegradable fluorescent particles

    Science.gov (United States)

    Martin, Sue I [Berkeley, CA; Fergenson, David P [Alamo, CA; Srivastava, Abneesh [Santa Clara, CA; Bogan, Michael J [Dublin, CA; Riot, Vincent J [Oakland, CA; Frank, Matthias [Oakland, CA

    2010-08-24

    A human-safe fluorescence particle that can be used for fluorescence detection instruments or act as a safe simulant for mimicking the fluorescence properties of microorganisms. The particle comprises a non-biological carrier and natural fluorophores encapsulated in the non-biological carrier. By doping biodegradable-polymer drug delivery microspheres with natural or synthetic fluorophores, the desired fluorescence can be attained or biological organisms can be simulated without the associated risks and logistical difficulties of live microorganisms.

  16. Sleep of Parents Living With a Child Receiving Hospital-Based Home Care: A Phenomenographical Study.

    Science.gov (United States)

    Angelhoff, Charlotte; Edéll-Gustafsson, Ulla; Mörelius, Evalotte

    2015-01-01

    Caring for an ill child at home gives the family the chance to be together in a familiar environment. However, this involves several nocturnal sleep disturbances, such as frequent awakenings and bad sleep quality, which may affect parents' ability to take care of the child and themselves. The aim of this study was to describe parents' perceptions of circumstances influencing their own sleep when living with a child enrolled in hospital-based home care (HBHC) services. This is a phenomenographical study with an inductive, exploratory design. Fifteen parents (11 mothers and 4 fathers) with children enrolled in HBHC services were interviewed. Data were analyzed to discover content-related categories describing differences in ways parents experienced sleep when caring for their children receiving HBHC. Four descriptive categories were detected: sleep influences mood and mood influences sleep; support influences safeness and safeness influences sleep; the child's needs influence routines and routines influence sleep; and "me time" influences sleep. Sleep does not affect only the parents' well-being but also the child's care. Symptoms of stress may limit the parents' capacity to meet the child's needs. Support, me time, and physical activity were perceived as essential sources for recovery and sleep. It is important for nurses to acknowledge parental sleep in the child's nursing care plan and help the parents perform self-care to promote sleep and maintain life, health, and well-being.

  17. Safe Haven.

    Science.gov (United States)

    Bush, Gail

    2003-01-01

    Discusses school libraries as safe havens for teenagers and considers elements that foster that atmosphere, including the physical environment, lack of judgments, familiarity, leisure, and a welcoming nature. Focuses on the importance of relationships, and taking the time to listen to teens and encourage them. (LRW)

  18. The Sweet-Home speech and multimodal corpus for home automation interaction

    OpenAIRE

    Vacher , Michel; Lecouteux , Benjamin; Chahuara , Pedro; Portet , François; Meillon , Brigitte; Bonnefond , Nicolas

    2014-01-01

    International audience; Ambient Assisted Living aims at enhancing the quality of life of older and disabled people at home thanks to Smart Homes and Home Automation. However, many studies do not include tests in real settings, because data collection in this domain is very expensive and challenging and because of the few available data sets. The SWEET-H OME multimodal corpus is a dataset recorded in realistic conditions in D OMUS, a fully equipped Smart Home with microphones and home automati...

  19. Effects of spinal immobilization at a 20° angle on cerebral oxygen saturations measured by INVOS™.

    Science.gov (United States)

    Aksel, Gökhan

    2018-01-01

    In this study, we aimed to investigate whether performing the immobilization at 20° instead of 0° changes cerebral oxygenation. 33 volunteers were put in a hard cervical collar and backboard at 0° and immobilized for 30min. The cerebral oxygen saturations of the volunteers were measured at 1, 5, and 30min after the start of the procedure (Group 1). The volunteers were asked to return the day after the Group 1 procedure but at the same time. Serial cerebral oxygen saturations were obtained at the same time intervals as in Group 1, but for Group 2, the backboard was set to 20°. When the cerebral oxygen saturations of the two groups were compared, there was a slight decrease when the backboard position was changed from 0° to 20°, but it was not statistically significant (P=0.220 and P=0.768, respectively). The results revealed that immobilizing the patients with a spinal backboard at 20° instead of 0° did not alter the cerebral oxygen saturations. Our study results revealed that spinal immobilization at 20°, which was a new suggestion for spinal immobilization following a report that this position reduced the decrease in pulmonary function secondary to spinal immobilization, did not alter the cerebral oxygenation, so this suggestion is safe at least from the standpoint of cerebral oxygenation. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Outcome of planned home and hospital births among low-risk women in Iceland in 2005-2009: a retrospective cohort study.

    Science.gov (United States)

    Halfdansdottir, Berglind; Smarason, Alexander Kr; Olafsdottir, Olof A; Hildingsson, Ingegerd; Sveinsdottir, Herdis

    2015-03-01

    At 2.2 percent in 2012, the home birth rate in Iceland is the highest in the Nordic countries and has been rising rapidly in the new millennium. The objective of this study was to compare the outcomes of planned home births and planned hospital births in comparable low-risk groups in Iceland. The study is a retrospective cohort study comparing the total population of 307 planned home births in Iceland in 2005-2009 to a matched 1:3 sample of 921 planned hospital births. Regression analysis, adjusted for confounding variables, was performed for the primary outcome variables. The rate of oxytocin augmentation, epidural analgesia, and postpartum hemorrhage was significantly lower when labor started as a planned home birth. Differences in the rates of other primary outcome variables were not significant. The home birth group had lower rates of operative birth and obstetric anal sphincter injury. The rate of 5-minute Apgar score home and hospital birth groups, but the home birth group had a higher rate of neonatal intensive care unit admission. Intervention and adverse outcome rates in both study groups, including transfer rates, were higher among primiparas than multiparas. Oxytocin augmentation, epidural analgesia, and postpartum hemorrhage rates were significantly interrelated. This study adds to the growing body of evidence that suggests that planned home birth for low-risk women is as safe as planned hospital birth. © 2015 Wiley Periodicals, Inc.

  1. Smoke-Free Homes and Home Exposure to Secondhand Smoke in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Pinpin Zheng

    2014-11-01

    Full Text Available Few studies have examined home exposure to secondhand smoke (SHS in China. This study aimed to document: (1 the prevalence and correlates of exposure to SHS in homes (in adult non-smokers in Shanghai, and (2 enforcement of rules, harm reduction behaviors, and self-efficacy for maintaining smoke-free homes in Shanghai. A total of 500 participants were recruited using a multistage proportional random sampling design in an urban and suburban district to complete a survey. Among the total 355 nonsmokers, 127 (35.8% participants reported being exposed to SHS in the past 7 days. Participants living with smokers in the home, with no smoking restriction at home, and having children younger than 18 were more likely to be exposed to SHS at home. Higher self-efficacy in maintaining a smoke-free home was negatively associated with home SHS exposure. Having visitors who smoke was the greatest policy enforcement challenge. Ineffective measures such as opening windows were more commonly used in homes with partial bans. Educational initiatives to protect against SHS exposure in the home should promote smoke-free homes, address challenges to implementing such policies, and address misconceptions regarding the effectiveness of supposed harm reduction behaviors.

  2. Would environmental pollution affect home prices? An empirical study based on China's key cities.

    Science.gov (United States)

    Hao, Yu; Zheng, Shaoqing

    2017-11-01

    With the development of China's economy, the problem of environmental pollution has become increasingly more serious, affecting the sustained and healthy development of Chinese cities and the willingness of residents to invest in fixed assets. In this paper, a panel data set of 70 of China's key cities from 2003 to 2014 is used to study the effect of environmental pollution on home prices in China's key cities. In addition to the static panel data regression model, this paper uses the generalized method of moments (GMM) to control for the potential endogeneity and introduce the dynamics. To ensure the robustness of the research results, this paper uses four typical pollutants: per capita volume of SO 2 emissions, industrial soot (dust) emissions, industrial wastewater discharge, and industrial chemical oxygen demand discharge. The analysis shows that environmental pollution does have a negative impact on home prices, and the magnitude of this effect is dependent on the level of economic development. When GDP per capita increases, the size of the negative impact on home prices tends to reduce. Industrial soot (dust) has the greatest impact, and the impact of industrial wastewater is relatively small. It is also found that some other social and economic factors, including greening, public transport, citizen income, fiscal situation, loans, FDI, and population density, have positive effects on home prices, but the effect of employment on home prices is relatively weak.

  3. Evaluation of home collection performed by a human milk bank in a university hospital in Brazil.

    Directory of Open Access Journals (Sweden)

    Glória Menezes

    2014-05-01

    Full Text Available Objective. Evaluation of procedures during household milking and transport of human milk associated with their quality control. Materials and methods. 48 donors registered in the Human Milk Bank of the Clinics Hospital of the Federal University at Uberlândia. Observations were made during home visits. A checklist was elaborated according to the technical standards for human milk banks, been associated with  physical-chemical, and microbiological controls. The chi-square test, logistic regression and Spearman test (p menor que 0.05 were used for data analysis. Results. The results suggest that most donors assimilated the guidelines of the milk bank staff and procedures were satisfactorily performed. Conclusion. It could be demonstrated that milking and home collection are safe and effective ways for obtaining donated human milk.

  4. DOE Zero Energy Ready Home Case Study: Sterling Brook Custom Homes — Village Park Eco Home, Double Park, TX

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    This builder won a Custom Builder honor in the 2014 Housing Innovation Awards for this showcase home that serves as an energy-efficient model home for the custom home builder: 1,300 visitors toured the home, thousands more learned about the home’s advanced construction via the webpage, YouTube, Twitter, Facebook, Instagram, and Pinterest.

  5. HOME Grantee Areas

    Data.gov (United States)

    Department of Housing and Urban Development — The HOME Investment Partnership Program (HOME) is authorized under Title II of the Cranston-Gonzalez National Affordable Housing Act. HOME provides formula grants to...

  6. More than a Safe Space

    Science.gov (United States)

    Sadowski, Michael

    2016-01-01

    Over the past three decades, much of the conversation about LGBTQ students in schools has centered on safety--anti-bullying policies, the "safe space" of gay-straight alliances, and "safe zones" marked by rainbow-colored stickers on classroom doors. In this article, Michael Sadowski argues that it's time to move beyond safety…

  7. Prevalence and variability of use of home mechanical ventilators, positive airway pressure and oxygen devices in the Lombardy region, Italy.

    Science.gov (United States)

    Vitacca, Michele; Barbano, Luca; Colombo, Daniele; Leoni, Olivia; Guffanti, Enrico

    2018-01-29

    Few studies have analyzed the prevalence and accessibility of home mechanical ventilation (HMV) in Italy. We aimed to investigate the prevalence and prescription variability of HMV as well as of long-term oxygen therapy (LTOT) and continuous positive airway pressure (CPAP), in the Lombardy Region. Prescribing rates of HMV (both noninvasive and tracheostomies), CPAP (auto-CPAP, CPAP/other sleep machines) and LTOT (liquid-O2, O2-gas, concentrators) in the 15 Local Healthcare districts of Lombardy were gathered from billing data for 2012 and compared. Crude rates (per 100,000 population) and rates for the different healthcare districts were calculated. In 2012, 6325 patients were on HMV (crude prescription rate: 63/100,000) with a high variation across districts (8/100,000 in Milano 1 vs 150/100,000 in Pavia). There were 14,237 patients on CPAP (crude prescription rate: 142/100,000; CPAP/other sleep machines 95.3% vs auto-CPAP 4.7%) with also high intra-regional variation (56/100,000 in Mantova vs. 260/100,000 in Pavia). There were 21,826 patients on LTOT (prescription rate: 217/100,000 rate; liquid-O2 94%, O2-gas 2.08%, O2-concentrators 3.8%), with again high intra-regional variation (100/100,000 in Bergamo vs 410/100,000 in Valle Camonica). The crude rate of HMV prescriptions in Lombardy is very high, with a high intra-regional variability in prescribing HMV, LTOT and CPAP which is partly explainable by the accessibility to specialist centers with HMV/sleep-study facilities. Analysis of administrative data and variability mapping can help identify areas of reduced access for an improved standardization of services. An audit among Health Payer and prescribers to interpret the described huge variability could be welcomed.

  8. Ground Zero(3: Inside the New American Home

    Directory of Open Access Journals (Sweden)

    Louise LACHAPELLE

    2011-09-01

    Full Text Available Cet article poursuit l’étude de la reconstruction sur le site du World Trade Center. Pour produire le lieu de la catastrophe comme site où la construction est possible, il aura fallu exclure rapidement la réalité des restes, débris et autres ruines. Il s’agit maintenant de prendrepour objet la constitution de ces collections liées aux événements du 11 septembre 2001 par différentes institutions muséales (dont les collections impliquant la conservation/conversion muséologique des restes, ainsi qu’un corpus d’expositions par lesquelles s’opère une mise à distance qui lève l’interdiction de voir ou de montrer les ruines et les restes afin de recréer de la frontière, aussi bien que rétablir un espace familier, « the space of [safe] viewing » (d’après Chouliaraki 2004, au centre d’une périphérie nationale et symbolique qu’on voudrait, à nouveau, croire « sécurisée » : the space of safe living, « Inside the New American Home ».Ground Zero : Inside the New American Home continue ainsi à développer cette critique de la culture et du sens rituel de l’art (Walter Benjamin 1940 en montrant que si le secours cherché auprès de l’autorité du musée et son expertise à traiter et à disséminer « la vérité » (Azoulay 2001 suggèrent une troublante collusion des pouvoirs (Klein 2007, c’est moins parce qu’elles conservent la mémoire d’un événement que parce qu’elles entretiennent le souvenir d’un art qui sauve, autrement dit, le souvenir d’une stratégie culturelle fondée sur le sacrifice. Le rôle d’un corpus de collections et d’expositions est donc considéré en relation avec d’autres mécanismes de cohésion et de contrôle post-9/11, par exemple le Homeland Security Department, la Security Fence et la Secure border initiative, afin de mettre en évidence le rôle des musées et d’une « muséologie de guerre » au sein de ces dispositifs culturels de clôture et

  9. Oxygen diffusion and oxygen effect in tumor tissue

    International Nuclear Information System (INIS)

    Eissa, H.M.; Hehn, G.

    1979-06-01

    The diffusion of oxygen in tumor cords of bronchus carcinoma of the lung have been studied with refined computer methods for solving the diffusion equation in axis symmetric tumor structures. In this tumor configuration we may find three different regions consisting of euoxic cells, hypoxic tumor cells and necrotic parts. In the case of oxygen supply from a capillary inside a cylinder of tumor tissue with radius 200 μm or in a tumor cord of radius 300 μm with oxygen supply by capillaries outside, we get a relation of well oxygenated cells to hypoxic cells approximately as 1:8 or as 1:1.1 respectively. Of course most of the tumor cords observed in histological slices have smaller diameters, so that an average of approximately 20% hypoxic cells can be assumed. Based on the work of Ardenne, the diffusion of oxygen and glucose in a tumor of type DS-carcinosarcom has been investigated in both intact tumor and tumor treated with ionizing radiation. We can show that a strong reoxygenation effect takes place in that the well supplied regions may increase in some tumor configurations up to a factor of four by volume. The biological consequences of the oxygen pressure determined in tumor cells are discussed in detail. The investigation of oxygen diffusion in the intercapillary tumor region should give a quantitative physical basis for considering the oxygen effect with the aim to explain the advantages of neutron therapy against conventional radiotherapy. (orig./MG) [de

  10. Health smart home: towards an assistant tool for automatic assessment of the dependence of elders.

    Science.gov (United States)

    Le, Xuan Hoa Binh; Di Mascolo, Maria; Gouin, Alexia; Noury, Norbert

    2007-01-01

    In order to help elders living alone to age in place independently and safely, it can be useful to have an assistant tool that can automatically assess their dependence and issue an alert if there is any loss of autonomy. The dependence can be assessed by the degree of performance, by the elders, of activities of daily living. This article presents an approach enabling the activity recognition for an elder living alone in a Health Smart Home equipped with noninvasive sensors.

  11. Safe injection procedures, injection practices, and needlestick ...

    African Journals Online (AJOL)

    Results: Safe injection procedures regarding final waste disposal were sufficiently adopted, while measures regarding disposable injection equipment, waste containers, hand hygiene, as well as injection practices were inadequately carried out. Lack of job aid posters that promote safe injection and safe disposal of ...

  12. Smart Cities - Smart Homes and Smart Home Technology

    OpenAIRE

    Faanes, Erlend Kydland

    2014-01-01

    This master’s thesis consists of two articles where the first article is theoretical and the second is the empirical study. Article I The purpose with this paper is to explore and illuminate how smart home and smart home technology can contribute to enhance health and Quality of Life in elderly citizens and allow them to live longer in their home. The paper provides a brief introduction to health promotion and highlights the thesis theoretical framework and foundation of Aaron Antonov...

  13. Nursing perception of patient transitions from hospitals to home with home health.

    Science.gov (United States)

    Smith, Shannon Bright; Alexander, Judith W

    2012-01-01

    The study's purpose was to determine nurses' opinions of sending patients from the hospital to home with home health services. The study occurred in the Charleston, South Carolina, Tricounty area (Berkeley, Charleston, and Dorchester counties). Home health agencies and hospitals were invited to participate. The study used a survey design to gather information on nursing perceptions of current practices and needed changes to improve transition of patients. The population was nurses (licensed practical nurses (LPNs) and registered nurses (RNs)) employed at inpatient hospitals or home health agencies in the area. Thirty-four RNs responded with no LPNs respondents. Agency administrators/chief nursing officers agreed for their agencies to participate and distributed the survey using a Research Electronic Data Capture (REDCap) Internet-based survey tool. Using the survey results and information from a literature review, the study developed a list of propositions, which participating administrators reviewed, for improving transitions to home. Both home health and hospital nurses reported a need to improve the process of sending patients from hospital to home with home health services. This study provides hospitals and home health agencies with propositions to facilitate the establishment of a process to communicate effectively patients care needs and streamline the discharging patients from the hospital to home health care; thus, improving patient transition. Case managers and discharge planners will need interagency collaboration along with evidence-based interventions to transition patients from the hospital to home with home health services with various populations. Direct patient care nurses in both hospital and home health settings should share the same accountability as case managers to ensure successful transitions.

  14. Representing in-home and out-of-home energy consumption behavior in Beijing

    International Nuclear Information System (INIS)

    Yu Biying; Zhang Junyi; Fujiwara, Akimasa

    2011-01-01

    It is expected that in-home and out-of-home energy consumption behavior in a household might be correlated with each other, probably due to the existence of household budget constraints. Ownership and usage of energy-saving technologies for in-home appliances (or vehicles) might lead to the increase in out-of-home (or in-home) energy consumption. It is therefore necessary to jointly represent in-home and out-of-home energy consumption in the same modeling framework. With this consideration, we first build a new type of energy consumption model based on the Multiple Discrete-Continuous Extreme Value (MDCEV) modeling framework. Next, we conducted a questionnaire survey in Beijing in 2009 and successfully collected the information about households' energy consumption, ownership/usage of in-home appliances and vehicles, and households' and their members' attributes from 1014 households. Throughout an empirical analysis, it is confirmed that the MDCEV model is effective to simultaneously describe the in-home and out-of-home energy consumption behavior. In addition, it is revealed that a set of household and personal attributes affect the ownership and usage of in-home appliances and vehicles. Furthermore, it is shown that the unobserved factors play a much more important role in explaining energy consumption behavior than the observed attributes of households and their members. - Highlights: → Representing in-home and out-of-home energy consumption behavior jointly. → MDCEV model is built to describe household energy consumption behavior. → Log-linear competitive relationships are found among expenditures of end-uses. → Model results provide some insights about the influence of varied observed factors. → Unobserved factors are more important in explaining energy consumption behavior.

  15. Pilot study for home monitoring of cough capacity in amyotrophic lateral sclerosis: A case series.

    Science.gov (United States)

    Paneroni, M; Trainini, D; Winck, J C; Vitacca, M

    2014-01-01

    Cough capacity derangement is associated with a high risk of pulmonary complications in amyotrophic lateral sclerosis patients when cough assistance is not routinely performed at home. The primary aim of this study was to evaluate the feasibility of a long-term home based daily self-monitoring cough capacity. Eighteen subjects were enrolled in a 9-month study at home. Changes in peak cough expiratory flow, oxygen saturation, respiratory discomfort and incidence of respiratory deterioration events were evaluated. In subjects presenting respiratory deterioration events, decline in the abovementioned respiratory variables was evaluated (#NCT00613899). During an average follow-up of 125±102 days, a total of 1175 measures were performed on 12 subjects. Mean compliance to proposed evaluations was 37±32% which worsened over time. Peak cough expiratory flow decreased by 15.08±32.43L/min monthly. Five subjects reported 6 episodes of respiratory deterioration events, after a mean period of 136±108 days. They had poor respiratory function and more years of disease. There was no difference in peak cough expiratory flow and its decline whether subjects presented respiratory deterioration events or not. In 4 subjects the respiratory discomfort score significantly worsened after respiratory deterioration events from 3.0±1.41 to 4.25±1.71. Daily self-monitoring of peak cough expiratory flow, oxygen saturation and respiratory discomfort seems difficult to obtain because of poor adherence to measures; this protocol does not seem to add anything to current practice of advising on clinical derangements. Confirmatory larger studies are necessary. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  16. Successful Use of Extracorporeal Membrane Oxygenation for the Treatment of Cardiogenic Shock due to Scorpion Envenomation

    Directory of Open Access Journals (Sweden)

    Amine Tarmiz

    2017-01-01

    Full Text Available Introduction. The occurrence of a cardiogenic shock is a rare presentation after scorpion envenomation. The treatment includes classically the use of inotropes and specific vasodilators. Case Presentation. We report a case of an 11-year-old boy presenting with cardiogenic shock and pulmonary edema after a scorpion sting. Despite adequate management at the emergency department and intensive care unit, the patient’s hemodynamic status worsened rapidly, justifying his transfer to our department for ventricular mechanical assistance by venoarterial extracorporeal membrane oxygenation. The following outcomes were favorable and the boy was discharged home on day 29 without aftereffects. Conclusion. This is the first report of successful use of extracorporeal membrane oxygenation for the treatment of cardiogenic shock after scorpion envenomation.

  17. Home Health Compare: Find a Home Health Agency

    Science.gov (United States)

    ... page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with " ... widget - Select to show Back to top Footer Home A federal government website managed and paid for ...

  18. Exercise at Home

    Science.gov (United States)

    ... Home Health Insights Exercise & Weight Exercise at Home Exercise at Home Make an Appointment Ask a Question ... with the movement and contact your provider. Posture Exercises Better posture means better breathing and movement. Axial ...

  19. Is 300 Seconds ACT Safe and Efficient during MiECC Procedures?

    Science.gov (United States)

    Bauer, Adrian; Hausmann, Harald; Schaarschmidt, Jan; Szlapka, Michal; Scharpenberg, Martin; Eberle, Thomas; Hasenkam, J Michael

    2017-12-31

     The recommended minimum activated clotting time (ACT) level for cardiopulmonary bypass (CPB) of 480 seconds originated from investigations with bubble oxygenators and uncoated extracorporeal circulation (ECC) systems. Modern minimal invasive ECC (MiECC) systems are completely closed circuits containing a membrane oxygenator and a tip-to-tip surface coating. We hypothesized that surface coating and the "closed-loop" design allow the MiECC to safely run with lower ACT levels and that an ACT level of 300 seconds can be safely applied without thromboembolic complications. The aim of this study was to investigate the potential risks during application of reduced heparin levels in patients undergoing coronary surgery.  In this study, 68 patients undergoing coronary artery bypass grafting with MiECC were randomized to either the study group with an ACT target of 300 seconds or the control group with an ACT of 450 seconds. All other factors of MiECC remained unchanged.  The study group received significantly less heparin and protamine (heparin [international units] median [min-max], Red_AC: 32,800 [23,000-51,500] vs. Full_AC: 50,000 [35,000-65,000] p  ACT in the study group was significantly lower at the start of MiECC (mean ± standard deviation: study group 400 ± 112 vs. control group 633 ± 177; p  ACT levels were: study group 344 ± 60 versus control group 506 ± 80. In both groups, the values of the endogenous thrombin potential (ETP) decreased simultaneously. None of the study participants experienced thromboembolic complications.  Since no evidence of increased thrombin formation (ETP) was found from a laboratory standpoint, we concluded that the use of MiECC with a reduced anticoagulation strategy seems possible. This alternative anticoagulation strategy leads to significant reduction in dosages of both heparin and protamine. We can confidently move forward with investigating this anticoagulation concept. However, to

  20. Home, Smart Home

    DEFF Research Database (Denmark)

    Hansen, Ellen Kathrine; Olesen, Gitte Gylling Hammershøj; Mullins, Michael

    2013-01-01

    The article places focus on how smart technologies integrated in a one family- home and particular the window offer unique challenges and opportunities for designing buildings with the best possible environments for people and nature. Toward an interdisciplinary approach, we address the interaction...... between daylight defined in technical terms and daylight defined in aesthetic, architectural terms. Through field-tests of a Danish carbon-neutral home and an analysis of five key design parameters, we explore the contradictions and potentials in smart buildings, using the smart window as example of how...... to the energy design is central. The study illuminates an approach of the design of smart houses as living organisms by connecting technology with the needs of the occupants with the power and beauty of daylight....

  1. Bringing Work Home: Take-Home Pesticide Exposure Among Farm Families

    NARCIS (Netherlands)

    Curwin, B.D.

    2006-01-01

    In this thesis take-home pesticide exposure among farm families, with an emphasis on herbicides, was investigated. Take-home exposure occurs when a worker unwittingly brings home a substance on his or her clothing or shoes, thereby potentially exposing his or her family. The pesticides investigated

  2. Managing Cassini Safe Mode Attitude at Saturn

    Science.gov (United States)

    Burk, Thomas A.

    2010-01-01

    The Cassini spacecraft was launched on October 15, 1997 and arrived at Saturn on June 30, 2004. It has performed detailed observations and remote sensing of Saturn, its rings, and its satellites since that time. In the event safe mode interrupts normal orbital operations, Cassini has flight software fault protection algorithms to detect, isolate, and recover to a thermally safe and commandable attitude and then wait for further instructions from the ground. But the Saturn environment is complex, and safety hazards change depending on where Cassini is in its orbital trajectory around Saturn. Selecting an appropriate safe mode attitude that insures safe operation in the Saturn environment, including keeping the star tracker field of view clear of bright bodies, while maintaining a quiescent, commandable attitude, is a significant challenge. This paper discusses the Cassini safe table management strategy and the key criteria that must be considered, especially during low altitude flybys of Titan, in deciding what spacecraft attitude should be used in the event of safe mode.

  3. Hospital in the Home nurses' recognition and response to clinical deterioration.

    Science.gov (United States)

    Gray, Erika; Currey, Judy; Considine, Julie

    2018-05-01

    To obtain an understanding of how Hospital in the Home (HITH) nurses recognise and respond to clinical deterioration in patients receiving care at home or in their usual place of residence. Recognising and responding to clinical deterioration is an international safety priority and a key nursing responsibility. Despite an increase in care delivery in home environments, how HITH nurses recognise and respond to clinical deterioration is not yet fully understood. A prospective, descriptive exploratory design was used. A survey containing questions related to participant characteristics and 10 patient scenarios was used to collect data from 47 nurses employed in the HITH units of three major health services in Melbourne, Australia. The 10 scenarios reflected typical HITH patients and included medical history and clinical assessment findings (respiratory rate, oxygen saturation, heart rate, blood pressure, temperature, conscious state and pain score). The three major findings from this study were that: (i) nurse and patient characteristics influenced HITH nurses' assessment decisions; (ii) the cues used by HITH nurses to recognise clinical deterioration varied according to the clinical context; and (iii) although HITH nurses work in an autonomous role, they engage in collaborative practice when responding to clinical deterioration. Hospital in the Home nurses play a fundamental role in patient assessment, and the context in which they recognise and respond to deterioration is markedly different to that of hospital nurses. The assessment, measurement and interpretation of clinical data are a nursing responsibility that is crucial to early recognition and response to clinical deterioration. The capacity of HITH services to care for increasing numbers of patients in their home environment, and to promptly recognise and respond to clinical deterioration should it occur, is fundamental to safety within the healthcare system. Hospital in the Home nurses are integral to a

  4. In-home contextual reality: a qualitative analysis using the Multiple Errands Test Home Version (MET-Home).

    Science.gov (United States)

    Burns, Suzanne Perea; Pickens, Noralyn Davel; Dawson, Deirdre R; Perea, Jaimee D; Vas, Asha K; Marquez de la Plata, Carlos; Neville, Marsha

    2018-02-06

    Adults with stroke frequently experience executive dysfunction. Despite the range of assessments that examine the effects of executive dysfunction on daily tasks, there remains a paucity of literature that examines the influence of the environment on performance in the community. The MET-Home is an ecologically valid assessment for examining post-stroke executive dysfunction in the home environment. This qualitative study explores the relationship between the environment and MET-Home performance among home-dwelling adults with stroke and matched controls. Using a descriptive qualitative approach, we analysed video, interview, and observation notes from a MET-Home validation study. An overarching theme of interplay between everyday task performance and the home environment produced further themes: naturalistically emerging supports and barriers and environment as strategy. Within naturalistically emerging supports and barriers, five contextual sub-themes were discovered: physical environment, social environment, temporal context, virtual context, and personal context. Within environment as strategy, we identified four sub-themes: reducing distractions, using everyday technologies, planning in context, and seeking social support. These findings extend the conceptualisation of how we evaluate executive dysfunction in the context of the community to also consider the inherent influence of the environment.

  5. Ca-48 targets - Home and abroad!

    Science.gov (United States)

    Greene, John P.; Carpenter, Michael; Janssens, Robert V. F.

    2018-05-01

    Using the method of reduction/distillation, high-purity films of robust and ductile calcium metal were prepared for use as targets in nuclear physics experiments. These targets, however, are extremely air-sensitive and procedures must be developed for their handling and use without exposure to the air. In most instances, the thin 48Ca target is used on a carrier foil (backing) and a thin covering film of similar material is employed to further reduce re-oxidation. Un-backed metallic targets are rarely produced due to these concerns. In addition, the low natural abundance of the isotope 48Ca provided an increased incentive for the best efficiencies available in their preparation. Here, we describe the preparation of 48Ca targets employing a gold backing and thin gold cover for use at home, Argonne National Laboratory (ANL), as well as abroad, at Osaka University. For the overseas shipments, much care and preparation were necessary to ensure good targets and safe arrival to the experimental facilities.

  6. Controlling ventilation for safe escape from coal mine fires

    Energy Technology Data Exchange (ETDEWEB)

    Wala, A M [University of Kentucky, Lexington, KY (United States). Mining Engineering Dept.

    1966-04-01

    If a fire occurs outby an underground coal mine section, the immediate safe evacuation of miners from the working section should always take precedence. Unfortunately, in many cases, the dedicated escapeway (escape routes) for the evacuation of the miners become contaminated by the byproducts of fire from the adjacent entries. The purpose of this paper is to present the ventilation-control process that would keep the escapeway free from contaminants and, thus, available for travel. A few scenarios of mine fires in longwall development panels are analysed and discussed. To perform these studies, a mine-fire simulator (MFS) was used. This (MFS) provides a dynamic representation of the fire`s progress (in real time) and gives a color-graphic visualization of the spready of oxygen, combustion products and temperature of the gases throughout the ventilation system. Also presented and discussed are ways in which the MFS can be used as a training and teaching tool for miners and particularly, for ventilation and safety specialists. 7 refs., 10 figs.

  7. Palliative sedation at home for terminally ill children with cancer.

    Science.gov (United States)

    Korzeniewska-Eksterowicz, Aleksandra; Przysło, Łukasz; Fendler, Wojciech; Stolarska, Małgorzata; Młynarski, Wojciech

    2014-11-01

    The presence of symptoms that are difficult to control always requires adjustment of treatment, and palliative sedation (PS) should be considered. We analyzed our experience in conducting PS at home for terminally ill children with cancer during a seven-year period. We performed a retrospective analysis of medical records of children with cancer treated at home between the years 2005 and 2011. We analyzed the data of 42 cancer patients (18% of all patients); in 21 cases, PS was initiated (solid tumors n = 11, brain tumors [5], bone tumors [4], leukemia [1]). Sedation was introduced because of pain (n = 13), dyspnea (9), anxiety (5), or two of those symptoms (6). The main drug used for sedation was midazolam; all patients received morphine. There were no significant differences in the dose of morphine or midazolam depending on the patient's sex; age was correlated with an increase of midazolam dose (R = 0.68; P = 0.005). Duration of sedation (R = 0.61; P = 0.003) and its later initiation (R = 0.43; P = 0.05) were correlated with an increase of the morphine dose. All patients received adjuvant treatment; in patients who required a morphine dose increase, metoclopramide was used more often (P = 0.0002). Patients did not experience any adverse reactions. Later introduction of sedation was associated with a marginally higher number of intervention visits and a significantly higher number of planned visits (R = 0.53; P = 0.013). Sedation may be safely used at home. It requires close monitoring and full cooperation between the family and hospice team. Because of the limited data on home PS in pediatric populations, further studies are needed. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  8. Smart homes and home health monitoring technologies for older adults: A systematic review.

    Science.gov (United States)

    Liu, Lili; Stroulia, Eleni; Nikolaidis, Ioanis; Miguel-Cruz, Antonio; Rios Rincon, Adriana

    2016-07-01

    Around the world, populations are aging and there is a growing concern about ways that older adults can maintain their health and well-being while living in their homes. The aim of this paper was to conduct a systematic literature review to determine: (1) the levels of technology readiness among older adults and, (2) evidence for smart homes and home-based health-monitoring technologies that support aging in place for older adults who have complex needs. We identified and analyzed 48 of 1863 relevant papers. Our analyses found that: (1) technology-readiness level for smart homes and home health monitoring technologies is low; (2) the highest level of evidence is 1b (i.e., one randomized controlled trial with a PEDro score ≥6); smart homes and home health monitoring technologies are used to monitor activities of daily living, cognitive decline and mental health, and heart conditions in older adults with complex needs; (3) there is no evidence that smart homes and home health monitoring technologies help address disability prediction and health-related quality of life, or fall prevention; and (4) there is conflicting evidence that smart homes and home health monitoring technologies help address chronic obstructive pulmonary disease. The level of technology readiness for smart homes and home health monitoring technologies is still low. The highest level of evidence found was in a study that supported home health technologies for use in monitoring activities of daily living, cognitive decline, mental health, and heart conditions in older adults with complex needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  9. Inherently safe light water reactors

    International Nuclear Information System (INIS)

    Ise, Takeharu

    1987-01-01

    Today's large nuclear power reactors of world-wise use have been designed based on the philosophy. It seems that recent less electricity demand rates, higher capital cost and the TMI accident let us acknowledge relative small and simplified nuclear plants with safer features, and that Chernobyl accident in 1983 underlines the needs of intrinsic and passive safety characteristics. In such background, several inherently safe reactor concepts have been presented abroad and domestically. First describing 'Can inherently safe reactors be designed,' then I introduce representative reactor concepts of inherently safe LWRs advocated abroad so far. All of these innovative reactors employ intrinsic and passive features in their design, as follows: (1) PIUS, an acronym for Process Inherent Ultimate Safety, or an integral PWR with passive heat sink and passive shutdown mechanism, advocated by ASEA-ATOM of Sweden. (2) MAP(Minimum Attention Plant), or a self-pressurized, natural circulation integral PWR, promoted by CE Inc. of the U.S. (3) TPS(TRIGA Power System), or a compact PWR with passive heat sink and inherent fuel characteristics of large prompt temperature coefficient, prompted by GA Technologies Inc. of the U.S. (4) PIUS-BWR, or an inherently safe BWR employing passively actuated fluid valves, in competition with PIUS, prompted by ORNL of the U.S. Then, I will describe the domestic trends in Japan and the innovative inherently safe LWRs presented domestically so far. (author)

  10. Oxygen effect and intracellular oxygen content (adaptation hypothesis)

    Energy Technology Data Exchange (ETDEWEB)

    Yarmonenko, S P; Ehpshtejn, I M [Akademiya Meditsinskikh Nauk SSSR, Moscow. Onkologicheskij Tsentr

    1977-01-01

    Experimental data indicating that a radiomodifying action of hypoxia is dependent on the ''prehistory'' of the irradiated object are considered. This dependence manifests itself in a decreased protective action of acute hypoxia on the hypoxia-adapted objects. To explain this a hypothesis is proposed connecting a degree of cell radiosensitivity modification, determined by the oxygen effect, with the intracellular oxygen content. The latter, in accord with current ideas, is regulated by variations in the diffusion resistance to oxygen shown by the cytoplasmic membranes depending on the energy level of the cell and the degree of its oxygenation.

  11. Oxygen effect and intracellular oxygen content (adaptation hypothesis)

    International Nuclear Information System (INIS)

    Yarmonenko, S.P.; Ehpshtejn, I.M.

    1977-01-01

    Experimental data indicating that a radiomodifying action of hypoxia is dependent on the ''prehistory'' of the irradiated object are considered. This dependence manifests itself in a decreased protective action of acute hypoxia on the hypoxia-adapted objects. To explain this a hypothesis is proposed connecting a degree of cell radiosensitivity modification, determined by the oxygen effect, with the intracellular oxygen content. The latter, in accord with current ideas, is regulated by variations in the diffusion resistance to oxygen shown by the cytoplasmic membranes depending on the energy level of the cell and the degree of its oxygenation

  12. Home iv Antibiotic Therapy through a Medical Day Care Unit

    Directory of Open Access Journals (Sweden)

    Marie Gourdeau

    1993-01-01

    Full Text Available An out-patient parenteral antibiotic therapy program provided through a medical day care unit was evaluated in a tertiary care hospital. From July 11, 1988 to December 31, 1990, 122 patients were treated either on site at the unit or at home with self-administered intravenous antibiotics. In all, 142 courses of parenteral antibiotics (mostly cephalosporins and clindamycin were given for a total of 124 infections, mostly bone and soft tissue infections (67 of 124, 54%. The duration of out-patient therapy ranged from two to 62 days with a mean duration of 9.4 days if treated at the unit, or 13.2 days in the home care model (1476 patient-days. Vein access was peripheral and catheters remained functional for an average of 4.9 days (range 0.5 to 22 days. Only two patients experienced adverse drug reactions that necessitated modification of treatment. One other case was readmitted to the hospital for surgical debridement. The average cost per patient-day was $66 compared with $375 for in-hospital therapy. This program proved to be safe, efficient, and cost-effective.

  13. Safeguards Automated Facility Evaluation (SAFE) methodology

    International Nuclear Information System (INIS)

    Chapman, L.D.; Grady, L.M.; Bennett, H.A.; Sasser, D.W.; Engi, D.

    1978-01-01

    The SAFE procedure is an efficient method of evaluating the physical protection system of a nuclear facility. Since the algorithms used in SAFE for path generation and evaluation are analytical, many paths can be evaluated with a modest investment in computer time. SAFE is easy to use because the information required is well-defined and the interactive nature of this procedure lends itself to straightforward operation. The modular approach that has been taken allows other functionally equivalent modules to be substituted as they become available. The SAFE procedure has broad applications in the nuclear facility safeguards field as well as in the security field in general. Any fixed facility containing valuable materials or components to be protected from theft or sabotage could be analyzed using this same automated evaluation technique

  14. The evolving role of the personal support worker in home care in Ontario, Canada.

    Science.gov (United States)

    Saari, Margaret; Patterson, Erin; Kelly, Shawna; Tourangeau, Ann E

    2018-03-01

    To meet increasing demand for home care, the role of personal support workers (PSWs) is shifting from providing primarily personal and supportive care to include care activities previously provided by regulated health professionals (RHPs). Much of the research examining this shift focuses on specialty programmes, with few studies investigating the daily care being provided by PSWs, frequency of care activities being provided by PSWs, and characteristics of the population receiving more complex tasks. Between January and April 2015, a review of 517 home-care service user charts was undertaken in Ontario, Canada, to: (1) describe the range of tasks being performed by PSWs in home care, (2) identify tasks transferred by RHPs to PSWs, and (3) examine characteristics of service users receiving transferred care. Findings indicate that normally, PSWs provide personal and supportive care commensurate with their training. However, in approximately one quarter of care plans reviewed, PSWs also completed more complex care activities transferred to them by RHPs. Service users receiving transferred care were older and had higher levels of cognitive and functional impairment. Although there is potential for the expansion of home-care services through increased utilisation of PSWs, healthcare leadership must ensure that the right provider is being utilised at the right time and in the right place to ensure safe and effective quality care. Thus, several actions are recommended: PSW core competencies be clearly articulated, processes used to transfer care activities from RHPs to PSWs be standardised and a team-based approach to the delivery of home-care services be considered. Utilisation of a team-based model can help establish positive relationships among home-care providers, provide increased support for PSWs, allow for easier scheduling of initial training and ensure regular reassessments of PSW competence among PSWs providing added skills. © 2017 John Wiley & Sons Ltd.

  15. Meals in nursing homes

    DEFF Research Database (Denmark)

    Kofod, Jens Erik; Birkemose, A.

    2004-01-01

    Undernutrition is present among 33% of nursing home residents in Denmark. Hence, it is relevant to examine the meal situation at nursing homes to single out factors that may increase or reduce the residents' food intake. in the ongoing Danish nursing home debate it is claimed that a new type...... of nursing home improves the residents' meal situation with a positive effect on nutrition. The aim of this work is to test the general hypothesis that (i) residents appreciate the meal situation in these nursing homes and (ii) nutritional status of the residents is improved in this type of nursing home....... This study was carried out in four Danish nursing homes at various locations in Denmark. The methods used are qualitative interviews and observations at four nursing homes in combination with measurement of body mass index (BMI) at two of the four nursing homes. Undernutrition is defined as a BMI below 20...

  16. Home Care Services

    Science.gov (United States)

    Home care is care that allows a person with special needs stay in their home. It might be for people who are getting ... are chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help ...

  17. Theory and development of fluorescence-based optochemical oxygen sensors: oxygen optodes.

    Science.gov (United States)

    Opitz, N; Lübbers, D W

    1987-01-01

    As the preceding considerations concerning the physical and technical features of oxygen optodes have demonstrated, fluorescence-based optochemical oxygen sensors possess certain advantages and peculiarities compared to conventionally applied electrochemical sensors such as polarographic oxygen electrodes. First, in contrast to oxygen electrodes, oxygen measurements with oxygen optodes do not suffer from distortions caused by the reference electrodes. In addition, because of the polarographic process, platinum electrodes continuously consume oxygen, which falsifies the results, especially when small sample volumes or long-term measurements, or both, are involved, whereas the sensor layer of oxygen optodes must only be equilibrated. Moreover, the surface of the platinum wire has to be catalytically clean in order to obtain a plateau of the polarogram and, consequently, to achieve a low rest current at zero PO2. Unfortunately, the demand for catalytically clean platinum surfaces turns out to be rather critical, since surface contamination occurs even with membranized electrodes, resulting in the well-known phenomenon of "electrode poisoning." The question of the specificity of oxygen electrodes also must be considered. In this context, CO2 and halothane may interfere with oxygen measurements, whereas fluorescence quenching is unaffected by CO2 and halothane affects the measurements only slightly, depending on the special indicator used. Furthermore, because of the flow dependence, oxygen measurements with the oxygen electrode show a distinct "stirring effect" caused by the turbulence in front of the electrode, which disturbs the diffusion field. Because of the completely different physical principle of fluorescence optical sensors, such influences are not observed with oxygen optodes. In addition, isolation and shielding of electrical circuits found in electrodes are not necessary for optodes. Furthermore, the sensitivity of oxygen optodes can be tuned to the desired

  18. Seniors managing multiple medications: using mixed methods to view the home care safety lens.

    Science.gov (United States)

    Lang, Ariella; Macdonald, Marilyn; Marck, Patricia; Toon, Lynn; Griffin, Melissa; Easty, Tony; Fraser, Kimberly; MacKinnon, Neil; Mitchell, Jonathan; Lang, Eddy; Goodwin, Sharon

    2015-12-12

    Patient safety is a national and international priority with medication safety earmarked as both a prevalent and high-risk area of concern. To date, medication safety research has focused overwhelmingly on institutional based care provided by paid healthcare professionals, which often has little applicability to the home care setting. This critical gap in our current understanding of medication safety in the home care sector is particularly evident with the elderly who often manage more than one chronic illness and a complex palette of medications, along with other care needs. This study addresses the medication management issues faced by seniors with chronic illnesses, their family, caregivers, and paid providers within Canadian publicly funded home care programs in Alberta (AB), Ontario (ON), Quebec (QC) and Nova Scotia (NS). Informed by a socio-ecological perspective, this study utilized Interpretive Description (ID) methodology and participatory photographic methods to capture and analyze a range of visual and textual data. Three successive phases of data collection and analysis were conducted in a concurrent, iterative fashion in eight urban and/or rural households in each province. A total of 94 participants (i.e., seniors receiving home care services, their family/caregivers, and paid providers) were interviewed individually. In addition, 69 providers took part in focus groups. Analysis was iterative and concurrent with data collection in that each interview was compared with subsequent interviews for converging as well as diverging patterns. Six patterns were identified that provide a rich portrayal of the complexity of medication management safety in home care: vulnerabilities that impact the safe management and storage of medication, sustaining adequate supports, degrees of shared accountability for care, systems of variable effectiveness, poly-literacy required to navigate the system, and systemic challenges to maintaining medication safety in the home

  19. Attitudes of palliative home care physicians towards palliative sedation at home in Italy.

    Science.gov (United States)

    Mercadante, Sebastiano; Masedu, Francesco; Mercadante, Alessandro; Marinangeli, Franco; Aielli, Federica

    2017-05-01

    Information about the attitudes towards palliative sedation (PS) at home is limited. The aim of this survey was to assess the attitudes of palliative care physicians in Italy regarding PS at home. A questionnaire was submitted to a sample of palliative care physicians, asking information about their activity and attitudes towards PS at home. This is a survey of home care physicians in Italy who were involved in end-of-life care decisions at home. One hundred and fifty participants responded. A large heterogeneity of home care organizations that generate some problems was found. Indications, intention and monitoring of PS seem to be appropriate, although some cultural and logistic conditions were limiting the use of PS. Specialized home care physicians are almost involved to start PS at home. Midazolam was seldom available at home and opioids were more frequently used. These data should prompt health care agencies to make a minimal set of drugs easily available for home care. Further research is necessary to compare attitudes in countries with different sociocultural profiles.

  20. Oxygen Therapy

    Science.gov (United States)

    ... their breathing to dangerously low levels. Will I need oxygen when I sleep? Usually if you use supplemental oxygen during the ... your health care provider tells you you only need to use oxygen for exercise or sleep. Even if you feel “fine” off of your ...

  1. A feasibility study of a new approach to clinical radiosensitisation: hypothermia and hyperbaric oxygen in combination with pharmacological vasodilatation

    International Nuclear Information System (INIS)

    Sealy, R.; Harrison, G.G.; Morrell, D.; Cape Town Univ.

    1986-01-01

    It is proposed that hyperbaric oxygen fails in the clinical situation due to a high proportion (greater than 33%) of hypoxic cells in human tumours. The means of overcoming this problem are reviewed. Additional to hyperbaric oxygenation, moderate hypothermia (30 0 C) to allow redistribution of oxygen in the tumour is proposed. A system of externally controlled intravenous anaesthesia has been developed for the single-subject hypervaric cylinder. Pharmacological vasodilatation is induced in the anaesthetised patient who is then fluid loaded and cooled. Initial single-sensitising treatments are advocated. Twenty-nine patients with advanced mouth cancer have completed a course of this treatment, of whom five of nine were free of disease after 2 years and 10 of 21 at 1 year, with three intercurrent deaths. Fifteen have experienced local failure. This approach would appear to be practical, safe and promising. (author)

  2. Bringing Your Baby Home

    Science.gov (United States)

    ... for Educators Search English Español Bringing Your Baby Home KidsHealth / For Parents / Bringing Your Baby Home What's ... recall your baby's seemingly endless crying episodes. The Home Front Introducing your baby to others at home ...

  3. 24 CFR 982.610 - Group home: Who may reside in a group home.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Group home: Who may reside in a group home. 982.610 Section 982.610 Housing and Urban Development Regulations Relating to Housing and... Housing Types Group Home § 982.610 Group home: Who may reside in a group home. (a) An elderly person or a...

  4. Retinal Vessel Oxygen Saturation during 100% Oxygen Breathing in Healthy Individuals.

    Directory of Open Access Journals (Sweden)

    Olof Birna Olafsdottir

    Full Text Available To detect how systemic hyperoxia affects oxygen saturation in retinal arterioles and venules in healthy individuals.Retinal vessel oxygen saturation was measured in 30 healthy individuals with a spectrophotometric retinal oximeter (Oxymap T1. Oximetry was performed during breathing of room air, 100% oxygen (10 minutes, 6L/min and then again room air (10 minutes recovery.Mean oxygen saturation rises modestly in retinal arterioles during 100% oxygen breathing (94.5%±3.8 vs. 92.0%±3.7% at baseline, p<0.0001 and dramatically in retinal venules (76.2%±8.0% vs. 51.3%±5.6%, p<0.0001. The arteriovenous difference decreased during 100% oxygen breathing (18.3%±9.0% vs. 40.7%±5.7%, p<0.0001. The mean diameter of arterioles decreased during 100% oxygen breathing compared to baseline (9.7±1.4 pixels vs. 10.3±1.3 pixels, p<0.0001 and the same applies to the mean venular diameter (11.4±1.2 pixels vs. 13.3±1.5 pixels, p<0.0001.Breathing 100% oxygen increases oxygen saturation in retinal arterioles and more so in venules and constricts them compared to baseline levels. The dramatic increase in oxygen saturation in venules reflects oxygen flow from the choroid and the unusual vascular anatomy and oxygen physiology of the eye.

  5. Home area networks

    NARCIS (Netherlands)

    Koonen, A.M.J.

    2013-01-01

    This article consists of a collection of slides from the author's conference presentation. Some of the specific areas/topics discussed include: Convergence in home networks, home service scenarios; Home wired network architectures, CapEx and OpEx; Residential Gateway; Optical fiber types;

  6. Breastfeeding FAQs: Safely Storing Breast Milk

    Science.gov (United States)

    ... Search English Español Breastfeeding FAQs: Safely Storing Breast Milk KidsHealth / For Parents / Breastfeeding FAQs: Safely Storing Breast ... may have. How do I store my breast milk? You can freeze and/or refrigerate your pumped ( ...

  7. Curiosity's Autonomous Surface Safing Behavior Design

    Science.gov (United States)

    Neilson, Tracy A.; Manning, Robert M.

    2013-01-01

    The safing routines on all robotic deep-space vehicles are designed to put the vehicle in a power and thermally safe configuration, enabling communication with the mission operators on Earth. Achieving this goal is made a little more difficult on Curiosity because the power requirements for the core avionics and the telecommunication equipment exceed the capability of the single power source, the Multi-Mission Radioisotope Thermoelectric Generator. This drove the system design to create an operational mode, called "sleep mode", where the vehicle turns off most of the loads in order to charge the two Li-ion batteries. The system must keep the vehicle safe from over-heat and under-heat conditions, battery cell failures, under-voltage conditions, and clock failures, both while the computer is running and while the system is sleeping. The other goal of a safing routine is to communicate. On most spacecraft, this simply involves turning on the receiver and transmitter continuously. For Curiosity, Earth is above the horizon only a part of the day for direct communication to the Earth, and the orbiter overpass opportunities only occur a few times a day. The design must robustly place the Rover in a communicable condition at the correct time. This paper discusses Curiosity's autonomous safing behavior and describes how the vehicle remains power and thermally safe while sleeping, as well as a description of how the Rover communicates with the orbiters and Earth at specific times.

  8. Design and Optimisation of Home Scale Greywater Recycling Package

    Directory of Open Access Journals (Sweden)

    a/l Arugam Kalaichelvan

    2018-01-01

    Full Text Available Water crisis is becoming one of the biggest challenges in some countries due to over population and drought. Therefore, government and non-government organisations in well-developed countries are encouraging industries to install water recycling package to reduce water usage and consume greywater instead. However the home scale is not yet available in the market. This research focuses on design a home scale greywater treatment system for toilet flushing within 3,000 to 5,000 USD as a collaboration with DD Techniche Sdn Bhd. Greywater is the waste water produced from laundry, kitchen and bathroom except the toilet waste and contains suspended solids, microorganisms, oil, nitrates and phosphorus which needs to be treated using suitable types of treatment for safe reuse. The treatments include physical, chemical and biological water treatment in which in this study the proposed system is a combination of all three. The design is evaluated using experimental methods to meet the standard of toilet flushing quality. The greywater system consists of the mechanical parts to control the flow of greywater and store the treated water including pumps, sand filtration tank, wire mesh chassis and collection tank. The final design has dimension of 6 m3 and optimised price within the budget.

  9. Biosensors for EVA: Muscle Oxygen and pH During Walking, Running and Simulated Reduced Gravity

    Science.gov (United States)

    Lee, S. M. C.; Ellerby, G.; Scott, P.; Stroud, L.; Norcross, J.; Pesholov, B.; Zou, F.; Gernhardt, M.; Soller, B.

    2009-01-01

    During lunar excursions in the EVA suit, real-time measurement of metabolic rate is required to manage consumables and guide activities to ensure safe return to the base. Metabolic rate, or oxygen consumption (VO2), is normally measured from pulmonary parameters but cannot be determined with standard techniques in the oxygen-rich environment of a spacesuit. Our group developed novel near infrared spectroscopic (NIRS) methods to calculate muscle oxygen saturation (SmO2), hematocrit, and pH, and we recently demonstrated that we can use our NIRS sensor to measure VO2 on the leg during cycling. Our NSBRI-funded project is looking to extend this methodology to examine activities which more appropriately represent EVA activities, such as walking and running and to better understand factors that determine the metabolic cost of exercise in both normal and lunar gravity. Our 4 year project specifically addresses risk: ExMC 4.18: Lack of adequate biomedical monitoring capability for Constellation EVA Suits and EPSP risk: Risk of compromised EVA performance and crew health due to inadequate EVA suit systems.

  10. No safe place: parental alcoholism and adolescent suicide.

    Science.gov (United States)

    Meyer, D C; Phillips, W M

    1990-10-01

    A child growing up in an alcoholic home develops either little self-consolidation (I-ness) and efficacy (I can) or a distorted self (I am insignificant). This results in a desperate search for a soothing-object (We-ness). The sadomasochistic behaviors, which a youth witnesses and is subjected to, become internalized as survival skills, but ultimately fail. These factors set the stage for a destructive modus operandi. When there is peer group attachment pressure, this teen does not find security when questioning, "Who am I?" because there is no "I" and no "We". Instead, this adolescent experiences fear, anxiety, and range, and wonders, "What's going to happen to me?" This propels the youth into frantic behaviors that are meant to confirm a sense of "We-ness" and competence. The result, however, is greater frustration and a mirroring of the opposite. Also, since there is a diminutive capacity for trust and an exiguous chance to reach out or respond to significant others, external soothingness becomes unobtainable. When the adolescent is confronted with aloneness, helplessness, and hopelessness, desperation results and a search for a safe place ensues. Suicide holds such an illusion. It is the embodiment of sadomasochism and permits the cognition "I am capable." A case study illustrates the problems.

  11. Home range and travels

    Science.gov (United States)

    Stickel, L.F.; King, John A.

    1968-01-01

    The concept of home range was expressed by Seton (1909) in the term 'home region,' which Burr (1940, 1943) clarified with a definition of home range and exemplified in a definitive study of Peromyscus in the field. Burt pointed out the ever-changing characteristics of home-range area and the consequent absence of boundaries in the usual sense--a finding verified by investigators thereafter. In the studies summarized in this paper, sizes of home ranges of Peromyscus varied within two magnitudes, approximately from 0.1 acre to ten acres, in 34 studies conducted in a variety of habitats from the seaside dunes of Florida to the Alaskan forests. Variation in sizes of home ranges was correlated with both environmental and physiological factors; with habitat it was conspicuous, both in the same and different regions. Food supply also was related to size of home range, both seasonally and in relation to habitat. Home ranges generally were smallest in winter and largest in spring, at the onset of the breeding season. Activity and size also were affected by changes in weather. Activity was least when temperatures were low and nights were bright. Effects of rainfall were variable. Sizes varied according to sex and age; young mice remained in the parents' range until they approached maturity, when they began to travel more widely. Adult males commonly had larger home ranges than females, although there were a number of exceptions. An inverse relationship between population density and size of home range was shown in several studies and probably is the usual relationship. A basic need for activity and exploration also appeared to influence size of home range. Behavior within the home range was discussed in terms of travel patterns, travels in relation to home sites and refuges, territory, and stability of size of home range. Travels within the home range consisted of repeated use of well-worn trails to sites of food, shelter, and refuge, plus more random exploratory travels

  12. DOE Challenge Home Case Study: e2 Homes – Winter Park, Florida

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-01-01

    This Challenge Home case study describes the first certified DOE Challenge Home as constructed by e2 Homes. Completed in May 2012, the “Wilson Residence” in Winter Park, Florida, is a 4,305-ft2 custom home that scores a HERS 57 without solar and a better than zero net-energy HERS -7 with solar.

  13. Simulation based training in a publicly funded home birth programme in Australia: A qualitative study.

    Science.gov (United States)

    Kumar, Arunaz; Nestel, Debra; Stoyles, Sally; East, Christine; Wallace, Euan M; White, Colleen

    2016-02-01

    Birth at home is a safe and appropriate choice for healthy women with a low risk pregnancy. However there is a small risk of emergencies requiring immediate, skilled management to optimise maternal and neonatal outcomes. We developed and implemented a simulation workshop designed to run in a home based setting to assist with emergency training for midwives and paramedical staff. The workshop was evaluated by assessing participants' satisfaction and response to key learning issues. Midwifery and emergency paramedical staff attending home births participated in a simulation workshop where they were required to manage birth emergencies in real time with limited availability of resources to suit the setting. They completed a pre-test and post-test evaluation form exploring the content and utility of the workshops. Content analysis was performed on qualitative data regarding the most important learning from the simulation activity. A total of 73 participants attended the workshop (midwifery=46, and paramedical=27). There were 110 comments, made by 49 participants. The most frequently identified key learning elements were related to communication (among midwives, paramedical and hospital staff and with the woman's partner), followed by recognising the role of other health care professionals, developing an understanding of the process and the importance of planning ahead. Home birth simulation workshop was found to be a useful tool by staff that provide care to women who are having a planned home birth. Developing clear communication and teamwork were found to be the key learning principles guiding their practice. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  14. ConductHome: Gesture Interface Control of Home Automation Boxes

    OpenAIRE

    J. Branstett; V. Gagneux; A. Leleu; B. Levadoux; J. Pascale

    2015-01-01

    This paper presents the interface ConductHome which controls home automation systems with a Leap Motion using "invariant gesture protocols". This interface is meant to simplify the interaction of the user with its environment. A hardware part allows the Leap Motion to be carried around the house. A software part interacts with the home automation box and displays the useful information for the user. An objective of this work is the development of a natural/invariant/simpl...

  15. Developing Safe Schools Partnerships with Law Enforcement

    Science.gov (United States)

    Rosiak, John

    2009-01-01

    Safe schools are the concern of communities throughout the world. If a school is safe, and if children feel safe, students "are better able to learn. But what are the steps to make" this happen? First, it is important to understand the problem: What are the threats to school safety? These include crime-related behaviors that find their way to…

  16. The Perioperative Surgical Home: Improving the Value and Quality of Care in Total Joint Replacement.

    Science.gov (United States)

    Chimento, George F; Thomas, Leslie C

    2017-09-01

    The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH. The PSH model guides the patient throughout the pre and perioperative process and into the postoperative phase. It has been shown in multiple studies to decrease length of stay, improve functional outcomes, allow more home discharges, and lower costs. There is no increase in complications or readmission rates. The PSH pathway is a safe and effective method of providing value-based care to patients undergoing hip and knee arthroplasty.

  17. Cost-effectiveness implications based on a comparison of nursing home and home health case mix.

    OpenAIRE

    Kramer, A M; Shaughnessy, P W; Pettigrew, M L

    1985-01-01

    Case-mix differences between 653 home health care patients and 650 nursing home patients, and between 455 Medicare home health patients and 447 Medicare nursing home patients were assessed using random samples selected from 20 home health agencies and 46 nursing homes in 12 states in 1982 and 1983. Home health patients were younger, had shorter lengths of stay, and were less functionally disabled than nursing home patients. Traditional long-term care problems requiring personal care were more...

  18. Safety, reliability, and validity of a physiologic definition of bronchopulmonary dysplasia.

    Science.gov (United States)

    Walsh, Michele C; Wilson-Costello, Deanna; Zadell, Arlene; Newman, Nancy; Fanaroff, Avroy

    2003-09-01

    Bronchopulmonary dysplasia (BPD) is the focus of many intervention trials, yet the outcome measure when based solely on oxygen administration may be confounded by differing criteria for oxygen administration between physicians. Thus, we wished to define BPD by a standardized oxygen saturation monitoring at 36 weeks corrected age, and compare this physiologic definition with the standard clinical definition of BPD based solely on oxygen administration. A total of 199 consecutive very low birthweight infants (VLBW, 501 to 1500 g birthweight) were assessed prospectively at 36+/-1 weeks corrected age. Neonates on positive pressure support or receiving >30% supplemental oxygen were assigned the outcome BPD. Those receiving or =88% for 60 minutes) or "BPD" (saturation reliability, test-retest reliability, and validity of the physiologic definition vs the clinical definition were assessed. A total of 199 VLBW were assessed, of whom 45 (36%) were diagnosed with BPD by the clinical definition of oxygen use at 36 weeks corrected age. The physiologic definition identified 15 infants treated with oxygen who successfully passed the saturation monitoring test in room air. The physiologic definition diagnosed BPD in 30 (24%) of the cohort. All infants were safely studied. The test was highly reliable (inter-rater reliability, kappa=1.0; test-retest reliability, kappa=0.83) and highly correlated with discharge home in oxygen, length of hospital stay, and hospital readmissions in the first year of life. The physiologic definition of BPD is safe, feasible, reliable, and valid and improves the precision of the diagnosis of BPD. This may be of benefit in future multicenter clinical trials.

  19. Home therapy with continuous infusion of factor VIII after minor surgery or serious haemorrhage.

    Science.gov (United States)

    Varon, D; Schulman, S; Bashari, D; Martinowitz, U

    1996-10-01

    Administration of factor VIII (F VIII) concentrates by continuous infusion is now routinely used at several haemophilia centers but almost exclusively for hospitalized patients. We evaluated various aspects of home therapy with continuous infusion of an immunoaffinity purified F VIII concentrate (Monoclate P®, Armour) in patients who would normally have been treated with high doses in bolus injections or with continuous infusion as in-patients. Twenty haemophilia A patients, eight after minor surgery and 12 for serious haemorrhage, received continuous infusion with undiluted F VIII by a minipump for a mean of 0.9 days in the hospital, followed by 3.3 days at home. Infusion bags were exchanged every 2.5 days. No haemorrhagic complications occurred, and five haemorrhages that had been resistant to treatment with bolus injections responded promptly to the continuous infusion. There were no technical problems and patient compliance and acceptance was good. We find this mode of therapy safe, efficacious and convenient for the patients as well as for the staff.

  20. TRAVEL AND HOME LEAVE

    CERN Multimedia

    Human Resources Division

    2002-01-01

    Administrative procedures for : Travel to the home station and home leave (hl) Additional travel to the home station (at) Travel to the home station and home leave for family reasons (hlf) As part of the process of simplifying administrative procedures, HR and AS Divisions have devised a new, virtually automatic procedure for payment of travel expenses to the home station. The changes are aimed at rationalising administrative procedures and not at reducing benefits. The conditions of eligibility are unchanged. The new procedure, which will be operational with effect from 1st June 2002, will greatly simplify the administrative processing of claims for travel expenses and the recording of home leaves. Currently, requests for payment are introduced manually into the Advances and Claims system (AVCL) by divisional secretariats. All travel to the home station starting prior to 1st June 2002 will be processed according to the existing system whereas that starting on 1st June and after will be processed accordi...

  1. Dimensions of work-home culture and their relations with the use of work-home arrangements and work-home interaction

    NARCIS (Netherlands)

    Dikkers, J.S.E.; Geurts, S.A.E.; Dulk, L. den; Peper, A.B.; Taris, T.W.; Kompier, M.A.J.

    2007-01-01

    This study examined the associations of work–home culture with (a) demographic and organizational characteristics, (b) the use of work–home arrangements, and (c) negative and positive work–home interaction, among 1,179 employees from one public and two private organizations. Substantial support was

  2. Dimensions of work-home culture and their relations with the use of work-home arrangements and work-home interaction

    NARCIS (Netherlands)

    Dikkers, J.S.E.; Geurts, S.A.E.; den Dulk, L.; Peper, B.; Taris, T.W.; Kompier, M.A.J.

    2007-01-01

    This study examined the associations of work-home culture with (a) demographic and organizational characteristics, (b) the use of work-home arrangements, and (c) negative and positive work-home interaction, among 1,179 employees from one public and two private organizations. Substantial support was

  3. 6. Home deliveries

    African Journals Online (AJOL)

    Sitwala

    determine factors associated with home deliveries. Main outcome ... deliver at home than a health facility compared to those who .... regression analysis, women who had four years of schooling or .... by report bias, the burden of home deliveries is a real challenge .... Journal of Econometrics 1987; 36: 185-204. 14. Michelo ...

  4. Home Energy Saver

    Science.gov (United States)

    release announcing Home Energy Saver and a Q-and-A. The "About" page should tell you everything you need to know about using Home Energy Saver. If you have any questions, please email the project leader, Dr. Evan Mills. News Releases Microsoft Licenses Berkeley Lab's Home Energy Saver Code for Its

  5. DOE Zero Energy Ready Home Case Study: Garbett Homes, Herriman, Utah

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    As the first net zero-energy production home certified in Utah, this house incorporates two 94% efficient tankless water heaters and two roof-mounted solar panels that preheat the home's water supply. This home won a 2013 Housing Innovation Award in the production builder category.

  6. Work-home interference in relation to work, organizational, and home characteristics

    NARCIS (Netherlands)

    Dikkers, J.S.E.

    2008-01-01

    In this thesis we examine work-home interference in relation to work, organizational, and home characteristics. The study is guided by the following three research questions: i) how are workload and negative WHI temporally related? (research question 1); ii) is work-home culture related to the use

  7. Safe start at home: what parents of newborns need after early discharge from hospital - a focus group study.

    Science.gov (United States)

    Kurth, Elisabeth; Krähenbühl, Katrin; Eicher, Manuela; Rodmann, Susanne; Fölmli, Luzia; Conzelmann, Cornelia; Zemp, Elisabeth

    2016-03-08

    The length of postpartum hospital stay is decreasing internationally. Earlier hospital discharge of mothers and newborns decreases postnatal care or transfers it to the outpatient setting. This study aimed to investigate the experiences of new parents and examine their views on care following early hospital discharge. Six focus group discussions with new parents (n = 24) were conducted. A stratified sampling scheme of German and Turkish-speaking groups was employed. A 'playful design' method was used to facilitate participants communication wherein they used blocks and figurines to visualize their perspectives on care models The visualized constructions of care models were photographed and discussions were audio-recorded and transcribed verbatim. Text and visual data was thematically analyzed by a multi-professional group and findings were validated by the focus group participants. Following discharge, mothers reported feeling physically strained during recuperating from birth and initiating breastfeeding. The combined requirements of infant and self-care needs resulted in a significant need for practical and medical support. Families reported challenges in accessing postnatal care services and lacking inter-professional coordination. The visualized models of ideal care comprised access to a package of postnatal care including monitoring, treating and caring for the health of the mother and newborn. This included home visits from qualified midwives, access to a 24-h helpline, and domestic support for household tasks. Participants suggested that improving inter-professional networks, implementing supervisors or a centralized coordinating center could help to remedy the current fragmented care. After hospital discharge, new parents need practical support, monitoring and care. Such support is important for the health and wellbeing of the mother and child. Integrated care services including professional home visits and a 24-hour help line may help meet the needs of

  8. Towards Safe Robotic Surgical Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael

    2015-01-01

    a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...... from several initial conditions to demonstrate that the designed control system is safe for every admissible initial condition....

  9. Safe use of ionizing radiations

    Energy Technology Data Exchange (ETDEWEB)

    1973-01-01

    Based on the ''Code of Practice for the protection of persons against ionizing radiations arising from medical and dental use'' (CIS 74-423), this handbook shows how hospital staff can avoid exposing themselves and others to these hazards. It is designed particularly for junior and student nurses. Contents: ionizing radiations, their types and characteristics; their uses and dangers; basic principles in their safe use; safe use in practice; explanation of terms.

  10. Staying Safe in the Water

    Centers for Disease Control (CDC) Podcasts

    2008-05-15

    In this podcast, Dr. Julie Gilchrist, a pediatrician and medical epidemiologist from CDC’s Injury Center, talks about staying safe in the water. Tips are for all audiences, with a focus on preventing drownings and keeping children safe in and around the pool, lake, or ocean.  Created: 5/15/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 5/19/2008.

  11. Does hospital at home for palliative care facilitate death at home? Randomised controlled trial

    Science.gov (United States)

    Grande, Gunn E; Todd, Chris J; Barclay, Stephen I G; Farquhar, Morag C

    1999-01-01

    Objective To evaluate the impact on place of death of a hospital at home service for palliative care. Design Pragmatic randomised controlled trial. Setting Former Cambridge health district. Participants 229 patients referred to the hospital at home service; 43 randomised to control group (standard care), 186 randomised to hospital at home. Intervention Hospital at home versus standard care. Main outcome measures Place of death. Results Twenty five (58%) control patients died at home compared with 124 (67%) patients allocated to hospital at home. This difference was not significant; intention to treat analysis did not show that hospital at home increased the number of deaths at home. Seventy three patients randomised to hospital at home were not admitted to the service. Patients admitted to hospital at home were significantly more likely to die at home (88/113; 78%) than control patients. It is not possible to determine whether this was due to hospital at home itself or other characteristics of the patients admitted to the service. The study attained less statistical power than initially planned. Conclusion In a locality with good provision of standard community care we could not show that hospital at home allowed more patients to die at home, although neither does the study refute this. Problems relating to recruitment, attrition, and the vulnerability of the patient group make randomised controlled trials in palliative care difficult. While these difficulties have to be recognised they are not insurmountable with the appropriate resourcing and setting. Key messagesTerminally ill patients allocated to hospital at home were no more likely to die at home than patients receiving standard careAlthough the subsample of patients actually admitted to hospital at home did show a significant increase in likelihood of dying at home, whether this was due to the service itself or the characteristics of patients admitted to hospital at home could not be determinedThe need to

  12. Second-home electricity consumption

    International Nuclear Information System (INIS)

    Andersen, Frits M.; Christensen, Morten S.; Jensen, Ole Michael; Kofoed, Niels-Ulrik; Morthorst, Poul Erik

    2008-01-01

    In Denmark, electricity consumption in first and second homes has developed quite differently. Since 1990, electricity consumption in ordinary residences has grown moderately, while consumption in weekend and second homes has increased considerably. In turn, this development has been blamed on a growing number of luxury cottages, new legislation permitting senior citizens to have their permanent address in their second home and a growing number of electric appliances. In order to examine the growing electricity consumption in second homes and to estimate future demand, a multidisciplinary study combining top-down and bottom-up analyses was conducted, i.e., combining models using aggregated economic parameters and feasibility studies using technical parameters, respectively. The top-down estimation showed that changes in electricity consumption in second homes correlate to changes in income. The bottom-up estimation showed that consumption was mainly affected by the frequency with which second homes were used in the winter time. This indicates that additional second homes, increased full-time use and intensified use of electric appliances are the main reasons for the observed increases in electricity consumption. Luxury tourism use and senior citizens' that use a few per cent of the second homes as their home contribute to a minor degree to the overall increase of electricity consumption. Scenarios show that this development may accelerate with increased leisure time, increased use and more permanent settlement in second homes

  13. Children, computer exposure and musculoskeletal outcomes: the development of pathway models for school and home computer-related musculoskeletal outcomes.

    Science.gov (United States)

    Harris, Courtenay; Straker, Leon; Pollock, Clare; Smith, Anne

    2015-01-01

    Children's computer use is rapidly growing, together with reports of related musculoskeletal outcomes. Models and theories of adult-related risk factors demonstrate multivariate risk factors associated with computer use. Children's use of computers is different from adult's computer use at work. This study developed and tested a child-specific model demonstrating multivariate relationships between musculoskeletal outcomes, computer exposure and child factors. Using pathway modelling, factors such as gender, age, television exposure, computer anxiety, sustained attention (flow), socio-economic status and somatic complaints (headache and stomach pain) were found to have effects on children's reports of musculoskeletal symptoms. The potential for children's computer exposure to follow a dose-response relationship was also evident. Developing a child-related model can assist in understanding risk factors for children's computer use and support the development of recommendations to encourage children to use this valuable resource in educational, recreational and communication environments in a safe and productive manner. Computer use is an important part of children's school and home life. Application of this developed model, that encapsulates related risk factors, enables practitioners, researchers, teachers and parents to develop strategies that assist young people to use information technology for school, home and leisure in a safe and productive manner.

  14. Leaving home in Denmark

    DEFF Research Database (Denmark)

    Nielsen, Rikke Skovgaard

    2015-01-01

    The paper focuses on ethnic differences in the timing and patterns of leaving the parental home. Leaving home is a key transition in the life course of the individual, and extensive research has been conducted on the timing and patterns of leaving it. However, ethnic differences in these patterns...... of leaving home. Results showed that while some differences disappeared when controlling for covariates, others persisted, thus indicating ethnic differences in home-leaving patterns. A strong link between leaving home and marriage was substantiated for Turks, but not for Somalis. The home-leaving patterns...... of Somalis were much more similar to those of Danes. Overall, Turkish descendants were similar to Turkish immigrants but with some differentiation. The analyses identified the existence of ethnic differences in home-leaving patterns but also found evidence of a shift towards less traditional patterns, i...

  15. Beyond Home Automation: Designing More Effective Smart Home Systems

    OpenAIRE

    Carner, Paolo

    2009-01-01

    This paper outlines a Smart Home Proof-of-Concept system that uses a Bayesian Network to predict the likelihood of a monitored event to occur. Firstly, this paper will provide an introduction to the concept of a smart home system; then it will outline how Artificial Intelligence concepts can be used to make such systems more effective. Finally, it will detail the implementation of a smart home system, which uses an inference engine to determine the likelihood of a fire. The system prototype h...

  16. How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study.

    Science.gov (United States)

    McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia

    2015-09-01

    Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Safe operating envelope

    Energy Technology Data Exchange (ETDEWEB)

    Oliva, N [Ontario Hydro, Toronto, ON (Canada)

    1997-12-01

    Safe Operating Envelope is described representing: The outer bound of plant conditions within which day-to-day plant operation must be maintained in order to comply with regulatory requirements, associated safety design criteria and corporate nuclear safety goals. Figs.

  18. Safe operating envelope

    International Nuclear Information System (INIS)

    Oliva, N.

    1997-01-01

    Safe Operating Envelope is described representing: The outer bound of plant conditions within which day-to-day plant operation must be maintained in order to comply with regulatory requirements, associated safety design criteria and corporate nuclear safety goals. Figs

  19. Smart homes, private homes? An empirical study of technology researchers? perceptions of ethical issues in developing smart-home health technologies

    OpenAIRE

    Birchley, Giles; Huxtable, Richard; Murtagh, Madeleine; ter Meulen, Ruud; Flach, Peter; Gooberman-Hill, Rachael

    2017-01-01

    Background Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology?s potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engine...

  20. Making and Executing Decisions for Safe and Independent Living (MED-SAIL): development and validation of a brief screening tool.

    Science.gov (United States)

    Mills, Whitney L; Regev, Tziona; Kunik, Mark E; Wilson, Nancy L; Moye, Jennifer; McCullough, Laurence B; Naik, Aanand D

    2014-03-01

    Older adults prefer to remain in their own homes for as long as possible. The purpose of this article is to describe the development and preliminary validation of Making and Executing Decisions for Safe and Independent Living (MED-SAIL), a brief screening tool for capacity to live safely and independently in the community. Prospective preliminary validation study. Outpatient geriatrics clinic located in a community-based hospital. Forty-nine community-dwelling older adults referred to the clinic for a comprehensive capacity assessment. We examined internal consistency, criterion-based validity, concurrent validity, and accuracy of classification for MED-SAIL. The items included in MED-SAIL demonstrated internal consistency (5 items; α = 0.85). MED-SAIL was significantly correlated with the Independent Living Scales (r = 0.573, p ≤0.001) and instrumental activities of daily living (r = 0.440, p ≤0.01). The Mann-Whitney U test revealed significant differences between the no capacity and partial/full capacity classifications on MED-SAIL (U(48) = 60.5, Z = -0.38, p SAIL as a brief screening tool to identify older adults with impaired capacity for remaining safe and independent in their current living environment. MED-SAIL is useful tool for health and social service providers in the community for the purpose of referral for definitive capacity evaluation. Published by Elsevier Inc.

  1. An Automated Safe-to-Mate (ASTM) Tester

    Science.gov (United States)

    Nguyen, Phuc; Scott, Michelle; Leung, Alan; Lin, Michael; Johnson, Thomas

    2013-01-01

    Safe-to-mate testing is a common hardware safety practice where impedance measurements are made on unpowered hardware to verify isolation, continuity, or impedance between pins of an interface connector. A computer-based instrumentation solution has been developed to resolve issues. The ASTM is connected to the circuit under test, and can then quickly, safely, and reliably safe-to-mate the entire connector, or even multiple connectors, at the same time.

  2. Wii, Kinect, and Move. Heart Rate, Oxygen Consumption, Energy Expenditure, and Ventilation due to Different Physically Active Video Game Systems in College Students.

    Science.gov (United States)

    Scheer, Krista S; Siebrant, Sarah M; Brown, Gregory A; Shaw, Brandon S; Shaw, Ina

    Nintendo Wii, Sony Playstation Move , and Microsoft XBOX Kinect are home video gaming systems that involve player movement to control on-screen game play. Numerous investigations have demonstrated that playing Wii is moderate physical activity at best, but Move and Kinect have not been as thoroughly investigated. The purpose of this study was to compare heart rate, oxygen consumption, and ventilation while playing the games Wii Boxing, Kinect Boxing, and Move Gladiatorial Combat. Heart rate, oxygen consumption, and ventilation were measured at rest and during a graded exercise test in 10 males and 9 females (19.8 ± 0.33 y, 175.4 ± 2.0 cm, 80.2 ± 7.7 kg,). On another day, in a randomized order, the participants played Wii Boxing, K inect Boxing, and Move Gladiatorial Combat while heart rate, ventilation, and oxygen consumption were measured. There were no differences in heart rate (116.0 ± 18.3 vs. 119.3 ± 17.6 vs. 120.1 ± 17.6 beats/min), oxygen consumption (9.2 ± 3.0 vs. 10.6 ± 2.4 vs. 9.6 ± 2.4 ml/kg/min), or minute ventilation (18.9 ± 5.7 vs. 20.8 ± 8.0 vs. 19.7 ± 6.4 L/min) when playing Wii boxing, Kinect boxing, or Move Gladiatorial Combat (respectively). Playing Nintendo Wii Boxing, XBOX Kinect Boxing, and Sony PlayStation Move Gladiatorial Combat all increase heart rate, oxygen consumption, and ventilation above resting levels but there were no significant differences between gaming systems. Overall, playing a "physically active" home video game system does not meet the minimal threshold for moderate intensity physical activity, regardless of gaming system.

  3. At Home in the Office. A Guide for the Home Worker.

    Science.gov (United States)

    Thomas, Neil; And Others

    This guide provides information to persons interested in establishing a work-at-home program, specifically those in clerical or support staff positions who use modern automated office equipment. The text is divided into two sections. The Home Worker section provides a summary of the At Home in the Office Project, personality characteristics…

  4. USING THE SAFE SYSTEM APPROACH TO KEEP OLDER DRIVERS SAFELY MOBILE

    Directory of Open Access Journals (Sweden)

    Jim LANGFORD

    2006-01-01

    Full Text Available In 2003, Australian road transport jurisdictions collectively accepted that the greatest road safety gains would be achieved through adopting a Safe System approach, derived from Sweden's Vision Zero and the Netherlands' Sustainable Safety strategies. A key objective of all three approaches is to manage vehicles, the road infrastructure, speeds, road users and the interactions between these components, to ensure that in the event of crashes, crash energies will remain at levels that minimize the probability of death and serious injury. Older drivers pose a particular challenge to the Safe System approach, given particularly their greater physical frailty, their driving patterns and for some at least, their reduced fitness to drive. This paper has analyzed the so-called ‘older driver problem’ and identified a number of key factors underpinning their crash levels, for which countermeasures can be identified and implemented within a Safe System framework. The recommended countermeasures consist of: (1 safer roads, through a series of design improvements particularly governing urban intersections; (2 safer vehicles, through both the promotion of crashworthiness as a critical consideration when purchasing a vehicle and the wide use of developed and developing ITS technologies; (3 safer speeds especially at intersections; and (4 safer road users, through both improved assessment procedures to identify the minority of older drivers with reduced fitness to drive and educational efforts to encourage safer driving habits particularly but not only through self-regulation.

  5. OxyGene: an innovative platform for investigating oxidative-response genes in whole prokaryotic genomes

    Directory of Open Access Journals (Sweden)

    Barloy-Hubler Frédérique

    2008-12-01

    Full Text Available Abstract Background Oxidative stress is a common stress encountered by living organisms and is due to an imbalance between intracellular reactive oxygen and nitrogen species (ROS, RNS and cellular antioxidant defence. To defend themselves against ROS/RNS, bacteria possess a subsystem of detoxification enzymes, which are classified with regard to their substrates. To identify such enzymes in prokaryotic genomes, different approaches based on similarity, enzyme profiles or patterns exist. Unfortunately, several problems persist in the annotation, classification and naming of these enzymes due mainly to some erroneous entries in databases, mistake propagation, absence of updating and disparity in function description. Description In order to improve the current annotation of oxidative stress subsystems, an innovative platform named OxyGene has been developed. It integrates an original database called OxyDB, holding thoroughly tested anchor-based signatures associated to subfamilies of oxidative stress enzymes, and a new anchor-driven annotator, for ab initio detection of ROS/RNS response genes. All complete Bacterial and Archaeal genomes have been re-annotated, and the results stored in the OxyGene repository can be interrogated via a Graphical User Interface. Conclusion OxyGene enables the exploration and comparative analysis of enzymes belonging to 37 detoxification subclasses in 664 microbial genomes. It proposes a new classification that improves both the ontology and the annotation of the detoxification subsystems in prokaryotic whole genomes, while discovering new ORFs and attributing precise function to hypothetical annotated proteins. OxyGene is freely available at: http://www.umr6026.univ-rennes1.fr/english/home/research/basic/software

  6. Evolution of Home Automation Technology

    OpenAIRE

    Mohd. Rihan; M. Salim Beg

    2009-01-01

    In modern society home and office automation has becomeincreasingly important, providing ways to interconnectvarious home appliances. This interconnection results infaster transfer of information within home/offices leading tobetter home management and improved user experience.Home Automation, in essence, is a technology thatintegrates various electrical systems of a home to provideenhanced comfort and security. Users are grantedconvenient and complete control over all the electrical homeappl...

  7. More Than Four Walls: The Meaning of Home in Home Birth Experiences

    Directory of Open Access Journals (Sweden)

    Emily Burns

    2015-04-01

    Full Text Available The “home versus hospital” as places of birth debate has had a long and at times vicious history. From academic literature to media coverage, the two have often been pitted against each other not only as opposing physical spaces, but also as opposing ideologies of birth. The hospital has been heavily critiqued as a site of childbirth since the 1960s, with particular focus on childbirth and medicalisation. The focus of much of the hospital and home birthing research exists on a continuum of medicalisation, safety, risk, agency, and maternal and neonatal health and wellbeing. While the hospital birthing space has been interrogated, a critique of home birthing space has remained largely absent from the social sciences. The research presented in this article unpacks the complex relationship between home birthing women and the spaces in which they birth. Using qualitative data collected with 59 home birthing women in Australia in 2010, between childbearing and the home should not be considered as merely an alternative to hospital births, but rather as an experience that completely renegotiates the home space. Home, for the participants in this study, is a dynamic, changing, and even spiritual element in the childbirth experience, and not simply the building in which it occurs.

  8. Second-home electricity consumption

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, Frits M.; Morthorst, Poul Erik [Risoe, Systems Analysis Department, Technical University of Denmark, P.O. Box 49, DK-4000 Roskilde (Denmark); Christensen, Morten S.; Kofoed, Niels-Ulrik [Esbensen Consulting Engineers, Carl Jacobsens Vej 25D, DK-2500 Valby (Denmark); Jensen, Ole Michael [Danish Building Research Institute, Department of Energy and Environment, University of Aalborg, P.O. Box 119, DK-2970 Horsholm (Denmark)

    2008-01-15

    In Denmark, electricity consumption in first and second homes has developed quite differently. Since 1990, electricity consumption in ordinary residences has grown moderately, while consumption in weekend and second homes has increased considerably. In turn, this development has been blamed on a growing number of luxury cottages, new legislation permitting senior citizens to have their permanent address in their second home and a growing number of electric appliances. In order to examine the growing electricity consumption in second homes and to estimate future demand, a multidisciplinary study combining top-down and bottom-up analyses was conducted, i.e., combining models using aggregated economic parameters and feasibility studies using technical parameters, respectively. The top-down estimation showed that changes in electricity consumption in second homes correlate to changes in income. The bottom-up estimation showed that consumption was mainly affected by the frequency with which second homes were used in the winter time. This indicates that additional second homes, increased full-time use and intensified use of electric appliances are the main reasons for the observed increases in electricity consumption. Luxury tourism use and senior citizens' that use a few per cent of the second homes as their home contribute to a minor degree to the overall increase of electricity consumption. Scenarios show that this development may accelerate with increased leisure time, increased use and more permanent settlement in second homes. (author)

  9. DOE Zero Energy Ready Home Case Study: Amaris Homes, Afton Model

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2017-09-01

    Amaris Homes built this 3,734-ft2 home in Afton, Minnesota, to the performance criteria of the DOE Zero Energy Ready Home (ZERH) program. A high-efficiency gas boiler provides hot water for the zoned radiant floor system as well as for faucets and showers. A high-efficiency heat pump provides zoned cooling.

  10. Cleaning and disinfection in home care: A comparison of 2 commercial products with potentially different consequences for respiratory health.

    Science.gov (United States)

    Goodyear, Nancy; Markkanen, Pia; Beato-Melendez, Christian; Mohamed, Hagir; Gore, Rebecca; Galligan, Catherine; Sama, Susan; Quinn, Margaret

    2018-04-01

    Home care aides perform personal care and homemaking services in client homes, including cleaning and disinfection (C&D). Although C&D are performed to remove soil and dust, they are increasingly performed for infection prevention. Many C&D products contain respiratory irritants. The objective of this study was to evaluate 2 commercial products for C&D effectiveness on common household surfaces in seniors' homes. Two C&D visits were conducted in 46 seniors' homes. One visit applied a bleach-containing cleaning product and the other applied an environmentally preferable product. Before and after C&D, the study team performed organic soil bioluminometer measurements on surfaces and collected cotton swab and wipe samples for total bacteria count, Staphylococcus aureus, and Clostridium difficile identification. Both products removed microorganisms from tested surfaces. S aureus was found in 7 households, 1 strain of which was methicillin-resistant. Both products removed S aureus from all surfaces. Bleach-containing products removed somewhat more soil than environmentally preferable products, although results were statistically significant for only 1 surface. The study showed similar, not identical, C&D performance for 2 cleaning products with potentially different consequences for respiratory health. Additional research is needed to develop robust recommendations for safe, effective C&D in home care. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  11. Feeling safe during an inpatient hospitalization: a concept analysis.

    Science.gov (United States)

    Mollon, Deene

    2014-08-01

    This paper aims to explore the critical attributes of the concept feeling safe. The safe delivery of care is a high priority; however; it is not really known what it means to the patient to 'feel safe' during an inpatient hospitalization. This analysis explores the topic of safety from the patient's perspective. Concept analysis. The data bases of CINAHL, Medline, PsychInfo and Google Scholar for the years 1995-2012 were searched using the terms safe and feeling safe. The eight-step concept analysis method of Walker and Avant was used to analyse the concept of feeling safe. Uses and defining attributes, as well as identified antecedents, consequences and empirical referents, are presented. Case examples are provided to assist in the understanding of defining attributes. Feeling safe is defined as an emotional state where perceptions of care contribute to a sense of security and freedom from harm. Four attributes were identified: trust, cared for, presence and knowledge. Relationship, environment and suffering are the antecedents of feeling safe, while control, hope and relaxed or calm are the consequences. Empirical referents and early development of a theory of feeling safe are explored. This analysis begins the work of synthesizing qualitative research already completed around the concept of feeling safe by defining the key attributes of the concept. Support for the importance of developing patient-centred models of care and creating positive environments where patients receive high-quality care and feel safe is provided. © 2014 John Wiley & Sons Ltd.

  12. Oxygen-Partial-Pressure Sensor for Aircraft Oxygen Mask

    Science.gov (United States)

    Kelly, Mark; Pettit, Donald

    2003-01-01

    A device that generates an alarm when the partial pressure of oxygen decreases to less than a preset level has been developed to help prevent hypoxia in a pilot or other crewmember of a military or other high-performance aircraft. Loss of oxygen partial pressure can be caused by poor fit of the mask or failure of a hose or other component of an oxygen distribution system. The deleterious physical and mental effects of hypoxia cause the loss of a military aircraft and crew every few years. The device is installed in the crewmember s oxygen mask and is powered via communication wiring already present in all such oxygen masks. The device (see figure) includes an electrochemical sensor, the output potential of which is proportional to the partial pressure of oxygen. The output of the sensor is amplified and fed to the input of a comparator circuit. A reference potential that corresponds to the amplified sensor output at the alarm oxygen-partial-pressure level is fed to the second input of the comparator. When the sensed partial pressure of oxygen falls below the minimum acceptable level, the output of the comparator goes from the low state (a few millivolts) to the high state (near the supply potential, which is typically 6.8 V for microphone power). The switching of the comparator output to the high state triggers a tactile alarm in the form of a vibration in the mask, generated by a small 1.3-Vdc pager motor spinning an eccentric mass at a rate between 8,000 and 10,000 rpm. The sensation of the mask vibrating against the crewmember s nose is very effective at alerting the crewmember, who may already be groggy from hypoxia and is immersed in an environment that is saturated with visual cues and sounds. Indeed, the sensation is one of rudeness, but such rudeness could be what is needed to stimulate the crewmember to take corrective action in a life-threatening situation.

  13. Strategy Guideline: Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Savage, C.; Hunt, A.

    2012-12-01

    This guideline will provide a general overview of the different kinds of demonstration home projects, a basic understanding of the different roles and responsibilities involved in the successful completion of a demonstration home, and an introduction into some of the lessons learned from actual demonstration home projects. Also, this guideline will specifically look at the communication methods employed during demonstration home projects. And lastly, we will focus on how to best create a communication plan for including an energy efficient message in a demonstration home project and carry that message to successful completion.

  14. Strategy Guideline. Demonstration Home

    Energy Technology Data Exchange (ETDEWEB)

    Hunt, A.; Savage, C.

    2012-12-01

    This guideline will provide a general overview of the different kinds of demonstration home projects, a basic understanding of the different roles and responsibilities involved in the successful completion of a demonstration home, and an introduction into some of the lessons learned from actual demonstration home projects. Also, this guideline will specifically look at the communication methods employed during demonstration home projects. And lastly, we will focus on how to best create a communication plan for including an energy efficient message in a demonstration home project and carry that message to successful completion.

  15. A comparison of home care clients and nursing home residents: can community based care keep the elderly and disabled at home?

    Science.gov (United States)

    Shugarman, L R; Fries, B E; James, M

    1999-01-01

    Admission cohorts from the Michigan Medicaid Home and Community-Based Waiver program and Ohio nursing homes were compared on measures of resource utilization including a modified Resource Utilization Groups (RUG-III) system, Activities of Daily Living (ADLs), and overall case mix. We found that, contrary to previous research, the two samples were remarkably similar across RUG-III categories. However, the nursing home sample was more functionally impaired on measures of ADL functioning and overall case mix. Results of this study may inform policymakers and providers of the potential for maintaining the appropriate population in the home with government-funded home care.

  16. At-home and away-from-home dietary patterns and BMI z-scores in Brazilian adolescents.

    Science.gov (United States)

    Cunha, Diana Barbosa; Bezerra, Ilana Nogueira; Pereira, Rosangela Alves; Sichieri, Rosely

    2018-01-01

    Away-from-home food intake has been associated with high rates of overweight among children and adolescents. However, there are no studies comparing at-home and away-from-home eating patterns among adolescents. The objective of this paper was to identify at-home and away-from-home dietary patterns among adolescents in Brazil, and to evaluate the relationship between these patterns and body mass index (BMI) z-scores. Data from the Brazilian National Dietary Survey 2008-2009 were analyzed in this cross-sectional study. Dietary intake was assessed by completion of written food records on two non-consecutive days. Five thousand two hundred sixty-six adolescents 10-19 years of age living in urban areas of Brazil were included in the analysis. Thirty-two food groups were examined by factor analysis, stratified by at-home and away-from-home eating. The associations between the food patterns and BMI z-scores were ascertained using linear regression analysis. In general, mean at-home food intake was greater than away-from-home food intake, but the ratio of away-from-home/at-home was greater than 30% for baked and deep-fried snacks, soft drinks, sandwiches, pizza, and desserts, and was lower than 10% for rice and beans. Three main similar dietary patterns were identified both at-home and away-from-home: the "Traditional pattern", the "Bread and Butter pattern" and the "Western pattern"; however, away-from-home patterns encompassed more overall food items. Only the at-home "Western pattern" was positively associated with BMI z-scores (β = 0.0006; p away-from-home food consumption is not associated. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Creating Safe Spaces for Music Learning

    Science.gov (United States)

    Hendricks, Karin S.; Smith, Tawnya D.; Stanuch, Jennifer

    2014-01-01

    This article offers a practical model for fostering emotionally safe learning environments that instill in music students a positive sense of self-belief, freedom, and purpose. The authors examine the implications for music educators of creating effective learning environments and present recommendations for creating a safe space for learning,…

  18. Alert management for home healthcare based on home automation analysis.

    Science.gov (United States)

    Truong, T T; de Lamotte, F; Diguet, J-Ph; Said-Hocine, F

    2010-01-01

    Rising healthcare for elder and disabled people can be controlled by offering people autonomy at home by means of information technology. In this paper, we present an original and sensorless alert management solution which performs multimedia and home automation service discrimination and extracts highly regular home activities as sensors for alert management. The results of simulation data, based on real context, allow us to evaluate our approach before application to real data.

  19. Keeping Food Safe

    Centers for Disease Control (CDC) Podcasts

    2009-05-27

    This CDC Kidtastics podcast discusses things kids and parents can do to help prevent illness by keeping food safe.  Created: 5/27/2009 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 5/27/2009.

  20. Plutonium safe handling

    International Nuclear Information System (INIS)

    Tvehlov, Yu.

    2000-01-01

    The abstract, prepared on the basis of materials of the IAEA new leadership on the plutonium safe handling and its storage (the publication no. 9 in the Safety Reports Series), aimed at presenting internationally acknowledged criteria on the radiation danger evaluation and summarizing the experience in the safe management of great quantities of plutonium, accumulated in the nuclear states, is presented. The data on the weapon-class and civil plutonium, the degree of its danger, the measures for provision of its safety, including the data on accident radiation consequences with the fission number 10 18 , are presented. The recommendations, making it possible to eliminate the super- criticality danger, as well as ignition and explosion, to maintain the tightness of the facility, aimed at excluding the radioactive contamination and the possibility of internal irradiation, to provide for the plutonium security, physical protection and to reduce irradiation are given [ru

  1. 16 CFR 460.16 - What new home sellers must tell new home buyers.

    Science.gov (United States)

    2010-01-01

    ... LABELING AND ADVERTISING OF HOME INSULATION § 460.16 What new home sellers must tell new home buyers. If you are a new home seller, you must put the following information in every sales contract: The type... exception to this rule. If the buyer signs a sales contract before you know what type of insulation will be...

  2. [Home births].

    Science.gov (United States)

    Welffens, K; Kirkpatrick, C; Daelemans, C; Derisbourg, S

    In Belgium, very few women give birth outside the delivery room. In the United Kingdom and in the Netherlands, they are more numerous. Several studies evaluated obstetric and neonatal outcomes of home births compared with hospital births. We selected seven recent and large studies (with cohorts of more than 5.000 women) using PubMed, Science Direct and Cochrane Database of Systematic Reviews. Several questions were examined. Is there any difference in maternal and neonatal outcomes depending on the intended place of birth? Does parity affect outcomes ? What are the characteristics of women who choose to deliver at home ? We conclude that giving birth at home improves obstetric outcomes but is riskier for the baby, especially for the first one. The women delivering at home are mainly white Europeans, between 25 and 35 years old, in a relationship, multiparous and wealthier. In order to avoid this increased risk for the baby while preserving the obstetric advantages, alongside birth centers offer an intermediate solution. They combine the reassuring home-like atmosphere with the safety of the hospital. In Belgium, the first alongside birth center " Le Cocon " (a low technicity unit distinct from the delivery room) offers now this type of alternative place of birth for women in Hôpital Erasme in Brussels.

  3. Cerebral oxygen saturation and cardiac output during anaesthesia in sitting position for neurosurgical procedures: a prospective observational study.

    Science.gov (United States)

    Schramm, P; Tzanova, I; Hagen, F; Berres, M; Closhen, D; Pestel, G; Engelhard, K

    2016-10-01

    Neurosurgical operations in the dorsal cranium often require the patient to be positioned in a sitting position. This can be associated with decreased cardiac output and cerebral hypoperfusion, and possibly, inadequate cerebral oxygenation. In the present study, cerebral oxygen saturation was measured during neurosurgery in the sitting position and correlated with cardiac output. Perioperative cerebral oxygen saturation was measured continuously with two different monitors, INVOS ® and FORE-SIGHT ® . Cardiac output was measured at eight predefined time points using transoesophageal echocardiography. Forty patients were enrolled, but only 35 (20 female) were eventually operated on in the sitting position. At the first time point, the regional cerebral oxygen saturation measured with INVOS ® was 70 (sd 9)%; thereafter, it increased by 0.0187% min -1 (P<0.01). The cerebral tissue oxygen saturation measured with FORE-SIGHT ® started at 68 (sd 13)% and increased by 0.0142% min -1 (P<0.01). The mean arterial blood pressure did not change. Cardiac output was between 6.3 (sd 1.3) and 7.2 (1.8) litre min -1 at the predefined time points. Cardiac output, but not mean arterial blood pressure, showed a positive and significant correlation with cerebral oxygen saturation. During neurosurgery in the sitting position, the cerebral oxygen saturation slowly increases and, therefore, this position seems to be safe with regard to cerebral oxygen saturation. Cerebral oxygen saturation is stable because of constant CO and MAP, while the influence of CO on cerebral oxygen saturation seems to be more relevant. NCT01275898. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Intersecting Homeliness: Vietnamese Australian Reflections of a Suburban Home (Strathfield, NSW

    Directory of Open Access Journals (Sweden)

    Helary Ngo

    2015-09-01

    Full Text Available In year 2013, I lived in Vietnam. Once a year, the Vietnamese people have a particular tradition called khom đất, where the people set out a guest table filled with delicious feast of food and paper clothing, shoes, accessories and money for the spirits of the house. Khom in khom đất means a set of rituals or prayer to bow down and pay respect. Đất means land. It is a ritual which acknowledges the spirits within the home and the agency these spirits have to the home. There would be separate rituals for different types of spirits and incense would burn as an offering to various places. For example, an incense and food offering would be on an alter directly above the fire stove in the kitchen to be grateful to the fire spirit of the home. There is a belief that if the fire spirit gets angry, the spirit may be a danger to the family. The spirit has the agency and a power over the home. It is a ritual to recognise that a home has its ghosts, its history and its spirits that reside long before the current people residents and that they have the power to protect or destroy. Mostly, it is to recognaise that land and place is not to be owned, and matters such as fire or water or wood is not mere commodities. Rather, these materialities are living and only would be at our disposal to help us when they given the respect and recognition that they are living and are powerful agents. Within the Vietnamese language, there is no specific word for differentiate ‘home’ and ‘house’ but rather, use the word ‘house’ to mean both the building and the home – nhà (Rather then state, ‘I go home’ one states literally, ‘I return to the house’ – Tôi về nhà. To state house rather than home could mean that home is not to be possessed but rather, has it’s own agency, vitality and spirit. With this in mind, I will tell you about a particular uncanny phenomenon that has happened in my family home in Strathfield (a loved family home where

  5. Training traditional birth attendants to use misoprostol and an absorbent delivery mat in home births.

    Science.gov (United States)

    Prata, Ndola; Quaiyum, Md Abdul; Passano, Paige; Bell, Suzanne; Bohl, Daniel D; Hossain, Shahed; Azmi, Ashrafi Jahan; Begum, Mohsina

    2012-12-01

    A 50-fold disparity in maternal mortality exists between high- and low-income countries, and in most contexts, the single most common cause of maternal death is postpartum hemorrhage (PPH). In Bangladesh, as in many other low-income countries, the majority of deliveries are conducted at home by traditional birth attendants (TBAs) or family members. In the absence of skilled birth attendants, training TBAs in the use of misoprostol and an absorbent delivery mat to measure postpartum blood loss may strengthen the ability of TBAs to manage PPH. These complementary interventions were tested in operations research among 77,337 home births in rural Bangladesh. The purpose of this study was to evaluate TBAs' knowledge acquisition, knowledge retention, and changes in attitudes and practices related to PPH management in home births after undergoing training on the use of misoprostol and the blood collection delivery mat. We conclude that the training was highly effective and that the two interventions were safely and correctly used by TBAs at home births. Data on TBA practices indicate adherence to protocol, and 18 months after the interventions were implemented, TBA knowledge retention remained high. This program strengthens the case for community-based use of misoprostol and warrants consideration of this intervention as a potential model for scale-up in settings where complete coverage of skilled birth attendants (SBAs) remains a distant goal. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. SETI@home

    Science.gov (United States)

    Project Help Donate Porting Graphics Add-ons Science About SETI@home About Astropulse Science Community Message boards Questions and Answers Teams Profiles User search Web sites Pictures and music User University of California SETI@home and Astropulse are funded by grants from the National Science Foundation

  7. Paramedic-Initiated Home Care Referrals and Use of Home Care and Emergency Medical Services.

    Science.gov (United States)

    Verma, Amol A; Klich, John; Thurston, Adam; Scantlebury, Jordan; Kiss, Alex; Seddon, Gayle; Sinha, Samir K

    2018-01-01

    We examined the association between paramedic-initiated home care referrals and utilization of home care, 9-1-1, and Emergency Department (ED) services. This was a retrospective cohort study of individuals who received a paramedic-initiated home care referral after a 9-1-1 call between January 1, 2011 and December 31, 2012 in Toronto, Ontario, Canada. Home care, 9-1-1, and ED utilization were compared in the 6 months before and after home care referral. Nonparametric longitudinal regression was performed to assess changes in hours of home care service use and zero-inflated Poisson regression was performed to assess changes in the number of 9-1-1 calls and ambulance transports to ED. During the 24-month study period, 2,382 individuals received a paramedic-initiated home care referral. After excluding individuals who died, were hospitalized, or were admitted to a nursing home, the final study cohort was 1,851. The proportion of the study population receiving home care services increased from 18.2% to 42.5% after referral, representing 450 additional people receiving services. In longitudinal regression analysis, there was an increase of 17.4 hours in total services per person in the six months after referral (95% CI: 1.7-33.1, p = 0.03). The mean number of 9-1-1 calls per person was 1.44 (SD 9.58) before home care referral and 1.20 (SD 7.04) after home care referral in the overall study cohort. This represented a 10% reduction in 9-1-1 calls (95% CI: 7-13%, p home care referral and 0.79 (SD 6.27) after home care referral, representing a 7% reduction (95% CI: 3-11%, p home care records were included in the analysis, the reductions in 9-1-1 calls and ambulance transports to ED were attenuated but remained statistically significant. Paramedic-initiated home care referrals in Toronto were associated with improved access to and use of home care services and may have been associated with reduced 9-1-1 calls and ambulance transports to ED.

  8. New American Home(regsign): Atlanta, Georgia - 2001; Building America--The New American Home

    International Nuclear Information System (INIS)

    IBACOS; Anderson, R.

    2001-01-01

    The New American Home(reg s ign) is an annual showcase project designed by committee and co-sponsored by the National Association of Home Builders' National Council of the Housing Industry, BUILDERS Magazine, and Ladies Home Journal. Hedgewood Properties teamed with Building America's IBACOS Consortium and Southface Energy Institute to build a house with a Home Energy Rating Systems (HERS) level of 90

  9. Digital Living at Home

    DEFF Research Database (Denmark)

    Andersen, Pernille Viktoria Kathja; Christiansen, Ellen Tove

    2013-01-01

    of these user voices has directed us towards a ‘home-keeping’ design discourse, which opens new horizons for design of digital home control systems by allowing users to perform as self-determined controllers and groomers of their habitat. The paper concludes by outlining the implications of a ‘home......Does living with digital technology inevitably lead to digital living? Users talking about a digital home control system, they have had in their homes for eight years, indicate that there is more to living with digital technology than a functional-operational grip on regulation. Our analysis......-keeping’ design discourse....

  10. Density functional theory study the effects of oxygen-containing functional groups on oxygen molecules and oxygen atoms adsorbed on carbonaceous materials.

    Science.gov (United States)

    Qi, Xuejun; Song, Wenwu; Shi, Jianwei

    2017-01-01

    Density functional theory was used to study the effects of different types of oxygen-containing functional groups on the adsorption of oxygen molecules and single active oxygen atoms on carbonaceous materials. During gasification or combustion reactions of carbonaceous materials, oxygen-containing functional groups such as hydroxyl(-OH), carbonyl(-CO), quinone(-O), and carboxyl(-COOH) are often present on the edge of graphite and can affect graphite's chemical properties. When oxygen-containing functional groups appear on a graphite surface, the oxygen molecules are strongly adsorbed onto the surface to form a four-member ring structure. At the same time, the O-O bond is greatly weakened and easily broken. The adsorption energy value indicates that the adsorption of oxygen molecules changes from physisorption to chemisorption for oxygen-containing functional groups on the edge of a graphite surface. In addition, our results indicate that the adsorption energy depends on the type of oxygen-containing functional group. When a single active oxygen atom is adsorbed on the bridge site of graphite, it gives rise to a stable epoxy structure. Epoxy can cause deformation of the graphite lattice due to the transition of graphite from sp2 to sp3 after the addition of an oxygen atom. For quinone group on the edge of graphite, oxygen atoms react with carbon atoms to form the precursor of CO2. Similarly, the single active oxygen atoms of carbonyl groups can interact with edge carbon atoms to form the precursor of CO2. The results show that oxygen-containing functional groups on graphite surfaces enhance the activity of graphite, which promotes adsorption on the graphite surface.

  11. Development of a Novel Cu(II Complex Modified Electrode and a Portable Electrochemical Analyzer for the Determination of Dissolved Oxygen (DO in Water

    Directory of Open Access Journals (Sweden)

    Salvatore Gianluca Leonardi

    2016-04-01

    Full Text Available The development of an electrochemical dissolved oxygen (DO sensor based on a novel Cu(II complex-modified screen printed carbon electrode is reported. The voltammetric behavior of the modified electrode was investigated at different scan rates and oxygen concentrations in PBS (pH = 7. An increase of cathodic current (at about −0.4 vs. Ag/AgCl with the addition of oxygen was observed. The modified Cu(II complex electrode was demonstrated for the determination of DO in water using chronoamperometry. A small size and low power consumption home-made portable electrochemical analyzer based on custom electronics for sensor interfacing and operating in voltammetry and amperometry modes has been also designed and fabricated. Its performances in the monitoring of DO in water were compared with a commercial one.

  12. Robotics to enable older adults to remain living at home.

    Science.gov (United States)

    Pearce, Alan J; Adair, Brooke; Miller, Kimberly; Ozanne, Elizabeth; Said, Catherine; Santamaria, Nick; Morris, Meg E

    2012-01-01

    Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1) what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2) what is the evidence demonstrating that robotic devices are effective in enabling independent living in community dwelling older people? Following database searches for relevant literature an initial yield of 161 articles was obtained. Titles and abstracts of articles were then reviewed by 2 independent people to determine suitability for inclusion. Forty-two articles met the criteria for question 1. Of these, 4 articles met the criteria for question 2. Results showed that robotics is currently available to assist older healthy people and people with disabilities to remain independent and to monitor their safety and social connectedness. Most studies were conducted in laboratories and hospital clinics. Currently limited evidence demonstrates that robots can be used to enable people to remain living at home, although this is an emerging smart technology that is rapidly evolving.

  13. Robotics to Enable Older Adults to Remain Living at Home

    Directory of Open Access Journals (Sweden)

    Alan J. Pearce

    2012-01-01

    Full Text Available Given the rapidly ageing population, interest is growing in robots to enable older people to remain living at home. We conducted a systematic review and critical evaluation of the scientific literature, from 1990 to the present, on the use of robots in aged care. The key research questions were as follows: (1 what is the range of robotic devices available to enable older people to remain mobile, independent, and safe? and, (2 what is the evidence demonstrating that robotic devices are effective in enabling independent living in community dwelling older people? Following database searches for relevant literature an initial yield of 161 articles was obtained. Titles and abstracts of articles were then reviewed by 2 independent people to determine suitability for inclusion. Forty-two articles met the criteria for question 1. Of these, 4 articles met the criteria for question 2. Results showed that robotics is currently available to assist older healthy people and people with disabilities to remain independent and to monitor their safety and social connectedness. Most studies were conducted in laboratories and hospital clinics. Currently limited evidence demonstrates that robots can be used to enable people to remain living at home, although this is an emerging smart technology that is rapidly evolving.

  14. Effectiveness of community based Safe Motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania.

    Science.gov (United States)

    Mushi, Declare; Mpembeni, Rose; Jahn, Albrecht

    2010-04-01

    In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%), only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs). Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (rho utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

  15. Oxygen therapy devices and portable ventilators for improved physical activity in daily life in patients with chronic respiratory disease.

    Science.gov (United States)

    Furlanetto, Karina Couto; Pitta, Fabio

    2017-02-01

    Patients with hypoxemia and chronic respiratory failure may need to use oxygen therapy to correct hypoxemia and to use ventilatory support to augment alveolar ventilation, reverse abnormalities in blood gases (in particular hypercapnia) and reduce the work of breathing. Areas covered: This narrative review provides an overview on the use of oxygen therapy devices or portable ventilators for improved physical activity in daily life (PADL) as well as discusses the issue of lower mobility in daily life among stable patients with chronic respiratory disease who present indication for long-term oxygen therapy (LTOT) or home-based noninvasive ventilation (NIV). A literature review of these concepts was performed by using all related search terms. Expert commentary: Technological advances led to the development of light and small oxygen therapy devices and portable ventilators which aim to facilitate patients' mobility and ambulation. However, the day-by-day dependence of a device may reduce mobility and partially impair patients' PADL. Nocturnal NIV implementation in hypercapnic patients seems promising to improve PADL. The magnitude of their equipment-related physical inactivity is underexplored up to this moment and more long-term randomized clinical trials and meta-analysis examining the effects of ambulatory oxygen and NIV on PADL are required.

  16. Safe injection practice among health care workers, Gharbiya, Egypt.

    Science.gov (United States)

    Ismail, Nanees A; Aboul Ftouh, Aisha M; El Shoubary, Waleed H

    2005-01-01

    A cross-sectional study was conducted in 25 health care facilities in Gharbiya governorate to assess safe injection practices among health care workers (HCWs). Two questionnaires, one to collect information about administrative issues related to safe injection and the other to collect data about giving injections, exposure to needle stick injuries, hepatitis B vaccination status and safe injection training. Practices of injections were observed using a standardized checklist. The study revealed that there was lack of both national and local infection control policies and lack of most of the supplies needed for safe injection practices. Many safe practices were infrequent as proper needle manipulation before disposal (41%), safe needle disposal (47.5%), reuse of used syringe & needle (13.2%) and safe syringe disposal (0%). Exposure to needle stick injuries were common among the interviewed HCWs (66.2%) and hand washing was the common post exposure prophylaxis measure (63.4%). Only 11.3% of HCWs had full course hepatitis B vaccination. Infection control -including safe injections- training programs should be afforded to all HCWs.

  17. Asthma Home Environment Checklist

    Science.gov (United States)

    This checklist guides home care visitors in identifying environmental asthma triggers most commonly found in homes. It includes sections on the building, home interior and room interior and provides low-cost action steps for remediation.

  18. SafeNet: a methodology for integrating general-purpose unsafe devices in safe-robot rehabilitation systems.

    Science.gov (United States)

    Vicentini, Federico; Pedrocchi, Nicola; Malosio, Matteo; Molinari Tosatti, Lorenzo

    2014-09-01

    Robot-assisted neurorehabilitation often involves networked systems of sensors ("sensory rooms") and powerful devices in physical interaction with weak users. Safety is unquestionably a primary concern. Some lightweight robot platforms and devices designed on purpose include safety properties using redundant sensors or intrinsic safety design (e.g. compliance and backdrivability, limited exchange of energy). Nonetheless, the entire "sensory room" shall be required to be fail-safe and safely monitored as a system at large. Yet, sensor capabilities and control algorithms used in functional therapies require, in general, frequent updates or re-configurations, making a safety-grade release of such devices hardly sustainable in cost-effectiveness and development time. As such, promising integrated platforms for human-in-the-loop therapies could not find clinical application and manufacturing support because of lacking in the maintenance of global fail-safe properties. Under the general context of cross-machinery safety standards, the paper presents a methodology called SafeNet for helping in extending the safety rate of Human Robot Interaction (HRI) systems using unsafe components, including sensors and controllers. SafeNet considers, in fact, the robotic system as a device at large and applies the principles of functional safety (as in ISO 13489-1) through a set of architectural procedures and implementation rules. The enabled capability of monitoring a network of unsafe devices through redundant computational nodes, allows the usage of any custom sensors and algorithms, usually planned and assembled at therapy planning-time rather than at platform design-time. A case study is presented with an actual implementation of the proposed methodology. A specific architectural solution is applied to an example of robot-assisted upper-limb rehabilitation with online motion tracking. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. DOE Zero Energy Ready Home Case Study: One Sky Homes — Cottle Zero Net Energy Home, San Jose, CA

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    This builder took home the Grand Winner prize in the Custom Builder category in the 2014 Housing Innovation Awards for its high performance building science approach. The builder used insulated concrete form blocks to create the insulated crawlspace foundation for its first DOE Zero Energy Ready Home, the first net zero energy new home certified in the state of California.

  20. Safety assessment of a home-based telecare system for adults with developmental disabilities in Indiana: a multi-stakeholder perspective.

    Science.gov (United States)

    Brewer, Jeffrey L; Taber-Doughty, Teresa; Kubik, Sara

    2010-01-01

    We investigated the perceptions of people about the safety, security and privacy of a telecare monitoring system for adults with developmental disabilities living in residential settings. The telecare system was used by remote caregivers overnight, when staff were not present in the homes. We surveyed 127 people from different stakeholder groups in the state of Indiana. The people surveyed included those with knowledge or experience of telecare, and those without. The stakeholders were clients, their advocates, service provider administrators and independent case coordinators. The responses in each category for every group were positive except one: only 4 of the 11 telecare case coordinators agreed that the telecare system provided a secure environment. Overall, the telecare system was perceived to be as safe, secure and private as the conventional alternative of having staff in the home.

  1. "Home is always home" : (former) street youth in Blantyre, Malawi, and the fluidity of constructing home

    NARCIS (Netherlands)

    Hendriks, T.D.

    2016-01-01

    For many Malawians the concept of home is strongly associated with the rural areas and one's (supposedly rural) place of birth. This 'grand narrative about home', though often reiterated, doesn't necessarily depict lived reality. Malawi's history of movement and labor migration coupled with

  2. "Home is always home" : (former) street youth in Blantyre, Malawi, and the fluidity of constructing home

    NARCIS (Netherlands)

    Hendriks, T.D.

    2017-01-01

    For many Malawians the concept of home is strongly associated with the rural areas and one's (supposedly rural) place of birth. This 'grand narrative about home', though often reiterated, doesn't necessarily depict lived reality. Malawi's history of movement and labor migration coupled with

  3. Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania

    Directory of Open Access Journals (Sweden)

    Jahn Albrecht

    2010-04-01

    Full Text Available Abstract Background In Tanzania, maternal mortality ratio remains unacceptably high at 578/100,000 live births. Despite a high coverage of antenatal care (96%, only 44% of deliveries take place within the formal health services. Still, "Ensure skilled attendant at birth" is acknowledged as one of the most effective interventions to reduce maternal deaths. Exploring the potential of community-based interventions in increasing the utilization of obstetric care, the study aimed at developing, testing and assessing a community-based safe motherhood intervention in Mtwara rural District of Tanzania. Method This community-based intervention was designed as a pre-post comparison study, covering 4 villages with a total population of 8300. Intervention activities were implemented by 50 trained safe motherhood promoters (SMPs. Their tasks focused on promoting early and complete antenatal care visits and delivery with a skilled attendant. Data on all 512 deliveries taking place from October 2004 to November 2006 were collected by the SMPs and cross-checked with health service records. In addition 242 respondents were interviewed with respect to knowledge on safe motherhood issues and their perception of the SMP's performance. Skilled delivery attendance was our primary outcome; secondary outcomes included antenatal care attendance and knowledge on Safe Motherhood issues. Results Deliveries with skilled attendant significantly increased from 34.1% to 51.4% (ρ Conclusion The study has demonstrated the effectiveness of community-based safe motherhood intervention in promoting the utilization of obstetric care and a skilled attendant at delivery. This improvement is attributed to the SMPs' home visits and the close collaboration with existing community structures as well as health services.

  4. Smart homes, private homes? An empirical study of technology researchers' perceptions of ethical issues in developing smart-home health technologies.

    Science.gov (United States)

    Birchley, Giles; Huxtable, Richard; Murtagh, Madeleine; Ter Meulen, Ruud; Flach, Peter; Gooberman-Hill, Rachael

    2017-04-04

    Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology's potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engineers themselves. By exploring the views of engineering researchers in a large smart-home project, we sought to contribute to dialogue between ethics and the engineering community. Either face-to-face or using Skype, we conducted in-depth qualitative interviews with 20 early- and mid-career smart-home researchers from a multi-centre smart-home project, who were asked to describe their own experience and to reflect more broadly about ethical considerations that relate to smart-home design. With participants' consent, interviews were audio-recorded, transcribed and analysed using a thematic approach. Two overarching themes emerged: in 'Privacy', researchers indicated that they paid close attention to negative consequences of potential unauthorised information sharing in their current work. However, when discussing broader issues in smart-home design beyond the confines of their immediate project, researchers considered physical privacy to a lesser extent, even though physical privacy may manifest in emotive concerns about being watched or monitored. In 'Choice', researchers indicated they often saw provision of choice to end-users as a solution to ethical dilemmas. While researchers indicated that choices of end-users may need to be restricted for technological reasons, ethical standpoints that restrict choice were usually assumed and embedded in design. The tractability of informational privacy may explain the greater attention that is paid to it. However, concerns about physical privacy may

  5. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

    Holm, Kristina Garne; Brødsgaard, Anne; Zachariassen, Gitte

    2016-01-01

    participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care......BACKGROUND: For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home...... visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. OBJECTIVE: To identify parental needs when wanting to provide neonatal home care supported by telemedicine. METHODS: The study used...

  6. Making the Transition from Traditional to Home Schooling: Home School Family Motivations

    Science.gov (United States)

    Anthony, Kenneth Vance; Burroughs, Susie

    2010-01-01

    This study examined the motivations of families that operate home schools. Four intact, religiously conservative families were interviewed and observed over one year. Findings showed that families were motivated by multiple factors to leave traditional schooling and begin home schooling. Additionally, the motivations to home school influenced the…

  7. Implicit attitudes towards risky and safe driving

    DEFF Research Database (Denmark)

    Martinussen, Laila Marianne; Sømhovd, Mikael Julius; Møller, Mette

    ; further, self-reports of the intention to drive safely (or not) are socially sensitive. Therefore, we examined automatic preferences towards safe and risky driving with a Go/No-go Association Task (GNAT). The results suggest that (1) implicit attitudes towards driving behavior can be measured reliably...... with the GNAT; (2) implicit attitudes towards safe driving versus towards risky driving may be separable constructs. We propose that research on driving behavior may benefit from routinely including measures of implicit cognition. A practical advantage is a lesser susceptibility to social desirability biases......, compared to self-report methods. Pending replication in future research, the apparent dissociation between implicit attitudes towards safe versus risky driving that we observed may contribute to a greater theoretical understanding of the causes of unsafe and risky driving behavior....

  8. Original article Psychological and socio-demographic correlates of women’s decisions to give birth at home

    Directory of Open Access Journals (Sweden)

    Urszula Domańska

    2014-09-01

    Full Text Available Background Some women decide to give birth at home. They treat their home as a safe place to do so, are against medicalization of natural labour or value activity and autonomy during labour. They are also characterized by good knowledge of their own bodies and about labour in general (including labour at home. Psychological studies have revealed a correlation between labour (including the derived satisfaction and the levels of dispositional optimism, perception of efficacy, and coping with pain. Analysis of the available demographic data shows that the decision to give birth at home is correlated with a certain socio-demographic profile of women. Participants and procedures One hundred thirty five mothers took part in the study. Among them 72 had given birth at home and 63 in a hospital. The following were assumed as important psychological determinants: dispositional optimism, sense of self-efficacy, strategies for coping with pain and their effectiveness. The LOT-R Test, GSES Scale, CSQ Questionnaire as well as a demographic questionnaire were used in the study. Results Women who gave birth at home were characterised by significantly higher levels of optimism and sense of self-efficacy in comparison with the other women. Women giving birth at home reinterpreted the sensations of pain more frequently than the others, who were more likely to catastrophise and pray/hope. The level of conviction about having control over pain was much higher in the experimental group. The relationship between choice of place to give birth and the level of education, marital status, area of residence as well as age is weak. Correlations between the place of birth and income, number of children as well as membership of religious communities are moderate and statistically significant. Conclusions It is important to see and meet the different expectations of the two distinct groups of women. Today’s phenomenon of homebirth requires systematic interdisciplinary

  9. Fight malaria at home: Therapeutic and prophylaxis clinical data

    Directory of Open Access Journals (Sweden)

    Deepak Bhattacharya

    2011-06-01

    Full Text Available Objective: To identify a new, safe and effective source to combat and prevent drug resistant malaria therapeutically and to make it as a home-made bio-medicine which is called as OMARIA (Orissa malaria research indigenous attempt and use it on long term basis (decade in mono clinical station and in field. Methods: The rind of a lesser known Indian indigenous fruit dalimba/ Punica granatum (P. granatum is taken. Manual process to make a hand-made or home-made bio-medicine is done. Hand-filled into gelatin capsules and administered as an internal medicine. Therapy to 532 clinical cases is given at the Govt Red Cross Clinic, and Prophylaxis at site is administered to 401 cases by adopting 3 villages. Results: Hydrophyllic, ellagitannins viz., punicalagin (C 48H28O 30; mw 1 1 00~1 1 25, punicalin (C 34H22O 22; mw 780~785, ellagic acid (C14H6O8; mw 302 and K+ co-exists as the only drug moieties. OMARIA has no other confounding or confabulating compounds. There is non alkaloid. Conclusions: OMARIA delivers therapeutics and prophylaxis to drug resistant Plasmodium falciparum (P. falciparum cases. There are no side effects and no contradictions. Non-toxic at bolus/loading doses. No case progressed to cerebral malaria. OMARIA is a first time work. Original report on pan global basis.

  10. Prospects for inherently safe reactors

    International Nuclear Information System (INIS)

    Barkenbus, J.N.

    1988-01-01

    Public fears over nuclear safety have led some within the nuclear community to investigate the possibility of producing inherently safe nuclear reactors; that is, reactors that are transparently incapable of producing a core melt. While several promising designs of such reactors have been produced, support for large-scale research and development efforts has not been forthcoming. The prospects for commercialization of inherently safe reactors, therefore, are problematic; possible events such as further nuclear reactor accidents and superpower summits, could alter the present situation significantly. (author)

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo ...

  12. 50 CFR 216.91 - Dolphin-safe labeling standards.

    Science.gov (United States)

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Dolphin-safe labeling standards. 216.91... MAMMALS Dolphin Safe Tuna Labeling § 216.91 Dolphin-safe labeling standards. (a) It is a violation of... include on the label of those products the term “dolphin-safe” or any other term or symbol that claims or...

  13. Effective Alternative to Constipation Medication in Nursing Home Residents: Libera Study

    Directory of Open Access Journals (Sweden)

    Ismael Sobrón Monge

    2017-07-01

    Full Text Available Introduction: The aim of this study is to ascertain the impact of administering a dessert rich in fibre and sorbitol on the prescription of laxatives in nursing home residents with constipation. Material and methods: Single-centre, interventional prospective study in elderly nursing home residents diagnosed with constipation and treated with laxatives, in which each patient is his/her own comparator. A dessert rich in fibre and sorbitol (high-fibre Resource® Fruit Purée was given for 7 weeks. The main variable was the difference in days of pharmacological treatment with laxatives between the week before the start of the study and the last week of the study. Results: 40 patients were studied with a median age of 88.5 years (range: 72–101. After 7 weeks, the residents required a mean of 3.5 fewer days per week of treatment with laxatives. Patients receiving pharmacological medication decreased by 40%. Weekly bowel movements increased by a mean of 2 while gastrointestinal discomfort decreased. The intervention did not change previous intake. Adherence to the prescribed regimen was over 94%. A decrease in the number of days with laxative therapy was associated with: consuming 5 or more desserts a week, being over 85, having poor oral health and not suffering from malnutrition or food disorders. Conclusions: Dispensing a dessert rich in fibre and sorbitol may be an effective and safe alternative to laxatives in elderly nursing home residents with constipation, and may help to reduce polymedication in these patients.

  14. Oxygen permeation through oxygen ion oxide-noble metal dual phase composites

    NARCIS (Netherlands)

    Chen, C.S.; Chen, C.S.; Kruidhof, H.; Bouwmeester, Henricus J.M.; Verweij, H.; Burggraaf, Anthonie; Burggraaf, A.J.

    1996-01-01

    Oxygen permeation behaviour of three composites, yttria-stabilized zirconia-palladium, erbia-stabilized bismuth oxidenoble metal (silver, gold) was studied. Oxygen permeation measurements were performed under controlled oxygen pressure gradients at elevated temperatures. Air was supplied at one side

  15. Medications: Using Them Safely

    Science.gov (United States)

    ... to Safely Give Ibuprofen Childproofing and Preventing Household Accidents Medicines for Diabetes Complementary and Alternative Medicine How Do Pain Relievers Work? What Medicines Are and What They Do Medicines ...

  16. Home automation becomes home entertainment. Emotion replaces function; Hausautomation sucht Naehe zum Home-Entertainment. Emotion verdraengt Funktion

    Energy Technology Data Exchange (ETDEWEB)

    Schmid, W.

    2006-09-15

    Home automation commonly applies to control of lighting, shading, heating, safety etc., i.e. a purely functional concept. Recently, many systems have come to integrate home entertainment as well: Bang and Olufsen and Revox meets heating, light, and ventilation. (orig.)

  17. There is no place like @home!: The value of home consultations in paediatric rehabilitation.

    Science.gov (United States)

    van Maren-Suir, I; Ketelaar, M; Brouns, B; van der Sanden, K; Verhoef, M

    2018-07-01

    Family-centred services (FCS) is widely regarded as the best practice approach in early interventions. Creating a therapeutic environment, which also stimulates collaboration between parents and service professionals, is a way to conform to the principles of FCS. The present paper describes the project entitled @home, involving the implementation of home consultations by a specialized team working with children aged 0-5 years at our rehabilitation centre in the Netherlands. The objectives of this article are to (a) describe the development and implementation of home consultations as part of regular care and (b) share the experiences of parents and service providers with home consultations. The implementation process was divided into 3 steps: (1) interviewing experts, (2) adjusting current rehabilitation trajectories, and (3) service providers offering consultations to children at home. The experiences with the home consultations were immediately incorporated in the system, making the implementation an iterative process. In 82% of the 133 home conducted consultations, the service professionals reported that it was more valuable to offer home consultations than seeing the child at the rehabilitation centre. The semistructured interviews revealed that parents and service providers found that they received and provided more tailored advice, perceived a more equal partnership between service professionals and parents, and reported that the home consultations provided a good natural therapeutic environment where a child can be itself and where the child performs best. By using the @home system based on the 3 service models, home consultations are now part of the regular paediatric rehabilitation system at our rehabilitation centre. © 2018 John Wiley & Sons Ltd.

  18. Pervasive Home Care - Technological support for treatment of diabetic foot ulcers at home

    DEFF Research Database (Denmark)

    Larsen, Simon Bo

    2006-01-01

    of the patient in collaboration with patient and home care clinicians. My main research method has been qualitative analysis of the empirical results generated during an experimental project using Participatory Design (PD) to investigate potential futures in the treatment of patients with diabetic foot ulcers...... the need arises for moving treatment and care involving specialised knowledge from the hospital to the home. In this dissertation I use the term Home Care" for the multidisciplinary investigation of how this movement can be supported with technology enabling the expert to carry on a treatment in the home...... approach that I outline in this dissertation. Furthermore I describe the results of the project contributing to three related scientific fields: home care technologies, telemedicine and computer supported cooperative work (CSCW). The main conclusion towards home care technologies is that the many visionary...

  19. The oxygen effect and adaptive response of cells. Report 3. Simulation of respiratory oxygenation and oxygen permeability of cells

    International Nuclear Information System (INIS)

    Ehpshtejn, I.M.

    1978-01-01

    Variations in the oxygen concentration in extracellural [O 2 ] 0 and intracellular [Osub(2)]sub(i) media of cells small in size (d = 2 ] 0 - t-curves). It is shown that the Value of [Osub(2)]sub(i) may be expressed by four variants of its functional dependence: (a) on enzymic reaction of oxygen consumption, (b) on the order of reaction with respect to oxygen, (c) on physiological parameters of cells, and (d) on characteristic oxygen concentrations in the system. Items (c) and (d) are based on the postulated diffusion-kinetic model of oxygen consumption by an idealized cell of small size that consists of a drop of homogenous solution of the respiratory enzyme which is characterized by an equivalent Michaelis constant. The drop is enveloped in a uniform membrane that possesses a definite diffuse resistance to oxygen

  20. SAFE MOTHERHOOD INTERVENTION STUDIES IN AFRICA: A ...

    African Journals Online (AJOL)

    hi-tech

    2000-11-01

    Nov 1, 2000 ... East African Medical Journal Vol. .... The present literature review identified two studies ... strategies used were: education of community members ... Three studies tested interventions to reduce travel ... home outweighed the perceived benefit of the homes in ..... concept: the Nsawam, Ghana experience.

  1. Implementation of Safe-by-Design for Nanomaterial Development and Safe Innovation: Why We Need a Comprehensive Approach.

    Science.gov (United States)

    Kraegeloh, Annette; Suarez-Merino, Blanca; Sluijters, Teun; Micheletti, Christian

    2018-04-14

    Manufactured nanomaterials (MNMs) are regarded as key components of innovations in various fields with high potential impact (e.g., energy generation and storage, electronics, photonics, diagnostics, theranostics, or drug delivery agents). Widespread use of MNMs raises concerns about their safety for humans and the environment, possibly limiting the impact of the nanotechnology-based innovation. The development of safe MNMs and nanoproducts has to result in a safe as well as functional material or product. Its safe use, and disposal at the end of its life cycle must be taken into account too. However, not all MNMs are similarly useful for all applications, some might bear a higher hazard potential than others, and use scenarios could lead to different exposure probabilities. To improve both safety and efficacy of nanotechnology, we think that a new proactive approach is necessary, based on pre-regulatory safety assessment and dialogue between stakeholders. On the basis of the work carried out in different European Union (EU) initiatives, developing and integrating MNMs Safe-by-Design and Trusted Environments (NANoREG, ProSafe, and NanoReg2), we present our point of view here. This concept, when fully developed, will allow for cost effective industrial innovation, and an exchange of key information between regulators and innovators. Regulators are thus informed about incoming innovations in good time, supporting a proactive regulatory action. The final goal is to contribute to the nanotechnology governance, having faster, cheaper, effective, and safer nano-products on the market.

  2. Proterozoic atmospheric oxygen

    DEFF Research Database (Denmark)

    Canfield, Donald Eugene

    2014-01-01

    This article is concerned with the evolution of atmospheric oxygen concentrations through the Proterozoic Eon. In particular, this article will seek to place the history of atmospheric oxygenation through the Proterozoic Eon in the context of the evolving physical environment including the history...... of continental growth and volcanic outgassing, as well as biogeochemical processing of elements within the oceans. The author will seek to explore constraints on the history of oxygenation and understand which processes have regulated oxygen through this eon....

  3. Safe havens in Europe: Switzerland and the ten dwarfs

    Directory of Open Access Journals (Sweden)

    Martin Paldam

    2013-12-01

    Full Text Available Eleven safe havens exist in Europe providing offshore banking and low taxes. Ten of these states are very small while Switzerland is moderately small. All 11countries are richer than their large neighbors. It is shown that causality is from small to safe haven towealth, and that theoretically equilibriums are likely to exist where a certain regulation is substantially lower in a small country than in its big neighbor. This generates a large capital inflow to the safe havens. The pool of funds that may reach the safe havens is shown to be huge. It is far in excess of the absorptive capacity of the safe havens, but it still explains, why they are rich. Microstates offer a veil of anonymity to funds passing through, and Switzerland offers safe storage of funds.

  4. Exploring new operational research opportunities within the Home Care context: the chemotherapy at home.

    Science.gov (United States)

    Chahed, Salma; Marcon, Eric; Sahin, Evren; Feillet, Dominique; Dallery, Yves

    2009-06-01

    Home Care (HC) services provide complex and coordinated medical and paramedical care to patients at their homes. As health care services move into the home setting, the need for developing innovative approaches that improve the efficiency of home care organizations increases. We first conduct a literature review of investigations dealing with operation planning within the area of home care management. We then address a particular issue dealing with the planning of operations related to chemotherapy at home as it is an emergent problem in the French context. Our interest is focused on issues specific to the anti-cancer drug supply chain. We identify various models that can be developed and analyze one of them.

  5. Safe and Liquid Mortgage Bonds

    DEFF Research Database (Denmark)

    Dick-Nielsen, Jens; Gyntelberg, Jacob; Lund, Jesper

    This paper shows that strict match pass-through funding of covered bonds provides safe and liquid mortgage bonds. Despite a 30% drop in house prices during the 2008 global crisis Danish mortgage bonds remained as liquid as most European government bonds. The Danish pass-through system effectively...... eliminates credit risk from the investor's perspective. Similar to other safe bonds, funding liquidity becomes the main driver of mortgage bond liquidity and this creates commonality in liquidity across markets and countries. These findings have implications for how to design a robust mortgage bond system...

  6. The Science of Home Automation

    Science.gov (United States)

    Thomas, Brian Louis

    Smart home technologies and the concept of home automation have become more popular in recent years. This popularity has been accompanied by social acceptance of passive sensors installed throughout the home. The subsequent increase in smart homes facilitates the creation of home automation strategies. We believe that home automation strategies can be generated intelligently by utilizing smart home sensors and activity learning. In this dissertation, we hypothesize that home automation can benefit from activity awareness. To test this, we develop our activity-aware smart automation system, CARL (CASAS Activity-aware Resource Learning). CARL learns the associations between activities and device usage from historical data and utilizes the activity-aware capabilities to control the devices. To help validate CARL we deploy and test three different versions of the automation system in a real-world smart environment. To provide a foundation of activity learning, we integrate existing activity recognition and activity forecasting into CARL home automation. We also explore two alternatives to using human-labeled data to train the activity learning models. The first unsupervised method is Activity Detection, and the second is a modified DBSCAN algorithm that utilizes Dynamic Time Warping (DTW) as a distance metric. We compare the performance of activity learning with human-defined labels and with automatically-discovered activity categories. To provide evidence in support of our hypothesis, we evaluate CARL automation in a smart home testbed. Our results indicate that home automation can be boosted through activity awareness. We also find that the resulting automation has a high degree of usability and comfort for the smart home resident.

  7. Prescribing quality for older people in Norwegian nursing homes and home nursing services using multidose dispensed drugs.

    Science.gov (United States)

    Halvorsen, Kjell H; Granas, Anne Gerd; Engeland, Anders; Ruths, Sabine

    2012-09-01

    To examine and compare the quality of drug prescribing for older patients in nursing homes and home nursing services. Cross-sectional study comprising 11,254 patients aged ≥ 65 years in nursing homes (n = 2986) and home nursing services (n = 8268). Potentially inappropriate medications were identified by using the Norwegian General Practice criteria and drug-drug interactions through a Norwegian Web-based tool. The impact of care setting on exposure to selected drug groups, potentially inappropriate medications, and drug interactions was calculated, adjusting for patients' age, gender, and number of drugs used. Patients in nursing homes and home nursing services used on average 5.7 (SD = 2.6) multidose dispensed regular drugs. Twenty-six percent used at least one potentially inappropriate medication, 31% in nursing homes and 25% in home nursing services, p nursing homes (18%) and home nursing services (9%), p nursing homes, more patients in home nursing services used cardiovascular drugs and fewer patients used psychotropic drugs. Altogether, 8615 drug-drug interactions were identified in 55% of patients, 48% in nursing homes and 57% in home nursing services, p quality of drug prescribing in nursing homes compared with home nursing services. Explanations as to why these differences exist need to be further explored. Copyright © 2011 John Wiley & Sons, Ltd.

  8. Tactics for homing in mobile life

    DEFF Research Database (Denmark)

    Petersen, Marianne Graves; Lynggard, Aviaja Borup; Krogh, Peter Gall

    2010-01-01

    For many people home making is an activity, which extends beyond a single house. We introduce the terminology of Homing as the act of home making, when in a primary home, secondary home or more temporary spaces. By point of departure in existing literature on home making and through ethnographic...

  9. Oxygen respiration rates of benthic foraminifera as measured with oxygen microsensors

    DEFF Research Database (Denmark)

    Geslin, E.; Risgaard-Petersen, N.; Lombard, Fabien

    2011-01-01

    of the foraminiferal specimens. The results show a wide range of oxygen respiration rates for the different species (from 0.09 to 5.27 nl cell−1 h−1) and a clear correlation with foraminiferal biovolume showed by the power law relationship: R = 3.98 10−3 BioVol0.88 where the oxygen respiration rate (R) is expressed......Oxygen respiration rates of benthic foraminifera are still badly known, mainly because they are difficult to measure. Oxygen respiration rates of seventeen species of benthic foraminifera were measured using microelectrodes and calculated on the basis of the oxygen fluxes measured in the vicinity...... groups (nematodes, copepods, ostracods, ciliates and flagellates) suggests that benthic foraminifera have a lower oxygen respiration rates per unit biovolume. The total contribution of benthic foraminifera to the aerobic mineralisation of organic matter is estimated for the studied areas. The results...

  10. Implementation of an Improved Safe Operating Envelope

    International Nuclear Information System (INIS)

    Prime, Robyn; McIntyre, Mark; Reeves, David

    2008-01-01

    This paper is a continuation of the paper presented at IYNC 2004 on 'The Definition of a Safe Operating Envelope'. The current paper concentrates on the implementation process of the Safe Operating Envelope employed at the Point Lepreau Generating Station. (authors)

  11. Windows Home Server users guide

    CERN Document Server

    Edney, Andrew

    2008-01-01

    Windows Home Server brings the idea of centralized storage, backup and computer management out of the enterprise and into the home. Windows Home Server is built for people with multiple computers at home and helps to synchronize them, keep them updated, stream media between them, and back them up centrally. Built on a similar foundation as the Microsoft server operating products, it's essentially Small Business Server for the home.This book details how to install, configure, and use Windows Home Server and explains how to connect to and manage different clients such as Windows XP, Windows Vist

  12. A model for oxygen conservation associated with titration during pediatric oxygen therapy.

    Directory of Open Access Journals (Sweden)

    Grace Wu

    Full Text Available Continuous oxygen treatment is essential for managing children with hypoxemia, but access to oxygen in low-resource countries remains problematic. Given the high burden of pneumonia in these countries and the fact that flow can be gradually reduced as therapy progresses, oxygen conservation through routine titration warrants exploration.To determine the amount of oxygen saved via titration during oxygen therapy for children with hypoxemic pneumonia.Based on published clinical data, we developed a model of oxygen flow rates needed to manage hypoxemia, assuming recommended flow rate at start of therapy, and comparing total oxygen used with routine titration every 3 minutes or once every 24 hours versus no titration.Titration every 3 minutes or every 24 hours provided oxygen savings estimated at 11.7% ± 5.1% and 8.1% ± 5.1% (average ± standard error of the mean, n = 3, respectively. For every 100 patients, 44 or 30 kiloliters would be saved-equivalent to 733 or 500 hours at 1 liter per minute.Ongoing titration can conserve oxygen, even performed once-daily. While clinical validation is necessary, these findings could provide incentive for the routine use of pulse oximeters for patient management, as well as further development of automated systems.

  13. Prepare Your Children to Eat 80,000 Meals Safely!

    Science.gov (United States)

    Petrak, Lynn

    1994-01-01

    Children need to be taught about food safety. The paper includes safety tips to remember when selecting, cooking, and eating meals, both at home and away from home. Information is included on grocery shopping, home storage, food preparation, cooking, serving, and leftovers. (SM)

  14. Comparison of Long-term Care in Nursing Homes Versus Home Health: Costs and Outcomes in Alabama.

    Science.gov (United States)

    Blackburn, Justin; Locher, Julie L; Kilgore, Meredith L

    2016-04-01

    To compare acute care outcomes and costs among nursing home residents with community-dwelling home health recipients. A matched retrospective cohort study of Alabamians aged more than or equal to 65 years admitted to a nursing home or home health between March 31, 2007 and December 31, 2008 (N = 1,291 pairs). Medicare claims were compared up to one year after admission into either setting. Death, emergency department and inpatient visits, inpatient length of stay, and acute care costs were compared using t tests. Medicaid long-term care costs were compared for a subset of matched beneficiaries. After one year, 77.7% of home health beneficiaries were alive compared with 76.2% of nursing home beneficiaries (p Home health beneficiaries averaged 0.2 hospital visits and 0.1 emergency department visits more than nursing home beneficiaries, differences that were statistically significant. Overall acute care costs were not statistically different; home health beneficiaries' costs averaged $31,423, nursing home beneficiaries' $32,239 (p = .5032). Among 426 dual-eligible pairs, Medicaid long-term care costs averaged $4,582 greater for nursing home residents (p nursing home or home health care. Additional research controlling for exogenous factors relating to long-term care decisions is needed. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD)

    Science.gov (United States)

    McCurdy, BR

    2012-01-01

    Executive Summary In July 2010, the Medical Advisory Secretariat (MAS) began work on a Chronic Obstructive Pulmonary Disease (COPD) evidentiary framework, an evidence-based review of the literature surrounding treatment strategies for patients with COPD. This project emerged from a request by the Health System Strategy Division of the Ministry of Health and Long-Term Care that MAS provide them with an evidentiary platform on the effectiveness and cost-effectiveness of COPD interventions. After an initial review of health technology assessments and systematic reviews of COPD literature, and consultation with experts, MAS identified the following topics for analysis: vaccinations (influenza and pneumococcal), smoking cessation, multidisciplinary care, pulmonary rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation for acute and chronic respiratory failure, hospital-at-home for acute exacerbations of COPD, and telehealth (including telemonitoring and telephone support). Evidence-based analyses were prepared for each of these topics. For each technology, an economic analysis was also completed where appropriate. In addition, a review of the qualitative literature on patient, caregiver, and provider perspectives on living and dying with COPD was conducted, as were reviews of the qualitative literature on each of the technologies included in these analyses. The Chronic Obstructive Pulmonary Disease Mega-Analysis series is made up of the following reports, which can be publicly accessed at the MAS website at: http://www.hqontario.ca/en/mas/mas_ohtas_mn.html. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework Influenza and Pneumococcal Vaccinations for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Smoking Cessation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive

  16. Smart Home Test Bed: Examining How Smart Homes Interact with the Power Grid

    Energy Technology Data Exchange (ETDEWEB)

    2016-11-01

    This fact sheet highlights the Smart Home Test Bed capability at the Energy Systems Integration Facility. The National Renewable Energy Laboratory (NREL) is working on one of the new frontiers of smart home research: finding ways for smart home technologies and systems to enhance grid operations in the presence of distributed, clean energy technologies such as photovoltaics (PV). To help advance this research, NREL has developed a controllable, flexible, and fully integrated Smart Home Test Bed.

  17. Home in the Making

    DEFF Research Database (Denmark)

    Kreuzer, Maria; von Wallpach, Sylvia; Muehlbacher, Hans

    2016-01-01

    In a context of unprecedented migration home reaches high relevance. This study aims at understanding the (re-)construction of home by first generation consumer migrants. The findings provide insights into consumers’ (re-)construction of various dimensions of home and identify “inner home” as a n...

  18. Smart assistants for smart homes

    OpenAIRE

    Rasch, Katharina

    2013-01-01

    The smarter homes of tomorrow promise to increase comfort, aid elderly and disabled people, and help inhabitants save energy. Unfortunately, smart homes today are far from this vision – people who already live in such a home struggle with complicated user interfaces, inflexible home configurations, and difficult installation procedures. Under these circumstances, smart homes are not ready for mass adoption. This dissertation addresses these issues by proposing two smart assistants for smart h...

  19. DOE Zero Energy Ready Home Case Study: TC Legend Homes, Seattle, Washington

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    This house incorporates slab-on-grade, EPS roof, and radiant heating with an air-to-water heat pump that also preheats domestic hot water. Without counting in the solar panels, the home earns a home energy rating system (HERS) score of 37, with projected utility bills of about $740 a year. With the 6.4-kW photovoltaic power system installed on the roof, the home’s HERS scores drops to -1 and utility bills for the all-electric home drop to zero. This home was awarded a 2013 Housing Innovation Award in the affordable builder category.

  20. Research on the model of home networking

    Science.gov (United States)

    Yun, Xiang; Feng, Xiancheng

    2007-11-01

    It is the research hotspot of current broadband network to combine voice service, data service and broadband audio-video service by IP protocol to transport various real time and mutual services to terminal users (home). Home Networking is a new kind of network and application technology which can provide various services. Home networking is called as Digital Home Network. It means that PC, home entertainment equipment, home appliances, Home wirings, security, illumination system were communicated with each other by some composing network technology, constitute a networking internal home, and connect with WAN by home gateway. It is a new network technology and application technology, and can provide many kinds of services inside home or between homes. Currently, home networking can be divided into three kinds: Information equipment, Home appliances, Communication equipment. Equipment inside home networking can exchange information with outer networking by home gateway, this information communication is bidirectional, user can get information and service which provided by public networking by using home networking internal equipment through home gateway connecting public network, meantime, also can get information and resource to control the internal equipment which provided by home networking internal equipment. Based on the general network model of home networking, there are four functional entities inside home networking: HA, HB, HC, and HD. (1) HA (Home Access) - home networking connects function entity; (2) HB (Home Bridge) Home networking bridge connects function entity; (3) HC (Home Client) - Home networking client function entity; (4) HD (Home Device) - decoder function entity. There are many physical ways to implement four function entities. Based on theses four functional entities, there are reference model of physical layer, reference model of link layer, reference model of IP layer and application reference model of high layer. In the future home network