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Sample records for surgical technology unit

  1. HUMANIZATION OF THE NURSING ASSISTANCE IN THE SURGICAL UNIT

    Directory of Open Access Journals (Sweden)

    Eliana Bedin

    2006-12-01

    Full Text Available ABSTRACT: This study consisted in a bibliographic review, which goal was a survey of the main national literature that approaches the humanization in the surgical unit, identifying and demonstrating the needs and the importance of the nursing staff daily activities. The search was made selecting the key words and the period between 1985 and 2002, where 31 articles were selected. Analyzing them we discussed about the theme, classifying it in four stages that made sense to the humanization for the nursing assistance in the surgical unit, describing aspects of the nursing graduation releasing for humanization, making ethics considerations to the assistance and demonstrating the needs of the humanized care in the presence of the technological development. We concluded that the humanization of the nursing assistance in the surgical units is a challenge, however, the humanized care is possible and essential to the nursing practice, mainly in a technological environment like the surgical unit. KEYWORDS: Operating Room Nursing; Assistance; Ethics.

  2. Acute surgical unit: The consultant experience

    Directory of Open Access Journals (Sweden)

    Patrick J Stokes

    2016-07-01

    Full Text Available Background Establishment of the Acute Surgical Unit (ASU has redefined the approach to emergency surgery in Australia with quantitative data showing improvement in patient outcomes. However, as qualitative data regarding the ASU remains scarce, we sought to determine the impact of the ASU on overall surgeon job satisfaction. Aims The aim of this paper was to specifically address the impact of the ASU on consultant surgeons overall job satisfaction. Methods We designed a 34 – item questionnaire with consultant general surgeons addressing important aspects of the ASU. Themes included on – call rostering and workload, academic pursuits, surgical training, work – life balance and overall job satisfaction. Results We received responses from 88 surgeons currently working on ASU units, responding correctly and in full to the survey. Overall, our surveyed cohort reported better on – call rostering, improved surgical training and higher levels of job satisfaction and overall work – life balance with ASU implementation. Conclusion Preliminary qualitative results indicate that the ASU may improve on – call rostering, work – life balance and overall job satisfaction.

  3. Review of emerging surgical robotic technology.

    Science.gov (United States)

    Peters, Brian S; Armijo, Priscila R; Krause, Crystal; Choudhury, Songita A; Oleynikov, Dmitry

    2018-04-01

    The use of laparoscopic and robotic procedures has increased in general surgery. Minimally invasive robotic surgery has made tremendous progress in a relatively short period of time, realizing improvements for both the patient and surgeon. This has led to an increase in the use and development of robotic devices and platforms for general surgery. The purpose of this review is to explore current and emerging surgical robotic technologies in a growing and dynamic environment of research and development. This review explores medical and surgical robotic endoscopic surgery and peripheral technologies currently available or in development. The devices discussed here are specific to general surgery, including laparoscopy, colonoscopy, esophagogastroduodenoscopy, and thoracoscopy. Benefits and limitations of each technology were identified and applicable future directions were described. A number of FDA-approved devices and platforms for robotic surgery were reviewed, including the da Vinci Surgical System, Sensei X Robotic Catheter System, FreeHand 1.2, invendoscopy E200 system, Flex® Robotic System, Senhance, ARES, the Single-Port Instrument Delivery Extended Research (SPIDER), and the NeoGuide Colonoscope. Additionally, platforms were reviewed which have not yet obtained FDA approval including MiroSurge, ViaCath System, SPORT™ Surgical System, SurgiBot, Versius Robotic System, Master and Slave Transluminal Endoscopic Robot, Verb Surgical, Miniature In Vivo Robot, and the Einstein Surgical Robot. The use and demand for robotic medical and surgical platforms is increasing and new technologies are continually being developed. New technologies are increasingly implemented to improve on the capabilities of previously established systems. Future studies are needed to further evaluate the strengths and weaknesses of each robotic surgical device and platform in the operating suite.

  4. United States advanced technologies

    International Nuclear Information System (INIS)

    Longenecker, J.R.

    1985-01-01

    In the United States, the advanced technologies have been applied to uranium enrichment as a means by which it can be assured that nuclear fuel cost will remain competitive in the future. The United States is strongly committed to the development of advanced enrichment technology, and has brought both advanced gas centrifuge (AGC) and atomic vapor laser isotope separation (AVLIS) programs to a point of significant technical refinement. The ability to deploy advanced technologies is the basis for the confidence in competitive future price. Unfortunately, the development of advanced technologies is capital intensive. The year 1985 is the key year for advanced technology development in the United States, since the decision on the primary enrichment technology for the future, AGC or AVLIS, will be made shortly. The background on the technology selection process, the highlights of AGC and AVLIS programs and the way to proceed after the process selection are described. The key objective is to maximize the sales volume and minimize the operating cost. This will help the utilities in other countries supply low cost energy on a reliable, long term basis. (Kako, I.)

  5. Recent technological advancements in laparoscopic surgical instruments

    Science.gov (United States)

    Subido, Edwin D. C.; Pacis, Danica Mitch M.; Bugtai, Nilo T.

    2018-02-01

    Laparoscopy was a progressive step to advancing surgical procedures as it minimised the scars left on the body after surgery, compared to traditional open surgery. Many years later, single-incision laparoscopic surgery (SILS) was created where, instead of having multiple incisions, only one incision is made or multiple small incisions in one location. SILS, or laparoendoscopic single-site surgery (LESS), may produce lesser scars but drawbacks for the surgeons are still present. This paper aims to present related literature of the recent technological developments in laparoscopic tools and procedure particularly in the vision system, handheld instruments. Tech advances in LESS will also be shown. Furthermore, this review intends to give an update on what has been going on in the surgical robot market and state which companies are interested and are developing robotic systems for commercial use to challenge Intuitive Surgical's da Vinci Surgical System that currently dominates the market.

  6. Wearable Technology for Global Surgical Teleproctoring.

    Science.gov (United States)

    Datta, Néha; MacQueen, Ian T; Schroeder, Alexander D; Wilson, Jessica J; Espinoza, Juan C; Wagner, Justin P; Filipi, Charles J; Chen, David C

    2015-01-01

    In underserved communities around the world, inguinal hernias represent a significant burden of surgically-treatable disease. With traditional models of international surgical assistance limited to mission trips, a standardized framework to strengthen local healthcare systems is lacking. We established a surgical education model using web-based tools and wearable technology to allow for long-term proctoring and assessment in a resource-poor setting. This is a feasibility study examining wearable technology and web-based performance rating tools for long-term proctoring in an international setting. Using the Lichtenstein inguinal hernia repair as the index surgical procedure, local surgeons in Paraguay and Brazil were trained in person by visiting international expert trainers using a formal, standardized teaching protocol. Surgeries were captured in real-time using Google Glass and transmitted wirelessly to an online video stream, permitting real-time observation and proctoring by mentoring surgeon experts in remote locations around the world. A system for ongoing remote evaluation and support by experienced surgeons was established using the Lichtenstein-specific Operative Performance Rating Scale. Data were collected from 4 sequential training operations for surgeons trained in both Paraguay and Brazil. With continuous internet connectivity, live streaming of the surgeries was successful. The Operative Performance Rating Scale was immediately used after each operation. Both surgeons demonstrated proficiency at the completion of the fourth case. A sustainable model for surgical training and proctoring to empower local surgeons in resource-poor locations and "train trainers" is feasible with wearable technology and web-based communication. Capacity building by maximizing use of local resources and expertise offers a long-term solution to reducing the global burden of surgically-treatable disease. Copyright © 2015 Association of Program Directors in Surgery

  7. Mobile surgical skills education unit: a new concept in surgical training.

    Science.gov (United States)

    Shaikh, Faisal M; Hseino, Hazem; Hill, Arnold D K; Kavanagh, Eamon; Traynor, Oscar

    2011-08-01

    Basic surgical skills are an integral part of surgical training. Simulation-based surgical training offers an opportunity both to trainees and trainers to learn and teach surgical skills outside the operating room in a nonpatient, nonstressed environment. However, widespread adoption of simulation technology especially in medical education is prohibited by its inherent higher cost, limited space, and interruptions to clinical duties. Mobile skills laboratory has been proposed as a means to address some of these limitations. A new program is designed by the Royal College of Surgeons in Ireland (RCSI), in an approach to teach its postgraduate basic surgical trainees the necessary surgical skills, by making the use of mobile innovative simulation technology in their own hospital settings. In this article, authors describe the program and students response to the mobile surgical skills being delivered in the region of their training hospitals and by their own regional consultant trainers.

  8. Discharge from an emergency department observation unit and a surgical assessment unit

    DEFF Research Database (Denmark)

    Schultz, Helen; Qvist, Niels; Backer Mogensen, Christian

    2014-01-01

    To investigate the experiences of patients with acute abdominal pain at discharge from an emergency department observation unit compared with discharge from a surgical assessment unit.......To investigate the experiences of patients with acute abdominal pain at discharge from an emergency department observation unit compared with discharge from a surgical assessment unit....

  9. Healthcare technology: physician collaboration in reducing the surgical cost.

    Science.gov (United States)

    Olson, Steven A; Obremskey, William T; Bozic, Kevin J

    2013-06-01

    The increasing cost of providing health care is a national concern. Healthcare spending related to providing hospital care is one of the primary drivers of healthcare spending in the United States. Adoption of advanced medical technologies accounts for the largest percentage of growth in healthcare spending in the United States when compared with other developed countries. Within the specialty of orthopaedic surgery, a variety of implants can result in similar outcomes for patients in several areas of clinical care. However, surgeons often do not know the cost of implants used in a specific procedure or how the use of an implant or technology affects the overall cost of the episode of care. The purposes of this study were (1) to describe physician-led processes for introduction of new surgical products and technologies; and (2) to inform physicians of potential cost savings of physician-led product contract negotiations and approval of new technology. We performed a detailed review of the steps taken by two centers that have implemented surgeon-led programs to demonstrate responsibility in technology acquisition and product procurement decision-making. Each program has developed a physician peer review process in technology and new product acquisition that has resulted in a substantial reduction in spending for the respective hospitals in regard to surgical implants. Implant costs have decreased between 3% and 38% using different negotiating strategies. At the same time, new product requests by physicians have been approved in greater than 90% of instances. Hospitals need physicians to be engaged and informed in discussions concerning current and new technology and products. Surgeons can provide leadership for these efforts to reduce the cost of high-quality care.

  10. Application Technology Research Unit

    Data.gov (United States)

    Federal Laboratory Consortium — To conduct fundamental and developmental research on new and improved application technologies to protect floricultural, nursery, landscape, turf, horticultural, and...

  11. Integrating information technologies as tools for surgical research.

    Science.gov (United States)

    Schell, Scott R

    2005-10-01

    Surgical research is dependent upon information technologies. Selection of the computer, operating system, and software tool that best support the surgical investigator's needs requires careful planning before research commences. This manuscript presents a brief tutorial on how surgical investigators can best select these information technologies, with comparisons and recommendations between existing systems, software, and solutions. Privacy concerns, based upon HIPAA and other regulations, now require careful proactive attention to avoid legal penalties, civil litigation, and financial loss. Security issues are included as part of the discussions related to selection and application of information technology. This material was derived from a segment of the Association for Academic Surgery's Fundamentals of Surgical Research course.

  12. Hypothermia in a surgical intensive care unit.

    Science.gov (United States)

    Abelha, Fernando J; Castro, Maria A; Neves, Aida M; Landeiro, Nuno M; Santos, Cristina C

    2005-06-06

    Inadvertent hypothermia is not uncommon in the immediate postoperative period and it is associated with impairment and abnormalities in various organs and systems that can lead to adverse outcomes. The aim of this study was to estimate the prevalence, the predictive factors and outcome of core hypothermia on admission to a surgical ICU. All consecutive 185 adult patients who underwent scheduled or emergency noncardiac surgery admitted to a surgical ICU between April and July 2004 were admitted to the study. Tympanic membrane core temperature (Tc) was measured before surgery, on arrival at ICU and every two hours until 6 hours after admission. The following variables were also recorded: age, sex, body weight and height, ASA physical status, type of surgery, magnitude of surgical procedure, anesthesia technique, amount of intravenous fluids administered during anesthesia, use of temperature monitoring and warming techniques, duration of the anesthesia, ICU length of stay, hospital length of stay and SAPS II score. Patients were classified as either hypothermic (Tc 35 degrees C). Univariate analysis and multiple regression binary logistic with an odds ratio (OR) and its 95% Confidence Interval (95%CI) were used to compare the two groups of patients and assess the relationship between each clinical predictor and hypothermia. Outcome measured as ICU length of stay and mortality was also assessed. Prevalence of hypothermia on ICU admission was 57.8%. In univariate analysis temperature monitoring, use of warming techniques and higher previous body temperature were significant protective factors against core hypothermia. In this analysis independent predictors of hypothermia on admission to ICU were: magnitude of surgery, use of general anesthesia or combined epidural and general anesthesia, total intravenous crystalloids administrated and total packed erythrocytes administrated, anesthesia longer than 3 hours and SAPS II scores. In multiple logistic regression analysis

  13. Hypothermia in a surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Landeiro Nuno M

    2005-06-01

    Full Text Available Abstract Background Inadvertent hypothermia is not uncommon in the immediate postoperative period and it is associated with impairment and abnormalities in various organs and systems that can lead to adverse outcomes. The aim of this study was to estimate the prevalence, the predictive factors and outcome of core hypothermia on admission to a surgical ICU. Methods All consecutive 185 adult patients who underwent scheduled or emergency noncardiac surgery admitted to a surgical ICU between April and July 2004 were admitted to the study. Tympanic membrane core temperature (Tc was measured before surgery, on arrival at ICU and every two hours until 6 hours after admission. The following variables were also recorded: age, sex, body weight and height, ASA physical status, type of surgery, magnitude of surgical procedure, anesthesia technique, amount of intravenous fluids administered during anesthesia, use of temperature monitoring and warming techniques, duration of the anesthesia, ICU length of stay, hospital length of stay and SAPS II score. Patients were classified as either hypothermic (Tc ≤ 35°C or normothermic (Tc> 35°C. Univariate analysis and multiple regression binary logistic with an odds ratio (OR and its 95% Confidence Interval (95%CI were used to compare the two groups of patients and assess the relationship between each clinical predictor and hypothermia. Outcome measured as ICU length of stay and mortality was also assessed. Results Prevalence of hypothermia on ICU admission was 57.8%. In univariate analysis temperature monitoring, use of warming techniques and higher previous body temperature were significant protective factors against core hypothermia. In this analysis independent predictors of hypothermia on admission to ICU were: magnitude of surgery, use of general anesthesia or combined epidural and general anesthesia, total intravenous crystalloids administrated and total packed erythrocytes administrated, anesthesia longer

  14. General surgical admissions in the intensive care unit in Ibadan ...

    African Journals Online (AJOL)

    Objectives:The Intensive Care Unit (ICU) has improved patient outcome in complex surgeries while the costs of maintaining services are high. ICU services in developing countries are often inadequate due to lack of funds. This study reviews the pattern and outcomes of General Surgical patients admitted to the ICU of our ...

  15. OPTION OF USERS IN SURGICAL CONTRACEPTION FAMILY HEALTH UNIT

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    Vagner Ferreira do Nascimento

    2013-09-01

    Full Text Available The study is a descriptive and quantitative approach, which aimed to meet customers the option of surgical contraception by a Family Health Unit in the municipality of Barra do Herons - Mato Grosso. Data were collected on 22 forms of reference that would be forwarded to the sector and family planning counseling. Data were collected and grouped by age, marital status, gender, children and quantitative choice of surgical method of contraception. The period of data collection occurred from March to December 2011. The age group with the highest participation was from 18 to 25 years. Predominantly single, female, with two sons and opting for sterilization. The variety of options to be used as contraceptive methods should be widely publicized and encouraged by health professionals, leaving the surgical methods of reversible or irreversible disruption as a last choice.

  16. Development of a handy-type laser surgical unit

    Science.gov (United States)

    Abe, Yusuke; Wakamatsu, Koh; Goto, Shigeru

    2005-07-01

    We proposed a concept of a handy-type laser surgical unit for use in outpatient, in ward and in open-air field. To investigate the possibility of the concept, a handy-type semiconductor laser surgical unit was developed experimentally using 2-watts power laser diode with no built-in electrical cooling unit (Peltier chip) and a small rechargeable battery. The drive circuit was constructed with only current limit and ACC circuits. The laser diode was cooled with heat sink and simple fan. Laser irradiation was set to stop at 30 degree Celsius by monitoring the temperature of laser diode with thermistor temperature sensor. With this system, 1.18 watts of laser power at the end of optical fiber with both 600 and 900mm core diameter, and about 30 minutes of continuous irradiating time with Ni-Cd battery (4.8V 1,500mA/h) could be obtained with no over heating in laser diode. The result showed that the high power semiconductor laser could be driven with small battery when specially designed. In an animal experiment, small bleeding could be managed with contact irradiation method. This kind of simple laser surgical unit is considered to be useful for the management of small bleedings in clinical.

  17. Peritonitis: 10 years' experience in a single surgical unit.

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    Agarwal, Nitin; Saha, Sudipta; Srivastava, Anurag; Chumber, Sunil; Dhar, Anita; Garg, Sanket

    2007-01-01

    Peritonitis secondary to gut perforation is still one of the commonest surgical emergencies in India and is associated with high morbidity and mortality. The present study examines the aetiology and outcome of peritonitis cases operated on in our surgical unit, and compares our findings with those of previous studies performed between 1981 and 1991. A retrospective study of 260 peritonitis patients operated on in a single surgical unit from 1995 to 2006 was done and data involving clinical presentation, operative findings and post-operative course were studied and analysed. Causes of peritonitis were small bowel perforation (96 ileal, 17 jejunal), peptic perforation (45 duodenal, 16 gastric), appendicular perforation (36), primary peritonitis (8), and others (42). The incidence of major complications was 25% (burst-11%, leak-5%, intraabdominal abscess-5%, multi-organ failure-6.5%). The overall mortality was 10%. High mortality was observed in jejunal, gall bladder and liver abscess perforation cases (> 20%). Histopathological evaluation (143 specimens) revealed tuberculosis in 42 (mostly small bowel), malignancy in 8, and inflammation in the rest. Comparisons with a similar study carried out in the same unit and published in 1995 revealed similar demographic features and mortality, but a change in the most common cause (peptic ulcer perforation to small bowel perforation), and an increased performance of enterostomy compared with primary repair in small bowel perforation and a decrease in the leak rate (13% to 4%). Small bowel perforation is the commonest form of perforation and the mortality rate associated with peritonitis remains unchanged.

  18. Assessment methods in surgical training in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Evgenios Evgeniou

    2013-02-01

    Full Text Available A career in surgery in the United Kingdom demands a commitment to a long journey of assessment. The assessment methods used must ensure that the appropriate candidates are selected into a programme of study or a job and must guarantee public safety by regulating the progression of surgical trainees and the certification of trained surgeons. This review attempts to analyse the psychometric properties of various assessment methods used in the selection of candidates to medical school, job selection, progression in training, and certification. Validity is an indicator of how well an assessment measures what it is designed to measure. Reliability informs us whether a test is consistent in its outcome by measuring the reproducibility and discriminating ability of the test. In the long journey of assessment in surgical training, the same assessment formats are frequently being used for selection into a programme of study, job selection, progression, and certification. Although similar assessment methods are being used for different purposes in surgical training, the psychometric properties of these assessment methods have not been examined separately for each purpose. Because of the significance of these assessments for trainees and patients, their reliability and validity should be examined thoroughly in every context where the assessment method is being used.

  19. Surgical Technology Integration with Tools for Cognitive Human Factors (STITCH)

    Science.gov (United States)

    2010-10-01

    Measurement Tool We conducted another round of data collection using the daVinci Surgical System at the University of Kentucky Hospital in May. In this...9 3. Tools and Display Technology...considering cognitive and environmental factors such as mental workload, stress, situation awareness, and level of comfort with complex tools . To

  20. The application of digital surgical diagnosis and treatment technology: a promising strategy for surgical reconstruction of craniomaxillofacial defect and deformity.

    Science.gov (United States)

    Wang, Li-ya; Du, Hong-ming; Zhang, Gang; Tang, Wei; Liu, Lei; Jing, Wei; Long, Jie

    2011-12-01

    The craniomaxillofacial defect and deformity always leads to serious dysfunction in mastication and facial contour damage, significantly reducing patients' quality of life. However, surgical reconstruction of a craniomaxillofacial hard tissue defect or deformity is extremely complex and often does not result in desired facial morphology. Improving the result for patients with craniomaxillofacial defect and deformity remains a challenge for surgeons. Using digital technology for surgical diagnosis and treatment may help solve this problem. Computer-assisted surgical technology and surgical navigation technology are included in the accurate digital diagnosis and treatment system we propose. These technologies will increase the accuracy of the design of the operation plan. In addition, the intraoperative real-time navigating location system controlling the robotic arm or advanced intelligent robot will provide accurate, individualized surgical treatment for patients. Here we propose the hypothesis that a digital surgical diagnosis and treatment technology may provide a new approach for precise surgical reconstruction of complicated craniomaxillofacial defect and deformity. Our hypothesis involves modern digital surgery, a three-dimensional navigation surgery system and modern digital imaging technology, and our key aim is to establish a technological platform for customized digital surgical design and surgical navigation for craniomaxillofacial defect and deformity. If the hypothesis is proven practical, this novel therapeutic approach could improve the result of surgical reconstruction for craniomaxillofacial defect and deformity for many patients. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Technological innovations in surgical approach for thyroid cancer.

    Science.gov (United States)

    Lang, Brian Hung-Hin; Lo, Chung-Yau

    2010-01-01

    Over the last decade, surgeons have witnessed dramatic changes in surgical practice as a result of the introduction of new technological advancement. Some of these changes include refinement of techniques in thyroid cancer surgery. The development of various endoscopic thyroidectomy techniques, the addition of the da Vinci robot, and the use of operative adjuncts in thyroid surgery, such as intraoperative neuromonitoring and quick intraoperative parathyroid hormone, have made thyroid cancer surgery not only safer and better accepted by patients with thyroid cancer but also offer them more surgical treatment options.

  2. Robotic technologies in surgical oncology training and practice.

    Science.gov (United States)

    Orvieto, Marcelo A; Marchetti, Pablo; Castillo, Octavio A; Coelho, Rafael F; Chauhan, Sanket; Rocco, Bernardo; Ardila, Bobby; Mathe, Mary; Patel, Vipul R

    2011-09-01

    The modern-day surgeon is frequently exposed to new technologies and instrumentation. Robotic surgery (RS) has evolved as a minimally invasive technique aimed to improve clinical outcomes. RS has the potential to alleviate the inherent limitations of laparoscopic surgery such as two dimensional imaging, limited instrument movement and intrinsic human tremor. Since the first reported robot-assisted surgical procedure performed in 1985, the technology has dramatically evolved and currently multiple surgical specialties have incorporated RS into their daily clinical armamentarium. With this exponential growth, it should not come as a surprise the ever growing requirement for surgeons trained in RS as well as the interest from residents to receive robotic exposure during their training. For this reason, the establishment of set criteria for adequate and standardized training and credentialing of surgical residents, fellows and those trained surgeons wishing to perform RS has become a priority. In this rapidly evolving field, we herein review the past, present and future of robotic technologies and its penetration into different surgical specialties. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Ventilator-associated pneumonia in surgical emergency intensive care unit.

    Science.gov (United States)

    Ertugrul, Bulent M; Yildirim, Ayse; Ay, Pinar; Oncu, Serkan; Cagatay, Atahan; Cakar, Nahit; Ertekin, Cemalettin; Ozsut, Halit; Eraksoy, Haluk; Calangu, Semra

    2006-01-01

    To investigate the incidence, risk factors and the etiology of ventilator-associated pneumonia (VAP) in surgical emergency intensive care unit (ICU) patients. We conducted this prospective cohort study in the surgical emergency ICU of Istanbul Medical Faculty between December 1999 and May 2001. We included 100 mechanically ventilated patients in this study. We diagnosed VAP according to the current diagnostic criteria. We identified the etiology of VAP cases by both quantitative cultures of endotracheal aspiration and blood cultures. To analyze the predisposing factors for the development of VAP, we recorded the following variables: age, gender, acute physiology and chronic health evaluation (APACHE) II score, Glasgow coma scale (GCS), sequential organ failure assessment (SOFA) score, serum albumin level, duration of mechanical ventilation (MV) prior to the development of VAP, and underlying diseases. We determined the VAP incidence rate as 28%. We found the APACHE II score and the duration of MV to be statistically significant variables for the development of VAP. There were no significant differences regarding age, gender, GCS, SOFA score, albumin level, or underlying diseases for the development of VAP. The isolated bacteria among VAP cases were as follows: Staphylococcus aureus (n=12, 43%), Acinetobacter spp. (n=6, 21%), coagulase-negative Staphylococci (n=4, 15%), Pseudomonas aeruginosa (n=3, 10.7%) and Klebsiella pneumoniae (n=3, 10.7%). Ventilator-associated pneumonia is a common infection, and certain interventions might affect the incidence of VAP. The ICU clinicians should be aware of the risk factors for VAP, which could prove useful in identifying patients at high risk for VAP, and modifying patient care to minimize the risk of VAP.

  4. New technologies and surgical innovation: five years of a local health technology assessment program in a surgical department.

    Science.gov (United States)

    Poulin, Paule; Austen, Lea; Kortbeek, John B; Lafrenière, René

    2012-06-01

    There is pressure for surgical departments to introduce new and innovative health technologies in an evidence-based manner while ensuring that they are safe and effective and can be managed with available resources. A local health technology assessment (HTA) program was developed to systematically integrate research evidence with local operational management information and to make recommendations for subsequent decision by the departmental executive committee about whether and under what conditions the technology will be used. The authors present a retrospective analysis of the outcomes of this program as used by the Department of Surgery & Surgical Services in the Calgary Health Region over a 5-year period from December 2005 to December 2010. Of the 68 technologies requested, 15 applications were incomplete and dropped, 12 were approved, 3 were approved for a single case on an urgent/emergent basis, 21 were approved for "clinical audit" for a restricted number of cases with outcomes review, 14 were approved for research use only, and 3 were referred to additional review bodies. Subsequent outcome reports resulted in at least 5 technologies being dropped for failure to perform. Decisions based on local HTA program recommendations were rarely "yes" or "no." Rather, many technologies were given restricted approval with full approval contingent on satisfying certain conditions such as clinical outcomes review, training protocol development, or funding. Thus, innovation could be supported while ensuring safety and effectiveness. This local HTA program can be adapted to a variety of settings and can help bridge the gap between evidence and practice.

  5. SI units in engineering and technology

    CERN Document Server

    Qasim, S H

    2016-01-01

    SI Units in Engineering and Technology focuses on the use of the International System of Units-Systeme International d'Unités (SI). The publication first elaborates on the SI, derivation of important engineering units, and derived SI units in science and engineering. Discussions focus on applied mechanics in mechanical engineering, electrical and magnetic units, stress and pressure, work and energy, power and force, and magnitude of SI units. The text then examines SI units conversion tables and engineering data in SI units. Tables include details on the sectional properties of metals in SI units, physical properties of important molded plastics, important physical constants expressed in SI units, and temperature, area, volume, and mass conversion. Tables that show the mathematical constants, standard values expressed in SI units, and Tex count conversion are also presented. The publication is a dependable source of data for researchers interested in the use of the International System of Units-Systeme Inter...

  6. The incidence, root-causes, and outcomes of adverse events in surgical units: implication for potential prevention strategies

    Directory of Open Access Journals (Sweden)

    Groenewegen Peter P

    2011-05-01

    Full Text Available Abstract Background We need to know the scale and underlying causes of surgical adverse events (AEs in order to improve the safety of care in surgical units. However, there is little recent data. Previous record review studies that reported on surgical AEs in detail are now more than ten years old. Since then surgical technology and quality assurance have changed rapidly. The objective of this study was to provide more recent data on the incidence, consequences, preventability, causes and potential strategies to prevent AEs among hospitalized patients in surgical units. Methods A structured record review study of 7,926 patient records was carried out by trained nurses and medical specialist reviewers in 21 Dutch hospitals. The aim was to determine the presence of AEs during hospitalizations in 2004 and to consider how far they could be prevented. Of all AEs, the consequences, responsible medical specialty, causes and potential prevention strategies were identified. Surgical AEs were defined as AEs attributable to surgical treatment and care processes and were selected for analysis in detail. Results Surgical AEs occurred in 3.6% of hospital admissions and represented 65% of all AEs. Forty-one percent of the surgical AEs was considered to be preventable. The consequences of surgical AEs were more severe than for other types of AEs, resulting in more permanent disability, extra treatment, prolonged hospital stay, unplanned readmissions and extra outpatient visits. Almost 40% of the surgical AEs were infections, 23% bleeding, and 22% injury by mechanical, physical or chemical cause. Human factors were involved in the causation of 65% of surgical AEs and were considered to be preventable through quality assurance and training. Conclusions Surgical AEs occur more often than other types of AEs, are more often preventable and their consequences are more severe. Therefore, surgical AEs have a major impact on the burden of AEs during hospitalizations

  7. 2006 Mississippi Curriculum Framework: Postsecondary Surgical Technology. (Program CIP: 51.0909 - Surgical Technology/Technologist)

    Science.gov (United States)

    Tice, Tonya; Elliott, Jessica; Gandy, Zielda; Wilkerson, Tammy

    2006-01-01

    As the world economy continues to evolve, businesses and industries must adopt new practices and processes in order to survive. Quality and cost control, work teams and participatory management, and an infusion of technology are transforming the way people work and do business. Employees are now expected to read, write, and communicate…

  8. Quality of life after stay in surgical intensive care unit.

    Science.gov (United States)

    Abelha, Fernando J; Santos, Cristina C; Maia, Paula C; Castro, Maria A; Barros, Henrique

    2007-07-24

    In addition to mortality, Health Related Quality of Life (HRQOL) has increasingly been claimed as an important outcome variable. The aim of this study was to assess HRQOL and independence in activities of daily living (ADL) six months after discharge from an Intensive Care Unit (ICU), and to study its determinants. All post-operative adult patients admitted to a surgical ICU between October 2004 and July 2005, were eligible for the study. The following variables were recorded on admission: age, gender, American Society of Anesthesiologists physical status (ASA-PS), type and magnitude of surgical procedure, ICU and hospital length of stay (LOS), mortality and Simplified Acute Physiology Score II (SAPS II). Six months after discharge, a Short Form-36 questionnaire (SF-36) and a questionnaire to assess dependency in ADL were sent to all survivors. Descriptive statistics was used to summarize data. Patient groups were compared using non-parametric tests. A logistic regression analysis was performed to identify covariate effects of each variable on dependency in personal and instrumental ADL, and for the change-in-health question of SF-36. Out of 333 hospital survivors, 226 completed the questionnaires. Fifty-nine percent reported that their general level of health was better on the day they answered the questionnaire than 12 months earlier. Patients with greater co-morbidities (ASA-PS III/IV), had lower SF-36 scores in all domains and were more frequently dependent in instrumental and personal ADL. Logistic regression showed that SAPS II was associated with changes in general level of health (OR 1.06, 95%CI, 1.01-1.11, p = 0,016). Six months after ICU discharge, 60% and 34% of patients, respectively, were dependent in at least one activity in instrumental ADL (ADLI) and personal ADL (ADLP). ASA-PS (OR 3.00, 95%CI 1.31-6.87, p = 0.009) and age (OR 2.36, 95%CI, 1.04-5.34, p = 0.04) were associated with dependency in ADLI. For ADLP, only ASA-PS (OR 4.58, 95%CI, 1

  9. The Business Engineering Surgical Technologies (BEST) teaching method: incubating talents for surgical innovation.

    Science.gov (United States)

    de Ruijter, V; Halvax, P; Dallemagne, B; Swanström, L; Marescaux, J; Perretta, S

    2015-01-01

    Technological innovation in surgical science and healthcare is vital and calls for close collaboration between engineering and surgery. To meet this objective, BEST was designed as a free sustainable innovative teaching method for young professionals, combining surgery, engineering, and business in a multidisciplinary, high-quality, low-cost, and learning-by-doing philosophy. This paper reviews the initial outcomes of the program and discusses lessons learned and future directions of this innovative educational method. BEST educational method is delivered in two parts: the first component consisting of live streaming or pre-recorded online lectures, with an interdisciplinary profile focused on surgery, engineering, and business. The second component is an annual 5-day on-site course, organized at IRCAD-IHU, France. The program includes workshops in engineering, entrepreneurship team projects, and in-depth hands-on experience in laparoscopy, robotic surgery, interventional radiology, and flexible endoscopy with special emphasis on the interdisciplinary aspect of the training. A panel of surgeons, engineers, well-established entrepreneurs, and scientists assessed the team projects for potential patent application. From November 2011 till September 2013, 803 individual and institutional users from 79 different countries attended the online course. In total, 134 young professionals from 32 different countries applied to the onsite course. Sixty participants were selected each year for the onsite course. In addition, five participants were selected for a web-based team. Thirteen provisional patents were filed for the most promising projects. BEST proved to be a global talent incubator connecting students to high-quality education despite institutional and economical boundaries. Viable and innovative ideas arose from this revolutionary approach which is likely to spin-off significant technology transfer and lead the way for future interdisciplinary hybrid surgical

  10. Technological advances in the surgical treatment of movement disorders.

    Science.gov (United States)

    Gross, Robert E; McDougal, Margaret E

    2013-08-01

    Technological innovations have driven the advancement of the surgical treatment of movement disorders, from the invention of the stereotactic frame to the adaptation of deep brain stimulation (DBS). Along these lines, this review will describe recent advances in inserting neuromodulation modalities, including DBS, to the target, and in the delivery of therapy at the target. Recent radiological advances are altering the way that DBS leads are targeted and inserted, by refining the ability to visualize the subcortical targets using high-field strength magnetic resonance imaging and other innovations, such as diffusion tensor imaging, and the development of novel targeting devices enabling purely anatomical implantations without the need for neurophysiological monitoring. New portable computed tomography scanners also are facilitating lead implantation without monitoring, as well as improving radiological verification of DBS lead location. Advances in neurophysiological mapping include efforts to develop automatic target verification algorithms, and probabilistic maps to guide target selection. The delivery of therapy at the target is being improved by the development of the next generation of internal pulse generators (IPGs). These include constant current devices that mitigate the variability introduced by impedance changes of the stimulated tissue and, in the near future, devices that deliver novel stimulation patterns with improved efficiency. Closed-loop adaptive IPGs are being tested, which may tailor stimulation to ongoing changes in the nervous system, reflected in biomarkers continuously recorded by the devices. Finer-grained DBS leads, in conjunction with new IPGs and advanced programming tools, may offer improved outcomes via current steering algorithms. Finally, even thermocoagulation-essentially replaced by DBS-is being advanced by new minimally-invasive approaches that may improve this therapy for selected patients in whom it may be preferred. Functional

  11. Patient-Specific Surgical Implants Made of 3D Printed PEEK: Material, Technology, and Scope of Surgical Application

    Directory of Open Access Journals (Sweden)

    Philipp Honigmann

    2018-01-01

    Full Text Available Additive manufacturing (AM is rapidly gaining acceptance in the healthcare sector. Three-dimensional (3D virtual surgical planning, fabrication of anatomical models, and patient-specific implants (PSI are well-established processes in the surgical fields. Polyetheretherketone (PEEK has been used, mainly in the reconstructive surgeries as a reliable alternative to other alloplastic materials for the fabrication of PSI. Recently, it has become possible to fabricate PEEK PSI with Fused Filament Fabrication (FFF technology. 3D printing of PEEK using FFF allows construction of almost any complex design geometry, which cannot be manufactured using other technologies. In this study, we fabricated various PEEK PSI by FFF 3D printer in an effort to check the feasibility of manufacturing PEEK with 3D printing. Based on these preliminary results, PEEK can be successfully used as an appropriate biomaterial to reconstruct the surgical defects in a “biomimetic” design.

  12. Patient-Specific Surgical Implants Made of 3D Printed PEEK: Material, Technology, and Scope of Surgical Application.

    Science.gov (United States)

    Honigmann, Philipp; Sharma, Neha; Okolo, Brando; Popp, Uwe; Msallem, Bilal; Thieringer, Florian M

    2018-01-01

    Additive manufacturing (AM) is rapidly gaining acceptance in the healthcare sector. Three-dimensional (3D) virtual surgical planning, fabrication of anatomical models, and patient-specific implants (PSI) are well-established processes in the surgical fields. Polyetheretherketone (PEEK) has been used, mainly in the reconstructive surgeries as a reliable alternative to other alloplastic materials for the fabrication of PSI. Recently, it has become possible to fabricate PEEK PSI with Fused Filament Fabrication (FFF) technology. 3D printing of PEEK using FFF allows construction of almost any complex design geometry, which cannot be manufactured using other technologies. In this study, we fabricated various PEEK PSI by FFF 3D printer in an effort to check the feasibility of manufacturing PEEK with 3D printing. Based on these preliminary results, PEEK can be successfully used as an appropriate biomaterial to reconstruct the surgical defects in a "biomimetic" design.

  13. Effects of Technological Advances in Surgical Education on Quantitative Outcomes From Residency Programs.

    Science.gov (United States)

    Dietl, Charles A; Russell, John C

    2016-01-01

    The purpose of this article is to review the literature on current technology for surgical education and to evaluate the effect of technological advances on the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies, American Board of Surgery In-Training Examination (ABSITE) scores, and American Board of Surgery (ABS) certification. A literature search was obtained from MEDLINE via PubMed.gov, ScienceDirect.com, and Google Scholar on all peer-reviewed studies published since 2003 using the following search queries: technology for surgical education, simulation-based surgical training, simulation-based nontechnical skills (NTS) training, ACGME Core Competencies, ABSITE scores, and ABS pass rate. Our initial search list included the following: 648 on technology for surgical education, 413 on simulation-based surgical training, 51 on simulation-based NTS training, 78 on ABSITE scores, and 33 on ABS pass rate. Further, 42 articles on technological advances for surgical education met inclusion criteria based on their effect on ACGME Core Competencies, ABSITE scores, and ABS certification. Systematic review showed that 33 of 42 and 26 of 42 publications on technological advances for surgical education showed objective improvements regarding patient care and medical knowledge, respectively, whereas only 2 of 42 publications showed improved ABSITE scores, but none showed improved ABS pass rates. Improvements in the other ACGME core competencies were documented in 14 studies, 9 of which were on simulation-based NTS training. Most of the studies on technological advances for surgical education have shown a positive effect on patient care and medical knowledge. However, the effect of simulation-based surgical training and simulation-based NTS training on ABSITE scores and ABS certification has not been assessed. Studies on technological advances in surgical education and simulation-based NTS training showing quantitative evidence that surgery residency

  14. [NIC as a tool for assessing competences of nursing students in clinical placement at surgical units].

    Science.gov (United States)

    Celma Vicente, Matilde; Ajuria-Imaz, Eloisa; Lopez-Morales, Manuel; Fernandez-Marín, Pilar; Menor-Castro, Alicia; Cano-Caballero Galvez, Maria Dolores

    2015-01-01

    This paper shows the utility of a NIC standardized language to assess the extent of nursing student skills at Practicum in surgical units To identify the nursing interventions classification (NIC) that students can learn to perform in surgical units. To determine the level of difficulty in learning interventions, depending on which week of rotation in clinical placement the student is. Qualitative study using Delphi consensus technique, involving nurses with teaching experience who work in hospital surgical units, where students undertake the Practicum. The results were triangulated through a questionnaire to tutors about the degree of conformity. A consensus was reached about the interventions that students can achieve in surgical units and the frequency in which they can be performed. The level of difficulty of each intervention, and the amount of weeks of practice that students need to reach the expected level of competence was also determined. The results should enable us to design better rotations matched to student needs. Knowing the frequency of each intervention that is performed in each unit determines the chances of learning it, as well as the indicators for its assessment. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  15. Patterns of Daily Costs Differ for Medical and Surgical Intensive Care Unit Patients.

    Science.gov (United States)

    Gershengorn, Hayley B; Garland, Allan; Gong, Michelle N

    2015-12-01

    Published studies suggest hospital costs on Day 1 in the intensive care unit (ICU) far exceed those of subsequent days, when costs are relatively stable. Yet, no study stratified patients by ICU type. To determine whether daily cost patterns differ by ICU type. We performed a retrospective study of adults admitted to five ICUs (two surgical: quaternary surgical ICU [SICU quat] and quaternary cardiac surgical ICU [CSICU quat]; two medical: tertiary medical ICU [MICU tertiary] and quaternary medical ICU [MICU quat]; one general: community medical surgical ICU [MSICU comm]) at Montefiore Medical Center in the Bronx, New York during 2013. After excluding costs clearly accrued outside the ICU, daily hospital costs were merged with clinical data. Patterns of daily unadjusted costs were evaluated in each ICU using median regression. Generalized estimating equations with first-order autocorrelation were used to identify factors independently associated with daily costs. Unadjusted daily costs were higher on Day 1 than on subsequent days only for surgical ICUs-SICU quat (median [interquartile range], $2,636 [$1,834-$4,282] on Day 1 vs. $1,840 [$1,501-$2,332] on Day 2; P cost from Days 1 to 2. After multivariate adjustment, there remained a significant decrease in cost from ICU Day 1 to 2 in surgical units with statistically similar Day 1 and 2 costs for other ICUs. Higher Day 1 costs are not seen in patients admitted to medical/nonsurgical ICUs.

  16. Hospital-acquired acute kidney injury in medical, surgical, and intensive care unit: A comparative study

    Directory of Open Access Journals (Sweden)

    T B Singh

    2013-01-01

    Full Text Available Acute kidney injury (AKI is a common complication in hospitalized patients. There are few comparative studies on hospital-acquired AKI (HAAKI in medical, surgical, and ICU patients. This study was conducted to compare the epidemiological characteristics, clinical profiles, and outcomes of HAAKI among these three units. All adult patients (>18 years of either gender who developed AKI based on RIFLE criteria (using serum creatinine, 48 h after hospitalization were included in the study. Patients of acute on chronic renal failure and AKI in pregnancy were excluded. Incidence of HAAKI in medical, surgical, and ICU wards were 0.54%, 0.72%, and 2.2% respectively ( P < 0.0001. There was no difference in age distribution among the groups, but onset of HAAKI was earliest in the medical ward ( P = 0.001. RIFLE-R was the most common AKI in medical (39.2% and ICU (50% wards but in the surgical ward, it was RIFLE-F that was most common (52.6%. Acute tubular necrosis was more common in ICU ( P = 0.043. Most common etiology of HAAKI in medical unit was drug induced (39.2%, whereas in surgical and ICU, it was sepsis (34% and 35.2% respectively. Mortality in ICU, surgical and medical units were 73.5%, 43.42%, and 37.2%, respectively ( P = 0.003. Length of hospital stay in surgical, ICU and medical units were different ( P = 0.007. This study highlights that the characters of HAAKI are different in some aspects among different hospital settings.

  17. Innovation in surgical technology and techniques: Challenges and ethical issues.

    Science.gov (United States)

    Geiger, James D; Hirschl, Ronald B

    2015-06-01

    The pace of medical innovation continues to increase. The deployment of new technologies in surgery creates many ethical challenges including how to determine safety of the technology, what is the timing and process for deployment of a new technology, how are patients informed before undergoing a new technology or technique, how are the outcomes of a new technology evaluated and how are the responsibilities of individual patients and society at large balanced. Ethical considerations relevant to the implementation of ECMO and robotic surgery are explored to further discussion of how we can optimize the delicate balance between innovation and regulation. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Medical and surgical applications of space biosensor technology

    Science.gov (United States)

    Hines, J. W.

    1996-01-01

    Researchers in space life sciences are rapidly approaching a technology impasse. Many of the critical questions on the impact of spaceflight on living systems simply cannot be answered with the limited available technologies. Research subjects, particularly small animal models like the rat, must be allowed to function relatively untended and unrestrained for long periods to fully reflect the impact of microgravity and spaceflight on their behavior and physiology. These requirements preclude the use of present hard-wired instrumentation techniques and limited data acquisition systems. Implantable sensors and miniaturized biotelemetry are the only means of capturing the fundamental and critical data. This same biosensor and biotelemetry technology has direct application to Earth-based medicine and surgery. Continuous, on-line data acquisition and improved measurement capabilities combined with the ease and flexibility offered by automated, wireless, and portable instruments and data systems, should provide a boon to the health care industry. Playing a key role in this technology revolution is the Sensors 2000! (S2K!) Program at NASA Ames Research Center. S2K!, in collaboration with space life sciences researchers and managers, provides an integrated capability for sensor technology development and applications, including advanced biosensor technology development, spaceflight hardware development, and technology transfer and commercialization. S2K! is presently collaborating on several spaceflight projects with dual-use medical applications. One prime example is a collaboration with the Fetal Treatment Center (FTC) at the University of California at San Francisco. The goal is to develop and apply implantable chemical sensor and biotelemetry technology to continuously monitor fetal patients during extra-uterine surgery, replacement into the womb, through birth and beyond. Once validated for ground use, the method will be transitioned to spaceflight applications to

  19. Medical and surgical applications of space biosensor technology

    Science.gov (United States)

    Hines, John W.

    1996-02-01

    Researchers in space life sciences are rapidly approaching a technology impasse. Many of the critical questions on the impact of spaceflight on living systems simply cannot be answered with the limited available technologies. Research subjects, particularly small animal models like the rat, must be allowed to function relatively untended and unrestrained for long periods to fully reflect the impact of microgravity and spaceflight on their behavior and physiology. These requirements preclude the use of present hard-wired instrumentation techniques and limited data acquisition systems. Implantable sensors and miniaturized biotelemetry are the only means of capturing the fundamental and critical data. This same biosensor and biotelemetry technology has direct application to Earth-based medicine and surgery. Continuous, on-line data acquisition and improved measurement capabilities combined with the ease and flexibility offered by automated, wireless, and portable instruments and data systems, should provide a boon to the health care industry. Playing a key role in this technology revolution is the Sensors 2000! (S2K!) Program at NASA Ames Research Center. S2K!, in collaboration with space life sciences researchers and managers, provides an integrated capability for sensor technology development and applications, including advanced biosensor technology development, spaceflight hardware development, and technology transfer and commercialization. S2K! is presently collaborating on several spaceflight projects with dual-use medical applications. One prime example is a collaboration with the Fetal Treatment Center (FTC) at the University of California at San Francisco. The goal is to develop and apply implantable chemical sensor and biotelemetry technology to continuously monitor fetal patients during extra-uterine surgery, replacement into the womb, through birth and beyond. Once validated for ground use, the method will be transitioned to spaceflight applications to

  20. Kinect technology for hand tracking control of surgical robots: technical and surgical skill comparison to current robotic masters.

    Science.gov (United States)

    Kim, Yonjae; Leonard, Simon; Shademan, Azad; Krieger, Axel; Kim, Peter C W

    2014-06-01

    Current surgical robots are controlled by a mechanical master located away from the patient, tracking surgeon's hands by wire and pulleys or mechanical linkage. Contactless hand tracking for surgical robot control is an attractive alternative, because it can be executed with minimal footprint at the patient's bedside without impairing sterility, while eliminating current disassociation between surgeon and patient. We compared technical and technologic feasibility of contactless hand tracking to the current clinical standard master controllers. A hand-tracking system (Kinect™-based 3Gear), a wire-based mechanical master (Mantis Duo), and a clinical mechanical linkage master (da Vinci) were evaluated for technical parameters with strong clinical relevance: system latency, static noise, robot slave tremor, and controller range. Five experienced surgeons performed a skill comparison study, evaluating the three different master controllers for efficiency and accuracy in peg transfer and pointing tasks. da Vinci had the lowest latency of 89 ms, followed by Mantis with 374 ms and 3Gear with 576 ms. Mantis and da Vinci produced zero static error. 3Gear produced average static error of 0.49 mm. The tremor of the robot used by the 3Gear and Mantis system had a radius of 1.7 mm compared with 0.5 mm for da Vinci. The three master controllers all had similar range. The surgeons took 1.98 times longer to complete the peg transfer task with the 3Gear system compared with Mantis, and 2.72 times longer with Mantis compared with da Vinci (p value 2.1e-9). For the pointer task, surgeons were most accurate with da Vinci with average error of 0.72 mm compared with Mantis's 1.61 mm and 3Gear's 2.41 mm (p value 0.00078). Contactless hand-tracking technology as a surgical master can execute simple surgical tasks. Whereas traditional master controllers outperformed, given that contactless hand-tracking is a first-generation technology, clinical potential is promising and could

  1. [Applications of 3D printing technology in teaching of oromaxillofacial head and neck surgical oncology].

    Science.gov (United States)

    Ruan, Min; Ji, Tong; Zhang, Chen-Ping

    2016-12-01

    With the increasing maturation of 3D printing technology, as well as its application in various industries, investigation of 3D printing technology into clinic medical education becomes an important task of the current medical education. The teaching content of oromaxillofacial head and neck surgical oncology is complicated and diverse, making lower understanding/memorizing efficiency and insufficient skill training. To overcome the disadvantage of traditional teaching method, it is necessary to introduce 3D printing technique into teaching of oromaxillofacial head and neck surgical oncology, in order to improve the teaching quality and problem solving capabilities, and finally promote cultivation of skilled and innovative talents.

  2. Peer-mentoring junior surgical trainees in the United Kingdom: a pilot program.

    Science.gov (United States)

    Vulliamy, Paul; Junaid, Islam

    2012-04-16

    Peer-mentoring has attracted substantial interest in various healthcare professions, but has not been formally integrated into postgraduate surgical training. This study aimed to assess the feasibility and acceptability of a peer-mentor scheme among junior surgical trainees in the United Kingdom. Trainees entering the first year of core surgical training (CST) in a single postgraduate school of surgery were allocated a mentor in the second year of CST. Allocation was based on location of the initial clinical placement. An anonymised questionnaire regarding the mentorship scheme was sent to all participants in the third month following its introduction. 18 trainees participated in the scheme, of whom 12 (67%) responded to the questionnaire. All respondents had made contact with their allocated mentor or mentee, and no trainees had opted out of the scheme. Areas in which the mentees received guidance included examinations (83%), CV development (67%), and workplace-based assessments (67%). All respondents felt that the mentor scheme was a good addition to CST. Suggestions for improvement of the scheme included introduction of structured meetings and greater engagement with allocated mentors. A pilot peer-mentoring scheme was well received by junior surgical trainees. Consideration should be given to expansion of this scheme and more rigorous assessment of its value.

  3. Facial transplantation: an anatomic and surgical analysis of the periorbital functional unit.

    Science.gov (United States)

    Vasilic, Dalibor; Barker, John H; Blagg, Ross; Whitaker, Iain; Kon, Moshe; Gossman, M Douglas

    2010-01-01

    Complete loss of eyelid pair is associated with chronic discomfort, corneal ulceration, and visual impairment. Contemporary reconstructive techniques rarely provide functionally acceptable results. Composite tissue allotransplantation may provide a viable alternative. This study reports on neurovascular anatomy and technical details of harvesting an isolated periorbital unit and discusses its functional potential. Twenty-four hemifaces (12 fresh cadavers) were dissected to study surgically relevant neurovascular structures and to develop an efficient harvest method. Angiographic analysis was performed in seven hemifaces following harvest. The superficial temporal and facial vessels demonstrated consistent location and diameters. Anatomic variability was characterized by the absence of the frontal branch of the superficial temporal artery or facial-to-angular artery continuation, but never of both vessels in the same hemiface. Angiographic analysis demonstrated filling of the eyelid arcades, provided the anastomoses between the internal and external carotid branches were preserved. The facial nerve exhibited consistent planar arrangement and diameters in the intraparotid and proximal extraparotid regions, but less so in the distal nerve course. The inferior zygomatic and buccal branches frequently coinnervated the orbicularis oculi and lower facial muscles with an unpredictable intermuscular course. Based on the foregoing, an effective surgical harvest of the periorbital composite was developed. Surgical harvest of a functional periorbital allotransplant is technically feasible. Revascularization of the isolated periorbital unit is influenced by variations in regional anatomy and cannot be guaranteed by a single vascular pedicle. The orbicularis oculi muscle and its innervation can be preserved, and recovery, albeit without the certainty of reflexive blinking, is expected.

  4. Impact of introduction of an acute surgical unit on management and outcomes of small bowel obstruction.

    Science.gov (United States)

    Musiienko, Anton M; Shakerian, Rose; Gorelik, Alexandra; Thomson, Benjamin N J; Skandarajah, Anita R

    2016-10-01

    The acute surgical unit (ASU) is a recently established model of care in Australasia and worldwide. Limited data are available regarding its effect on the management of small bowel obstruction. We compared the management of small bowel obstruction before and after introduction of ASU at a major tertiary referral centre. We hypothesized that introduction of ASU would correlate with improved patient outcomes. A retrospective review of prospectively maintained databases was performed over two separate 2-year periods, before and after the introduction of ASU. Data collected included demographics, co-morbidity status, use of water-soluble contrast agent and computed tomography. Outcome measures included surgical intervention, time to surgery, hospital length of stay, complications, 30-day readmissions, use of total parenteral nutrition, intensive care unit admissions and overall mortality. Total emergency admissions to the ASU increased from 2640 to 4575 between the two time periods. A total of 481 cases were identified (225 prior and 256 after introduction of ASU). Mortality decreased from 5.8% to 2.0% (P = 0.03), which remained significant after controlling for confounders with multivariate analysis (odds ratio = 0.24, 95% confidence interval 0.08-0.73, P = 0.012). The proportion of surgically managed patients increased (20.9% versus 32.0%, P = 0.003) and more operations were performed within 5 days from presentation (76.6% versus 91.5%, P = 0.02). Fewer patients received water-soluble contrast agent (27.1% versus 18.4%, P = 0.02), but more patients were investigated with a computed tomography (70.7% versus 79.7%, P = 0.02). The ASU model of care resulted in decreased mortality, shorter time to intervention and increased surgical management. Overall complications rate and length of stay did not change. © 2015 Royal Australasian College of Surgeons.

  5. Surgical tissue banking - the role of nuclear technology

    International Nuclear Information System (INIS)

    Hasim Mohamad

    2002-01-01

    Before 1980s amniotic membranes were mainly used clinically either in fresh forms or preserved in glycerol without sterilization. There were problems of graft infections and difficulty in maintaining standard of graft quality and uniformity of the amnion when applied on the recipient patients. Nuclear technology has helped to sterilize these membranes such that they can be processed, dried and then double packed before finally irradiated with gamma rays emitted from the radionuclide cobalt-60. The irradiated amniotic membranes can be kept at room temperature and are readily available for used by doctors without relying on glycerol for preservation or freezers for storage. Similarly allograft bones can be processed and be stored in similar manner otherwise they need to be frozen at -80 to -160 degree C. Radiation technology has benefited many patients in many countries in the Asia Pacific region through sterilization of tissues. Bone such as femoral heads can be processed into radiation sterilized bone chips or grounded bones and has been successfully used for filling up of cavities left by benign bone tumors, bone cysts etc. These materials are safe and cheap and save the recipients in-term of money and a second surgery and on the extreme case, patients may avoid amputation if an irradiated long bone is available. Orthopedic, neuro- and dental surgeons have reported many such successful outcomes. Also bum patients have been shown to benefit from amniotic membranes or porcine skin which were processed and irradiated prior to treatment. In some countries in this region, amniotic membranes have been used as en effective wound dressing for leprosy patients as well. Reports of these cases are to be presented. (Author)

  6. Assisted Reproductive Technology Surveillance - United States, 2015.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara B; Folger, Suzanne G; Boulet, Sheree L; Warner, Lee; Barfield, Wanda D

    2018-02-16

    Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Although the majority of infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks for both mothers and infants, including obstetric complications, preterm delivery (state-specific information for the United States (including the District of Columbia and Puerto Rico) on ART procedures performed in 2015 and compares birth outcomes that occurred in 2015 (resulting from ART procedures performed in 2014 and 2015) with outcomes for all infants born in the United States in 2015. 2015. In 1995, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493 [October 24, 1992]). Data are collected through the National ART Surveillance System, a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia, and Puerto Rico). In 2015, a total of 182,111 ART procedures (range: 135 in Alaska to 23,198 in California) with the intent to transfer at least one embryo were performed in 464 U.S. fertility clinics and reported to CDC. These procedures resulted in 59,334 live-birth deliveries (range: 55 in Wyoming to 7,802 in California) and 71,152 infants born (range: 68 in Wyoming to 9,176 in California). Nationally, the number of ART procedures performed per 1 million women of reproductive age (15-44 years), a proxy measure of the ART utilization rate, was

  7. The United States Department of Energy Office of Industrial Technology`s Technology Benefits Recording System

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, K.R.; Moore, N.L.

    1994-09-01

    The U.S. Department of Energy (DOE) Office of Industrial Technology`s (OIT`s) Technology Benefits Recording System (TBRS) was developed by Pacific Northwest Laboratory (PNL). The TBRS is used to organize and maintain records of the benefits accrued from the use of technologies developed with the assistance of OIT. OIT has had a sustained emphasis on technology deployment. While individual program managers have specific technology deployment goals for each of their ongoing programs, the Office has also established a separate Technology Deployment Division whose mission is to assist program managers and research and development partners commercialize technologies. As part of this effort, the Technology Deployment Division developed an energy-tracking task which has been performed by PNL since 1977. The goal of the energy-tracking task is to accurately assess the energy savings impact of OIT-developed technologies. In previous years, information on OIT-sponsored technologies existed in a variety of forms--first as a hardcopy, then electronically in several spreadsheet formats that existed in multiple software programs. The TBRS was created in 1993 for OIT and was based on information collected in all previous years from numerous industrial contacts, vendors, and plants that have installed OIT-sponsored technologies. The TBRS contains information on technologies commercialized between 1977 and the present, as well as information on emerging technologies in the late development/early commercialization stage of the technology life cycle. For each technology, details on the number of units sold and the energy saved are available on a year-by-year basis. Information regarding environmental benefits, productivity and competitiveness benefits, or impact that the technology may have had on employment is also available.

  8. Nuclear Systems (NS): Technology Demonstration Unit (TDU)

    Data.gov (United States)

    National Aeronautics and Space Administration — The Nuclear Systems Project demonstrates nuclear power technology readiness to support the goals of NASA's Space Technology Mission Directorate. To this end, the...

  9. Healthcare information technology and medical-surgical nurses: the emergence of a new care partnership.

    Science.gov (United States)

    Moore, An'Nita; Fisher, Kathleen

    2012-03-01

    Healthcare information technology in US hospitals and ambulatory care centers continues to expand, and nurses are expected to effectively and efficiently utilize this technology. Researchers suggest that clinical information systems have expanded the realm of nursing to integrate technology as an element as important in nursing practice as the patient or population being served. This study sought to explore how medical surgical nurses make use of healthcare information technology in their current clinical practice and to examine the influence of healthcare information technology on nurses' clinical decision making. A total of eight medical surgical nurses participated in the study, four novice and four experienced. A conventional content analysis was utilized that allowed for a thematic interpretation of participant data. Five themes emerged: (1) healthcare information technology as a care coordination partner, (2) healthcare information technology as a change agent in the care delivery environment, (3) healthcare information technology-unable to meet all the needs, of all the people, all the time, (4) curiosity about healthcare information technology-what other bells and whistles exist, and (5) Big Brother is watching. The results of this study indicate that a new care partnership has emerged as the provision of nursing care is no longer supplied by a single practitioner but rather by a paired team, consisting of nurses and technology, working collaboratively in an interdependent relationship to achieve established goals.

  10. Using Appreciative Inquiry to Discover and Deliver Change for Surgical Technology Students

    Science.gov (United States)

    Cabai, Katherine A.

    2012-01-01

    The purpose of this study was to examine efficacious teaching-learning strategies that community college stakeholders employ that enhance surgical technology student outcomes. Knowles's adult learning theory, constructivist theory, and appreciative inquiry served as the theoretical foundation for this study. Discovering effective aspects and…

  11. Organizational effects on patient satisfaction in hospital medical-surgical units.

    Science.gov (United States)

    Bacon, Cynthia Thornton; Mark, Barbara

    2009-05-01

    The purpose of this study was to examine the relationships between hospital context, nursing unit structure, and patient characteristics and patients' satisfaction with nursing care in hospitals. Although patient satisfaction has been widely researched, our understanding of the relationship between hospital context and nursing unit structure and their impact on patient satisfaction is limited. The data source for this study was the Outcomes Research in Nursing Administration Project, a multisite organizational study conducted to investigate relationships among nurse staffing, organizational context and structure, and patient outcomes. The sample for this study was 2,720 patients and 3,718 RNs in 286 medical-surgical units in 146 hospitals. Greater availability of nursing unit support services and higher levels of work engagement were associated with higher levels of patient satisfaction. Older age, better health status, and better symptom management were also associated with higher levels of patient satisfaction. Organizational factors in hospitals and nursing units, particularly support services on the nursing unit and mechanisms that foster nurses' work engagement and effective symptom management, are important influences on patient satisfaction.

  12. Prevalence of graduated compression stocking-associated pressure injuries in surgical intensive care units.

    Science.gov (United States)

    Hobson, Deborah B; Chang, Tracy Y; Aboagye, Jonathan K; Lau, Brandyn D; Shihab, Hasan M; Fisher, Betsy; Young, Samantha; Sujeta, Nancy; Shaffer, Dauryne L; Popoola, Victor O; Kraus, Peggy S; Knorr, Gina; Farrow, Norma E; Streiff, Michael B; Haut, Elliott R

    2017-08-01

    This study aimed to determine the prevalence of static graduated compression stocking (sGCS)-associated pressure injury among patients in surgical intensive care units (ICUs). We retrospectively reviewed data from wound care rounds between April 2011 and June 2012 at 3 surgical ICUs at an urban, tertiary care hospital. Patients with sGCS-associated pressure injury were identified and descriptive analysis was performed on their demographic, perioperative, and postoperative characteristics. We examined 1787 individual patients during 2391 patient encounters. A total of 129 (7.2%) of patients developed pressure injuries. Forty patients (2.2%) developed sGCS-associated pressure injury. Static GCS-associated pressure injury accounted for 31% (40/129) of all pressure injuries and 74% (40/54) of all medical device-related pressure injury. Eighteen (45%) and 6 (15%) developed stage 1 and 2 pressure injury, respectively, and 16 (40%) developed deep tissue injuries. The mean age of our patients was 64.7 years, about half (47.5%) were male, and their mean Acute Physiology and Chronic Health Evaluation II score was 18.8. Many had comorbid conditions, including obesity (44.5%) and diabetes (42.5%), and required mechanical ventilation (45%). Pressure injuries are a notable complication of sGCS in surgical ICU patients. Appropriate measures are required to help avoid this potentially preventable harm. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Key performance indicators in an acute surgical unit: have we made an impact?

    Science.gov (United States)

    Hsee, Li; Devaud, Marcelo; Civil, Ian

    2012-10-01

    Timely access to acute surgery is a worldwide issue and New Zealand is similarly affected. Auckland City Hospital is one of the largest metropolitan public hospitals in New Zealand where more than 60 % of surgical admissions fit into the acute category. In January 2009, an Acute Surgical Unit (ASU) was set up to improve acute surgical flow. Key performance indicators (KPIs) were identified as valuable tools in evaluating ASU service performance. Our goals were to describe the current acute patient pathway, present the early trend of KPIs for the ASU and determine whether an impact has been made on acute surgical patients. A retrospective review of patients admitted with acute general surgical conditions from January 2008 (pre-ASU) to October 2010 was performed. Patient data were identified through hospital electronic records. KPIs assessed included: (1) time to assess referred patients from the emergency department (ED) and from GPs [where patient assessment occurs in the assessment and planning unit (APU)]; (2) preoperative length of stay (LOS[PO]); (3) length of stay of nonadmitted patients (LOS[NA]); (4) case volume "in h" (0730-1730) versus "after h"; and (5) readmission rate. Statistical analysis was performed with one-way ANOVA, regression, and χ(2) tests. Results show a reduction of mean time from referral to assessment from 2.28 to 1.6 h in the ED (p ≤ 0.001). Patients are seen in APU after GP referral sooner as well as the time from referral to assessment reducing from 2 to 1.76 h (p < 0.001). The LOS[PO] has not changed significantly overall (34.58 vs. 34.88 h, p = not significant [NS]). However, there are encouraging signs in high-volume procedures, such as appendicectomy. The mean LOS[PO] for appendicectomy was 7.81 h but is now 6.53 h (p ≤ 0.005). The LOS[NA] has decreased from 15.23 to 9.48 h (p < 0.005). Since the development of the ASU, the number of cases operated on "in hours" is increasing with a corresponding decrease in "after hours

  14. Surgical procedures performed in the neonatal intensive care unit on critically ill neonates: feasibility and safety

    International Nuclear Information System (INIS)

    Mallick, M.S.; Jado, A.M.; Al-Bassam, A.R.

    2008-01-01

    Transferring unstable, ill neonates to and from the operating rooms carries significant risks and can lead to morbidity. We report on our experience in performing certain procedures in critically ill neonates in the neonatal intensive care unit (NICU). We examined the feasibility and safety for such an approach. All surgical procedures performed in the NICU between January 1999 and December 2005 were analyzed in terms of demographic data, diagnosis, preoperative stability of the patient, procedures performed, complications and outcome. Operations were performed at beside in the NICU in critically ill, unstable neonates who needed emergency surgery, in neonates of low birth weight (<1000 gm) and in neonates on special equipments like higher frequency ventilators and nitrous oxide. Thirty-seven surgical procedures were performed including 12 laparotomies, bowel resection and stomies, 7 repairs of congenital diaphragmatic hernias, 4 ligations of patent ductus arteriosus and various others. Birth weights ranged between 850 gm and 3500 gm (mean 2000 gm). Gestational age ranged between 25 to 42 weeks (mean, 33 weeks). Age at surgery was between 1 to 30 days (mean, 30 days). Preoperatively, 19 patients (51.3%) were on inotropic support and all were intubated and mechanically ventilated. There was no mortality related to surgical procedures. Postoperatively, one patient developed wound infection and disruption. Performing major surgical procedures in the NICU is both feasible and safe. It is useful in very low birth weight, critically ill neonates who have definite risk attached to transfer to the operating room. No special area is needed in the NICU to perform complication-free surgery, but designing an operating room within the NICU will be ideal. (author)

  15. Mortality of induced abortion, other outpatient surgical procedures and common activities in the United States.

    Science.gov (United States)

    Raymond, Elizabeth G; Grossman, Daniel; Weaver, Mark A; Toti, Stephanie; Winikoff, Beverly

    2014-11-01

    The recent surge of new legislation regulating induced abortion in the United States is ostensibly motivated by the desire to protect women's health. To provide context for interpreting the risk of abortion, we compared abortion-related mortality to mortality associated with other outpatient surgical procedures and selected nonmedical activities. We calculated the abortion-related mortality rate during 2000-2009 using national data. We searched PubMed and other sources for contemporaneous data on mortality associated with other outpatient procedures commonly performed on healthy young women, marathon running, bicycling and driving. The abortion-related mortality rate in 2000-2009 in the United States was 0.7 per 100,000 abortions. Studies in approximately the same years found mortality rates of 0.8-1.7 deaths per 100,000 plastic surgery procedures, 0-1.7deaths per 100,000 dental procedures, 0.6-1.2 deaths per 100,000 marathons run and at least 4 deaths among 100,000 cyclists in a large annual bicycling event. The traffic fatality rate per 758 vehicle miles traveled by passenger cars in the United States in 2007-2011 was about equal to the abortion-related mortality rate. The safety of induced abortion as practiced in the United States for the past decade met or exceeded expectations for outpatient surgical procedures and compared favorably to that of two common nonmedical voluntary activities. The new legislation restricting abortion is unnecessary; indeed, by reducing the geographic distribution of abortion providers and requiring women to travel farther for the procedure, these laws are potentially detrimental to women's health. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. [Mortality and length of stay in a surgical intensive care unit.].

    Science.gov (United States)

    Abelha, Fernando José; Castro, Maria Ana; Landeiro, Nuno Miguel; Neves, Aida Maria; Santos, Cristina Costa

    2006-02-01

    Outcome in intensive care can be categorized as mortality related or morbidity related. Mortality is an insufficient measure of ICU outcome when measured alone and length of stay may be seen as an indirect measure of morbidity related outcome. The aim of the present study was to estimate the incidence and predictive factors for intrahospitalar outcome measured by mortality and LOS in patients admitted to a surgical ICU. In this prospective study all 185 patients, who underwent scheduled or emergency surgery admitted to a surgical ICU in a large tertiary university medical center performed during April and July 2004, were eligible to the study. The following variables were recorded: age, sex, body weight and height, core temperature (Tc), ASA physical status, emergency or scheduled surgery, magnitude of surgical procedure, anesthesia technique, amount of fluids during anesthesia, use of temperature monitoring and warming techniques, duration of the anesthesia, length of stay in ICU and in the hospital and SAPS II score. The mean length of stay in the ICU was 4.09 +/- 10.23 days. Significant risk factors for staying longer in ICU were SAPS II, ASA physical status, amount of colloids, fresh frozen plasma units and packed erythrocytes units used during surgery. Fourteen (7.60%) patients died in ICU and 29 (15.70%) died during their hospitalization. Statistically significant independent risk factors for mortality were emergency surgery, major surgery, high SAPS II scores, longer stay in ICU and in the hospital. Statistically significant protective factors against the probability of dying in the hospital were low body weight and low BMI. In conclusion, prolonged ICU stay is more frequent in more severely ill patients at admission and it is associated with higher hospital mortality. Hospital mortality is also more frequent in patients submitted to emergent and major surgery.

  17. Patient care and administrative activities of nurses in clinical/surgical units

    Directory of Open Access Journals (Sweden)

    Marilia Moura Luvisotto

    2010-06-01

    Full Text Available Objectives: To identify the administrative and nursing care activities most performed by nurses in clinical/surgical units and to determine which are most and least pleasant to them. Methods: A descriptive-exploratory field study, with a quantitative approach and with a sample made up of 40 nurses working in clinical/surgical units who answered a three-part questionnaire composed of identification data and characterization of the professional; a list of nursing and administrative activities for the nurse to grade according to the numbers: “0 = I do not perform it”, “1 = I perform it occasionally”, “2 = I perform it often”, “3 = I perform it daily”; two open-ended questions, in which the nurse listed the activities he/she enjoyed the most and the least. Results: The administrative activities most performed by the nurses were: changing work shifts, preparing employee daily task charts and managing tests; the most performed nursing care activities were related to the stages of the Nursing Care Systematization and the interaction with the multi-professional team; the most enjoyable activities were direct patient care, patient evaluation and implementation of the systematization; the least enjoyable activities were administrative and bureaucratic routines, justification of complaints/problem-solving and preparation of employee task charts. Conclusion: Compared to administrative activities, nursing activities were performed most during the daily routine of the nurse, and the most enjoyable activities were those related to patient care, according to the opinions of the professionals.

  18. The Syrian civil war: The experience of the Surgical Intensive Care Units.

    Science.gov (United States)

    Ozdogan, Hatice Kaya; Karateke, Faruk; Ozdogan, Mehmet; Cetinalp, Sibel; Ozyazici, Sefa; Gezercan, Yurdal; Okten, Ali Ihsan; Celik, Muge; Satar, Salim

    2016-01-01

    Since the civilian war in Syria began, thousands of seriously injured trauma patients from Syria were brought to Turkey for emergency operations and/or postoperative intensive care. The aim of this study was to present the demographics and clinical features of the wounded patients in Syrian civil war admitted to the surgical intensive care units in a tertiary care centre. The records of 80 trauma patients admitted to the Anaesthesia, General Surgery and Neurosurgery ICUs between June 1, 2012 and July 15, 2014 were included in the study. The data were reviewed regarding the demographics, time of presentation, place of reference, Acute Physiology and Chronic Health Evaluation II (APACHE II) score and Injury Severity Score (ISS), surgical procedures, complications, length of stay and mortality. A total of 80 wounded patients (70 males and 10 females) with a mean age of 28.7 years were admitted to surgical ICUs. The most frequent cause of injury was gunshot injury. The mean time interval between the occurrence of injury and time of admission was 2.87 days. Mean ISS score on admission was 21, and mean APACHE II score was 15.7. APACHE II scores of non-survivors were significantly increased compared with those of survivors (P=0.001). No significant differences was found in the age, ISS, time interval before admission, length of stay in ICU, rate of surgery before or after admission. The most important factor affecting mortality in this particular trauma-ICU patient population from Syrian civil war was the physiological condition of patients on admission. Rapid transport and effective initial and on-road resuscitation are critical in decreasing the mortality rate in civil wars and military conflicts.

  19. Prospective analysis of skin findings in surgical critically Ill patients intensive care unit

    Directory of Open Access Journals (Sweden)

    Suzan Demir Pektas

    2017-01-01

    Full Text Available Background: Intensive Care Units (ICUs are places where critically ill patients are managed. Aim: We aimed to investigate skin disorders that developed in critically ill surgical patients during their stay in the ICU. Methods: The prevalence of dermatological disorders and factors affecting their clinical features was prospectively analyzed in surgical ICU patients. We recorded age, sex, type of ICU, comorbidities, skin disorders, time to consultation, duration of ICU stay, and mortality rate. Results: Our study included 605 patients (mean age of 60.1 ± 20.2 years; 56.4% males. Seventy-three (12.1% patients were consulted with the Dermatology Department, among which 28.8% had infectious dermatological lesions, 26% dermatoses, and 45.2% drug reactions. The most common infectious dermatological disorder was wound infection (55.6%, the most common drug reaction was maculopapular drug eruption (75.8%, and the most common dermatosis was frictional blisters (47.4%. Multiple comorbidities, hypertension, diabetes mellitus, coronary artery disease, Parkinson disease, and stroke increased dermatological disorders (P < 0.05. The consulted patients had a median ICU stay of 7 days (range 2–53 days; consultation was significantly more common when it exceeded 10 days (74% vs. 26%, P < 0.05. The consulted patients died more commonly (P < 0.05. Infectious dermatological disorders and dermatoses were more common in patients older and younger than 50 years, respectively (P < 0.05. Dermatoses were more common among women (P < 0.05. The median time to consultation was 6 (2–30 days; it was longest for dermatological infections and shortest for dermatoses (P < 0.05. Infectious dermatological disorders were significantly more common among the deceased patients (P < 0.05. Conclusion: Multiple factors including multiple comorbidities, duration of ICU stay, time to consultation, and mortality increase dermatological disorders among surgical ICU patients.

  20. The challenges of clinical education in a baccalaureate surgical technology students in Iran: a qualitative study.

    Science.gov (United States)

    Zardosht, Roghayeh; Moonaghi, Hossein Karimi; Razavi, Mohammad Etezad; Ahmady, Soleiman

    2018-02-01

    Clinical education is an integral part of the surgical technology curriculum, in which students combine and integrate knowledge, skills, attitudes, values and philosophies of the profession. It is difficult to learn and adapt to different types of skills and roles in the operating room environment. This qualitative study examines the difference between the clinical education of Surgical Technology and other clinical settings, and the challenges faced by students in the field, within the course. This was a qualitative content analysis study conducted in 2016. The participants in this study were 16 baccalaureate surgical technology students of the University for Medical Sciences in Khorasan Razavi province. A semi-structured interview method was run to collect the required data. The sampling was initially purposive, then in the snowball method which continued until data saturation. All interviews were recorded, then transcribed, and analyzed using a continuous comparative method and conventional qualitative content analysis method. From the deep and rich descriptions of the participants, three themes including "stressful environment", "controversy between anticipation of role and reality", and "humiliating experiences" as well as a general theme of "bitter education" were obtained. Students' orientation before attending the operating room, accompanying, supporting, and a full-time attendance of the specialist instructor, strengthening the prerequisite knowledge and skills for the students in this field, teaching ethics, and professional interactions, play an important role in the student's acceptance of the operating room, in the surgery team and the improvement of the quality of clinical education of these students.

  1. H-index and academic rank in general surgery and surgical specialties in the United States.

    Science.gov (United States)

    Ashfaq, Awais; Kalagara, Roshini; Wasif, Nabil

    2018-09-01

    H-index serves as an alternative to measure academic achievement. Our objective is to study the h-index as a measure of academic attainment in general surgery and surgical specialties. A database of all surgical programs in the United States was created. Publish or Perish software was used to determine surgeons h-index. A total of 134 hospitals and 3712 surgeons (79% male) were included. Overall, mean h-index was 14.9 ± 14.8. H-index increased linearly with academic rank: 6.8 ± 6.4 for assistant professors (n = 1557, 41.9%), 12.9 ± 9.3 for associate professors (n = 891, 24%), and 27.9 ± 17.4 for professors (n = 1170, 31.5%); P h-indices (18.7 ± 16.7 and 18.4 ± 17.6, respectively). Surgeons with additional postgraduate degrees, university affiliations and male had higher mean h-indices; P h-index and the number of publications (R2 = 0.817) and citations (R2 = 0.768). The h-index of academic surgeons correlates with academic rank and serves a potential tool to measure academic productivity. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Moral distress among nurses in medical, surgical and intensive-care units.

    Science.gov (United States)

    Lusignani, Maura; Giannì, Maria Lorella; Re, Luca Giuseppe; Buffon, Maria Luisa

    2017-09-01

    To assess the frequency, intensity and level of moral distress perceived by nurses working in medical, surgical and intensive care units. Moral distress among nurses compromises their ability to provide optimal patient care and may cause them to leave their job. A cross-sectional questionnaire survey of 283 registered nurses was conducted to evaluate the frequency, intensity and levels of moral distress. A revised version of the Moral Distress Scale (MDS-R) was used. The highest level of moral distress was associated with the provision of treatments and aggressive care that were not expected to benefit the patients and the competency of the health-care providers. Multivariate regression showed that nurses working in medical settings, nurses with lower levels of experience working in medical, surgical or intensive care settings, and nurses who intend to leave their job experienced the highest levels of moral distress. The present study indicates that nurses experience an overall moderate level of moral distress. Gaining further insight into the issue of moral distress among nurses and the clinical situations that most frequently cause this distress will enable development of strategies to reduce moral distress and to improve nurse satisfaction and, consequently, patient care. © 2016 John Wiley & Sons Ltd.

  3. Staff perceptions of leadership during implementation of task-shifting in three surgical units.

    Science.gov (United States)

    Henderson, Amanda; Paterson, Karyn; Burmeister, Liz; Thomson, Bernadette; Young, Louise

    2013-03-01

    Registered nurses are difficult to recruit and retain. Task shifting, which involves reallocation of delegation, can reduce demand for registered nurses. Effective leadership is needed for successful task shifting. This study explored leadership styles of three surgical nurse unit managers. Staff completed surveys before and after the implementation of task shifting. Task shifting involved the introduction of endorsed enrolled nurses (licensed nurses who must practise under registered nurse supervision) to better utilize registered nurses. Implementation of task shifting occurred over 4 months in a 700-bed tertiary hospital, in southeast Queensland, Australia. A facilitator assisted nurse unit managers during implementation. The impact was assessed by comparison of data before (n = 49) and after (n = 72) task shifting from registered nurses and endorsed enrolled nurses (n = 121) who completed the Ward Organization Features Survey. Significant differences in leadership and staff organization subscales across the settings suggest that how change involving task shifting is implemented influences nurses' opinions of leadership. Leadership behaviours of nurse unit managers is a key consideration in managing change such as task shifting. Consistent and clear messages from leaders about practice change are viewed positively by nursing staff. In the short term, incremental change possibly results in staff maintaining confidence in leadership. © 2012 Blackwell Publishing Ltd.

  4. United States Japan Industry and Technology Management Training

    National Research Council Canada - National Science Library

    Gercik, Patricia

    2001-01-01

    .... The intellectual focus of the Program is to integrate the research methodologies of the social sciences, the humanities, and technology to approach issues confronting the United States and Japan...

  5. Validation of Surgical Intensive Care-Infection Registry: a medical informatics system for intensive care unit research, quality of care improvement, and daily patient care.

    Science.gov (United States)

    Golob, Joseph F; Fadlalla, Adam M A; Kan, Justin A; Patel, Nilam P; Yowler, Charles J; Claridge, Jeffrey A

    2008-08-01

    We developed a prototype electronic clinical information system called the Surgical Intensive Care-Infection Registry (SIC-IR) to prospectively study infectious complications and monitor quality of care improvement programs in the surgical and trauma intensive care unit. The objective of this study was to validate SIC-IR as a successful health information technology with an accurate clinical data repository. Using the DeLone and McLean Model of Information Systems Success as a framework, we evaluated SIC-IR in a 3-month prospective crossover study of physician use in one of our two surgical and trauma intensive care units (SIC-IR unit versus non SIC-IR unit). Three simultaneous research methodologies were used: a user survey study, a pair of time-motion studies, and an accuracy study of SIC-IR's clinical data repository. The SIC-IR user survey results were positive for system reliability, graphic user interface, efficiency, and overall benefit to patient care. There was a significant decrease in prerounding time of nearly 4 minutes per patient on the SIC-IR unit compared with the non SIC-IR unit. The SIC-IR documentation and data archiving was accurate 74% to 100% of the time depending on the data entry method used. This accuracy was significantly improved compared with normal hand-written documentation on the non SIC-IR unit. SIC-IR proved to be a useful application both at individual user and organizational levels and will serve as an accurate tool to conduct prospective research and monitor quality of care improvement programs.

  6. Post-Caesarean Section Surgical Site Infection Surveillance Using an Online Database and Mobile Phone Technology.

    Science.gov (United States)

    Castillo, Eliana; McIsaac, Corrine; MacDougall, Bhreagh; Wilson, Douglas; Kohr, Rosemary

    2017-08-01

    Obstetric surgical site infections (SSIs) are common and expensive to the health care system but remain under reported given shorter postoperative hospital stays and suboptimal post-discharge surveillance systems. SSIs, for the purpose of this paper, are defined according to the Center for Disease Control and Prevention (1999) as infection incurring within 30 days of the operative procedure (in this case, Caesarean section [CS]). Demonstrate the feasibility of real-life use of a patient driven SSIs post-discharge surveillance system consisting of an online database and mobile phone technology (surgical mobile app - how2trak) among women undergoing CS in a Canadian urban centre. Estimate the rate of SSIs and associated predisposing factors. Prospective cohort of consecutive women delivering by CS at one urban Canadian hospital. Using surgical mobile app-how2trak-predetermined demographics, comorbidities, procedure characteristics, and self-reported symptoms and signs of infection were collected and linked to patients' incision self-portraits (photos) on postpartum days 3, 7, 10, and 30. A total of 105 patients were enrolled over a 5-month period. Mean age was 31 years, 13% were diabetic, and most were at low risk of surgical complications. Forty-six percent of surgeries were emergency CSs, and 104/105 received antibiotic prophylaxis. Forty-five percent of patients (47/105) submitted at least one photo, and among those, one surgical site infection was detected by photo appearance and self-reported symptoms by postpartum day 10. The majority of patients whom uploaded photos did so multiple times and 43% of them submitted photos up to day 30. Patients with either a diagnosis of diabetes or self-reported Asian ethnicity were less likely to submit photos. Post-discharge surveillance for CS-related SSIs using surgical mobile app how2trak is feasible and deserves further study in the post-discharge setting. Copyright © 2017. Published by Elsevier Inc.

  7. Combined enteral feeding and total parenteral nutritional support improves outcome in surgical intensive care unit patients.

    Science.gov (United States)

    Hsu, Min-Hui; Yu, Ying E; Tsai, Yueh-Miao; Lee, Hui-Chen; Huang, Ying-Che; Hsu, Han-Shui

    2012-09-01

    For intensive care unit (ICU) patients with gastrointestinal dysfunction and in need of total parenteral nutrition (TPN) support, the benefit of additional enteral feeding is not clear. This study aimed to investigate whether combined TPN with enteral feeding is associated with better outcomes in surgical intensive care unit (SICU) patients. Clinical data of 88 patients in SICU were retrospectively collected. Variables used for analysis included route and percentage of nutritional support, total caloric intake, age, gender, body weight, body mass index, admission diagnosis, surgical procedure, Acute Physiology and Chronic Health Evaluation (APACHE) II score, comorbidities, length of hospital stay, postoperative complications, blood glucose values and hospital mortality. Wound dehiscence and central catheter infection were observed more frequently in the group of patients receiving TPN calories less than 90% of total calorie intake (p = 0.004 and 0.043, respectively). APACHE II scores were higher in nonsurvivors than in survivors (p = 0.001). More nonsurvivors received TPN calories exceeding 90% of total calorie intake and were in need of dialysis during ICU admission (p = 0.005 and 0.013, respectively). Multivariate analysis revealed that the percentage of TPN calories over total calories and APACHE II scores were independent predictors of ICU mortality in patients receiving supplementary TPN after surgery. In SICU patients receiving TPN, patients who could be fed enterally more than 10% of total calories had better clinical outcomes than patients receiving less than 10% of total calorie intake from enteral feeding. Enteral feeding should be given whenever possible in severely ill patients. 2012 Published by Elsevier B.V

  8. The application of wearable technology in surgery: ensuring the positive impact of the wearable revolution on surgical patients.

    Science.gov (United States)

    Slade Shantz, Jesse Alan; Veillette, Christian J H

    2014-01-01

    Wearable technology has become an important trend in consumer electronics in the past year. The miniaturization and mass production of myriad sensors have made possible the integration of sensors and output devices in wearable platforms. Despite the consumer focus of the wearable revolution some surgical applications are being developed. These fall into augmentative, assistive, and assessment functions and primarily layer onto current surgical workflows. Some challenges to the adoption of wearable technologies are discussed and a conceptual framework for understanding the potential of wearable technology to revolutionize surgical practice are presented.

  9. Virtual reality technology and surgical training--a survey of general surgeons in Ireland.

    Science.gov (United States)

    Early, S A; Roche-Nagle, G

    2006-01-01

    Virtual Reality Technology (VRT) is a validated method of training in industry but only recently has found a place in the postgraduate surgical curriculum. We surveyed 143 Irish consultant surgeons to ascertain their opinions on this topical issue. The survey consisted of 22 questions to which the consultants were asked to respond by choosing from a 5-point Likert scale. Sixty-five per cent responded. A majority of 72% had seen VRT but only 47% had 'hands on' experience. Forty-six per cent believed that they were poorly informed regarding available technologies. As consultants became more informed about VRT significant differences were seen with regard to attitudes regarding the role of VR in skills in surgical training (p<0.05) and in the ability to define teaching objectives (p<0.005). Our survey suggests that the underuse of the current offerings is not due to a perceived lack of interest on the part of the surgical trainers. Suppliers of these programmes have a responsibility to adequately educate and collaborate with all parties involved to improve overall benefit from these simulators.

  10. Surgical Procedures of the Elbow: A Nationwide Cross-Sectional Observational Study in the United States

    Directory of Open Access Journals (Sweden)

    Ahmet Kinaci

    2015-01-01

    Full Text Available Background:  Elbow surgery is shared by several subspecialties. We were curious about the most common elbow surgeries and their corresponding diagnoses in the United States.   Methods:  We used the National Hospital Discharge Survey (NHDS and the National Survey of Ambulatory Surgery (NSAS data gathered in 2006-databases that together provide an estimate of all inpatient and ambulatory surgical care in the US.  Results:  An estimated 150,000 elbow surgeries were performed in the US in 2006, 75% in an outpatient setting. The most frequent diagnosis treated operative was enthesopathy (e.g. lateral epicondylitis and it was treated with several different procedures. More than three quarters of all elbow surgeries treated enthesopathy, cubital tunnel syndrome, or fracture (radial head in particular. Arthroscopy and arthroplasty accounted for less than 10% of all elbow surgeries.  Conclusions:  Elbow surgery in the United States primarily addresses enthesopathies such as tennis elbow, cubital tunnel syndrome, and trauma. It is notable that some of the most common elbow surgeries (those that address enthesopathy and radial head fracture are some of the most variably utilized and debated.

  11. Epidemiology of surgical castration of dogs and cats in the United States.

    Science.gov (United States)

    Trevejo, Rosalie; Yang, Mingyin; Lund, Elizabeth M

    2011-04-01

    To estimate the prevalence of surgical castration among dogs and cats evaluated at private US veterinary hospitals and to determine the influence of sex, age, breed, geographic location, and prepaid wellness plan enrollment on the likelihood of castration. Retrospective period prevalence study. 320,172 cats and 1,339,860 dogs examined at 651 hospitals during 2007 Procedures-Univariate and multivariate analyses were used to compare prevalence among subpopulations for each species. The overall prevalence of castration was 82% in cats and 64% in dogs. Prevalence increased significantly with age in both species. Among cats, males were slightly more likely to be castrated than females (prevalence ratio [PR] = 1.03) and mixed breeds slightly less likely than purebreds (PR = 0.99). Among dogs, males were less likely to be castrated than females (PR = 0.93) and mixed breeds more likely than purebreds (PR = 1.19). Prevalence was lowest in dogs in the Southeastern United States (61%). Dogs and cats on a wellness plan were more likely to be castrated than those not on a plan (PR = 1.33 and 1.18, respectively). Among commonly reported dog breeds, pit bull-type dogs (27%) and Chihuahuas (46%) were least likely to be castrated. Many young adult (1- to Chihuahua), and dogs in the Southeastern United States. Additional research is needed to evaluate the potential impact of wellness programs on an owner's decision to have his or her pet castrated.

  12. The vacuum system for technological unit development and design

    Science.gov (United States)

    Zhukeshov, A. M.; Gabdullina, A. T.; Amrenova, A. U.; Giniyatova, Sh G.; Kaibar, A.; Sundetov, A.; Fermakhan, K.

    2015-11-01

    The paper shows results of development of plasma technological unit on the basis of accelerator of vacuum arc and automated system. During the previous years, the authors investigated the operation of pulsed plasma accelerator and developed unique technologies for hardening of materials. Principles of plasma formation in pulsed plasma accelerator were put into basis of the developed unit. Operation of the pulsed arc accelerator was investigated at different parameters of the charge. The developed vacuum system is designed for production of hi-tech plasma units in high technologies in fields of nanomaterials, mechanical and power engineering and production with high added value. Unlike integrated solutions, the system is a module one to allow its low cost, high reliability and simple maintenance. The problems of use of robots are discussed to modernize the technological process.

  13. The vacuum system for technological unit development and design

    International Nuclear Information System (INIS)

    Zhukeshov, A M; Gabdullina, A T; Amrenova, A U; Giniyatova, Sh G; Kaibar, A; Sundetov, A; Fermakhan, K

    2015-01-01

    The paper shows results of development of plasma technological unit on the basis of accelerator of vacuum arc and automated system. During the previous years, the authors investigated the operation of pulsed plasma accelerator and developed unique technologies for hardening of materials. Principles of plasma formation in pulsed plasma accelerator were put into basis of the developed unit. Operation of the pulsed arc accelerator was investigated at different parameters of the charge. The developed vacuum system is designed for production of hi-tech plasma units in high technologies in fields of nanomaterials, mechanical and power engineering and production with high added value. Unlike integrated solutions, the system is a module one to allow its low cost, high reliability and simple maintenance. The problems of use of robots are discussed to modernize the technological process. (paper)

  14. Assessment of Clinical Education in the Alborz University of Medical Sciences from Surgical Technology and Anesthesiology Students’ Point of View

    Directory of Open Access Journals (Sweden)

    T. Bahrami Babaheidary

    2012-07-01

    Conclusion: Because of surgical technology and anesthesiology students needs to acquire clinical skills along with theoretical training, providing suitable clinical environment seems to be critical to achieve essential in-depth experience in professional aspects.

  15. Transcatheter aortic valve replacement in patients with severe aortic stenosis who are at high risk for surgical complications: summary assessment of the California Technology Assessment Forum.

    Science.gov (United States)

    Tice, Jeffrey A; Sellke, Frank W; Schaff, Hartzell V

    2014-08-01

    The California Technology Assessment Forum is dedicated to assessment and public reporting of syntheses of available data on medical technologies. In this assessment, transcatheter aortic valve replacement (TAVR) was evaluated for patients with severe aortic stenosis (AS) who are at high risk for complications. In this assessment, 5 criteria were used: Regulatory approval, sufficient scientific evidence to allow conclusions on effectiveness, evidence that the technology improves net health outcomes, evidence that the technology is as beneficial as established methods, and availability of the technology outside investigational settings. In this assessment, all 5 criteria were judged to have been met. The primary benefit of TAVR is the ability to treat AS in patients who would otherwise be ineligible for surgical aortic valve replacement. It may also be useful for patients at high surgical risk by potentially reducing periprocedural complications and avoiding the morbidity and recovery from undergoing heart surgery. Potential harms include the need for conversion to an open procedure, perioperative death, myocardial infarction, stroke, bleeding, valve embolization, aortic regurgitation, heart block that requires a permanent pacemaker, renal failure, pulmonary failure, and major vascular complications such as cardiac perforation or arterial dissection. Potential long-term harms include death, stroke, valve failure or clotting, and endocarditis. As highlighted at the February 2012 California Technology Assessment Forum meeting, the dispersion of this technology to new centers across the United States must proceed with careful thought given to training and proctoring multidisciplinary teams to become new centers of excellence. TAVR is a potentially lifesaving procedure that may improve quality of life for patients at high risk for surgical AVR. However, attention needs to be paid to appropriate patient selection, their preoperative evaluation, surgical techniques, and

  16. Effect of delirium motoric subtypes on administrative documentation of delirium in the surgical intensive care unit.

    Science.gov (United States)

    Bui, Lan N; Pham, Vy P; Shirkey, Beverly A; Swan, Joshua T

    2017-06-01

    This study compares the proportions of surgical intensive care unit (ICU) patients with delirium detected using the Confusion Assessment Method for the ICU (CAM-ICU) who received administrative documentation for delirium using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, stratified by delirium motoric subtypes. This retrospective cohort study was conducted at a surgical ICU from 06/2012 to 05/2013. Delirium was assessed twice daily and was defined as having ≥1 positive CAM-ICU rating. Delirious patients were categorized into hyperactive/mixed and hypoactive subtypes using corresponding Richmond Agitation Sedation Scales. Administrative documentation of delirium was defined as having ≥1 of 32 unique ICD-9-CM codes. Proportions were compared using Pearson's Chi-square test. Of included patients, 40 % (423/1055) were diagnosed with delirium, and 17 % (183/1055) had an ICD-9-CM code for delirium. The sensitivity and specificity of ICD-9-CM codes for delirium were 36 and 95 %. ICD-9-CM codes for delirium were available for 42 % (95 % CI 35-48 %; 105/253) of patients with hyperactive/mixed delirium and 27 % (95 % CI 20-34 %; 46/170) of patients with hypoactive delirium (relative risk = 1.5; 95 % CI 1.2-2.0; p = 0.002). ICD-9-CM codes yielded a low sensitivity for identifying patients with CAM-ICU positive delirium and were more likely to identify hyperactive/mixed delirium compared with hypoactive delirium.

  17. Surgical stress response and the potential role of preoperative glucocorticoids on post-anesthesia care unit recovery

    DEFF Research Database (Denmark)

    Steinthorsdottir, Kristin J; Kehlet, Henrik; Aasvang, Eske K

    2017-01-01

    The immediate postoperative course in the post-anesthesia care unit (PACU) remains a challenge across surgical procedures. Postoperative pain, sedation/cognitive dysfunction, nausea and vomiting (PONV), circulatory and respiratory problems and orthostatic intolerance constitute the bulk of the di......-anesthesia care unit (PACU), but with a scarcity of intervention studies using glucocorticoids to control inflammation. We, therefore, suggest a future research focus on the role of inflammation and effect of glucocorticoids in the PACU setting to improve patient recovery....

  18. Pneumonia in the surgical intensive care unit: is every one preventable?

    Science.gov (United States)

    Wahl, Wendy L; Zalewski, Christy; Hemmila, Mark R

    2011-10-01

    Pneumonia is a major complication for hospitalized patients and has come under the scrutiny of health care regulating bodies, which propose that hospital-acquired pneumonia should not be reimbursed and potentially be a "never event." We hypothesized that many of our acutely injured patients develop pneumonia at the time of their initial traumatic event despite aggressive measures to prevent pneumonia during hospitalization. This retrospective review included all mechanically ventilated patients admitted to a mixed surgical intensive care units (ICU; trauma, general surgery, and burns) who developed pneumonia from 2006 to 2008. All pneumonia diagnosed by culture were obtained from bronchoalveolar lavage (BAL) specimens with ≥ 10(4) colony forming united (CFU)/mL considered a positive result. Criteria for ventilator-associated pneumonia (VAP) applied only to those patients ventilated mechanically for >48 hours at the time of a positive BAL culture. Aspiration organisms included Streptococcus species, methicillin-sensitive Staphylococcus aureus, Haemophilus influenzae, and oral flora. This was an institutional review board-approved study. There were 208 mechanically ventilated who patients underwent BAL, half of which were performed in the first 48 hours after admission for fever, infiltrate on chest radiograph, or increasing white blood cell count (early BAL group). Of these patients, 58% had positive BAL cultures (pneumonia) but did not have VAP. Only 10% of patients studied with early BAL had no growth on culture. Although the predominant organisms in the early BAL group were aspiration-type organisms, 17% had resistant pathogens, and 16% had other Gram-negative rods (GNR). This percentage was compared with the VAP group in whom 33% of patients had resistant organisms (P = .04) and 8% other GNR (P = NS). Twenty-five patients with ≤ 10(4) CFU/mL on early BAL underwent repeat BAL, and 16 (64%) were later diagnosed with VAP. Many intubated patients in the surgical

  19. Nasal Carriage of Staphylococcus Aureus and Cross-Contamination in a Surgical Intensive Care Unit: Efficacy of Mupirocin Ointment

    NARCIS (Netherlands)

    D. Talon; C. Rouget; V. Cailleaux; P. Bailly; M. Thouverez; F. Barale; Y. Michel-Briand

    1995-01-01

    textabstractA six month prospective study was carried out in a surgical intensive care unit (SICU) of a university hospital to assess the incidence and routes of exogenous colonization by Staphylococcus aureus. A total of 157 patients were included in the study. One thousand one hundred and eleven

  20. 76 FR 5834 - International Business Machines Corporation, Global Technology Services Business Unit, Integrated...

    Science.gov (United States)

    2011-02-02

    ... Machines Corporation, Global Technology Services Business Unit, Integrated Technology Services, Cost and..., applicable to workers of International Business Machines Corporation, Global Technology Services Business... engaged in activities related to support for the Global Technology Services Business Unit. The company...

  1. Does adoption of electronic health records improve organizational performances of hospital surgical units? Results from the French e-SI (PREPS-SIPS) study.

    Science.gov (United States)

    Plantier, Morgane; Havet, Nathalie; Durand, Thierry; Caquot, Nicolas; Amaz, Camille; Philip, Irène; Biron, Pierre; Perrier, Lionel

    2017-02-01

    Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances. The aim of this study was to evaluate the impact of EHR use on the organizational performances of acute care hospital surgical units throughout France. This retrospective study was based on data derived from three national databases for year the 2012: IPAQSS (Indicators of improvement in the quality and the management of healthcare, "IPAQSS"), Hospi-Diag (French hospital performance indicators), and the national accreditation database. National data and methodological support were provided by the French Ministry of Health (DGOS) and the French National Authority for Health (HAS). Multivariate linear models were used to assess four organizational performance indicators: the occupancy rate of surgical inpatient beds, operating room utilization, the activity per surgeon, and the activity per both nurse anesthetist and anesthesiologist which were dependent variables. Several independent variables were taken into account, including the degree of EHR use. The models revealed a significant positive impact of EHR use on operating room utilization and bed occupancy rates for surgical inpatient units. No significant association was found between the activity per surgeon or the activity per nurse anesthetist and anesthesiologist with EHR use. All four organizational performance indicators were impacted by the type of hospital, the geographical region, and the severity of the pathologies. We were able to verify the purported potential benefits of EHR use on the organizational performances of surgical

  2. Application of virtual surgical planning with computer assisted design and manufacturing technology to cranio-maxillofacial surgery.

    Science.gov (United States)

    Zhao, Linping; Patel, Pravin K; Cohen, Mimis

    2012-07-01

    Computer aided design and manufacturing (CAD/CAM) technology today is the standard in manufacturing industry. The application of the CAD/CAM technology, together with the emerging 3D medical images based virtual surgical planning (VSP) technology, to craniomaxillofacial reconstruction has been gaining increasing attention to reconstructive surgeons. This article illustrates the components, system and clinical management of the VSP and CAD/CAM technology including: data acquisition, virtual surgical and treatment planning, individual implant design and fabrication, and outcome assessment. It focuses primarily on the technical aspects of the VSP and CAD/CAM system to improve the predictability of the planning and outcome.

  3. Using virtual reality technology and hand tracking technology to create software for training surgical skills in 3D game

    Science.gov (United States)

    Zakirova, A. A.; Ganiev, B. A.; Mullin, R. I.

    2015-11-01

    The lack of visible and approachable ways of training surgical skills is one of the main problems in medical education. Existing simulation training devices are not designed to teach students, and are not available due to the high cost of the equipment. Using modern technologies such as virtual reality and hands movements fixation technology we want to create innovative method of learning the technics of conducting operations in 3D game format, which can make education process interesting and effective. Creating of 3D format virtual simulator will allow to solve several conceptual problems at once: opportunity of practical skills improvement unlimited by the time without the risk for patient, high realism of environment in operational and anatomic body structures, using of game mechanics for information perception relief and memorization of methods acceleration, accessibility of this program.

  4. Proposal for a United Nations Basic Space Technology Initiative

    Science.gov (United States)

    Balogh, Werner

    Putting space technology and its applications to work for sustainable economic and social development is the primary objective of the United Nations Programme on Space Applications, launched in 1971. A specific goal for achieving this objective is to establish a sustainable national space capacity. The traditional line of thinking has supported a logical progression from building capacity in basic space science, to using space applications and finally - possibly - to establishing indigenous space technology capabilities. The experience in some countries suggests that such a strict line of progression does not necessarily hold true and that priority given to the establishment of early indigenous space technology capabilities may contribute to promoting the operational use of space applications in support of sustainable economic and social development. Based on these findings and on the experiences with the United Nations Basic Space Science Initiative (UNBSSI) as well as on a series of United Nations/International Academy of Astronautics Workshops on Small Satellites in the Service of Developing Countries, the United Nations Office for Outer Space Affairs (UNOOSA) is considering the launch of a dedicated United Nations Basic Space Technology Initiative (UNBSTI). The initiative would aim to contribute to capacity building in basic space technology and could include, among other relevant fields, activities related to the space and ground segments of small satellites and their applications. It would also provide an international framework for enhancing cooperation between all interested actors, facilitate the exchange of information on best practices, and contribute to standardization efforts. It is expected that these activities would advance the operational use of space technology and its applications in an increasing number of space-using countries and emerging space nations. The paper reports on these initial considerations and on the potential value-adding role

  5. In-hospital fellow coverage reduces communication errors in the surgical intensive care unit.

    Science.gov (United States)

    Williams, Mallory; Alban, Rodrigo F; Hardy, James P; Oxman, David A; Garcia, Edward R; Hevelone, Nathanael; Frendl, Gyorgy; Rogers, Selwyn O

    2014-06-01

    Staff coverage strategies of intensive care units (ICUs) impact clinical outcomes. High-intensity staff coverage strategies are associated with lower morbidity and mortality. Accessible clinical expertise, team work, and effective communication have all been attributed to the success of this coverage strategy. We evaluate the impact of in-hospital fellow coverage (IHFC) on improving communication of cardiorespiratory events. A prospective observational study performed in an academic tertiary care center with high-intensity staff coverage. The main outcome measure was resident to fellow communication of cardiorespiratory events during IHFC vs home coverage (HC) periods. Three hundred twelve cardiorespiratory events were collected in 114 surgical ICU patients in 134 study days. Complete data were available for 306 events. One hundred three communication errors occurred. IHFC was associated with significantly better communication of events compared to HC (Pcommunicated 89% of events during IHFC vs 51% of events during HC (PCommunication patterns of junior and midlevel residents were similar. Midlevel residents communicated 68% of all on-call events (87% IHFC vs 50% HC, Pcommunicated 66% of events (94% IHFC vs 52% HC, PCommunication errors were lower in all ICUs during IHFC (Pcommunication errors. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. A Comparative Study of Surgical Training in South East Asia, Australia and The United Kingdom

    Directory of Open Access Journals (Sweden)

    Siew Kheong Lum

    2009-07-01

    Conclusion: Quality of training can be improved by changing to a curriculum and competency based model, utilization of continuous assessment methods, reducing service requirements and better compensation for trainers. Southeast Asia has the potential to provide centres of excellence for surgical training. Surgical educators in SEA will find useful information in this paper to improve their programs which will hopefully evolve into a common core curriculum and enable cross border exchange of surgical trainees in SEA for broader exposure.

  7. Solving challenges in inter- and trans-disciplinary working teams: Lessons from the surgical technology field.

    Science.gov (United States)

    Korb, Werner; Geißler, Norman; Strauß, Gero

    2015-03-01

    Engineering a medical technology is a complex process, therefore it is important to include experts from different scientific fields. This is particularly true for the development of surgical technology, where the relevant scientific fields are surgery (medicine) and engineering (electrical engineering, mechanical engineering, computer science, etc.). Furthermore, the scientific field of human factors is important to ensure that a surgical technology is indeed functional, process-oriented, effective, efficient as well as user- and patient-oriented. Working in such trans- and inter-disciplinary teams can be challenging due to different working cultures. The intention of this paper is to propose an innovative cooperative working culture for the interdisciplinary field of computer-assisted surgery (CAS) based on more than ten years of research on the one hand and the interdisciplinary literature on working cultures and various organizational theories on the other hand. In this paper, a retrospective analysis of more than ten years of research work in inter- and trans-disciplinary teams in the field of CAS will be performed. This analysis is based on the documented observations of the authors, the study reports, protocols, lab reports and published publications. To additionally evaluate the scientific experience in an interdisciplinary research team, a literature analysis regarding scientific literature on trans- and inter-disciplinarity was performed. Own research and literature analyses were compared. Both the literature and the scientific experience in an interdisciplinary research team show that consensus finding is not always easy. It is, however, important to start trans- and interdisciplinary projects with a shared mental model and common goals, which include communication and leadership issues within the project teams, i.e. clear and unambiguous information about the individual responsibilities and objectives to attain. This is made necessary due to differing

  8. Evaluation of a technology unit in a girls' primary school

    Science.gov (United States)

    Eke, Marion; Gardner, Paul L.

    1991-12-01

    Rapid advances in technology are changing the structure of the workforce. There are elite highly-paid hi-tech occupations and low status poorly-paid jobs. Women are unfortunately more likely to be found in the latter category. To allow them to qualify and compete for the higher-status positions, girls need to participate in the physical sciences and in technology studies. However, they are rarely attracted to them in secondary school, possibly because they are already alienated from them by the time they leave primary school. This paper reports some of the outcomes of a curriculum unit taught in two primary school classes in an independent school for girls. The unit was cross-curricular, involving technology, science and other fields of knowledge; it made extensive use of LEGO Technic materials. The evaluation of the unit, based on observations, a teacher journal and pupil questionnaires, focussed upon the issue of whether it assisted the girls to feel happier about working with unfamiliar technology and feel more capable of doing so. Implications for teaching technology are also discussed.

  9. Missed surgical intensive care unit billing: potential financial impact of 24/7 faculty presence.

    Science.gov (United States)

    Hendershot, Kimberly M; Bollins, John P; Armen, Scott B; Thomas, Yalaunda M; Steinberg, Steven M; Cook, Charles H

    2009-07-01

    To efficiently capture evaluation and management (E&M) and procedural billing in our surgical intensive care unit (SICU), we have developed an electronic billing system that links to the electronic medical record (EMR). In this system, only notes electronically signed and coded by an attending generate billing charges. We hypothesized that capture of missed billing during nighttime and weekends might be sufficient to subsidize 24/7 in-house attending coverage. A retrospective chart EMR review was performed of the EMRs for all SICU patients during a 2-month period. Note type, date, time, attending signature, and coding were analyzed. Notes without attending signature, diagnosis, or current procedural terminology (CPT) code were considered incomplete and identified as "missed billing." Four hundred and forty-three patients had 465 admissions generating 2,896 notes. Overall, 76% of notes were signed and coded by an attending and billed. Incomplete (not billed) notes represented an overall missed billing opportunity of $159,138 for the 2-month time period (approximately $954,000 annually). Unbilled E&M encounters during weekdays totaled $54,758, whereas unbilled E&M and procedures from weeknights and weekends totaled $88,408 ($44,566 and $43,842, respectively). Missed billing after-hours thus represents approximately $530K annually, extrapolating to approximately $220K in collections from our payer mix. Surprisingly, missed E&M and procedural billing during weekdays totaled $70,730 (approximately $425K billing, approximately $170K collections annually), and typically represented patients seen, but transferred from the SICU before attending documentation was completed. Capture of nighttime and weekend ICU collections alone may be insufficient to add faculty or incentivize in-house coverage, but could certainly complement other in-house derived revenues to such ends. In addition, missed daytime billing in busy modern ICUs can be substantial, and use of an EMR to identify

  10. The turn team: a novel strategy for reducing pressure ulcers in the surgical intensive care unit.

    Science.gov (United States)

    Still, Mary D; Cross, Linda C; Dunlap, Martha; Rencher, Rugenia; Larkins, Elizabeth R; Carpenter, David L; Buchman, Timothy G; Coopersmith, Craig M

    2013-03-01

    Pressure ulcers cause significant morbidity and mortality in the surgical intensive care unit (SICU). The purpose of this study was to determine if a dedicated team tasked with turning and repositioning all hemodynamically stable SICU patients could decrease the formation of pressure ulcers. A total of 507 patients in a 20-bed SICU in a university hospital were assessed for pressure ulcers using a point prevalence strategy, between December 2008 and September 2010, before and after implementation of a team tasked with turning and repositioning all hemodynamically stable patients every 2 hours around the clock. At baseline, when frequent turning was encouraged but not required, a total of 42 pressure ulcers were identified in 278 patients. After implementation of the turn team, a total of 12 pressure ulcers were identified in 229 patients (p < 0.0001). The preintervention group included 34 stage I and II ulcers and 8 higher stage ulcers. After implementation of the turn team, there were 7 stage I and II ulcers and 5 higher stage ulcers. The average Braden score was 16.5 in the preintervention group and 13.4 in the postintervention group (p = 0.04), suggesting that pressure ulcers were occurring in higher risk patients after implementation of the turn team. A team dedicated to turning SICU patients every 2 hours dramatically decreased the incidence of pressure ulcers. The majority of stage I and stage II ulcers appear to be preventable with an aggressive intervention aimed at pressure ulcer prevention. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  11. A retrospective study of end-of-life care decisions in the critically Ill in a surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Yi Lin Lee

    2018-01-01

    Full Text Available Aim: Progress in medical care and technology has led to patients with more advanced illnesses being admitted to the Intensive Care Unit (ICU. The practice of approaching end-of-life (EOL care decisions and limiting care is well documented in Western literature but unknown in Singapore. We performed a retrospective cohort study to describe the practice of EOL care in patients dying in a Singapore surgical ICU (SICU. The surgical critical care population was chosen as it is unique because surgeons are frequently involved in the EOL process. Methods: All consecutive patients aged 21 and above admitted to the SICU from July 2011 to March 2012, and who passed away in the ICU or within 7 days of discharge from the ICU (to account for transferred patients out of the ICU after end-of life care decisions were made and subsequently passed away were included in the study. Results: There were 473 SICU admissions during this period, out of which 53 were included with a mean age of 67.2 ± 11.1 years. EOL discussions were held in 81.1% of patients with a median time from admission to first discussion at 1 day (IQR 0–2.75 and a median number of ICU discussion of 1 (IQR 1–2. As most patients lacked decision-making capacity (inability to retain and process information secondary to the underlying disease pathology or sedative use, a surrogate was involved: group decision in 27.9%, child in 25.6% and an unclear family nominated member in 20.9%. 28.3% of patients were managed as for full active with resuscitation, 39.6% nonescalation of care, and 32.1% for withdrawal. The main reasons for conservative management (nonescalation and withdrawal of care were certain death in 52.3%, medical futility with minimal response to maximal care (27.3%, and the presence of underlying malignancy (18.2%. There was no significant difference between race or religion among patients for active or conservative management. Conclusion: 71.7% of patients who passed away in the ICU or

  12. 75 FR 20388 - International Business Machines Corporation, Global Technology Services Business Unit, Integrated...

    Science.gov (United States)

    2010-04-19

    ... Machines Corporation, Global Technology Services Business Unit, Integrated Technology Services, Cost and... Technology Services Business Unit, Integrated Technology Services, Cost and Expense Team working from various... Technology Services Business Unit. The company reports that workers leased from Datrose, Inc., were employed...

  13. Does Wearable Medical Technology With Video Recording Capability Add Value to On-Call Surgical Evaluations?

    Science.gov (United States)

    Gupta, Sameer; Boehme, Jacqueline; Manser, Kelly; Dewar, Jannine; Miller, Amie; Siddiqui, Gina; Schwaitzberg, Steven D

    2016-10-01

    Background Google Glass has been used in a variety of medical settings with promising results. We explored the use and potential value of an asynchronous, near-real time protocol-which avoids transmission issues associated with real-time applications-for recording, uploading, and viewing of high-definition (HD) visual media in the emergency department (ED) to facilitate remote surgical consults. Study Design First-responder physician assistants captured pertinent aspects of the physical examination and diagnostic imaging using Google Glass' HD video or high-resolution photographs. This visual media were then securely uploaded to the study website. The surgical consultation then proceeded over the phone in the usual fashion and a clinical decision was made. The surgeon then accessed the study website to review the uploaded video. This was followed by a questionnaire regarding how the additional data impacted the consultation. Results The management plan changed in 24% (11) of cases after surgeons viewed the video. Five of these plans involved decision making regarding operative intervention. Although surgeons were generally confident in their initial management plan, confidence scores increased further in 44% (20) of cases. In addition, we surveyed 276 ED patients on their opinions regarding concerning the practice of health care providers wearing and using recording devices in the ED. The survey results revealed that the majority of patients are amenable to the addition of wearable technology with video functionality to their care. Conclusions This study demonstrates the potential value of a medically dedicated, hands-free, HD recording device with internet connectivity in facilitating remote surgical consultation. © The Author(s) 2016.

  14. Robotic technology results in faster and more robust surgical skill acquisition than traditional laparoscopy.

    Science.gov (United States)

    Moore, Lee J; Wilson, Mark R; Waine, Elizabeth; Masters, Rich S W; McGrath, John S; Vine, Samuel J

    2015-03-01

    Technical surgical skills are said to be acquired quicker on a robotic rather than laparoscopic platform. However, research examining this proposition is scarce. Thus, this study aimed to compare the performance and learning curves of novices acquiring skills using a robotic or laparoscopic system, and to examine if any learning advantages were maintained over time and transferred to more difficult and stressful tasks. Forty novice participants were randomly assigned to either a robotic- or laparoscopic-trained group. Following one baseline trial on a ball pick-and-drop task, participants performed 50 learning trials. Participants then completed an immediate retention trial and a transfer trial on a two-instrument rope-threading task. One month later, participants performed a delayed retention trial and a stressful multi-tasking trial. The results revealed that the robotic-trained group completed the ball pick-and-drop task more quickly and accurately than the laparoscopic-trained group across baseline, immediate retention, and delayed retention trials. Furthermore, the robotic-trained group displayed a shorter learning curve for accuracy. The robotic-trained group also performed the more complex rope-threading and stressful multi-tasking transfer trials better. Finally, in the multi-tasking trial, the robotic-trained group made fewer tone counting errors. The results highlight the benefits of using robotic technology for the acquisition of technical surgical skills.

  15. Introduction of an acute surgical unit: comparison of performance indicators and outcomes for operative management of acute appendicitis.

    Science.gov (United States)

    Lancashire, John F; Steele, M; Parker, D; Puhalla, H

    2014-08-01

    The Acute Surgical Unit (ASU) is a recent change in management of acute general surgical patients in hospitals worldwide. In contrast to traditional management of acute surgical presentations by a rotating on-call system, ASUs are shown to deliver improved efficiency and patient outcomes. This study investigated the impact of an ASU on operative management of appendicitis, the most common acute surgical presentation, by comparing performance indicators and patient outcomes prior to and after introduction of an ASU at the Gold Coast Hospital, Queensland, Australia. A retrospective study of patients admitted from the Emergency Department (ED) and who underwent emergency appendectomy from February 2010 to January 2011 (pre-ASU) and after introduction of the ASU from February 2011 to January 2012 (post-ASU). A total of 548 patients underwent appendectomy between February 2010 and January 2012, comprising 247 pre-ASU and 301 post-ASU patients. Significant improvements were demonstrated: reduced time to surgical review, fewer complications arising from operations commencing during ASU in-hours, and more appendectomies performed during the daytime attended by the consultant. There was no significant difference in total cost of admission or total admission length of stay. This study demonstrated that ASUs have potential to significantly improve the outcomes for operative management of acute appendicitis compared to the traditional on-call model. The impact of the ASU was limited by access to theaters and restricted ASU operation hours. Further investigation of site-specific determinants could be beneficial to optimize this new model of acute surgical care.

  16. DESIGNING FEATURES OF POWER OPTICAL UNITS FOR TECHNOLOGICAL EQUIPMENT

    Directory of Open Access Journals (Sweden)

    M. Y. Afanasiev

    2016-03-01

    Full Text Available This paper considers the question of an optical unit designing for transmitting power laser radiation through an optical fiber. The aim of this work is designing a simple construction unit with minimized reflection losses. The source of radiation in the optical unit described below is an ultraviolet laser with diode pumping. We present the general functioning scheme and designing features for the three main parts: laser beam deflecting system, laser beam dump and optical unit control system. The described laser beam deflection system is composed of a moving flat mirror and a spherical scattering mirror. Comparative analysis of the production technology for such mirrors was carried out, and, as a result, the decision was made to produce both mirrors of 99.99 % pure molybdenum without coating. A moving mirror deflects laser emission from a source through a fiber or deflects it on a spherical mirror and into the laser beam dump, moreover, switching from one position to another occurs almost immediately. It is shown that a scattering mirror is necessary, otherwise, the absorbing surface of the beam dump is being worn out irregularly. The laser beam dump is an open conical cavity, in which the conical element with its spire turned to the emission source is placed. Special microgeometry of the internal surface of the beam dump is suggested for the better absorption effect. An optical unit control system consists of a laser beam deflection system, laser temperature sensor, deflection system solenoid temperature sensor, and deflection mirror position sensor. The signal processing algorithm for signals coming from the sensors to the controller is described. The optical unit will be used in special technological equipment.

  17. Evaluating Russian space nuclear reactor technology for United States applications

    International Nuclear Information System (INIS)

    Polansky, G.F.; Schmidt, G.L.; Voss, S.S.; Reynolds, E.L.

    1994-01-01

    Space nuclear power and nuclear electric propulsion are considered important technologies for planetary exploration, as well as selected earth orbit applications. The Nuclear Electric Propulsion Space Test Program (NEPSTP) was intended to provide an early flight demonstration of these technologies at relatively low cost through extensive use of existing Russian technology. The key element of Russian technology employed in the program was the Topaz II reactor. Refocusing of the activities of the Ballistic Missile Defense Organization (BMDO), combined with budgetary pressures, forced the cancellation of the NEPSTP at the end of the 1993 fiscal year. The NEPSTP was faced with many unique flight qualification issues. In general, the launch of a spacecraft employing a nuclear reactor power system complicates many spacecraft qualification activities. However, the NEPSTP activities were further complicated because the reactor power system was a Russian design. Therefore, this program considered not only the unique flight qualification issues associated with space nuclear power, but also with differences between Russian and United States flight qualification procedures. This paper presents an overview of the NEPSTP. The program goals, the proposed mission, the spacecraft, and the Topaz II space nuclear power system are described. The subject of flight qualification is examined and the inherent difficulties of qualifying a space reactor are described. The differences between United States and Russian flight qualification procedures are explored. A plan is then described that was developed to determine an appropriate flight qualification program for the Topaz II reactor to support a possible NEPSTP launch

  18. Relationship between job stress level and coping strategies used by Hong Kong nurses working in an acute surgical unit.

    Science.gov (United States)

    Wang, Wenru; Kong, Amelia Wai Man; Chair, Sek Ying

    2011-11-01

    The aim of this study is to explore the relationship between job stress and coping strategies of Hong Kong nurses working in an acute surgical unit. This is a descriptive correlational study. Data were collected from 98 Hong Kong surgical nurses using the Nursing Stress Scale and the Jalowiec Coping Scale. Results showed that workload (M = 15.36), lack of support (M = 13.32), and inadequate preparation (M = 12.33) are the most common stressors for Hong Kong surgical nurses. The most frequent strategies used by nurses to cope with stress can be characterized as evasive (M = 19.23), confrontive (M = 17.46), and optimistic (M = 15.81), all of which are also rated as the most effective strategies in reducing stress levels. Only the confrontive, optimistic, supportant, and emotive coping strategies reveal significant correlations (p stress levels of nurses, whereas the evasive, fatalistic, palliative, and self-reliant strategies showed no significant correlation with stress levels (p > .05). Recognizing the impacts of job-related stress and making use of effective coping methods play a vital role in reducing nurse's stress. A change in leadership styles from the managerial level and reallocation of manpower may help reduce job stress. The use of confrontive and optimistic coping strategies in reducing job-related stress for surgical nurses should be advocated and promoted in their daily work. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Barriers and bridges to infection prevention and control: results of a qualitative case study of a Netherlands' surgical unit.

    Science.gov (United States)

    Backman, Chantal; Marck, Patricia B; Krogman, Naomi; Taylor, Geoff; Sales, Anne; Bonten, Marc J M; Gigengack-Baars, Ada C M

    2012-01-01

    The objectives of the study are to observe the overall work environment including infection prevention and control (IP&C) practices on the target surgical unit; to analyse the policies and procedures in the hospital and unit environments; to analyse the barriers and bridges to IP&C that practitioners identify in visual narratives of their unit environment and to collect monthly specific IP&C-related anonymised data. In this qualitative case study analysis, a socio-ecological approach on health systems informed the research design and provided a framework to better understand the complexity of implementing effective IP&C. The study was conducted on a surgical unit at a Netherlands' hospital that reported successful reductions in the prevalence of targeted multidrug-resistant organisms. Research methods included unit observations (n=3), review of relevant policies and procedures, five practitioner-led photo walkabouts of the unit (n=7), three photo elicitation focus groups with practitioners (n=13) and the review of related IP&C data. The findings indicate some conditions and processes present that may influence the low prevalence of multidrug-resistant organisms, including the 'search and destroy' active surveillance strategy, low occupancy rates, a centralised bed cleaning system and the presence of an active grass roots Hygiene in Practice group, which engages practitioners in several ongoing activities to promote IP&C on the units. Further research on the benefits of practitioner-led community of practices on IP&C practices such as the Hygiene in Practice group is also recommended. Additional case studies to compare theses practices with other acute care hospital around the world would be a valuable way to better understand what IP&C programmes are most effective in which contexts and for what reasons. Further data are available by contacting the primary author directly.

  20. Rapid control of a methicillin resistant Staphylococcus aureus (MRSA) outbreak in a medical surgical intensive care unit (ICU).

    Science.gov (United States)

    Khan, Anjum; Lampitoc, Marianita; Salaripour, Maryam; McKernan, Patricia; Devlin, Roslyn; Muller, Matthew P

    2009-01-01

    Outbreaks of methicillin resistant Staphylococcus aureus in the intensive care unit setting can be prolonged and difficult to control. This report describes the rapid control of an outbreak of methicillin resistant Staphylococcus aureus in a 24-bed open-concept medical surgical intensive care unit with a baseline methicillin resistant Staphylococcus aureus acquisition rate of 1.5 cases per 1000 patient days. This institution's infection control policy mandates an outbreak investigation if two cases of hospital-acquired methicillin resistant Staphylococcus aureus colonization or infection are identified in an intensive care unit within a four-week period. In July 2007, methicillin resistant Staphylococcus aureus was identified in the sputum of two patients within a one-week period. Screening of all patients in the intensive care unit identified one additional case and a fourth case was identified from a clinical specimen before control measures were implemented. Initial control measures included healthcare worker education, enhanced surveillance, patient cohorting, and enhanced environmental cleaning. Despite these measures, three more cases occurred. All patients were then placed in contact isolation, healthcare workers were screened, and the nursing staff was cohorted. After two weeks without a case, two additional cases were identified. Decolonization of all positive patients was initiated. No further cases occurred over a five-week period and the outbreak was declared over. The outbreak resulted in nine cases of methicillin resistant Staphylococcus aureus colonization (n = 8) or infection (n = 1) over an 11-week period. Only one of 175 healthcare workers was colonized and it was not the outbreak strain. Early detection and the stepwise addition of infection control measures resulted in the rapid control of an outbreak of methicillin resistant Staphylococcus aureus in a medical surgical intensive care unit without unit closure. A low threshold of suspicion and

  1. Pilot Study of a New Nonradioactive Surgical Guidance Technology for Locating Nonpalpable Breast Lesions.

    Science.gov (United States)

    Cox, Charles E; Garcia-Henriquez, Norbert; Glancy, M Jordan; Whitworth, Pat; Cox, John M; Themar-Geck, Melissa; Prati, Ronald; Jung, Michelle; Russell, Scott; Appleton, Kristie; King, Jeff; Shivers, Steven C

    2016-06-01

    The current technique for locating nonpalpable breast lesions is wire localization (WL). Radioactive seed localization and intraoperative ultrasound were developed to improve difficulties with WL. The SAVI SCOUT surgical guidance system was developed to improve these methods. The SCOUT system is a non-radioactive, FDA-cleared medical device that uses electromagnetic wave technology to provide real-time guidance during excisional breast procedures. Consenting patients underwent localization and excision using an implantable electromagnetic wave reflective device (reflector) and a detector handpiece with a console. Using image guidance, the reflector was placed up to 7 days before the surgical procedure. The primary end points of the study were successful reflector placement, localization, and retrieval. The secondary end points were percentage of clear margins, reexcision rates, days of placement before excision, and physician comparison with WL. This study analyzed 50 patients. The reflectors were placed under mammographic guidance (n = 18, 36 %) or ultrasound guidance (n = 32, 64 %). Of the 50 patients, 10 (20 %) underwent excisional biopsy and 40 (80 %) had a lumpectomy. The lesion and reflector were successfully removed in all 50 patients, and no adverse events occurred. Of the 41 patients who had in situ and/or invasive carcinoma identified, 38 (93 %) had clear margins and 3 (7 %) were recommended for reexcision. These data suggest that the SCOUT system is safe and effective for guiding the excision of nonpalpable breast lesions and a viable alternative to standard localization options. A larger prospective, multi-institution trial of SCOUT currently is underway to validate these findings.

  2. Nursing assessment of continuous vital sign surveillance to improve patient safety on the medical/surgical unit.

    Science.gov (United States)

    Watkins, Terri; Whisman, Lynn; Booker, Pamela

    2016-01-01

    Evaluate continuous vital sign surveillance as a tool to improve patient safety in the medical/surgical unit. Failure-to-rescue is an important measure of hospital quality. Patient deterioration is often preceded by changes in vital signs. However, continuous multi-parameter vital sign monitoring may decrease patient safety with an abundance of unnecessary alarms. Prospective observational study at two geographically disperse hospitals in a single hospital system. A multi-parameter vital sign monitoring system was installed in a medical/surgical unit in Utah and one in Alabama providing continuous display of SpO2, heart rate, blood pressure and respiration rate on a central station. Alarm thresholds and time to alert annunciations were set based on prior analysis of the distribution of each vital sign. At the end of 4 weeks, nurses completed a survey on their experience. An average alert per patient, per day was determined retrospectively from the saved vital signs data and knowledge of the alarm settings. Ninety-two per cent of the nurses agreed that the number of alarms and alerts were appropriate; 54% strongly agreed. On average, both units experienced 10·8 alarms per patient, per day. One hundred per cent agreed the monitor provided valuable patient data that increased patient safety; 79% strongly agreed. Continuous, multi-parameter patient monitoring could be performed on medical/surgical units with a small and appropriate level of alarms. Continuous vital sign assessment may have initiated nursing interventions that prevented failure-to-rescue events. Nurses surveyed unanimously agreed that continuous vital sign surveillance will help enhance patient safety. Nursing response to abnormal vital signs is one of the most important levers in patient safety, by providing timely recognition of early clinical deterioration. This occurs through diligent nursing surveillance, involving assessment, interpretation of data, recognition of a problem and meaningful

  3. Communication and Culture in the Surgical Intensive Care Unit: Boundary Production and the Improvement of Patient Care.

    Science.gov (United States)

    Conn, Lesley Gotlib; Haas, Barbara; Cuthbertson, Brian H; Amaral, Andre C; Coburn, Natalie; Nathens, Avery B

    2016-06-01

    This ethnography explores communication around critically ill surgical patients in three surgical intensive care units (ICUs) in Canada. A boundary framework is used to articulate how surgeons', intensivists', and nurses' communication practices shape and are shaped by their respective disciplinary perspectives and experiences. Through 50 hours of observations and 43 interviews, these health care providers are found to engage in seven communication behaviors that either mitigate or magnify three contested symbolic boundaries: expertise, patient ownership, and decisional authority. Where these boundaries are successfully mitigated, experiences of collaborative, high-quality patient care are produced; by contrast, boundary magnification produces conflict and perceptions of unsafe patient care. Findings reveal that high quality and safe patient care are produced through complex social and cultural interactions among surgeons, intensivists, and nurses that are also expressions of knowledge and power. This enhances our understanding of why current quality improvement efforts targeting communication may be ineffective. © The Author(s) 2015.

  4. Interhospital Variability in Perioperative Red Blood Cell Ordering Patterns in United States Pediatric Surgical Patients.

    Science.gov (United States)

    Thompson, Rachel M; Thurm, Cary W; Rothstein, David H

    2016-10-01

    To evaluate perioperative red blood cell (RBC) ordering and interhospital variability patterns in pediatric patients undergoing surgical interventions at US children's hospitals. This is a multicenter cross-sectional study of children aged blood type and crossmatch were included when done on the day before or the day of the surgical procedure. The RBC transfusions included were those given on the day of or the day after surgery. The type and crossmatch-to-transfusion ratio (TCTR) was calculated for each surgical procedure. An adjusted model for interhospital variability was created to account for variation in patient population by age, sex, race/ethnicity, payer type, and presence/number of complex chronic conditions (CCCs) per patient. A total of 357 007 surgical interventions were identified across all participating hospitals. Blood type and crossmatch was performed 55 632 times, and 13 736 transfusions were provided, for a TCTR of 4:1. There was an association between increasing age and TCTR (R(2) = 0.43). Patients with multiple CCCs had lower TCTRs, with a stronger relationship (R(2) = 0.77). There was broad variability in adjusted TCTRs among hospitals (range, 2.5-25). The average TCTR in US children's hospitals was double that of adult surgical data, and was associated with wide interhospital variability. Age and the presence of CCCs markedly influenced this ratio. Studies to evaluate optimal preoperative RBC ordering and standardization of practices could potentially decrease unnecessary costs and wasted blood. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Which hemostatic device in thyroid surgery? A network meta-analysis of surgical technologies.

    Science.gov (United States)

    Garas, George; Okabayashi, Koji; Ashrafian, Hutan; Shetty, Kunal; Palazzo, Fausto; Tolley, Neil; Darzi, Ara; Athanasiou, Thanos; Zacharakis, Emmanouil

    2013-09-01

    Energy-based hemostatic devices are increasingly being used in thyroid surgery. However, there are several limitations with regard to the existing evidence and a paucity of guidelines on the subject. The goal of this review is to employ the novel evidence synthesis technique of a network meta-analysis to assess the comparative effectiveness of surgical technologies in thyroid surgery and contribute to enhanced governance in the field of thyroid surgery. Articles published between January 2000 and June 2012 were identified from Embase, Medline, Cochrane Library, and PubMed databases. Randomized controlled trials of any size comparing the use of ultrasonic coagulation (harmonic scalpel) or Ligasure either head-to-head or against the "clamp-and-tie" technique were included. Two reviewers independently critically appraised and extracted the data from each study. The number of patients who experienced postoperative events was extracted in dichotomous format or continuous outcomes. Odds ratios were calculated by a Bayesian network meta-analysis, and metaregression was used for pair-wise comparisons. Indirect and direct comparisons were performed and inconsistency was assessed. Thirty-five randomized controlled trials with 2856 patients were included. Ultrasonic coagulation ranked first (followed by Ligasure and then clamp-and-tie) with the lowest risk of postoperative hypoparathyroidism (odds ratio 1.43 [95% confidence interval (CI) 0.77-2.67] and 0.70 [CI 0.43-1.13], ultrasonic coagulation vs. Ligasure and ultrasonic coagulation vs. clamp-and-tie, respectively), least blood loss (-0.25 [CI -0.84 to -0.35] and -1.22 [CI -1.85 to -0.59]), and drain output (0.28 [CI -0.35 to -0.91] and -0.36 [CI -0.70 to -0.03]). From a health technology viewpoint, ultrasonic coagulation was associated with the shortest operative time (-0.66 [CI -1.17 to -0.14] and -1.29 [CI -1.59 to -1.00]) and hospital stay (-0.28 [CI -0.78 to 0.22] and -0.56 [CI -1.28 to 0.15]). The only exception

  6. Real-time monitoring for detection of retained surgical sponges and team motion in the surgical operation room using radio-frequency-identification (RFID) technology: a preclinical evaluation.

    Science.gov (United States)

    Kranzfelder, Michael; Zywitza, Dorit; Jell, Thomas; Schneider, Armin; Gillen, Sonja; Friess, Helmut; Feussner, Hubertus

    2012-06-15

    Technical progress in the surgical operating room (OR) increases constantly, facilitating the development of intelligent OR systems functioning as "safety backup" in the background of surgery. Precondition is comprehensive data retrieval to identify imminent risky situations and inaugurate adequate security mechanisms. Radio-frequency-identification (RFID) technology may have the potential to meet these demands. We set up a pilot study investigating feasibility and appliance reliability of a stationary RFID system for real-time surgical sponge monitoring (passive tagged sponges, position monitoring: mayo-stand/abdominal situs/waste bucket) and OR team tracking (active transponders, position monitoring: right/left side of OR table). In vitro: 20/20 sponges (100%) were detected on the mayo-stand and within the OR-phantom, however, real-time detection accuracy declined to 7/20 (33%) when the tags were moved simultaneously. All retained sponges were detected correctly. In vivo (animal): 7-10/10 sterilized sponges (70%-100%) were detected correctly within the abdominal cavity. OR-team: detection accuracy within the OR (surveillance antenna) and on both sides of the OR table (sector antenna) was 100%. Mean detection time for position change (left to right side and contrariwise) was 30-60 s. No transponder failure was noted. This is the first combined RFID system that has been developed for stationary use in the surgical OR. Preclinical evaluation revealed a reliable sponge tracking and correct detection of retained textiles (passive RFID) but also demonstrated feasibility of comprehensive data acquisition of team motion (active RFID). However, detection accuracy needs to be further improved before implementation into the surgical OR. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. "The study on surgical services for the United States": a valid prescription for American surgery?

    Science.gov (United States)

    Hughes, E F; Lewit, E M; Pauly, M V

    1977-01-01

    The overall approach of SOSSUS to the study of surgical services, the interpretation of findings, and policy recommendations are rightly called into question. But singular concern with the consequences of monopolistic control by the profession is no substitute for analysis of the dynamics among demand, production, and supply of surgery. Any delivery system--and many models are feasible--involving consumers, providers, and payers is a market in which multidimensional behavior must be anticipated.

  8. Making the pediatric perioperative surgical home come to life by leveraging existing health information technology.

    Science.gov (United States)

    Leahy, Izabela C; Borczuk, Rachel; Ferrari, Lynne R

    2017-06-01

    To design a patient data dashboard for the Department of Anesthesiology, Perioperative and Pain Medicine at Boston Children's Hospital that supports care integration across the healthcare system as described by the pediatric perioperative surgical home (PPSH) initiative. By using 360 Technology, patient data was automatically pulled from all available Electronic Health Record sources from 2005 to the present. The PPSH dashboard described in this report provides a guide for implementation of PPSH Clinical Care Pathways. The dashboard integrates several databases to allow for visual longitudinal tracking of patient care, outcomes, and cost. The integration of electronic information provided the ability to display, compare, and analyze selected PPSH metrics in real time. By utilizing the PPSH dashboard format the use of an automated, integrated clinical, and financial health data profile for a specific patient population may improve clinicians' ability to have a comprehensive assessment of all care elements. This more global clinical thinking has the potential to produce bottom-up, evidence-based healthcare reform. The experience with the PPSH dashboard provides solid evidence for the use of integrated Electronic Health Record to improve patient outcomes and decrease cost.

  9. EFFECTS OF AROMATHERAPY MASSAGE ON THE SLEEP QUALITY AND PHYSIOLOGICAL PARAMETERS OF PATIENTS IN A SURGICAL INTENSIVE CARE UNIT.

    Science.gov (United States)

    Özlü, Zeynep Karaman; Bilican, Pınar

    2017-01-01

    Surgical pain is experienced by inpatients with clinical, disease-related concerns, unknown encounters after surgery, quality of sleep, restrictions in position after surgery is known to be serious. The study was conducted to determine the effect of aromatherapy massage on quality of sleep and physiological parameters in surgical intensive care patients. This is an experimental study. The sample of this study consisted of 60 patients who were divided into two groups as experimental group and control group including 30 patients in each one. The participants were postoperative patients, absent complications, who were unconscious and extubated. A data collection form on personal characteristics of the patients, a registration form on their physical parameters and the Richards-Campbell Sleep Scale (RCSQ) were used to collect the data of the study. The Richards-Campbell Sleep Scale indicated that while the experimental group had a mean score of 53.80 ± 13.20, the control group had a mean score of 29.08 ± 9.71 and there was a statistically significant difference between mean scores of the groups. In a comparison of physiologic parameters, only diastolic blood pressure measuring between parameters in favor of an assembly as a statistically significant difference was detected. Results of the study showed that aromatherapy massage enhanced the sleep quality of patients in a surgical intensive care unit and resulted in some positive changes in their physiological parameters.

  10. [Statistics of causes of death and analysis of risk factors in a surgical intensive care unit].

    Science.gov (United States)

    Jianhua, Yao; Xingxing, Shi; Fen, Wang; Xijing, Zhang

    2015-11-01

    To summarize the causes of death and to analyze the risk factors in a surgical intensive care unit (SICU). The relevant information of patients died in the SICU of Xijing Hospital of Fourth Military Medical University in past 15 years (from December 1999 to February 2015) was retrospectively analyzed. The gender, age, reason and date of hospitalization, date of transfer SICU, past medical history, whether or not admitted directly from emergency department or transferred from other department, operated or not, date of death, the main cause of death, acute physiology and chronic health evaluation II (APACHE II) score, the history of undergoing mechanical ventilation, continuous renal replacement therapy (CRRT), or antifungal therapy, as well as the ratio of the patients with body temperature higher than 39 °C, white blood cell (WBC) count higher than 10 x 10⁹/L, platelet (PLT) count below 100 x 10⁹/L, albumin (Alb) below 35 g/L of two periods, namely from December 1999 to July 2007 (the first period), and from August 2007 to February 2015 (the second period) were compared. The above parameters were compared with those of 201 survivors in SICU, and the risk factors leading to death were analyzed by logistic regression. From December 1999 to February 2015, 4 317 patients were taken care of in the SICU. Among them, the number of death was 186, and the mortality rate was 4.3%. In the first time period (from December 1999 to July 2007), the total number of patients was 1 356, and the number of death were 109 (the mortality rate was 8.0%). In the second period, i.e. from August 2007 to February 2015, the number of SICU patients was 2,961, and 77 died (the mortality rate was 2.6%). The difference of mortality rate between the two periods was statistically significant (χ² = 66.707, P = 0.001 ). The death rate of patients transferred directly from emergency department in the first period was 79.8% (87/109), and it was lower in the second period (51.9%, 40/77, χ² = 16

  11. Effects of intensivist coverage in a post-anaesthesia care unit on surgical patients' case mix and characteristics of the intensive care unit.

    Science.gov (United States)

    Kastrup, Marc; Seeling, Matthes; Barthel, Stefan; Bloch, Andy; le Claire, Marie; Spies, Claudia; Scheller, Matthias; Braun, Jan

    2012-07-18

    There is an increasing demand for intensive care in hospitals, which can lead to capacity limitations in the intensive care unit (ICU). Due to postponement of elective surgery or delayed admission of emergency patients, outcome may be negatively influenced. To optimize the admission process to intensive care, the post-anaesthesia care unit (PACU) was staffed with intensivist coverage around the clock. The aim of this study is to demonstrate the impact of the PACU on the structure of ICU-patients and the contribution to overall hospital profit in terms of changes in the case mix index for all surgical patients. The administrative data of all surgical patients (n = 51,040) 20 months prior and 20 months after the introduction of a round-the-clock intensivist staffing of the PACU were evaluated and compared. The relative number of patients with longer length of stay (LOS) (more than seven days) in the ICU increased after the introduction of the PACU. The average monthly number of treatment days of patients staying less than 24 hours in the ICU decreased by about 50% (138.95 vs. 68.19 treatment days, P case mix index (CMI) per hospital day for all surgical patients was significantly higher after the introduction of a PACU: 0.286 (± 0.234) vs. 0.309 (± 0.272) P case mix index of the patients per hospital day, increased after the implementation of a PACU and more patients can be treated in the same time, due to a better use of resources.

  12. The Prevalence of HIV in Cancer Patients at the Surgical Oncology Unit of Donka University Hospital of Conakry (Guinea).

    Science.gov (United States)

    Traore, Bangaly; Bah, Thierno Souleymane; Traore, Fode Amara; Sow, Mamadou Saliou; Diane, Solomana; Keita, Mamady; Cisse, Mohamed; Koulibaly, Moussa; Camara, Naby Daouda

    2015-01-01

    Aim. To determine the prevalence of HIV infection among patients seen at the surgical oncology unit of Donka (Conakry, Guinea). Method. We conducted a retrospective and descriptive study of HIV infection in cancer patients from May 2007 to December 2012. Social characteristics (age, gender, marital status, and education) and immune status (HIV type, CD4 count) were reviewed. Results. Out of 2598 cancer patients, 54 (2.1%) tested positive for HIV. There were 11 (20.4%) defining AIDS and 43 (79.6%) nondefining AIDS cancers. The most frequent cancers were breast (14) (26.0%), non-Hodgkin lymphoma (6) (11.1%), liver (6) (11.1%), eye and annexes (6) (11.1%), and cervical cancer (5) (9.3%). These patients were female in 34 (63.0%) and had a median age of 39 years and body mass index was 20,3 Kg/m(2). They were unschooled in 40 (74.1%) and married in 35 (64.8%). CD4 count showed a median of 317 cells/mL. Antiretroviral treatment was performed in 40 (74.1%). Conclusion. HIV prevalence is higher in patients in our unit of surgical oncology. Breast cancer was the most common in this association. A national survey of a large sample is needed to determine the true prevalence and impact of HIV on cancer prognosis.

  13. The Prevalence of HIV in Cancer Patients at the Surgical Oncology Unit of Donka University Hospital of Conakry (Guinea

    Directory of Open Access Journals (Sweden)

    Bangaly Traore

    2015-01-01

    Full Text Available Aim. To determine the prevalence of HIV infection among patients seen at the surgical oncology unit of Donka (Conakry, Guinea. Method. We conducted a retrospective and descriptive study of HIV infection in cancer patients from May 2007 to December 2012. Social characteristics (age, gender, marital status, and education and immune status (HIV type, CD4 count were reviewed. Results. Out of 2598 cancer patients, 54 (2.1% tested positive for HIV. There were 11 (20.4% defining AIDS and 43 (79.6% nondefining AIDS cancers. The most frequent cancers were breast (14 (26.0%, non-Hodgkin lymphoma (6 (11.1%, liver (6 (11.1%, eye and annexes (6 (11.1%, and cervical cancer (5 (9.3%. These patients were female in 34 (63.0% and had a median age of 39 years and body mass index was 20,3 Kg/m2. They were unschooled in 40 (74.1% and married in 35 (64.8%. CD4 count showed a median of 317 cells/mL. Antiretroviral treatment was performed in 40 (74.1%. Conclusion. HIV prevalence is higher in patients in our unit of surgical oncology. Breast cancer was the most common in this association. A national survey of a large sample is needed to determine the true prevalence and impact of HIV on cancer prognosis.

  14. The Prevalence of HIV in Cancer Patients at the Surgical Oncology Unit of Donka University Hospital of Conakry (Guinea)

    International Nuclear Information System (INIS)

    Traore, B.; Diane, S.; Keita, M. S.; Bah, T. S.; Sow, M. S.; Cisse, M.; Koulibaly, M.; Camara, N. D.

    2015-01-01

    To determine the prevalence of HIV infection among patients seen at the surgical oncology unit of Donka (Conakry, Guinea). Method. We conducted a retrospective and descriptive study of HIV infection in cancer patients from May 2007 to December 2012. Social characteristics (age, gender, marital status, and education) and immune status (HIV type, CD4 count) were reviewed. Results. Out of 2598 cancer patients, 54 (2.1%) tested positive for HIV. There were 11 (20.4%) defining AIDS and 43 (79.6%) non defining AIDS cancers. The most frequent cancers were breast (14) (26.0%), non-Hodgkin lymphoma (6) (11.1%), liver (6) (11.1%), eye and annexes (6) (11.1%), and cervical cancer (5) (9.3%). These patients were female in 34 (63.0%) and had a median age of 39 years and body mass index was 20,3 Kg/m 2 . They were unschooled in 40 (74.1%) and married in 35 (64.8%). CD4 count showed a median of 317 cells/mL. Antiretroviral treatment was performed in 40 (74.1%). Conclusion. HIV prevalence is higher in patients in our unit of surgical oncology. Breast cancer was the most common in this association. A national survey of a large sample is needed to determine the true prevalence and impact of HIV on cancer prognosis

  15. Hemodynamic and oxygenation changes in surgical intensive care unit patients with fever and fever lowering nursing interventions.

    Science.gov (United States)

    Çelik, Sevim; Yildirim, Ismail; Arslan, Ibrahim; Yildirim, Sinan; Erdal, Fatih; Yandi, Yunus Emre

    2011-12-01

    The purpose of this study was to determine the effects of fever and nursing interventions to lower fever on hemodynamic values and oxygenation in febrile (temperature greater than 38.3°C) surgical intensive care unit patients. This retrospective study was conducted in 53 febrile patients out of 519 patients admitted to the surgical intensive care unit at a university hospital. Data were obtained from the medical records, laboratory files and nursing notes. Statistical analysis of the data was analyzed by repeated measures analysis of variance and a paired sample t-test. The average hourly urine output (F = 5.46; P = 0.002) and systolic blood pressure (F = 2.87; P = 0.03) were significantly lower after fever onset. Heart rate, respiratory rate, positive end-expiratory pressure settings and FiO(2) settings were unchanged after the development of fever. Diastolic blood pressure and oxygen saturation had non-statistically significant decreases. Nursing interventions for febrile patients consisted of medication administration (69.8%), ice (62.3%) and sponging with tepid water (62.3%). The present results showed that fever was associated with an increase in heart rate, decreased systolic arterial pressure, mean arterial pressure, oxygen saturation and hourly urine output. © 2011 Blackwell Publishing Asia Pty Ltd.

  16. Stress and coping among surgical unit nurses of a teaching hospital

    Directory of Open Access Journals (Sweden)

    Laura de Azevedo Guido

    2012-06-01

    Full Text Available This study aimed at identifying the stressors, the level of stress and coping strategies used by nurses in a surgical clinic of a university hospital. It is a cross-sectional study whose population consisted of nine nurses. Data were collected, between May and June 2005, through the Survey Form for Daily Activities and Coping Strategies Inventory. It was verified that activities related to personnel management were valued as the most stressful. Indicating a nurse in a state of alert for high levels of stress was valued like three medium levels and five with low level of stress. It was observed that solving problems was the most commonly used factor to face stress. Knowledge of the stressors and the ways of coping with them can help assist in the development of possible solutions to minimize their effects and become the most productive and less stressful aspect of the daily life.

  17. Surgical planning for microsurgical excision of cerebral arterio-venous malformations using virtual reality technology.

    Science.gov (United States)

    Ng, Ivan; Hwang, Peter Y K; Kumar, Dinesh; Lee, Cheng Kiang; Kockro, Ralf A; Sitoh, Y Y

    2009-05-01

    To evaluate the feasibility of surgical planning using a virtual reality platform workstation in the treatment of cerebral arterio-venous malformations (AVMs) Patient-specific data of multiple imaging modalities were co-registered, fused and displayed as a 3D stereoscopic object on the Dextroscope, a virtual reality surgical planning platform. This system allows for manipulation of 3D data and for the user to evaluate and appreciate the angio-architecture of the nidus with regards to position and spatial relationships of critical feeders and draining veins. We evaluated the ability of the Dextroscope to influence surgical planning by providing a better understanding of the angio-architecture as well as its impact on the surgeon's pre- and intra-operative confidence and ability to tackle these lesions. Twenty four patients were studied. The mean age was 29.65 years. Following pre-surgical planning on the Dextroscope, 23 patients underwent microsurgical resection after pre-surgical virtual reality planning, during which all had documented complete resection of the AVM. Planning on the virtual reality platform allowed for identification of critical feeders and draining vessels in all patients. The appreciation of the complex patient specific angio-architecture to establish a surgical plan was found to be invaluable in the conduct of the procedure and was found to enhance the surgeon's confidence significantly. Surgical planning of resection of an AVM with a virtual reality system allowed detailed and comprehensive analysis of 3D multi-modality imaging data and, in our experience, proved very helpful in establishing a good surgical strategy, enhancing intra-operative spatial orientation and increasing surgeon's confidence.

  18. Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study.

    Science.gov (United States)

    Mason, Virginia M; Leslie, Gail; Clark, Kathleen; Lyons, Pat; Walke, Erica; Butler, Christina; Griffin, Martha

    2014-01-01

    Preparation for replacing the large proportion of staff nurses reaching retirement age in the next few decades in the United States is essential to continue delivering high-quality nursing care and improving patient outcomes. Retaining experienced critical care nurses is imperative to successfully implementing the orientation of new inexperienced critical care nurses. It is important to understand factors that affect work engagement to develop strategies that enhance nurse retention and improve the quality of patient care. Nurses' experience of moral distress has been measured in medical intensive care units but not in surgical trauma care units, where nurses are exposed to patients and families faced with sudden life-threatening, life-changing patient consequences.This pilot study is a nonexperimental, descriptive, correlational design to examine the effect of compassion satisfaction, compassion fatigue, moral distress, and level of nursing education on critical care nurses' work engagement. This is a partial replication of Lawrence's dissertation. The study also asked nurses to describe sources of moral distress and self-care strategies for coping with stress. This was used to identify qualitative themes about the nurse experiences. Jean Watson's theory of human caring serves as a framework to bring meaning and focus to the nursing-patient caring relationship.A convenience sample of 26 of 34 eligible experienced surgical intensive care unit trauma nurses responded to this survey, indicating a 77% response rate. Twenty-seven percent of the nurses scored high, and 73% scored average on compassion satisfaction. On compassion fatigue, 58% scored average on burnout and 42% scored low. On the secondary traumatic stress subscale, 38% scored average, and 62% scored low. The mean moral distress situations subscale score was 3.4, which is elevated. The mean 9-item Utrecht Work Engagement Scale total score, measuring work engagement, was 3.8, which is considered low

  19. Unlicensed and off-label use of drugs in pediatric surgical units at tertiary care hospitals of Pakistan.

    Science.gov (United States)

    Aamir, Muhammad; Khan, Jamshaid Ali; Shakeel, Faisal; Asim, Syed Muhammad

    2017-08-01

    Background Unlicensed and off-label prescribing practice is global dilemma around the world. This pioneering study was designed to determine unlicensed and off-label use of drug in surgical wards of tertiary care hospitals of Pakistan. Objective To assess unlicensed and off-label use of drugs in pediatric surgical unit at three tertiary care hospitals in Peshawar, Pakistan. Setting Two government and one private tertiary care hospitals in Pakistan. Method Drug profiles of 895 patients from three different clinical settings were evaluated for unlicensed and off-label use of drugs using Micromedex DRUGDEX. Main outcome measure Characteristics of the unlicensed and off-label drug prescriptions. Result Total of 3168 prescribed drugs were analyzed in this study. Indication (38.7%) and dose (34.8%) were the most frequent off-label categories. In comparison with the corresponding reference categories, infants and children, male patients and having less than five prescribed drugs were significant predictors of unlicensed prescriptions. In comparison with the corresponding reference categories, significant predictors of off-label drug prescribing were children younger than two year, children between 2-12 years, patient staying at hospital less than 5 days and patients having less than five prescribed drugs. Conclusion The prevalence of unlicensed and off-label drug prescriptions are high at pediatric surgical ward of tertiary care hospitals. More awareness of the efficacy and safety of drugs are required in pediatrics. In addition, new formulations with advanced dosing for children are also required to minimize the risk of adverse outcomes.

  20. Surgical Ligation of Patent Ductus Arteriosus in Very-low-birth-weight Premature Infants in the Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Yu-Chen Ko

    2009-01-01

    Full Text Available This study reported our experience of bedside patent ductus arteriosus (PDA ligation for prematurity in the neonatal intensive care unit (NICU. Between April 1992 and March 2006, 41 very-low-birth-weight premature infants underwent PDA ligation in the NICU. There were 18 male and 23 female infants. The mean gestational age and birth weight were 26.9 weeks and 900.9 g, respectively. Preoperatively, 25 infants were ventilator-dependent. After operation, there were five deaths caused by complications of prematurity. Surgical complications occurred in four and all recovered well after treatment. Twenty preoperatively intubated babies survived and were extubated at 21.6 ± 12.7 days postoperatively. In conclusion, bedside PDA ligation in the NICU is safe and effective. It can avoid transportation of critically ill, very small infants. We suggest surgical closure as the primary treatment in very-low-birth-weight infants who are ventilator-dependent to avoid the possible complications of indomethacin and prolonged intubation.

  1. Patients' views of patient-centred care: a phenomenological case study in one surgical unit.

    Science.gov (United States)

    Marshall, Amy; Kitson, Alison; Zeitz, Kathryn

    2012-12-01

    To report a study of patients' views of patient-centred care. The study aimed to explore patients' understanding and conceptualization of patient-centred care and link it to existing literature on the topic. Patient-centred care currently lacks a widely accepted definition, with much of the literature based on definitions formulated by health professionals and researchers. Qualitative research study grounded in phenomenology. Interpersonal interviews were conducted with ten participants who were patients in a surgical ward in a large metropolitan hospital in South Australia in 2010. Participants were unfamiliar with the concept of patient-centred care, but despite this, were able to describe what the term meant to them and what they wanted from their care. Patients equated the type and quality of care they received with the staff that provided it and themes of connectedness, involvement and attentiveness were prevalent in their descriptions of what they wanted from their care. Ensuring that patients have a voice in the definition and conceptualization of patient-centred care is essential and further and regular consultation with patients about their needs and priorities will ensure an integrated approach to patient-centred care. © 2012 Blackwell Publishing Ltd.

  2. Successful implementation of a packed red blood cell and fresh frozen plasma transfusion protocol in the surgical intensive care unit.

    Directory of Open Access Journals (Sweden)

    Benjamin E Szpila

    Full Text Available Blood product transfusions are associated with increased morbidity and mortality. The purpose of this study was to determine if implementation of a restrictive protocol for packed red blood cell (PRBC and fresh frozen plasma (FFP transfusion safely reduces blood product utilization and costs in a surgical intensive care unit (SICU.We performed a retrospective, historical control analysis comparing before (PRE and after (POST implementation of a restrictive PRBC/FFP transfusion protocol for SICU patients. Univariate analysis was utilized to compare patient demographics and blood product transfusion totals between the PRE and POST cohorts. Multivariate logistic regression models were developed to determine if implementation of the restrictive transfusion protocol is an independent predictor of adverse outcomes after controlling for age, illness severity, and total blood products received.829 total patients were included in the analysis (PRE, n=372; POST, n=457. Despite higher mean age (56 vs. 52 years, p=0.01 and APACHE II scores (12.5 vs. 11.2, p=0.006, mean units transfused per patient were lower for both packed red blood cells (0.7 vs. 1.2, p=0.03 and fresh frozen plasma (0.3 vs. 1.2, p=0.007 in the POST compared to the PRE cohort, respectively. There was no difference in inpatient mortality between the PRE and POST cohorts (7.5% vs. 9.2%, p=0.39. There was a decreased risk of urinary tract infections (OR 0.47, 95%CI 0.28-0.80 in the POST cohort after controlling for age, illness severity and amount of blood products transfused.Implementation of a restrictive transfusion protocol can effectively reduce blood product utilization in critically ill surgical patients with no increase in morbidity or mortality.

  3. Conflict in the intensive care unit: Nursing advocacy and surgical agency.

    Science.gov (United States)

    Pecanac, Kristen E; Schwarze, Margaret L

    2018-02-01

    Nurses and surgeons may experience intra-team conflict during decision making about the use of postoperative life-sustaining treatment in the intensive care unit due to their perceptions of professional roles and responsibilities. Nurses have a sense of advocacy-a responsibility to support the patient's best interest; surgeons have a sense of agency-a responsibility to keep the patient alive. The objectives were to (1) describe the discourse surrounding the responsibilities of nurses and surgeons, as "advocates" and "agents," and (2) apply these findings to determine how differences in role responsibilities could foster conflict during decision making about postoperative life-sustaining treatment in the intensive care unit. Articles, books, and professional documents were explored to obtain descriptions of nurses' and surgeons' responsibilities to their patients. Using discourse analysis, responsibilities were grouped into themes and then compared for potential for conflict. Ethical considerations: No data were collected from human participants and ethical review was not required. The texts were analyzed by a surgeon and a nurse to minimize profession-centric biases. Four themes in nursing discourse were identified: responsibility to support patient autonomy regarding treatment decisions, responsibility to protect the patient from the physician, responsibility to act as an intermediary between the physician and the patient, and the responsibility to support the well-being of the patient. Three themes in surgery discourse were identified personal responsibility for the patient's outcome, commitment to patient survival, and the responsibility to prevent harm to the patient from surgery. These responsibilities may contribute to conflict because each profession is working toward different goals and each believes they know what is best for the patient. It is not clear from the existing literature that either profession understands each other's responsibilities

  4. [The geriatric perioperative unit, a high performance care department for elderly surgical patients].

    Science.gov (United States)

    Papas, Anne; Caillard, Laurence; Nion, Nathalie

    2011-01-01

    For over a year Professor Marc Verny's geriatric department at Pitié-Salpêtrière hospital in Paris has had ten beds set aside for the perioperative care of elderly people. This geriatric perioperative unit (UPOG) offers patients the skills of a multidisciplinary team trained in the specificities of caring for elderly patients often suffering from polypathology. The team works closely together around a common goal: the rapid return of the patient's autonomy during the postoperative period, crucial for the future of elderly people. So far UPOG's results have been very positive, as more than 90% of patients regain their autonomy after a short and uncomplicated period of postoperative care.

  5. Fission Surface Power Technology Demonstration Unit Test Results

    Science.gov (United States)

    Briggs, Maxwell H.; Gibson, Marc A.; Geng, Steven M.; Sanzi, James L.

    2016-01-01

    The Fission Surface Power (FSP) Technology Demonstration Unit (TDU) is a system-level demonstration of fission power technology intended for use on manned missions to Mars. The Baseline FSP systems consists of a 190 kWt UO2 fast-spectrum reactor cooled by a primary pumped liquid metal loop. This liquid metal loop transfers heat to two intermediate liquid metal loops designed to isolate fission products in the primary loop from the balance of plant. The intermediate liquid metal loops transfer heat to four Stirling Power Conversion Units (PCU), each of which produce 12 kWe (48 kW total) and reject waste heat to two pumped water loops, which transfer the waste heat to titanium-water heat pipe radiators. The FSP TDU simulates a single leg of the baseline FSP system using an electrically heater core simulator, a single liquid metal loop, a single PCU, and a pumped water loop which rejects the waste heat to a Facility Cooling System (FCS). When operated at the nominal operating conditions (modified for low liquid metal flow) during TDU testing the PCU produced 8.9 kW of power at an efficiency of 21.7 percent resulting in a net system power of 8.1 kW and a system level efficiency of 17.2 percent. The reduction in PCU power from levels seen during electrically heated testing is the result of insufficient heat transfer from the NaK heater head to the Stirling acceptor, which could not be tested at Sunpower prior to delivery to the NASA Glenn Research Center (GRC). The maximum PCU power of 10.4 kW was achieved at the maximum liquid metal temperature of 875 K, minimum water temperature of 350 K, 1.1 kg/s liquid metal flow, 0.39 kg/s water flow, and 15.0 mm amplitude at an efficiency of 23.3 percent. This resulted in a system net power of 9.7 kW and a system efficiency of 18.7 percent.

  6. Prospective Trial of House Staff Time to Response and Intervention in a Surgical Intensive Care Unit: Pager vs. Smartphone.

    Science.gov (United States)

    Tatum, James M; White, Terris; Kang, Christopher; Ley, Eric J; Melo, Nicolas; Bloom, Matthew; Alban, Rodrigo F

    The objective of the study was to characterize house staff time to response and intervention when notified of a patient care issue by pager vs. smartphone. We hypothesized that smartphones would reduce house staff time to response and intervention. Prospective study of all electronic communications was conducted between nurses and house staff between September 2015 and October 2015. The 4-week study period was randomly divided into two 2-week study periods where all electronic communications between intensive care unit nurses and intensive care unit house staff were exclusively by smartphone or by pager, respectively. Time of communication initiation, time of house staff response, and time from response to clinical intervention for each communication were recorded. Outcomes are time from nurse contact to house staff response and intervention. Single-center surgical intensive care unit of Cedars-Sinai Medical Center in Los Angeles, California, an academic tertiary care and level I trauma center. All electronic communications occurring between nurses and house staff in the study unit during the study period were considered. During the study period, 205 nurse-house staff electronic communications occurred, 100 in the phone group and 105 in the pager group. House staff response to communication time was significantly shorter in the phone group (0.5 [interquartile range = 1.7] vs. 2 [3]min, p house staff intervention after response was also significantly more rapid in the phone group (0.8 [1.7] vs. 1 [2]min, p = 0.003). Dedicated clinical smartphones significantly decrease time to house staff response after electronic nursing communications compared with pagers. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Society for Assisted Reproductive Technology and assisted reproductive technology in the United States: a 2016 update.

    Science.gov (United States)

    Toner, James P; Coddington, Charles C; Doody, Kevin; Van Voorhis, Brad; Seifer, David B; Ball, G David; Luke, Barbara; Wantman, Ethan

    2016-09-01

    The Society for Assisted Reproductive Technology (SART) was established within a few years of assisted reproductive technology (ART) in the United States, and has not only reported on the evolution of infertility care, but also guided it toward improved success and safety. Moving beyond its initial role as a registry, SART has expanded its role to include quality assurance, data validation, practice and advertising guidelines, research, patient education and advocacy, and membership support. The success of ART in this country has greatly benefited from SART's role, as highlighted by a series of graphs. SART continues to set the standard and lead the way. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. The Rationalization of Automatic Units for HPDC Technology

    Directory of Open Access Journals (Sweden)

    A. Herman

    2012-04-01

    Full Text Available The paper deals with problem of optimal used automatic workplace for HPDC technology - mainly from aspects of operations sequence, efficiency of work cycle and planning of using and servicing of HPDC casting machine. Presented are possible ways to analyse automatic units for HPDC. The experimental part was focused on the rationalization of the current work cycle time for die casting of aluminium alloy. The working place was described in detail in the project. The measurements were carried out in detail with the help of charts and graphs mapped cycle of casting workplace. Other parameters and settings have been identified.The proposals for improvements were made after the first measurements and these improvements were subsequently verified. The main actions were mainly software modifications of casting center. It is for the reason that today's sophisticated workplaces have the option of a relatively wide range of modifications without any physical harm to machines themselves. It is possible to change settings or unlock some unsatisfactory parameters.

  9. United States Department of Energy solar receiver technology development

    Science.gov (United States)

    Klimas, P. C.; Diver, R. B.; Chavez, J. M.

    The United States Department of Energy (DOE), through Sandia National Laboratories, has been conducting a Solar Thermal Receiver Technology Development Program, which maintains a balance between analytical modeling, bench and small scale testing, and experimentation conducted at scales representative of commercially-sized equipment. Central receiver activities emphasize molten salt-based systems on large scales and volumetric devices in the modeling and small scale testing. These receivers are expected to be utilized in solar power plants rated between 100 and 200 MW. Distributed receiver research focuses on liquid metal refluxing devices. These are intended to mate parabolic dish concentrators with Stirling cycle engines in the 5 to 25 kW(sub e) power range. The effort in the area of volumetric receivers is less intensive and highly cooperative in nature. A ceramic foam absorber of Sandia design was successfully tested on the 200 kW(sub t) test bed at Plataforma Solar during 1989. Material integrity during the approximately 90-test series was excellent. Significant progress has been made with parabolic dish concentrator-mounted receivers using liquid metals (sodium or a potassium/sodium mixture) as heat transport media. Sandia has successfully solar-tested a pool boiling reflux receiver sized to power a 25 kW Stirling engine. Boiling stability and transient operation were both excellent. This document describes these activities in detail and will outline plans for future development.

  10. Combining Latin Hypercube Designs and Discrete Event Simulation in a Study of a Surgical Unit

    DEFF Research Database (Denmark)

    Dehlendorff, Christian; Andersen, Klaus Kaae; Kulahci, Murat

    Summary form given only:In this article experiments on a discrete event simulation model for an orthopedic surgery are considered. The model is developed as part of a larger project in co-operation with Copenhagen University Hospital in Gentofte. Experiments on the model are performed by using...... Latin hypercube designs. The parameter set consists of system settings such as use of preparation room for sedation and the number of operating rooms, as well as management decisions such as staffing, size of the recovery room and the number of simultaneously active operating rooms. Sensitivity analysis...... and optimization combined with meta-modeling are employed in search for optimal setups. The primary objective in this article is to minimize time spent by the patients in the system. The overall long-term objective for the orthopedic surgery unit is to minimize time lost during the pre- and post operation...

  11. CAD/CAM technologies in the surgical and prosthetic treatment of the edentulous patient with biomymetic individualized approach.

    Science.gov (United States)

    Pozzi, A; Gargari, M; Barlattani, A

    2008-04-01

    The advent of modern endosseous implant design and improved surface technology has allowed the development of new restorative techniques that decrease patient's total treatment time. Utilizing the latest scanning, CAD/CAM and manufacturing technolgies we are able to manufacture individualized dental restoration with high accuracy and a perfect precision of fit. This report describes the rehabilitation of a completely edentulous patient utilizing a CT-based implant planning with computer-assisted surgical design, simultaneous CAD/CAM fabrication of a surgical template, a flapless surgical placement of the implants, and a prefabricated fixed complete denture for an immediately loaded restoration according to Nobel Biocare's Teeth-in-an-Hour™ (Nobel Biocare Goteborg, Sweden) protocol. This systematic approach to full mouth rehabilitation reduces the time necessary for an edentulous patient to go from severely atrophic alveolar support to implant retained prosthetic restoration. These aspects of minimally invasive and simplified surgery, along with reducing the treatment time and postsurgical discomfort, are beneficial to the patient, and allowing for rehabilitation with the same level of success as in flap surgery. The Teeth-in-an-Hour protocol is a unique solution made possible by the Procera System. With the aid of the CT scans and a virtual planning software, a custom fabricated precision drill guide and a pre-manufactured prosthesis can be made before surgery. The execution of implant placement is performed with a flapless procedure that results in minimal surgical intervention. This results in a short and non-traumatic surgery with a minimum of postoperative complications, allowing the patient to leave the chair with a fixed prosthesis. Utilizing the latest scanning, CAD/CAM and manufacturing technologies the dental team is able to develop individualized zirconia full arch framework with high accuracy and precision of fit.

  12. Anatomy and Physiology. Module Set II: Major Body Systems. Teacher Edition [and] Student Edition. Surgical Technology.

    Science.gov (United States)

    Hilley, Robert

    This document, which is the second part of a two-part set of modules on anatomy and physiology for future surgical technicians, contains the teacher and student editions of an introduction to anatomy and physiology that consists of modules on the following body systems: integumentary system; skeletal system; muscular system; nervous system;…

  13. Using evidence to improve satisfaction with medication side-effects education on a neuro-medical surgical unit.

    Science.gov (United States)

    Ahrens, Susan L; Wirges, Ashley M

    2013-10-01

    Patient satisfaction is viewed as a significant indicator of quality of care. More specifically, improving patient satisfaction related to communication about medications and potential side effects can improve healthcare outcomes. Patient satisfaction scores related to medication side effects on a neuro-medical surgical unit were monitored following a quality improvement program. These patients frequently experience cognitive impairment and functional difficulties that can affect the way they understand and handle medications. The purpose of this quality improvement practice change was to (a) develop an educational approach for post acute neurosurgical patients and (b) evaluate whether the use of the approach is successful in improving patient satisfaction scores related to medication education on side effects. The quality improvement program interventions included (a) patient informational handouts inserted into admission folders, (b) nurse education about the importance of providing education on side effects to patient and discussion of their involvement with the program, (c) unit flyers with nurse education, and (d) various communications with bedside nurses through personal work mail and emails. The primary focus was for nurses to employ the "teach back" method to review and reinforce the medication side-effect teaching with patients. Evaluation of the data showed an increase in patient satisfaction after the implementation of the "Always Ask" program.

  14. NEW TECHNOLOGIES IN THE DIAGNOSIS AND REHABILITATION TREATMENT OF DYSURIA AFTER SURGICAL TREATMENT FOR PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    T. G. Markosyan

    2012-01-01

    Full Text Available The paper deals with the latest neurophysiological technologies for the recognition and treatment of neurogenic disorders of urination and erection in a group of patients operated on for prostate cancer (PC. Acicular electromyography of pelvic floor muscles with transcranial magnetic stimulation of micturition and erectile centers has been put into practice to examine this category of patients. The basic neurophysiological parameters of the muscles examined (cortical and segmental evoked motor response the latency, central motor conduction time (CMCT, and motor unit potential (MUP amplitude and duration were estimated. To develop a normative base, the neurophysiological features of the pelvic floor were studied in healthy volunteers (n = 12 who formed a control group. Examinations were made in 17 patients who had undergone operations for PC at Moscow hospitals 3 to 18 months before, such as retropubic prostatectomy (n = 11 and transurethral resection plus high-intensity focused ultrasound (HIFU ablation (n = 6. Spontaneous urination was absent in 4 (23.5% of cases; urinary incontinence was observed in 6 (35.2% patients. The study group patients were found to have significant disorders of corticospinal tract conduction and those of perineal muscle contraction as potential fibrillation and positive pointed waves, as well as considerable CMCM prolongation and MUP polyphasia. Denervation alterations in PC patients after surgery and delayed reinnervation processes, nerve control recovery are determined by not only the surgery itself, but also by the features of the course of the underlying cancer process. Pelvic floor muscle studies indicated that HIFU was a very traumatic treatment for PC due to the fact that physical exposure spread outside the prostate to the neuromuscular structures. The denervation alterations detected in the pelvic floor muscles became essential in the elaboration of adequate treatment policy. The use of agents improving the

  15. NEW TECHNOLOGIES IN THE DIAGNOSIS AND REHABILITATION TREATMENT OF DYSURIA AFTER SURGICAL TREATMENT FOR PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    T. G. Markosyan

    2014-07-01

    Full Text Available The paper deals with the latest neurophysiological technologies for the recognition and treatment of neurogenic disorders of urination and erection in a group of patients operated on for prostate cancer (PC. Acicular electromyography of pelvic floor muscles with transcranial magnetic stimulation of micturition and erectile centers has been put into practice to examine this category of patients. The basic neurophysiological parameters of the muscles examined (cortical and segmental evoked motor response the latency, central motor conduction time (CMCT, and motor unit potential (MUP amplitude and duration were estimated. To develop a normative base, the neurophysiological features of the pelvic floor were studied in healthy volunteers (n = 12 who formed a control group. Examinations were made in 17 patients who had undergone operations for PC at Moscow hospitals 3 to 18 months before, such as retropubic prostatectomy (n = 11 and transurethral resection plus high-intensity focused ultrasound (HIFU ablation (n = 6. Spontaneous urination was absent in 4 (23.5% of cases; urinary incontinence was observed in 6 (35.2% patients. The study group patients were found to have significant disorders of corticospinal tract conduction and those of perineal muscle contraction as potential fibrillation and positive pointed waves, as well as considerable CMCM prolongation and MUP polyphasia. Denervation alterations in PC patients after surgery and delayed reinnervation processes, nerve control recovery are determined by not only the surgery itself, but also by the features of the course of the underlying cancer process. Pelvic floor muscle studies indicated that HIFU was a very traumatic treatment for PC due to the fact that physical exposure spread outside the prostate to the neuromuscular structures. The denervation alterations detected in the pelvic floor muscles became essential in the elaboration of adequate treatment policy. The use of agents improving the

  16. Miniaturized Power Processing Unit Study: A Cubesat Electric Propulsion Technology Enabler Project

    Science.gov (United States)

    Ghassemieh, Shakib M.

    2014-01-01

    This study evaluates High Voltage Power Processing Unit (PPU) technology and driving requirements necessary to enable the Microfluidic Electric Propulsion technology research and development by NASA and university partners. This study provides an overview of the state of the art PPU technology with recommendations for technology demonstration projects and missions for NASA to pursue.

  17. Pattern of surgical procedures performed in the orthopaedic units of a tertiary hospital in South West Nigeria

    Directory of Open Access Journals (Sweden)

    Thomas O Adekoya-Cole

    2016-01-01

    Full Text Available Background: Lagos University Teaching Hospital (LUTH is one of the foremost teaching institutions in Nigeria. It is a recognized training institution for residency training in Nigeria. However, a thorough evaluation of the procedures being undertaken by the orthopaedic teams in this centre and the impact on the type of training being passed on to the resident doctors in training is the focus of this paper. Objectives: To determine the pattern of procedures performed by the orthopaedic units of the Department of Surgery, LUTH with a view to import the findings in re-organizing its structure based on service requirement, manpower allocation and to make recommendation. Methods: We retrospectively reviewed data including age, sex, procedures and leading surgeons retrieved from all our operating theatres over a period from 1st January 2010 to 31st December 2011. The data retrieved was analyzed. Results: A total 741 procedures were performed over the 2 year period. More male patients (58.5% had procedures performed on them than the female patients. The mean age of patients treated was 37.2±15.5 years. Trauma related procedures accounted for 68.8% of the total procedures. Open reduction and internal fixation surgical operations were the most common trauma related procedure while ablative surgical operations following Diabetic Mellitus foot syndrome were the most common non-trauma related procedure performed. Conclusion: Trauma related surgery remains the most common procedures in our teaching hospital. Efforts should be made to increase the number of elective operations like Arthroplasties, Arthroscopic operations and Spinal axis correction operations being performed.

  18. An analysis of surgical and anaesthetic factors affecting skin graft viability in patients admitted to a Burns Intensive Care Unit.

    Science.gov (United States)

    Isitt, Catherine E; McCloskey, Kayleigh A; Caballo, Alvaro; Sharma, Pranev; Williams, Andrew; Leon-Villapalos, Jorge; Vizcaychipi, Marcela P

    2016-01-01

    Skin graft failure is a recognised complication in the treatment of major burns. Little research to date has analysed the impact of the complex physiological management of burns patients on the success of skin grafting. We analysed surgical and anaesthetic variables to identify factors contributing to graft failure. Inclusion criteria were admission to our Burns Intensive Care Unit (BICU) between January 2009 and October 2013 with a major burn. After exclusion for death before hospital discharge or prior skin graft at a different hospital, 35 patients remained and were divided into those with successful autografts (n=16) and those with a failed autograft (n=19). For the purposes of this study, we defined poor autograft viability as requiring at least one additional skin graft to the same site. Logistic regression of variables was performed using SPSS (Version 22.0 IBMTM). Age, Sex, %Total Burn Surface Area or Belgian Outcome Burns Injury score did not significantly differ between groups. No differences were found in any surgical factor at logistic regression (graft site, harvest site, infection etc.). When all operations were analysed, the use of colloids was found to be significantly associated with graft failure (p=0.035, CI 95%) and this remained significant when only split thickness skin grafts (STSGs) and debridement operations were included (p=0.034, CI 95%). No differences were found in crystalloid use, intraoperative temperature, pre-operative haemoglobin and blood products or vasopressor use. This analysis highlights an independent association between colloids and graft failure which has not been previously documented.

  19. Incidence, microbiological profile of nosocomial infections, and their antibiotic resistance patterns in a high volume Cardiac Surgical Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Manoj Kumar Sahu

    2016-01-01

    Full Text Available Background: Nosocomial infections (NIs in the postoperative period not only increase morbidity and mortality, but also impose a significant economic burden on the health care infrastructure. This retrospective study was undertaken to (a evaluate the incidence, characteristics, risk factors and outcomes of NIs and (b identify common microorganisms responsible for infection and their antibiotic resistance profile in our Cardiac Surgical Intensive Care Unit (CSICU. Patients and Methods: After ethics committee approval, the CSICU records of all patients who underwent cardiovascular surgery between January 2013 and December 2014 were reviewed retrospectively. The incidence of NI, distribution of NI sites, types of microorganisms and their antibiotic resistance, length of CSICU stay, and patient-outcome were determined. Results: Three hundred and nineteen of 6864 patients (4.6% developed NI after cardiac surgery. Lower respiratory tract infections (LRTIs accounted for most of the infections (44.2% followed by surgical-site infection (SSI, 11.6%, bloodstream infection (BSI, 7.5%, urinary tract infection (UTI, 6.9% and infections from combined sources (29.8%. Acinetobacter, Klebsiella, Escherichia coli, and Staphylococcus were the most frequent pathogens isolated in patients with LRTI, BSI, UTI, and SSI, respectively. The Gram-negative bacteria isolated from different sources were found to be highly resistant to commonly used antibiotics. Conclusion: The incidence of NI and sepsis-related mortality, in our CSICU, was 4.6% and 1.9%, respectively. Lower respiratory tract was the most common site of infection and Gram-negative bacilli, the most common pathogens after cardiac surgery. Antibiotic resistance was maximum with Acinetobacter spp.

  20. The clinical value of daily routine chest radiographs in a mixed medical-surgical intensive care unit is low.

    Science.gov (United States)

    Graat, Marleen E; Choi, Goda; Wolthuis, Esther K; Korevaar, Johanna C; Spronk, Peter E; Stoker, Jaap; Vroom, Margreeth B; Schultz, Marcus J

    2006-02-01

    The clinical value of daily routine chest radiographs (CXRs) in critically ill patients is unknown. We conducted this study to evaluate how frequently unexpected predefined major abnormalities are identified with daily routine CXRs, and how often these findings lead to a change in care for intensive care unit (ICU) patients. This was a prospective observational study conducted in a 28-bed, mixed medical-surgical ICU of a university hospital. Over a 5-month period, 2,457 daily routine CXRs were done in 754 consecutive ICU patients. The majority of these CXRs did not reveal any new predefined major finding. In only 5.8% of daily routine CXRs (14.3% of patients) was one or more new and unexpected abnormality encountered, including large atelectases (24 times in 20 patients), large infiltrates (23 in 22), severe pulmonary congestion (29 in 25), severe pleural effusion (13 in 13), pneumothorax/pneumomediastinum (14 in 13), and malposition of the orotracheal tube (32 in 26). Fewer than half of the CXRs with a new and unexpected finding were ultimately clinically relevant; in only 2.2% of all daily routine CXRs (6.4% of patients) did these radiologic abnormalities result in a change to therapy. Subgroup analysis revealed no differences between medical and surgical patients with regard to the incidence of new and unexpected findings on daily routine CXRs and the effect of new and unexpected CXR findings on daily care. In the ICU, daily routine CXRs seldom reveal unexpected, clinically relevant abnormalities, and they rarely prompt action. We propose that this diagnostic examination be abandoned in ICU patients.

  1. Ultrasonography of gallbladder in surgical patients with a prolonged stay (> 14 days) in the intensive care unit

    International Nuclear Information System (INIS)

    Sustic, A.; Miletic, D.; Cicvaric, T.

    2005-01-01

    Background. The aim of this study was to establish the incidence of abnormal ultrasonographic (US) findings of gallbladder (GB) in surgical patients with the prolonged stay in the intensive care unit (ICU) and to correlate these findings with the severity of illness. Methods. In the prospective study fifty-seven (57) adult surgical patients (male 66%; age 49±18 yr.) with the prolonged stay in ICU (>14 days) were analyzed. In all patients the US examination was performed on the 15th day of their stay in ICU. The presence of the following US findings was analyzed: GB wall thickening (?4 mm), biliary sludge, GB hydrops, striated GB wall and pericholecystitic fluid. The severity of illness was also evaluated on the 15th day of the stay in ICU using Simplified Acute Physiology Score (SAPS II). Results. At least one abnormal US finding was found in 36 (63%), patients with GB wall thickening in 32 (56%), biliary sludge in 23 (40%), pericholecystitic fluid in 9 (16%), hydrops of GB in 7 (12%), and striated GB wall in 4 (7%) cases, respectively. Two to five US findings were found in 20 (35%) patients, three to five in 12 (21%), four to five in 10 (18%), while all five US findings were present in 4 (7%) cases. The patients with one and more US findings had significantly higher SAPS II than the patients who presented regular US findings of the GB (36±9 vs. 28±7; p < 0.01). The patients with two and more US findings had higher SAPS II than those with one or none US criteria (40±8 vs. 29±6; p < 0.001), while the patients with three and more had higher SAPS II than those with two, one or none (41±8 vs. 31±9; p < 0.001). The patients with four or five US findings had higher SAPS II than those with three or less (42±11 vs. 31±6; p < 0.001) while the patients with all five had higher SAPS II than all others (45±10 vs. 32±9; p < 0.001). A significant positive correlation between the number of US findings and SAPS II was present (r 0.57; p < 0.001). Conclusions. More than

  2. Assisted Reproductive Technology Surveillance - 
United States, 2013.

    Science.gov (United States)

    Sunderam, Saswati; Kissin, Dmitry M; Crawford, Sara B; Folger, Suzanne G; Jamieson, Denise J; Warner, Lee; Barfield, Wanda D

    2015-12-04

    Since the first U.S. infant conceived with assisted reproductive technology (ART) was born in 1981, both the use of ART and the number of fertility clinics providing ART services have increased steadily in the United States. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures). Women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks to both mothers and infants, including obstetric complications, preterm delivery, and low birthweight infants. This report provides state-specific information for the United States (including Puerto Rico) on ART procedures performed in 2013 and compares infant outcomes that occurred in 2013 (resulting from ART procedures performed in 2012 and 2013) with outcomes for all infants born in the United States in 2013. 2013. In 1996, CDC began collecting data on ART procedures performed in fertility clinics in the United States as mandated by the Fertility Clinic Success Rate and Certification Act of 1992 (FCSRCA) (Public Law 102-493). Data are collected through the National ART Surveillance System (NASS), a web-based data collection system developed by CDC. This report includes data from 52 reporting areas (the 50 states, the District of Columbia [DC], and Puerto Rico). In 2013, a total of 160,521 ART procedures (range: 109 in Wyoming to 20,299 in California) with the intent to transfer at least one embryo were performed in 467 U.S. fertility clinics and were reported to CDC. These procedures resulted in 53,252 live-birth deliveries (range: 47 in Alaska to 6,979 in California) and 66,691 infants (range: 61 in Alaska to 8,649 in California). Nationally, the total number of ART procedures performed per million women of reproductive age (15-44 years), a proxy measure of the ART usage rate, was 2,521 (range: 352 in Puerto Rico to 7,688 in DC). ART use

  3. Having faith in each other: not-for-profit giant Ascension Health hooks up with United Surgical Partners for ASC joint venture.

    Science.gov (United States)

    Romano, Michael

    2004-09-13

    In the biggest deal of its kind, not-for-profit giant Ascension is going to build ambulatory surgery centers with for-profit United Surgical Partners, which already has a deal with Baylor, left. "Hospitals are realizing that outpatient services are the future. This strategy is sound," one healthcare consultant said.

  4. Consistent adoption of the International System of Units (SI) in nuclear science and technology

    Energy Technology Data Exchange (ETDEWEB)

    Klumpar, J; Kovar, Z [Ceskoslovenska Akademie Ved, Prague. Laborator Radiologicke Dozimetrie; Sacha, J [Slovenska Akademia Vied, Bratislava (Czechoslovakia). Fyzikalny Ustav

    1975-11-01

    The principles are stressed behind a consistent introduction of the International System of Units (SI) in Czechoslovakia complying with the latest edition of the Czechoslovak Standard CSN 01 1300 on the prescribed system of national and international units. The use of special and auxiliary units in nuclear physics and technology is discussed, particular attention being devoted to the units of activity and to the time units applied in radiology. Conversion graph and tables are annexed.

  5. An overview of enabling technology research in the United States

    International Nuclear Information System (INIS)

    Baker, Charles C.

    2002-01-01

    The mission of the US Fusion Energy Sciences Program is to advance plasma science, fusion science, and fusion technology--the knowledge base needed for an economically and environmentally attractive fusion energy source. In support of this overall mission, the Enabling Technology Program in the US incorporates both near and long term R and D, contributes to material and engineering sciences as well as technology development, contributes to spin-off applications, and performs global systems assessments and focused design studies. This work supports both magnetic and inertial fusion energy (IFE) concepts. The Enabling Technology research mission is to contribute to the national science and technology base by developing the enabling technology for existing and next-step experimental devices, by exploring and understanding key materials and technology feasibility issues for attractive fusion power sources, by conducting advanced design studies that integrate the wealth of our understanding to guide R and D priorities and by developing design solutions for next-step and future devices. The Enabling Technology Program Plan is organized around five elements: plasma technologies, fusion (chamber) technologies, materials sciences, advanced design, and IFE chamber and target technologies. The principal technical features and research objectives are described for each element

  6. Label-free optical imaging technologies for rapid translation and use during intraoperative surgical and tumor margin assessment

    Science.gov (United States)

    Boppart, Stephen A.; Brown, J. Quincy; Farah, Camile S.; Kho, Esther; Marcu, Laura; Saunders, Christobel M.; Sterenborg, Henricus J. C. M.

    2018-02-01

    The biannual International Conference on Biophotonics was recently held on April 30 to May 1, 2017, in Fremantle, Western Australia. This continuing conference series brought together key opinion leaders in biophotonics to present their latest results and, importantly, to participate in discussions on the future of the field and what opportunities exist when we collectively work together for using biophotonics for biological discovery and medical applications. One session in this conference, entitled "Tumor Margin Identification: Critiquing Technologies," challenged invited speakers and attendees to review and critique representative label-free optical imaging technologies and their application for intraoperative assessment and guidance in surgical oncology. We are pleased to share a summary in this outlook paper, with the intent to motivate more research inquiry and investigations, to challenge these and other optical imaging modalities to evaluate and improve performance, to spur translation and adoption, and ultimately, to improve the care and outcomes of patients.

  7. The economic burden of nurse-sensitive adverse events in 22 medical-surgical units: retrospective and matching analysis.

    Science.gov (United States)

    Tchouaket, Eric; Dubois, Carl-Ardy; D'Amour, Danielle

    2017-07-01

    The aim of this study was to assess the economic burden of nurse-sensitive adverse events in 22 acute-care units in Quebec by estimating excess hospital-related costs and calculating resulting additional hospital days. Recent changes in the worldwide economic and financial contexts have made the cost of patient safety a topical issue. Yet, our knowledge about the economic burden of safety of nursing care is quite limited in Canada in general and Quebec in particular. Retrospective analysis of charts of 2699 patients hospitalized between July 2008 - August 2009 for at least 2 days of 30-day periods in 22 medical-surgical units in 11 hospitals in Quebec. Data were collected from September 2009 to August 2010. Nurse-sensitive adverse events analysed were pressure ulcers, falls, medication administration errors, pneumonia and urinary tract infections. Descriptive statistics identified numbers of cases for each nurse-sensitive adverse event. A literature analysis was used to estimate excess median hospital-related costs of treatments with these nurse-sensitive adverse events. Costs were calculated in 2014 Canadian dollars. Additional hospital days were estimated by comparing lengths of stay of patients with nurse-sensitive adverse events with those of similar patients without nurse-sensitive adverse events. This study found that five adverse events considered nurse-sensitive caused nearly 1300 additional hospital days for 166 patients and generated more than Canadian dollars 600,000 in excess treatment costs. The results present the financial consequences of the nurse-sensitive adverse events. Government should invest in prevention and in improvements to care quality and patient safety. Managers need to strengthen safety processes in their facilities and nurses should take greater precautions. © 2017 John Wiley & Sons Ltd.

  8. Implementation of central line-associated bloodstream infection prevention bundles in a surgical intensive care unit using peer tutoring.

    Science.gov (United States)

    Park, Sang-Won; Ko, Suhui; An, Hye-Sun; Bang, Ji Hwan; Chung, Woo-Young

    2017-01-01

    Central line-associated bloodstream infections (CLABSIs) can be prevented through well-coordinated, multifaceted programs. However, implementation of CLABSI prevention programs requires individualized strategies for different institutional situations, and the best strategy in resource-limited settings is uncertain. Peer tutoring may be an efficient and effective method that is applicable in such settings. A prospective intervention was performed to reduce CLABSIs in a surgical intensive care unit (SICU) at a tertiary hospital. The core interventions consisted of implementation of insertion and maintenance bundles for CLABSI prevention. The overall interventions were guided and coordinated by active educational programs using peer tutoring. The CLABSI rates were compared for 9 months pre-intervention, 6 months during the intervention and 9 months post-intervention. The CLABSI rate was further observed for three years after the intervention. The rate of CLABSIs per 1000 catheter-days decreased from 6.9 infections in the pre-intervention period to 2.4 and 1.8 in the intervention (6 m; P  = 0.102) and post-intervention (9 m; P  = 0.036) periods, respectively. A regression model showed a significantly decreasing trend in the infection rate from the pre-intervention period ( P  tutoring in a resource-limited setting was useful and effectively reduced CLABSIs. However, maintaining the reduced CLABSI rate will require further strategies.

  9. The Compliance Rates of Hand Hygiene in Intensive Care Unit and Surgical Services at a State Hospital in Turkey

    Directory of Open Access Journals (Sweden)

    Serap Süzük

    2015-12-01

    Full Text Available Objective: The most efficient and most cost effective method for preventing health care associated infections is hand hygiene. Although hand hygiene is the most effective and simple method, compliance rates are very low among health care workers. It was aimed to evaluate the rates of compliance of healthcare workers in a state hospital. Material and Method: In this study, totally 112 healthcare workers (31 doctors and 81 nurses were evaluated with the 5-indication observation method in a period between January and July 2013. Results: A total of 754 (65.9% out of 1.144 cases were resulted in accurate hand washing and hand-rubbing. When the intensive care unit and surgical clinics were evaluated together, it was found that hand hygiene compliance rates were 51.26% in 199 cases and 66.85% in 591 cases for doctors and nurses, respectively. Conclusion: Consequently, we think that pre-informed observations are important training instruments for hand hygiene compliance.

  10. External Validation of Risk Prediction Scores for Invasive Candidiasis in a Medical/Surgical Intensive Care Unit: An Observational Study

    Science.gov (United States)

    Ahmed, Armin; Baronia, Arvind Kumar; Azim, Afzal; Marak, Rungmei S. K.; Yadav, Reema; Sharma, Preeti; Gurjar, Mohan; Poddar, Banani; Singh, Ratender Kumar

    2017-01-01

    Background: The aim of this study was to conduct external validation of risk prediction scores for invasive candidiasis. Methods: We conducted a prospective observational study in a 12-bedded adult medical/surgical Intensive Care Unit (ICU) to evaluate Candida score >3, colonization index (CI) >0.5, corrected CI >0.4 (CCI), and Ostrosky's clinical prediction rule (CPR). Patients' characteristics and risk factors for invasive candidiasis were noted. Patients were divided into two groups; invasive candidiasis and no-invasive candidiasis. Results: Of 198 patients, 17 developed invasive candidiasis. Discriminatory power (area under receiver operator curve [AUROC]) for Candida score, CI, CCI, and CPR were 0.66, 0.67, 0.63, and 0.62, respectively. A large number of patients in the no-invasive candidiasis group (114 out of 181) were exposed to antifungal agents during their stay in ICU. Subgroup analysis was carried out after excluding such patients from no-invasive candidiasis group. AUROC of Candida score, CI, CCI, and CPR were 0.7, 0.7, 0.65, and 0.72, respectively, and positive predictive values (PPVs) were in the range of 25%–47%, along with negative predictive values (NPVs) in the range of 84%–96% in the subgroup analysis. Conclusion: Currently available risk prediction scores have good NPV but poor PPV. They are useful for selecting patients who are not likely to benefit from antifungal therapy. PMID:28904481

  11. Patients' experiences and satisfaction about care provided by male nurses in medical surgical units in Islamabad, Pakistan: A pilot study.

    Science.gov (United States)

    Younas, Ahtisham; Sundus, Amara

    2018-01-01

    Nursing is predominantly a female profession and caring has been considered an attribute of female nurses, which could imply a noncaring image of male nurses. To determine patients' experiences and satisfaction from care provided by male nurses in a private hospital in Islamabad, Pakistan. This cross-sectional study included a purposive sample of 50 patients admitted to medical surgical units for at least 2 days and who had at least three professional interactions with a male nurse. The Newcastle Satisfaction with Nursing Scale was used for data collection. Descriptive statistics were used for data analysis. The total score for experience and satisfaction was 81 and 51, respectively. A statistically significant difference existed between experience and satisfaction scores of male and female participants, indicating that males were more pleased and satisfied with their experience of receiving care from male nurses compared to the female participants. The male nurses were concerned for their patients, they were knowledgeable about the patients' condition and care, and provided them with clear explanations of the medical and nursing procedures. However, they seem to lack interpersonal relationship with patients and did not take initiative in understanding their patients. © 2017 Wiley Periodicals, Inc.

  12. Technology in the United Kingdom’s Higher Education Context

    OpenAIRE

    Price, Linda; Kirkwood, Adrian

    2008-01-01

    Frequently, university-wide strategic decisions about technology are made without fully understanding the implications for resources, administration, teaching programmes, teaching practices and learning approaches, often resulting in technology-led course designs. Yet evidence shows that it is not the technology per se that changes learning and teaching but the pedagogical advantage we make of its use. In parallel, professional development programmes have largely focused on how to use the tec...

  13. United States panel presentations[Nuclear power technology in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Beyea, J [National Audubon Society, New York, NY (United States)

    1990-07-01

    Before I begin I have to make a disclaimer. That is that I am going to be talking about public perception because I think that is very important. But I do not want to give the impression that I think the public is wrong. I happen to agree with the public's perception of nuclear power, and I want to make that clear. I do not like the current generation of nuclear plants as I have made clear in many statements that I have made. On the other hand, in the long term, I feel that we have only two choices on the supply side, and that is nuclear power and solar electricity. And although I think solar electricity has the best chance, I am realistic enough to know that technologies do not always work the way I want. And so I think it is necessary to have at least some kind of nuclear option available. On the other hand, I do not think just any kind of nuclear technology will do. I want to talk to you about the conditions that I think you have to take into account when you try to design reactors that are publicly acceptable. I look at this as an insurance policy. Again, I do not want to be misquoted: I think nuclear power should be considered as an insurance policy, not as our first line of defense. Having made those disclaimers, what we need to do is set out a problem statement. The problem statement I set out is, 'How could one design and demonstrate a nuclear reactor that would regain public confidence in the United States, if one chose to do that?' By regaining confidence, I mean regaining sufficient confidence to site reactors at a number of locations. It is a pretty heavy task because the public cannot judge the technical issues. They have to judge the players by their characters and their histories, just as the way we calibrate anyone that knows things that we do not. I have three theses that I think are crucial. The first is that people do not believe in the claims of advocates, of any point of view, not just nuclear power, once the advocates have been proved wrong on

  14. Developing maintenance technologies for FBR's heat exchanger units by advanced laser processing

    International Nuclear Information System (INIS)

    Nishimura, Akihiko; Shimada, Yukihiro

    2011-01-01

    Laser processing technologies were developed for the purpose of maintenance of FBR's heat exchanger units. Ultrashort laser processing fabricated fiber Bragg grating sensor for seismic monitoring. Fiber laser welding with a newly developed robot system repair cracks on inner wall of heat exchanger tubes. Safety operation of the heat exchanger units will be improved by the advanced laser processing technologies. These technologies are expected to be applied to the maintenance for the next generation FBRs. (author)

  15. Uniting Legislation with RFID Privacy-Enhancing Technologies

    NARCIS (Netherlands)

    Rieback, M.R.; Crispo, B.; Tanenbaum, A.S.

    2005-01-01

    RFID is a popular identification and automation technology with serious security and privacy threats. Legislation expounds upon the actual security and privacy needs of people in RFID-enabled environments, while technology helps to ensure legal compliance. This paper examines the main aims of RFID

  16. The Journey towards Technological Literacy for All in the United States--Are We There Yet?

    Science.gov (United States)

    Reed, Philip A.

    2007-01-01

    This article aims to examine if technology education is getting close to the destination of technological literacy for all in the United States. People now live at a point where all those interested in technological literacy must take a critical, unrelenting look at the profession's history, research base, and contemporary practice. Here, the…

  17. Antibiotic stewardship in the newborn surgical patient: A quality improvement project in the neonatal intensive care unit.

    Science.gov (United States)

    Walker, Sarah; Datta, Ankur; Massoumi, Roxanne L; Gross, Erica R; Uhing, Michael; Arca, Marjorie J

    2017-12-01

    There is significant diversity in the utilization of antibiotics for neonates undergoing surgical procedures. Our institution standardized antibiotic administration for surgical neonates, in which no empiric antibiotics were given to infants with surgical conditions postnatally, and antibiotics are given no more than 72 hours perioperatively. We compared the time periods before and after implementation of antibiotic protocol in an institution review board-approved, retrospective review of neonates with congenital surgical conditions who underwent surgical correction within 30 days after birth. Surgical site infection at 30 days was the primary outcome, and development of hospital-acquired infections or multidrug-resistant organism were secondary outcomes. One hundred forty-eight infants underwent surgical procedures pre-protocol, and 127 underwent procedures post-protocol implementation. Surgical site infection rates were similar pre- and post-protocol, 14% and 9% respectively, (P = .21.) The incidence of hospital-acquired infections (13.7% vs 8.7%, P = .205) and multidrug-resistant organism (4.7% vs 1.6%, P = .143) was similar between the 2 periods. Elimination of empiric postnatal antibiotics did not statistically change rates of surgical site infection, hospital-acquired infections, or multidrug-resistant organisms. Limiting the duration of perioperative antibiotic prophylaxis to no more than 72 hours after surgery did not increase the rate of surgical site infection, hospital-acquired infections, or multidrug-resistant organism. Median antibiotic days were decreased with antibiotic standardization for surgical neonates. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Surgical Navigation Technology Based on Augmented Reality and Integrated 3D Intraoperative Imaging

    Science.gov (United States)

    Elmi-Terander, Adrian; Skulason, Halldor; Söderman, Michael; Racadio, John; Homan, Robert; Babic, Drazenko; van der Vaart, Nijs; Nachabe, Rami

    2016-01-01

    Study Design. A cadaveric laboratory study. Objective. The aim of this study was to assess the feasibility and accuracy of thoracic pedicle screw placement using augmented reality surgical navigation (ARSN). Summary of Background Data. Recent advances in spinal navigation have shown improved accuracy in lumbosacral pedicle screw placement but limited benefits in the thoracic spine. 3D intraoperative imaging and instrument navigation may allow improved accuracy in pedicle screw placement, without the use of x-ray fluoroscopy, and thus opens the route to image-guided minimally invasive therapy in the thoracic spine. Methods. ARSN encompasses a surgical table, a motorized flat detector C-arm with intraoperative 2D/3D capabilities, integrated optical cameras for augmented reality navigation, and noninvasive patient motion tracking. Two neurosurgeons placed 94 pedicle screws in the thoracic spine of four cadavers using ARSN on one side of the spine (47 screws) and free-hand technique on the contralateral side. X-ray fluoroscopy was not used for either technique. Four independent reviewers assessed the postoperative scans, using the Gertzbein grading. Morphometric measurements of the pedicles axial and sagittal widths and angles, as well as the vertebrae axial and sagittal rotations were performed to identify risk factors for breaches. Results. ARSN was feasible and superior to free-hand technique with respect to overall accuracy (85% vs. 64%, P dimensions, except for vertebral body axial rotation, were risk factors for larger breaches when performed with the free-hand method. Conclusion. ARSN without fluoroscopy was feasible and demonstrated higher accuracy than free-hand technique for thoracic pedicle screw placement. Level of Evidence: N/A PMID:27513166

  19. United States geothermal technology: Equipment and services for worldwide applications

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    This document has two intended audiences. The first part, ``Geothermal Energy at a Glance,`` is intended for energy system decision makers and others who are interested in wide ranging aspects of geothermal energy resources and technology. The second part, ``Technology Specifics,`` is intended for engineers and scientists who work with such technology in more detailed ways. The glossary at the end of the document defines many of the specialized terms. A directory of US geothermal industry firms who provide goods and services for clients around the world is available on request.

  20. The United States Advanced Reactor Technologies Research and Development Program

    International Nuclear Information System (INIS)

    O’Connor, Thomas J.

    2014-01-01

    The following aspects are addressed: • Nuclear energy mission; • Reactor research development and deployment (RD&D) programs: - Light Water Reactor Sustainability Program; - Small Modular Reactor Licensing Technical Support; - Advanced Reactor Technologies (ART)

  1. Enrichment supply and technology outside the United States

    International Nuclear Information System (INIS)

    Levin, S.A.; Blumkin, S.

    1977-01-01

    This is a review of foreign uranium enrichment capacity and uranium isotope separation technology, based on news items and articles in the public literature. Tables are included presenting capacity plans, growth, sales, research and development, etc

  2. History of technology in the intensive care unit.

    Science.gov (United States)

    Puri, Nitin; Puri, Vinod; Dellinger, R P

    2009-01-01

    Critical care medicine is a young specialty and since its inception has been heavily reliant upon technology. Invasive monitoring has its humble beginnings in the continuous monitoring of heart rate and rhythm. From the development of right heart catheterization to the adaption of the echocardiogram for use in shock, intensivists have used technology to monitor hemodynamics. The care of the critically ill has been buoyed by investigators who sought to offer renal replacement therapy to unstable patients and worked to improve the monitoring of oxygen saturation. The evolution of mechanical ventilation for the critically ill embodies innumerable technological advances. More recently, critical care has insisted upon rigorous testing and cost-benefit analysis of technological advances.

  3. United States Superconducting MHD Magnet Technology Development Program

    International Nuclear Information System (INIS)

    Dawson, A.M.; Marston, P.G.; Thome, R.J.; Iwasa, Y.; Tarrh, J.M.

    1981-01-01

    A three-faceted program supported by the U.S. Dep of Energy is described. These facets include basic technology development, technology transfer and construction by industry of magnets for the national MHD program. The program includes the maintenance of a large component test facility; investigation of superconductor stability and structural behavior; measurements of materials' properties at low temperatures; structural design optimization; analytical code development; cryogenic systems and power supply design. The technology transfer program is designed to bring results of technology development and design and construction effort to the entire superconducting magnet community. The magnet procurement program is responsible for developing conceptual designs of magnets needed for the national MHD program, for issuing requests for quotation, selecting vendors and supervising design, construction, installation and test of these systems. 9 refs

  4. SELECTION OF KURAU FISHING TECHNOLOGY UNITS Eleutheronema tetradactylum WHICH COMPETITIVE AND SUSTAINABLE

    Directory of Open Access Journals (Sweden)

    Muhammad Natsir Kholis

    2018-01-01

    Full Text Available Environmentally friendly fishing technology unit is needed in sustainable fisheries management. The purpose of this study was to determine the fishing technology unit of kurau competitive and sustainable. Data collection was carried out from July to September 2016 in the Coastal Pambang of Bengkalis District of Riau Province, by using the survey method. The analytical data method used is scoring the biological, technical and socioeconomic aspects the fishing technology unit of kurau. Results of research show that combined analysis of biological, technical and socioeconomic aspects have the value of the VA fishing line function (2.48 is higher than the other three fishing gear. Thus, the fishing line is a selected fishing technology unit of kurau competitive and sustainable in the Coastal Pambang Bengkalis District. Keywords: competitive,coastal pambang, fishing technology, kurau fish,sustainable fishing

  5. Plastic surgery: quo vadis? Current trends and future projections of aesthetic plastic surgical procedures in the United States.

    Science.gov (United States)

    Broer, P Niclas; Levine, Steven M; Juran, Sabrina

    2014-03-01

    The objective of this article was to evaluate past and current trends regarding aesthetic operations in the United States and to project future changes regarding such procedures. Cosmetic surgery statistics from the American Society for Aesthetic Plastic Surgery from 1997 to 2012 were analyzed by sex, age, and ethnic group. Then, using population projections from the U.S. Census Bureau based on the 2010 census, two projection scenarios of the expected number of aesthetic plastic surgery procedures were generated. The scenarios included the presumed occurrence and nonoccurrence of a recession like that which occurred in 2007. Aesthetic procedures are expected to grow from 1,688,694 in 2012 to 3,847,929 by 2030, representing an average annual growth rate of 7.1 percent. Should another recession of similar degree to the one in 2007 occur, procedures would increase to only 2,086,994, displaying an average annual growth percentage rate of 1.3 percent. Because the age distribution of the patient population will change, preferences for specific procedures according to age influence-and thus are reflected in-future demand for those procedures. Furthermore, the ethnic profile of patients will change significantly, with 32 percent of all procedures being performed on patients other than Caucasians by 2030. Demand for aesthetic plastic surgical procedures is expected to continue to grow, while depending on the economic performance at the macro level and changing demographic dynamics of the U.S. population. Considering all investigated factors and trends among all patients, the most commonly requested procedures by 2030 are likely to be (1) breast augmentations, (2) lipoplasties, and (3) blepharoplasties.

  6. Transmission dynamics of carbapenemase-producing Klebsiella pneumoniae and anticipated impact of infection control strategies in a surgical unit.

    Directory of Open Access Journals (Sweden)

    Vana Sypsa

    Full Text Available BACKGROUND: Carbapenemase-producing Klebsiella pneumoniae (CPKP has been established as important nosocomial pathogen in many geographic regions. Transmission from patient to patient via the hands of healthcare workers is the main route of spread in the acute-care setting. METHODOLOGY/PRINCIPAL FINDINGS: Epidemiological and infection control data were recorded during a prospective observational study conducted in a surgical unit of a tertiary-care hospital in Greece. Surveillance culture for CPKP were obtained from all patients upon admission and weekly thereafter. The Ross-Macdonald model for vector-borne diseases was applied to obtain estimates for the basic reproduction number R(0 (average number of secondary cases per primary case in the absence of infection control and assess the impact of infection control measures on CPKP containment in endemic and hyperendemic settings. Eighteen of 850 patients were colonized with CPKP on admission and 51 acquired CPKP during hospilazation. R(0 reached 2 and exceeded unity for long periods of time under the observed hand hygiene compliance (21%. The minimum hand hygiene compliance level necessary to control transmission was 50%. Reduction of 60% to 90% in colonized patients on admission, through active surveillance culture, contact precautions and isolation/cohorting, in combination with 60% compliance in hand hygiene would result in rapid decline in CPKP prevalence within 8-12 weeks. Antibiotics restrictions did not have a substantial benefit when an aggressive control strategy was implemented. CONCLUSIONS/SIGNIFICANCE: Surveillance culture on admission and isolation/cohorting of colonized patients coupled with moderate hand hygiene compliance and contact precautions may lead to rapid control of CPKP in endemic and hyperendemic healthcare settings.

  7. Transmission Dynamics of Carbapenemase-Producing Klebsiella Pneumoniae and Anticipated Impact of Infection Control Strategies in a Surgical Unit

    Science.gov (United States)

    Sypsa, Vana; Psichogiou, Mina; Bouzala, Georgia-Aikaterina; Hadjihannas, Linos; Hatzakis, Angelos; Daikos, Georgios L.

    2012-01-01

    Background Carbapenemase-producing Klebsiella pneumoniae (CPKP) has been established as important nosocomial pathogen in many geographic regions. Transmission from patient to patient via the hands of healthcare workers is the main route of spread in the acute-care setting. Methodology/Principal Findings Epidemiological and infection control data were recorded during a prospective observational study conducted in a surgical unit of a tertiary-care hospital in Greece. Surveillance culture for CPKP were obtained from all patients upon admission and weekly thereafter. The Ross-Macdonald model for vector-borne diseases was applied to obtain estimates for the basic reproduction number R0 (average number of secondary cases per primary case in the absence of infection control) and assess the impact of infection control measures on CPKP containment in endemic and hyperendemic settings. Eighteen of 850 patients were colonized with CPKP on admission and 51 acquired CPKP during hospilazation. R0 reached 2 and exceeded unity for long periods of time under the observed hand hygiene compliance (21%). The minimum hand hygiene compliance level necessary to control transmission was 50%. Reduction of 60% to 90% in colonized patients on admission, through active surveillance culture, contact precautions and isolation/cohorting, in combination with 60% compliance in hand hygiene would result in rapid decline in CPKP prevalence within 8–12 weeks. Antibiotics restrictions did not have a substantial benefit when an aggressive control strategy was implemented. Conclusions/Significance Surveillance culture on admission and isolation/cohorting of colonized patients coupled with moderate hand hygiene compliance and contact precautions may lead to rapid control of CPKP in endemic and hyperendemic healthcare settings. PMID:22859965

  8. The application of surgical navigation system using optical molecular imaging technology in orthotopic breast cancer and metastasis studies

    Science.gov (United States)

    Chi, Chongwei; Zhang, Qian; Kou, Deqiang; Ye, Jinzuo; Mao, Yamin; Qiu, Jingdan; Wang, Jiandong; Yang, Xin; Du, Yang; Tian, Jie

    2014-02-01

    Currently, it has been an international focus on intraoperative precise positioning and accurate resection of tumor and metastases. The methods such as X-rays, computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) have played an important role in preoperative accurate diagnosis. However, most of them are inapplicable for intraoperative surgery. We have proposed a surgical navigation system based on optical molecular imaging technology for intraoperative detection of tumors and metastasis. This system collects images from two CCD cameras for real-time fluorescent and color imaging. For image processing, the template matching algorithm is used for multispectral image fusion. For the application of tumor detection, the mouse breast cancer cell line 4T1-luc, which shows highly metastasis, was used for tumor model establishment and a model of matrix metalloproteinase (MMP) expressing breast cancer. The tumor-bearing nude mice were given tail vein injection of MMP 750FAST (PerkinElmer, Inc. USA) probe and imaged with both bioluminescence and fluorescence to assess in vivo binding of the probe to the tumor and metastases sites. Hematoxylin and eosin (H&E) staining was performed to confirm the presence of tumor and metastasis. As a result, one tumor can be observed visually in vivo. However liver metastasis has been detected under surgical navigation system and all were confirmed by histology. This approach helps surgeons to find orthotopic tumors and metastasis during intraoperative resection and visualize tumor borders for precise positioning. Further investigation is needed for future application in clinics.

  9. Clinicopathological study of breast diseases presenting to the surgical oncology unit of Donka University Hospital in Conakry, Guinea.

    Science.gov (United States)

    Traoré, B; Keita, M; Diane, S; Dankoro, A; Kabba, I S; Keita, N

    2012-01-01

    The aim of this study was to describe the characteristics and trends in the number of patients presenting with breast diseases (BD), their evolution in time, and the referral route. We reviewed all patients with breast disease who consulted at the Unit of Surgical Oncology of Donka from May 2007 to December 2009, examining the distribution of breast diseases. The numbers of women diagnosed with breast cancers was analysed with respect to time and referral source. There was a progressive increase in the number of patients presenting with breast diseases from year to year: 66 cases in 2007, 134 in 2008 and 227 in 2009. Of 423 patients with breast disease, 184 (43.5%) were diagnosed with breast cancer: 178 women and 6 men. Moreover, the percentage with breast cancer varied significantly according to referral route (p<10-3); 56.0% among patients referred by health professionals and 22.3% in women who self-referred. Mean age at diagnosis of breast cancer was 48 years (n=178), 52.2% were post-menopausal. Women with breast cancer had on average 4.7 full term pregnancies. The tumor was considered aggressive in 62.9% of women because of the rapidity of its evolution. Early stage at diagnosis was made only for 4.3% of the cases. The hormone receptor were positive in 4 of 13 cases (30.7%), and the Cerb2 oncogene was over expressed in 8 of 11 cases (72.7%). A better organisation of the consultation services in a unit of oncology in a developing country can allow a better sorting and a good orientation of the patients and thus allow the early detection of the breast cancer. This requires adequate awareness of the population, a better involvement and adequate training of the health professionals dedicated to the tasks. The study of the Cerb2's expression and the hormone receptor are to be considered for better understanding the aggressiveness of the breast cancer found in our practice.

  10. Adoption of precision agriculture technology in the Southeastern United States

    Science.gov (United States)

    Agricultural production in the Southeast is diverse and differs from other regions of the United States (U.S.). Crops grown in the Southeast are specific to the region, such as cotton and peanuts. Corn farmers supply most of the grain produced to the poultry industry to support over 15 billion dolla...

  11. A cross sectional study of surgical training among United Kingdom general practitioners with specialist interests in surgery.

    Science.gov (United States)

    Ferguson, H J M; Fitzgerald, J E F; Reilly, J; Beamish, A J; Gokani, V J

    2015-04-08

    Increasing numbers of minor surgical procedures are being performed in the community. In the UK, general practitioners (family medicine physicians) with a specialist interest (GPwSI) in surgery frequently undertake them. This shift has caused decreases in available cases for junior surgeons to gain and consolidate operative skills. This study evaluated GPwSI's case-load, procedural training and perceptions of offering formalised operative training experience to surgical trainees. Prospective, questionnaire-based cross-sectional study. A novel, 13-item, self-administered questionnaire was distributed to members of the Association of Surgeons in Primary Care (ASPC). A total 113 of 120 ASPC members completed the questionnaire, representing a 94% response rate. Respondents were general practitioners practising or intending to practice surgery in the community. Respondents performed a mean of 38 (range 5-150) surgical procedures per month in primary care. 37% (42/113) of respondents had previously been awarded Membership or Fellowship of a Surgical Royal College; 22% (25/113) had completed a surgical certificate or diploma or undertaken a course of less than 1 year duration. 41% (46/113) had no formal British surgical qualifications. All respondents believed that surgical training in primary care could be valuable for surgical trainees, and the majority (71/113, 63%) felt that both general practice and surgical trainees could benefit equally from such training. There is a significant volume of surgical procedures being undertaken in the community by general practitioners, with the capacity and appetite for training of prospective surgeons in this setting, providing appropriate standards are achieved and maintained, commensurate with current standards in secondary care. Surgical experience and training of GPwSI's in surgery is highly varied, and does not yet benefit from the quality assurance secondary care surgical training in the UK undergoes. The Royal Colleges of

  12. Surgical competence.

    Science.gov (United States)

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  13. United-States: the forefront of new nuclear technologies

    International Nuclear Information System (INIS)

    Le Ngoc, B.

    2015-01-01

    In the U.S. there are about 50 enterprises developing new concepts in the nuclear sector specially in power production (smaller reactors) and waste management. These enterprises require important technological and financial means to engage experts and build prototypes so U.S. authorities have developed a platform named GAIN (Gateway for Accelerated Innovation on Nuclear) for providing technological support and financing. The American Department of Energy (DoE) will keep on financing research in the nuclear sector. The American 2016 finance law provides a 9% increase for financing nuclear programmes. Research on Small Modular Reactors (SMR) with a power output ranging from 50 to 300 MW will be favored.

  14. Telecommunications technology and rural education in the United States

    Science.gov (United States)

    Perrine, J. R.

    1975-01-01

    The rural sector of the US is examined from the point of view of whether telecommunications technology can augment the development of rural education. Migratory farm workers and American Indians were the target groups which were examined as examples of groups with special needs in rural areas. The general rural population and the target groups were examined to identify problems and to ascertain specific educational needs. Educational projects utilizing telecommunications technology in target group settings were discussed. Large scale regional ATS-6 satellite-based experimental educational telecommunications projects were described. Costs and organizational factors were also examined for large scale rural telecommunications projects.

  15. Adoption of Rice Technologies Introduced by the United States ...

    African Journals Online (AJOL)

    The study determined the levels of adoption of improved rice technologies introduced by USAID MARKETS project phase one in Anambra and Ebonyi States, Nigeria. The population of the study included all project participant rice farmers of USAID MARKETS project in both Anambra and Ebonyi States. A total sample of 80 ...

  16. Recent technology for nuclear steam turbine-generator units

    International Nuclear Information System (INIS)

    Moriya, Shin-ichi; Kuwashima, Hidesumi; Ueno, Takeshi; Ooi, Masao

    1988-01-01

    As the next nuclear power plants subsequent to the present 1,100 MWe plants, the technical development of ABWRs was completed, and the plan for constructing the actual plants is advanced. As for the steam turbine and generator facilities of 1,350 MWe output applied to these plants, the TC6F-52 type steam turbines using 52 in long blades, moisture separation heaters, butterfly type intermediate valves, feed heater drain pumping-up system and other new technologies for increasing the capacity and improving the thermal efficiency were adopted. In this paper, the outline of the main technologies of those and the state of examination when those are applied to the actual plants are described. As to the technical fields of the steam turbine system for ABWRs, the improvement of the total technologies of the plants was promoted, aiming at the good economical efficiency, reliability and thermal efficiency of the whole facilities, not only the main turbines. The basic specification of the steam turbine facilities for 50 Hz ABWR plants and the main new technologies applied to the turbines are shown. The development of 52 in long last stage blades, the development of the analysis program for the coupled vibration of the large rotor system, the development of moisture separation heaters, the turbine control system, condensate and feed water system, and the generators are described. (Kako, I.)

  17. The provision of assistive technology products and services for people with dementia in the United Kingdom.

    Science.gov (United States)

    Gibson, Grant; Newton, Lisa; Pritchard, Gary; Finch, Tracy; Brittain, Katie; Robinson, Louise

    2016-07-01

    In this review we explore the provision of assistive technology products and services currently available for people with dementia within the United Kingdom. A scoping review of assistive technology products and services currently available highlighted 171 products or product types and 331 services. In addition, we assimilated data on the amount and quality of information provided by assistive technology services alongside assistive technology costs. We identify a range of products available across three areas: assistive technology used 'by', 'with' and 'on' people with dementia. Assistive technology provision is dominated by 'telecare' provided by local authorities, with services being subject to major variations in pricing and information provision; few currently used available resources for assistive technology in dementia. We argue that greater attention should be paid to information provision about assistive technology services across an increasingly mixed economy of dementia care providers, including primary care, local authorities, private companies and local/national assistive technology resources. © The Author(s) 2014.

  18. Implementation of central line-associated bloodstream infection prevention bundles in a surgical intensive care unit using peer tutoring

    Directory of Open Access Journals (Sweden)

    Sang-Won Park

    2017-10-01

    Full Text Available Abstract Background Central line-associated bloodstream infections (CLABSIs can be prevented through well-coordinated, multifaceted programs. However, implementation of CLABSI prevention programs requires individualized strategies for different institutional situations, and the best strategy in resource-limited settings is uncertain. Peer tutoring may be an efficient and effective method that is applicable in such settings. Methods A prospective intervention was performed to reduce CLABSIs in a surgical intensive care unit (SICU at a tertiary hospital. The core interventions consisted of implementation of insertion and maintenance bundles for CLABSI prevention. The overall interventions were guided and coordinated by active educational programs using peer tutoring. The CLABSI rates were compared for 9 months pre-intervention, 6 months during the intervention and 9 months post-intervention. The CLABSI rate was further observed for three years after the intervention. Results The rate of CLABSIs per 1000 catheter-days decreased from 6.9 infections in the pre-intervention period to 2.4 and 1.8 in the intervention (6 m; P = 0.102 and post-intervention (9 m; P = 0.036 periods, respectively. A regression model showed a significantly decreasing trend in the infection rate from the pre-intervention period (P < 0.001, with incidence-rate ratios of 0.348 (95% confidence interval [CI], 0.98–1.23 in the intervention period and 0.257 (95% CI, 0.07–0.91 in the post-intervention period. However, after the 9-month post-intervention period, the yearly CLABSI rates reverted to 3.0–5.4 infections per 1000 catheter-days over 3 years. Conclusions Implementation of CLABSI prevention bundles using peer tutoring in a resource-limited setting was useful and effectively reduced CLABSIs. However, maintaining the reduced CLABSI rate will require further strategies.

  19. Making Choices in the Virtual World: The New Model at United Technologies Information Network.

    Science.gov (United States)

    Gulliford, Bradley

    1998-01-01

    Describes changes in services of the United Technologies Corporation Information Network from a traditional library system to a virtual system of World Wide Web sites, a document-delivery unit, telephone and e-mail reference, and desktop technical support to provide remote access. Staff time, security, and licensing issues are addressed.…

  20. Consumer-based technology for distribution of surgical videos for objective evaluation.

    Science.gov (United States)

    Gonzalez, Ray; Martinez, Jose M; Lo Menzo, Emanuele; Iglesias, Alberto R; Ro, Charles Y; Madan, Atul K

    2012-08-01

    The Global Operative Assessment of Laparoscopic Skill (GOALS) is one validated metric utilized to grade laparoscopic skills and has been utilized to score recorded operative videos. To facilitate easier viewing of these recorded videos, we are developing novel techniques to enable surgeons to view these videos. The objective of this study is to determine the feasibility of utilizing widespread current consumer-based technology to assist in distributing appropriate videos for objective evaluation. Videos from residents were recorded via a direct connection from the camera processor via an S-video output via a cable into a hub to connect to a standard laptop computer via a universal serial bus (USB) port. A standard consumer-based video editing program was utilized to capture the video and record in appropriate format. We utilized mp4 format, and depending on the size of the file, the videos were scaled down (compressed), their format changed (using a standard video editing program), or sliced into multiple videos. Standard available consumer-based programs were utilized to convert the video into a more appropriate format for handheld personal digital assistants. In addition, the videos were uploaded to a social networking website and video sharing websites. Recorded cases of laparoscopic cholecystectomy in a porcine model were utilized. Compression was required for all formats. All formats were accessed from home computers, work computers, and iPhones without difficulty. Qualitative analyses by four surgeons demonstrated appropriate quality to grade for these formats. Our preliminary results show promise that, utilizing consumer-based technology, videos can be easily distributed to surgeons to grade via GOALS via various methods. Easy accessibility may help make evaluation of resident videos less complicated and cumbersome.

  1. The Supply and Demand of Technology and Engineering Teachers in the United States: Who Knows?

    Science.gov (United States)

    Moye, Johnny J.

    2017-01-01

    The purpose of this study was to determine the supply and demand of technology and engineering teachers in the United States. Once gathered, the resulting data (that was available) was compared to previous studies to determine trends. The researcher reviewed the 2010-11 through 2015-16 Technology & Engineering Teacher Education Directories. To…

  2. Recent technology for BWR nuclear steam turbine unit

    International Nuclear Information System (INIS)

    Moriya, Shin-ichi; Masuda, Toyohiko; Kashiwabara, Katsuto; Oshima, Yoshikuni

    1990-01-01

    As to the ABWR plants which is the third improvement standard boiling water reactor type plants, already the construction of a plant of 1356 MWe class for 50 Hz is planned. Hitachi Ltd. has accumulated the technology for the home manufacture of a whole ABWR plant including a turbine. As the results, the application of a butterfly type combination intermediate valve to No.5 plant in Kashiwazaki Kariwa Nuclear Power Station, Tokyo Electric Power Co., Inc., which began the commercial operation recently and later plants, the application of a moisture separating heater to No.4 plant in Hamaoka Nuclear Power Station, Chubu Electric Power Co., Inc., which is manufactured at present and later plants and so on were carried out. As to the steam turbine facilities for nuclear power generation manufactured by Hitachi Ltd., three turbines of 1100 MWe class for 50 Hz and one turbine for 60 Hz are in operation. As the new technologies for the steam turbines, the development of 52 in long last stage blades, the new design techniques for the rotor system, the moisture separating heater, the butterfly type combination intermediate valve, cross-around pipes and condensate and feedwater system are reported. (K.I.)

  3. Technology of research of hydroturbine unit work using seismic methods

    Science.gov (United States)

    Seleznev, V. S.; Liseikin, A. V.; Gromyko, P. V.; Soloviev, V. M.

    2013-05-01

    On August, 17, 2009 one of the most significant accident in hydropower engineering was happened at Sayano-Shushenskaya Hydroelectric Power Station. Specialists of Geophysical Survey SB RAS took part in the State Committee on investigation of the accident cause at Sayano-Shushenskaya HPS. It was determined, that the cause of the accident was a break of stud-bolts on the turbine cover. Why stud-bolts did not stand a load? There were assumptions that hydraulic shock provoked the accident. But, if it is so, seismic station "Cheremushky", situated in 4 km away from the HPS, should has a record of this event. First of all, investigating the record, got at the seismic station in the moment of the accident, it was determined that strength of seismic waves, recorded at the moment of the accident, did not exceed strength of waves got at trotyl explosion of 500 g at a distance to 4 km. The version of hydraulic shock was not proved. There were distinguished low-frequency oscillations and it was determined that the hydroturbine unit (HU) had been raised up more then 10 m in height for 10 sec. Analyzing the seismic station records during the period of more than a year before the accident and records of operating modes of different HU, there was determined that oscillations radiated by second (damaged) HU were approximately 1.5 times more intense than oscillations from all other HU. After the accident at Sayano-Shushenskaya HPS hydroturbine units were started in turns: at first there were started hydroturbine units of old construction (3, 4, 5, 6), then HP of new construction (1, 7, 8, 9). We installed 10 - 15 three-component seismic stations in different points around a HU and studied field of seismic oscillations from it's work. It was determined, that HU radiates a set of monochromatic oscillations divisible by speed of rotation equal to 2.381 Hz. Change of these signals amplitude is connected with change of HU operation modes. Research of changes in oscillations spectral

  4. No Correlation Between Work-Hours and Operative Volumes--A Comparison Between United States and Danish Operative Volumes Achieved During Surgical Residency.

    Science.gov (United States)

    Kjærgaard, Jane; Sillesen, Martin; Beier-Holgersen, Randi

    2016-01-01

    Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week. We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. Retrospective comparative study. The data from the US population was extracted from the Accreditation Council for Graduate Medical Education database for General Surgery residents from 2012 to 2013. For Danish residents, a questionnaire with case categories matching the Accreditation Council for Graduate Medical Education categories were sent to all Danish surgeons graduating the national surgical residency program in 2012 or 2013, 54 in total. In all, 30 graduated residents (55%) responded to the Danish survey. We found no significant differences in mean total major procedures (1002.4 vs 976.9, p = 0.28) performed during residency training, but comparing average major procedures per year, the US residents achieve significantly more (132.3 vs 195.4, p work-hours and operative volumes achievable. Factors other than work-hours seem to effect on operative volumes achieved during training. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Surgical Assisting

    Science.gov (United States)

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  6. Technology transfer at Three Mile Island Unit 2

    International Nuclear Information System (INIS)

    Burton, H.M.; Bixby, W.W.

    1982-01-01

    The Department of Energy (DOE) formulated a program at TMI-2 in concert with the Coordination Agreement. The DOE TME-2 Information and Examination Program (TI and EP) aims to fulfill three general objectives. First, the TI and EP aims to obtain information from the TMI-2 accidient for resolving specific safety and licensing concerns; modifying applicable standards, specifications, and regulations; and defining changes in design, maintenance, operation, and personnel training. Second, the TI and EP uses TMI-2 information to advance technology in decontamination work; radioactive waste immobilization and disposal; system requalification; damaged fuel handling; and plant, reactor, and safety engineering. Finally, the TI and EP distributes the information gained from the Program to others that are engaged in research and development, design, construction, operation, maintenance, and regulation of nuclear power plants

  7. Low-level radioactive waste disposal technologies used outside the United States

    International Nuclear Information System (INIS)

    Templeton, K.J.; Mitchell, S.J.; Molton, P.M.; Leigh, I.W.

    1994-01-01

    Low-level radioactive waste (LLW) disposal technologies are an integral part of the waste management process. In the United States, commercial LLW disposal is the responsibility of the State or groups of States (compact regions). The United States defines LLW as all radioactive waste that is not classified as spent nuclear fuel, high- level radioactive waste, transuranic waste, or by-product material as defined in Section II(e)(2) of the Atomic Energy Act. LLW may contain some long-lived components in very low concentrations. Countries outside the United States, however, may define LLW differently and may use different disposal technologies. This paper outlines the LLW disposal technologies that are planned or being used in Canada, China, Finland, France, Germany, Japan, Sweden, Taiwan, and the United Kingdom (UK)

  8. Application of CFB technology for large power generating units and CO2 capture

    International Nuclear Information System (INIS)

    Ryabov, G. A.; Folomeev, O. M.; Sankin, D. A.; Khaneev, K. V.; Bondarenko, I. G.; Mel'nikov, D. A.

    2010-01-01

    Data on the development of the circulating fluidized bed (CFB) technology for combustion of fuels in large power generating units are examined. The problems with raising the steam parameters and unit power of boilers with a circulating fluidized bed are examined. With the boiler system at the 460 MW unit at Lagisza (Poland) as an example, the feasibility of raising the efficiency of units with CFB boilers through deep recovery of the heat of the effluent gases and reducing expenditure for in-house needs is demonstrated. Comparative estimates of the capital and operating costs of 225 and 330 MW units are used to determine the conditions for optimum use of CFB boilers in the engineering renovation of thermal power plants in Russia. New areas for the application of CFB technology in CO 2 capture are analyzed in connection with the problem of reducing greenhouse gas emissions.

  9. Fewer intensive care unit refusals and a higher capacity utilization by using a cyclic surgical case schedule

    NARCIS (Netherlands)

    van Houdenhoven, Mark; van Oostrum, Jeroen M.; Wullink, Gerhard; Hans, Elias W.; Hurink, Johann L.; Bakker, Jan; Kazemier, Geert

    Purpose: Mounting health care costs force hospital managers to maximize utilization of scarce resources and simultaneously improve access to hospital services. This article assesses the benefits of a cyclic case scheduling approach that exploits a master surgical schedule (MSS). An MSS maximizes

  10. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

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

    Science.gov (United States)

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

    2018-01-01

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

  12. Control and automation technology in United States nuclear power plants

    International Nuclear Information System (INIS)

    Sun, B.K.H.

    1997-01-01

    The need to use computers for nuclear power plant design, engineering, operation and maintenance has been growing since the inception of commercial nuclear power electricity generation in the 1960s. The needs have intensified in recent years as the demands of safety and reliability, as well as economic competition, have become stronger. The rapid advance of computer hardware and software technology in the last two decades has greatly enlarged the potential of computer applications to plant instrumentation and control of future plants, as well as those needed for operation of existing plants. The traditional role of computers for mathematical calculations and data manipulation has been expanded to automate plant control functions and to enhance human performance and productivity. The major goals of using computers for instrumentation and control of nuclear power plants are (1) to improve safety; (2) to reduce challenges to the power plant; (3) to reduce the cost of operations and maintenance; (4) to enhance power production, and (5) to increase productivity of people. Many functions in nuclear power plants are achieved by a combination of human action and automation. Increasingly, computer-based systems are used to support operations and maintenance personnel in the performance of their tasks. There are many benefits which can accrue from the use of computers but it is important to ensure that the design and implementation of the support system and the human task places the human in the correct role in relation to the machine; that is, in a management position, with the computer serving the human. In addition, consideration must be given to computer system integrity, software validation and verification, consequences of error, etc., to ensure its reliability for nuclear power plant applications. (author). 31 refs

  13. Control and automation technology in United States nuclear power plants

    International Nuclear Information System (INIS)

    Sun, B.K.H.

    1995-01-01

    The need to use computers for nuclear power plant design, engineering, operation and maintenance has been growing since the inception of commercial nuclear power electricity generation in the 1960s. The needs have intensified in recent years as the demands of safety and reliability, as well as economic competition, have become stronger. The rapid advanced of computer hardware and software technology in the last two decades has greatly enlarged the potential of computer applications to plant instrumentation and control of future plants, as well as those needed for operation of existing plants. The traditional role of computers for mathematical calculations and data manipulation has been expanded to automate plant control functions and to enhance human performance and productivity. The major goals of using computers for instrumentation and control of nuclear power plants are: (1) to improve safety; (2) to reduce challenges to capital investments; (3) to reduce the cost of operations and maintenance; (4) to enhance power production; and (5) to increase productivity of people. Many functions in nuclear power plants are achieved by a combination of human action and automation. Increasingly, computer-based systems are used to support operations and maintenance personnel in the performance of their tasks. There are many benefits which can accrue from the use of computers but it is important to ensure that the design and implementation of the support system, and the human task places the human in the correct role in the relation to the machine; that is, in a management position, with the computer serving the human. In addition, consideration must be given to computer system integrity, software validation and verification, consequences of error, etc., to ensure its reliability for nuclear power plant applications. (author). 31 refs

  14. Control and automation technology in United States nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Sun, B K.H. [Sunutech, Inc., Los Altos, CA (United States)

    1997-07-01

    The need to use computers for nuclear power plant design, engineering, operation and maintenance has been growing since the inception of commercial nuclear power electricity generation in the 1960s. The needs have intensified in recent years as the demands of safety and reliability, as well as economic competition, have become stronger. The rapid advance of computer hardware and software technology in the last two decades has greatly enlarged the potential of computer applications to plant instrumentation and control of future plants, as well as those needed for operation of existing plants. The traditional role of computers for mathematical calculations and data manipulation has been expanded to automate plant control functions and to enhance human performance and productivity. The major goals of using computers for instrumentation and control of nuclear power plants are (1) to improve safety; (2) to reduce challenges to the power plant; (3) to reduce the cost of operations and maintenance; (4) to enhance power production, and (5) to increase productivity of people. Many functions in nuclear power plants are achieved by a combination of human action and automation. Increasingly, computer-based systems are used to support operations and maintenance personnel in the performance of their tasks. There are many benefits which can accrue from the use of computers but it is important to ensure that the design and implementation of the support system and the human task places the human in the correct role in relation to the machine; that is, in a management position, with the computer serving the human. In addition, consideration must be given to computer system integrity, software validation and verification, consequences of error, etc., to ensure its reliability for nuclear power plant applications. (author). 31 refs.

  15. Surgical Treatment of Subungual Squamous Cell Carcinoma by Wide Excision of the Nail Unit and Skin Graft Reconstruction: An Evaluation of Treatment Efficiency and Outcomes.

    Science.gov (United States)

    Topin-Ruiz, Solène; Surinach, Catherine; Dalle, Stéphane; Duru, Gérard; Balme, Brigitte; Thomas, Luc

    2017-05-01

    The best surgical treatment modalities for subungual squamous cell carcinoma (SUSCC) without bone invasion need to be determined. The limited available data on Mohs micrographic surgery do not demonstrate its use as a standard procedure. A previous study in a limited series of patients has shown that wide surgical excision of the nail unit was associated with a low rate of recurrence. To confirm the efficiency of wide surgical excision of the nail unit with full-thickness skin graft reconstruction on a series of patients with SUSCC with an extended follow-up and to evaluate short- and long-term postoperative morbidity and patient satisfaction. A consecutive series of 55 patients with biopsy-proven SUSCC without bone invasion treated by wide surgical excision of the nail unit followed by full-thickness skin graft reconstruction from January 1, 2000, to August 31, 2012 were included. After a minimum follow-up of 5 years, the recurrences were collected from the referring physicians. Statistical analysis was conducted from January 1 to June 30, 2016. Demographic data, pathologic characteristics of tumors, postoperative follow-up, and recurrences were collected from medical records. Patients' satisfaction with surgery, quality of life, and delayed postoperative morbidity (functional outcome and sensory disorders) were assessed from a questionnaire mailed to patients and physicians. Among the 55 patients (23 women and 32 men; mean age, 64 years), the mean follow-up was 6.6 years (range, 5.0-11.2 years), with a minimum follow-up of 5 years. Fifty-two questionnaires (95%) were returned. Two recurrences were observed. Minor early postoperative complications, such as graft infection and delayed wound healing, were seen in 6 patients; 8 patients experienced severe pain. Late postoperative complications included hypersensitivity to mechanical shocks (39 of 51 patients [76%]), mildly increased sensitivity to cold (38 of 51 patients [75%]), loss of fine touch sensation (17 of 35

  16. Effects of Patient Care Unit Design and Technology on Nurse and Patient Care Technician Communication.

    Science.gov (United States)

    Beck, Mary S; Doscher, Mindy

    2018-04-01

    The current study described RN and patient care technician (PCT) communication in centralized and hybrid decentralized workstation designs using hands-free communication technology and infrared locator badge technology to facilitate communication. New construction of an oncology unit provided the opportunity to compare staff communication in two different workstation designs. Observations and questionnaires compared nurse and PCT communication in the two-unit designs. Descriptive statistics were used to analyze the differences. The hybrid decentralized unit had increased use of hands-free communication technology and hallway communication by nurses and PCTs, and increased patient room communication by nurses. Perceptions of communication between nurses and PCTs and congruency of priorities for care were similar for both units. The locator badge technology had limited adoption. Replacement of nurse workstations with new construction or remodeling impact staff communication patterns, necessitating that nurse leaders understand the impact of design and technology on communication. [Journal of Gerontological Nursing, 44(4), 17-22.]. Copyright 2018, SLACK Incorporated.

  17. Multipurpose units: combining of technological operations of a soil cultivating and seeding

    Directory of Open Access Journals (Sweden)

    D. A. Petukhov

    2015-01-01

    Full Text Available The modern domestic market of technique for grain crops seeding differs variety of machines brands and types. The intensive type technologies combining technological operations of a soil cultivating and grain crops seeding in one pass are more widely used. The authors have established that one-operational units in new machine park have to be replaced multipurpose, universal and combined machines. Such approach will reduce number of machines in grain production from 20-30 to 5-6 name titles. Possibilities of multipurpose sowing units for simultaneous fertilizers application, soil cultivating and weeds destruction were analyzed. It was specified that nowadays there are several technologies types with two, four or six operations overlapping. Operational performance, technological and economical efficiency of the best multipurpose and also efficiency of technological operations overlapping at grain crops cultivating in the conditions of their real operation and at a trial establishment in the Kuban research institute of information and technical and economic studies of agro-industrial complex engineering and technical services were studied. Tit was defined that use of multipurpose sowing units and also studied efficiency of decreases operational costs by 48-71 percent, fuel consumption - by 41-76 percent and reduces labor input by 72-80 percent. Thus grain crops seeding is possible in optimal agrotime because of 4-6 technological operations overlapping in one pass.

  18. There′s no place like home: Boarding surgical ICU patients in other ICUs and the effect of distances from the home unit

    Science.gov (United States)

    Pascual, Jose L.; Blank, Nicholas W.; Holena, Daniel N.; Robertson, Matthew P.; Diop, Mouhamed; Allen, Steve R.; Martin, Niels D.; Kohl, Benjamin A.; Sims, Carrie A.; Schwab, C. William; Reilly, Patrick M.

    2014-01-01

    BACKGROUND Intensive care units (ICUs) function frequently at capacity, requiring incoming critically ill patients to be placed in alternate geographically distinct ICUs. In some medical ICU populations, “boarding” in an overflow ICU has been associated with increased mortality. We hypothesized that surgical ICU patients experience more complications when boarding in an overflow ICU and that the frequency of these complications are greatest in boarders farthest from the home unit (HU). METHODS A 5-year (June 2005 to June 2010) retrospective review of a prospectively maintained ICU database was performed, and demographics, severity of illness, length of stay, and incidence of ICU complications were extracted. Distances between boarding patients’ rooms and the HU were measured. Complications occurring in patients located in the same floor (BUSF) and different floor (BUDF) boarding units were compared and stratified by distance from HU to the patient room. Logistic regression was used to develop control for known confounders. RESULTS A total of 7,793 patients were admitted to the HU and 833 to a boarding unit (BUSF, n = 712; BUDF, n = 121). Boarders were younger, had a lower length of stay, and Acute Physiology and Chronic Health Evaluation II and were more of tentrauma/emergency surgery patients. Compared with in-HU patients, the incidence of aspiration pneumonia (2.2% vs. 3.6%, p boarding patients particularly if they are located on a different floor or far from the HU. When surgical ICU bed availability forces overflow admissions to non–home ICUs, greater interdisciplinary awareness, education, and training may be needed to ensure equivalent care and outcomes. LEVEL OF EVIDENCE Epidemiologic study, level III. Therapeutic study, level IV. PMID:24662877

  19. There's no place like home: boarding surgical ICU patients in other ICUs and the effect of distances from the home unit.

    Science.gov (United States)

    Pascual, Jose L; Blank, Nicholas W; Holena, Daniel N; Robertson, Matthew P; Diop, Mouhamed; Allen, Steve R; Martin, Niels D; Kohl, Benjamin A; Sims, Carrie A; Schwab, C William; Reilly, Patrick M

    2014-04-01

    Intensive care units (ICUs) function frequently at capacity, requiring incoming critically ill patients to be placed in alternate geographically distinct ICUs. In some medical ICU populations, "boarding" in an overflow ICU has been associated with increased mortality. We hypothesized that surgical ICU patients experience more complications when boarding in an overflow ICU and that the frequency of these complications are greatest in boarders farthest from the home unit (HU). A 5-year (June 2005 to June 2010) retrospective review of a prospectively maintained ICU database was performed, and demographics, severity of illness, length of stay, and incidence of ICU complications were extracted. Distances between boarding patients' rooms and the HU were measured. Complications occurring in patients located in the same floor (BUSF) and different floor (BUDF) boarding units were compared and stratified by distance from HU to the patient room. Logistic regression was used to develop control for known confounders. A total of 7,793 patients were admitted to the HU and 833 to a boarding unit (BUSF, n = 712; BUDF, n = 121). Boarders were younger, had a lower length of stay, and Acute Physiology and Chronic Health Evaluation II and were more often trauma/emergency surgery patients. Compared with in-HU patients, the incidence of aspiration pneumonia (2.2% vs. 3.6%, p boarding patients particularly if they are located on a different floor or far from the HU. When surgical ICU bed availability forces overflow admissions to non-home ICUs, greater interdisciplinary awareness, education, and training may be needed to ensure equivalent care and outcomes. Epidemiologic study, level III. Therapeutic study, level IV.

  20. Incidence, outcome and risk factors for sepsis - a two year retrospective study at surgical intensive care unit of a teaching hospital in Pakistan

    International Nuclear Information System (INIS)

    Asghar, A.; Hashmi, M.; Rashid, S.; Khan, F.H.

    2016-01-01

    Background: Sepsis is amongst the leading causes of admission to the intensive care units and is associated with a high mortality. However, data from developing countries is scarse. Aim of conducting this study was to determine the incidence, outcome and risk factors for sepsis on admission to surgical intensive care unit (SICU) of a teaching hospital in Pakistan. Methods: Two year retrospective observational study included all consecutive adult admissions to the surgical intensive care unit (SICU) of a University Hospital, from January 2012 to December 2013. Results: Two hundred and twenty-nine patients met the inclusion criteria. Average age of the patients was 46.35±18.23 years (16-85), mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 15.92±8.13 and males were 67.6 percentage. Median length of ICU stay was 4 [IQR 5]. 43 percentage patients fulfilled the criteria of sepsis at the time of admission to the SICU and incidence of severe sepsis/septic shock was 35 percentage. Abdominal sepsis was the most frequent source of infection (57.5 percentage). The overall intensive care unit mortality was 32.31 percentage but the mortality of sepsis-group was 51.15 percentage as compared to 17.7 percentage of the non-sepsis group. Stepwise logistic regression model showed that increasing age, female gender, non-operative admission, admission under general surgery and co-morbidities like ischaemic heart disease and chronic kidney disease were significant predictors of sepsis. Conclusion: The incidence of sepsis and severe sepsis/septic shock, on admission to SICU is high and mortality of the sepsis group is nearly three times the mortality of the non-sepsis group. (author)

  1. A tailored relocation stress intervention programme for family caregivers of patients transferred from a surgical intensive care unit to a general ward.

    Science.gov (United States)

    Lee, Seul; Oh, HyunSoo; Suh, YeonOk; Seo, WhaSook

    2017-03-01

    To develop and examine a relocation stress intervention programme tailored for the family caregivers of patients scheduled for transfer from a surgical intensive care unit to a general ward. Family relocation stress syndrome has been reported to be similar to that exhibited by patients, and investigators have emphasised that nurses should make special efforts to relieve family relocation stress to maximise positive contributions to the well-being of patients by family caregivers. A nonequivalent control group, nonsynchronised pretest-post-test design was adopted. The study subjects were 60 family caregivers of patients with neurosurgical or general surgical conditions in the surgical intensive care unit of a university hospital located in Incheon, South Korea. Relocation stress and family burden were evaluated at three times, that is before intervention, immediately after transfer and four to five days after transfer. This relocation stress intervention programme was developed for the family caregivers based on disease characteristics and relocation-related needs. In the experimental group, relocation stress levels significantly and continuously decreased after intervention, whereas in the control group, a slight nonsignificant trend was observed. Family burden levels in the control group increased significantly after transfer, whereas burden levels in the experimental group increased only marginally and nonsignificantly. No significant between-group differences in relocation stress or family burden levels were observed after intervention. Relocation stress levels of family caregivers were significantly decreased after intervention in the experimental group, which indicates that the devised family relocation stress intervention programme effectively alleviated family relocation stress. The devised intervention programme, which was tailored to disease characteristics and relocation-related needs, may enhance the practicality and efficacy of relocation stress

  2. Peer-to-peer nursing rounds and hospital-acquired pressure ulcer prevalence in a surgical intensive care unit: a quality improvement project.

    Science.gov (United States)

    Kelleher, Alyson Dare; Moorer, Amanda; Makic, MaryBeth Flynn

    2012-01-01

    We conducted a quality improvement project in order to evaluate the effect of nurse-to-nurse bedside "rounding" as a strategy to decrease hospital-acquired pressure ulcers (HAPU) in a surgical intensive care unit. We instituted weekly peer-to-peer bedside skin rounds in a 17-bed surgical intensive care unit. Two nurses were identified as skin champions and trained by the hospital's certified WOC nurse to conduct skin rounds. The skin champion nurses conducted weekly peer-to-peer rounds that included discussions about key elements of our patients' skin status including current Braden Scale for Pressure Sore Risk score, and implementation of specific interventions related to subscale risk assessment. If a pressure ulcer was present, the current action plan was reevaluated for effectiveness. Quarterly HAPU prevalence studies were conducted from January 2008 to December 2010. Nineteen patients experienced a HAPU: 17 were located on the coccyx and 2 on the heel. Ten ulcers were classified as stage II, 3 PU were stage IV, 5 were deemed unstageable, and 1 was classified as a deep tissue injury. The frequency of preventive interventions rose during our quality improvement project. Specifically, the use of prevention surfaces increased 92%, repositioning increased 30%, nutrition interventions increased 77%, and moisture management increased 100%. Prior to focused nursing rounds, the highest HAPU prevalence rate was 27%. After implementing focused nursing rounds, HAPU rates trended down and were 0% for 3 consecutive quarters.

  3. Interprofessional Simulations Promote Knowledge Retention and Enhance Perceptions of Teamwork Skills in a Surgical-Trauma-Burn Intensive Care Unit Setting.

    Science.gov (United States)

    George, Katie L; Quatrara, Beth

    The current state of health care encompasses highly acute, complex patients, managed with ever-changing technology. The ability to function proficiently in critical care relies on knowledge, technical skills, and interprofessional teamwork. Integration of these factors can improve patient outcomes. Simulation provides "hands-on" practice and allows for the integration of teamwork into knowledge/skill training. However, simulation can require a significant investment of time, effort, and financial resources. The Institute of Medicine recommendations from 2015 include "strengthening the evidence base for interprofessional education (IPE)" and "linking IPE with changes in collaborative behavior." In one surgical-trauma-burn intensive care unit (STBICU), no IPE existed. The highly acute and diverse nature of the patients served by the unit highlights the importance of appropriate training. This is heightened during critical event situations where patients deteriorate rapidly and the team intervenes swiftly. The aims of this study were to (1) evaluate knowledge retention and analyze changes in perceptions of teamwork among nurses and resident physicians in a STBICU setting after completion of an interprofessional critical event simulation and (2) provide insight for future interprofessional simulations (IPSs), including the ideal frequency of such training, associated cost, and potential effect on nursing turnover. A comparison-cohort pilot study was developed to evaluate knowledge retention and analyze changes in perceptions of teamwork. A 1-hour critical event IPS was held for nurses and resident physicians in a STBICU setting. A traumatic brain injury patient with elevated intracranial pressure, rapid deterioration, and cardiac arrest was utilized for the simulation scenario. The simulation required the team to use interventions to reduce elevated intracranial pressure and then perform cardiac resuscitation according to Advanced Cardiac Life Support guidelines. A

  4. Whole Language, Computers and CD-ROM Technology: A Kindergarten Unit on "Benjamin Bunny."

    Science.gov (United States)

    Balajthy, Ernest

    A kindergarten teacher, two preservice teachers, and a college consultant on educational computer technology designed and developed a 10-day whole-language integrated unit on the theme of Beatrix Potter's "Benjamin Bunny." The project was designed as a demonstration of the potential of integrating the CD-ROM-based version of…

  5. Stages of Adoption Concern and Technology Acceptance in a Critical Care Nursing Unit.

    Science.gov (United States)

    Berg, Gina M; LoCurto, Jamie; Lippoldt, Diana

    2017-09-01

    The aim of this study is to examine the stages of concern (self, task, and impact) and usability (trust, perceived usefulness, and ease of use) shifts experienced by nurses adopting new technology. Patient care processes in critical care units can be disrupted with the incorporation of information technology. New users of technology typically transition through stages of concern and experience shifts in acceptance during assimilation. Critical care nurses (N = 41) were surveyed twice: (1) pre, immediately after training, and (2) post, 3 months after implementation of technology. From presurvey to postsurvey, self-concerns decreased 14%, whereas impact concerns increased 22%. Furthermore, there was a 30% increase in trust and a 17% increase in perceived usefulness, even with a 27% decrease in ease of use. Adoption of new technology requires critical care nurses to adapt current practices, which may improve trust and perceived usefulness yet decrease perceptions of ease of use.

  6. Identifying the Infection Control Areas Requiring Modifications in Thoracic Surgery Units: Results of a Two-Year Surveillance of Surgical Site Infections in Hospitals in Southern Poland.

    Science.gov (United States)

    Dubiel, Grzegorz; Rogoziński, Paweł; Żaloudik, Elżbieta; Bruliński, Krzysztof; Różańska, Anna; Wójkowska-Mach, Jadwiga

    2017-10-01

    Surgical site infection (SSI) is considered to be a priority in infection control. The objective of this study is the analysis of results of active targeted surveillance conducted over a two-year period in the Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra, in southern Poland. The retrospective analysis was carried out on the basis of results of active monitoring of SSI in the 45-bed Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra between April 1, 2014 and April 30, 2016. Surgical site infections were identified based on the definitions of the European Centre for Disease Prevention and Control (ECDC) taking into account the time of symptom onset, specifically, whether the symptoms occurred within 30 d after the surgical procedure. Detection of SSI relied on daily inspection of incisions by a trained nurse, analysis of medical and nursing entries in the computer system, and analysis of all results of microbiologic tests taken in the unit and in the operating room. In the study period, data were collected regarding 1,387 treatment procedures meeting the registration criteria. Forty cases of SSI were detected yielding an incidence rate of 3%. Most cases (55%) were found in the course of hospitalization and 45% were detected after the patient's discharge. The SSIs were classified as follows: superficial, 37.5%; deep infections, 7.5%; and organ/space infection, 55%. Among patients who were diagnosed with SSI, most were male (77.5%). For patients with an American Society of Anesthesiologists (ASA) score I-II the incidence rate was 2%; ASA score III or more, 3.7%. The incidence rate varied from 0.3% in clean surgical site to 6.5% in clean-contaminated site. The study validated the usefulness of targeted surveillance in monitoring SSIs in patients hospitalized in thoracic surgery departments. Surgical site infection surveillance identified areas of care requiring modifications, namely

  7. Nurse-to-nurse shift handoffs on medical-surgical units: A process within the flow of nursing care.

    Science.gov (United States)

    Ernst, Katherine M; McComb, Sara A; Ley, Cathaleen

    2018-03-01

    To qualitatively investigate the medical-surgical nurse shift handoff as a process within the workflow of the exchanging nurses. Specifically, this study sought to identify the ideal handoff, ways the handoff deviated from ideal, and subsequent effect on nursing care. The functions as well as information content of the handoff have been studied. However, typical studies look at the handoff as an isolated activity utilising nurse perceptions as the primary measure of quality. Semi-structured focus groups were conducted to discuss nurses' perspectives on ideal handoffs, ways handoffs deviate from the ideal including frequent and significant deviations and the effects on subsequent care. Twenty-one medical-surgical nurses participated in one of five audio-taped focus group sessions. Three sessions were conducted at hospital A; two sessions at unaffiliated hospital B. The general inductive approach was used to analyse verbatim transcripts. Transcript segments relevant for answering the research questions were coded as ideal or not ideal. Conceptual themes were then developed. Two major themes were identified: teams/teamwork and constructing and communicating a shared understanding of the patients' conditions. The importance of nurse preparatory activities was revealed including the incoming nurses reading patients' health records and outgoing nurses rounding on patients. The impact of shared expectations was identified across the team, where teams include, in addition to the two nurses, the electronic health record, other hospital staff and patients/families with a bedside handoff. New potential nurse-centred process and outcome measures were proposed. Evaluating handoffs by their effect on the nursing performance both during and after the handoff offers a new framework to objectively assess handoff effectiveness. The handoff is a process which may significantly affect the incoming nurse's transition into and administration of nursing care. © 2018 John Wiley & Sons

  8. China, the United States, and competition for resources that enable emerging technologies

    Science.gov (United States)

    Gulley, Andrew L.; Nassar, Nedal T.; Xun, Sean

    2018-01-01

    Historically, resource conflicts have often centered on fuel minerals (particularly oil). Future resource conflicts may, however, focus more on competition for nonfuel minerals that enable emerging technologies. Whether it is rhenium in jet engines, indium in flat panel displays, or gallium in smart phones, obscure elements empower smarter, smaller, and faster technologies, and nations seek stable supplies of these and other nonfuel minerals for their industries. No nation has all of the resources it needs domestically. International trade may lead to international competition for these resources if supplies are deemed at risk or insufficient to satisfy growing demand, especially for minerals used in technologies important to economic development and national security. Here, we compare the net import reliance of China and the United States to inform mineral resource competition and foreign supply risk. Our analysis indicates that China relies on imports for over half of its consumption for 19 of 42 nonfuel minerals, compared with 24 for the United States—11 of which are common to both. It is for these 11 nonfuel minerals that competition between the United States and China may become the most contentious, especially for those with highly concentrated production that prove irreplaceable in pivotal emerging technologies.

  9. Impacts of reproductive technologies on beef production in the United States.

    Science.gov (United States)

    Dahlen, Carl; Larson, Jamie; Lamb, G Cliff

    2014-01-01

    Estimations of world population growth indicate that by the year 2050 we will reach nine billion habitants on earth. These estimates impose a tremendous challenge in the current agricultural systems as food supply will need to increase by 100 % in the next 40 years (Food and Agriculture Organization of the United Nations 2009). Beef will be a primary protein source that will assist in meeting the requirements for a portion of the protein in diets of this expanding global populace. Beef is a high-quality protein that contains all essential amino acids for the human body and also contains additional essential nutrients such as iron, zinc, B vitamins, riboflavin, selenium, choline, and conjugated linoleic acid (CLA). Adopting reproductive technologies at greater rates than currently used is a viable method to dramatically enhance production efficiency of beef cattle enterprises.Artificial insemination (AI), estrous synchronization and fixed-time AI (TAI), semen and embryo cryopreservation, multiple ovulation and embryo transfer (MOET), in vitro fertilization, sex determination of sperm or embryos, and nuclear transfer are technologies that are used to enhance the production efficiency of beef operations. In many cases, the development of these technologies is responsible for significant changes to traditional livestock production practices. However, adoption of these technologies appears to has not grown at the same rate in the United States as other formidable beef producing nations. For example, sales of beef semen for AI increased from 3.3 to 11.9 million units between 1993 and 2011 in Brazil, whereas that in the United States has increased from 2.9 to 3.8 million units during the same period. The significant increases in adoption of reproductive technologies in developing countries is likely as a result of the development of practical estrous synchronization and TAI systems that have allowed beef producers the opportunity to eliminate detection of estrus in their

  10. [Complex technology for water and wastewater disinfection and its industrial realization in prototype unit].

    Science.gov (United States)

    Arakcheev, E N; Brunman, V E; Brunman, M V; Konyashin, A V; Dyachenko, V A; Petkova, A P

    Usage of complex automated electrolysis unit for drinking water disinfection and wastewater oxidation and coagulation is scoped, its ecological and energy efficiency is shown. Properties of technological process of anolyte production using membrane electrolysis of brine for water disinfection in municipal pipelines and potassium ferrate production using electrochemical dissolution of iron anode in NaOH solution for usage in purification plants are listed. Construction of modules of industrial prototype for anolyte and ferrate production and applied aspects of automation of complex electrolysis unit are proved. Results of approbation of electrolytic potassium ferrate for drinking water disinfection and wastewater, rain water and environmental water oxidation and coagulation are shown.

  11. Enhancing the ecological and operational characteristics of water treatment units at TPPs based on baromembrane technologies

    Science.gov (United States)

    Chichirova, N. D.; Chichirov, A. A.; Filimonova, A. A.; Saitov, S. R.

    2017-12-01

    The innovative baromembrane technologies for water demineralization were introduced at Russian TPPs more than 25 years ago. While being used in the power engineering industry of Russia, these technologies demonstrated certain advantages over the traditional ion-exchange and thermal technologies of makeup water treatment for steam boilers. Water treatment units based on the baromembrane technology are compact, easy to operate, and highly automated. The experience gained from the use of these units shows that their reliability depends directly on preliminary water treatment. The popular water pretreatment technology with coagulation by aluminum oxychloride proved to be inefficient during the seasonal changes of source water quality that occurs at some stations. The use of aluminum coagulant at pH 8 and higher does not ensure the stable and qualitative pretreatment regime: soluble aluminum forms slip on membranes of the ultrafiltration unit, thereby causing pollution and intoxication as well as leading to structural damages or worsening of mechanical properties of the membranes. The problem of increased pH and seasonal changes of the source water quality can be solved by substitution of the traditional coagulant into a new one. To find the most successful coagulant for water pretreatment, experiments have been performed on both qualitative and quantitative analysis of the content of natural organic matters in the Volga water and their structure. We have developed a software program and measured the concentrations of soluble aluminum and iron salts at different pH values of the source water. The analysis of the obtained results has indicated that iron sulfate at pH 6.0-10.2, in contrast to aluminum oxychloride, is not characterized by increased solubility. Thus, the basic process diagrams of water pretreatment based on baromembrane technologies with pretreatment through coagulation by iron salts and wastewater amount reducing from 60-40 to 5-2% have been introduced for

  12. Paediatric Abdominal Surgical Emergencies in a General Surgical ...

    African Journals Online (AJOL)

    ... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...

  13. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  14. Development of tritium technology for the United States magnetic fusion energy program

    International Nuclear Information System (INIS)

    Anderson, J.L.; Wilkes, W.R.

    1980-01-01

    Tritium technology development for the DOE fusion program is taking place principally at three laboratories, Mound Facility, Argonne National Laboratory and the Los Alamos Scientific Laboratory. This paper will review the major aspects of each of the three programs and look at aspects of the tritium technology being developed at other laboratories within the United States. Facilities and experiments to be discussed include the Tritium Effluent Control Laboratory and the Tritium Storage and Delivery System for the Tokamak Fusion Test Reactor at Mound Facility; the Lithium Processing Test Loop and the solid breeder blanket studies at Argonne; and the Tritium Systems Test Assembly at Los Alamos

  15. Coverage Range and Cost Comparison of Remote Antenna Unit Designs for Inbuilding Radio over Fiber Technology

    Directory of Open Access Journals (Sweden)

    Razali Ngah

    2013-09-01

    Full Text Available Future communication needs to be ubiquitous, broadband, convergent, and seamless. Radio over fiber (RoF technology is one of the most important enabler in access network for the technologies. Adoption of RoF faces bottleneck in optoelectronics, that they are still expensive, high power consumption, and limited in bandwidth. To solve the problem, transceiver in remote antenna unit (RAU is developed, i.e. electroabsorption transceiver (EAT and asymmetric FabryPerot modulator (AFPM. This paper compares their coverage range and cost in providing WCDMA and WLAN services. Needed gain of RF amplifier for supporting picocell is also discussed.

  16. GUIDING PRINCIPLES FOR GOOD PRACTICES IN HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT UNITS.

    Science.gov (United States)

    Sampietro-Colom, Laura; Lach, Krzysztof; Pasternack, Iris; Wasserfallen, Jean-Blaise; Cicchetti, Americo; Marchetti, Marco; Kidholm, Kristian; Arentz-Hansen, Helene; Rosenmöller, Magdalene; Wild, Claudia; Kahveci, Rabia; Ulst, Margus

    2015-01-01

    Health technology assessment (HTA) carried out for policy decision making has well-established principles unlike hospital-based HTA (HB-HTA), which differs from the former in the context characteristics and ways of operation. This study proposes principles for good practices in HB-HTA units. A framework for good practice criteria was built inspired by the EFQM excellence business model and information from six literature reviews, 107 face-to-face interviews, forty case studies, large-scale survey, focus group, Delphi survey, as well as local and international validation. In total, 385 people from twenty countries have participated in defining the principles for good practices in HB-HTA units. Fifteen guiding principles for good practices in HB-HTA units are grouped in four dimensions. Dimension 1 deals with principles of the assessment process aimed at providing contextualized information for hospital decision makers. Dimension 2 describes leadership, strategy and partnerships of HB-HTA units which govern and facilitate the assessment process. Dimension 3 focuses on adequate resources that ensure the operation of HB-HTA units. Dimension 4 deals with measuring the short- and long-term impact of the overall performance of HB-HTA units. Finally, nine core guiding principles were selected as essential requirements for HB-HTA units based on the expertise of the HB-HTA units participating in the project. Guiding principles for good practices set up a benchmark for HB-HTA because they represent the ideal performance of HB-HTA units; nevertheless, when performing HTA at hospital level, context also matters; therefore, they should be adapted to ensure their applicability in the local context.

  17. Attitudes of Serbian food technology students towards surgical and immunocastration of boars and their sensitivity to androstenone and skatole

    Science.gov (United States)

    Tomasevic, I.; Đekić, I.; Font-i-Furnols, M.; Aluwé, M.; Čandek-Potokar, M.; Bonneau, M.; Weiler, U.

    2017-09-01

    Various European Union pork chain actors and stakeholders agreed in 2010 on a road map to voluntarily abandon piglet castration by 1 January 2018. Because currently in Serbia, male piglets are surgically castrated and consumers are not used to the boar taint odour and flavour, the introduction of boar meat may modify the acceptability of pork. The objective of the study was to investigate the attitudes, awareness and opinions of future Serbian food technologist towards surgical castration of boars and its alternatives, and to test their sensitivity to androstenone and skatole. We found that they were concerned about the animal welfare issues and that they were willing to pay a little more for meat from animals treated with dignity. This was more so if they were females and less so if they had had a rural upbringing. They strongly believed that surgical castration is painful for the animals, but at the same time agreed that meat from castrated pigs is of better quality. Their ambiguous attitudes regarding efficacy and quality of alternatives to surgical castration clearly indicated the knowledge gap that must be filled by appropriate modifications of the curriculum. Students demonstrated average sensitivity to both androstenone and skatole. Females exhibited higher intensities of difference in both cases.

  18. Regional Centres for Space Science and Technology Education Affiliated to the United Nations

    Science.gov (United States)

    Aquino, A. J. A.; Haubold, H. J.

    2010-05-01

    Based on resolutions of the United Nations General Assembly, Regional Centres for space science and technology education were established in India, Morocco, Nigeria, Brazil and Mexico. Simultaneously, education curricula were developed for the core disciplines of remote sensing, satellite communications, satellite meteorology, and space and atmospheric science. This paper provides a brief report on the status of the operation of the Regional Centres and draws attention to their educational activities.

  19. A comparison of the information technology knowledge of United States and German auditors

    OpenAIRE

    Greenstein-Prosch, Marilyn; McKee, Thomas E.; Quick, Reiner

    2008-01-01

    The International Federation of Accountants has stated that competence in information technology is imperative for the professional accountant due to its pervasive use in the business world. Auditors would normally be expected to have higher knowledge than the average accountant since they must audit the work of many different clients with diverse information systems. We surveyed 2,500 United States and German auditing professionals to determine their self-reported knowledge le...

  20. Support for Development of Electronics and Materials Technologies by the Governments of the United States, Japan, West Germany, France, and the United Kingdom.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    The governments of the United States, Japan, West Germany, France, and the United Kingdom each have large research and development efforts involving government agencies, universities and industry. This document provides a comparative overview of policies and programs which contribute to the development of technologies in the general area of…

  1. Regional characteristics of individual housing units in Serbia from the aspect of applied building technologies

    Directory of Open Access Journals (Sweden)

    Jovanović-Popović Milica

    2014-01-01

    Full Text Available Individual housing units in Serbia have been studied from the aspect of applied technical solutions. Analyzed data have been collected during a field research in accordance with the current administrative regional division, and they represent a basis for definition of regional typology of individual housing units. Characteristic types of objects of each region’s typology have been further analyzed. Upon these analyses regional characteristics of individual housing units regarding applied construction types, building technologies and materials have been defined and presented. [Projekat Ministarstva nauke Republike Srbije, br. TR 36034: Investigation and Systematization of Serbian Housing in Context of Globalization and European Integration in the Framework of Quality and Living-Standard Improvement

  2. The radioactive waste debate in the United States and nuclear technology for peaceful purposes

    Science.gov (United States)

    Tehan, Terrence Norbert

    Many ethical, cultural, and economic concerns have accompanied the rapid growth of Western technology. Nuclear technology in particular has experienced considerable opposition because of its perceived dangers, especially disposal of atomic waste. While this field of science remains in its infancy, many legal, political and ecological groups oppose any further application of nuclear technology--including the significant medical, environmental, and economic benefits possible from a safe and responsible application of nuclear energy. Complete and objective knowledge of this technology is needed to balance a healthy respect for the danger of atomic power with its many advantages. This study focuses on one aspect of nuclear technology that has particularly aroused political and social controversy: nuclear waste. Finding ways of disposing safely of nuclear waste has become an extremely volatile issue because of the popular misconception that there is no permanent solution to this problem. This investigation will demonstrate that the supposedly enduring waste problem has been resolved in several industrial countries that now outstrip the United States in safe commercial applications of nuclear science. This dissertation offers a reasoned and objective contribution to the continuing national debate on the peaceful uses of nuclear technology. This debate becomes more crucial as the nation seeks a dependable substitute for the non-renewable sources of energy now rapidly being exhausted.

  3. ALTERNATIVE REMEDIATION TECHNOLOGY STUDY FOR GROUNDWATER TREATMENT AT 200-PO-1 OPERABLE UNIT AT HANFORD SITE

    Energy Technology Data Exchange (ETDEWEB)

    DADO MA

    2008-07-31

    This study focuses on the remediation methods and technologies applicable for use at 200-PO-I Groundwater Operable Unit (OU) at the Hanford Site. The 200-PO-I Groundwater au requires groundwater remediation because of the existence of contaminants of potential concern (COPC). A screening was conducted on alternative technologies and methods of remediation to determine which show the most potential for remediation of groundwater contaminants. The possible technologies were screened to determine which would be suggested for further study and which were not applicable for groundwater remediation. COPCs determined by the Hanford Site groundwater monitoring were grouped into categories based on properties linking them by remediation methods applicable to each COPC group. The screening considered the following criteria. (1) Determine if the suggested method or technology can be used for the specific contaminants found in groundwater and if the technology can be applied at the 200-PO-I Groundwater au, based on physical characteristics such as geology and depth to groundwater. (2) Evaluate screened technologies based on testing and development stages, effectiveness, implementability, cost, and time. This report documents the results of an intern research project conducted by Mathew Dado for Central Plateau Remediation in the Soil and Groundwater Remediation Project. The study was conducted under the technical supervision of Gloria Cummins and management supervision of Theresa Bergman and Becky Austin.

  4. Design and Test Plans for a Non-Nuclear Fission Power System Technology Demonstration Unit

    Science.gov (United States)

    Mason, Lee; Palac, Donald; Gibson, Marc; Houts, Michael; Warren, John; Werner, James; Poston, David; Qualls, Arthur Lou; Radel, Ross; Harlow, Scott

    2012-01-01

    A joint National Aeronautics and Space Administration (NASA) and Department of Energy (DOE) team is developing concepts and technologies for affordable nuclear Fission Power Systems (FPSs) to support future exploration missions. A key deliverable is the Technology Demonstration Unit (TDU). The TDU will assemble the major elements of a notional FPS with a non-nuclear reactor simulator (Rx Sim) and demonstrate system-level performance in thermal vacuum. The Rx Sim includes an electrical resistance heat source and a liquid metal heat transport loop that simulates the reactor thermal interface and expected dynamic response. A power conversion unit (PCU) generates electric power utilizing the liquid metal heat source and rejects waste heat to a heat rejection system (HRS). The HRS includes a pumped water heat removal loop coupled to radiator panels suspended in the thermal-vacuum facility. The basic test plan is to subject the system to realistic operating conditions and gather data to evaluate performance sensitivity, control stability, and response characteristics. Upon completion of the testing, the technology is expected to satisfy the requirements for Technology Readiness Level 6 (System Demonstration in an Operational and Relevant Environment) based on the use of high-fidelity hardware and prototypic software tested under realistic conditions and correlated with analytical predictions.

  5. Attitudes of Registered and Licensed Practical Nurses About the Importance of Families in Surgical Hospital Units: Findings From the Landspitali University Hospital Family Nursing Implementation Project.

    Science.gov (United States)

    Blöndal, Katrin; Zoëga, Sigridur; Hafsteinsdottir, Jorunn E; Olafsdottir, Olof Asdis; Thorvardardottir, Audur B; Hafsteinsdottir, Sigrun A; Sveinsdóttir, Herdis

    2014-08-01

    The purpose of this study was to examine attitudes of registered nurses and licensed practical nurses about the importance of the family in surgical hospital units before (T1) and after (T2) implementation of a Family Systems Nursing educational intervention based on the Calgary Family Assessment and Intervention Models. This study was part of the Landspitali University Hospital Family Nursing Implementation Project and used a nonrandomized, quasi-experimental design with nonequivalent group before and after and without a control group. There were 181 participants at T1 and 130 at T2. No difference was found in nurses' attitudes as measured by the Families Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire, before and after the educational intervention. Attitudes toward families were favorable at both times. Analysis of demographic variables showed that age, work experience, and workplace (inpatient vs. outpatient units) had an effect on the nurses' attitudes toward families. The influence of work experience on attitudes toward family care warrants further exploration. © The Author(s) 2014.

  6. Research on Key Technologies of Unit-Based CNC Machine Tool Assembly Design

    Directory of Open Access Journals (Sweden)

    Zhongqi Sheng

    2014-01-01

    Full Text Available Assembly is the part that produces the maximum workload and consumed time during product design and manufacturing process. CNC machine tool is the key basic equipment in manufacturing industry and research on assembly design technologies of CNC machine tool has theoretical significance and practical value. This study established a simplified ASRG for CNC machine tool. The connection between parts, semantic information of transmission, and geometric constraint information were quantified to assembly connection strength to depict the assembling difficulty level. The transmissibility based on trust relationship was applied on the assembly connection strength. Assembly unit partition based on assembly connection strength was conducted, and interferential assembly units were identified and revised. The assembly sequence planning and optimization of parts in each assembly unit and between assembly units was conducted using genetic algorithm. With certain type of high speed CNC turning center, as an example, this paper explored into the assembly modeling, assembly unit partition, and assembly sequence planning and optimization and realized the optimized assembly sequence of headstock of CNC machine tool.

  7. Identification of Promising Remediation Technologies for Iodine in the UP-1 Operable Unit

    Energy Technology Data Exchange (ETDEWEB)

    Strickland, Christopher E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Johnson, Christian D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lee, Brady D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Qafoku, Nikolla [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Szecsody, James E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Truex, Michael J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Vermeul, Vincent R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2017-09-01

    Iodine-129 (129I) generated at the U.S. Department of Energy (DOE) Hanford Site during plutonium production was released to the subsurface, resulting in several large, though dilute, plumes in the groundwater, including the plume in the 200-UP-1 operable unit (OU). Because 129I is an uncommon contaminant, relevant remediation experience and scientific literature are limited, though work is under way to better understand the fate and transport of 129I in the environment and the effectiveness of potential remediation technologies. The recent UP-1 Evaluation Plan for Iodine and report on the Conceptual Model of Iodine Behavior in the Subsurface at the Hanford Site provide information on the history of contamination in the 200-UP-1 OU, relevant controlling processes (biological and geochemical), risk, the conceptual site model, and potential remedial options, which provided a foundation for this study. In this study, available information was compiled and used to categorize potential remediation technologies, culminating in a recommendation of promising technologies for further evaluation. Approaches to improve the technical information about promising technologies are also recommended in this study so that a subsequent evaluation of potential remediation alternatives can assess these technologies.

  8. Improved nurse job satisfaction and job retention with the transition from a "mandatory consultation" model to a "semiclosed" surgical intensive care unit: a 1-year prospective evaluation.

    Science.gov (United States)

    Haut, Elliott R; Sicoutris, Corinna P; Meredith, Denise M; Sonnad, Seema S; Reilly, Patrick M; Schwab, C William; Hanson, C William; Gracias, Vicente H

    2006-02-01

    The change from a "mandatory consultation" to a "semiclosed" surgical intensive care unit (SICU) model will impact nurses considerably. We hypothesize that nurse job satisfaction, job turnover rates, and hospital costs for temporary agency nurses will improve and these improvements will be more dramatic in SICU sections with greater involvement of a dedicated surgical critical care service (SCCS). Prospective longitudinal survey. Tertiary-care university hospital. SICU staff nurses. Change from mandatory consultation to semiclosed SICU. We surveyed SICU nurses during the year-long transition to a semiclosed SICU service (five time points, 3-month intervals). The first four surveys included ten questions on nurse job satisfaction. The final survey included two additional questions. All questions were on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Nurse job turnover rates and money spent on agency nurses were compared over time; 503 of a possible 914 surveys were completed (55% overall return rate). Nurse job satisfaction scores significantly improved over time for all questions (p job turnover rate dropped from 25% to 16% (p = .15). The scores for both year-end statements ("I am more satisfied with my job now than 1 year ago" and "The SCCS management of all orders has improved my job satisfaction") were significantly higher in sections with greater SCCS involvement (p = .0070 and p job satisfaction improved significantly with the transition to a semiclosed SICU. This higher satisfaction was associated with a significant decrease in spending on temporary agency nurses and a trend toward increased staff nurse job retention. SICU sections with greater SCCS involvement had more dramatic improvements. This semiclosed SICU model may help retain SICU nurses in a competitive job market in which experienced nurses are in short supply.

  9. Surgical smoke.

    Science.gov (United States)

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

  10. Propulsion Control Technology Development in the United States A Historical Perspective

    Science.gov (United States)

    Jaw, Link C.a; Garg, Sanjay

    2005-01-01

    This paper presents a historical perspective of the advancement of control technologies for aircraft gas turbine engines. The paper primarily covers technology advances in the United States in the last 60 years (1940 to approximately 2002). The paper emphasizes the pioneering technologies that have been tested or implemented during this period, assimilating knowledge and experience from industry experts, including personal interviews with both current and retired experts. Since the first United States-built aircraft gas turbine engine was flown in 1942, engine control technology has evolved from a simple hydro-mechanical fuel metering valve to a full-authority digital electronic control system (FADEC) that is common to all modern aircraft propulsion systems. At the same time, control systems have provided engine diagnostic functions. Engine diagnostic capabilities have also evolved from pilot observation of engine gauges to the automated on-board diagnostic system that uses mathematical models to assess engine health and assist in post-flight troubleshooting and maintenance. Using system complexity and capability as a measure, we can break the historical development of control systems down to four phases: (1) the start-up phase (1942 to 1949), (2) the growth phase (1950 to 1969), (3) the electronic phase (1970 to 1989), and (4) the integration phase (1990 to 2002). In each phase, the state-of-the-art control technology is described and the engines that have become historical landmarks, from the control and diagnostic standpoint, are identified. Finally, a historical perspective of engine controls in the last 60 years is presented in terms of control system complexity, number of sensors, number of lines of software (or embedded code), and other factors.

  11. Functional unit, technological dynamics, and scaling properties for the life cycle energy of residences.

    Science.gov (United States)

    Frijia, Stephane; Guhathakurta, Subhrajit; Williams, Eric

    2012-02-07

    Prior LCA studies take the operational phase to include all energy use within a residence, implying a functional unit of all household activities, but then exclude related supply chains such as production of food, appliances, and household chemicals. We argue that bounding the functional unit to provision of a climate controlled space better focuses the LCA on the building, rather than activities that occur within a building. The second issue explored in this article is how technological change in the operational phase affects life cycle energy. Heating and cooling equipment is replaced at least several times over the lifetime of a residence; improved efficiency of newer equipment affects life cycle energy use. The third objective is to construct parametric models to describe LCA results for a family of related products. We explore these three issues through a case study of energy use of residences: one-story and two-story detached homes, 1,500-3,500 square feet in area, located in Phoenix, Arizona, built in 2002 and retired in 2051. With a restricted functional unit and accounting for technological progress, approximately 30% of a building's life cycle energy can be attributed to materials and construction, compared to 0.4-11% in previous studies.

  12. Development of radiation protection technology for application of the retired steam generator, Kori Unit no. 1

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. H.; Jang, D. C.; Song, K. S.; Lee, S. J.; Ahn, C. S.; Kim, D. H.; Im, Y. K.; Kim, H. D. [Hanil Nuclear Co., Ltd., Anyang (Korea, Republic of)

    2005-04-15

    It is a field study to develop and verify maintenance technologies such as verification and technology development of ECT (Eddy current test) using failure, heat tube excavation and field pressure test regarding the utilization of retired steam generator using 2 units of Retired Steam Generator in Kori 1 that was replaced for the first time in Korea in 1998. Since May, 2003, our team has investigated Retired Steam Generator which was stored in Radioactive waste warehouse in Korea Hydro and Nuclear Power Kori unit no.1 Branch, in order to study natural fault ECT signal acquisition, maintenance technology verification, small tubes/samples abstraction. A temporal task zone was made focusing on 'Man Way at the bottom of Chamber 'A'.' The purpose of the study is to establish Radiological Protection and Radioactive Waste Treatment Plan by setting ALARA (As Low As Reasonably Achievable) goal systematically, which is the basic concept of Radiological Protection and reduction in exposure of radiological workers to radioactive materials with proper Radiological Protection countermeasures according to the changes in radioactivity, to prevent expansion from contamination and to manage 'Radioactive Waste Reduction Activities' effectively.

  13. Size matters: Installed maximal unit size predicts market life cycles of electricity generation technologies and systems

    International Nuclear Information System (INIS)

    Li, N.

    2008-01-01

    The electricity generation technologies and systems are complex and change in very dynamic fashions, with a multitude of energy sources and prime movers. Since an important concept in generator design is the 'economies of scale', we discover that the installed maximal unit size (capacity) of the generators is a key 'envelope-pushing' characteristic with logistical behaviors. The logistical wavelet analysis of the max unit sizes for different fuels and prime movers, and the cumulative capacities, reveals universal quantitative features in the aggregate evolution of the power industry. We extract the transition times of the max sizes (spanning 10-90% of the saturation limits) for different technologies and systems, and discover that the max size saturation in the 90-99% range precedes the saturation of cumulative capacities of the corresponding systems in the US. While these universal laws are still empirical, they give us a simple yet elegant framework to examine the evolution of the power industry and markets in predictive, not just descriptive, terms. Such laws give us a quantitative tool to spot trends and predict future development, invaluable in planning and resource allocation based on intrinsic technology and system market life cycles

  14. Technology and place: A geography of waste-to-energy in the United States

    Science.gov (United States)

    Howell, Jordan Patterson

    The adoption of technologies differs across space, for reasons attributed to economics, politics, and culture, but also due to limitations imposed by both the physical environment and the technology itself. This dissertation considers the case of waste-to-energy (WTE) incinerators in the United States, and asks why this technology is used in some places but rejected in others. The answer to this simple question is remarkably complex, as understandings and arguments about technology and the environment are mobilized differently by various actors to champion, oppose, or in some cases remain ambivalent about the installation and operation of WTE facilities. In this dissertation I explore the geography of WTE incineration in the United States since the 19th century. Informed by the insights of actor-network theory and the social construction of technology school, I employ the tools of discourse analysis to examine published and unpublished statements, papers, project studies, policy briefs, and archival materials generated alongside the development of WTE facilities in the United States, considering the specific case studies discussed below but also WTE technology in general. I look at federal, state, and local environmental agency documents as well as the papers of consulting firms, environmental and industry advocacy groups, and private companies. I also devote significant attention to the analysis of news media outlets in communities where WTE facilities are located or have been considered. In addition to these literal texts, I examine non-written and visual materials associated with WTE facilities, including films, websites, signage and logos, advertising campaigns, facility architecture, and artwork, as well as more abstract `texts' such as industry conferences, trade-show handouts, promotional materials, and academic and industry research programs. I build on this textual analysis with observations of WTE facilities in action. After an introductory chapter, I

  15. A fate worse than death? Long-term outcome of trauma patients admitted to the surgical intensive care unit.

    Science.gov (United States)

    Livingston, David H; Tripp, Tovah; Biggs, Carina; Lavery, Robert F

    2009-08-01

    Trauma centers successfully save lives of severely injured patients who would have formerly died. However, survivors often have multiple complications and morbidities associated with prolonged intensive care unit (ICU) stays. Because the reintegration of patients into the society to lead an active and a productive life is the ultimate goal of trauma center care, we questioned whether our "success" may condemn these patients to a fate worse than death? Charts on all patients > or =18 years with ICU stay > or =10 days, discharged alive between June 1, 2002, and May 31, 2005, were reviewed. Patients with complete spinal cord injuries were excluded. Demographics, Injury Severity Score (ISS), presence of severe traumatic brain injury (TBI; Head Abbreviated Injury Scale [AIS] score = 4 or 5), presence of extremity fractures, need for operative procedures, ventilator days, complications, and discharge disposition were collected. Glasgow Outcome Scale score was calculated on discharge. Patients were contacted by phone to determine general health, work status, and using this data, Glasgow Outcome Scale score and a modified Functional Independence Measure (FIM) score were calculated. Two hundred and forty-one patients met inclusion criteria. Thirty-three patients died postdischarge from the hospital and 39 were known to be alive from the electronic medical records but were unable to be contacted. Sixty-nine patients could not be tracked down and were ultimately considered as lost to follow-up. The remaining 100 patients who were successfully contacted participated in the study. Eighty-one percent were men with a mean age of 42 years, mean and median ISS of 28. Severe TBI was present in 50 (50%) patients. Mean and median follow-up was 3.3 years from discharge. At the time of follow-up, 92 (92%) patients were living at home, 5 in nursing homes, and 3 in assisted living, a shelter, or halfway house. FIM scores ranged from 6 to 12 with 55% reached a maximal FIM score of 12. One

  16. Robust technology and system for management of sucker rod pumping units in oil wells

    Science.gov (United States)

    Aliev, T. A.; Rzayev, A. H.; Guluyev, G. A.; Alizada, T. A.; Rzayeva, N. E.

    2018-01-01

    We propose a technology for calculating the robust, normalized correlation functions of the signal from the force sensor on the rod string attached to the hanger of the sucker rod pumping unit. The robust normalized correlation functions are used to form sets of informative attribute combinations, each of which corresponds to a technical condition of the sucker rod pumping unit. We demonstrate how these sets can be used to solve identification and management problems in the oil production process in real time using inexpensive controllers. The results obtained from using the system on real objects are also presented in this paper. It was determined that the energy saved and prolonged overhaul period substantially increased the cost-effectiveness.

  17. The technology of the bearings used in the nuclear power generation system turbine generator units

    International Nuclear Information System (INIS)

    Vialettes, J.M.; Rossato, M.

    1997-01-01

    A bearing consists of all the stationary part which allow the relative motion in rotation or in translation, of a shaft line. Inside the bearing there is a journal bearing with a metallic anti-friction coating (the babbitt metal). The high power turbine generator unit rotors are supported by smooth transversal journal bearings fed with oil which fills the empty space and runs along the shaft. The technologies used for the bearings and the thrust bearings of the turbine generator units and the various shaft lines of the French CP0/CP1- and CP2/1300 MW-type nuclear power plants are described. The experience feedback is then discussed in terms of the dynamics of the shaft line, i.e. vibrational problems, the influence of the alignment and the babbitt metal incidents. (author)

  18. Groundwater Monitoring Plan for the Reactor Technology Complex Operable Unit 2-13

    International Nuclear Information System (INIS)

    Richard P. Wells

    2007-01-01

    This Groundwater Monitoring Plan describes the objectives, activities, and assessments that will be performed to support the on-going groundwater monitoring requirements at the Reactor Technology Complex, formerly the Test Reactor Area (TRA). The requirements for groundwater monitoring were stipulated in the Final Record of Decision for Test Reactor Area, Operable Unit 2-13, signed in December 1997. The monitoring requirements were modified by the First Five-Year Review Report for the Test Reactor Area, Operable Unit 2-13, at the Idaho National Engineering and Environmental Laboratory to focus on those contaminants of concern that warrant continued surveillance, including chromium, tritium, strontium-90, and cobalt-60. Based upon recommendations provided in the Annual Groundwater Monitoring Status Report for 2006, the groundwater monitoring frequency was reduced to annually from twice a year

  19. Development of interface technology between unit processes in E-Refining process

    Energy Technology Data Exchange (ETDEWEB)

    Lee, S. H.; Lee, H. S.; Kim, J. G. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2010-10-15

    The pyroprocessing is composed mainly four subprocesses, such as an electrolytic reduction, an electrorefining, an electrowinning, and waste salt regeneration/ solidification processes. The electrorefining process, one of main processes which are composed of pyroprocess to recover the useful elements from spent fuel, is under development by Korea Atomic Energy Research Institute as a sub process of pyrochemical treatment of spent PWR fuel. The CERS(Continuous ElectroRefining System) is composed of some unit processes such as an electrorefiner, a salt distiller, a melting furnace for the U-ingot and U-chlorinator (UCl{sub 3} making equipment) as shown in Fig. 1. In this study, the interfaces technology between unit processes in E-Refining system is investigated and developed for the establishment of integrated E-Refining operation system as a part of integrated pyroprocessing

  20. Needs assessment for remote systems technology at the Chornobyl Unit 4 shelter

    International Nuclear Information System (INIS)

    Carteret, B.A.; Holliday, M.A.; Jones, E.D.

    1997-12-01

    The accident at Chornobyl Unit 4 on April 26, 1986, resulted in a series of unprecedented scientific and technical challenges. The reactor building was damaged extensively. Following the accident, immediate action was needed to seal off the gaping crater created by the accident, which was a continuing source of airborne contamination. Under extreme conditions, a structure called the open-quotes Shelterclose quotes was built over the remains of the reactor building. The Shelter, which was quickly completed in November 1986, was meant to provide immediate but temporary containment. Now, 11 years later, there are significant concerns about its structural integrity and projected life expectancy. The United States and other participating G-7 countries are supporting nuclear safety upgrade efforts in Eastern Europe with a primary focus on placing the Chornobyl Nuclear Power Plant (ChNPP) Unit 4 Shelter in a stable and environmentally acceptable condition. Application of remote systems technologies will play an important part in achieving the goals of this program. The G-7 nations have agreed to support these efforts, including the identification and development of remote system technologies for fuel removal. However at this time they have taken a firm stance against funding actual fuel removal activities. The U.S. Department of Energy Office of Nuclear Energy, Science and Technology requested that a needs assessment be performed to evaluate the requirements for applying remote systems, including robotics, at the Shelter. This document is intended to be used to identify remote systems needs and requirements at the Shelter and to provide general information on the conditions in the Shelter that could impact the use of remote systems. This document is intended as a source of information to assist those who will be implementing the Shelter Implementation Plan tasks. The document provides background information and general guidance on the application of remote systems

  1. Quality and productivity drive innovation and improvement at United Technologies Aerospace Operations, Inc.

    Science.gov (United States)

    Jamar, L. G.

    1986-01-01

    Quality and innovation are the hallmarks of the national space program. In programs that preceded the Shuttle Program the emphasis was on meeting the risks and technical challenges of space with safety, quality, reliability, and success. At United Technologies Aerospace Operations, Inc. (UTAO), the battle has developed along four primary fronts. These fronts include programs to motivate and reward people, development and construction of optimized processes and facilities, implementation of specifically tailored management systems, and the application of appropriate measurement and control systems. Each of these initiatives is described. However, to put this quality and productivity program in perspective, UTAO and its role in the Shuttle Program are described first.

  2. Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery.

    Science.gov (United States)

    Chung, Eric

    2017-07-01

    Male stress urinary incontinence (SUI) remains a debilitating condition that adversely impacts all domains of quality of life and is associated with significant social stigma and health economic burden. The incidence of post-prostatectomy urinary incontinence (PPI) depends on the definition of urinary incontinence and the length of patient follow up. In patients with persistent PPI following failure of conservative measures, surgical treatment is recommended although there is no published guideline on when surgery should be performed, and what the best surgical option is. Male slings (MS) can be divided into adjustable or non-adjustable types, and offers an attractive option for patients who wish to avoid mechanical handling during urinary voiding. Published intermediate data supports good safety and efficacy rate in men with mild to moderate degree of SUI. The AMS 800 artificial urinary sphincter (AUS) remains the standard of treatment for complete continence and has the longest efficacy and safety records. Other AUS-like devices are designed to address current AMS 800 limitations but themselves are fraught with their own issues.

  3. Different patterns of inappropriate antimicrobial use in surgical and medical units at a tertiary care hospital in Switzerland: a prevalence survey.

    Directory of Open Access Journals (Sweden)

    Alexia Cusini

    Full Text Available BACKGROUND: Unnecessary or inappropriate use of antimicrobials is associated with the emergence of antimicrobial resistance, drug toxicity, increased morbidity and health care costs. Antimicrobial use has been reported to be incorrect or not indicated in 9-64% of inpatients. We studied the quality of antimicrobial therapy and prophylaxis in hospitalized patients at a tertiary care hospital to plan interventions to improve the quality of antimicrobial prescription. METHODOLOGY/PRINCIPAL FINDINGS: Experienced infectious diseases (ID fellows performed audits of antimicrobial use at regular intervals among all patients--with or without antimicrobials--hospitalized in predefined surgical, medical, haemato-oncological, or intensive care units. Data were collected from medical and nursing patient charts with a standardized questionnaire. Appropriateness of antimicrobial use was evaluated using a modified algorithm developed by Gyssens et al.; the assessment was double-checked by a senior ID specialist. We evaluated 1577 patients of whom 700 (44.4% had antimicrobials, receiving a total of 1270 prescriptions. 958 (75.4% prescriptions were for therapy and 312 (24.6% for prophylaxis. 37.0% of therapeutic and 16.6% of prophylactic prescriptions were found to be inappropriate. Most frequent characteristics of inappropriate treatments included: No indication (17.5%; incorrect choice of antimicrobials (7.6%; incorrect application of drugs (9.3%; and divergence from institutional guidelines (8%. Characteristics of inappropriate prophylaxes were: No indication (9%; incorrect choice of antimicrobials (1%; duration too long or other inappropriate use (6.7%. Patterns of inappropriate antimicrobial varied widely in the different hospital units; empirical prescriptions were more frequently incorrect than prescriptions based on available microbiological results. CONCLUSIONS/SIGNIFICANCE: Audits of individual patient care provide important data to identify local

  4. Surgical Navigation Technology Based on Augmented Reality and Integrated 3D Intraoperative Imaging: A Spine Cadaveric Feasibility and Accuracy Study.

    Science.gov (United States)

    Elmi-Terander, Adrian; Skulason, Halldor; Söderman, Michael; Racadio, John; Homan, Robert; Babic, Drazenko; van der Vaart, Nijs; Nachabe, Rami

    2016-11-01

    A cadaveric laboratory study. The aim of this study was to assess the feasibility and accuracy of thoracic pedicle screw placement using augmented reality surgical navigation (ARSN). Recent advances in spinal navigation have shown improved accuracy in lumbosacral pedicle screw placement but limited benefits in the thoracic spine. 3D intraoperative imaging and instrument navigation may allow improved accuracy in pedicle screw placement, without the use of x-ray fluoroscopy, and thus opens the route to image-guided minimally invasive therapy in the thoracic spine. ARSN encompasses a surgical table, a motorized flat detector C-arm with intraoperative 2D/3D capabilities, integrated optical cameras for augmented reality navigation, and noninvasive patient motion tracking. Two neurosurgeons placed 94 pedicle screws in the thoracic spine of four cadavers using ARSN on one side of the spine (47 screws) and free-hand technique on the contralateral side. X-ray fluoroscopy was not used for either technique. Four independent reviewers assessed the postoperative scans, using the Gertzbein grading. Morphometric measurements of the pedicles axial and sagittal widths and angles, as well as the vertebrae axial and sagittal rotations were performed to identify risk factors for breaches. ARSN was feasible and superior to free-hand technique with respect to overall accuracy (85% vs. 64%, P dimensions, except for vertebral body axial rotation, were risk factors for larger breaches when performed with the free-hand method. ARSN without fluoroscopy was feasible and demonstrated higher accuracy than free-hand technique for thoracic pedicle screw placement. N/A.

  5. Use of solidification/stabilization treatment technology for environmental remediation in the United States and Canada

    International Nuclear Information System (INIS)

    Wilk, C.M.

    2002-01-01

    In the United States (U.S.) Solidification/Stabilization (S/S) treatment is used to treat hazardous wastes for disposal, and in the remediation/site restoration of contaminated land. S/S is also an increasingly popular technology for Brownfields (industrial property) redevelopment since treated wastes can often be left on-site and to actually improve the site's soil for subsequent construction. The U.S. Environmental Protection Agency (EPA) considers S/S to be an established treatment technology. EPA has identified S/S treatment as Best Demonstrated Available Treatment Technology (BDAT) for at least 57 commonly produced industrial wastes (Resource Conservation and Recovery Act (RCRA)-listed hazardous wastes) and has selected S/S treatment for 25% of its Superfund (abandoned or uncontrolled) site remediation projects. S/S treatment involves mixing a binding reagent into the contaminated media or waste. Successful treatment is accomplished through physical changes to the waste form, and often, chemical changes to the hazardous constituents themselves. Commonly used S/S binding reagents in include portland cement, cement kiln dust, lime, lime kiln dust and fly ash. These materials are used alone or in combination. Proprietary reagents are also beginning to be marketed and used in the U.S. and Canada. This paper will discuss: (a) applicability of the technology to various wastes, (b) basic cement chemistry relating to S/S, (c) tests used to design treatability studies and to verify treatment, (d) basics on implementation of the technology in the field, and (e) examples of actual projects. (author)

  6. An Examination of Information Technology and Its Perceived Quality Issues in Single System Hospitals in the United States

    Science.gov (United States)

    Byrd, Linda W.

    2009-01-01

    The safety and quality of healthcare is of great concern in the United States. The positive effects of information technology reported in past research, especially case studies, has encouraged expectations that information technology may increase the quality of healthcare while reducing costs of healthcare. The goals of this study was to examine…

  7. Increasing use of less-invasive hemodynamic monitoring in 3 specialty surgical intensive care units: a 5-year experience at a tertiary medical center.

    Science.gov (United States)

    Kirton, Orlando C; Calabrese, Rebecca C; Staff, Ilene

    2015-01-01

    Less-invasive hemodynamic monitoring (eg, esophageal doppler monitoring [EDM] and arterial pressure contour analysis, FloTrac) is increasingly used as an alternative to pulmonary artery catheters (PACs) in critically ill intensive care unit (ICU). The decrease in use of PACs is not associated with increased mortality. Five-year retrospective review of 1894 hemodynamically monitored patients admitted to 3 surgical ICUs in a university-affiliate, tertiary care urban hospital. Data included the number of admissions, diagnosis-related group discharge case mix, length of stay, insertion of monitoring devices (PAC, EDM, and FloTrac probes), administered intravenous vasoactive agents (β-predominant agonists--dobutamine, epinephrine, and dopamine; vasopressors--norepinephrine and phenylephrine), and mortality. Data from hospital administrative databases were compiled to create patient characteristic and monitoring variables across a 5-year time period, 2005 to 2009 inclusive. Chi-square for independent proportions, 1-way analysis of variance, and Kruskal-Wallis tests were used; tests for trend were conducted. An α level of .05 was considered significant. Statistical Package for the Social Sciences v14 was used for all statistical testing. There was a significant change in the type of hemodynamic monitors inserted in 2 of the 3 surgical ICUs (in the general surgery and neurointensive care but not in the cardiac ICU) from PACs to less-invasive devices (FloTrac or EDM) during the 5-year study period (P < .001). There was no change in mortality rate over the time period (P = .492). There was an overall increase in the proportion of monitored patients who received intravenous vasoactive agents (P < .001) with a progressive shift from β-agonists to vasopressors (P < .002). Multivariate analyses indicated that age, case mix, and use of vasoactive agents were all independent predictors of inhospital mortality (P = .001) but that type of monitoring was not (P = .638). In a 5

  8. Reliability of wireless monitoring using a wearable patch sensor in high-risk surgical patients at a step-down unit in the Netherlands: a clinical validation study.

    Science.gov (United States)

    Breteler, Martine J M; Huizinga, Erik; van Loon, Kim; Leenen, Luke P H; Dohmen, Daan A J; Kalkman, Cor J; Blokhuis, Taco J

    2018-02-27

    Intermittent vital signs measurements are the current standard on hospital wards, typically recorded once every 8 hours. Early signs of deterioration may therefore be missed. Recent innovations have resulted in 'wearable' sensors, which may capture patient deterioration at an earlier stage. The objective of this study was to determine whether a wireless 'patch' sensor is able to reliably measure respiratory and heart rate continuously in high-risk surgical patients. The secondary objective was to explore the potential of the wireless sensor to serve as a safety monitor. In an observational methods comparisons study, patients were measured with both the wireless sensor and bedside routine standard for at least 24 hours. University teaching hospital, single centre. Twenty-five postoperative surgical patients admitted to a step-down unit. Primary outcome measures were limits of agreement and bias of heart rate and respiratory rate. Secondary outcome measures were sensor reliability, defined as time until first occurrence of data loss. 1568 hours of vital signs data were analysed. Bias and 95% limits of agreement for heart rate were -1.1 (-8.8 to 6.5) beats per minute. For respiration rate, bias was -2.3 breaths per minute with wide limits of agreement (-15.8 to 11.2 breaths per minute). Median filtering over a 15 min period improved limits of agreement of both respiration and heart rate. 63% of the measurements were performed without data loss greater than 2 min. Overall data loss was limited (6% of time). The wireless sensor is capable of accurately measuring heart rate, but accuracy for respiratory rate was outside acceptable limits. Remote monitoring has the potential to contribute to early recognition of physiological decline in high-risk patients. Future studies should focus on the ability to detect patient deterioration on low care environments and at home after discharge. © Article author(s) (or their employer(s) unless otherwise stated in the text of

  9. A Prospective, Single Arm, Multi-site, Clinical Evaluation of a Nonradioactive Surgical Guidance Technology for the Location of Nonpalpable Breast Lesions during Excision.

    Science.gov (United States)

    Cox, Charles E; Russell, Scott; Prowler, Vanessa; Carter, Ebonie; Beard, Abby; Mehindru, Ankur; Blumencranz, Peter; Allen, Kathleen; Portillo, Michael; Whitworth, Pat; Funk, Kristi; Barone, Julie; Norton, Denise; Schroeder, Jerome; Police, Alice; Lin, Erin; Combs, Freddie; Schnabel, Freya; Toth, Hildegard; Lee, Jiyon; Anglin, Beth; Nguyen, Minh; Canavan, Lynn; Laidley, Alison; Warden, Mary Jane; Prati, Ronald; King, Jeff; Shivers, Steven C

    2016-10-01

    This study was a multicenter evaluation of the SAVI SCOUT(®) breast localization and surgical guidance system using micro-impulse radar technology for the removal of nonpalpable breast lesions. The study was designed to validate the results of a recent 50-patient pilot study in a larger multi-institution trial. The primary endpoints were the rates of successful reflector placement, localization, and removal. This multicenter, prospective trial enrolled patients scheduled to have excisional biopsy or breast-conserving surgery of a nonpalpable breast lesion. From March to November 2015, 154 patients were consented and evaluated by 20 radiologists and 16 surgeons at 11 participating centers. Patients had SCOUT(®) reflectors placed up to 7 days before surgery, and placement was confirmed by mammography or ultrasonography. Implanted reflectors were detected by the SCOUT(®) handpiece and console. Presence of the reflector in the excised surgical specimen was confirmed radiographically, and specimens were sent for routine pathology. SCOUT(®) reflectors were successfully placed in 153 of 154 patients. In one case, the reflector was placed at a distance from the target that required a wire to be placed. All 154 lesions and reflectors were successfully removed during surgery. For 101 patients with a preoperative diagnosis of cancer, 86 (85.1 %) had clear margins, and 17 (16.8 %) patients required margin reexcision. SCOUT(®) provides a reliable and effective alternative method for the localization and surgical excision of nonpalpable breast lesions using no wires or radioactive materials, with excellent patient, radiologist, and surgeon acceptance.

  10. Technology transfer and radioactive waste management at TMI-2 [Three Mile Island Unit 2

    International Nuclear Information System (INIS)

    Saunders, J.R.

    1988-01-01

    The accident that occurred on March 28, 1979, at the Three Mile Island Unit 2 (TMI-2) nuclear generating station caused extensive damage to the reactor core and created high radiation contamination levels throughout the facility. The electric power industry, regulators, and government agencies were faced with one of the most technically challenging recovery situations ever encountered in this country. But it was also realized that this adversity presented opportunities for the advancement of state-of-the-art technologies as well as the potential to produce information that could enhance nuclear power plant safety and reliability. Perhaps one of the more significant aspects of the TMI-2 recovery has been the advancement of radioactive waste management technology. The high levels and unusual nature of the TMI-2 radioactive waste necessitated the development of innovative techniques for processing, packaging, shipping, and disposal. The investment in research was rewarded with large volume reductions and associated cost savings. It is anticipated that the TMI-2 radioactive waste management technology will make major contributions to the design of new systems to meet this growing need. The following areas appear particularly suited for this purpose: volume reduction, high-integrity containers, and selective isotope removal

  11. Technological developments in real-time operational hydrologic forecasting in the United States

    Science.gov (United States)

    Hudlow, Michael D.

    1988-09-01

    The hydrologic forecasting service of the United States spans applications and scales ranging from those associated with the issuance of flood and flash warnings to those pertaining to seasonal water supply forecasts. New technological developments (underway in or planned by the National Weather Service (NWS) in support of the Hydrologic Program) are carried out as combined efforts by NWS headquarters and field personnel in cooperation with other organizations. These developments fall into two categories: hardware and software systems technology, and hydrometeorological analysis and prediction technology. Research, development, and operational implementation in progress in both of these areas are discussed. Cornerstones of an overall NWS modernization effort include implementation of state-of-the-art data acquisition systems (including the Next Generation Weather Radar) and communications and computer processing systems. The NWS Hydrologic Service will capitalize on these systems and will incorporate results from specific hydrologic projects including collection and processing of multivariate data sets, conceptual hydrologic modeling systems, integrated hydrologic modeling systems with meteorological interfaces and automatic updating of model states, and extended streamflow prediction techniques. The salient aspects of ongoing work in these areas are highlighted in this paper, providing some perspective on the future U.S. hydrologic forecasting service and its transitional period into the 1990s.

  12. Experience of Using Domestic High-Frequency Electric Welding Technology in Surgical Treatment of Patients with Abdominal Pathology

    Directory of Open Access Journals (Sweden)

    A.M. Babiy

    2014-04-01

    Full Text Available The article presents the experience of using electric welding technology of biological tissues with domestic high-frequency electrical generator EC 300 M1 in 176 patients at open and laparoscopic surgery for abdominal pathology. The analysis of findings showed that electric welding of living tissue provides reliable hemostasis, promotes tissue repair after their separation.

  13. Customized Knee Prosthesis in Treatment of Giant Cell Tumors of the Proximal Tibia: Application of 3-Dimensional Printing Technology in Surgical Design.

    Science.gov (United States)

    Luo, Wenbin; Huang, Lanfeng; Liu, He; Qu, Wenrui; Zhao, Xin; Wang, Chenyu; Li, Chen; Yu, Tao; Han, Qing; Wang, Jincheng; Qin, Yanguo

    2017-04-07

    BACKGROUND We explored the application of 3-dimensional (3D) printing technology in treating giant cell tumors (GCT) of the proximal tibia. A tibia block was designed and produced through 3D printing technology. We expected that this 3D-printed block would fill the bone defect after en-bloc resection. Importantly, the block, combined with a standard knee joint prosthesis, provided attachments for collateral ligaments of the knee, which can maintain knee stability. MATERIAL AND METHODS A computed tomography (CT) scan was taken of both knee joints in 4 patients with GCT of the proximal tibia. We developed a novel technique - the real-size 3D-printed proximal tibia model - to design preoperative treatment plans. Hence, with the application of 3D printing technology, a customized proximal tibia block could be designed for each patient individually, which fixed the bone defect, combined with standard knee prosthesis. RESULTS In all 4 cases, the 3D-printed block fitted the bone defect precisely. The motion range of the affected knee was 90 degrees on average, and the soft tissue balance and stability of the knee were good. After an average 7-month follow-up, the MSTS score was 19 on average. No sign of prosthesis fracture, loosening, or other relevant complications were detected. CONCLUSIONS This technique can be used to treat GCT of the proximal tibia when it is hard to achieve soft tissue balance after tumor resection. 3D printing technology simplified the design and manufacturing progress of custom-made orthopedic medical instruments. This new surgical technique could be much more widely applied because of 3D printing technology.

  14. Development of an Educational Game to Set Up Surgical Instruments on the Mayo Stand or Back Table: Applied Research in Production Technology.

    Science.gov (United States)

    Paim, Crislaine Pires Padilha; Goldmeier, Silvia

    2017-01-10

    Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education. The study was characterized by applied research in production technology. It included the phases of analysis and design, development, and evaluation. The objectives of the educational game were developed through Bloom's taxonomy. Parallel to the physical development of the educational game, a proposed model for the use of digital elements in educational game activities was applied to develop the game content. The development of the game called "Playing with Tweezers" was carried out in 3 phases and was evaluated by 15 participants, comprising students and professional experts in various areas of knowledge such as nursing, information technology, and education. An environment was created with an initial screen, menu buttons containing the rules of the game, and virtual tour modes for learning and assessment. The "digital" nursing student needs engagement, stimulation, reality, and entertainment, not just readings. "Playing with Tweezers" is an example of educational gaming as an innovative teaching strategy in nursing that encourages the strategy of involving the use of educational games to support theoretical or practical classroom teaching. Thus, the teacher does not work with only 1 type of teaching methodology, but with a combination of different methodologies. In addition, we cannot forget that skill training in an educational game does not

  15. An appraisal of existing decontamination technology used in the United States of America

    International Nuclear Information System (INIS)

    Domenech, J.S.; Frost, F.; Curran, A.R.; Grave, M.J.

    1984-01-01

    This report is a review of decontamination technology applied by industry to radioactively contaminated components in the U.S.A. In addition some newer techniques under development or recently emerging are discussed. Mechanical, chemical, manual and other techniques such as electropolishing and ultrasonics are reviewed. Whilst the emphasis is mainly on non-destructive techniques for components some discussion of segmentation is included as this is inevitable during concrete decontamination; and also when decontamination of components occurs as part of a decommissioning programme the use of segmentation techniques may facilitate the process. A bibliography has been included to facilitate further reading. It is important to consider the relevance of the US data in this report to the United Kingdom both to the learning curve of development and the different nuclear reactor systems in the respective countries. The authors have therefore listed some conclusions and recommendations which have become apparent to them whilst undertaking the study. (U.K.)

  16. Dual Comb Unit High-g Accelerometer Based on CMOS-MEMS Technology

    Directory of Open Access Journals (Sweden)

    Mehrdad Mottaghi

    2009-04-01

    Full Text Available In this paper a capacitive based high-g accelerometer with superior level of sensitivity is presented. It takes advantage of dual comb unit configuration and surface micromachining fabrication process. All aspects of mechanical design such as sensor structure, modal analysis, energy dissipations, dynamic response and stresses in moving structure as well as anchors are described. Electrical circuit based on CMOS technology and its output signal is presented. Fabrication process and packaging are also discussed. The proposed sensor can endure impact loads up to 120,000 g (g = 9.81 m.s-2 and achieves 16.75 µV.g-1 sensitivity with 5 V bridge excitation voltage. Main resonant frequency of structure is found to be 42.4 kHz. Intended applications of suggested sensor include military and aerospace industries as well as field of impact engineering.

  17. Advanced spent fuel processing technologies for the United States GNEP programme

    International Nuclear Information System (INIS)

    Laidler, J.J.

    2007-01-01

    Spent fuel processing technologies for future advanced nuclear fuel cycles are being developed under the scope of the Global Nuclear Energy Partnership (GNEP). This effort seeks to make available for future deployment a fissile material recycling system that does not involve the separation of pure plutonium from spent fuel. In the nuclear system proposed by the United States under the GNEP initiative, light water reactor spent fuel is treated by means of a solvent extraction process that involves a group extraction of transuranic elements. The recovered transuranics are recycled as fuel material for advanced burner reactors, which can lead in the long term to fast reactors with conversion ratios greater than unity, helping to assure the sustainability of nuclear power systems. Both aqueous and pyrochemical methods are being considered for fast reactor spent fuel processing in the current US development programme. (author)

  18. Study of the uses of Information and Communication Technologies by Pain Treatment Unit Physicians.

    Science.gov (United States)

    Muriel Fernandez, Jorge; Sánchez Ledesma, María José; López Millan, Manuel; García Cenador, María Begoña

    2017-05-01

    Adequate use of Information and Communication Technologies (ICTs) in health has been shown to save the patient and caregiver time, improve access to the health system, improve diagnosis and control of disease or treatment. All this results in cost savings, and more importantly, they help improve the quality of service and the lives of patients. The purpose of this study is to analyse the differences in the uses of this ICTs between those physicians that belong to Pain Treatment Units (PU) and other physicians that work in pain not linked to these PUs. An online survey, generated by Netquest online survey tool, was sent to both groups of professionals and the data collected was statistical analysed through a logistic regression methodology which is the Logit binomial model. Our results show that those physicians that belong to PUs use ICTs more frequently and consider it more relevant to their clinical practice.

  19. Metal recycling technology and related issues in the United States, a BNFL perspective

    International Nuclear Information System (INIS)

    Bradbury, P.; Dam, S.; Starke, W.

    1995-01-01

    Radioactively contaminated metallic materials comprise a large part of the potential waste products which result from nuclear facility repair, refurbishment, and decommissioning. United States Government (Departments of Energy and Defense) facilities, U.S. nuclear power plants, and other commercial nuclear fuel cycle facilities have large inventories of radioactive scrap metal which could be decontaminated and recycled into useful radioactive and non-radioactive products. Residual radioactivity and recycling criteria is needed to avoid the high cost of disposal and the waste of natural resources. In the United Kingdom, BNFL has decommissioned the gaseous diffusion plant at Capenhurst and has recycled a large fraction of the metallic scrap into the metals market. Other structural materials have also been released as uncontaminated scrap. U.K. release criteria for residual radionuclide contamination have been applied to these operations. A variety of techniques were utilized to size reduce large components, to remove radioactivity, and to survey and release these materials. These methods and the application of release criteria has a direct relationship to methods which would be applicable in the U.S. and in other countries. This paper will describe the specific U.K. technology and experience in the decontamination, recycle, and release of scrap metal. It will also describe the U.S. environment for metal recycle, including the volumes and levels of contamination, and the current and proposed release criteria. Comparisons will be presented between the U.S. and U.K., both in technology and methodology for recycle and in regulatory criteria for residual radioactivity and material release and for ultimate decommissioning. The paper will then provide suggested approaches and criteria for U.S. recycling and decommissioning. (author)

  20. Augmented reality telementoring (ART) platform: a randomized controlled trial to assess the efficacy of a new surgical education technology.

    Science.gov (United States)

    Vera, Angelina M; Russo, Michael; Mohsin, Adnan; Tsuda, Shawn

    2014-12-01

    Laparoscopic skills training has evolved over recent years. However, conveying a mentor's directions using conventional methods, without realistic on-screen visual cues, can be difficult and confusing. To facilitate laparoscopic skill transference, an augmented reality telementoring (ART) platform was designed to overlay the instruments of a mentor onto the trainee's laparoscopic monitor. The aim of this study was to compare the effectiveness of this new teaching modality to traditional methods in novices performing an intracorporeal suturing task. Nineteen pre-medical and medical students were randomized into traditional mentoring (n = 9) and ART (n = 10) groups for a laparoscopic suturing and knot-tying task. Subjects received either traditional mentoring or ART for 1 h on the validated fundamentals of laparoscopic surgery intracorporeal suturing task. Tasks for suturing were recorded and scored for time and errors. Results were analyzed using means, standard deviation, power regression analysis, correlation coefficient, analysis of variance, and student's t test. Using Wright's cumulative average model (Y = aX (b)) the learning curve slope was significantly steeper, demonstrating faster skill acquisition, for the ART group (b = -0.567, r (2) = 0.92) than the control group (b = -0.453, r (2) = 0.74). At the end of 10 repetitions or 1 h of practice, the ART group was faster versus traditional (mean 167.4 vs. 242.4 s, p = 0.014). The ART group also had fewer fails (8) than the traditional group (13). The ART Platform may be a more effective training technique in teaching laparoscopic skills to novices compared to traditional methods. ART conferred a shorter learning curve, which was more pronounced in the first 4 trials. ART reduced the number of failed attempts and resulted in faster suture times by the end of the training session. ART may be a more effective training tool in laparoscopic surgical training for complex tasks than traditional methods.

  1. Provider-based research networks and diffusion of surgical technologies among patients with early-stage kidney cancer.

    Science.gov (United States)

    Tan, Hung-Jui; Meyer, Anne-Marie; Kuo, Tzy-Mey; Smith, Angela B; Wheeler, Stephanie B; Carpenter, William R; Nielsen, Matthew E

    2015-03-15

    Provider-based research networks such as the National Cancer Institute's Community Clinical Oncology Program (CCOP) have been shown to facilitate the translation of evidence-based cancer care into clinical practice. This study compared the utilization of laparoscopy and partial nephrectomy among patients with early-stage kidney cancer according to their exposure to CCOP-affiliated providers. With linked Surveillance, Epidemiology, and End Results-Medicare data, patients with T1aN0M0 kidney cancer who had been treated with nephrectomy from 2000 to 2007 were identified. For each patient, the receipt of care from a CCOP physician or hospital and treatment with laparoscopy or partial nephrectomy were determined. Adjusted for patient characteristics (eg, age, sex, and marital status) and other organizational features (eg, community hospital and National Cancer Institute-designated cancer center), multivariate logistic regression was used to estimate the association between each surgical innovation and CCOP affiliation. During the study interval, 1578 patients (26.8%) were treated by a provider with a CCOP affiliation. Trends in the utilization of laparoscopy and partial nephrectomy remained similar between affiliated and nonaffiliated providers (P ≥ .05). With adjustments for patient characteristics, organizational features, and clustering, no association was noted between CCOP affiliation and the use of laparoscopy (odds ratio [OR], 1.11; 95% confidence interval [CI], 0.81-1.53) or partial nephrectomy (OR, 1.04; 95% CI, 0.82-1.32) despite the more frequent receipt of these treatments in academic settings (P kidney cancer, indicating perhaps a more limited scope to provider-based research networks as they pertain to translational efforts in cancer care. © 2014 American Cancer Society.

  2. Information needs of health technology assessment units and agencies in Spain.

    Science.gov (United States)

    Galnares-Cordero, Lorea; Gutiérrez-Ibarluzea, Iñaki

    2010-10-01

    The aim of this study was to analyze the information needs of Spanish health technology assessment (HTA) agencies and units to facilitate access to the resources they require to substantiate their reports. A questionnaire was designed and distributed among HTA bodies to ascertain the actual situation of subscriptions to information resources and what information specialists from these bodies considered would be the ideal subscription situation. Their information needs were then studied, and the resources that best met these needs were put forward. Following this definition, a subscriptions policy was adopted with suppliers and publishers. The survey showed that HTA bodies share a minimum of core subscriptions that includes open sources (MEDLINE, DARE) and sources that the government subscribes to for the health community (ISI Web of Science, Cochrane Library Plus). There was no common approach to determining which databases to subscribe to (UpToDate, EMBASE, Ovid EBMR, CINAHL, or ECRI). After identifying the information needs, a list of resources was proposed that would best cover these needs and, of these, subscription to the following was proposed: Scopus, Ovid EBMR, Clinical Evidence, DynaMed, ECRI, and Hayes. There are differences in the way that HTA agencies and units access the different resources of biomedical information. Combined subscription to several resources for documentation services was suggested as a way of resolving these differences.

  3. Testing of an Annular Linear Induction Pump for the Fission Surface Power Technology Demonstration Unit

    Science.gov (United States)

    Polzin, K. A.; Pearson, J. B.; Webster, K.; Godfoy, T. J.; Bossard, J. A.

    2013-01-01

    Results of performance testing of an annular linear induction pump that has been designed for integration into a fission surface power technology demonstration unit are presented. The pump electromagnetically pushes liquid metal (NaK) through a specially-designed apparatus that permits quantification of pump performance over a range of operating conditions. Testing was conducted for frequencies of 40, 55, and 70 Hz, liquid metal temperatures of 125, 325, and 525 C, and input voltages from 30 to 120 V. Pump performance spanned a range of flow rates from roughly 0.3 to 3.1 L/s (4.8 to 49 gpm), and pressure heads of <1 to 104 kPa (<0.15 to 15 psi). The maximum efficiency measured during testing was 5.4%. At the technology demonstration unit operating temperature of 525 C the pump operated over a narrower envelope, with flow rates from 0.3 to 2.75 L/s (4.8 to 43.6 gpm), developed pressure heads from <1 to 55 kPa (<0.15 to 8 psi), and a maximum efficiency of 3.5%. The pump was supplied with three-phase power at 40 and 55 Hz using a variable-frequency motor drive, while power at 55 and 70 Hz was supplied using a variable-frequency power supply. Measured performance of the pump at 55 Hz using either supply exhibited good quantitative agreement. For a given temperature, the peak in efficiency occurred at different flow rates as the frequency was changed, but the maximum value of efficiency was relative insensitive within 0.3% over the frequency range tested, including a scan from 45 to 78 Hz. The objectives of the FSP technology project are as follows:5 • Develop FSP concepts that meet expected surface power requirements at reasonable cost with added benefits over other options. • Establish a nonnuclear hardware-based technical foundation for FSP design concepts to reduce overall development risk. • Reduce the cost uncertainties for FSP and establish greater credibility for flight system cost estimates. • Generate the key nonnuclear products to allow Agency

  4. Unit 1 and Unit 2 Nuclear Power Plant Mochovce construction finishing from primary contractor of technological part. Skoda Praha a. s. point of view

    International Nuclear Information System (INIS)

    Horky, F.

    2000-01-01

    In this paper the history of delivery of technological part for NPP V-1 Mochovce as well as of reconstruction and safety improvements by the Skoda Praha a.s. is presented. Primary contractor of technological part Skoda Praha together with its final suppliers proved ability to realize under hard conditions such a complicated work what was indisputedly Units 1 and 2 finishing. Company proved capability to conform itself flexibly in the course of work to requirements of customer for realization of safety measures which means that Units 1 and 2 fully satisfy international standards. By fulfilment of primary contractor of technology obligations and above all by takeover of complex responsibility for both Units putting in operation including responsibility for 'past' Skoda Praha put away one of basic problems which occurred in decision making to whom will be assigned construction finishing contract. These facts fully qualify Skoda Praha to be selected for possible Units 3 and 4 construction finishing as one of chief construction finishing participant

  5. Characterization of a clinical unit for digital radiography based on irradiation side sampling technology

    Energy Technology Data Exchange (ETDEWEB)

    Rivetti, Stefano [Fisica Medica, Ospedale di Sassuolo S.p.A., 41049 Sassuolo (Italy); Lanconelli, Nico [Alma Mater Studiorum, Physics Department, University of Bologna, 40127 Bologna (Italy); Bertolini, Marco; Nitrosi, Andrea [Medical Physics Unit, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, 42123 Reggio Emilia (Italy); Burani, Aldo [Ospedale di Sassuolo S.p.A., 41049 Sassuolo (Italy)

    2013-10-15

    Purpose: A characterization of a clinical unit for digital radiography (FUJIFILM FDR D-EVO) is presented. This system is based on the irradiation side sampling (ISS) technology and can be equipped with two different scintillators: one traditional gadolinium-oxysulphide phosphor (GOS) and a needle structured cesium iodide (CsI) phosphor panel.Methods: The characterization was achieved in terms of response curve, modulation transfer function (MTF), noise power spectra (NPS), detective quantum efficiency (DQE), and psychophysical parameters (contrast-detail analysis with an automatic reading of CDRAD images). For both scintillation screens the authors accomplished the measurements with four standard beam conditions: RAQ3, RQA5, RQA7, and RQA9.Results: At the Nyquist frequency (3.33 lp/mm) the MTF is about 35% and 25% for CsI and GOS detectors, respectively. The CsI scintillator has better noise properties than the GOS screen in almost all the conditions. This is particularly true for low-energy beams, where the noise for the GOS system can go up to a factor 2 greater than that found for CsI. The DQE of the CsI detector reaches a peak of 60%, 60%, 58%, and 50% for the RQA3, RQA5, RQA7, and RQA9 beams, respectively, whereas for the GOS screen the maximum DQE is 40%, 44%, 44%, and 35%. The contrast-detail analysis confirms that in the majority of cases the CsI scintillator is able to provide improved outcomes to those obtained with the GOS screen.Conclusions: The limited diffusion of light produced by the ISS reading makes possible the achievement of very good spatial resolution. In fact, the MTF of the unit with the CsI panel is only slightly lower to that achieved with direct conversion detectors. The combination of very good spatial resolution, together with the good noise properties reached with the CsI screen, allows achieving DQE on average about 1.5 times greater than that obtained with GOS. In fact, the DQE of unit equipped with CsI is comparable to the best

  6. Report to the United States Congress clean coal technology export markets and financing mechanisms

    International Nuclear Information System (INIS)

    1994-05-01

    This report responds to a Congressional Conference Report that requests that $625,000 in funding provided will be used by the Department to identify potential markets for clean coal technologies in developing countries and countries with economies in transition from nonmarket economies and to identify existing, or new, financial mechanisms or financial support to be provided by the Federal government that will enhance the ability of US industry to participate in these markets. The Energy Information Administration (EIA) expects world coal consumption to increase by 30 percent between 1990 and 2010, from 5.1 to 6.5 billion short tons. Five regions stand out as major foreign markets for the export of US clean coal technologies: China; The Pacific Rim (other than China); South Asia (primarily India); Transitional Economies (Central Europe and the Newly Independent States); and Other Markets (the Americas and Southern Africa). Nearly two-thirds of the expected worldwide growth in coal utilization will occur in China, one quarter in the United States. EIA forecasts nearly a billion tons per year of additional coal consumption in China between 1990 and 2010, a virtual doubling of that country's coal consumption. A 30-percent increase in coal consumption is projected in other developing countries over that same period. This increase in coal consumption will be accompanied by an increase in demand for technologies for burning coal cost-effectively, efficiently and cleanly. In the Pacific Rim and South Asia, rapid economic growth coupled with substantial indigenous coal supplies combine to create a large potential market for CCTS. In Central Europe and the Newly Independent States, the challenge will be to correct the damage of decades of environmental neglect without adding to already-considerable economic disruption. Though the situation varies, all these countries share the basic need to use indigenous low-quality coal cleanly and efficiently

  7. Surgical orthodontics.

    Science.gov (United States)

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  8. A report from the second US/Japan workshop on global change research: Environmental response technologies (mitigation and adaptation). United States-Japan Science and Technology Agreement

    Energy Technology Data Exchange (ETDEWEB)

    Edgerton, S. [comp.] [National Science Foundation, Washington, DC (United States). Committee on Earth and Environmental Sciences; Mizuno, Tateki [comp.] [National Inst. for Resources and Environment, MITI (Japan)

    1993-12-31

    The Second US - Japan Workshop on Global Change: Environmental Response Technologies for Global Change was hosted by the Program on Resources at the East-West Center, in Honolulu, Hawaii on February 1--3, 1993, on behalf of the United States Committee on Earth and Environmental Sciences (CEES) of the Federal Coordinating Council for Science, Engineering, and Technology (FCCSET). This workshop brought together over fifty leading scientists from the two countries to review existing technologies and to identify needed research on the development of new technologies for mitigation and adaptation of global change. The Workshop was organized around three areas of research: (1) capture, fixation/utilization, and disposal of CO{sub 2} (e.g. CO{sub 2}, separation and capture technologies, ocean and land disposal of CO{sub 2}; (2) energy production and conservation technologies to reduce greenhouse gas emissions (e.g. combustion efficiency, non-carbon based energy technologies, energy conservation technologies); and (3) adaptation technologies and practices related to global climate change (e.g., adaptation responses of crops to climate change, adapting urban infrastructure for climate change). Priorities for joint research in each of these areas were discussed. Selected papers have been processed separately for inclusion in the Energy Science and Technology Database.

  9. Proteção renal na unidade de terapia intensiva cirúrgica Renal protection in a surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Luciana Moraes dos Santos

    2006-09-01

    increase of life expectancy, older patients with more co-morbidity are being submitted to high risk surgical procedures, what make clinical practice related to organ protection possible modifier of short and long term survival. This review about renal protection in surgical intensive care unit points risk factors and discusses scientific evidence related to reduction of renal dysfunction in perioperative. CONTENTS: Although low extraction and adequate renal reserve of oxygen, the kidney is extremely sensible to hypoperfusion being renal acute insufficiency a frequent complication of hemodynamic instability. This apparent paradox, high oxygen content and reduced extraction with high incidence of renal damage to hypotension reflects the intra-renal gradient of oxygen, what makes renal medulla highly susceptible to ischemia. Factors associated with renal lesion are observed in all fases of perioperative period: fasting, contrast use, hypovolemia, hypotension, catecholamine and cytokine release, extracorporeal circulation, trauma, rabdomiolisys and aortic clamp. CONCLUSIONS: Management of renal damage is based in principals of perioperative renal physiology and glomerular hemodynamic. Clinical practice directed to organic protection should be implemented to minimize the impact this dysfunction.

  10. Policy drivers and barriers for coal-to-liquids (CtL) technologies in the United States

    International Nuclear Information System (INIS)

    Vallentin, Daniel

    2008-01-01

    Because of a growing dependence on oil imports, powerful industrial, political and societal stakeholders in the United States are trying to enhance national energy security through the conversion of domestic coal into synthetic hydrocarbon liquid fuels-so-called coal-to-liquids (CtL) processes. However, because of the technology's high costs and carbon intensity, its market deployment is strongly affected by the US energy, technology and climate policy setting. This paper analyses and discusses policy drivers and barriers for CtL technologies in the United States and reaches the conclusion that an increasing awareness of global warming among US policy-makers raises the requirements for the technology's environmental performance and, thus, limits its potential to regional niche markets in coal-producing states or strategic markets, such as the military, with specific security and fuel requirements

  11. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated

  12. Levelised unit electricity cost comparison of alternate technologies for baseload generation in Ontario

    Energy Technology Data Exchange (ETDEWEB)

    Ayres, M.; McRae, M.; Stogran, M.

    2004-08-15

    This report provides a comparison of the lifetime cost of constructing, operating and decommissioning new generation suitable for supplying baseload power by early in the next decade. New baseload generation options in Ontario are nuclear, coal-fired steam turbines or combined cycle gas turbines (CCGT). Nuclear and coal-fired units are characterised by high capital costs and low operating costs. As such, they are candidates for baseload operation only. Gas-fired generation is characterised by lower capital costs and higher operating costs and thus may meet the requirements for operation as peaking and/or baseload generation. The comparison of baseload generating technologies is made by reference to the estimated levelised unit electricity cost (LUEC). The LUEC can be thought of as a 'supply cost', where the unit cost is the price needed to recover all costs over the period. It is determined by finding the price that sets the sum of all future discounted cash flows (net present value, or NPV) to zero. It can also be thought of as representing the constant real wholesale price of electricity that meets the financing cost, debt repayment, income tax and cash flow constraints associated with the construction operation and decommissioning of a generating plant. Levelised unit cost comparisons are usually made with different sets of financing assumptions. This report considers two base cases, which we describe as 'merchant' and 'public' financing. The term 'merchant plant' is used to refer to ones that are built and operated by private investors. These investors pay for their capital through debt and by raising equity, and thus pay return on equity and interest on debt throughout their lifetime. These projects include income taxes, both provincial and federal. Publicly financed projects typically are not subject to income taxes or to the same constraints on raising finance through issuing debt and equity. However, they are

  13. Levelised unit electricity cost comparison of alternate technologies for baseload generation in Ontario

    International Nuclear Information System (INIS)

    Ayres, M.; McRae, M.; Stogran, M.

    2004-08-01

    This report provides a comparison of the lifetime cost of constructing, operating and decommissioning new generation suitable for supplying baseload power by early in the next decade. New baseload generation options in Ontario are nuclear, coal-fired steam turbines or combined cycle gas turbines (CCGT). Nuclear and coal-fired units are characterised by high capital costs and low operating costs. As such, they are candidates for baseload operation only. Gas-fired generation is characterised by lower capital costs and higher operating costs and thus may meet the requirements for operation as peaking and/or baseload generation. The comparison of baseload generating technologies is made by reference to the estimated levelised unit electricity cost (LUEC). The LUEC can be thought of as a 'supply cost', where the unit cost is the price needed to recover all costs over the period. It is determined by finding the price that sets the sum of all future discounted cash flows (net present value, or NPV) to zero. It can also be thought of as representing the constant real wholesale price of electricity that meets the financing cost, debt repayment, income tax and cash flow constraints associated with the construction operation and decommissioning of a generating plant. Levelised unit cost comparisons are usually made with different sets of financing assumptions. This report considers two base cases, which we describe as 'merchant' and 'public' financing. The term 'merchant plant' is used to refer to ones that are built and operated by private investors. These investors pay for their capital through debt and by raising equity, and thus pay return on equity and interest on debt throughout their lifetime. These projects include income taxes, both provincial and federal. Publicly financed projects typically are not subject to income taxes or to the same constraints on raising finance through issuing debt and equity. However, they are constrained to provide a rate of return. The

  14. Cyclone Boiler Field Testing of Advanced Layered NOx Control Technology in Sioux Unit 1

    Energy Technology Data Exchange (ETDEWEB)

    Marc A. Cremer; Bradley R. Adams

    2006-06-30

    A four week testing program was completed during this project to assess the ability of the combination of deep staging, Rich Reagent Injection (RRI), and Selective Non-Catalytic Reduction (SNCR) to reduce NOx emissions below 0.15 lb/MBtu in a cyclone fired boiler. The host site for the tests was AmerenUE's Sioux Unit 1, a 500 MW cyclone fired boiler located near St. Louis, MO. Reaction Engineering International (REI) led the project team including AmerenUE, FuelTech Inc., and the Electric Power Research Institute (EPRI). This layered approach to NOx reduction is termed the Advanced Layered Technology Approach (ALTA). Installed RRI and SNCR port locations were guided by computational fluid dynamics (CFD) based modeling conducted by REI. During the parametric testing, NOx emissions of 0.12 lb/MBtu were achieved consistently from overfire air (OFA)-only baseline NOx emissions of 0.25 lb/MBtu or less, when firing the typical 80/20 fuel blend of Powder River Basin (PRB) and Illinois No.6 coals. From OFA-only baseline levels of 0.20 lb/MBtu, NOx emissions of 0.12 lb/MBtu were also achieved, but at significantly reduced urea flow rates. Under the deeply staged conditions that were tested, RRI performance was observed to degrade as higher blends of Illinois No.6 were used. NOx emissions achieved with ALTA while firing a 60/40 blend were approximately 0.15 lb/MBtu. NOx emissions while firing 100% Illinois No.6 were approximately 0.165 lb/MBtu. Based on the performance results of these tests, economics analyses of the application of ALTA to a nominal 500 MW cyclone unit show that the levelized cost to achieve 0.15 lb/MBtu is well below 75% of the cost of a state of the art SCR.

  15. Assessing the level of healthcare information technology adoption in the United States: a snapshot

    Directory of Open Access Journals (Sweden)

    Middleton Blackford

    2006-01-01

    Full Text Available Abstract Background Comprehensive knowledge about the level of healthcare information technology (HIT adoption in the United States remains limited. We therefore performed a baseline assessment to address this knowledge gap. Methods We segmented HIT into eight major stakeholder groups and identified major functionalities that should ideally exist for each, focusing on applications most likely to improve patient safety, quality of care and organizational efficiency. We then conducted a multi-site qualitative study in Boston and Denver by interviewing key informants from each stakeholder group. Interview transcripts were analyzed to assess the level of adoption and to document the major barriers to further adoption. Findings for Boston and Denver were then presented to an expert panel, which was then asked to estimate the national level of adoption using the modified Delphi approach. We measured adoption level in Boston and Denver was graded on Rogers' technology adoption curve by co-investigators. National estimates from our expert panel were expressed as percentages. Results Adoption of functionalities with financial benefits far exceeds adoption of those with safety and quality benefits. Despite growing interest to adopt HIT to improve safety and quality, adoption remains limited, especially in the area of ambulatory electronic health records and physician-patient communication. Organizations, particularly physicians' practices, face enormous financial challenges in adopting HIT, and concerns remain about its impact on productivity. Conclusion Adoption of HIT is limited and will likely remain slow unless significant financial resources are made available. Policy changes, such as financial incentivesto clinicians to use HIT or pay-for-performance reimbursement, may help health care providers defray upfront investment costs and initial productivity loss.

  16. Survey of information technology in Intensive Care Units in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Hallett David

    2008-01-01

    Full Text Available Abstract Background The Intensive Care Unit (ICU is a data-rich environment where information technology (IT may enhance patient care. We surveyed ICUs in the province of Ontario, Canada, to determine the availability, implementation and variability of information systems. Methods A self-administered internet-based survey was completed by ICU directors between May and October 2006. We measured the spectrum of ICU clinical data accessible electronically, the availability of decision support tools, the availability of electronic imaging systems for radiology, the use of electronic order entry and medication administration systems, and the availability of hardware and wireless or mobile systems. We used Fisher's Exact tests to compare IT availability and Classification and Regression Trees (CART to estimate the optimal cut-point for the number of computers per ICU bed. Results We obtained responses from 50 hospitals (68.5% of institutions with level 3 ICUs, of which 21 (42% were university-affiliated. The majority electronically accessed laboratory data and imaging reports (92% and used picture archiving and communication systems (PACS (76%. Other computing functions were less prevalent (medication administration records 46%, physician or nursing notes 26%; medication order entry 22%. No association was noted between IT availability and ICU size or university affiliation. Sites used clinical information systems from15 different vendors and 8 different PACS systems were in use. Half of the respondents described the number of computers available as insufficient. Wireless networks and mobile computing systems were used in 23 ICUs (46%. Conclusion Ontario ICUs demontrate a high prevalence of the use of basic information technology systems. However, implementation of the more complex and potentially more beneficial applications is low. The wide variation in vendors utilized may impair information exchange, interoperability and uniform data collection.

  17. Government financial support for civil aircraft research, technology and development in four European countries and the United States

    Science.gov (United States)

    Chandler, B.; Golaszewski, R.; Patten, C.; Rudman, B.; Scott, R.

    1980-01-01

    Data on the levels of government financial support for civil aircraft airframe and engine (CAAE) research and technology (R&T) in the United States and Europe (United Kingdom, West Germany, France and The Netherlands) and means of comparing these levels are provided. Data are presented for the years 1974-1977. European R&T expenditure data were obtained through visits to each of the four European countries, to the Washington office of the European Communities, and by a search of applicable literature. CAAE R&T expenditure data for the United States were obtained from NASA and Federal Aviation Administration (FAA).

  18. Patient-specific surgical simulation.

    Science.gov (United States)

    Soler, Luc; Marescaux, Jacques

    2008-02-01

    Technological innovations of the twentieth century have provided medicine and surgery with new tools for education and therapy definition. Thus, by combining Medical Imaging and Virtual Reality, patient-specific applications providing preoperative surgical simulation have become possible.

  19. ICEMENERG technologies of water treatment applied at Cernavoda NPP Unit 1

    International Nuclear Information System (INIS)

    Stanca, Angela; Bolma, Aurelia; Serbanescu, Agnes; Raducanu, Alice

    2002-01-01

    The paper presents the ICEMENERG technologies for water treatment applied at Cernavoda Unit 1, the treatment of the additional water for power steam generators and the chemical treatment of cooling system water. The requirements for quality of water totally demineralized as imposed by the AECL-ANSALDO consortium are as following: electrical conductivity, < 0.2 mS/cm; total silicon, <0.02 mg/L; ionic silicon, <0.01 mg/L; sodium, < 0.05 mg/L; TOC, <0.300 mg/L. These requirements raise rather difficult problems to be solved because the raw water source in case of Cernavoda NPP is Danube River which presents a raising trend of organic and inorganic contamination. Accordingly, experiments at laboratory scale reproducing the entire technological flow were conducted. The following operations were studied: pretreatment with limewash, ferric chloride (with and without coagulation additives); demineralization with ion exchangers of Purolite and Amberlite types. The system consisted of a cationic stage, formed of an strongly acid step with countercurrent recovery and an anionic stage formed of two steps, namely, a weakly basic step and a strongly basic step with recovery inserted; finishing on mixed bed. The paper presents also the chemical treatment/conditioning of the cooling loop of turbine condenser. The Cernavoda NPP cooling system is an open system with a single flow of cooling water comprising two systems, namely, the circulation water system ensuring the steam condenser cooling and the servicing water system ensuring the cooling of heat exchangers in the recirculated water circuit (RCWS), the turbine oil coolants, the coolants of auxiliary steam as well as the emergency core cooling system. Studies were conducted to ensure the chemical conditioning of the raw water from Danube River, particularly, to destroy and remove the shells, the algae and other components. Finally, the following four steps of conditioning the water of the cooling system are summarized: 1

  20. Computational fluid dynamics research at the United Technologies Research Center requiring supercomputers

    Science.gov (United States)

    Landgrebe, Anton J.

    1987-01-01

    An overview of research activities at the United Technologies Research Center (UTRC) in the area of Computational Fluid Dynamics (CFD) is presented. The requirement and use of various levels of computers, including supercomputers, for the CFD activities is described. Examples of CFD directed toward applications to helicopters, turbomachinery, heat exchangers, and the National Aerospace Plane are included. Helicopter rotor codes for the prediction of rotor and fuselage flow fields and airloads were developed with emphasis on rotor wake modeling. Airflow and airload predictions and comparisons with experimental data are presented. Examples are presented of recent parabolized Navier-Stokes and full Navier-Stokes solutions for hypersonic shock-wave/boundary layer interaction, and hydrogen/air supersonic combustion. In addition, other examples of CFD efforts in turbomachinery Navier-Stokes methodology and separated flow modeling are presented. A brief discussion of the 3-tier scientific computing environment is also presented, in which the researcher has access to workstations, mid-size computers, and supercomputers.

  1. An Ethnographic Study of Health Information Technology Use in Three Intensive Care Units.

    Science.gov (United States)

    Leslie, Myles; Paradis, Elise; Gropper, Michael A; Kitto, Simon; Reeves, Scott; Pronovost, Peter

    2017-08-01

    To identify the impact of a full suite of health information technology (HIT) on the relationships that support safety and quality among intensive care unit (ICU) clinicians. A year-long comparative ethnographic study of three academic ICUs was carried out. A total of 446 hours of observational data was collected in the form of field notes. A subset of these observations-134 hours-was devoted to job-shadowing individual clinicians and conducting a time study of their HIT usage. Significant variation in HIT implementation rates and usage was noted. Average HIT use on the two "high-use" ICUs was 49 percent. On the "low-use" ICU, it was 10 percent. Clinicians on the high-use ICUs experienced "silo" effects with potential safety and quality implications. HIT work was associated with spatial, data, and social silos that separated ICU clinicians from one another and their patients. Situational awareness, communication, and patient satisfaction were negatively affected by this siloing. HIT has the potential to accentuate social and professional divisions as clinical communications shift from being in-person to electronically mediated. Socio-technically informed usability testing is recommended for those hospitals that have yet to implement HIT. For those hospitals already implementing HIT, we suggest rapid, locally driven qualitative assessments focused on developing solutions to identified gaps between HIT usage patterns and organizational quality goals. © Health Research and Educational Trust.

  2. Ordered Effects of Technology Education Units on Higher-Order Critical Thinking Skills of Middle School Students

    Science.gov (United States)

    Mojica, Kern D.

    2010-01-01

    In this quasi-experimental quantitative study, 105 eighth grade students at a suburban middle school in New York State participated in a seven month-long project involving the ordered effects of the technology education units of Lego[R] Mindstorms(TM) NXT Robotics System, Digital Storytelling with Microsoft Windows Movie Maker, and the Marble Maze…

  3. Analyzing the Curricula of Doctor of Philosophy in Educational Technology-Related Programs in the United States

    Science.gov (United States)

    Almaden, Abdullah; Ku, Heng-Yu

    2017-01-01

    The purpose of this study was to analyze on-campus and online PhD programs in educational technology-related fields in the United States. In particular, it sought to evaluate the most common program titles; core, elective, and research courses based on program curricula. The research design was quantitative content analysis and data were collected…

  4. Surgical smoke - a health hazard in the operating theatre: a study to quantify exposure and a survey of the use of smoke extractor systems in UK plastic surgery units.

    Science.gov (United States)

    Hill, D S; O'Neill, J K; Powell, R J; Oliver, D W

    2012-07-01

    Surgeons and operating theatre personnel are routinely exposed to the surgical smoke plume generated through thermal tissue destruction. This represents a significant chemical and biological hazard and has been shown to be as mutagenic as cigarette smoke. It has previously been reported that ablation of 1 g of tissue produces a smoke plume with an equivalent mutagenicity to six unfiltered cigarettes. We studied six human and 78 porcine tissue samples to find the mass of tissue ablated during 5 min of monopolar diathermy. The total daily duration of diathermy use in a plastic surgery theatre was electronically recorded over a two-month period. On average the smoke produced daily was equivalent to 27-30 cigarettes. Our survey of smoke extractor use in UK plastic surgery units revealed that only 66% of units had these devices available. The Health and Safety Executive recommend specialist smoke extractor use, however they are not universally utilised. Surgical smoke inhalation is an occupational hazard in the operating department. Our study provides data to quantify this exposure. We hope this evidence can be used together with current legislation to make the use of surgical smoke extractors mandatory to protect all personnel in the operating theatre. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Surgical ethics: surgical virtue and more.

    Science.gov (United States)

    Vercler, Christian J

    2015-01-01

    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  6. Oil atlas: National Petroleum Technology Office activities across the United States

    Energy Technology Data Exchange (ETDEWEB)

    Tiedemann, H.A.

    1998-03-01

    Petroleum imports account for the largest share of the US trade deficit. Over one-third of the 1996 merchandise trade deficit is attributed to imported oil. The good news is that substantial domestic oil resources, both existing and yet-to-be-discovered, can be recovered using advanced petroleum technologies. The Energy Information Agency estimates that advanced technologies can yield 10 billion additional barrels, equal to $240 billion in import offsets. The US Department of Energy`s National Petroleum Technology Office works with industry to develop advanced petroleum technologies and to transfer successful technologies to domestic oil producers. This publication shows the locations of these important technology development efforts and lists DOE`s partners in this critical venture. The National Petroleum Technology Office has 369 active technology development projects grouped into six product lines: Advanced Diagnostics and Imaging Systems; Advanced Drilling, Completion, and Stimulation; Reservoir Life Extension and Management; Emerging Processing Technology Applications; Effective Environmental Protection; and Crosscutting Program Areas.

  7. Recent Weather Technologies Delivered to America's Space Program by the Applied Meteorology Unit

    Science.gov (United States)

    Bauman, WIlliam, H., III; Crawford, Winifred

    2009-01-01

    The Applied Meteorology Unit (AMU) is a unique joint venture of NASA, the Air Force and the National Weather Service (NWS) and has been supporting the Space Program for nearly two decades. The AMU acts as a bridge between the meteorological research community and operational forecasters by developing, evaluating and transitioning new technology and techniques to improve weather support to spaceport operations at the Eastern Range (ER) and Kennedy Space Center. Its primary customers are the 45th Weather Squadron at Cape Canaveral Air Force Station (CCAFS), the Spaceflight Meteorology Group at Johnson Space Center and the National Weather Service Office in Melbourne, FL. Its products are used to support NASA's Shuttle and ELV programs as well as Department of Defense and commercial launches from the ER. Shuttle support includes landing sites beyond the ER. The AMU is co-located with the Air Force operational forecasters at CCAFS to facilitate continuous two-way interaction between the AMU and its operational customers. It is operated under a NASA, Air Force, and NWS Memorandum of Understanding (MOU) by a competitively-selected contractor. The contract, which is funded and managed by NASA, provides five full time professionals with degrees in meteorology or related fields, some of whom also have operational experience. NASA provides a Ph.D.- level NASA civil service scientist as Chief of the AMU. The AMU is tasked by its customers through a unique, nationally recognized process. The tasks are limited to development, evaluation and operational transition of technology to improve weather support to spaceport operations and providing expert advice to the customers. The MOU expressly forbids using the AMU resources to conduct operations or do basic research. The presentation will provide a brief overview of the AMU and how it is tasked by its customers to provide high priority products and services. The balance of the presentation will cover a sampling of products

  8. [Application of new technologies in the design, manufacture and use of technology deployment of field medical units and establishments].

    Science.gov (United States)

    Iakovlev, S V; Sidorov, V A; Korniushko, I G; Medvedev, V R; Matveev, A G

    2011-11-01

    Presented data is about attendance means of deployment of field medical units and pieces of army-level medical services and disaster medicine Defense Ministry did not ensure compliance with requirements to create optimal conditions for highly effective work of the medical staff, placing the wounded, the use of modern aids and appliances. The prospects of creation of mobile unit for high-availability modular pre-fabricated on the basis of tent structures, pneumoconstructions and removable habitable bodies, containers, tents, pneumocovers till 2020 are analyzed. Livelihood systems provide armor protection against fragments, bullets, flames, damaging factors of chemical and biological weapons.

  9. Quality of laparoscopic radical hysterectomy in developing countries: a comparison of surgical and oncologic outcomes between a comprehensive cancer center in the United States and a cancer center in Colombia.

    Science.gov (United States)

    Pareja, Rene; Nick, Alpa M; Schmeler, Kathleen M; Frumovitz, Michael; Soliman, Pamela T; Buitrago, Carlos A; Borrero, Mauricio; Angel, Gonzalo; Reis, Ricardo Dos; Ramirez, Pedro T

    2012-05-01

    To help determine whether global collaborations for prospective gynecologic surgery trials should include hospitals in developing countries, we compared surgical and oncologic outcomes of patients undergoing laparoscopic radical hysterectomy at a large comprehensive cancer center in the United States and a cancer center in Colombia. Records of the first 50 consecutive patients who underwent laparoscopic radical hysterectomy at The University of Texas MD Anderson Cancer Center in Houston (between April 2004 and July 2007) and the first 50 consecutive patients who underwent the same procedure at the Instituto de Cancerología-Clínica las Américas in Medellín (between December 2008 and October 2010) were retrospectively reviewed. Surgical and oncologic outcomes were compared between the 2 groups. There was no significant difference in median patient age (US 41.9 years [range 23-73] vs. Colombia 44.5 years [range 24-75], P=0.09). Patients in Colombia had a lower median body mass index than patients in the US (24.4 kg/m(2) vs. 28.7 kg/m(2), P=0.002). Compared to patients treated in Colombia, patients who underwent surgery in the US had a greater median estimated blood loss (200 mL vs. 79 mL, P<0.001), longer median operative time (328.5 min vs. 235 min, P<0.001), and longer postoperative hospital stay (2 days vs. 1 day, P<0.001). Surgical and oncologic outcomes of laparoscopic radical hysterectomy were not worse at a cancer center in a developing country than at a large comprehensive cancer center in the United States. These results support consideration of developing countries for inclusion in collaborations for prospective surgical studies. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  11. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  12. The role of health information technology in care coordination in the United States.

    Science.gov (United States)

    Hsiao, Chun-Ju; King, Jennifer; Hing, Esther; Simon, Alan E

    2015-02-01

    Examine the extent to which office-based physicians in the United States receive patient health information necessary to coordinate care across settings and determine whether receipt of information needed to coordinate care is associated with use of health information technology (HIT) (defined by presence or absence of electronic health record system and electronic sharing of information). Cross-sectional study using the 2012 National Electronic Health Records Survey (65% weighted response rate). Office-based physicians. Use of HIT and 3 types of patient health information needed to coordinate care. In 2012, 64% of physicians routinely received the results of a patient's consultation with a provider outside of their practice, whereas 46% routinely received a patient's history and reason for a referred consultation from a provider outside of their practice. About 54% of physicians reported routinely receiving a patient's hospital discharge information. In adjusted analysis, significant differences in receiving necessary information were observed by use of HIT. Compared with those not using HIT, a lower percentage of physicians who used an electronic health record system and shared patient health information electronically failed to receive the results of outside consultations or patient's history and reason for a referred consultation. No significant differences were observed for the receipt of hospital discharge information by use of HIT. Among physicians routinely receiving information needed for care coordination, at least 54% of them did not receive the information electronically. Although a higher percentage of physicians using HIT received patient information necessary for care coordination than those who did not use HIT, more than one third did not routinely receive the needed patient information at all.

  13. "Run-through" training at specialist training year 1 and uncoupled core surgical training for oral and maxillofacial surgery in the United Kingdom: a snapshot survey.

    Science.gov (United States)

    Garg, M; Collyer, J; Dhariwal, D

    2018-05-01

    Training in oral and maxillofacial surgery (OMFS) in the UK has undergone considerable changes during the last 10years, and "core" surgical training has replaced "basic" surgical training. In 2014 a pilot "run-through" training programme from specialist training year one (ST1)-ST7 was introduced to facilitate early entry into the speciality. Run-through training guarantees that a trainee, after a single competitive selection process and satisfactory progress, will be given training that covers the entire curriculum of the speciality, whereas uncoupled training requires a second stage of competitive recruitment after the first one (for OMFS only) or two years of "core" training to progress to higher specialty training. The first two years of run-through training (ST1-ST2) are the same as for core surgical training. Dual-qualified maxillofacial aspirants and those in their second degree course are curious to know whether they should go for the uncoupled core surgical training or the run-through programme in OMFS. The General Medical Council (GMC) has now agreed that run-through training can be rolled out nationally in OMFS. To assess the two pathways we used an online questionnaire to gain feedback about the experience from all OMFS ST3 and run-through trainees (ST3/ST4) in 2016-2017. We identified and contacted 21 trainees, and 17 responded, including seven run-through trainees. Eleven, including five of the run-through trainees, recommended the run-through training programme in OMFS. Six of the seven run-through trainees had studied dentistry first. The overall mean quality of training was rated as 5.5 on a scale 0-10 by the 17 respondents. This survey gives valuable feedback from the current higher surgical trainees in OMFS, which will be useful to the GMC, Health Education England, OMFS Specialist Advisory Committee, and those seeking to enter higher surgical training in OMFS. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published

  14. Measuring relative efficiency of applied science and technology universities in province of Semnan, Iran and providing suggestions for merging units

    Directory of Open Access Journals (Sweden)

    Abolfazl Danaei

    2013-03-01

    Full Text Available University of applied science and technology has been designed to create a platform for multilateral activities such as industrial, military and academic in developing countries to promote science and scientific research applications. These universities are responsible to promote practical training in quantitative and qualitative indicators and they provide appropriate infrastructure to implement theoretical graduates to solve practical problems to build necessary infrastructure to transfer modern technology into developing countries. During the past few years, there have been tremendous development on these units but some of them have not been efficient. In this paper, we present an empirical study to measure the relative efficiencies of various units of applied science and technology universities using data envelopment analysis. The proposed model of this paper uses two inputs including human resources as well as total assets and two outputs including the number of graduate students as well as operating profit. The results of the study have indicated that some of the units are inefficient and need to be merged with other units to increase the relative efficiency of these universities.

  15. [Contribution of computer-aided design for the conception of custom-made implants in Pectus Excavatum surgical treatment. Experience of the Nantes plastic surgery unit].

    Science.gov (United States)

    Tilliet Le Dentu, H; Lancien, U; Sellal, O; Duteille, F; Perrot, P

    2018-02-01

    Pectus excavatum is the most common congenital chest malformation and is a common reason for consultation in plastic surgery. Our attitude is most often a filling of the depression with a custom-made silicone prosthesis. The objective of this work was to evaluate the interest of computer-aided design (CAD) of implants compared to the conventional plaster molds method. We have collected all the cases of custom-made silicone implants to treat funnel chests in our plastic surgery department. The quality of the results was evaluated by the patient, and in a blind manner by the surgical team using photographs and standardized surveys. The pre-operative delays, the operating time and length of hospital stays, the number of surgical recoveries, and the post-operative surgical outcomes were recorded. Between 1990 and 2016, we designed 29 silicone thoracic implants in our department. Before 2012, implants were made from plaster chest molds (n=13). After this date, implants were designed by CAD (n=16). Patients rated their results as "good" or "excellent" in 77% and 86% of cases respectively in the plaster and CAD groups. The surgical team's ratings for CAD implant reconstructions were better than in the plaster group: 8.17 versus 6.96 (P=0.001). CAD implants were significantly less detectable than the plaster group implants. The operating time was reduced in the CAO group: 60.2 compared to 74.7minutes in the plaster group (P=0.04), as was the length of hospitalization: 3.5 versus 5.3 days (P=0.01). There were no significant differences between the two groups in terms of post-operative complications. The management of pectus excavatum by a custom-made silicone implant is a minimally invasive method that provides good cosmetic results. The design of these implants is facilitated and qualitatively improved by CAD. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. A case-control study of surgical site infection following operative fixation of fractures of the ankle in a large U.K. trauma unit.

    Science.gov (United States)

    Korim, M T; Payne, R; Bhatia, M

    2014-05-01

    Most of the literature on surgical site infections following the surgical treatment of fractures of the ankle is based on small series of patients, focusing on diabetics or the elderly. None have described post-operative functional scores in those patients who develop an infection. We performed an age- and gender-matched case-control study to identify patient- and surgery-related risk factors for surgical site infection following open reduction and internal fixation of a fracture of the ankle. Logistic regression analysis was used to identify significant risk factors for infection and to calculate odds ratios (OR). Function was assessed using the Olerud and Molander Ankle Score. The incidence of infection was 4% (29/717) and 1.1% (8/717) were deep infections. The median ankle score was significantly lower in the infection group compared with the control group (60 vs 90, Mann-Whitney test p fractures (OR = 4, p = 0.048) were significant risk factors for infection. A low incidence of infection following open reduction and internal fixation of fractures of the ankle was observed. Both superficial and deep infections result in lower functional scores.

  17. Explaining technological change of wind power in China and the United States: Roles of energy policies, technological learning, and collaboration

    Science.gov (United States)

    Tang, Tian

    The following dissertation explains how technological change of wind power, in terms of cost reduction and performance improvement, is achieved in China and the US through energy policies, technological learning, and collaboration. The objective of this dissertation is to understand how energy policies affect key actors in the power sector to promote renewable energy and achieve cost reductions for climate change mitigation in different institutional arrangements. The dissertation consists of three essays. The first essay examines the learning processes and technological change of wind power in China. I integrate collaboration and technological learning theories to model how wind technologies are acquired and diffused among various wind project participants in China through the Clean Development Mechanism (CDM)--an international carbon trade program, and empirically test whether different learning channels lead to cost reduction of wind power. Using pooled cross-sectional data of Chinese CDM wind projects and spatial econometric models, I find that a wind project developer's previous experience (learning-by-doing) and industrywide wind project experience (spillover effect) significantly reduce the costs of wind power. The spillover effect provides justification for subsidizing users of wind technologies so as to offset wind farm investors' incentive to free-ride on knowledge spillovers from other wind energy investors. The CDM has played such a role in China. Most importantly, this essay provides the first empirical evidence of "learning-by-interacting": CDM also drives wind power cost reduction and performance improvement by facilitating technology transfer through collaboration between foreign turbine manufacturers and local wind farm developers. The second essay extends this learning framework to the US wind power sector, where I examine how state energy policies, restructuring of the electricity market, and learning among actors in wind industry lead to

  18. Low Energy Technology. A Unit of Instruction on Energy Conservation in Field Crop Production.

    Science.gov (United States)

    Davis, George; Scanlon, Dennis C.

    This unit of instruction on energy conservation in field crop production was designed for use by agribusiness and natural resources teachers in Florida high schools and by agricultural extension agents as they work with adults and students. It is one of a series of 11 instructional units (see note) written to help teachers and agents to educate…

  19. Low Energy Technology. A Unit of Instruction in Florida Agriculture. Crop Protection with Integrated Pest Management.

    Science.gov (United States)

    Florida Univ., Gainesville. Inst. of Food and Agricultural Sciences.

    This unit of instruction on integrated pest management was designed for use by agribusiness and natural resources teachers in Florida high schools and by agricultural extension agents as they work with adults and students. It is one of a series of 11 instructional units (see note) written to help teachers and agents to educate their students and…

  20. Information Technology & Applications Corporation v. United States: An Interested Party's "Substantial Chance" at APA Standing

    National Research Council Canada - National Science Library

    Slicker, Christina

    2003-01-01

    .... Building on CICA's "interested party" definition with Information Technology's refinement of "substantial chance" rule, the Federal Circuit has effectively translated "APA standing" into the language...

  1. The value of advanced technology in meeting 2050 greenhouse gas emissions targets in the United States

    International Nuclear Information System (INIS)

    Kyle, Page; Clarke, Leon; Pugh, Graham; Wise, Marshall; Calvin, Kate; Edmonds, James; Kim, Son

    2009-01-01

    This paper, a contribution to the EMF 22 subgroup on Transition Scenarios, examines the relationship between technology evolution over the next 40 years and the cost, energy, and greenhouse gas emissions consequences of possible U.S. mitigation goals. The paper explores these issues within the context of cumulative emissions targets based on linear reductions in CO 2 -e emissions of 50% and 80% below 1990 levels by 2050. Six technology futures were constructed within the MiniCAM integrated assessment model and then applied to the emissions targets. The paper explores the influence of technology availability and expectations of future technology availability on the economic consequences of emissions mitigation, on the time path of emissions mitigation, and on the evolution of the U.S. energy system over time. One of the strongest themes to emerge from the scenarios in this study is that near-term decision-making depends on the availability of technology decades into the future, when deep emissions reductions are required to meet the cumulative emissions goals. In the scenarios in this paper, it is the expectations about future technology that have the most dramatic effect on greenhouse gas emissions prices and emissions reductions in 2020, as opposed to near-term technology availability. Moreover, it is the nature of technology 20, 30, and 40 years out, rather than availability and deployment of technology in the next decade, that will largely determine the character of the mid-century energy system.

  2. ANALISIS KEPUASAN PEGAWAI TERHADAP LAYANAN UNIT SISTEM INFORMASI MENGGUNAKAN TECHNOLOGY ACCEPTANCE MODEL DI PT KERETA API INDONESIA (PERSERO

    Directory of Open Access Journals (Sweden)

    Yuda Yuliana

    2016-09-01

    Full Text Available Abstract Satisfaction in work is an individual thing. Each individual will have a level of satisfaction varies according to the system of values prevailing in him. This study was conducted to determine the level of employee satisfaction with the services in the information systems unit PT Kereta Api Indonesia (Persero in order to get results that can make service information systems unit to be better again. Based on the analysis of Multiple Linear Regression method Technology Acceptance Model , obtained the result that the employees satisfied with the usability factor ( Perceived Usefulness the variable Perceived Usefulness and Perceived Ease of Use influencing variable Attitude Toward Using With his existing results of scientific research , the expected improvement in the quality of services provided to the employee information systems unit.   Keywords: Employee Satisfaction, Perceived Usefulness, Perceived Ease of Use, Attitude Toward Using.

  3. Short rotation woody crops: Using agroforestry technology for energy in the United States

    International Nuclear Information System (INIS)

    Wright, L.L.; Ranney, J.W.

    1991-01-01

    Agroforestry in the United States is being primarily defined as the process of using trees in agricultural systems for conservation purposes and multiple products. The type of agroforestry most commonly practiced in many parts of the world, that is the planting of tree crops in combination with food crops or pasture, is the type least commonly practiced in the United States. One type of agroforestry technique, which is beginning now and anticipated to expand to several million acres in the United States, is the planting of short-rotation woody crops (SRWCs) primarily to provide fiber and fuel. Research on SRWC's and environmental concerns are described

  4. UNITED STATES DEPARTMENT OF ENERGY OFFICE OF ENVIRONMENTAL MANAGEMENT WASTE PROCESSING ANNUAL TECHNOLOGY DEVELOPMENT REPORT 2008

    Energy Technology Data Exchange (ETDEWEB)

    Bush, S.

    2009-11-05

    The Office of Waste Processing identifies and reduces engineering and technical risks and uncertainties of the waste processing programs and projects of the Department of Energy's Environmental Management (EM) mission through the timely development of solutions to technical issues. The risks, and actions taken to mitigate those risks, are determined through technology readiness assessments, program reviews, technology information exchanges, external technical reviews, technical assistance, and targeted technology development and deployment. The Office of Waste Processing works with other DOE Headquarters offices and project and field organizations to proactively evaluate technical needs, identify multi-site solutions, and improve the technology and engineering associated with project and contract management. Participants in this program are empowered with the authority, resources, and training to implement their defined priorities, roles, and responsibilities. The Office of Waste Processing Multi-Year Program Plan (MYPP) supports the goals and objectives of the U.S. Department of Energy (DOE) - Office of Environmental Management Engineering and Technology Roadmap by providing direction for technology enhancement, development, and demonstration that will lead to a reduction of technical risks and uncertainties in EM waste processing activities. The MYPP summarizes the program areas and the scope of activities within each program area proposed for the next five years to improve safety and reduce costs and environmental impacts associated with waste processing; authorized budget levels will impact how much of the scope of activities can be executed, on a year-to-year basis. Waste Processing Program activities within the Roadmap and the MYPP are described in these seven program areas: (1) Improved Waste Storage Technology; (2) Reliable and Efficient Waste Retrieval Technologies; (3) Enhanced Tank Closure Processes; (4) Next-Generation Pretreatment Solutions; (5

  5. United States Department Of Energy Office Of Environmental Management Waste Processing Annual Technology Development Report 2008

    International Nuclear Information System (INIS)

    Bush, S.

    2009-01-01

    The Office of Waste Processing identifies and reduces engineering and technical risks and uncertainties of the waste processing programs and projects of the Department of Energy's Environmental Management (EM) mission through the timely development of solutions to technical issues. The risks, and actions taken to mitigate those risks, are determined through technology readiness assessments, program reviews, technology information exchanges, external technical reviews, technical assistance, and targeted technology development and deployment. The Office of Waste Processing works with other DOE Headquarters offices and project and field organizations to proactively evaluate technical needs, identify multi-site solutions, and improve the technology and engineering associated with project and contract management. Participants in this program are empowered with the authority, resources, and training to implement their defined priorities, roles, and responsibilities. The Office of Waste Processing Multi-Year Program Plan (MYPP) supports the goals and objectives of the U.S. Department of Energy (DOE) - Office of Environmental Management Engineering and Technology Roadmap by providing direction for technology enhancement, development, and demonstration that will lead to a reduction of technical risks and uncertainties in EM waste processing activities. The MYPP summarizes the program areas and the scope of activities within each program area proposed for the next five years to improve safety and reduce costs and environmental impacts associated with waste processing; authorized budget levels will impact how much of the scope of activities can be executed, on a year-to-year basis. Waste Processing Program activities within the Roadmap and the MYPP are described in these seven program areas: (1) Improved Waste Storage Technology; (2) Reliable and Efficient Waste Retrieval Technologies; (3) Enhanced Tank Closure Processes; (4) Next-Generation Pretreatment Solutions; (5

  6. The Status of Technology and Engineering Education in the United States: A Fourth Report of the Findings from the States (2011-12)

    Science.gov (United States)

    Moye, Johnny J.; Dugger, William E., Jr.; Starkweather, Kendall N.

    2012-01-01

    Technology and engineering education continues to evolve as it becomes more apparent that students need this information to become more successful in college and careers. The International Technology and Engineering Educators Association (ITEEA ) has tracked the status of technology education in the United States in three separate studies over the…

  7. Surgical innovations in canine gonadectomy

    OpenAIRE

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated negative consequences (lengthy placement, impaired wound healing around bulky knots, and the effect of unsightly knots on cosmetics). A study in 9 dogs found that celiotomy closure was easily achiev...

  8. [Diagnosis and the technology for optimizing the medical support of a troop unit].

    Science.gov (United States)

    Korshever, N G; Polkovov, S V; Lavrinenko, O V; Krupnov, P A; Anastasov, K N

    2000-05-01

    The work is devoted to investigation of the system of military unit medical support with the use of principles and states of organizational diagnosis; development of the method allowing to assess its functional activity; and determination of optimization trends. Basing on the conducted organizational diagnosis and expert inquiry the informative criteria were determined which characterize the stages of functioning of the military unit medical support system. To evaluate the success of military unit medical support the complex multi-criteria pattern was developed and algorithm of this process optimization was substantiated. Using the results obtained, particularly realization of principles and states of decision taking theory in machine program it is possible to solve more complex problem of comparison between any number of military units: to dispose them according to priority decrease; to select the programmed number of the best and worst; to determine the trends of activity optimization in corresponding medical service personnel.

  9. TO APPLICATION OF BIO-GAS UNITS: ORGANIZATIONAL AND TECHNOLOGICAL MODEL

    Directory of Open Access Journals (Sweden)

    Thuy Nga Nguyen

    2011-01-01

    Full Text Available Analysis of the published papers written by national and foreign researchers reveals that an increasing global energy deficit, exhaustion of  fossil organic and nuclear fuels, chemical and radio-active contamination of the environment are main reasons in favour of  thorough investigation  and wide introduction of non-conventional and renewable energy sources. Nowadays Vietnamese Institute of Energy Science has been developing the state-of-the-art bio-gas technologies on the  basis of application and modernization of Chinese and Dutch family-style technologies. The most rational technologies are combined ones which operate using various types of energy raw materials, for example, solar and bio-gas energy because usage of solar energy expands operational possibilities of the bio-gas system, ensures its operation within wide temperature range creating necessary parameters for the required technological task.

  10. 5.4. The technology of complex reprocessing of Tok-Mack deposit al-unites

    International Nuclear Information System (INIS)

    Nazarov, Sh.B.; Safiev, Kh.S.; Mirsaidov, U.

    2008-01-01

    On the base of passed investigations and obtained results of al-unitesraw materials reprocessing author present the technology of complexreprocessing of these ores on: sulfuric salts; potassium sulfates, sodium andnatrium carbonate; calcium sulfates, alumina

  11. Sensitivity of super-efficient data envelopment analysis results to individual decision-making units: an example of surgical workload by specialty.

    Science.gov (United States)

    Dexter, Franklin; O'Neill, Liam; Xin, Lei; Ledolter, Johannes

    2008-12-01

    We use resampling of data to explore the basic statistical properties of super-efficient data envelopment analysis (DEA) when used as a benchmarking tool by the manager of a single decision-making unit. Our focus is the gaps in the outputs (i.e., slacks adjusted for upward bias), as they reveal which outputs can be increased. The numerical experiments show that the estimates of the gaps fail to exhibit asymptotic consistency, a property expected for standard statistical inference. Specifically, increased sample sizes were not always associated with more accurate forecasts of the output gaps. The baseline DEA's gaps equaled the mode of the jackknife and the mode of resampling with/without replacement from any subset of the population; usually, the baseline DEA's gaps also equaled the median. The quartile deviations of gaps were close to zero when few decision-making units were excluded from the sample and the study unit happened to have few other units contributing to its benchmark. The results for the quartile deviations can be explained in terms of the effective combinations of decision-making units that contribute to the DEA solution. The jackknife can provide all the combinations contributing to the quartile deviation and only needs to be performed for those units that are part of the benchmark set. These results show that there is a strong rationale for examining DEA results with a sensitivity analysis that excludes one benchmark hospital at a time. This analysis enhances the quality of decision support using DEA estimates for the potential ofa decision-making unit to grow one or more of its outputs.

  12. A feasibility pilot study on the use of complementary therapies delivered via mobile technologies on Icelandic surgical patients' reports of anxiety, pain, and self-efficacy in healing.

    Science.gov (United States)

    Hansen, Margaret M

    2015-03-28

    Complementary therapies (CT), such as relaxation technique, massage, guided imagery, and accupuncture have shown to benefit patients undergoing surgery. The aim of this study was to determine the feasibility of using audio relaxation technique (ART), music intervention (MI), nature video application with music (NVAM), and nature video application without music (NVA) delivered via mobile technologies in a clinical setting. Secondary, the effects of ART, MI, NVAM and NVA on patients' state anxiety, pain perception, and perceived self-efficacy in healing were determined. A randomized clinical trial (RCT) involving 105 same day surgery (SDS) patients, who were assigned to an ART (n = 25), MI (n = 25), NVAM (n = 15), NVA (n = 16), or a control group (n = 24) were assessed for state anxiety, self-reported pain, and self-efficacy four days prior to surgery, immediately prior and following a surgical intervention, and day five post-operative. ANOVA found no statistically significant differences in anxiety scores; pain, or perceived self-efficacy between the five groups. Matched pairs t-Test revealed all participants had an increase in anxiety from pre-op to day 10 follow-up; a significant change in pain levels from pre-op to day 10 follow-up; and all participants had a significant increase in general self-efficacy from pre-op to day 10 follow-up. Mean pain level scores from day 1 to pre-op showed a significant decrease in pain for the ART group and NVAM group. Matched pairs t-Test for self-efficacy scores indicated the MI group and the NVA group had significant increases in self-efficacy. A significant decrease in anxiety from pre-op to day 10 for participants reporting a prior history of anxiety and for those reporting prior history of taking anti-anxiety medications. Despite the non-significant findings between the five groups, at any measurement point, there were valuable trends toward significance and confirmed feasibility in a clinical setting

  13. Evaluating the development of carbon capture and storage technologies in the United States

    International Nuclear Information System (INIS)

    van Alphen, Klaas; Noothout, Paul M.; Hekkert, Marko P.; Turkenburg, Wim C.

    2010-01-01

    Carbon capture and storage (CCS) is seen as an important solution to solve the twin challenge of reducing GHG emissions, while utilizing fossil fuel reserves to meet future energy requirements. In this study an innovation systems perspective is applied to review the development of CCS technologies in the US between 2000 and 2009 and to come up with policy recommendations for technology managers that wish to accelerate the deployment of CCS. The analysis describes the successful built-up of an innovation system around CCS and pinpoints the key determinants for this achievement. However, the evaluation of the system's performance also indicates that America's leading role in the development of CCS should not be taken for granted. It shows that the large CCS R and D networks, as well as the extensive CCS knowledge base, which have been accumulated over the past decade, have not yet been valorized by entrepreneurs to explore the market for integrated CCS concepts linked to power generation. Therefore, it is argued that the build-up of the innovation system has entered a critical phase that is decisive for a further thriving development of CCS technologies in the US. This study provides a clear understanding of the current barriers to the technology's future deployment and outlines a policy strategy that (1) stimulates technological learning; (2) facilitates collaboration and coordination in CCS actor networks; (3) creates financial and market incentives for the technology; and (4) provides supportive regulation and sound communication on CCS. (author)

  14. [da Vinci surgical system].

    Science.gov (United States)

    Watanabe, Gou; Ishikawa, Norihiro

    2014-07-01

    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  15. The Health Information Technology Competencies Tool: Does It Translate for Nursing Informatics in the United States?

    Science.gov (United States)

    Sipes, Carolyn; Hunter, Kathleen; McGonigle, Dee; West, Karen; Hill, Taryn; Hebda, Toni

    2017-12-01

    Information technology use in healthcare delivery mandates a prepared workforce. The initial Health Information Technology Competencies tool resulted from a 2-year transatlantic effort by experts from the US and European Union to identify approaches to develop skills and knowledge needed by healthcare workers. It was determined that competencies must be identified before strategies are established, resulting in a searchable database of more than 1000 competencies representing five domains, five skill levels, and more than 250 roles. Health Information Technology Competencies is available at no cost and supports role- or competency-based queries. Health Information Technology Competencies developers suggest its use for curriculum planning, job descriptions, and professional development.The Chamberlain College of Nursing informatics research team examined Health Information Technology Competencies for its possible application to our research and our curricular development, comparing it originally with the TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 tools, which examine informatics competencies at four levels of nursing practice. Additional analysis involved the 2015 Nursing Informatics: Scope and Standards of Practice. Informatics is a Health Information Technology Competencies domain, so clear delineation of nursing-informatics competencies was expected. Researchers found TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 differed from Health Information Technology Competencies 2016 in focus, definitions, ascribed competencies, and defined levels of expertise. When Health Information Technology Competencies 2017 was compared against the nursing informatics scope and standards, researchers found an increase in the number of informatics competencies but not to a significant degree. This is not surprising

  16. “Too busy to think, too tired to learn” - the attrition of the apprenticeship model of surgical training in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Andrea Kelly

    2006-04-01

    Full Text Available Abstract: This article examines the notion of apprenticeship as experienced by trainee surgeons within the modern NHS, and attempts to demonstrate some unintended consequences of managerial target setting upon the training process. It argues that this situation is made more critical by the lack of explicit standards and curriculum by which trainees may assess their progress, and also that the potential grafting of behaviourist competence-based training models onto older notions of apprenticeship will be inadequate to meet the need for an holistic account of the development of professional practice. Alternative theoretical perspectives are examined, in particular social accounts of shared and collaborative expertise such as Lave and Wenger’s “community of practice” and Vygotsky’s thinking on the “zone of proximal development” with its emphasis on a highly active pedagogic role for both mentor and peers. A parallel is also suggested with Leder’s work on therapeutic discourse, in the sense that both patient and trainee actively construct shared interpretative modes with the doctor-mentor. These accounts challenge the traditional model of medical education which assumes a linear hierarchy of learning, effectively ignoring the cyclic nature of surgical development, and the mutual learning needs of “new comers” and “old-timers”. In order to initiate the modelling of surgical development, it is suggested that: • a dynamic and non-linear view of progress is required; • the link between formal structured training and opportunistic learning “on the job” is crucial; • assessment strategies are needed that promote, rather than hinder, the learning that derives from reflective practice.

  17. The Framework for an Information Technology Strategic Roadmap for the United States Marine Corps: How Current Acquisitions Align to the Current Strategic Direction of the Department of Defense, Department of the Navy, and United States Marine Corps

    National Research Council Canada - National Science Library

    Garcia, Richard D; Sloan, Joshua K

    2008-01-01

    ... (IT) roadmap may comprise a "tipping point" for future warfighting effectiveness. This thesis begins the basis for a framework for an information technology strategic roadmap for the United States Marine Corps...

  18. The Use of Technology for STD Partner Services in the United States: A Structured Review.

    Science.gov (United States)

    Kachur, Rachel; Hall, Wendasha; Coor, Alexandra; Kinsey, Jennine; Collins, Dayne; Strona, F V

    2018-05-01

    Since the late 1990s, health departments and STD programs throughout the U.S. have used technologies, such as the internet and mobile phones, to provide services to persons with a sexually transmitted infection, including HIV, and their sex partners, also known as partner services. This study reviewed the published literature to assess and compare partner services outcomes as a result of using technology and to calculate cost savings through cases averted. We conducted a structured literature review of all U.S. studies that examined the use of technology to notify persons exposed to an STD (syphilis, chlamydia, gonorrhea), including HIV, by health care professionals in the U.S. from 2000 to 2017. Outcome measures, including the number of the number of partners notified, screened or tested; and new positives identified, were captured and cost savings were calculated, when data were available. Seven studies were identified. Methods used for partner services differed across studies, although email was the primary mode in 6 (83%) of the 7 studies. Only 2 of the 7 studies compared use of technology for partner services to traditional partner services. Between 10% and 97% of partners were successfully notified of their exposure through the use of technology and between 34% and 81% were screened or tested. Five studies reported on new infections identified, which ranged from 3-19. Use of technology for partner serves saved programs between $22,795 and $45,362 in direct and indirect medical costs. Use of technology for partner services increased the number of partners notified, screened or tested, and new infections found. Importantly, the use of technology allowed programs to reach partners who otherwise would not have been notified of their exposure to an STD or HIV. Improved response times and time to treatment were also seen as was re-engagement into care for previous HIV positive patients. Data and outcome measures across the studies were not standardized, making it

  19. Use of Technology for HIV Prevention Among Adolescent and Adult Women in the United States.

    Science.gov (United States)

    Blackstock, Oni J; Patel, Viraj V; Cunningham, Chinazo O

    2015-12-01

    Although the proportion of new HIV infections in the USA among women has decreased over the last few years, still, approximately 20 % of new infections occur annually among adolescent and adult women. The development of effective evidence-based prevention interventions remains an important approach to further decreasing these numbers. Technology-delivered prevention interventions hold tremendous potential due, in part, to their ability to reach beyond the walls of brick-and-mortar intervention sites to engage individuals where they are. While most technology-delivered interventions have focused on adolescents and men who have sex with men, much fewer have specifically targeted adolescent or adult women despite evidence showing that interventions tailored to specific target populations are most effective. We summarize the recently published literature on technology-delivered HIV prevention interventions for US adolescent and adult women and provide suggestions for next steps in this nascent but emergent area of prevention research.

  20. Technological innovation and its effect on public health in the United States

    Science.gov (United States)

    Gill, Preetinder Singh

    2013-01-01

    Background Good public health ensures an efficient work force. Organizations can ensure a prominent position on the global stage by staying on the leading edge of technological development. Public health and technological innovation are vital elements of prosperous economies. It is important to understand how these elements affect each other. This research study explored and described the relationship between these two critical elements/constructs. Methods Indicators representing technological innovation and public health were identified. Indicator data from 2000 to 2009 were collected from various US federal government sources, for the four US Census regions. The four US Census regions were then compared in terms of these indicators. Canonical correlation equations were formulated to identify combinations of the indicators that are strongly related to each other. Additionally, the cause–effect relationship between public health and technological innovation was described using the structural equation modeling technique. Results The four US Census regions ranked differently in terms of both type of indicators in a statistically significant manner. The canonical correlation analysis showed that the first set of canonical variables had a fairly strong relationship, with a magnitude > 0.65 at the 95% confidence interval, for all census regions. Structural equation modeling analysis provided β 12.98, for all census regions. The threshold Student’s t statistic was 1.98. Hence, it was found that the β values were significant at the 95% confidence interval, for all census regions. Discussion The results of the study showed that better technological innovation indicator scores were associated with better public health indicator scores. Furthermore, the study provided preliminary evidence that technological innovation shares causal relation with public health. PMID:23378771

  1. Occurrence of nosocomial methicillin-resistant Staphylococcus aureus as a marker for transmission in a surgical intensive care unit in China

    NARCIS (Netherlands)

    Chen, Yong; Zhao, Wei; Liu, Hui; Song, Qing; Wang, Yan; Zhao, Jingya; Zheng, Dongyu; Han, Xuelin; Hu, Xiaohua; Grundmann, Hajo; Han, Li

    In 2008, an intensive care unit (ICU) in a large Chinese hospital was moved from a 6-bed old ward to a 20-bed new ward. After the move, the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in patients and environmental sites decreased significantly, but the number of ICU-acquired

  2. Meeting United States re-licensing requirements related to environmental protection using innovative technologies

    International Nuclear Information System (INIS)

    Taft, E.P.; Winchell, F.C.; Cook, T.C.

    1998-01-01

    Procedure for meeting re-licensing requirements related to environmental protection and an overview of several new and emerging technologies regarding the development of ways to prevent fish passage through hydraulic turbines at hydroelectric power dams is described. Fish mortality and injury has long been a concern in the hydroelectric industry and research and development efforts have been ongoing since the 1970s to prevent fish passage through turbines. Several new and emerging technologies are examined that have the potential for wide-spread cost-effective applications

  3. Guiding principles for good practices in hospital-based health technology assessment units

    DEFF Research Database (Denmark)

    Sampietro-Colom, Laura; Lach, Krzysztof; Pasternack, Iris

    2015-01-01

    OBJECTIVES: Health technology assessment (HTA) carried out for policy decision making has well-established principles unlike hospital-based HTA (HB-HTA), which differs from the former in the context characteristics and ways of operation. This study proposes principles for good practices in HB-HTA...

  4. United States Offshoring of Information Technology: An Empirical Investigation of Factors Inhibiting Sub-Saharan Africa

    Science.gov (United States)

    Omoregie, Harry O.

    2012-01-01

    In the last decade, the global information technology offshoring (ITO) and business process outsourcing (BPO) services have grown significantly, especially in Asia. The increased demand for offshore services in Asia has presented a difficult problem for U.S. organizations because countries such as India are now experiencing saturation of labor…

  5. The Department of Defense Critical Technologies Plan for the Committees on Armed Services United States Congress

    Science.gov (United States)

    1991-05-01

    Early focus is on investigag advanced simulation technology for engine controls ( ASTEC ) to expl1oit increases in computational power, and on... ASTEC (FY 1992). 0 1 A * F electronics (FY 1992). * Fiber optics sensors/integration (FY 1994). * lightweight nozzle actuator (1FY 1995). 14-10

  6. Evaluating the development of carbon capture and storage technologies in the United States

    NARCIS (Netherlands)

    Alphen, K. van; Noothout, P.M.; Hekkert, M.P.; Turkenburg, W.C.

    2010-01-01

    Carbon capture and storage (CCS) is seen as an important solution to solve the twin challenge of reducing GHG emissions, while utilizing fossil fuel reserves to meet future energy requirements. In this study an innovation systems perspective is applied to review the development of CCS technologies

  7. An Empirical Analysis of United States Consumers' Concerns about Eight Food Production and Processing Technologies

    OpenAIRE

    Hwang, Yun Jae; Roe, Brian E.; Teisl, Mario F.

    2005-01-01

    For a representative sample of U.S. consumers, we rank, correlate and explain ratings of concern toward eight food production and processing technologies (antibiotics, pesticides, artificial growth hormones, genetic modification, irradiation, artificial colors/flavors, pasteurization, and preservatives). Concern is highest for pesticides and hormones, followed by concern toward antibiotics, genetic modification and irradiation. We document standard relationships between many demographic, econ...

  8. Testing Predictive Models of Technology Integration in Mexico and the United States

    Science.gov (United States)

    Velazquez, Cesareo Morales

    2008-01-01

    Data from Mexico City, Mexico (N = 978) and from Texas, USA (N = 932) were used to test the predictive validity of the teacher professional development component of the Will, Skill, Tool Model of Technology Integration in a cross-cultural context. Structural equation modeling (SEM) was used to test the model. Analyses of these data yielded…

  9. Children Designing & Engineering: Contextual Learning Units in Primary Design and Technology

    Science.gov (United States)

    Hutchinson, Patricia

    2002-01-01

    The Children Designing & Engineering (CD&E) Project at the College of New Jersey is a collaborative effort of the College's Center for Design and Technology and the New Jersey Chamber of Commerce. The Project, funded by the National Science Foundation (NSF), has been charged to develop instructional materials for grades K-5. The twelve…

  10. Follicular unit extraction hair transplant automation: options in overcoming challenges of the latest technology in hair restoration with the goal of avoiding the line scar.

    Science.gov (United States)

    Rashid, Rashid M; Morgan Bicknell, Lindsay T

    2012-09-15

    Follicular unit extraction (FUE) provides many advantages over the strip surgical method of harvesting hair grafts for hair restoration. However, FUE also has its shortcomings because it is a more time intensive approach that results in increased costs and is technically a more challenging technique of hair transplantation. In this manuscript, we seek to share approaches used at our center to help minimize and/or improve on some of the challenges of FUE.

  11. Regional Centres for Space Science and Technology Education and ICG Information Centres affiliated to the United Nations

    Science.gov (United States)

    Gadimova, S.; Haubold, H. J.

    2009-06-01

    Based on resolutions of the United Nations General Assembly, Regional Centres for Space Science and Technology Education were established in India, Morocco, Nigeria, Brazil and Mexico. Simultaneously, education curricula were developed for the core disciplines of remote sensing, satellite communications, satellite meteorology, and space and atmospheric science. This paper provides a brief summary on the status of the operation of the regional centres with a view to use them as information centres of the International Committee on Global Navigation Satellite Systems (ICG), and draws attention to their educational activities.

  12. The Internet of Citizens. A lawyer’s view on some technological developments in the United Kingdom and India

    OpenAIRE

    Noto La Diega, Guido

    2017-01-01

    This article is a useful tool for both Asian and European readers as regards some of the state-of-the-art technologies revolving around the Internet of Things (‘IoT’) and their intersection with cloud computing (the Clouds of Things, ‘CoT’) in both the continents. The main legal issues will be presented, with a focus on intellectual property, consumer protection, and privacy. India and the United Kingdom are selected because they are at the forefront of the IoT innovation in their respective ...

  13. Light water reactor (LWR) innovation needs in the United States: The Massachusetts Institute of Technology LWR innovation project

    International Nuclear Information System (INIS)

    Golay, M.W.

    1988-01-01

    A major effort under way within the Massachusetts Institute of Technology (MIT) Engineering School is focused on the contributions that technology innovation can make in revitalizing nuclear power in the United States. A principal component of this effort is a project to improve the designs of the next generation of light water reactors (LWRs) with emphasis on achieving improved capacity factors and safety, and reducing the construction duration. The motivation for this overall effort is to prevent the nuclear option from being unnecessarily lost by being available only in uneconomic configurations. In considering how to advance this effort, the authors focused on refining the designs of new reactors because this is the area where the greatest opportunities for improvements exist

  14. RM12-2703 Advanced Rooftop Unit Control Retrofit Kit Field Demonstration: Hawaii and Guam Energy Improvement Technology Demonstration Project

    Energy Technology Data Exchange (ETDEWEB)

    Doebber, I. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Dean, J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Dominick, J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Holland, G. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-03-01

    As part of its overall strategy to meet its energy goals, the Naval Facilities Engineering Command (NAVFAC) partnered with U.S. Department of Energy's (DOE) National Renewable Energy Laboratory (NREL) to rapidly demonstrate and deploy cost-effective renewable energy and energy efficiency technologies. This was one of several demonstrations of new and underutilized commercial energy efficiency technologies. The consistent year-round demand for air conditioning and dehumidification in Hawaii provides an advantageous demonstration location for advanced rooftop control (ARC) retrofit kits to packaged rooftop units (RTUs). This report summarizes the field demonstration of ARCs installed on nine RTUs serving a 70,000-ft2 exchange store (large retail) and two RTUs, each serving small office buildings located on Joint Base Pearl Harbor-Hickam (JBPHH).

  15. Technology meets tradition: The perceived impact of the introduction of information and communication technology on ward rounds in the intensive care unit.

    Science.gov (United States)

    Plumb, Jennifer J; Hains, Isla; Parr, Michael J; Milliss, David; Herkes, Robert; Westbrook, Johanna I

    2017-09-01

    Public policy in many health systems is currently dominated by the quest to find ways to 'do more with less'-to achieve better outcomes at a reduced cost. The success or failure of initiatives in support of this quest are often understood in terms of an adversarial dynamic or struggle between the professional logics of medicine and of management. Here, we use the case of the introduction of information and communication technology (ICT) to a well-established ritual of medical autonomy (the medical ward round) to articulate a more nuanced explanation of how and why new ways of working with technology are accepted and adopted (or not). The study was conducted across four intensive care units (ICUs) in major teaching hospitals in Sydney, Australia. Using interviews, we examined 48 doctors' perceptions of the impact of ICT on ward round practice. We applied the concept of institutional logics to frame our analysis. Interview transcripts were analysed using a hybrid of deductive and inductive thematic analysis. The doctors displayed a complex engagement with the technology that belies simplistic characterisations of medical rejection of managerial encroachment. In fact, they selectively welcomed into the ward round aspects of the technology which reinforced the doctor's place in the healthcare hierarchy and which augmented their role as scientists. At the same time, they guarded against allowing managerial logic embedded in ICT to de-emphasise their embodied subjectivity in relation to the patient as a person rather than as a collection of parameters. ICT can force the disruption of some aspects of existing routines, even where these are long-established rituals. Resistance arose when the new technology did not fit with the 'logic of care'. Incorporation of the logic of care into the design and customisation of clinical information systems is a challenge and potentially counterproductive, because it could attempt to apply a technological fix to what is essentially a

  16. UNITED STATES DEPARTMENT OF ENERGY WASTE PROCESSING ANNUAL TECHNOLOGY DEVELOPMENT REPORT 2007

    Energy Technology Data Exchange (ETDEWEB)

    Bush, S

    2008-08-12

    The Office of Environmental Management's (EM) Roadmap, U.S. Department of Energy--Office of Environmental Management Engineering & Technology Roadmap (Roadmap), defines the Department's intent to reduce the technical risk and uncertainty in its cleanup programs. The unique nature of many of the remaining facilities will require a strong and responsive engineering and technology program to improve worker and public safety, and reduce costs and environmental impacts while completing the cleanup program. The technical risks and uncertainties associated with cleanup program were identified through: (1) project risk assessments, (2) programmatic external technical reviews and technology readiness assessments, and (3) direct site input. In order to address these needs, the technical risks and uncertainties were compiled and divided into the program areas of: Waste Processing, Groundwater and Soil Remediation, and Deactivation and Decommissioning (D&D). Strategic initiatives were then developed within each program area to address the technical risks and uncertainties in that program area. These strategic initiatives were subsequently incorporated into the Roadmap, where they form the strategic framework of the EM Engineering & Technology Program. The EM-21 Multi-Year Program Plan (MYPP) supports the goals and objectives of the Roadmap by providing direction for technology enhancement, development, and demonstrations that will lead to a reduction of technical uncertainties in EM waste processing activities. The current MYPP summarizes the strategic initiatives and the scope of the activities within each initiative that are proposed for the next five years (FY2008-2012) to improve safety and reduce costs and environmental impacts associated with waste processing; authorized budget levels will impact how much of the scope of activities can be executed, on a year-to-year basis. As a result of the importance of reducing technical risk and uncertainty in the EM Waste

  17. Energy technologies for the United Kingdom: an appraisal for R, D and D planning

    International Nuclear Information System (INIS)

    1979-01-01

    The subject is discussed in chapters. The general energy situation is described and reference is made to the first discussion paper, published in September 1976. The second chapter identifies the UK's needs for energy research, development and demonstration, and discusses the factors to be considered before decisions are made on the programmes to be undertaken. (Annex A in Volume II (published separately) discusses strategy for the UK's R, D and D in each of the main technologies, including nuclear power, in the light of these considerations). Chapter three covers energy conservation R, D and D; chapter four deals with R, D and D on the supply and use of fuels; and chapter five, the renewable energy sources. The separately published annexes (Volume II) are entitled; technologies; energy modelling methodology; the exploratory scenario; low energy futures. (U.K.)

  18. The Benevolent Hegemon: The United States National Space Protection Strategy-Anchored in Cooperation Not Technology

    Science.gov (United States)

    2010-04-01

    for data distribution, and not methods of firepower delivery, protection is unnecessary. 1 In addition, since the physical loss of a satellite does...capabilities at the transmission sites, the satellites, or the user equipment; (2) physical attacks against actual spacecraft or ground stations; (3...Barry D. “Doctrine, Technology, and War.” In Warfare Studies AY10 Coursebook , edited by Sharon McBride, 15-35. Maxwell AFB, AL: Air University Press

  19. Research on Key Technologies of Unit-Based CNC Machine Tool Assembly Design

    OpenAIRE

    Zhongqi Sheng; Lei Zhang; Hualong Xie; Changchun Liu

    2014-01-01

    Assembly is the part that produces the maximum workload and consumed time during product design and manufacturing process. CNC machine tool is the key basic equipment in manufacturing industry and research on assembly design technologies of CNC machine tool has theoretical significance and practical value. This study established a simplified ASRG for CNC machine tool. The connection between parts, semantic information of transmission, and geometric constraint information were quantified to as...

  20. Research, development and demonstration on energy technologies for the United Kingdom

    International Nuclear Information System (INIS)

    1980-02-01

    The subject is covered in sections, entitled: introduction -the general energy situation (global aspects); the UK's needs for energy R, D and D (relative importance to the UK of R, D and D on different energy technologies including nuclear power); energy conservation R, D and D; R, D and D on the supply and use of conventional fuels (including nuclear fuels); R, D and D on renewable energy sources; the national strategy for energy R, D and D. (U.K.)

  1. Increasing the Mobility of Dismounted Marines. Small Unit Mobility Enhancement Technologies: Unmanned Ground Vehicles Market Survey

    Science.gov (United States)

    2009-10-01

    DARPA) Legged Squad Support System (LS3) Program. DARPA’s LS3 Program is an effort to develop a walking platform, preferably a quadruped, which...top-scoring UGV’s are track- or wheel-based; only the BigDog is a leg -based system. This presented BigDog with certain advantages (particularly...Technologies, Inc.’s ( DTI ) first location in Ranlo, North Carolina) – is a system capable of wheeled or tracked locomotion and was recently

  2. United States Department Of Energy Office Of Environmental Management Technology Development Report Fiscal Year 2010

    International Nuclear Information System (INIS)

    Bush, S.

    2010-01-01

    The mission of the Department of Energy's (DOE's) Office of Environmental Management (EM) is to clean up the environmental legacy of nuclear weapons research and production during the Cold War. That mission includes cleaning up nuclear waste, contaminated groundwater and soil, nuclear materials, and contaminated facilities covering two million acres of land in thirty-five states. EM's principal program goals include timely completion of tank waste treatment facilities, reduction of the life-cycle costs and acceleration of the cleanup of the Cold War legacy, and reduction of the EM footprint. The mission of the EM Technology Innovation and Development program is to transform science and innovation into practical solutions to achieve the EM mission. During fiscal year 2010 (October 2009-September 2010), EM focused upon accelerating environmental cleanup by expeditiously filling identified gaps in available knowledge and technology in the EM program areas. This report describes some of the approaches and transformational technologies in tank waste processing, groundwater and soil remediation, nuclear materials disposition, and facility deactivation and decommissioning developed during fiscal year 2010 that will enable EM to meet its most pressing program goals.

  3. Extra heavy oil and refinery residues upgrading through Eni Slurry Technology : first EST commercial unit

    Energy Technology Data Exchange (ETDEWEB)

    Rispoli, G.; Sanfilippo, D.; Amoroso, A [Eni S.p.A., Rome (Italy)

    2009-07-01

    The production of heavy crude oils is projected to continue to grow in the upstream oil industry given that large reserves of unconventional extra heavy crude and bitumen exist in several geographic areas including Canada and Venezuela. As reserves of conventional crude oil continue to decline, these unconventional feedstocks are becoming an opportunity to pursue, but they require effective technologies for upgrading and meeting the growing demand for light and middle distillate fuels. This paper described the proprietary technology that offers a solution to upstream and downstream oil producers for bottom-of-the-barrel upgrading. En i Slurry Technology (EST) is constructing an industrial plant in its Sannazzaro refinery in Italy. The plant is designed to convert 23,000 BPSD of vacuum residue into high quality diesel and other valuable refinery streams such as liquefied petroleum gas, naphtha and jet fuel. EST is an H-addition process characterized by the use of a special homogeneous isothermal intrinsically safe reactor, and of a nano-dispersed non-ageing catalyst. EST converts more than 98 per cent of any type of residues to about 110 per cent volume of light products and distillates or extra heavy oils to high quality bottomless SCO. In typical performance, HDS is greater than 85 per cent, HDM greater than 99 per cent and HDCCR greater than 97 per cent. EST also achieves the target of zero fuel oil - zero coke. 12 refs., 4 tabs., 5 figs.

  4. UNITED STATES DEPARTMENT OF ENERGY OFFICE OF ENVIRONMENTAL MANAGEMENT TECHNOLOGY DEVELOPMENT REPORT FISCAL YEAR 2010

    Energy Technology Data Exchange (ETDEWEB)

    Bush, S.

    2010-10-22

    The mission of the Department of Energy's (DOE's) Office of Environmental Management (EM) is to clean up the environmental legacy of nuclear weapons research and production during the Cold War. That mission includes cleaning up nuclear waste, contaminated groundwater and soil, nuclear materials, and contaminated facilities covering two million acres of land in thirty-five states. EM's principal program goals include timely completion of tank waste treatment facilities, reduction of the life-cycle costs and acceleration of the cleanup of the Cold War legacy, and reduction of the EM footprint. The mission of the EM Technology Innovation and Development program is to transform science and innovation into practical solutions to achieve the EM mission. During fiscal year 2010 (October 2009-September 2010), EM focused upon accelerating environmental cleanup by expeditiously filling identified gaps in available knowledge and technology in the EM program areas. This report describes some of the approaches and transformational technologies in tank waste processing, groundwater and soil remediation, nuclear materials disposition, and facility deactivation and decommissioning developed during fiscal year 2010 that will enable EM to meet its most pressing program goals.

  5. Robotic surgical training.

    Science.gov (United States)

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey.

  6. Interdisciplinary Navigation Unit for Mathematics and Earth Science Using Geospatial Technology

    Science.gov (United States)

    Smaglik, S. M.; Harris, V.

    2006-12-01

    Central Wyoming College (CWC) is located northeast of the Wind River Mountains. Although many people find recreation in the wilderness and remote areas surrounding the area, people still lose their lives because they become lost or disoriented. Creating an interdisciplinary field-based curriculum unit within mathematics (MATH 1000) and earth science (GEOL 1070) courses for non-science and education majors, provides students an opportunity to develop critical thinking skills and quantitative literacy. It also provides some necessary skills for survival and an understanding of landscape formation and wilderness navigation using geoscience. A brief history of navigation, including the importance of finding latitude and longitude, and the fairly recent implementation of the Global Positioning System, precedes activities in which students learn to use a basic compass. In addition to learning how to adjust for magnetic declination they read topographic maps, specifically USGS quadrangles, and learn how to use the scale in the legend to verify calculations using the Pythagorean Theorem. Students learn how to estimate distance and time required for traveling a pre- determined distance while using dimensional analysis to convert from the English system to metric. They learn how to read and measure latitude and longitude, as well as universal transverse Mercator projection measurements (UTM's), to find their position. The basic mathematical skills are assessed through hands-on activities such as finding their location on a map using a compass, a GPS unit, and Google Earth, and using a combination of maps, compasses, and GPS units to navigate through a course. Our goal is to provide life-saving information to students while incorporating necessary core curriculum from both mathematics and earth science classes. We work to create field-based activities, as well as assessments, to insure that students who complete the course are prepared to safely enjoy the outdoors and are

  7. Emergency Preparedness technology support to the Health and Safety Executive (HSE), Nuclear Installations Inspectorate (NII) of the United Kingdom

    International Nuclear Information System (INIS)

    O'Kula, K.R.

    1994-03-01

    The Nuclear Installations Inspectorate (NII) of the United Kingdom (UK) suggested the use of an accident progression logic model method developed by Westinghouse Savannah River Company (WSRC) and Science Applications International Corporation (SAIC) for K Reactor to predict the magnitude and timing of radioactivity releases (the source term) based on an advanced logic model methodology. Predicted releases are output from the personal computer-based model in a level-of-confidence format. Additional technical discussions eventually led to a request from the NII to develop a proposal for assembling a similar technology to predict source terms for the UK's advanced gas-cooled reactor (AGR) type. To respond to this request, WSRC is submitting a proposal to provide contractual assistance as specified in the Scope of Work. The work will produce, document, and transfer technology associated with a Decision-Oriented Source Term Estimator for Emergency Preparedness (DOSE-EP) for the NII to apply to AGRs in the United Kingdom. This document, Appendix A is a part of this proposal

  8. Comparison of Advanced Residential Water Heating Technologies in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Maguire, Jeff [National Renewable Energy Lab. (NREL), Golden, CO (United States); Fang, Xia [National Renewable Energy Lab. (NREL), Golden, CO (United States); Wilson, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2013-05-01

    In this study, gas storage, gas tankless, condensing, electric storage, heat pump, and solar water heaters were simulated in several different climates across the United States, installed in both conditioned and unconditioned space and subjected to several different draw profiles. While many pre-existing models were used, new models of condensing and heat pump water heaters were created specifically for this work. In each case modeled, the whole house was simulated along with the water heater to capture any interactions between the water heater and the space conditioning equipment.

  9. Advanced Motor Control Test Facility for NASA GRC Flywheel Energy Storage System Technology Development Unit

    Science.gov (United States)

    Kenny, Barbara H.; Kascak, Peter E.; Hofmann, Heath; Mackin, Michael; Santiago, Walter; Jansen, Ralph

    2001-01-01

    This paper describes the flywheel test facility developed at the NASA Glenn Research Center with particular emphasis on the motor drive components and control. A four-pole permanent magnet synchronous machine, suspended on magnetic bearings, is controlled with a field orientation algorithm. A discussion of the estimation of the rotor position and speed from a "once around signal" is given. The elimination of small dc currents by using a concurrent stationary frame current regulator is discussed and demonstrated. Initial experimental results are presented showing the successful operation and control of the unit at speeds up to 20,000 rpm.

  10. Status report on compact gasifier cogeneration units in Germany. Applications of the cogeneration gasifier technology; Stand kleintechnischer Vergaser-BHKW-Anlagen in Deutschland. Einsatz der BHKW-Vergasertechnologie

    Energy Technology Data Exchange (ETDEWEB)

    Zschunke, Tobias; Schuessler, Ingmar; Salomo, Bert [Hochschule Zittau/Goerlitz (Germany); Braekow, Dieter [Foerdergesellschaft Erneuerbare Energien e.V., Berlin (Germany); Treppe, Konrad [Technische Univ. Dresden (Germany). Inst. fuer Verfahrenstechnik und Umwelttechnik

    2010-07-01

    In contrast to biogas, the use of solid biomass with low water content in cogeneration units is lagging several years of development behind. A promising variant is a wood gas engine cogeneration unit. Different energy sources can be combined, e.g. in an Otto engine and a Stirling engine. The authors describe the technology for compact systems. (orig.)

  11. United States Department of Agriculture-Agricultural Research Service research in application technology for pest management.

    Science.gov (United States)

    Smith, L A; Thomson, S J

    2003-01-01

    A research summary is presented that emphasizes ARS achievements in application technology over the past 2-3 years. Research focused on the improvement of agricultural pesticide application is important from the standpoint of crop protection as well as environmental safety. Application technology research is being actively pursued within the ARS, with a primary focus on application system development, drift management, efficacy enhancement and remote sensing. Research on application systems has included sensor-controlled hooded sprayers, new approaches to direct chemical injection, and aerial electrostatic sprayers. For aerial application, great improvements in on-board flow controllers permit accurate field application of chemicals. Aircraft parameters such as boom position and spray release height are being altered to determine their effect on drift. Other drift management research has focused on testing of low-drift nozzles, evaluation of pulsed spray technologies and evaluation of drift control adjuvants. Research on the use of air curtain sprayers in orchards, air-assist sprayers for row crops and vegetables, and air deflectors on aircraft has documented improvements in application efficacy. Research has shown that the fate of applied chemicals is influenced by soil properties, and this has implications for herbicide efficacy and dissipation in the environment. Remote sensing systems are being used to target areas in the field where pests are present so that spray can be directed to only those areas. Soil and crop conditions influence propensity for weeds and insects to proliferate in any given field area. Research has indicated distinct field patterns favorable for weed growth and insect concentration, which can provide further assistance for targeted spraying.

  12. Accomplishments and challenges of surgical simulation.

    Science.gov (United States)

    Satava, R M

    2001-03-01

    For nearly a decade, advanced computer technologies have created extraordinary educational tools using three-dimensional (3D) visualization and virtual reality. Pioneering efforts in surgical simulation with these tools have resulted in a first generation of simulators for surgical technical skills. Accomplishments include simulations with 3D models of anatomy for practice of surgical tasks, initial assessment of student performance in technical skills, and awareness by professional societies of potential in surgical education and certification. However, enormous challenges remain, which include improvement of technical fidelity, standardization of accurate metrics for performance evaluation, integration of simulators into a robust educational curriculum, stringent evaluation of simulators for effectiveness and value added to surgical training, determination of simulation application to certification of surgical technical skills, and a business model to implement and disseminate simulation successfully throughout the medical education community. This review looks at the historical progress of surgical simulators, their accomplishments, and the challenges that remain.

  13. Using laser technological unit ALTI "Karavella" for precision components of IEP production

    Science.gov (United States)

    Labin, N. A.; Chursin, A. D.; Paramonov, V. S.; Klimenko, V. I.; Paramonova, G. M.; Kolokolov, I. S.; Vinogradov, K. Y.; Betina, L. L.; Bulychev, N. A.; Dyakov, Yu. A.; Zakharyan, R. A.; Kazaryan, M. A.; Koshelev, K. K.; Kosheleva, O. K.; Grigoryants, A. G.; Shiganov, I. N.; Krasovskii, V. I.; Sachkov, V. I.; Plyaka, P. S.; Feofanov, I. N.; Chen, C.

    2015-12-01

    The paper revealed the using of industrial production equipment ALTI "Karavella-1", "Karavella-1M", "Karavella-2" and "Karavella-2M" precision components of IEP production [1-4]. The basis for the ALTI using in the IEP have become the positive results of research and development of technologies of foil (0.01-0.2 mm) and thin sheets (0.3-1 mm) materials micromachining by pulsed radiation CVL [5, 6]. To assess the micromachining quality and precision the measuring optical microscope (UHL VMM200), projection microscope (Mitutoyo PV5100) and Carl Zeiss microscope were used.

  14. Comparison of surgical outcomes among infants in neonatal intensive care units treated by pediatric surgeons versus general surgeons: The need for pediatric surgery specialists.

    Science.gov (United States)

    Boo, Yoon Jung; Lee, Eun Hee; Lee, Ji Sung

    2017-11-01

    This study compared the outcomes of infants who underwent surgery in neonatal intensive care units by pediatric surgeons and by general surgeons. This was a retrospective study of infants who underwent surgery in neonatal intensive care units between 2010 and 2014. A total of 227 patients were included. Of these patients, 116 were operated on by pediatric surgeons (PS) and 111 were operated on by general surgeons (GS). The outcome measures were the overall rate of operative complications, unplanned reoperation, mortality rate, length of stay, operative time, and number of total number of operative procedures. The overall operative complication rate was higher in the GS group compared with the PS group (18.7% vs. 7.0%, p=0.0091). The rate of unplanned reoperations was also higher in the GS group (10.8% vs. 3.5%, p=0.0331). The median operation time (90min vs. 75min, p=0.0474) and median length of stay (24days vs. 18days, p=0.0075) were significantly longer in the GS group. The adjusted odd ratios of postoperative complications for GS were 2.9 times higher than that of PS (OR 2.90, p=0.0352). The operative quality and patient outcomes of the PS group were superior to those of the GS group. III. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Application of Digital Technology for the Plant Protection System in Ulchin Nuclear Power Plant Units 5 and 6

    International Nuclear Information System (INIS)

    Deucksoo, Lee; Insik, Kim

    2006-01-01

    Since the completion of construction of Ulchin Nuclear Power Plant Units 3 and 4 (UCN 3 and 4), the first units of the OPR (Optimized Power Reactor) series, various advanced design features have been incorporated to the following OPRs. The Ulchin Nuclear Power Plant Units 5 and 6(UCN 5 and 6) which started commercial operation in Korea from 2004 and 2005 respectively, are designed to provide improvements in safety, reliability and costs by applying both advanced proven technology and experiences gained from the construction and operation of the previous OPRs. Among those improvements, the digital plant protection system (DPPS) and the digital engineered safety feature actuation system (DESFAS) are the key elements to the UCN 5 and 6 designs. The DPPS and DESFAS utilizing the digital computer technology offer a solution to the obsolescence problem of analog system. These features also provide the potential for additional benefits such as ease of maintenance, increased performance, reduction of internal and external cross channel wiring, improvement of the surveillance testability and flexibility of control logic programming change. During the initial design stage, the Korean regulatory body had evaluated these design concepts intensively and concluded it to be acceptable for the safety point of view. Also, in-depth review on the detailed design and the special evaluation/audit for the software design process has been performed to secure the quality of the software. As a result, every issue raised during licensing review has been clarified and the operating licenses for the UCN 5 and 6 were issued in October, 2003 and October, 2004 respectively, by the government. In this paper, design characteristics of the UCN 5 and 6 are introduced, and advanced design features and implementation process are presented focused on the DPPS/DESFAS with some benefit analysis results. (authors)

  16. New multimedia advances in surgical information.

    Science.gov (United States)

    Glenn, Ian C; Abdulhai, Sophia; Lamoshi, Abdulraouf; Ponsky, Todd A

    2018-06-01

    When discussing new trends in pediatric surgery, the tendency is to focus on novel surgical technology and techniques. However, it is equally important to examine how the practicing surgeon stays abreast in an ever-changing field. This article serves as a brief guide to the future of surgical education for the attending surgeon. Broadly, advances in surgical education consist of new methods of filtration and delivery of knowledge.

  17. Environmental issues in planning building energy technologies R ampersand D in the United States

    International Nuclear Information System (INIS)

    Farhar, B.C.; Abel, F.H.; Nicholls, A.K.; Millhone, J.P.

    1991-08-01

    The US Department of Energy's Office of Building Technologies (OBT) has begun studies on the relationship and impact of buildings energy use on the environment, particularly with respect to global climate change, acid rain, stratospheric ozone depletion, and indoor air quality. The paper presents an overview of international and US federal activity in global change to set OBT's activities in context. The paper then reviews briefly the contribution of buildings to atmospheric problems through building energy use. OBT's program primarily supports projects with indirect environmental impacts through energy efficiency (e.g., thermally activated heat pumps use natural gas instead of electricity) and the use of renewables in buildings. The paper briefly describes the OBT program and covers an inventory of projects that OBT has funded on environmental/building problems. Analyses have included three kinds of topics: (1) CFC substitutes for refrigeration equipment, (2) incorporating the cost of externalities into utility electricity generation, and (3) indoor air quality. The paper shows how environmental issues are being taken into account in planning the US R ampersand D program in building energy technologies. 27 refs

  18. Challenges in safety regulation of R and D activities for advanced technologies in DAE units

    International Nuclear Information System (INIS)

    Shukla, Dinesh Kumar

    2016-01-01

    DAE is engaged in intensive research and developmental activities, especially for advanced technologies such as accelerators, lasers, supercomputers, advanced materials and instrumentation. The starting point of an R and D project might be a hypothesis to be tested, problem to be solved, or the performance of an item to be improved, and there may be many possible solutions and technologies that could be used. R and D is quite different from designing, constructing, operating a plant. In these, precisely described result can be defined from the beginning and can be described in design specifications, process descriptions and procedures. However, while established procedures may be available to begin an R and D project, deviation from these procedures may occur often as a legitimate component of the conduct of R and D. Nevertheless, the R and D activities have to be performed in a manner which provides assurance that safety requirements are adequately addressed. Hence, the regulatory approach for enforcing the safety regulation in such facilities is also not as rigid as those for an operating industry. This paper is aimed to discuss some of the key challenges in regulating such R and D activities and also attempts to suggest a way forward. (author)

  19. Radiation therapy technology (radiation therapists) manpower needs 1992 comparison of radiation therapeutic technology education in Europe and the United States 1994

    International Nuclear Information System (INIS)

    Rominger, C. Jules; Owen, Jean; Thompson, Phyllis; Giordano, Patricia; Buck, Beverly; Hanks, Gerald

    1995-01-01

    The shortage of radiation therapists (radiation therapy technologists) has existed in the United States for many years. It now appears the supply may be matching the demand. This report analyzes the data from the most recent manpower study from ACR/ASTRO carried out in 1990 using the Patterns of Care Master Facility list. The report is a comparison of these figures with similar figures published in IJROBP in December, 1983. Between 1980 and 1990 the number of radiation therapists rose from 3096 to 5353, an increase of 72%. During this period of time, the number of radiation therapy machines increased 47%, and the number of patients being treated increased 30%. The total number of educational programs in radiation therapy technology increased from 101 in 1989 to 123 in 1993. The total enrollment in these programs grew from 806 in 1989 to 1591 in 1993. The number of first time examinees in radiation therapy technology by ARRT in 1983 was 387 and increased to 943 in 1994. It is apparent that as a result of the increase in the number of radiation therapy educational programs and the more effective recruitment into these program, the supply of graduating radiation therapists has reached the demand. The future needs for entry level radiation therapists should be based on current data as well as new Blue Book standards that are being developed

  20. Ultrasonic inspection technology development and search units design examples of practical applications

    CERN Document Server

    Brook, Mark V

    2012-01-01

    "Ultrasonic testing is a relatively new branch of science and industry. The development of ultrasonic testing started in the late 1920s. At the beginning, the fundamentals of this method were borrowed from basic physics, geometrical and wave optics, acoustics and seismology. Later it became clear that some of these theories and calculation methods could not always explain the phenomena observed in many specific cases of ultrasonic testing. Without knowing the nuances of the ultrasonic wave propagation in the test object it is impossible to design effective inspection technique and search units for it realization. This book clarifies the theoretical differences of ultrasonics from the other wave propagation theories presenting both basics of physics in the wave propagation, elementary mathematic and advanced practical applications. Almost every specific technique presented in this book is proofed by actual experimental data and examples of calculations"--

  1. Impact of 2001 Building Technology, state and community programs on United States employment and wage income

    International Nuclear Information System (INIS)

    MJ Scott; DJ Hostick; DB Elliott

    2000-01-01

    The Department of Energy Office of Building Technology, State and Community Programs (BTS) is interested in assessing the potential economic impacts of its portfolio of programs on national employment and income. A special purpose version of the IMPLAN input-output model allied In Build is used in this study of all 38 BTS programs included in the FY2001 federal budget. Energy savings, investments, and impacts on U.S. national employment and wage income are reported by program for selected years to the year 2030. Energy savings from these programs have the potential of creating a total of nearly 332,000 jobs and about $5.3 billion in wage income (1995$) by the year 2030. Because the required investments to achieve these savings are capital intensive, the net effect after investment is 304,000 jobs and $5.0 billion

  2. Acquisition of Japanese science and technology information in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Kinzey, B.

    1991-04-01

    Critical needs exist in the U.S. for access to and productive use of Japanese scientific and technological (S T) information. Japan has become a major competitor to the U.S. in numerous areas and the acquisition of intelligence on Japanese S T activities is becoming a necessary endeavor to maintain the health of much of U.S. industry. Unfortunately, most American organizations are still relatively inexperienced in the acquisition and use of different foreign information sources compared to their Japanese counterparts. As in any new endeavor, would-be or should-be users may be unaware of the range of different information sources available and potential benefits or pitfalls that accompany their use. This paper describes some common sources of information on Japanese S T activities and notes their associated strengths and weaknesses. General cautions and recommendations regarding the use of different sources compiled from personal and related staff experiences are also provided. 3 refs., 1 tab.

  3. Electrochemically regenerable carbon dioxide/moisture control technology for an Advanced Extravehicular Mobility Unit

    Science.gov (United States)

    Lee, M. C.; Sudar, M.; Cusick, R. J.

    1987-01-01

    Regenerable CO2/moisture removal techniques that reduce the expendables and logistics requirements are needed to sustain people undertaking EVAs for the Space Station. Here, the development of electrochemically regenerable CO2 absorption (ERCA) technology to replace the nonregenerable LiOH absorber for the advanced Portable Life Support System (PLSS) is reported. During EVA the ERCA uses a mechanism involving gas absorption into a liquid absorbent for the removal and storage of the metabolically produced CO2 and moisture. Following the EVA, the expended absorbent is regenerated onboard the Space Station by an electrochemical CO2 concentrator. The ERCA concept has the ability to effectively satisfy the high metabolic CO2 and moisture removal requirements of PLSS applications. This paper defines the ERCA concept and its advantages for the PLSS application, reviews breadboard test data, and presents physical characteristics of the breadboard and projected flight hardware.

  4. Impact of building technology, state and community programs on United States employment and wage income

    International Nuclear Information System (INIS)

    Scott, M.J.; Hostick, D.J.; Elliott, D.B.; Schultz, R.W.

    1998-04-01

    As part of measuring the impact of government programs on improving the energy efficiency of the nation's building stock, the Department of Energy Office of Building Technology, State and Community Programs (BTS) is interested in assessing the economic impacts of its portfolio of programs, specifically the potential impact on national employment and income. This assessment is being done for the first time in FY99 as a supplement to the Government Performance and Results Act (GPRA--formerly, Quality Metrics) estimates of primary energy savings and environmental and direct financial benefits of the BTS programs. The programmatic needs of BTS suggest that a simple, flexible, user-friendly method is needed to derive national employment and income impacts of individual BTS programs. Therefore, BTS funded Pacific Northwest National Laboratory (PNNL) to develop a special-purpose version of the Impact Analysis for Planning (IMPLAN) national input-output model (Minnesota IMPLAN Group, Inc. 1997) specifically to estimate the employment and income effects of building energy technologies. The special-purpose version of the IMPLAN model used in this study is called ImBuild. Extensive documentation and a user's guide are provided in Scott et al. (1998). Compared with simple economic multiplier approaches, such as the published multipliers from the Department of Commerce Regional Input-Output Modeling System (RIMS 2), ImBuild allows for more complete and automated analysis of the economic impacts of energy efficiency investments in buildings. ImBuild is also easier to use than existing macroeconomic simulation models. In this report, the authors use the ImBuild model to calculate the impact of all 32 BTS programs reported in the BTS GPRA Metrics Estimates, FY99 Budget Request, December 19, 1997

  5. Evolution of surgical skills training

    Science.gov (United States)

    Roberts, Kurt E; Bell, Robert L; Duffy, Andrew J

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients. Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. The Accreditation Council of Graduate Medical Education’s (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent. Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients. PMID:16718842

  6. Innovation in pediatric surgical education.

    Science.gov (United States)

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Science, Technology and Innovation through Entrepreneurship Education in the United Arab Emirates (UAE

    Directory of Open Access Journals (Sweden)

    Irfan Hameed

    2016-12-01

    Full Text Available The purpose of this study is to investigate the ways of achieving Science, Technology and Innovation (STI in UAE. Previously, sustainability within an entrepreneurship context has been related to economic viability as opposed to sustainability in its broadest sense. Through a survey research method, we have highlighted the effects of three independent variables and two intervening variables on three important outcomes, innovation, need for achievement and motivation, which ultimately contributes towards STI. These data have been collected from the students of a well-known university in Al-Ain, UAE. The responses of 251 students have been utilized for analysis. For hypotheses testing, we used AMOS 18 (Structural Equation Modeling and SPSS 20. The study revealed that all of the predictors have a strong effect on the outcome variables, which leads to STI in UAE. There is a strong need to revise the curriculum of higher education institutions of UAE to develop self-confidence, locus of control and risk taking propensity among students. The study provides novel insight into entrepreneurship education and serves as an initial benchmark in the field.

  8. Reductions in Average Lengths of Stays for Surgical Procedures Between the 2008 and 2014 United States National Inpatient Samples Were Not Associated With Greater Incidences of Use of Postacute Care Facilities.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H

    2018-03-01

    Diagnosis-related group (DRG) based reimbursement creates incentives for reduction in hospital length of stay (LOS). Such reductions might be accomplished by lesser incidences of discharges to home. However, we previously reported that, while controlling for DRG, each 1-day decrease in hospital median LOS was associated with lesser odds of transfer to a postacute care facility (P = .0008). The result, though, was limited to elective admissions, 15 common surgical DRGs, and the 2013 US National Readmission Database. We studied the same potential relationship between decreased LOS and postacute care using different methodology and over 2 different years. The observational study was performed using summary measures from the 2008 and 2014 US National Inpatient Sample, with 3 types of categories (strata): (1) Clinical Classifications Software's classes of procedures (CCS), (2) DRGs including a major operating room procedure during hospitalization, or (3) CCS limiting patients to those with US Medicare as the primary payer. Greater reductions in the mean LOS were associated with smaller percentages of patients with disposition to postacute care. Analyzed using 72 different CCSs, 174 DRGs, or 70 CCSs limited to Medicare patients, each pairwise reduction in the mean LOS by 1 day was associated with an estimated 2.6% ± 0.4%, 2.3% ± 0.3%, or 2.4% ± 0.3% (absolute) pairwise reduction in the mean incidence of use of postacute care, respectively. These 3 results obtained using bivariate weighted least squares linear regression were all P < .0001, as were the corresponding results obtained using unweighted linear regression or the Spearman rank correlation. In the United States, reductions in hospital LOS, averaged over many surgical procedures, are not accomplished through a greater incidence of use of postacute care.

  9. Developing information technology at the Medical Research Unit of the Albert Schweitzer Hospital in Lambaréné, Gabon.

    Science.gov (United States)

    Dibacka, Paterne Lessihuin; Bounda, Yann; Nguema, Davy Ondo; Lell, Bertrand

    2010-03-01

    Information technology has become a key resource for research institutions, providing services such as hardware, software and network maintenance, as well as data management services. The IT department of the Medical Research Unit (MRU) of the Albert Schweitzer Hospital in Lambaréné, Gabon is a good example of how IT has developed at African Research Centres in recent years and demonstrates the scope of work that a modern research centre needs to offer. It illustrates the development in the past 15 years--from single computers maintained by investigators to the present situation of a group of well-trained local IT personal who are in charge of a variety of hardware and software and who also develop applications for use in a research environment. Open source applications are particularly suited for these needs and various applications are used in data management, data analysis, accounting, administration and quality management.

  10. A united refinement technology for commercial pure Al by Al-10Ti and Al-Ti-C master alloys

    Energy Technology Data Exchange (ETDEWEB)

    Ma Xiaoguang [Key Laboratory of Liquid Structure and Heredity of Materials, Ministry of Education, Shandong University, Jinan 250061 (China); Liu Xiangfa [Key Laboratory of Liquid Structure and Heredity of Materials, Ministry of Education, Shandong University, Jinan 250061 (China)], E-mail: xfliu@sdu.edu.cn; Ding Haimin [Key Laboratory of Liquid Structure and Heredity of Materials, Ministry of Education, Shandong University, Jinan 250061 (China)

    2009-03-05

    Because flake-like TiAl{sub 3} particles in Al-Ti-C master alloys prepared in a melt reaction method dissolve slowly when they are added into Al melt at 720 deg. C, Ti atoms cannot be released rapidly to play the assistant role of grain refinement, leading to a poor refinement efficiency of Al-Ti-C master alloys. A united refinement technology by Al-10Ti and Al-Ti-C master alloys was put forward in this paper. The rational combination of fine blocky TiAl{sub 3} particles in Al-10Ti and TiC particles in Al-Ti-C can improve the nucleation rate of {alpha}-Al. It not only improves the grain refinement efficiency of Al-Ti-C master alloys, but also reduces the consumption.

  11. An Analysis of Information Technology Adoption by IRBs of Large Academic Medical Centers in the United States.

    Science.gov (United States)

    He, Shan; Botkin, Jeffrey R; Hurdle, John F

    2015-02-01

    The clinical research landscape has changed dramatically in recent years in terms of both volume and complexity. This poses new challenges for Institutional Review Boards' (IRBs) review efficiency and quality, especially at large academic medical centers. This article discusses the technical facets of IRB modernization. We analyzed the information technology used by IRBs in large academic institutions across the United States. We found that large academic medical centers have a high electronic IRB adoption rate; however, the capabilities of electronic IRB systems vary greatly. We discuss potential use-cases of a fully exploited electronic IRB system that promise to streamline the clinical research work flow. The key to that approach utilizes a structured and standardized information model for the IRB application. © The Author(s) 2014.

  12. Automated system of monitoring and positioning of functional units of mining technological machines for coal-mining enterprises

    Directory of Open Access Journals (Sweden)

    Meshcheryakov Yaroslav

    2018-01-01

    Full Text Available This article is show to the development of an automated monitoring and positioning system for functional nodes of mining technological machines. It describes the structure, element base, algorithms for identifying the operating states of a walking excavator; various types of errors in the functioning of microelectromechanical gyroscopes and accelerometers, as well as methods for their correction based on the Madgwick fusion filter. The results of industrial tests of an automated monitoring and positioning system for functional units on one of the opencast coal mines of Kuzbass are presented. This work is addressed to specialists working in the fields of the development of embedded systems and control systems, radio electronics, mechatronics, and robotics.

  13. A united refinement technology for commercial pure Al by Al-10Ti and Al-Ti-C master alloys

    International Nuclear Information System (INIS)

    Ma Xiaoguang; Liu Xiangfa; Ding Haimin

    2009-01-01

    Because flake-like TiAl 3 particles in Al-Ti-C master alloys prepared in a melt reaction method dissolve slowly when they are added into Al melt at 720 deg. C, Ti atoms cannot be released rapidly to play the assistant role of grain refinement, leading to a poor refinement efficiency of Al-Ti-C master alloys. A united refinement technology by Al-10Ti and Al-Ti-C master alloys was put forward in this paper. The rational combination of fine blocky TiAl 3 particles in Al-10Ti and TiC particles in Al-Ti-C can improve the nucleation rate of α-Al. It not only improves the grain refinement efficiency of Al-Ti-C master alloys, but also reduces the consumption

  14. Industrial Sector Technology Use Model (ISTUM): industrial energy use in the United States, 1974-2000. Volume 4. Technology appendix. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    1979-10-01

    Volume IV of the ISTUM documentation gives information on the individual technology specifications, but relates closely with Chapter II of Volume I. The emphasis in that chapter is on providing an overview of where each technology fits into the general-model logic. Volume IV presents the actual cost structure and specification of every technology modeled in ISTUM. The first chapter presents a general overview of the ISTUM technology data base. It includes an explanation of the data base printouts and how the separate-cost building blocks are combined to derive an aggregate-technology cost. The remaining chapters are devoted to documenting the specific-technology cost specifications. Technologies included are: conventional technologies (boiler and non-boiler conventional technologies); fossil-energy technologies (atmospheric fluidized bed combustion, low Btu coal and medium Btu coal gasification); cogeneration (steam, machine drive, and electrolytic service sectors); and solar and geothermal technologies (solar steam, solar space heat, and geothermal steam technologies), and conservation technologies.

  15. Progress of ITER full tungsten divertor technology qualification in Japan: Manufacturing full-scale plasma-facing unit prototypes

    International Nuclear Information System (INIS)

    Ezato, Koichiro; Suzuki, Satoshi; Seki, Yohji; Yamada, Hirokazu; Hirayama, Tomoyuki; Yokoyama, Kenji; Escourbiac, Frederic; Hirai, Takeshi

    2016-01-01

    Highlights: • JADA has demonstrated the feasibility of manufacturing the full-W plasma-facing units (W-PFU). • The surface profiles of the W monoblocks of the W-PFU prototypes on the test frame to mimic the support structure of the ITER OVT were examined by using an optical three-dimensional measurement system. The results show the most W monoblock surface in the target part locates within + 0.25 mm from the CAD data. • The strict profile control with the profile tolerance of ±0.3 mm is imposed on the OVT to prevent the leading edges of the W monoblocks from over-heating. • The present full-scale prototyping demonstrates to satisfy this requirement on the surface profile. • It can be concluded that the technical maturities of JADA and its suppliers are as high as to start series manufacturing the ITER divertor components. - Abstract: Japan Atomic Energy Agency (JAEA) is in progress for technology demonstration toward Full-tungsten (W) ITER divertor outer vertical target (OVT), especially, W monoblock technology that needs to withstand the repetitive heat load as high as 20 MW/m 2 for 10 s. Under the framework of the W divertor qualification program developed ITER organization, JAEA as Japanese Domestic Agency (JADA) manufactured seven full-scale plasma-facing unit (PFU) prototypes with the Japanese industries. Four prototypes that have 146 W monoblock joint with casted copper (Cu) interlayer passed successfully the ultrasonic testing. In the other three prototypes that have the different W/Cu interlayer joint, joint defects were found. The dimension measurements reveal the requirements of the gap between W monoblocks and the surface profile of PFU are feasible.

  16. Progress of ITER full tungsten divertor technology qualification in Japan: Manufacturing full-scale plasma-facing unit prototypes

    Energy Technology Data Exchange (ETDEWEB)

    Ezato, Koichiro, E-mail: ezato.koichiro@jaea.go.jp [Department of ITER Project, Naka Fusion Institute, Sector of Fusion Research and Development, Japan Atomic Energy Agency (Japan); Suzuki, Satoshi; Seki, Yohji; Yamada, Hirokazu; Hirayama, Tomoyuki; Yokoyama, Kenji [Department of ITER Project, Naka Fusion Institute, Sector of Fusion Research and Development, Japan Atomic Energy Agency (Japan); Escourbiac, Frederic; Hirai, Takeshi [ITER Organization, route de vinon sur Verdon, 13067 St Paul lez Durance (France)

    2016-11-01

    Highlights: • JADA has demonstrated the feasibility of manufacturing the full-W plasma-facing units (W-PFU). • The surface profiles of the W monoblocks of the W-PFU prototypes on the test frame to mimic the support structure of the ITER OVT were examined by using an optical three-dimensional measurement system. The results show the most W monoblock surface in the target part locates within + 0.25 mm from the CAD data. • The strict profile control with the profile tolerance of ±0.3 mm is imposed on the OVT to prevent the leading edges of the W monoblocks from over-heating. • The present full-scale prototyping demonstrates to satisfy this requirement on the surface profile. • It can be concluded that the technical maturities of JADA and its suppliers are as high as to start series manufacturing the ITER divertor components. - Abstract: Japan Atomic Energy Agency (JAEA) is in progress for technology demonstration toward Full-tungsten (W) ITER divertor outer vertical target (OVT), especially, W monoblock technology that needs to withstand the repetitive heat load as high as 20 MW/m{sup 2} for 10 s. Under the framework of the W divertor qualification program developed ITER organization, JAEA as Japanese Domestic Agency (JADA) manufactured seven full-scale plasma-facing unit (PFU) prototypes with the Japanese industries. Four prototypes that have 146 W monoblock joint with casted copper (Cu) interlayer passed successfully the ultrasonic testing. In the other three prototypes that have the different W/Cu interlayer joint, joint defects were found. The dimension measurements reveal the requirements of the gap between W monoblocks and the surface profile of PFU are feasible.

  17. Evolving Educational Techniques in Surgical Training.

    Science.gov (United States)

    Evans, Charity H; Schenarts, Kimberly D

    2016-02-01

    Training competent and professional surgeons efficiently and effectively requires innovation and modernization of educational methods. Today's medical learner is quite adept at using multiple platforms to gain information, providing surgical educators with numerous innovative avenues to promote learning. With the growth of technology, and the restriction of work hours in surgical education, there has been an increase in use of simulation, including virtual reality, robotics, telemedicine, and gaming. The use of simulation has shifted the learning of basic surgical skills to the laboratory, reserving limited time in the operating room for the acquisition of complex surgical skills". Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Buried chip skin grafting in neuropathic diabetic foot ulcers following vacuum-assisted wound bed preparation: enhancing a classic surgical tool with novel technologies.

    Science.gov (United States)

    Kopp, Jürgen; Kneser, Ulrich; Bach, Alexander D; Horch, Raymund E

    2004-09-01

    In patients with diabetes mellitus, complications such as polyneuropathy and peripheral angiopathy inevitably lead to diabetic foot complications including foot ulcers, gangrene, and osteoarthropathy. These conditions necessitate minor or major amputation as part of treatment. In patients with Charcot's arthropathy and predominant neuropathy, recurrent foot ulcers are common in areas of high pressure. Such high pressure is caused by the degrading of the architecture of the foot and inadequate footwear. These patients are a clinical challenge. A select group of such patients may benefit from free surgical tissue transfer, though free or local flap surgery is often difficult or even impossible owing to an impaired arterial circulation. In such wounds, surgical debridement followed by skin grafts often fail due to bacterial burden in the wounds. To circumvent these problems, the authors developed a therapeutic approach using buried chip skin grafting to close granulation wound beds in diabetic feet. Locally applied vacuum therapy (VAC) for wound bed preparation of chronic, nonresponsive foot ulcers and subsequent grafting using the burying technique with a minute fraction of skin was used. Firm closure was achieved. The closed wound was resistant to mechanical irritation.

  19. Energy cost unit of street and park lighting system with solar technology for a more friendly city

    Science.gov (United States)

    Warman, E.; Nasution, F. S.; Fahmi, F.

    2018-03-01

    Street and park lighting system is part of a basic infrastructure need to be available in such a friendly city. Enough light will provide more comfort to citizens, especially at night since its function to illuminate roads and park environments around the covered area. The necessity to add more and more lighting around the city caused the rapid growth of the street and park lighting system while the power from PLN (national electricity company) is insufficient and the cost is getting higher. Therefore, it is necessary to consider other energy sources that are economical, environmentally friendly with good continuity. Indonesia, which located on the equator, have benefited from getting solar radiation throughout the year. This free solar radiation can be utilized as an energy source converted by solar cells to empower street and park lighting system. In this study, we planned the street and park lighting with solar technology as alternatives. It was found that for Kota Medan itself, an average solar radiation intensity of 3,454.17 Wh / m2 / day is available. By using prediction and projection method, it was calculated that the energy cost unit for this system was at Rp 3,455.19 per kWh. This cost was higher than normal energy cost unit but can answer the scarcity of energy availability for street and park lighting system

  20. Low-impact sampling under an active solid low-level radioactive waste disposal unit using horizontal drilling technology

    International Nuclear Information System (INIS)

    Puglisi, C.V.; Vold, E.L.

    1995-01-01

    The purpose of this project was to determine the performance of the solid low-level radioactive waste (LLRW) disposal units located on a mesa top at TA-54, Area G, Los Alamos National Laboratory (LANL), Los Alamos, NM, and to provide in-situ (vadose zone) site characterization information to Area G's Performance Assessment. The vadose zone beneath an active disposal unit (DU 37), was accessed by utilizing low-impact, air-rotary horizontal drilling technology. Core samples were pulled, via wire-line core method, in 3 horizontal holes fanning out below DU 37 at approximately 5 foot intervals depending on recovery percentage. Samples were surveyed and prepared in-field following Environmental Restoration (ER) guidelines. Samples were transferred from the field to the CST-9 Radvan for initial radiological screening. Following screening, samples were delivered to CST-3 analytical lab for analyses including moisture content, 23 inorganics, 60 volatile organic compounds (VOC's), 68 semivolatile organic compounds (SVOC's), tritium, lead 210, radium 226 ampersand 228, cesium 137, isotopic plutonium, americium 241, strontium 90, isotopic uranium, and isotopic thorium. Other analyses included matric potential, alpha spectroscopy, gamma spectroscopy, and gross alpha/beta. The overall results of the analysis identified only tritium as having migrated from the DU. Am-241, Eu-152, and Pu-238 were possibly identified above background but the results are not definitive. Of all organics analysed for, only ethyl acetate was tentatively identified slightly above background. All inorganics were found to be well below regulatory limits. Based on the results of the above mentioned analyses, it was determined that Area G's disposal units are performing well and no significant liquid phase migration of contaminants has occurred

  1. Assisted reproductive technology in the United States: 2001 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology registry.

    Science.gov (United States)

    2007-06-01

    To summarize the procedures and outcomes of assisted reproductive technologies (ART) that were initiated in the United States in 2001. Data were collected electronically using the Society for Assisted Reproductive Technology (SART) Clinic Outcome Reporting System software and submitted to the American Society for Reproductive Medicine/SART Registry. Three hundred eighty-five clinics submitted data on procedures performed in 2001. Data were collated after November 2002 [corrected] so that the outcomes of all pregnancies would be known. Incidence of clinical pregnancy, ectopic pregnancy, abortion, stillbirth, and delivery. Programs reported initiating 108,130 cycles of ART treatment. Of these, 79,042 cycles involved IVF (with and without micromanipulation), with a delivery rate per retrieval of 31.6%; 340 were cycles of gamete intrafallopian transfer, with a delivery rate per retrieval of 21.9%; 661 were cycles of zygote intrafallopian transfer, with a delivery rate per retrieval of 31.0%. The following additional ART procedures were also initiated: 8,147 fresh donor oocyte cycles, with a delivery rate per transfer of 47.3%; 14,509 frozen ET procedures, with a delivery rate per transfer of 23.5%; 3,187 frozen ETs employing donated oocytes or embryos, with a delivery rate per transfer of 27.4%; and 1,366 cycles using a host uterus, with a delivery rate per transfer of 38.7%. In addition, 112 cycles were reported as combinations of more than one treatment type, 8 cycles as research, and 85 as embryo banking. As a result of all procedures, 29,585 deliveries were reported, resulting in 41,168 neonates. In 2001, there were more programs reporting ART treatment and a significant increase in reported cycles compared with 2000.

  2. Micro-surgical endodontics.

    Science.gov (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  3. Surgical management of Gerhardt syndrome.

    Science.gov (United States)

    Chirilă, M; Mureşan, R; Cosgarea, M; Tomescu, E

    2010-01-01

    Adduction bilateral vocal fold immobility syndrome may be due by both recurrent laryngeal nerves paralysis--Gerhardt syndrome--and all intrinsic laryngeal muscles paralysis--Riegel syndrome. Etiology of Gerhardt syndrome is thyroid surgery, intubation's maneuver, trauma, neurological disorders, extrala-ryngeal malignancies. The manifestations of Gerhardt syndrome are inspiratory dyspnea and slightly influenced voicing by paramedian vocal folds paralysis with an important narrowing of the airway at the glottic level. The surgical procedures for enlargement of the glottic space can be classified in many ways and their major characteristics are: changes at the glottic level; surgical approach: open neck or endoscopic, with or without opening of the mucosal lining; the need for tracheostomy; the equipment used. The aim of this review is to expound the variety of interventions through the last century marked by the development of the diagnostic methods, the anesthesia and the surgical armament with sophisticated instruments and technologies.

  4. Three-Dimensional Printing Surgical Applications.

    Science.gov (United States)

    AlAli, Ahmad B; Griffin, Michelle F; Butler, Peter E

    2015-01-01

    Three-dimensional printing, a technology used for decades in the industrial field, gains a lot of attention in the medical field for its potential benefits. With advancement of desktop printers, this technology is accessible and a lot of research is going on in the medical field. To evaluate its application in surgical field, which may include but not limited to surgical planning, surgical education, implants, and prosthesis, which are the focus of this review. Research was conducted by searching PubMed, Web of science, and other reliable sources. We included original articles and excluded articles based on animals, those more than 10 years old, and those not in English. These articles were evaluated, and relevant studies were included in this review. Three-dimensional printing shows a potential benefit in surgical application. Printed implants were used in patient in a few cases and show successful results; however, longer follow-up and more trials are needed. Surgical and medical education is believed to be more efficient with this technology than the current practice. Printed surgical instrument and surgical planning are also believed to improve with three-dimensional printing. Three-dimensional printing can be a very powerful tool in the near future, which can aid the medical field that is facing a lot of challenges and obstacles. However, despite the reported results, further research on larger samples and analytical measurements should be conducted to ensure this technology's impact on the practice.

  5. Governing new technology: A comparative analysis of government support for nanotechnology in the Netherlands and the United States

    Science.gov (United States)

    Eijmberts, Johannes

    This study examines this variance in national government support for nanotechnology---its shape, size, and policy priorities---by comparing the United States and the Netherlands. Our operating hypothesis is that national government support for nanotechnology development is driven not by the intrinsic nature of the technology but by longstanding structural and institutional arrangements. That is, in the U.S., pluralist political traditions and reliance on classical liberal market economics would suggest a detached national government approach, leaving any initiative to market actors. At the same time, legacies of corporatism in the Dutch political system and a tradition of greater direct government involvement in the national economy would suggest a government-led policy on nanotechnology development. The findings show otherwise. Early on, the U.S. government established the National Nanotechnology Initiative, an overarching federal mechanism to promote and coordinate nanotechnology development. Yet, despite its appearance of central direction and coordination, the NNI reflected pluralist arrangements by leaving ample autonomy for participating federal departments and agencies. The creation of the NNI was driven particularly by concerns of about foreign challenges to American global leadership in science and technology. In the Netherlands, by contrast, the path taken shows the legacy of Dutch corporatist practice---slow, incremental, and embedded in pre-existing institutional arrangements. The Dutch government initially took no directive role, relying instead on established links among universities, public research funding organizations, and industries to advance nanotechnology development in the Netherlands. However, over time, Dutch government involvement in nanotechnology grew to be more supportive, sizeable, comprehensive, and directive---particulary by requiring substantial investments in risk-related research as a condition for public funding and, notably, by

  6. New technologies for information retrieval to achieve situational awareness and higher patient safety in the surgical operating room: the MRI institutional approach and review of the literature.

    Science.gov (United States)

    Kranzfelder, Michael; Schneider, Armin; Gillen, Sonja; Feussner, Hubertus

    2011-03-01

    Technical progress in the operating room (OR) increases constantly, but advanced techniques for error prevention are lacking. It has been the vision to create intelligent OR systems ("autopilot") that not only collect intraoperative data but also interpret whether the course of the operation is normal or deviating from the schedule ("situation awareness"), to recommend the adequate next steps of the intervention, and to identify imminent risky situations. Recently introduced technologies in health care for real-time data acquisition (bar code, radiofrequency identification [RFID], voice and emotion recognition) may have the potential to meet these demands. This report aims to identify, based on the authors' institutional experience and a review of the literature (MEDLINE search 2000-2010), which technologies are currently most promising for providing the required data and to describe their fields of application and potential limitations. Retrieval of information on the functional state of the peripheral devices in the OR is technically feasible by continuous sensor-based data acquisition and online analysis. Using bar code technologies, automatic instrument identification seems conceivable, with information given about the actual part of the procedure and indication of any change in the routine workflow. The dynamics of human activities also comprise key information. A promising technology for continuous personnel tracking is data acquisition with RFID. Emotional data capture and analysis in the OR are difficult. Although technically feasible, nonverbal emotion recognition is difficult to assess. In contrast, emotion recognition by speech seems to be a promising technology for further workflow prediction. The presented technologies are a first step to achieving an increased situational awareness in the OR. However, workflow definition in surgery is feasible only if the procedure is standardized, the peculiarities of the individual patient are taken into account

  7. A Political, Economic, Social, Technology, Legal and Environmental (PESTLE) Approach for Risk Identification of the Tidal Industry in the United Kingdom

    OpenAIRE

    Kolios, Athanasios J.; Read, G.

    2013-01-01

    This paper presents a comprehensive analysis of renewable and especially tidal energy through a political, economic, social, technology, legal and environmental (PESTLE) analysis approach and by reviewing the most up to date relevant literature. The study focuses on the United Kingdom given the favourable environmental resources for such technologies; the number of different design concepts that are currently under development as well as the research funding that has been invested over the la...

  8. Critical factors for bioenergy technology implementation. Five case studies of bioenergy markets in the United States, Sweden and Austria

    Energy Technology Data Exchange (ETDEWEB)

    Roos, Anders [Swedish Univ. of Agricultural Sciences, Uppsala (Sweden). Dept. of Forest-Industry-Market Studies

    1998-07-01

    This report analyses the driving forces of, and barriers to, biomass energy technology implementation with the objective of defining the most important factors behind the growth of bioenergy markets and suggesting strategies for policy makers and investors. The approach is to describe the important factors for the development of real bioenergy markets at two levels: (1) Institutional, primarily policy, and (2) market structure. Concepts from economic theory, primarily transaction cost theory and industrial organisation, are used in a qualitative way. The report is based on literature studies and field studies of bioenergy markets in three countries: the United States of America, Austria, and Sweden. It is divided into five sections. After the introduction in section one, literature with relevance for this study is reviewed in section two. In section three the energy policy and energy sectors of each country are described. The descriptions include an overview of the biomass energy sectors. Five cases of developed bioenergy markets in the three countries are presented in section four. The cases are residential heating with wood pellets in New Hampshire, United States, biomass power production in Maine, residential heating with pellets in Sweden, biomass district heating in Sweden, and biomass district heating in Austria. All markets are described in terms of the historical development, technical issues, economics, market structure and local policy influences. In the discussion in section five a number of key factors behind the success or failure of bioenergy are presented. Six factors are most important: (1) Complementaries between the bioenergy operations and another activity (for instance when the bioenergy production uses biomass waste products from another industry); (2) economics of scale within the bioenergy business through larger production series, standards, specialization etc.; (3) a competitive bioenergy market (Many sellers and buyers operate in the

  9. Critical factors for bioenergy technology implementation. Five case studies of bioenergy markets in the United States, Sweden and Austria

    International Nuclear Information System (INIS)

    Roos, Anders

    1998-01-01

    This report analyses the driving forces of, and barriers to, biomass energy technology implementation with the objective of defining the most important factors behind the growth of bioenergy markets and suggesting strategies for policy makers and investors. The approach is to describe the important factors for the development of real bioenergy markets at two levels: (1) Institutional, primarily policy, and (2) market structure. Concepts from economic theory, primarily transaction cost theory and industrial organisation, are used in a qualitative way. The report is based on literature studies and field studies of bioenergy markets in three countries: the United States of America, Austria, and Sweden. It is divided into five sections. After the introduction in section one, literature with relevance for this study is reviewed in section two. In section three the energy policy and energy sectors of each country are described. The descriptions include an overview of the biomass energy sectors. Five cases of developed bioenergy markets in the three countries are presented in section four. The cases are residential heating with wood pellets in New Hampshire, United States, biomass power production in Maine, residential heating with pellets in Sweden, biomass district heating in Sweden, and biomass district heating in Austria. All markets are described in terms of the historical development, technical issues, economics, market structure and local policy influences. In the discussion in section five a number of key factors behind the success or failure of bioenergy are presented. Six factors are most important: (1) Complementaries between the bioenergy operations and another activity (for instance when the bioenergy production uses biomass waste products from another industry); (2) economics of scale within the bioenergy business through larger production series, standards, specialization etc.; (3) a competitive bioenergy market (Many sellers and buyers operate in the

  10. Critical factors for bioenergy technology implementation. Five case studies of bioenergy markets in the United States, Sweden and Austria

    Energy Technology Data Exchange (ETDEWEB)

    Roos, Anders [Swedish Univ. of Agricultural Sciences, Uppsala (Sweden). Dept. of Forest-Industry-Market Studies

    1998-07-01

    This report analyses the driving forces of, and barriers to, biomass energy technology implementation with the objective of defining the most important factors behind the growth of bioenergy markets and suggesting strategies for policy makers and investors. The approach is to describe the important factors for the development of real bioenergy markets at two levels: (1) Institutional, primarily policy, and (2) market structure. Concepts from economic theory, primarily transaction cost theory and industrial organisation, are used in a qualitative way. The report is based on literature studies and field studies of bioenergy markets in three countries: the United States of America, Austria, and Sweden. It is divided into five sections. After the introduction in section one, literature with relevance for this study is reviewed in section two. In section three the energy policy and energy sectors of each country are described. The descriptions include an overview of the biomass energy sectors. Five cases of developed bioenergy markets in the three countries are presented in section four. The cases are residential heating with wood pellets in New Hampshire, United States, biomass power production in Maine, residential heating with pellets in Sweden, biomass district heating in Sweden, and biomass district heating in Austria. All markets are described in terms of the historical development, technical issues, economics, market structure and local policy influences. In the discussion in section five a number of key factors behind the success or failure of bioenergy are presented. Six factors are most important: (1) Complementaries between the bioenergy operations and another activity (for instance when the bioenergy production uses biomass waste products from another industry); (2) economics of scale within the bioenergy business through larger production series, standards, specialization etc.; (3) a competitive bioenergy market (Many sellers and buyers operate in the

  11. Development and evaluation of a holistic surgical head and neck cancer post-treatment follow-up clinic using touchscreen technology-Feasibility study.

    Science.gov (United States)

    Semple, C J; Lannon, D; Qudairat, E; McCaughan, E; McCormac, R

    2018-03-01

    The efficacy of traditional follow-up care is being challenged, as cancer survivors' supportive and psychological needs are often neither identified, nor addressed. This study's aim was to develop a holistic surgical follow-up clinic for oral and oropharyngeal cancer patients were participants completed a disease-specific health-related quality of life tool (UWQOLv4) and item prompt list (Patient Concern Inventory) on a touchscreen computer. Information generated was used to focus the consultation on patient's identified needs and concerns. By means of a prospective non-randomised, pre-test post-test design, this follow-up clinic was evaluated using the patient enablement instrument (PEI) and patient content checklist (PCC). Feasibility was explored from the patient perspective (satisfaction survey) and clinician perspective (qualitative interview). Forty-four consecutive patients were recruited. Findings demonstrating five of the eight topics (overall QOL, emotions, head and neck symptoms, side-effects of treatment, chronic non-specific) on PCC were discussed more frequently, but changes were not statistically significant. The PEI highlighted a trend towards perceived improvement in four of the six items. Using touchscreen computers to aid communication during routine follow-up was reported as both feasible and beneficial by patients and clinicians. Providing a patient-focused follow-up consultation can facilitate the identification of unmet needs, permitting timely and appropriate intervention being initiated. © 2018 John Wiley & Sons Ltd.

  12. [Management of postoperative pain in surgical units].

    Science.gov (United States)

    Delbos, A

    1998-01-01

    In order to improve the management of postoperative pain many publications insist on progressive changes in care organization. The following list outlines steps to be taken for implementation of these changes: 1) an initial analysis of management of post-operative pain allows awareness of reforms to be proposed; 2) participation of health teams in special training in order to use evaluation tools and collect data (use of analgesics, adverse effects); 3) establishing policies and procedures: recovery room, guidelines for analgesic use and adverse effects; 4) notifying patient about the various procedures to be used in postoperative period--discussion with the patient during the preoperative interview; 5) current use of standard patient-controlled analgesia (PCA) and locoregional analgesia; 6) use of combined techniques in order to achieve a balanced analgesia; 7) implementing a quality assurance programme which should include analgesic effectiveness, patient satisfaction and prevention of complications; and 8) planning of an Acute Pain Service based on a clinical nurse co-ordinator which offers highly effective forms of postsurgical analgesia.

  13. Data-mining analysis of the provision of mobility devices in the United States with emphasis on complex rehab technology.

    Science.gov (United States)

    Sprigle, Stephen; Johnson Taylor, Susan

    2017-11-28

    The objective of this study was to describe the provision of wheeled-mobility equipment from the perspective of a large equipment supplier in the United States. The records of clients who were prescribed a mobility device over a 6-month period were randomly sampled to product a dataset of 1,689 clients. Analysis was limited to descriptive statistics and measures of relationships. The majority of the clients were adults (72%) and female (58%) with 62% receiving a manual wheelchair. The majority of interventions (58%) included some contribution from the client or client's family. Overall, 86% of all prescribed wheelchairs were classified as complex rehab technology (CRT). About half (52%) of all interventions involved a therapist. Therapist involvement was 2.5 times more likely during CRT interventions compared to standard durable medical equipment (StdDME). The project provides a novel description of mobility-related equipment provision using a large retrospective dataset. The analysis demonstrates the utility of analyzing a large number of client interventions. The capabilities of such analyses have business, clinical, and policy implications. Combining the data available from suppliers with prospective collection of client-specific information, such as outcomes, would be a more powerful means to assess the provision of wheeled-mobility equipment.

  14. Assistive technology needs, functional difficulties, and services utilization and coordination of children with developmental disabilities in the United States.

    Science.gov (United States)

    Lin, Sue C; Gold, Robert S

    2018-01-01

    Assistive technology (AT) enhances the ability of individuals with disabilities to be fully engaged in activities at home, at school, and within their communities-especially for children with developmental disabilities (DD) with physical, sensory, learning, and/or communication impairments. The prevalence of children with DD in the United States has risen from 12.84% in 1997 to 15.04% in 2008. Thus, it is important to monitor the status of their AT needs, functional difficulties, services utilization, and coordination. Using data from the 2009-2010 National Survey on Children with Special Health Care Needs (NS-CSHCN), we conducted bivariate and multivariate statistical analysis, which found that 90% or more of parents of both children with DD and other CSHCN reported that their child's AT needs were met for vision, hearing, mobility, communication, and durable medical equipment; furthermore, children with DD had lower odds of AT needs met for vision and hearing and increased odds for meeting AT needs in mobility and communication. Our findings outline the current AT needs of children with DD nationally. Fulfilling these needs has the potential to engender positive lifelong effects on the child's disabilities, sense of independence, self-confidence, and productivity.

  15. Wireless sensor and data transmission needs and technologies for patient monitoring in the operating room and intensive care unit.

    Science.gov (United States)

    Paksuniemi, M; Sorvoja, H; Alasaarela, E; Myllyla, R

    2005-01-01

    In the intensive care unit, or during anesthesia, patients are attached to monitors by cables. These cables obstruct nursing staff and hinder the patients from moving freely in the hospital. However, rapidly developing wireless technologies are expected to solve these problems. To this end, this study revealed problem areas in current patient monitoring and established the most important medical parameters to monitor. In addition, usable wireless techniques for short-range data transmission were explored and currently employed wireless applications in the hospital environment were studied. The most important parameters measured of the patient include blood pressures, electrocardiography, respiration rate, heart rate and temperature. Currently used wireless techniques in hospitals are based on the WMTS and WLAN standards. There are no viable solutions for short-range data transmission from patient sensors to patient monitors, but potentially usable techniques in the future are based on the WPAN standards. These techniques include Bluetooth, ZigBee and UWB. Other suitable techniques might be based on capacitive or inductive coupling. The establishing of wireless techniques depends on ensuring the reliability of data transmission, eliminating disturbance by other wireless devices, ensuring patient data security and patient safety, and lowering the power consumption and price.

  16. Surgical travellers: tapestry to Bayeux.

    Science.gov (United States)

    Hedley-Whyte, John; Milamed, Debra R

    2014-09-01

    The planning for surgery in war was revisited in 1937 when Ian Fraser was elected a member of the Surgical Travellers. At their 1938 Surgical Travellers meeting in Vienna, Ian and Eleanor Fraser were evicted from their hotel room by the Nazis. The 1939 meeting in Belfast discussed the organization of surgery and the conduct of Emergency Medical Service Hospitals in the United Kingdom; the vast majority were to be under civilian government and military control. From 1943 lengthy and informative organizational meetings were held at least monthly under the chairmanship of Sir Alexander Hood, KBE, Head of the RAMC. Surgical Consultants, now Major Generals, Brigadiers or Full Colonels in the British and U.S. Armies stationed in the UK, prepared for the invasion of Europe. The allocation of medical, surgical, nursing and auxiliary responsibilities was delineated. Liaison with the RAF and US Army Air Force was close as it was with the proposed leaders, Ulstermen Brooke and Montgomery. Montgomery chose Arthur Porritt as Surgeon in Chief to Supreme Headquarters Allied Expeditionary Force (SHAEF), and Eisenhower, General Albert W. Kenner. Just after D-Day, Porritt met Ian Fraser, who had waded in on Arromanches Beach. The triage and evacuation plans for Allied casualties had been controversial, particularly as regards Landing Ship Tanks (LSTs). The dispute with the Hood-selected surgeons on one side, against medical and surgical deployment of LSTs, and Admiral Ernest King and Winston Churchill on the other, favouring LST use for surgery and evacuation. King and Churchill were correct but total Allied air superiority allowed wide use of many of the Allies' Dakotas; 10,000 DC-3s were eventually in service. Supported by forty Allied combat planes to each Luftwaffe, the dispute about Landing Ship Tank use in about a fortnight became moot. The multifaceted role of the Princess Royal in the Emergency Medical Services of the United Kingdom and her close liaison with the Consultant

  17. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  18. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  19. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

  20. Construction and validation of a tool to Assess the Use of Light Technologies at Intensive Care Units.

    Science.gov (United States)

    Marinho, Pabliane Matias Lordelo; Campos, Maria Pontes de Aguiar; Rodrigues, Eliana Ofélia Llapa; Gois, Cristiane Franca Lisboa; Barreto, Ikaro Daniel de Carvalho

    2016-12-19

    to construct and validate a tool to assess the use of light technologies by the nursing team at Intensive Care Units. methodological study in which the tool was elaborated by means of the psychometric method for construction based on the categorization of health technologies by Merhy and Franco, from the National Humanization Policy, using the Nursing Intervention Classification taxonomy to categorize the domains of the tool. Agreement Percentages and Content Validity Indices were used for the purpose of validation. The result of the application of the Interrater Agreement Percentage exceeded the recommended level of 80%, highlighting the relevance for the proposed theme in the assessment, with an agreement rate of 99%. the tool was validated with four domains (Bond, Autonomy, Welcoming and Management) and nineteen items that assess the use of light technologies at Intensive Care Units. construir e validar um instrumento para avaliação do uso de tecnologias leves, pela equipe de enfermagem, em Unidades de Terapia Intensiva. estudo metodológico no qual o instrumento foi elaborado utilizando o método psicométrico para construção com base na categorização das tecnologias em saúde de Merhy e Franco, da Política Nacional de Humanização, utilizando-se a taxonomia Nursing Intervention Classification para categorizar os domínios do instrumento. Utilizou-se o Percentual de Concordância e o Índice de Validade de Conteúdo (IVC) para validação. o resultado da aplicação do Percentual de Concordância entre os juízes foi superior ao recomendado de 80%, havendo destaque na avaliação da pertinência ao tema proposto, apresentando um percentual de concordância de 99%. o instrumento foi validado com quatro domínios (Vínculo, Autonomia, Acolhimento e Gestão) e dezenove itens que avaliam o uso das tecnologias leves em Unidade de Terapia Intensiva. construir y validar un instrumento para evaluación del uso de tecnologías leves, por el equipo de enfermer

  1. Effect of Computer Animation Technique on Students' Comprehension of the "Solar System and Beyond" Unit in the Science and Technology Course

    Science.gov (United States)

    Aksoy, Gokhan

    2013-01-01

    The purpose of this study is to determine the effect of computer animation technique on academic achievement of students in the "Solar System and Beyond" unit lecture as part of the Science and Technology course of the seventh grade in primary education. The sample of the study consists of 60 students attending to the 7th grade of primary school…

  2. The Leadership Role of the Teacher Librarian in Technology Integration: Early Results of a Survey of Highly Certified Teacher Librarians in the United States

    Science.gov (United States)

    Everhart, Nancy; Mardis, Marcia A.; Johnston, Melissa

    2010-01-01

    In 2008, the United States' Institute for Museum and Library Services funded Project Leadership-in-Action (LIA) that included surveys of the technology integration practices of teacher librarian leaders with National Board Certification. Preliminary 2009 survey results suggested that the 295 respondents worked in well-resourced libraries with…

  3. [Surgical treatment of gynecomastia].

    Science.gov (United States)

    Târcoveanu, E; Lupaşcu, C; Vasilescu, A; Moldovanu, R; Ichim, Mihaela; Georgescu, St; Niculescu, D; Dănilă, N; Dimofte, G; Anton, Raluca; Crumpei, Felicia; Florea, Niculina; Ungureanu, Cristina

    2008-01-01

    Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, the surgical procedure is the treatment of choice. There are two main surgical procedures: subdermal mastectomy and liposuction. To evaluate the results after surgical treatment (mastectomy) performed in a general surgery unit. We performed a retrospective study; all the patients operated for gynecomastia were reviewed. The clinical, imaging, biological, intraoperative and histological data were included into a MS Access database and statistical analyzed. From 1990-2007, 114 patients were admitted in the First Surgical Clinic Iaşi for gynecomastia. Only 12.6% from the patients were with bilateral gynecomastia. The mean age was 40.54 +/- 1.83 years old (range 12-84). Mean body mass was 26.72 +/- 0.46 kg/m2 (range 18.5-41), and about 20% from the patients had a BMI of over 30 kg/m2. We also noted that 46.5% were smokers. Simon classification was used for preoperative staging: 2.6% from the cases (N = 3) were included in stage I, 16.7% (N = 19) in stage IIa, 50% (N = 57) in stage IIb and 30.7% in stage III. The patients included in stages IIa and I are younger then the patients included in stage III (p = 0.024). Mastodynia was noted in 46 cases (40.4%). Ultrasound exam was performed in all the cases, and the larger diameter of the nodule measured was 3.75 +/- 0.18 cm (range 0.5-9.7). Only three cases were preoperatively treated with tamoxifen. Most of the cases were operated using general anesthesia (53.5%). Mastectomy was performed by peri-areolar (70.2%), elliptical (28.9%) or radial (0.9%) incisions. The subdermal mastectomy using peri-areolar approach was performed especially for the cases included in stages I, IIa and IIb--p gynecomastia in 6 cases; the other cases presented dilated ducts. We also noted intraductal papillary hyperplasia in 87 cases and chronic inflammation in 35 cases. The histological exam also revealed intraductal papilloma--9 cases, fibro

  4. Thermostable adenylate kinase technology: a new process indicator and its use as a validation tool for the reprocessing of surgical instruments.

    Science.gov (United States)

    Hesp, J R; Poolman, T M; Budge, C; Batten, L; Alexander, F; McLuckie, G; O'Brien, S; Wells, P; Raven, N D H; Sutton, J M

    2010-02-01

    Adenylate kinase (tAK), a thermostable enzyme, was assessed as a possible means of providing a quantitative measure of cleaning efficacy suitable for validating the performance of an automated washer disinfector (AWD) during routine use. Two indicator formulations were developed using either a commercially available washer disinfector soil or a protein-based soil. Each indicator consisted of 100 microg (in test soil) of tAK dried on to a steel or plastic surface. These indicators were placed in each basket of a washer disinfector and processed alongside soiled surgical instruments during a standard day's operation. After processing, remaining tAK activity was detected using a rapid enzyme assay (2 min detection time) in a handheld hygiene monitor. The amount of tAK remaining on each indictor after a full AWD cycle was found to range from 0.1 to 0.4 ng, which represented a mean log(10) removal of 5.8+/-0.3. There was no statistical difference in the residual tAK activity between individual runs or the position of the indicator in the machine. The tAK indicator was also used to analyse the protein removal within each component of the wash cycle. These results demonstrated that all phases of the wash process contributed to the removal of the protein load, with the main wash alone being responsible for 3.6-4.0 log(10) reductions in protein activity. We propose that a quantitative cleaning index using such rapid readout indicator devices would provide a valuable addition to the methodologies for validating cleaning processes.

  5. Virtual reality in surgical education.

    Science.gov (United States)

    Ota, D; Loftin, B; Saito, T; Lea, R; Keller, J

    1995-03-01

    Virtual reality (VR) is an emerging technology that can teach surgeons new procedures and can determine their level of competence before they operate on patients. Also VR allows the trainee to return to the same procedure or task several times later as a refresher course. Laparoscopic surgery is a new operative technique which requires the surgeon to observe the operation on a video-monitor and requires the acquisition of new skills. VR simulation could duplicate the operative field and thereby enhance training and reduce the need for expensive animal training models. Our preliminary experience has shown that we have the technology to model tissues and laparoscopic instruments and to develop in real time a VR learning environment for surgeons. Another basic need is to measure competence. Surgical training is an apprenticeship requiring close supervision and 5-7 years of training. Technical competence is judged by the mentor and has always been subjective. If VR surgical simulators are to play an important role in the future, quantitative measurement of competence would have to be part of the system. Because surgical competence is "vague" and is characterized by such terms as "too long, too short" or "too close, too far," it is possible that the principles of fuzzy logic could be used to measure competence in a VR surgical simulator. Because a surgical procedure consists of a series of tasks and each task is a series of steps, we will plan to create two important tasks in a VR simulator and validate their use. These tasks consist of laparoscopic knot tying and laparoscopic suturing. Our hypothesis is that VR in combination with fuzzy logic can educate surgeons and determine when they are competent to perform these procedures on patients.

  6. Surgical repair for acute type A aortic dissection in octogenarians.

    Science.gov (United States)

    El-Sayed Ahmad, Ali; Papadopoulos, Nestoras; Detho, Faisal; Srndic, Edin; Risteski, Petar; Moritz, Anton; Zierer, Andreas

    2015-02-01

    Despite limited data, the necessity for immediate surgical intervention in octogenarians with acute type A aortic dissection (AAD) has recently been questioned because the surgical risk may outweigh its potential benefits. At the same time, evolving stent graft technologies are pushing in the market for pathology within the ascending aorta, even for treatment of AAD. Against this background, we analyzed our institutional experience in this patient cohort during the last 8 years. Between October 2005 and October 2013, 39 patients aged older than 80 years (82 ± 2 years) underwent surgical repair for AAD, of which 29 patients (74%) were men. Owing to patient age and comorbidities, we aimed to limit the operation to supracoronary hemiarch replacement whenever possible. Clinical data were prospectively entered into our institutional database. Late follow-up was 3.6 ± 2.8 years and was 100% complete. Hemiarch replacement was performed in 32 patients (82%), and full arch replacement was necessary in the remaining 7. In 31 patients (79%), the aortic root could be glued and reconstructed or remained untouched. The remaining 8 patients (21%) underwent the bio-Bentall procedure. Mean ventilation time was 46 ± 23 hours, and the intensive care unit stay was 5 ± 9 days. We observed new postoperative permanent neurologic deficits in 2 patients (5%) and transient neurologic deficits in 3 (8%). The 30-day mortality was 26% (n = 10). Kaplan-Meier estimates for late survival were 46% ± 16% at 5 years. Given the guidelines regarding the predicted risk of death in patients with untreated AAD, current data suggest a survival benefit with immediate open surgical intervention even in octogenarians. Similarly to the early days of transcatheter-based aortic valve implantation, open surgical reference data are warranted to set the bar for upcoming endovascular treatment of AAD in octogenarians. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights

  7. Developing Tomorrow’s Innovative Surgical Solutions

    Directory of Open Access Journals (Sweden)

    Philip Breedon

    2009-11-01

    Full Text Available Designers are increasingly becoming aware of the potential use and integration of smart materials and technologies within their designs. One of the critical steps towards building innovative surgical solutions will be to link physicians and product designers utilising the appropriate materials and technologies to provide tangible improvements in patient care and treatment.

  8. TECHNOLOGICAL INNOVATION IN PROJECTS OF NEW PRODUCT DEVELOPMENT: AN EXPLORATORY STUDY ON RELATIONSHIP MANAGEMENT INTEGRATION AMONG UNITS OF A MULTINATIONAL COMPANY

    Directory of Open Access Journals (Sweden)

    Daniel Jugend

    2012-04-01

    Full Text Available Although the topic of integration in product development is widely debated in the literature, there are few studies that address the participation by subsidiaries of multinational and R & D centers around the world in development projects of new products. Focusing on the perception of the Brazilian unit, this paper aims to present and analyze integration practices among subsidiaries, headquarters and R&D centers in product development projects in a multinational high tech company. For this purpose, was conducted an exploratory and qualitative researched operationalized by case study. Among the main results, it was noted collaboration between locals marketing and engineering with the R & D centers, important role of senior management in the Brazilian unit to communicate outcomes of the strategic planning of products and technologies established by the headquarters to the subsidiary, the adoption of technological and information mechanisms and the application of methods such as technology roadmap.

  9. Surgical Vision: Google Glass and Surgery.

    Science.gov (United States)

    Chang, Johnny Yau Cheung; Tsui, Lok Yee; Yeung, Keith Siu Kay; Yip, Stefanie Wai Ying; Leung, Gilberto Ka Kit

    2016-08-01

    Google Glass is, in essence, a smartphone in the form of a pair of spectacles. It has a display system, a bone conduction "speaker," video camera, and connectivity via WiFi or Bluetooth technologies. It can also be controlled by voice command. Seizing Google Glass' capabilities as windows of opportunity, surgeons have been the first group of doctors trying to incorporate the technology into their daily practices. Experiences from different groups have demonstrated Google Glass' potential in improving perioperative care, intraoperative communication and documentation, surgical outcome as well as surgical training. On the other hand, the device has technical limitations, notably suboptimal image qualities and a short battery life. Its operational functions also bring forth concerns on the protection of patient privacy. Nonetheless, the technological advances that this device embodies hold promises in surgical innovations. Further studies are required, and surgeons should explore, investigate, and embrace similar technologies with keen and informed anticipation. © The Author(s) 2016.

  10. Surgical treatment of Chiari malformation: review and progress

    Directory of Open Access Journals (Sweden)

    ZHANG Yuan-zheng

    2012-08-01

    Full Text Available The surgical treatment of Chiari malformation (CM began in 1932. With the advance of medical technology, the surgical technique of CM is also in constant improvement. But due to its pathogenesis has not yet clear, there is no accepted optimal method, and different levels of the operation is still controversial. The author reviewed the concept, pathogenesis, diagnosis and surgical treatment of CM. The hot topics and new technological application were also reviewed in this article.

  11. Postoperative Haematocrit and Outcome in Critically Ill Surgical Patients.

    Science.gov (United States)

    Lopes, Ana Martins; Silva, Diana; Sousa, Gabriela; Silva, Joana; Santos, Alice; Abelha, Fernando José

    2017-08-31

    Haematocrit has been studied as an outcome predictor. The aim of this study was to evaluate the correlation between low haematocrit at surgical intensive care unit admission and high disease scoring system score and early outcomes. This retrospective study included 4398 patients admitted to the surgical intensive care unit between January 2006 and July 2013. Acute physiology and chronic health evaluation and simplified acute physiology score II values were calculated and all variables entered as parameters were evaluated independently. Patients were classified as haematocrit if they had a haematocrit < 30% at surgical intensive care unit admission. The correlation between admission haematocrit and outcome was evaluated by univariate analysis and linear regression. A total of 1126 (25.6%) patients had haematocrit. These patients had higher rates of major cardiac events (4% vs 1.9%, p < 0.001), acute renal failure (11.5% vs 4.7%, p < 0.001), and mortality during surgical intensive care unit stay (3% vs 0.8%, p < 0.001) and hospital stay (12% vs 5.9%, p < 0.001). A haematocrit level < 30% at surgical intensive care unit admission was frequent and appears to be a predictor for poorer outcome in critical surgical patients. Patients with haematocrit had longer surgical intensive care unit and hospital stay lengths, more postoperative complications, and higher surgical intensive care unit and hospital mortality rates.

  12. Technology.

    Science.gov (United States)

    Online-Offline, 1998

    1998-01-01

    Focuses on technology, on advances in such areas as aeronautics, electronics, physics, the space sciences, as well as computers and the attendant progress in medicine, robotics, and artificial intelligence. Describes educational resources for elementary and middle school students, including Web sites, CD-ROMs and software, videotapes, books,…

  13. Developing antiviral surgical gown using nonwoven fabrics for ...

    African Journals Online (AJOL)

    EB

    Developing antiviral surgical gown using nonwoven fabrics for health care sector. *Parthasarathi V, Thilagavathi G. Department of Fashion Technology, PSG college of Technology, Peelamedu, Coimbatore – 641 004,. India. Abstract. Background: Healthcare workers' uniforms including surgical gowns are used as barriers ...

  14. An overview of pre-surgical evaluation

    Directory of Open Access Journals (Sweden)

    Kurupath Radhakrishnan

    2014-01-01

    Full Text Available The success of an epilepsy surgery program depends upon the early identification of potential surgical candidates and selecting from them, ideal candidates for surgery, who are destined to have a post-operative seizure-free outcome without any unacceptable neurological deficits. Since epilepsy surgery centers in resource-poor countries will lack the full range of state-of-the-art technologies usually available in resource-rich countries to perform pre-surgical evaluation, cost-effectively utilization of the locally available investigative facilities to select the surgical candidates becomes challenging. In the present era of rapid electronic communications and telemedicine, it has become possible for epilepsy surgery centers to pool their technological and human resources and to partner with centers nationally and internationally in implementing pre-surgical evaluation strategies.

  15. Assessment of Surgical Skills and Competency.

    Science.gov (United States)

    Bhatti, Nasir I

    2017-10-01

    Evaluation of surgical skills and competency are important aspects of the medical education process. Measurable and reproducible methods of assessment with objective feedback are essential components of surgical training. Objective Structured Assessment of Technical Skills (OSATS) is widely used across the medical specialties and otolaryngology-specific tools have been developed and validated for sinus and mastoid surgery. Although assessment of surgical skills can be time-consuming and requires human and financial resources, new evaluation methods and emerging technology may alleviate these barriers while also improving data collection practices. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Exploring Instructors' Technology Readiness, Attitudes and Behavioral Intentions towards E-Learning Technologies in Egypt and United Arab Emirates

    Science.gov (United States)

    El Alfy, Shahira; Gómez, Jorge Marx; Ivanov, Danail

    2017-01-01

    This paper explores the association between technology readiness, (a meta-construct consisting of optimism, innovativeness, discomfort, and insecurity), attitude, and behavioral intention towards e-learning technologies adoption within an education institution context. The empirical study data is collected at two private universities located in…

  17. Report by the AERES on the unit: Department of Nuclear Technology under the supervision of the establishments and bodies: Atomic Energy Commission (CEA)

    International Nuclear Information System (INIS)

    2010-02-01

    This report is a kind of audit report on a research laboratory, the DTN (Department of Nuclear Technology) which comprises four departments: technology of industrial reactors, advanced technologies and processes, transfer modelling and nuclear measurements, thermal-hydraulic and technological studies. The authors discuss an assessment of the whole unit activities in terms of strengths and opportunities, aspects to be improved, risks and recommendations, productions and publications, scientific quality, influence and attractiveness (awards, recruitment capacity, capacity to obtain financing and to tender, participation to international programs), strategy and governance, and project. The same discussion is proposed for the different research themes: design of nuclear installation circuits and components, thermal-hydraulic and severe accidents, instrumentation for nuclear measurements and process control, transfers in reactors and in the environment

  18. [Surgical correction of cleft palate].

    Science.gov (United States)

    Kimura, F T; Pavia Noble, A; Soriano Padilla, F; Soto Miranda, A; Medellín Rodríguez, A

    1990-04-01

    This study presents a statistical review of corrective surgery for cleft palate, based on cases treated at the maxillo-facial surgery units of the Pediatrics Hospital of the Centro Médico Nacional and at Centro Médico La Raza of the National Institute of Social Security of Mexico, over a five-year period. Interdisciplinary management as performed at the Cleft-Palate Clinic, in an integrated approach involving specialists in maxillo-facial surgery, maxillar orthopedics, genetics, social work and mental hygiene, pursuing to reestablish the stomatological and psychological functions of children afflicted by cleft palate, is amply described. The frequency and classification of the various techniques practiced in that service are described, as well as surgical statistics for 188 patients, which include a total of 256 palate surgeries performed from March 1984 to March 1989, applying three different techniques and proposing a combination of them in a single surgical time, in order to avoid complementary surgery.

  19. Heat recovery from UPS units - Analysis of a first unit and technology assessment; Waermerueckgewinnung in USV-Anlagen. Analyse einer Erstanlage und Potentialabschaetzung

    Energy Technology Data Exchange (ETDEWEB)

    Stahl, S.; Schlegel, A.

    2009-11-15

    UPS units (uninterruptible power supply) generate large heat losses, which have to be dissipated with cooling units. awtec has developed a unique UPS system with integrated heat recovery which was installed in 2001 (Building Gretag/SAP in Regensdorf) and which is still running error-free. With this system the waste heat can be recovered and electrical energy for the refrigeration system can be saved likewise. The measured data shows that during the heating season, the unit transfers virtually all heat loss (about 20 MWh/year) to the space heating system. The building's refrigeration system, however, has its own heat recovery system, so the actual annual energy savings can be estimated to be only about 4 MWh of electricity. The prototype shows that awtec built a robust unit which - given an appropriate cooling and heating system - has the potential for high energy savings (without central heat recovery system: 4 MWh electric + 20 MWh thermal) without increased investment. Based on the UPS heat recovery development, previous projects of the Swiss Federal Office of Energy and a market survey, scenarios for the cooling and heat recovery from UPS units were developed. Since the same concepts also apply to the cooling of servers and other IT components, they were also included in the analysis. The scenario analysis shows that a high potential for savings of electric energy and heat exists in this area. In particular, the direct cooling of the IT components with cooling water offers big benefits for heat recovery and free cooling (cooling without the use of the refrigeration system) compared to conventional air cooling. These direct cooling systems are currently mainly used for special applications or as a fallback in case of overheating problems. Passive cooling through geothermal probes, which are now mainly used for buildings with small heat pump systems, provides an interesting approach to the cooling of IT equipment in accordance with the temperature level. It

  20. Technology

    Directory of Open Access Journals (Sweden)

    Xu Jing

    2016-01-01

    Full Text Available The traditional answer card reading method using OMR (Optical Mark Reader, most commonly, OMR special card special use, less versatile, high cost, aiming at the existing problems proposed a method based on pattern recognition of the answer card identification method. Using the method based on Line Segment Detector to detect the tilt of the image, the existence of tilt image rotation correction, and eventually achieve positioning and detection of answers to the answer sheet .Pattern recognition technology for automatic reading, high accuracy, detect faster

  1. Modeling nurses' attitude toward using automated unit-based medication storage and distribution systems: an extension of the technology acceptance model.

    Science.gov (United States)

    Escobar-Rodríguez, Tomás; Romero-Alonso, María Mercedes

    2013-05-01

    This article analyzes the attitude of nurses toward the use of automated unit-based medication storage and distribution systems and identifies influencing factors. Understanding these factors provides an opportunity to explore actions that might be taken to boost adoption by potential users. The theoretical grounding for this research is the Technology Acceptance Model. The Technology Acceptance Model specifies the causal relationships between perceived usefulness, perceived ease of use, attitude toward using, and actual usage behavior. The research model has six constructs, and nine hypotheses were generated from connections between these six constructs. These constructs include perceived risks, experience level, and training. The findings indicate that these three external variables are related to the perceived ease of use and perceived usefulness of automated unit-based medication storage and distribution systems, and therefore, they have a significant influence on attitude toward the use of these systems.

  2. Deriving DICOM surgical extensions from surgical workflows

    Science.gov (United States)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  3. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  4. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  5. CHARACTERIZING COSTS, SAVINGS AND BENEFITS OF A SELECTION OF ENERGY EFFICIENT EMERGING TECHNOLOGIES IN THE UNITED STATES

    Energy Technology Data Exchange (ETDEWEB)

    Xu, T.; Slaa, J.W.; Sathaye, J.

    2010-12-15

    Implementation and adoption of efficient end-use technologies have proven to be one of the key measures for reducing greenhouse gas (GHG) emissions throughout the industries. In many cases, implementing energy efficiency measures is among one of the most cost effective investments that the industry could make in improving efficiency and productivity while reducing CO2 emissions. Over the years, there have been incentives to use resources and energy in a cleaner and more efficient way to create industries that are sustainable and more productive. With the working of energy programs and policies on GHG inventory and regulation, understanding and managing the costs associated with mitigation measures for GHG reductions is very important for the industry and policy makers around the world. Successful implementation of emerging technologies not only can help advance productivities and competitiveness but also can play a significant role in mitigation efforts by saving energy. Providing evaluation and estimation of the costs and energy savings potential of emerging technologies is the focus of our work in this project. The overall goal of the project is to identify and select emerging and under-utilized energy-efficient technologies and practices as they are important to reduce energy consumption in industry while maintaining economic growth. This report contains the results from performing Task 2"Technology evaluation" for the project titled"Research Opportunities in Emerging and Under-Utilized Energy-Efficient Industrial Technologies," which was sponsored by California Energy Commission and managed by CIEE. The project purpose is to analyze market status, market potential, and economic viability of selected technologies applicable to the U.S. In this report, LBNL first performed re-assessments of all of the 33 emerging energy-efficient industrial technologies, including re-evaluation of the 26 technologies that were previously identified by Martin et al. (2000) and

  6. The pregnant female surgical resident

    Directory of Open Access Journals (Sweden)

    Shifflette V

    2018-05-01

    Full Text Available Vanessa Shifflette,1 Susannah Hambright,2 Joseph Darryl Amos,1 Ernest Dunn,3 Maria Allo4 1Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, TX, USA; 2Methodist Surgical Associates, Methodist Dallas Medical Center, Dallas, TX, USA; 3Graduate Medical Education - General Surgery, Methodist Dallas Medical Center, Dallas, TX, USA; 4Santa Clara Valley Medical Center, San Jose, CA, USA Background: Surgery continues to be an intense, time-consuming residency. Many medical students decide against surgery as a profession due to the long work hours and family strain. The pregnant female surgical resident has an added stress factor compared to her male counterpart. Methods: We distributed an electronic, online 26-question survey to 32 general surgery programs in the southwestern region of the United States. Each program distributed our survey to the female surgical residents who had been pregnant during residency in the last 5 years. Each program was re-contacted 6 weeks after the initial contact. Most questions were in a 5-point Likert scale format. The responses were collected and analyzed using the Survey Monkey website. Results: An unvalidated survey was sent to 32 general surgery programs and 26 programs responded (81%. Each program was asked for the total number of possible responses from female residents that met our criteria (60 female residents. Seven of the programs (27% stated that they have had zero residents pregnant. We had 22 residents respond (37%. Over half of the residents (55% were pregnant during their 2nd or 3rd year of residency, with only 18% pregnant during a research year. Thirty-one percent had a lower American Board of Surgery In-Training Exam (ABSITE score. Ninety percent of the residents were able to take 4 weeks or more for maternity leave. Most of the residents (95% stated that they would do this again during residency given the opportunity, but many of the residents felt that returning back to work

  7. Simulation-based surgical education.

    Science.gov (United States)

    Evgeniou, Evgenios; Loizou, Peter

    2013-09-01

    The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training. Simulation offers the opportunity for repeated practice in a safe and controlled environment, focusing on trainees and tailored to their needs. Recent technological advances have led to the development of various simulators, which have already been introduced in surgical training. The complexity and fidelity of the available simulators vary, therefore depending on our recourses we should select the appropriate simulator for the task or skill we want to teach. Educational theory informs us about the importance of context in professional learning. Simulation should therefore recreate the clinical environment and its complexity. Contemporary approaches to simulation have introduced novel ideas for teaching teamwork, communication skills and professionalism. In order for simulation-based training to be successful, simulators have to be validated appropriately and integrated in a training curriculum. Within a surgical curriculum, trainees should have protected time for simulation-based training, under appropriate supervision. Simulation-based surgical education should allow the appropriate practice of technical skills without ignoring the clinical context and must strike an adequate balance between the simulation environment and simulators. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  8. Surgical data science: The new knowledge domain.

    Science.gov (United States)

    Vedula, S Swaroop; Hager, Gregory D

    2017-04-01

    Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care. We foresee the emergence of Surgical/Interventional Data Science (SDS) as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model and quantify the pathways or processes within the context of patient health states or outcomes, and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data is pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care including prevention, diagnosis, intervention, or post-operative recovery. Existing literature already provides preliminary results suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from pre-, intra-, and post-operative contexts, how it could support intra-operative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective assessments, automated virtual coaching, and robot

  9. Surgical data science: The new knowledge domain

    Science.gov (United States)

    Vedula, S. Swaroop; Hager, Gregory D.

    2017-01-01

    Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care. We foresee the emergence of Surgical/Interventional Data Science (SDS) as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model and quantify the pathways or processes within the context of patient health states or outcomes, and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data is pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care including prevention, diagnosis, intervention, or post-operative recovery. Existing literature already provides preliminary results suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from pre-, intra-, and post-operative contexts, how it could support intra-operative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective assessments, automated virtual coaching, and robot

  10. Surgical data science: the new knowledge domain

    Directory of Open Access Journals (Sweden)

    Vedula S. Swaroop

    2017-04-01

    Full Text Available Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care, with the goal of maximizing the quality and value of care. Whereas innovations in diagnostic and therapeutic technologies have driven past improvements in the quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytical techniques, and translation or integration of research findings into patient care. We foresee the emergence of surgical/interventional data science (SDS as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model, and quantify the pathways or processes within the context of patient health states or outcomes and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data are pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care, including prevention, diagnosis, intervention, or postoperative recovery. The existing literature already provides preliminary results, suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from preoperative, intraoperative, and postoperative contexts, how it could support intraoperative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective

  11. Remote Video Auditing in the Surgical Setting.

    Science.gov (United States)

    Pedersen, Anne; Getty Ritter, Elizabeth; Beaton, Megan; Gibbons, David

    2017-02-01

    Remote video auditing, a method first adopted by the food preparation industry, was later introduced to the health care industry as a novel approach to improving hand hygiene practices. This strategy yielded tremendous and sustained improvement, causing leaders to consider the potential effects of such technology on the complex surgical environment. This article outlines the implementation of remote video auditing and the first year of activity, outcomes, and measurable successes in a busy surgery department in the eastern United States. A team of anesthesia care providers, surgeons, and OR personnel used low-resolution cameras, large-screen displays, and cell phone alerts to make significant progress in three domains: application of the Universal Protocol for preventing wrong site, wrong procedure, wrong person surgery; efficiency metrics; and cleaning compliance. The use of cameras with real-time auditing and results-sharing created an environment of continuous learning, compliance, and synergy, which has resulted in a safer, cleaner, and more efficient OR. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  12. Surgical treatment of craniofacial haemangioma in children

    African Journals Online (AJOL)

    Keywords: craniofacial area, haemangioma, surgical treatment ... Correspondence to Kamal Abdel-Elah Aly, Pediatric Surgery Unit, ..... Adverse effects of systemic glucocorticosteroid therapy in infants with hemangiomas. Arch Dermatol 2004; 140:963–969. 23 Siegfried EC, Keenan WJ, Al Jureidini S. More on propranolol ...

  13. Surgical Treatment of Hepatocellular Carcinoma

    Science.gov (United States)

    Zamora-Valdes, Daniel; Taner, Timucin; Nagorney, David M.

    2017-01-01

    Hepatocellular carcinoma (HCC) is a major cause of cancer-related death worldwide. In select patients, surgical treatment in the form of either resection or transplantation offers a curative option. The aims of this review are to (1) review the current American Association for the Study of Liver Diseases/European Association for the Study of the Liver guidelines on the surgical management of HCC and (2) review the proposed changes to these guidelines and analyze the strength of evidence underlying these proposals. Three authors identified the most relevant publications in the literature on liver resection and transplantation for HCC and analyzed the strength of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification. In the United States, the liver allocation system provides priority for liver transplantation to patients with HCC within the Milan criteria. Current evidence suggests that liver transplantation may also be indicated in certain patient groups beyond Milan criteria, such as pediatric patients with large tumor burden or adult patients who are successfully downstaged. Patients with no underlying liver disease may also benefit from liver transplantation if the HCC is unresectable. In patients with no or minimal (compensated) liver disease and solitary HCC ≥2 cm, liver resection is warranted. If liver transplantation is not available or contraindicated, liver resection can be offered to patients with multinodular HCC, provided that the underlying liver disease is not decompensated. Many patients may benefit from surgical strategies adapted to local resources and policies (hepatitis B prevalence, organ availability, etc). Although current low-quality evidence shows better overall survival with aggressive surgical strategies, this approach is limited to select patients. Larger and well-designed prospective studies are needed to better define the benefits and limits of such approach. PMID:28975836

  14. Assisted reproductive technologies before de European Court of Human Rights: From Evans v. The United Kingdom to Parrillo v. Italy

    OpenAIRE

    Farnós Amorós, Esther

    2016-01-01

    Although most of the European legal systems regulate assisted reproductive technologies, diversity among member states regarding highly sensitive questions remains (e.g., conditions for access to certain treatments; use of Preimplantation Genetic Diagnosis in order to avoid a children’s genetic disease; resource to heterologous technologies with donated gametes; effects of international surrogacy arrangements; or the final destiny of cryopreserved embryos resulting from an “in vitro” fertiliz...

  15. Using Innovative Knowledge Management Tools for Information Technology Development, Acquisition, and Integration in the United States Army

    Science.gov (United States)

    2007-06-15

    wireless KM tool that suffers from lack of notoriety is the National Security Agency’s (NSA) wireless technology vulnerabilities database ( VAPED ). This...in the unpopularity of programs like the VAPED and the demise of the Quantum Leap exercise. The commercial world is producing even more technology... VAPED , the SDR forum, the WiMAX forum, GCN Labs and others previously cited are examples of readily available government and commercial IT knowledge

  16. The cutting-edge training modalities and educational platforms for accredited surgical training: A systematic review

    OpenAIRE

    Forgione, Antonello; Guraya, Salman Y.

    2017-01-01

    Background: Historically, operating room (OR) has always been considered as a stand-alone trusted platform for surgical education and training. However, concerns about financial constraints, quality control, and patient safety have urged the surgical educators to develop more cost-effective, surgical educational platforms that can be employed outside the OR. Furthermore, trained surgeons need to regularly update their surgical skills to keep abreast with the emerging surgical technologies. Th...

  17. Challenges faced by hospitals in providing surgical care and ...

    African Journals Online (AJOL)

    Esem

    essential surgical staff, inadequate funding, poor state of ... individuals interested in surgical care in the developing world has been ... 5.69 per 100,000 in the United States . ... categorical variables e.g gender, the percentage of the ... lack of materials and supplies to be used, inability to pay ... Confirming a big gap in.

  18. Assessing information and communication technology in surgical ...

    African Journals Online (AJOL)

    2012-08-03

    Aug 3, 2012 ... c. evaluate computer-IT literacy and competency d. identify ... on real patients is unacceptable during the early stages of training. ... operating room time and cost. ... canulation), computer based systems, simulated patients.

  19. The Influence of Curriculum, Instruction, Technology, and Social Interactions on Two Fifth-Grade Students' Epistemologies in Modeling Throughout a Model-Based Curriculum Unit

    Science.gov (United States)

    Baek, Hamin; Schwarz, Christina V.

    2015-04-01

    In the past decade, reform efforts in science education have increasingly attended to engaging students in scientific practices such as scientific modeling. Engaging students in scientific modeling can help them develop their epistemologies by allowing them to attend to the roles of mechanism and empirical evidence when constructing and revising models. In this article, we present our in-depth case study of how two fifth graders—Brian and Joon—who were students in a public school classroom located in a Midwestern state shifted their epistemologies in modeling as they participated in the enactment of a technologically enhanced, model-based curriculum unit on evaporation and condensation. First, analyses of Brian's and Joon's models indicate that their epistemologies in modeling related to explanation and empirical evidence shifted productively throughout the unit. Additionally, while their initial and final epistemologies in modeling were similar, the pathways in which their epistemologies in modeling shifted differed. Next, analyses of the classroom activities illustrate how various components of the learning ecology including technological tools, the teacher's scaffolding remarks, and students' collective activities and conversations, were marshaled in the service of the two students' shifting epistemologies in modeling. These findings suggest a nuanced view of individual learners' engagement in scientific modeling, their epistemological shifts in the practice, and the roles of technology and other components of a modeling-oriented learning environment for such shifts.

  20. Integration of improved decontamination and characterization technologies in the decommissioning of the CP-5 research reactor, United States of America

    Energy Technology Data Exchange (ETDEWEB)

    Boing, L E; Bhattacharyya, S K [Technology Development Division, Decommissioning Program, Argonne National Laboratory, Argonne, IL (United States)

    2002-02-01

    The aging of research reactors worldwide has resulted in a heightened awareness in the international decommissioning community of the timeliness to review and address the needs of research reactor operators in planning for and eventually performing the decommissioning of these types of facilities. Many reactors already undergoing decommissioning can be used as test beds for evaluating enhanced or new/innovative technologies for decommissioning; it is possible that new techniques could be made available for future research reactor-decommissioning projects. Potentially, the new technologies will result in: reduced radiation doses to the work force, larger safety margins in performing decommissioning and cost and schedule savings to the decommissioners in performing the decommissioning of these facilities. Testing of these enhanced technologies for decontamination, dismantling, characterization, remote operations and worker protection are critical to furthering advancements in the technical specialty of decommissioning. Furthermore, regulatory acceptance and routine utilization for future research decommissioning will be assured by testing and developing these technologies in realistically contaminated environments prior to their use in actual research reactor decommissioning. The decommissioning of the CP-5 Research Reactor located at the ANL-East Site has been completed. In this paper we present results of work performed at Argonne National Laboratory (ANL) in the development, testing and deployment of innovative and/or enhanced technologies for the decommissioning of research reactors. In addition, details are provided on other related U.S. D and D activities, which may be useful to the international research reactor D and D community. (author)

  1. Integration of improved decontamination and characterization technologies in the decommissioning of the CP-5 research reactor, United States of America

    International Nuclear Information System (INIS)

    Boing, L.E.; Bhattacharyya, S.K.

    2002-01-01

    The aging of research reactors worldwide has resulted in a heightened awareness in the international decommissioning community of the timeliness to review and address the needs of research reactor operators in planning for and eventually performing the decommissioning of these types of facilities. Many reactors already undergoing decommissioning can be used as test beds for evaluating enhanced or new/innovative technologies for decommissioning; it is possible that new techniques could be made available for future research reactor-decommissioning projects. Potentially, the new technologies will result in: reduced radiation doses to the work force, larger safety margins in performing decommissioning and cost and schedule savings to the decommissioners in performing the decommissioning of these facilities. Testing of these enhanced technologies for decontamination, dismantling, characterization, remote operations and worker protection are critical to furthering advancements in the technical specialty of decommissioning. Furthermore, regulatory acceptance and routine utilization for future research decommissioning will be assured by testing and developing these technologies in realistically contaminated environments prior to their use in actual research reactor decommissioning. The decommissioning of the CP-5 Research Reactor located at the ANL-East Site has been completed. In this paper we present results of work performed at Argonne National Laboratory (ANL) in the development, testing and deployment of innovative and/or enhanced technologies for the decommissioning of research reactors. In addition, details are provided on other related U.S. D and D activities, which may be useful to the international research reactor D and D community. (author)

  2. Development of a Cognitive Robotic System for Simple Surgical Tasks

    Directory of Open Access Journals (Sweden)

    Riccardo Muradore

    2015-04-01

    Full Text Available The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded project Intelligent Surgical Robotics (I-SUR. The main goal of the project is to demonstrate that autonomous robotic surgical systems can carry out simple surgical tasks effectively and without major intervention by surgeons. To fulfil this goal, we have developed innovative solutions (both in terms of technologies and algorithms for the following aspects: fabrication of soft organ models starting from CT images, surgical planning and execution of movement of robot arms in contact with a deformable environment, designing a surgical interface minimizing the cognitive load of the surgeon supervising the actions, intra-operative sensing and reasoning to detect normal transitions and unexpected events. All these technologies have been integrated using a component-based software architecture to control a novel robot designed to perform the surgical actions under study. In this work we provide an overview of our system and report on preliminary results of the automatic execution of needle insertion for the cryoablation of kidney tumours.

  3. "Social, technological, and research responses to potential erosion and sediment disasters in the western United States, with examples from California"

    Science.gov (United States)

    R. M. Rice

    1985-01-01

    Synopsis - Examples from California are used to illustrate typical responses to erosion and debris flow disasters the United States. Political institutions leave virtually all responsibility for disaster prevention to the lowest levels of government or to individuals. Three circumstances in which disasters occur are discussed: urbanized debris cones, urbanized unstable...

  4. Social, technological, and research responses to potential erosion and sediment disasters in the western United States, with examples from California

    Science.gov (United States)

    R. M. Rice

    1985-01-01

    Examples from California are used to illustrate typical responses to erosion and debris flow disasters in the United States. Political institutions leave virtually all responsibility for disaster prevention to the lowest levels of government or to individuals. Three circumstances in which disasters occur are discussed: urbanized debris cones, urbanized unstable...

  5. Duration of orthognathic-surgical treatment.

    Science.gov (United States)

    Paunonen, Jaakko; Helminen, Mika; Peltomäki, Timo

    2017-07-01

    The objective of this study was to determine the duration of orthognathic-surgical treatment conducted with conventional pre- and post-surgical orthodontic treatment phases. The study material was comprised of the files of 185 consecutive patients treated in Oral and Maxillofacial Unit, Tampere University Hospital, Finland, in 2007-2014. The files were reviewed and the following data was obtained: gender and age of patients, ICD-10 diagnosis, type of malocclusion, duration of pre- and post-surgical orthodontic treatment and type of operation. Total treatment duration (median) from placement of separating rings for banding until fixed orthodontic appliances were removed and retention period started was 31.1 months, of which pre-surgical orthodontics took 24.4 months and postsurgical 6.4 months. Treatment duration (median) was in BSSO was 32.1, LeFort 1 30.1 and bimaxillary osteotomy 29.7 months. Orthodontic extractions were performed in 35 patients (19%). If the orthodontic treatment included tooth extraction, the duration of pre-surgical treatment was on average 10 months longer, which is a statistically highly significant difference (p pre-surgical orthodontic treatment prolong treatment time by an average of 8-9 months.

  6. Surgical site infections

    African Journals Online (AJOL)

    Decrease the inflammatory response Vasodilatation leads to better perfusion and ... Must NOT be allowed to come in contact with brain, meninges, eyes or .... project (SCIP): Evolution of National Quality Measure. Surgical. Infection 2008 ...

  7. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  8. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  9. Surgical Management of Hemorrhoids

    Science.gov (United States)

    Agbo, S. P.

    2011-01-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

  10. Surgical site infections

    African Journals Online (AJOL)

    Surgical site infections (SSIs) are a worldwide problem that has ... deep tissue is found on clinical examination, re-opening, histopathological or radiological investigation ..... Esposito S, Immune system and SSI, Journal of Chemotherapy, 2001.

  11. Surgical management of pain

    African Journals Online (AJOL)

    If these therapies fail, and with a thorough multidisciplinary approach involving carefully ... Generally, surgical pain management is divided into neuro- modulative .... 9 suggested. It is important to be sure that the underlying instability or.

  12. [Simulation in surgical training].

    Science.gov (United States)

    Nabavi, A; Schipper, J

    2017-01-01

    Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

  13. ANALYSIS AND PARAMETRIC OPTIMIZATION OF ENERGY-AND-TECHNOLOGY UNITS ON THE BASIS OF THE POWER EQUIPMENT OF COMPRESSOR PLANTS OF MAIN GAS PIPELINES

    Directory of Open Access Journals (Sweden)

    V. A. Sednin

    2017-01-01

    Full Text Available On the basis of the gas compressor units of compressor plants of a main gas pipeline mathematical models of the macro-level were generated for analysis and parametric optimization of combined energy-and-technology units. In continuation of the study these models was applied to obtain the regression dependencies. For this purpose, a numerical experiment was used which had been designed with the use of regression analysis mathematical tool, which assumes that the test results should represent independent, normally distributed, random variables with approximately equal variance. Herewith we study the dependence of the optimization criterion on the value of control parameters (factors. Planning, conducting and processing of results of the experiment was conducted in the following sequence: choice of the optimization criteria, selection of control parameters (factors, encoding factors, the matrix of experiment compiling, assessing significance of regression coefficients, testing the adequacy of the model and reproducibility of the experiments. As the optimization criteria the electricity capacity and efficiency of combined energy-technology units were adopted. As control parameters for the installation with a gas-expansion-and-generator machine the temperature of the fuel gas before the expander, the pressure of the fuel gas after the expander and the temperature of the air supplied to the compressor of the engine were adopted, while for the steam turbine the adopted optimization criteria were compression in the compressor of the engine, the steam consumption for the technology and the temperature of the air supplied to the compressor of the engine. The application of the outlined methodological approach makes it possible to obtain a simple polynomial dependence, which significantly simplify the procedures of analysis, parametric optimization and evaluation of efficiency in the feasibility studies of the options of construction of the energy

  14. Of Levers and Electrons and Learning and Enlightenment: Technological Augmentation of Cognition in the United States Since 1776.

    Science.gov (United States)

    Merzbach, Uta C.

    An extensive historical background for an exhibition dealing with the technological augmentation of human intellect is presented. The main theme underlying the discussion is the changing concept of cognition in the last 200 years. Five main views of the learning process are traced as they developed in philosophy and in practical application: the…

  15. Fullness of life as minimal unit: Science, technology, engineering, and mathematics (STEM) learning across the life span.

    NARCIS (Netherlands)

    Roth, W.-M.; Eijck, van M.W.

    2011-01-01

    Challenged by a National Science Foundation–funded conference, 2020 Vision: The Next Generation of STEM Learning Research, in which participants were asked to recognize science, technology, engineering, and mathematics (STEM) learning as lifelong, life-wide, and life-deep, we draw upon 20 years of

  16. Work Addiction and 21st Century Information Technologies in Traditional and Virtual Work Spaces in the United States

    Science.gov (United States)

    Hunka, Patricia L.

    2014-01-01

    This study was completed to understand whether or not work addiction or work addiction intensity could be predicted from mobile technology use. The study further investigated whether or not gender, workspace, income, or education level would moderate the relationship. The sample used was drawn from service industry employees who are not in the…

  17. Implementation of a Sage-Based Stirling Model Into a System-Level Numerical Model of the Fission Power System Technology Demonstration Unit

    Science.gov (United States)

    Briggs, Maxwell H.

    2011-01-01

    The Fission Power System (FPS) project is developing a Technology Demonstration Unit (TDU) to verify the performance and functionality of a subscale version of the FPS reference concept in a relevant environment, and to verify component and system models. As hardware is developed for the TDU, component and system models must be refined to include the details of specific component designs. This paper describes the development of a Sage-based pseudo-steady-state Stirling convertor model and its implementation into a system-level model of the TDU.

  18. CRADA with United Solar Technologies and Pacific Northwest Laboratory (PNL-021): Thin film materialsfor low-cost high performance solar concentrators

    Science.gov (United States)

    Martin, P. M.; Affinito, J. D.; Gross, M. E.; Bennett, W. D.

    1995-03-01

    The objectives of this project were to develop and evaluate promising low-cost dielectric and polymer-protected thin-film reflective metal coatings to be applied to preformed continuously-curved solar reflector panels to enhance their solar reflectance, and to demonstrate protected solar reflective coatings on preformed solar concentrator panels. The opportunity for this project arose from a search by United Solar Technologies (UST) for organizations and facilities capable of applying reflective coatings to large preformed panels. PNL was identified as being uniquely qualified to participate in this collaborative project.

  19. IEA Wind Task 26. Wind Technology, Cost, and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States: 2007–2012

    Energy Technology Data Exchange (ETDEWEB)

    Vitina, Aisma [Ea Energy Analyses, Copenhagen (Denmark); Lüers, Silke [Deutsche WindGuard, Varel (Germany); Wallasch, Anna-Kathrin [Deutsche WindGuard, Varel (Germany); Berkhout, Volker [Fraunhofer IWES, Kassel (Germany); Duffy, Aidan [Dublin Inst. of Technology and Dublin Energy Lab. (Ireland); Cleary, Brendan [Dublin Inst. of Technology and Dublin Energy Lab. (Ireland); Husabø, Lief I. [Norwegian Water Resources and Energy Directorate (NVE), Oslo (Norway); Weir, David E. [Norwegian Water Resources and Energy Directorate (NVE), Oslo (Norway); Lacal-Arántegui, Roberto [European Commission, Ispra (Italy). Joint Research Centre; Hand, Maureen [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lantz, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States); Belyeu, Kathy [Belyeu Consulting, Takoma Park, MD (United States); Wiser, Ryan H [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoen, Ben [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-06-01

    The International Energy Agency Implementing Agreement for cooperation in Research, Development, and Deployment of Wind Energy Systems (IEA Wind) Task 26—The Cost of Wind Energy represents an international collaboration dedicated to exploring past, present and future cost of wind energy. This report provides an overview of recent trends in wind plant technology, cost, and performance in those countries that are currently represented by participating organizations in IEA Wind Task 26: Denmark, Germany, Ireland, Norway, and the United States as well as the European Union.

  20. The Effectiveness of Drama Method in Unit “The Systems in Our Bodies” in Science and Technology Course: Using Two Tier Diagnostic Test

    OpenAIRE

    Ümmühan Ormancı; Sevil ÖZCAN

    2012-01-01

    In the study, it has been aimed to examine the effect of usage the drama method on the students’ success in the unit of “The Systems in Our Bodies’ in Science and Technology course. In this regard, as success test in the study, two tier diagnostic tests were used. In the study, a quasi-experimental pretest-posttest design was used and 36 students in the 6th grade were included in the study. In the application period; the lessons were maintained with drama method supported the Science and Tech...

  1. Cataract surgical rate in Yemen: 2012

    Directory of Open Access Journals (Sweden)

    Saleh A. Al-Akily

    2017-01-01

    Conclusion: CSR has increased in Yemen in the recent years but is still below the target suggested by WHO. There is need to increase the cataract surgical rate in Yemen mainly in rural areas. Inadequate number of eye surgeons, limited accessibility of cataract surgical services in rural areas and the affordability of surgery to large sections of society are major constraints that have to be addressed. The information from this study will help and enable Ministry of Health and other eye care providers to more equitably disperse trained ophthalmic personnel and eye units in Yemeni governorates.

  2. Dr Kathryn Beers, Assistant Director Physical Sciences and Engineering, Office of Science and Technology Policy Executive Office of the President United States of America visit the CMS experiment at point 5.

    CERN Multimedia

    Maximilien Brice

    2007-01-01

    Dr Kathryn Beers, Assistant Director Physical Sciences and Engineering, Office of Science and Technology Policy Executive Office of the President United States of America visit the CMS experiment at point 5.

  3. 20 January 2014 - Members of the Regional Assemblies and Parliaments United Kingdom of Great Britain and Northern Ireland visiting the LHC tunnel at Point 8 with Technology Department, Vacuum, Surfaces and Coatings Group P. Cruikshank.

    CERN Document Server

    Pantelia, Anna

    2014-01-01

    20 January 2014 - Members of the Regional Assemblies and Parliaments United Kingdom of Great Britain and Northern Ireland visiting the LHC tunnel at Point 8 with Technology Department, Vacuum, Surfaces and Coatings Group P. Cruikshank.

  4. WWER-1000 unit reliability problems from the point of view of the main supplier of technological equipment

    International Nuclear Information System (INIS)

    Bursa, V.; Holousova, M.; Turnik, S.

    1990-01-01

    At Skoda Works in Plzen, data from the period of construction of nuclear power plants are processed on an ICL DRS 300 computer. The database systems DBASE II and DATAFLEX are available for creating reliability information systems. The information system that is being developed for WWER-1000 units is tested at the WWER-440 units of the Dukovany and Mochovce nuclear power plants. Activities in the field of evaluation of structure reliability of WWER-1000 nuclear power plants are aimed at two major goals, viz., developing a methodology for testing the reliability of the whole unit and its subsystems, and performing reliability analysis and calculations of reliability indices of the secondary circuit of a WWER-1000 nuclear power plant. The reason for the latter concern is the fact that in 1984-1986, secondary circuits contributed 46% to failures of Czechoslovak WWER-440 nuclear power plants. According to existing analyses, the time fluctuations of reliability indices obey no rule that could be employed for inferring indices expected in steady-state operating conditions from indices established in the starting stage of operation. (Z.M.). 10 refs

  5. Post surgical complications from students' large animal surgical ...

    African Journals Online (AJOL)

    A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...

  6. Availability of advanced foreign energy conversion and conservation technology for use in the United States. Biennial report

    Energy Technology Data Exchange (ETDEWEB)

    Straus, R W; Thurman, R S; Carsey, J N; Fujishima, C; Hammel, J; Dietrich, P; Pfeil, R; Bottomley, K

    1978-12-01

    The assignment by DOE requested Galaxy to, Review and evaluate all field data and to define areas where foreign work is ready to be implemented by US; areas where US work might be dropped since foreign R and D is more advanced; areas where foreign R and D indicate sufficient promise for the US to initiate work in; areas where cooperative R and D ventures or licensing agreements might prove beneficial, etc. The specific technologies to be investigated by Galaxy were set forth in Tasks I and V of the contract as follows: Task I: (A) waste heat utilization, (B) advanced cycles, (C) component reliability and efficiency, (D) heat transfer, and (E) combustion and materials; Task V: (A) controls and process efficiency; (B) materials and fabrication; (C) components and heat engines; (D) thermodynamics and heat transfer; (E) fuel cells; (F) combustion and alternate fuels; and (G) heat utilization, planning and analysis. The foreign technology is briefly identified within the areas set forth. (WHK)

  7. Exploring the Eastern United States Continental Shelf with the NOAA Cooperative Institute for Ocean Exploration, Research, and Technology

    Science.gov (United States)

    Glickson, D.; Pomponi, S. A.

    2016-02-01

    The Cooperative Institute for Ocean Exploration, Research, and Technology (CIOERT) serves NOAA priorities in three theme areas: exploring the eastern U.S. continental shelf, improving the understanding of coral and sponge ecosystems, and developing advanced underwater technologies. CIOERT focuses on the exploration and research of ecosystems and habitats along frontier regions of the eastern U.S. continental shelf that are of economic, scientific, or cultural importance or of natural hazards concern. One particular focus is supporting ocean exploration and research through the use of advanced underwater technologies and techniques in order to improve the understanding of vulnerable deep and shallow coral and sponge ecosystems. CIOERT expands the scope and efficiency of exploration and research by developing, testing, and applying new and/or innovative uses of existing technologies to ocean exploration and research activities. In addition, CIOERT is dedicated to expanding ocean literacy and building NOAA's technical and scientific workforce through hands-on, at-sea experiences. A recent CIOERT cruise characterized Gulf of Mexico mesophotic and deepwater reef ecosystems off the west Florida shelf, targeting northern Pulley Ridge. This project created and ground-truthed new sonar maps made with an autonomous underwater vehicle; conducted video and photographic transects of benthic habitat and fish using a remotely operated vehicle; and examined the connectivity of fauna from shallow to deep reef ecosystems. CIOERT was established in 2009 by FAU-Harbor Branch Oceanographic Institute, with University of North Carolina, Wilmington, SRI International, and the University of Miami. The primary NOAA partner is the Office of Oceanic and Atmospheric Research's Office of Ocean Exploration and Research.

  8. Developing the STS sound pollution unit for enhancing students' applying knowledge among science technology engineering and mathematics

    Science.gov (United States)

    Jumpatong, Sutthaya; Yuenyong, Chokchai

    2018-01-01

    STEM education suggested that students should be enhanced to learn science with integration between Science, Technology, Engineering and Mathematics. To help Thai students make sense of relationship between Science, Technology, Engineering and Mathematics, this paper presents learning activities of STS Sound Pollution. The developing of STS Sound Pollution is a part of research that aimed to enhance students' perception of the relationship between Science Technology Engineering and Mathematics. This paper will discuss how to develop Sound Pollution through STS approach in framework of Yuenyong (2006) where learning activities were provided based on 5 stages. These included (1) identification of social issues, (2) identification of potential solutions, (3) need for knowledge, (4) decisionmaking, and (5) socialization stage. The learning activities could be highlighted as following. First stage, we use video clip of `Problem of people about Sound Pollution'. Second stage, students will need to identification of potential solutions by design Home/Factory without noisy. The need of scientific and other knowledge will be proposed for various alternative solutions. Third stage, students will gain their scientific knowledge through laboratory and demonstration of sound wave. Fourth stage, students have to make decision for the best solution of designing safety Home/Factory based on their scientific knowledge and others (e.g. mathematics, economics, art, value, and so on). Finally, students will present and share their Design Safety Home/Factory in society (e.g. social media or exhibition) in order to validate their ideas and redesigning. The paper, then, will discuss how those activities would allow students' applying knowledge of science technology engineering, mathematics and others (art, culture and value) for their possible solution of the STS issues.

  9. Mr. Pat McDonald, Director of "Key Business Technologies", Department of Trade and Industry, United Kingdom

    CERN Multimedia

    Maximilien Brice

    2002-01-01

    Photos 01,02: Mr Pat McDonald, Director of "Key Business Technologies", Department of Trade and Industry, UK (third from left, front) in front of the ATLAS End-Cap Toroid vacuum vessel in the ATLAS assembly hall with, from left to right, Fred Wickens, Chris Jones, Peter Fletcher, Ray Browne, Neil Geddes, Jim Fleming, Anne Trefethen, Jim Wilson, Edwin Towndrow, Sharon Bonfield, Guy Rickett, Ken Smith, Peter Jenni. Photo 03: Mr Pat McDonald, Director of "Key Business Technologies", Department of Trade and Industry, UK (fifth from left) visiting ATLAS assembly hall with, from left to right, Jim Wilson, Peter Jenni, Ken Smith, Edwin Towndrow, Ray Brown, Chris Jones, Neil Geddes, Sharon Bonfield, Anne Trefethen, Jim Fleming, Fred Wickens. Photo 04: Mr Pat McDonald, Director of "Key Business Technologies", Department of Trade and Industry, UK (fourth from right) in front of the ATLAS Barrel Toroid coil casing in the ATLAS assembly hall with, from left to right, Peter Jenni, Jim Wilson, Guy Rickett, Anne Trefethen, ...

  10. The role of government in the development and diffusion of renewable energy technologies: Wind power in the United States, California, Denmark and Germany, 1970--2000

    Science.gov (United States)

    Sawin, Janet Laughlin

    2001-07-01

    This dissertation seeks to determine the role of government policy in advancing the development and diffusion of renewable energy technologies, and to determine if specific policies or policy types are more effective than others in achieving these ends. This study analyzes legislation, regulations, research and development (R&D) programs and their impacts on wind energy in California, the rest of the United States, Denmark and Germany, from 1970 through 2000. These countries (and state) were chosen because each has followed a very different path and has adopted wind energy at different rates. Demand for energy, particularly electricity, is rising rapidly worldwide. Renewable energy technologies could meet much of the world's future demand for electricity without the national security, environmental and social costs of conventional technologies. But renewables now play only a minor role in the electric generation systems of most countries. According to conventional economic theory, renewable energy will achieve greater market penetration once it is cost-competitive with conventional generation. This dissertation concludes, however, that government policy is the most significant causal variable in determining the development and diffusion of wind energy technology. Policy is more important for bringing wind energy to maturity than a nation's wind resource potential, wealth, relative differences in electricity prices, or existing infrastructure. Further, policy is essential for enabling a technology to succeed in the marketplace once it is cost-competitive. Policies can affect a technology's perceived, or real, costs; they can reduce risks or increase the availability and affordability of capital; appropriate and consistent policies can eliminate barriers to wind technology. To be adopted on a large scale, renewables require effective, appropriate and, above all, consistent policies that are legislated with a long-term view toward advancing a technology and an

  11. 3D Surgical Simulation

    Science.gov (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  12. Sustained diffusion of renewable energy. Politically defined investment contexts for the diffusion of renewable electricity technologies in Spain, the Netherlands and United Kingdom

    International Nuclear Information System (INIS)

    Dinica, V.

    2003-01-01

    The increasing concerns regarding the security of energy supply, climate change, and the environmental-health impacts of fossil fuels' burning and nuclear energy use have consolidated the political interest in many countries to support the diffusion of renewable energy technologies. In the industrialized countries that have adopted so far policies for renewable energy support, diffusion results are mixed. The core questions that challenge policy makers and academics are: How to design policies that are effective in market introduction and able to sustain diffusion in the long-term? and: What is the impact of different policy approaches in terms of technical and cost-performance improvements of renewable energy technologies? The study addresses these questions and proposes to analyze the diffusion potential of support systems from the perspective of investors. Policy design needs to account for the investment risks associated with support schemes and the profitability they enable for investors. But, still, the effectiveness of a specific support system may not be the same across national contexts. Financing agents and economic actors have different business requirements and business culture in various countries, which influences the effects of support systems. The technical particularities of technologies may also influence the diffusion process. In order to track down influences, the book examines the market diffusion processes of three renewable electricity technologies in three countries: wind energy in Spain, the Netherlands and the United Kingdom; biomass in Spain; and small hydropower technology in Spain. The book may be particularly interesting for policy makers and policy scholars concerned with the challenge of greening the energy supply, and understanding diffusion processes and their consequences

  13. The heavy-duty vehicle future in the United States: A parametric analysis of technology and policy tradeoffs

    International Nuclear Information System (INIS)

    Askin, Amanda C.; Barter, Garrett E.; West, Todd H.; Manley, Dawn K.

    2015-01-01

    We present a parametric analysis of factors that can influence advanced fuel and technology deployments in U.S. Class 7–8 trucks through 2050. The analysis focuses on the competition between traditional diesel trucks, natural gas vehicles (NGVs), and ultra-efficient powertrains. Underlying the study is a vehicle choice and stock model of the U.S. heavy-duty vehicle market. The model is segmented by vehicle class, body type, powertrain, fleet size, and operational type. We find that conventional diesel trucks will dominate the market through 2050, but NGVs could have significant market penetration depending on key technological and economic uncertainties. Compressed natural gas trucks conducting urban trips in fleets that can support private infrastructure are economically viable now and will continue to gain market share. Ultra-efficient diesel trucks, exemplified by the U.S. Department of Energy's SuperTruck program, are the preferred alternative in the long haul segment, but could compete with liquefied natural gas (LNG) trucks if the fuel price differential between LNG and diesel increases. However, the greatest impact in reducing petroleum consumption and pollutant emissions is had by investing in efficiency technologies that benefit all powertrains, especially the conventional diesels that comprise the majority of the stock, instead of incentivizing specific alternatives. -- Highlights: •We present a parametric analysis of factors U.S. Class 7–8 trucks through 2050. •Conventional diesels will be more than 70% of U.S. heavy-duty vehicles through 2050. •CNG trucks are well suited to large, urban fleets with private refueling. •Ultra-efficient long haul diesel trucks are preferred over LNG at current fuel prices

  14. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  15. Surgical Treatment of Acute Pancreatitis.

    Science.gov (United States)

    Werner, Jens; Uhl, Waldemar; Büchler, Markus W.

    2003-10-01

    Patients with predicted severe necrotizing pancreatitis as diagnosed by C-reactive protein (>150 mg/L) and/or contrast-enhanced computed tomography should be managed in the intensive care unit. Prophylactic broad-spectrum antibiotics reduce infection rates and survival in severe necrotizing pancreatitis. Endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy is a causative therapy for gallstone pancreatitis with impacted stones, biliary sepsis, or obstructive jaundice. Fine needle aspiration for bacteriology should be performed to differentiate between sterile and infected pancreatic necrosis in patients with sepsis syndrome. Infected pancreatic necrosis in patients with clinical signs and symptoms of sepsis is an indication for surgery. Patients with sterile pancreatic necrosis should be managed conservatively. Surgery in patients with sterile necrosis may be indicated in cases of persistent necrotizing pancreatitis and in the rare cases of "fulminant acute pancreatitis." Early surgery, within 14 days after onset of the disease, is not recommended in patients with necrotizing pancreatitis. The surgical approach should be organ-preserving (debridement/necrosectomy) and combined with a postoperative management concept that maximizes postoperative evacuation of retroperitoneal debris and exudate. Minimally invasive surgical procedures have to be regarded as an experimental approach and should be restricted to controlled trials. Cholecystectomy should be performed to avoid recurrence of gallstone-associated acute pancreatitis.

  16. Luminex® xMAP® technology is an effective strategy for high-definition human leukocyte antigen typing of cord blood units prior to listing.

    Science.gov (United States)

    Guarene, Marco; Badulli, Carla; Cremaschi, Anna L; Sbarsi, Ilaria; Cacciatore, Rosalia; Tinelli, Carmine; Pasi, Annamaria; Bergamaschi, Paola; Perotti, Cesare G

    2018-05-01

    Allele-level donor-recipient match at HLA-A, HLA-B, HLA-C and HLA-DRB1 loci impacts the outcome after cord blood transplantation for hematologic malignancies and modifies the strategy of donor selection. High definition of both class I and II HLA loci at time of listing is a way to improve the attractiveness of cord blood bank inventories, reducing the time for donor search and procurement and simplifying donor choice, in particular, for patients of non-European heritage. In 2014, Luminex ® xMAP ® technology was introduced in our laboratory practice and was applied to cord blood units typing. In this study, we evaluated the impact of this strategy in comparison with the platform in use until 2013, relying on LiPA reverse polymerase chain reaction-sequence-specific oligonucleotide (revPCR-SSO) plus polymerase chain reaction-sequence-specific primer (PCR-SSP). In 2014, the time for testing was shorter (141 vs 181 days on average), the number of test repetitions was lower (in particular for HLA-A locus, p = 0.026), and the cost reduced (240.7 vs 395.6 euros per unit on average) compared to 2013, demonstrating that Luminex xMAP technology is superior to the previous approach. Luminex xMAP platform has useful application in cord blood banking programs, to achieve high-definition HLA typing of cord blood units at the time of banking in a quick, accurate, and cost-effective manner.

  17. SURGICAL SITE INFECTION: REVIEW

    Directory of Open Access Journals (Sweden)

    P. H. M. Bonai

    2016-07-01

    Full Text Available Nosocomial infection or nosocomial infection (NI is one of the factors that increase the cost of maintaining patients in the health system, even in processes that should safely occur, such as hospital patients and performing simple and routine surgical procedures surgical centers and clinics leading to complications resulting from these infections that prolong hospital stay and promote pain and suffering to the patient, resulting in the defense of the quality of services and influencing negatively the hospitals. Therefore, the aim of this study was to review the factors that result in surgical site infection, with the purpose of better understanding of the subject and the possibility of preventive actions to better treatment outcome of the patient.

  18. Barriers and Benefits in Telemedicine Arising Between a High-Technology Hospital Service Provider and Remote Public Healthcare Units: A Qualitative Study in Brazil.

    Science.gov (United States)

    de Souza, Carlos Henrique Amaral; Morbeck, Renata Albaladejo; Steinman, Milton; Hors, Cora Pereira; Bracco, Mario Maia; Kozasa, Elisa H; Leão, Eliseth Ribeiro

    2017-06-01

    In Brazil, the Program for Institutional Development of the Unified Healthcare System (PROADI-SUS) has implemented a telemedicine service for urgent situations and emergencies. It is delivered by a high-technology (HT) hospital to 15 remote healthcare units (RUs) in 11 different Brazilian states. The aim of this study was to investigate possible barriers and benefits in telemedicine service among these units. We performed a qualitative study on the perceptions of physicians involved in telemedicine service in their role as providers and consultants. An individual, semistructured recorded interview was conducted with 28 physicians (17 HT; 11 RU) encompassing telemedicine resources and interaction among HT and RU physicians. Data analysis was performed by Discourse of Collective Subject. We identified the following barriers in the telemedicine service: (1) lack of experience in the use of technology or the quality of the internet signal; (2) the multiplicity of different telemedicine platforms; (3) the quality of the image sent to the HT hospital; (4) the misunderstanding that telemedicine is a time-consuming technology instead of a resource that may help to save lives; (5) not feeling comfortable exposing doubts to other HT colleagues; (6) problems in the management of telemedicine use in the RUs; and (7) political and legal issues. However, important benefits in telemedicine service were also described. The structural barriers should be the target of hospital managers. Development of standard remote care protocols may increase the use of telemedicine and create new work routines. Given the relationship difficulties among the RU and HT doctors during telemedicine consultations, other meetings should be organized to allow more interpersonal interactions. These meetings may also have the goal of sharing outcome indicators of their joint activity in telemedicine to stimulate and make them aware of the benefits of their interaction.

  19. Analysis on the revision of the United States authorizing procedure for the transfer of unclassified nuclear technology

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sung-ho; Seo, Hana; Lee, Chansuh; Kim, Jong-sook [Korea Institute of Nuclear Nonproliferation and Control, Daejeon (Korea, Republic of)

    2015-10-15

    The DOE (Department Of Energy) has not comprehensively update 10CFR810 since 1986. Since then, the global civil nuclear market has expanded, particularly in China, the Middle East, and Eastern Europe, with vendors from France, Japan, the Republic of Korea, Russia, and Canada. In result, DOE issued revised 810 in respond to comments received from the public and commercial nuclear market changes. This regulation revision improves the efficiency of authorization process to promote national nuclear industry while maintaining nonproliferation control. Even though ROK has initiated a legal basis for Intangible technology transfer (ITT) for nuclear export control, working implementation system is not set up. This research proposes recommendable ITT implementation of the ROK according to the analysis result of the US regulation. In this revision, of 124 countries had been classified as general authorization under 10CFR810, 80 countries reclassified into the specific authorization. By remaining 'fast track' for specific authorization, in particular, time frames for internal DOE and interagency reviews are reduced. This means the US government actively copes with commercial nuclear market expands to promote their industry. Meanwhile, by remaining some of nuclear-weapon states (China, Russia, India) as specific authorization maintaining that the determinations are consistent with current US national security, diplomatic, and trade policy. By benchmarking the US regulation, Korea can improve the efficiency of the technology transfer authorization process easing the regulatory burden by reducing uncertainty and timelines while maintaining the highest level of nonproliferation control.

  20. Injury Rates on New and Old Technology Oil and Gas Rigs Operated by the Largest United States Onshore Drilling Contractor

    Science.gov (United States)

    Blackley, David J.; Retzer, Kyla D.; Hubler, Warren G.; Hill, Ryan D.; Laney, A. Scott

    2015-01-01

    Background Occupational fatality rates among oil and gas extraction industry and specifically among drilling contractor workers are high compared to the U.S. all-industry average. There is scant literature focused on non-fatal injuries among drilling contractors, some of which have introduced engineering controls to improve rig efficiency and reduce injury risk. Methods We compared injury rates on new and old technology rigs operated by the largest U.S. drilling contractor during 2003–2012, stratifying by job type and grouping outcomes by injury severity and body part affected. Results Six hundred seventy-one injuries were recorded over 77.4 million person-hours. The rate on new rigs was 66% of that on old rigs. Roughnecks had lower injury rates on new rigs, largely through reduced limb injury rates. New rigs had lower rates in each non-fatal injury severity category. Conclusions For this company, new technology rigs appear to provide a safer environment for roughnecks. Future studies could include data from additional companies. PMID:25164118

  1. Analysis on the revision of the United States authorizing procedure for the transfer of unclassified nuclear technology

    International Nuclear Information System (INIS)

    Yoon, Sung-ho; Seo, Hana; Lee, Chansuh; Kim, Jong-sook

    2015-01-01

    The DOE (Department Of Energy) has not comprehensively update 10CFR810 since 1986. Since then, the global civil nuclear market has expanded, particularly in China, the Middle East, and Eastern Europe, with vendors from France, Japan, the Republic of Korea, Russia, and Canada. In result, DOE issued revised 810 in respond to comments received from the public and commercial nuclear market changes. This regulation revision improves the efficiency of authorization process to promote national nuclear industry while maintaining nonproliferation control. Even though ROK has initiated a legal basis for Intangible technology transfer (ITT) for nuclear export control, working implementation system is not set up. This research proposes recommendable ITT implementation of the ROK according to the analysis result of the US regulation. In this revision, of 124 countries had been classified as general authorization under 10CFR810, 80 countries reclassified into the specific authorization. By remaining 'fast track' for specific authorization, in particular, time frames for internal DOE and interagency reviews are reduced. This means the US government actively copes with commercial nuclear market expands to promote their industry. Meanwhile, by remaining some of nuclear-weapon states (China, Russia, India) as specific authorization maintaining that the determinations are consistent with current US national security, diplomatic, and trade policy. By benchmarking the US regulation, Korea can improve the efficiency of the technology transfer authorization process easing the regulatory burden by reducing uncertainty and timelines while maintaining the highest level of nonproliferation control

  2. Injury rates on new and old technology oil and gas rigs operated by the largest United States onshore drilling contractor.

    Science.gov (United States)

    Blackley, David J; Retzer, Kyla D; Hubler, Warren G; Hill, Ryan D; Laney, A Scott

    2014-10-01

    Occupational fatality rates among oil and gas extraction industry and specifically among drilling contractor workers are high compared to the U.S. all-industry average. There is scant literature focused on non-fatal injuries among drilling contractors, some of which have introduced engineering controls to improve rig efficiency and reduce injury risk. We compared injury rates on new and old technology rigs operated by the largest U.S. drilling contractor during 2003-2012, stratifying by job type and grouping outcomes by injury severity and body part affected. Six hundred seventy-one injuries were recorded over 77.4 million person-hours. The rate on new rigs was 66% of that on old rigs. Roughnecks had lower injury rates on new rigs, largely through reduced limb injury rates. New rigs had lower rates in each non-fatal injury severity category. For this company, new technology rigs appear to provide a safer environment for roughnecks. Future studies could include data from additional companies. © 2014 Wiley Periodicals, Inc.

  3. Retained surgical sponge

    International Nuclear Information System (INIS)

    Koyama, Masashi; Kurono, Kenji; Iida, Akihiko; Suzuki, Hirochika; Hara, Masaki; Mizutani, Hirokazu; Ohba, Satoru; Mizutani, Masaru; Nakajima, Yoichiro.

    1993-01-01

    The CT, US, and MRI findings of confirmed retained surgical sponges were reviewed. The CT examinations in eight lesions demonstrated round or oval masses with heterogeneous internal structures. The US examinations in 5 lesions demonstrated low echogenic masses with high echogenic internal structures, which suggested retained surgical sponges. MR imagings in three lesions showed slightly high intensity comparable to that of muscles on T1-weighted images and high signal intensity on T2-weighted images, suggesting fluid collections of high protein concentration. (author)

  4. Surgical drill system and surgical drill bit to be used therein

    NARCIS (Netherlands)

    Margallo Balbas, E.; Wieringa, P.A.; French, P.J.; Lee, R.A.; Breedveld, P.

    2007-01-01

    Surgical drill system comprising a mechanical drill bit and means for imaging the vicinity of the drill bit tip, said means comprising: at least one optical fiber having a distal end and a proximal end, said distal end being located adjacent said drill bit tip, an optical processing unit, said

  5. Radiation exposure reduction technologies for a Japanese Advanced BWR (Dose Rate Reduction Experience in Shika Unit 2)

    International Nuclear Information System (INIS)

    Saito, Takeshi; Ichikawa, Koji; Ishimaru, Hiroshi; Aizawa, Motohiro; Sato, Yoshiteru; Morita, Shoichi

    2012-09-01

    Operating experiences of the advanced boiling water reactor (ABWR) have been accumulated in Japan since the first ABWRs Kashiwazaki-Kariwa NPS unit 6 and 7 came into service. Shika NPS unit 2 (Shika-2) of Hokuriku Electric Power Co. is the fourth ABWR plant in Japan. Since ABWRs have no piping of the reactor recirculation system (RRS), which is the largest source of radiation in conventional BWRs, carbon steel piping of the reactor water cleanup system (RWCU) and residual heat removal system (RHR) are the largest source in ABWRs. Therefore we have focused on reduction methods of radioactive material on carbon steel surface in order to reduce the quantity of occupational exposure in Shika-2. In Shika-2 the following methods have been adopted. Before fuel loading, alkaline pre-filming process was applied to the RWCU piping during plant startup testing. After start of operation, the feed water iron concentration control (or nickel/iron ratio control) method was applied. Furthermore, during shutdown operation the RHR system was operated when the reactor water temperature was dropped to 120 degree C with the use of condenser heat sink cooling operation. These dose rate reduction methods worked well in Shika-2 as expected. The quantity of occupational exposure at the 3 rd outage in Shika-2 was approximately 0.35 person-Sv. On the basis of the results obtained thus far, the occupational dose expected at the outage after deposition amount of radioactivity reaching the equilibrium state has been estimated to be around 0.5 person-Sv. This value is considered to be in low level compared with the worldwide statistics. (authors)

  6. [Surgical treatment of anal fistula].

    Science.gov (United States)

    Zeng, Xiandong; Zhang, Yong

    2014-12-01

    Anal fistula is a common disease. It is also quite difficult to be solved without recurrence or damage to the anal sphincter. Several techniques have been described for the management of anal fistula, but there is no final conclusion of their application in the treatment. This article summarizes the history of anal fistula management, the current techniques available, and describes new technologies. Internet online searches were performed from the CNKI and Wanfang databases to identify articles about anal fistula management including seton, fistulotomy, fistulectomy, LIFT operation, biomaterial treatment and new technology application. Every fistula surgery technique has its own place, so it is reasonable to give comprehensive individualized treatment to different patients, which may lead to reduced recurrence and avoidance of damage to the anal sphincter. New technologies provide promising alternatives to traditional methods of management. Surgeons still need to focus on the invention and improvement of the minimally invasive techniques. Besides, a new therapeutic idea is worth to explore that the focus of surgical treatment should be transferred to prevention of the formation of anal fistula after perianal abscess.

  7. Virtual reality in surgical training.

    Science.gov (United States)

    Lange, T; Indelicato, D J; Rosen, J M

    2000-01-01

    Virtual reality in surgery and, more specifically, in surgical training, faces a number of challenges in the future. These challenges are building realistic models of the human body, creating interface tools to view, hear, touch, feel, and manipulate these human body models, and integrating virtual reality systems into medical education and treatment. A final system would encompass simulators specifically for surgery, performance machines, telemedicine, and telesurgery. Each of these areas will need significant improvement for virtual reality to impact medicine successfully in the next century. This article gives an overview of, and the challenges faced by, current systems in the fast-changing field of virtual reality technology, and provides a set of specific milestones for a truly realistic virtual human body.

  8. Evaluation of medication errors with implementation of electronic health record technology in the medical intensive care unit

    Directory of Open Access Journals (Sweden)

    Liao TV

    2017-05-01

    Full Text Available T Vivian Liao,1 Marina Rabinovich,2 Prasad Abraham,2 Sebastian Perez,3 Christiana DiPlotti,4 Jenny E Han,5 Greg S Martin,5 Eric Honig5 1Department of Pharmacy Practice, College of Pharmacy, Mercer Health Sciences Center, 2Department of Pharmacy and Clinical Nutrition, Grady Health System, 3Department of Surgery, Emory University, 4Pharmacy, Ingles Markets, 5Department of Medicine, Emory University, Atlanta, GA, USA Purpose: Patients in the intensive care unit (ICU are at an increased risk for medication errors (MEs and adverse drug events from multifactorial causes. ME rate ranges from 1.2 to 947 per 1,000 patient days in the medical ICU (MICU. Studies with the implementation of electronic health records (EHR have concluded that it significantly reduced overall prescribing errors and the number of errors that caused patient harm decreased. However, other types of errors, such as wrong dose and omission of required medications increased after EHR implementation. We sought to compare the number of MEs before and after EHR implementation in the MICU, with additional evaluation of error severity.Patients and methods: Prospective, observational, quality improvement study of all patients admitted to a single MICU service at an academic medical center. Patients were evaluated during four periods over 2 years: August–September 2010 (preimplementation; period I, January–February 2011 (2 months postimplementation; period II, August–September 2012 (21 months postimplementation; period III, and January–February 2013 (25 months postimplementation; period IV. All medication orders and administration records were reviewed by an ICU clinical pharmacist and ME was defined as a deviation from established standards for prescribing, dispensing, administering, or documenting medication. The frequency and classification of MEs were compared between groups by chi square; p<0.05 was considered significant.Results: There was a statistically significant increase

  9. Surgical management of spontaneous hypertensive brainstem hemorrhage

    Directory of Open Access Journals (Sweden)

    Bal Krishna Shrestha

    2015-09-01

    Full Text Available Spontaneous hypertensive brainstem hemorrhage is the spontaneous brainstem hemorrhage associated with long term hypertension but not having definite focal or objective lesion. It is a catastrophic event which has a poor prognosis and usually managed conservatively. It is not uncommon, especially in eastern Asian populations, accounting approximately for 10% of the intracerebral hemorrhage. Before the advent of computed tomography, the diagnosis of brainstem hemorrhage was usually based on the clinical picture or by autopsy and believed to be untreatable via surgery. The introduction of computed tomography permitted to categorize the subtypes of brainstem hemorrhage with more predicted outcome. Continuous ongoing developments in the stereotactic surgery and microsurgery have ad