[Crisis unit at the general hospital: Determinants of further hospitalization].

Science.gov (United States)

Norotte, C; Omnès, C; Crozier, C; Verlyck, C; Romanos, M

2017-10-01

The availability of short-stay beds for brief admission (less than 72hours) of crisis patients presenting to the emergency room is a model that has gained a growing interest because it allows time for developing alternatives to psychiatric hospitalization and favors a maintained functioning in the community. Still, the determinants influencing the disposition decision at discharge after crisis intervention remain largely unexplored. The primary objective of this study was to determine the factors predicting aftercare dispositions at crisis unit discharge: transfer for further hospitalization or return to the community. Secondary objectives included the description of clinical and socio-demographic characteristics of patients admitted to the crisis unit upon presentation to the emergency room. All patients (n=255) admitted to the short-stay unit of the emergency department of Rambouillet General Hospital during a one-year period were included in the study. Patient characteristics were collected in a retrospective manner from medical records: patterns of referral, acute stressors, presenting symptoms, initial patient demand, Diagnostic and Statistical Manual, 5th edition (DSM-5) disorders, psychiatric history, and socio-demographic characteristics were inferred. Logistic regression analysis was used to determine the factors associated with hospitalization decision upon crisis intervention at discharge. Following crisis intervention at the short-stay unit, 100 patients (39.2%) required further hospitalization and were transferred. Statistically significant factors associated with a higher probability of hospitalization (P<0.05) included the patient's initial wish to be hospitalized (OR=4.28), the presence of a comorbid disorder (OR=3.43), a referral by family or friends (OR=2.89), a history of psychiatric hospitalization (OR=2.71) and suicidal ideation on arrival in the emergency room (OR=2.26). Conversely, significant factors associated with a lower probability of

Impact of daily chlorhexidine baths and hand hygiene compliance on nosocomial infection rates in critically ill patients.

Science.gov (United States)

Martínez-Reséndez, Michel Fernando; Garza-González, Elvira; Mendoza-Olazaran, Soraya; Herrera-Guerra, Alexis; Rodríguez-López, Juan Manuel; Pérez-Rodriguez, Edelmiro; Mercado-Longoria, Roberto; Camacho-Ortiz, Adrián

2014-07-01

Up to 25% of all nosocomial infections (NIs) develop in critically ill patients. Our objective was to evaluate chlorhexidine (CHX) bathing and hand hygiene (HH) compliance in the reduction of NIs in the intensive care unit. The study comprised three 6-month periods: preintervention (PIP; soap/water bathing), intervention (IP; bathing with CHX-impregnated wipes), and postintervention (PoIP; soap/water bathing). An HH program was implemented during the IP and PoIP. Primary outcomes were global and specific NI rates. A total of 1007 patients were included. Infection rates per 100 discharges were higher in the PIP compared with the IP and also higher in the PoIP compared with the IP (P = .0004 and .0109, respectively). Global infection rates per 1000 hospital-days were higher in the PIP than in the IP (P = .0268). The rates of ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infection (CAUTI) were higher in the PIP than in the IP (P = .036 and .0001, respectively). Isolation of Acinetobacter baumannii from VAP specimens (P = .0204) and isolation of Candida spp from CAUTI specimens (P = .0005) decreased as well. The combined intervention reduced global and specific infection rates, including rates of VAP associated with A baumannii and CAUTI associated with Candida spp. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Radiation decontamination unit for the community hospital

International Nuclear Information System (INIS)

Waldron, R.L. II; Danielson, R.A.; Shultz, H.E.; Eckert, D.E.; Hendricks, K.O.

1981-01-01

Freestanding radiation decontamination units including surgical capability can be developed and made operational in small/medium sized community hospitals at relatively small cost and with minimal plant reconstrution. The Radiological Assistance Program of the United States Department of Energy and the Radiation Emergency Assistance Center Training Site of Oak Rige Associated Universities are ready to support individual hospitals and physicians in this endeavor. Adequate planning rather than luck, should be used in dealing with potential radiation accident victims. The radiation emergency team is headed by a physician on duty in the hospital. The senior administrative person on duty is responsible for intramural and extramural communications. Rapid mobilization of the radiation decontamination unit is important

DUST-BATHING BEHAVIORS OF AFRICAN HERBIVORES AND THE POTENTIAL RISK OF INHALATIONAL ANTHRAX.

Science.gov (United States)

Barandongo, Zoe R; Mfune, John K E; Turner, Wendy C

2018-01-01

:  Anthrax in herbivorous wildlife and livestock is generally assumed to be transmitted via ingestion or inhalation of Bacillus anthracis spores. Although recent studies have highlighted the importance of the ingestion route for anthrax transmission, little is known about the inhalational route in natural systems. Dust bathing could aerosolize soilborne pathogens such as B. anthracis, exposing dust-bathing individuals to inhalational infections. We investigated the potential role of dust bathing in the transmission of inhalational anthrax to herbivorous wildlife in Etosha National Park, Namibia, an area with endemic seasonal anthrax outbreaks. We 1) cultured soils from dust-bathing sites for the presence and concentration of B. anthracis spores, 2) monitored anthrax carcass sites, the locations with the highest B. anthracis concentrations, for evidence of dust bathing, including a site where a zebra died of anthrax on a large dust bath, and 3) characterized the ecology and seasonality of dust bathing in plains zebra ( Equus quagga), blue wildebeest ( Connochaetes taurinus), and African savanna elephant ( Loxodonta africana) using a combination of motion-sensing camera traps and direct observations. Only two out of 83 dust-bath soils were positive for B. anthracis, both with low spore concentrations (≤20 colony-forming units per gram). We also detected no evidence of dust baths occurring at anthrax carcass sites, perhaps due to carcass-induced changes in soil composition that may deter dust bathing. Finally, despite observing some seasonal variation in dust bathing, preliminary evidence suggests that the seasonality of dust bathing and anthrax mortalities are not correlated. Thus, although dust bathing creates a dramatic cloud of aerosolized soil around an individual, our microbiologic, ecologic, and behavioral results in concert demonstrate that dust bathing is highly unlikely to transmit inhalational anthrax infections.

Effect and efficacy of thermal environment provided by a new bathing style, “mist sauna bathing”

Directory of Open Access Journals (Sweden)

IWASE Satoshi

2013-02-01

Full Text Available Mist sauna is a style of bathing in which hot water vapor is sprayed into a bathroom, establishing an air temperature of 40°C with saturated humidity. Bath heater and dryer equipment with mist sauna function was released onto the Japanese market in 2004. After their introduction, various studies investigated the effects of mist sauna bathing, and it has been demonstrated that mist sauna bathing has various effects and efficacies, not only hyperthermic effects but also other effects including on physical appearance. Mist sauna bathing occurs in a bathroom, usually without a toilet, in which the room temperature is approximately 40°C with 100% relative humidity. It has been shown that the mist sauna causes little hemodynamic change, which ensures its safety during bathing. Therefore, we can enjoy safer physiological bathing in a mist sauna than in traditional hot water immersion bathing. In addition, the mist sauna elicits benefits such as improved skin condition, heat acclimation, and autonomic balance. Since mist sauna bathing does not involve immersion of the body in bathtub water, it is less likely to result in an accident during bathing because of the low impact of hemodynamic changes. Recently, mist sauna bathing has drawn attention in the field of nursing care as a bathing style for the hospitalized elderly that can reduce the burden on care-giving personnel during bathing. It is expected that mist sauna will be adopted by homes and various facilities as a useful approach for various purposes, regardless of the user’s age or gender.

Radiation decontamination unit for the community hospital.

Science.gov (United States)

Waldron, R L; Danielson, R A; Shultz, H E; Eckert, D E; Hendricks, K O

1981-05-01

"Freestanding" radiation decontamination units including surgical capability can be developed and made operational in small/medium sized community hospitals at relatively small cost and with minimal plant reconstruction. Because of the development of nuclear power plants in relatively remote areas and widespread transportation of radioactive materials it is important for hospitals and physicians to be prepared to handle radiation accident victims. The Radiological Assistance Program of the United States Department of Energy and the Radiation Emergency Assistance Center Training Site of Oak Ridge Associated Universities are ready to support individual hospitals and physicians in this endeavor. Adequate planning rather than luck, should be used in dealing with potential radiation accident victims. The radiation emergency team is headed by a physician on duty in the hospital. It is important that the team leader be knowledgeable in radiation accident management and have personnel trained in radiation accident management as members of this team. The senior administrative person on duty is responsible for intramural and extramural communications. Rapid mobilization of the radiation decontamination unit is important. Periodic drills are necessary for this mobilization and the smooth operation of the unit.

Electrodeposition of gold from formaldehyde-sulfite baths: bath stability and deposits characterization

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Juliana L. Cardoso

2011-01-01

Full Text Available It was investigated Au(I-sulfite baths containing formaldehyde. As a result, high stability was achieved for baths containing formaldehyde concentration close to 10 mL L-1 with a lifetime superior to 600 days. On the other hand, cyclic voltammograms indicated that the increase of formaldehyde concentration in the bath promotes decreasing of the maximum cathodic current, so that, if the formaldehyde concentration is high, the surface areal concentration of gold will be low. Also, the lowest surface roughness was obtained for 10 mL L-1 of formaldehyde.

Usefulness of implantable loop recorder in a patient with syncope during bathing

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Motohiro Nakao, MD

2013-02-01

Full Text Available A 27-year-old man presented to our hospital with a 1-year-hisory of repeated syncope, which particularly occurred while bathing or on a hot day. The head-up tilt test did not induce arrhythmia; however, blood pressure decreased by 39 mm Hg without any symptoms. Given that no bradycardia/tachycardia was induced on electrophysiological study and carotid sinus massage, an implantable loop recorder (ILR was implanted. After 2 months, syncope again occurred during bathing at midnight. Sinus arrest and a maximum ventricular pause of 10.2 s were documented using the ILR. After pacemaker implantation, the patient had not experienced syncope for 14 months.

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.

Design, Planning and Management of the Hospital Custody Unit at Hospital Universitario Fundación Alcorcón

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C. de la Fuente-Martín

Full Text Available Objective: The design and management of a Hospital Custody Unit at Hospital Universitario Fundación Alcorcón, to focus the aim of this study on specialized medical care for extra-penitentiary patients who have suffered from a disease. We are building a new space to facilitate their daily lives at hospital and we want to offer a double function to the patients that consists of a custody space and a health rehabilitation space. Material and methods: We carried out a scientific literature search on the international and national databases, about Hospital Custody Units or Restricted Access Units. The language of the reviews that we checked was English and Spanish. Results: We wrote the Action Guide of the Hospital Custody Unit for the design, planning and management of the Hospital Custody Unit at Hospital Universitario Fundación Alcorcón. (We included complementary bibliographic material and the Quick Guide in the Unit. Discussion: The Hospital Custody Unit will be compatible with medical activity, occupational safety and the custody of patients that are in prison. We thus require consensus with police departments about custody protocols along with assistance from the clinicians' teams at penitentiary centers and referral hospitals. Furthermore, it is important to step up special care for mental health and to promote telemedicine and new technologies to streamline medical care along with coordination with healthcare professionals.

Clinical and anti-aging effect of mud-bathing therapy for patients with fibromyalgia.

Science.gov (United States)

Maeda, Toyoki; Kudo, Yoshihiro; Horiuchi, Takahiko; Makino, Naoki

2017-12-06

Spa bathing is known as a medical treatment for certain diseases causing chronic pains. Spa water contains mineral components which lower the specific heat of the water, resulting in a higher efficiency to warm body-core temperature. This phenomenon yields pain-relieving effect for rheumatoid arthritis, low back pain, sciatic neuralgia, fibromyalgia, etc. Here we introduce medical and biological effects of mud-spa-bathing therapy for fibromyalgia other than pain relief, the changes of blood examination data, and the telomere length of circulating leukocytes. The enrolled 7 patients with fibromyalgia syndrome were hospitalized and were subject to daily mud bathing at 40 °C for 10 min for about a month. Then, their subjective pain was reduced to about a quarter in average. They also showed lowered serum triglyceride and C-reactive protein level, maintaining the levels of aspartate transaminase and creatine phosphokinase, and increases of the red blood cell count, the serum albumin level, and the serum LDL-cholesterol level in comparison with cases without mud-bathing therapy, suggesting that mud bathing prevents inflammation and muscle atrophy and improves nutritional condition in fibromyalgia. In addition, the analysis of telomere length of peripheral leukocytes revealed a trend of negative correlation between telomere shortening and laboratory data change of hemoglobin and serum albumin. These telomeric changes can be explained hypothetically by an effect of mud bathing extending life-span of circulating leukocytes.

Psychiatric units in Brazilian general hospitals: a growing philanthropic field.

Science.gov (United States)

Botega, Neury José

2002-06-01

Some countries, mainly in North America and Europe, have adopted psychiatric wards in the general hospital as an alternative to the classic psychiatric hospital. In Brazil there are 6,169 general hospitals, 1.3% of which with a psychiatric unit. This service strategy is scarcely developed in the country and comprises only 4% of all psychiatric admissions. There was no information on the facilities and functioning of the psychiatric units in general hospitals. To determine the main characteristics of psychiatric units in Brazilian general hospitals and to assess the current trends in the services provided. A mailing survey assessed all 94 Brazilian general hospitals which made psychiatric admissions. A two-page questionnaire was designed to determine the main characteristics of each institution and of the psychiatric unit. Seventy-nine (84%) questionnaires were returned. In contrast to the 1970s and 1980s, in the last decade the installation of psychiatric units has spread to smaller philanthropic institutions that are not linked to medical schools. A fifth of hospitals admit psychiatric patients to medical wards because there is no specialist psychiatric ward. They try to meet all the local emergency demands, usually alcohol-dependent patients who need short term admission. This could signal the beginning of a program through which mental health professionals may become an integral part of general health services. The inauguration of psychiatric wards in philanthropic hospitals, as well as the admission of psychiatric patients in their medical wards, is a phenomenon peculiar to this decade. The installation of psychiatric services in these and other general hospitals would overcome two of major difficulties encountered: prejudice and a lack of financial resources.

Large capacity water and air bath calorimeters

International Nuclear Information System (INIS)

James, S.J.; Kasperski, P.W.; Renz, D.P.; Wetzel, J.R.

1993-01-01

EG and G Mound Applied Technologies has developed an 11 in. x 17 in. sample size water bath and an 11 in. x 17 in. sample size air bath calorimeter which both function under servo control mode of operation. The water bath calorimeter has four air bath preconditioners to increase sample throughput and the air bath calorimeter has two air bath preconditioners. The large capacity calorimeters and preconditioners were unique to Mound design which brought about unique design challenges. Both large capacity systems calculate the optimum set temperature for each preconditioner which is available to the operator. Each system is controlled by a personal computer under DOS which allows the operator to download data to commercial software packages when the calorimeter is idle. Qualification testing yielded a one standard deviation of 0.6% for 0.2W to 3.0W Pu-238 heat standard range in the water bath calorimeter and a one standard deviation of 0.3% for the 6.0W to 20.0W Pu-238 heat standard range in the air bath calorimeter

21 CFR 890.5110 - Paraffin bath.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Paraffin bath. 890.5110 Section 890.5110 Food and... PHYSICAL MEDICINE DEVICES Physical Medicine Therapeutic Devices § 890.5110 Paraffin bath. (a) Identification. A paraffin bath is a device intended for medical purposes that consists of a tub to be filled...

Pre-operative antiseptic shower and bath policy decreases the rate of S. aureus and methicillin-resistant S. aureus surgical site infections in patients undergoing joint arthroplasty.

Science.gov (United States)

Colling, Kristin; Statz, Catherine; Glover, James; Banton, Kaysie; Beilman, Greg

2015-04-01

Surgical site infection (SSI) following joint arthroplasty increases length of stay, hospital cost, and leads to patient and healthcare provider dissatisfaction. Due to the presence of non-biologic implants (the prosthetic joint) in these procedures, infection is often devastating and treatment of the infection is more difficult. For this reason, prevention of SSI is of crucial importance in this population. Staphylococcus aureus colonizes the nares of approximately 30-40% of the population, is the most common pathogen causing SSI, and is associated with high morbidity and mortality rate. A pre-operative shower or bath with an antiseptic is an inexpensive and effective method of removal of these transient skin pathogens prior to the procedure and may be used to decrease SSI. We hypothesize that a preoperative antiseptic shower or bath will decrease the rate of SSI. A retrospective review was performed at two affiliated hospitals within the same system, one with a hospital-wide policy enforcing pre-operative antiseptic shower or bath and the other with no policy, with cases included from January 2010 to June 2012. International Classification of Disease-Ninth Revision-Clinical Modification (ICD-9-CM) codes and chart review were used to identify patients undergoing joint arthroplasty and to identify those with SSI. Two thousand three-hundred forty-nine arthroplasties were performed at the University of Minnesota Medical Center, a tertiary-care hospital with a pre-operative antiseptic shower or bath policy in place. An additional 1,693 procedures were performed at Fairview Ridges Hospital, a community hospital with no pre-operative policy. There was no difference in the rate of SSI between the two hospitals (1.96% vs. 1.95%; p=1.0). However, the rate of SSI caused by S. aureus was significantly decreased by pre-operative antiseptic shower/bath (17% vs. 61%; p=0.03), as was the rate of methicillin-resistant S. aureus (MRSA) infections (2% vs. 24% p=0.002). A pre

Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

Science.gov (United States)

Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki

2017-09-19

Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the

Decoherence by engineered quantum baths

Energy Technology Data Exchange (ETDEWEB)

Rossini, Davide [NEST-CNR-INFM and Scuola Normale Superiore, Piazza dei Cavalieri 7, I-56126 Pisa (Italy); Calarco, Tommaso [Dipartimento di Fisica, Universita di Trento and BEC-CNR-INFM, I-38050 Povo (Italy); Giovannetti, Vittorio [NEST-CNR-INFM and Scuola Normale Superiore, Piazza dei Cavalieri 7, I-56126 Pisa (Italy); Montangero, Simone [NEST-CNR-INFM and Scuola Normale Superiore, Piazza dei Cavalieri 7, I-56126 Pisa (Italy); Fazio, Rosario [NEST-CNR-INFM and Scuola Normale Superiore, Piazza dei Cavalieri 7, I-56126 Pisa (Italy)

2007-07-13

Optical lattices can be used to simulate quantum baths and hence they can be of fundamental help to study, in a controlled way, the emergence of decoherence in quantum systems. Here we show how to implement a pure dephasing model for a two-level system coupled to an interacting spin bath. In this scheme it is possible to implement a large variety of spin environments embracing Ising, XY and Heisenberg universality classes. After having introduced the model, we calculate exactly the decoherence for the Ising and the XY spin bath model. We find universal features depending on the critical behaviour of the spin bath, both in the short- and long-time limits. The rich scenario that emerges can be tested experimentally and can be of importance for the understanding of the coherence loss in open quantum systems.

Cross Selling Implementation From Outpatient Unit to Radiology Unit in Semen Gresik Hospital

OpenAIRE

Rochmah, Thinni Nurul; Faradisa, Mutiara Ayu

2013-01-01

Thelow visitingnumberinhospital€™sunitarecloselyrelatedtomarketingactivities,includinginternal marketing which consistsof cross sellingfromother units.Thisstudy aims toanalyze crossselling implementation from Outpatient Unit to Radiology Unit in Semen Gresik Hospital. This study was a cross sectional analytic design. Samplewastakenbysimple random samplingwithsamplesize25respondents.Independentvariableswere marketing policy,employee commitment,perception, motivation,andreadiness ofcross sellin...

Exposure measurement in the neighboring hospital beds during an x-ray procedure in hospitalization unit

Energy Technology Data Exchange (ETDEWEB)

Goto, Rafael E.; Capeleti, Felipe F.; Cabete, Henrique V., E-mail: rafael.goto@fcmsantacasasp.edu.br, E-mail: felipe.capeleti@fcmsantacasasp.edu.br, E-mail: henrique@gmpbrasil.com.br [Faculdade de Ciencias Medicas da Santa Casa Sao Paulo, SP (Brazil); GMP Consultoria em Radioprotecao e Fisica Medica e Assessoria LTDA, Sao Paulo, SP (Brazil)

2017-11-01

There are lots of discussion about the exposure in hospitalization units in Brazil, especially around labor legislation and economic advantages of unhealthiness. With the attention focused on hospitalized patients, there were measured the exposure in neighboring beds of the patient submitted to an X-ray procedure with a mobile X-ray system that could be used to illustrate the discussion with consistent values. The most common X-ray procedure made in hospitalization units are chests images with techniques between 70 to 120 kV and 5 to 20 mAs. The measurement was made during routine exposure and simulations using a scattering phantom with Radcal AccuPro electrometer and 1800cc ionization chamber in a private hospital and a philanthropic hospital, both in Sao Paulo, Brazil. The ionization chambers are placed at 2 meters distance of the patient exposed of both sides during the routine procedure. During the simulation, a nylon phantom of 20 centimeters thick and 30 x 30 cm² size was placed on the bed, a typical exposure technique was used and the exposure was measured surrounding the phantom at 0.6, 1.0 and 2.0 meters distance for scattered radiation characterization. Initial results showed that the neighboring exposure at about 2 meters distance from the exposed patient bed have low values, even when exposure is integrated during the length of hospital stay. Therefore, the exposure in hospitalization units are very low compared to the exams doses. (author). (author)

The potential of lipopolysaccharide as a real-time biomarker of bacterial contamination in marine bathing water.

Science.gov (United States)

Sattar, Anas A; Jackson, Simon K; Bradley, Graham

2014-03-01

The use of total lipopolysaccharide (LPS) as a rapid biomarker for bacterial pollution was investigated at a bathing and surfing beach during the UK bathing season. The levels of faecal indicator bacteria Escherichia coli (E. coli), the Gram-positive enterococci, and organisms commonly associated with faecal material, such as total coliforms and Bacteroides, were culturally monitored over four months to include a period of heavy rainfall and concomitant pollution. Endotoxin measurement was performed using a kinetic Limulus Amebocyte Lysate (LAL) assay and found to correlate well with all indicators. Levels of LPS in excess of 50 Endotoxin Units (EU) mL(-1) were found to correlate with water that was unsuitable for bathing under the current European regulations. Increases in total LPS, mainly from Gram-negative indicator bacteria, are thus a potential real-time, qualitative method for testing bacterial quality of bathing waters.

A theory of electron baths: One-electron system dynamics

International Nuclear Information System (INIS)

McDowell, H.K.

1992-01-01

The second-quantized, many-electron, atomic, and molecular Hamiltonian is partitioned both by the identity or labeling of the spin orbitals and by the dynamics of the spin orbitals into a system coupled to a bath. The electron bath is treated by a molecular time scale generalized Langevin equation approach designed to include one-electron dynamics in the system dynamics. The bath is formulated as an equivalent chain of spin orbitals through the introduction of equivalent-chain annihilation and creation operators. Both the dynamics and the quantum grand canonical statistical properties of the electron bath are examined. Two versions for the statistical properties of the bath are pursued. Using a weak bath assumption, a bath statistical average is defined which allows one to achieve a reduced dynamics description of the electron system which is coupled to the electron bath. In a strong bath assumption effective Hamiltonians are obtained which reproduce the dynamics of the bath and which lead to the same results as found in the weak bath assumption. The effective (but exact) Hamiltonian is found to be a one-electron Hamiltonian. A reduced dynamics equation of motion for the system population matrix is derived and found to agree with a previous version. This equation of motion is useful for studying electron transfer in the system when coupled to an electron bath

Hospital Mortality in the United States following Acute Kidney Injury

Directory of Open Access Journals (Sweden)

Jeremiah R. Brown

2016-01-01

Full Text Available Acute kidney injury (AKI is a common reason for hospital admission and complication of many inpatient procedures. The temporal incidence of AKI and the association of AKI admissions with in-hospital mortality are a growing problem in the world today. In this review, we discuss the epidemiology of AKI and its association with in-hospital mortality in the United States. AKI has been growing at a rate of 14% per year since 2001. However, the in-hospital mortality associated with AKI has been on the decline starting with 21.9% in 2001 to 9.1 in 2011, even though the number of AKI-related in-hospital deaths increased almost twofold from 147,943 to 285,768 deaths. We discuss the importance of the 71% reduction in AKI-related mortality among hospitalized patients in the United States and draw on the discussion of whether or not this is a phenomenon of hospital billing (coding or improvements to the management of AKI.

Hospital librarianship in the United States: at the crossroads.

Science.gov (United States)

Wolf, Diane G; Chastain-Warheit, Christine C; Easterby-Gannett, Sharon; Chayes, Marion C; Long, Bradley A

2002-01-01

This paper examines recent developments in hospital librarianship in the United States, including the current status of hospital-based clinical library services. Several examples of hospital library services are presented that demonstrate some characteristics of struggling and thriving services. The implications of the informationist concept are considered. The continuation of the hospital librarian's primary role in support of patient care is explored, as core competencies are reexamined for relevancy in the new millennium.

Assessment of cyanobacteria impact on bathing water quality in Poland

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Krzysztof Skotak

2012-12-01

Full Text Available Introduction: Quality of bathing water is of key importance for bathers’ health, mainly due to the fact, that each year millions of people use bathing sites as places for recreation and sport activities. Most of the bathing sites are of adequate quality of water, but still there are cases of health risk because bathing water is polluted. One of the main health risk factor in bathing water are cyanobacteria and their blooms. Cyanobacteria are microorganisms of morphological features of bacteria and algae. They live in colonies, which in large quantities show up as streaks, dense foam on the water surface. The aim of this paper was to assess the impact of cyanobacteria blooms on health regarding bathing water quality in Poland. Materials and methods: Assessment covered all bathing sites in Poland supervised by Polish National Sanitary Inspection (PIS in the period from 2007 to 2009. The base was data collected during bathing water monitoring conducted by PIS and their formal decisions of bathing bans introduced in response to revealed bathing water pollution. Results and discussion: The results of assessment indicate, that about one-fourth of all bathing bans in Poland was due to cyanobacteria blooms. Conclusions: Every fifth bathing sites located on artificial lake or water reservoir and every tenth on the sea bathing sites were polluted. Average period of bathing ban due to cyanobacteria blooms in Poland varies. Relatively the shortest bathing bans were observed on the sea bathing sites (no longer than one week on average. Much longer were bathing bans on lakes and artificial lakes (one month on average.

Effects of system-bath coupling on a photosynthetic heat engine: A polaron master-equation approach

Science.gov (United States)

Qin, M.; Shen, H. Z.; Zhao, X. L.; Yi, X. X.

2017-07-01

Stimulated by suggestions of quantum effects in energy transport in photosynthesis, the fundamental principles responsible for the near-unit efficiency of the conversion of solar to chemical energy became active again in recent years. Under natural conditions, the formation of stable charge-separation states in bacteria and plant reaction centers is strongly affected by the coupling of electronic degrees of freedom to a wide range of vibrational motions. These inspire and motivate us to explore the effects of the environment on the operation of such complexes. In this paper, we apply the polaron master equation, which offers the possibilities to interpolate between weak and strong system-bath coupling, to study how system-bath couplings affect the exciton-transfer processes in the Photosystem II reaction center described by a quantum heat engine (QHE) model over a wide parameter range. The effects of bath correlation and temperature, together with the combined effects of these factors are also discussed in detail. We interpret these results in terms of noise-assisted transport effect and dynamical localization, which correspond to two mechanisms underpinning the transfer process in photosynthetic complexes: One is resonance energy transfer and the other is the dynamical localization effect captured by the polaron master equation. The effects of system-bath coupling and bath correlation are incorporated in the effective system-bath coupling strength determining whether noise-assisted transport effect or dynamical localization dominates the dynamics and temperature modulates the balance of the two mechanisms. Furthermore, these two mechanisms can be attributed to one physical origin: bath-induced fluctuations. The two mechanisms are manifestations of the dual role played by bath-induced fluctuations depending on the range of parameters. The origin and role of coherence are also discussed. It is the constructive interplay between noise and coherent dynamics, rather

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

Directory of Open Access Journals (Sweden)

Susan J. Armstrong

2015-05-01

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

Bath Salts

Science.gov (United States)

... deaths and been blamed for a handful of suicides and murders. Two of the chemicals in bath salts (mephedrone and MDPV) are Schedule I class drugs. That means they have a high potential for abuse and no accepted medical use . People who are ...

Thermal baths as quantum resources: more friends than foes?

Science.gov (United States)

Kurizki, Gershon; Shahmoon, Ephraim; Zwick, Analia

2015-12-01

In this article we argue that thermal reservoirs (baths) are potentially useful resources in processes involving atoms interacting with quantized electromagnetic fields and their applications to quantum technologies. One may try to suppress the bath effects by means of dynamical control, but such control does not always yield the desired results. We wish instead to take advantage of bath effects, that do not obliterate ‘quantumness’ in the system-bath compound. To this end, three possible approaches have been pursued by us. (i) Control of a quantum system faster than the correlation time of the bath to which it couples: such control allows us to reveal quasi-reversible/coherent dynamical phenomena of quantum open systems, manifest by the quantum Zeno or anti-Zeno effects (QZE or AZE, respectively). Dynamical control methods based on the QZE are aimed not only at protecting the quantumness of the system, but also diagnosing the bath spectra or transferring quantum information via noisy media. By contrast, AZE-based control is useful for fast cooling of thermalized quantum systems. (ii) Engineering the coupling of quantum systems to selected bath modes: this approach, based on field-atom coupling control in cavities, waveguides and photonic band structures, allows one to drastically enhance the strength and range of atom-atom coupling through the mediation of the selected bath modes. More dramatically, it allows us to achieve bath-induced entanglement that may appear paradoxical if one takes the conventional view that coupling to baths destroys quantumness. (iii) Engineering baths with appropriate non-flat spectra: this approach is a prerequisite for the construction of the simplest and most efficient quantum heat machines (engines and refrigerators). We may thus conclude that often thermal baths are ‘more friends than foes’ in quantum technologies.

Thermal baths as quantum resources: more friends than foes?

International Nuclear Information System (INIS)

Kurizki, Gershon; Zwick, Analia; Shahmoon, Ephraim

2015-01-01

In this article we argue that thermal reservoirs (baths) are potentially useful resources in processes involving atoms interacting with quantized electromagnetic fields and their applications to quantum technologies. One may try to suppress the bath effects by means of dynamical control, but such control does not always yield the desired results. We wish instead to take advantage of bath effects, that do not obliterate ‘quantumness’ in the system-bath compound. To this end, three possible approaches have been pursued by us. (i) Control of a quantum system faster than the correlation time of the bath to which it couples: such control allows us to reveal quasi-reversible/coherent dynamical phenomena of quantum open systems, manifest by the quantum Zeno or anti-Zeno effects (QZE or AZE, respectively). Dynamical control methods based on the QZE are aimed not only at protecting the quantumness of the system, but also diagnosing the bath spectra or transferring quantum information via noisy media. By contrast, AZE-based control is useful for fast cooling of thermalized quantum systems. (ii) Engineering the coupling of quantum systems to selected bath modes: this approach, based on field–atom coupling control in cavities, waveguides and photonic band structures, allows one to drastically enhance the strength and range of atom–atom coupling through the mediation of the selected bath modes. More dramatically, it allows us to achieve bath-induced entanglement that may appear paradoxical if one takes the conventional view that coupling to baths destroys quantumness. (iii) Engineering baths with appropriate non-flat spectra: this approach is a prerequisite for the construction of the simplest and most efficient quantum heat machines (engines and refrigerators). We may thus conclude that often thermal baths are ‘more friends than foes’ in quantum technologies. (invited comment)

20 CFR 654.412 - Bathing, laundry, and handwashing.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Bathing, laundry, and handwashing. 654.412... RESPONSIBILITIES OF THE EMPLOYMENT SERVICE SYSTEM Housing for Agricultural Workers Housing Standards § 654.412 Bathing, laundry, and handwashing. (a) Bathing and handwashing facilities, supplied with hot and cold...

Effects and safety of mechanical bathing as a complementary therapy for terminal stage cancer patients from the physiological and psychological perspective: a pilot study.

Science.gov (United States)

Fujimoto, Sawako; Iwawaki, Yoko; Takishita, Yukie; Yamamoto, Yoko; Murota, Masako; Yoshioka, Saori; Hayano, Azusa; Hosokawa, Toyoshi; Yamanaka, Ryuya

2017-11-01

In palliative care hospitals in Japan, mechanical bathing is conducted to maintain cleanliness. However, the physiological and psychological influence of mechanical bathing on patients has not been sufficiently studied. The objective of this study was to assess, using physiological and psychological indices, the effects of mechanical bathing care for patients in the terminal stage of cancer. Mechanical bathing was performed using a Marine Court SB7000 in a supine or semi-seated position. The heart rate variability analysis method was used to measure autonomic nervous system function. The patients' state of anxiety was assessed using the State-Trait Anxiety Inventory (STAI), a psychological index, and patients' verbal responses were also collected after mechanical bathing. Twenty-four patients were enrolled in this study. Their sympathetic and parasympathetic nervous activity did not differ before and after bathing. A significant difference was found between pre- and post-bathing anxiety, as evaluated by STAI (P mechanical bathing according to STAI evaluation and their verbal responses. The findings suggest that the method of bathing used in this study is safe and pain-relieving for terminal stage cancer patients. It is thus possible to provide safe and comfortable care for terminal stage cancer patients using mechanical baths. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

New system for bathing bedridden patients

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Greenleaf, J. E.; Staley, R. A.; Payne, P. A.

1973-01-01

Multihead shower facility can be used with minimal patient handling. Waterproof curtain allows patient to bathe with his head out of shower. He can move completely inside shower to wash his face and hair. Main advantage of shower system is time saved in giving bath.

Influence of bath temperature and bath composition on Co-Ag electrodeposition

International Nuclear Information System (INIS)

Garcia-Torres, Jose; Valles, Elisa; Gomez, Elvira

2010-01-01

A study of the best conditions to prepare smooth heterogeneous Co-Ag films with low amounts of S from a thiourea-based electrolytic bath has been performed. Using a 0.01 M AgClO 4 + 0.1 M Co(ClO 4 ) 2 + 0.1 M thiourea + 0.1 M sodium gluconate + 0.3 M H 3 BO 3 + 0.1 M NaClO 4 bath, low temperature (10 o C) allowed obtaining compact and smooth deposits containing 2 wt.% sulphur. Decreasing thiourea content 0.06 M and increasing gluconate concentration up to 0.3 M, better deposits (more compact with lower sulphur content (1.2 wt.%)) were obtained. A clear influence of the species present in the bath on the film quality was observed: while gluconate favoured film cohesion, boric acid hindered hydrogen adsorption. For all films, fcc-Ag, hcp-Co and hcp-CoAg 3 phases were always detected by XRD, TEM and electron diffraction, their proportions varying with the electrodeposition conditions. Magnetic measurements revealed that the increase in the CoAg 3 led to an increase in the film coercivity. GMR values were only measured at cryogenic temperatures, they being higher for the deposits with the lowest sulphur content revealing that sulphur exerts a negative effect on magnetoresistance.

A controlled trial of the effect of aromatherapy on birth outcomes using "Rose essential oil" inhalation and foot bath

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Masoomeh Kheirkhah

2013-12-01

Full Text Available Background and aim: Aromatherapy is the art and science of using essential oils extracted from aromatic plants, and is concerned with natural balance, coordination and promotion of health. This study was designed to determine the effect of "rose (Rosa damascena essential oil" inhalation and foot bath on the improvement of maternal and neonatal health outcomes. Material and methods: This study was a randomized clinical trial, conducted on 80 primiparous women in Shahid Akbar Abadi Maternity Hospital, Tehran, Iran. Subjects were randomly assigned to aromatherapy and control groups. Aromatherapy group received methods of inhalation and foot bath with rose essential oil for 10 minutes at the beginning of the active phase and then at the onset of the transitional phase of labor. Control group received the routine care of the delivery room. The measured variables in this study included episiotomy in the second stages of labor, Apgar score, admission to neonatal intensive care unit (NICU, and maternal satisfaction with the administration of pain relievers. Statistical analysis of the extracted data was performed using SPSS version 16 with Chi-square and t student test. Results: Two groups were significantly different in terms of the second stage of labor duration (P

Effect of radon baths having a radon concentration of 100 mach units (36. 4 nanocuries/liter) on patients having a deforming osteoarthrosis with myocardial damage

Energy Technology Data Exchange (ETDEWEB)

Tsarfis, P G; Kostrova, V D; Gerasimenko, V N; Fiveiskaya, A A

1974-01-01

The patients took the radon baths at a temperature of 36/sup 0/C for a period of 15 minutes. The treatment consisted of 14 to 16 baths with a break of one day between baths. After completing the baths, pain in the limbs subsided significantly and disappeared in three-fourths of the patients. Locomotor function improved. Muscle tone increased. Improvement in physical function was noted in 75 out of 80 patients. 3 references. (SJR)

Thermal and cardiorespiratory newborn adaptations during hot tub bath

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Gentil Gomes da Fonseca Filho

2017-03-01

Full Text Available Objective: To evaluate thermal and cardiorespiratory adaptation during hot tub bath and shower in healthy newborns in the first hours of life. Study design: This is a randomized blind controlled trial, registered in ReBEC (No. RBR-4z26f3 with 184 newborns divided into hot tub group (n=84 and shower (n=100. Newborns from intervention group were immersed in a hot tub with warm water up to the neck, without exposure to air flow, and control group received traditional shower. Heart rate, respiratory rate and temperature were measured before and immediately after bath by an investigator blinded to the type of bath. Results: Groups were similar in gender, gestational age, birth weight, Apgar score at 5th minute and hours of life, p => 0.05. To analyze thermal and cardiorespiratory adjustments, difference between post-bath variables and pre-bath was calculated. In this analysis, it was found statistically significant difference between two types of bath regarding heart rate, respiratory rate and temperature. Hot tub bath decreases heart and respiratory rates and increases temperature, whereas shower provides the opposite effect (0.0001. Conclusion: This study demonstrates that hot tub baths and shower, in healthy newborns, promote thermal and cardiorespiratory adaptations, reflecting thermal, cardiac and respiratory positive reactions after hot tub bath.

Recent Trends in Out-of-Hospital Births in the United States.

Science.gov (United States)

MacDorman, Marian F; Declercq, Eugene; Mathews, T J

2013-01-01

Although out-of-hospital births are still relatively rare in the United States, it is important to monitor trends in these births, as they can affect patterns of facility usage, clinician training, and resource allocation, as well as health care costs. Trends and characteristics of home and birth center births are analyzed to more completely profile contemporary out-of-hospital births in the United States. National birth certificate data were used to examine a recent increase in out-of-hospital births. After a gradual decline from 1990 to 2004, the number of out-of-hospital births increased from 35,578 in 2004 to 47,028 in 2010. In 2010, 1 in 85 US infants (1.18%) was born outside a hospital; about two-thirds of these were born at home, and most of the rest were born in birth centers. The proportion of home births increased by 41%, from 0.56% in 2004 to 0.79% in 2010, with 10% of that increase occurring in the last year. The proportion of birth center births increased by 43%, from 0.23% in 2004 to 0.33% in 2010, with 14% of the increase in the last year. About 90% of the total increase in out-of hospital births from 2004 to 2010 was a result of increases among non-Hispanic white women, and 1 in 57 births to non-Hispanic white women (1.75%) in 2010 was an out-of-hospital birth. Most home and birth center births were attended by midwives. Home and birth center births in the United States are increasing, and the rate of out-of-hospital births is now at the highest level since 1978. There has been a decline in the risk profile of out-of-hospital births, with a smaller proportion of out-of-hospital births in 2010 than in 2004 occurring to adolescents and unmarried women and fewer preterm, low-birth-weight, and multiple births. © 2013 This article is a U.S. Government work and is in the public domain in the United States.

A quantum Otto engine with finite heat baths

DEFF Research Database (Denmark)

Pozas-Kerstjens, Alejandro; Brown, Eric G.; Hovhannisyan, Karen V.

2018-01-01

We study a driven harmonic oscillator operating an Otto cycle by strongly interacting with two thermal baths of finite size. Using the tools of Gaussian quantum mechanics, we directly simulate the dynamics of the engine as a whole, without the need to make any approximations. This allows us...... to understand the non-equilibrium thermodynamics of the engine not only from the perspective of the working medium, but also as it is seen from the thermal baths' standpoint. For sufficiently large baths, our engine is capable of running a number of perfect cycles, delivering finite power while operating very...... close to maximal efficiency. Thereafter, having traversed the baths, the perturbations created by the interaction abruptly deteriorate the engine's performance. Weadditionally study the correlations generated in the system, and, in particular, we find a direct connection between the build up of bath...

Corrigendum | Gehrels | Research in Hospitality Management

African Journals Online (AJOL)

Li, L. (2016). Are social media applications a facilitator or barrier to learning for tourism and hospitality management students? Research in Hospitality Management, 6 (2), 195–202. https://doi.org/10.1080/22243534.2016.1253289. Acknowledgement — I thank University of Surrey, University of Derby, and Bath Spa ...

Unit cost of medical services at different hospitals in India.

Directory of Open Access Journals (Sweden)

Susmita Chatterjee

Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising

Unit Cost of Medical Services at Different Hospitals in India

Science.gov (United States)

Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

2013-01-01

Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates

Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002-20121.

Science.gov (United States)

Strollo, Sara; Lionakis, Michail S; Adjemian, Jennifer; Steiner, Claudia A; Prevots, D Rebecca

2016-01-01

Invasive candidiasis is a major nosocomial fungal disease in the United States associated with high rates of illness and death. We analyzed inpatient hospitalization records from the Healthcare Cost and Utilization Project to estimate incidence of invasive candidiasis-associated hospitalizations in the United States. We extracted data for 33 states for 2002-2012 by using codes from the International Classification of Diseases, 9th Revision, Clinical Modification, for invasive candidiasis; we excluded neonatal cases. The overall age-adjusted average annual rate was 5.3 hospitalizations/100,000 population. Highest risk was for adults >65 years of age, particularly men. Median length of hospitalization was 21 days; 22% of patients died during hospitalization. Median unadjusted associated cost for inpatient care was $46,684. Age-adjusted annual rates decreased during 2005-2012 for men (annual change -3.9%) and women (annual change -4.5%) and across nearly all age groups. We report a high mortality rate and decreasing incidence of hospitalizations for this disease.

Linear-algebraic bath transformation for simulating complex open quantum systems

International Nuclear Information System (INIS)

Huh, Joonsuk; Mostame, Sarah; Fujita, Takatoshi; Aspuru-Guzik, Alán; Yung, Man-Hong

2014-01-01

In studying open quantum systems, the environment is often approximated as a collection of non-interacting harmonic oscillators, a configuration also known as the star-bath model. It is also well known that the star-bath can be transformed into a nearest-neighbor interacting chain of oscillators. The chain-bath model has been widely used in renormalization group approaches. The transformation can be obtained by recursion relations or orthogonal polynomials. Based on a simple linear algebraic approach, we propose a bath partition strategy to reduce the system-bath coupling strength. As a result, the non-interacting star-bath is transformed into a set of weakly coupled multiple parallel chains. The transformed bath model allows complex problems to be practically implemented on quantum simulators, and it can also be employed in various numerical simulations of open quantum dynamics. (paper)

DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

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Max Joseph Herman

2009-12-01

Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

[Alcohol versus bath and natural drying for term newborns' umbilical cord care: a prospective randomized clinical trial].

Science.gov (United States)

Covas, María del Carmen; Alda, Ernesto; Medina, María Sol; Ventura, Silvia; Pezutti, Ornella; Paris de Baeza, Ana; Sillero, Josefna; Esandi, María Eugenia

2011-08-01

Umbilical cord (UC) care is a cause of concern for parents right from birth until its separation. Standard practice in Argentina includes frequent cleansing of the UC with alcohol and body bath only two days after its separation. The effect of different methods of UC care on its separation time and on colonization with microorganisms has been insufficiently explored. Main: To compare the effect on time of UC separation when using body bath with neutral soap followed by natural drying of the UC vs. standard care. Secondary: a) colonization rates during hospitalization; b) incidence of skin infection and conjunctivitis and c) parental comfort with both types of care. Normal term newborns (≥37 weeks), born at the HPS, and whose parents provided informed consent. Open prospective controlled clinical trial, with random allocation to two groups: study group -natural drying of the UC and body bath with neutral soap- and control group -UC hygiene with alcohol 70% at each diaper change until its separation and bath two days later-. UC separation time; UC colonization during hospital stay and skin and conjunctive infections in the first 30 days of life were monitored. Analysis was by intention-to-treat. 362 newborns were included, 181 in each group. The groups were well balanced in baseline characteristics. Being in the study group was associated with a shorter time to UC separation (median [interquartile range]= 6.00 [3] vs. 7.00 [4] days; p natural drying of the UC reduced the time to cord separation. This practice increased the colonization rate, but the risk of skin and conjunctive infections was apparently not modified by it. However, the study has insufficient power for secondary outcomes. Health care providers should continue to develop evidence to support or eliminate historical practices.

Severe Maternal Morbidity and Hospital Cost among Hospitalized Deliveries in the United States.

Science.gov (United States)

Chen, Han-Yang; Chauhan, Suneet P; Blackwell, Sean C

2018-05-03

 The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization.  We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012. We used data from the National (Nationwide) Inpatient sample of the Healthcare Cost and Utilization Project. The delivery hospitalizations with SMM were identified by having at least one of the 25 previously established list of diagnosis and procedure codes. Aggregate and mean hospital costs were estimated. A generalized linear regression model was used to examine the association between SMM and hospital costs.  Of 7,438,946 delivery hospitalizations identified, the rate of SMM was 154 per 10,000 delivery hospitalizations. Without any SMM, the mean hospital cost was $4,300 and with any SMM, the mean hospital cost was $11,000. After adjustment, comparing to those without any SMM, the mean cost of delivery hospitalizations with any SMM was 2.1 (95% confidence interval: 2.1-2.2) times higher, and this ratio increases from 1.7-fold in those with only one SMM to 10.3-fold in those with five or more concurrent SMM.  The hospital cost with any SMM was 2.1 times higher than those without any SMM. Our findings highlight the need to identify interventions and guide research efforts to mitigate the rate of SMM and its economic burden. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

[Management of malnutrition in geriatric hospital units in Germany].

Science.gov (United States)

Smoliner, C; Volkert, D; Wirth, R

2013-01-01

Elderly hospitalized patients have a high risk for developing malnutrition. The causes for an impaired nutritional status in old age are various and the impact is far-reaching. Malnutrition is a comorbidity that is well treatable and various studies show the favorable effect of nutrition therapy on nutritional status and prognosis. In the past few years, several guidelines have been developed to improve nutritional management and to ensure standardized procedures to identify patients at nutritional risk who will benefit from nutrition therapy. However, it is still not clear to what extent nutrition management has been implemented in geriatric wards in Germany. This survey is intended to give an overview on the situation of the current diagnosis and therapy of malnutrition and nutritional management in geriatric hospital units for acute and rehabilitative care. In 2011, the task force of the German Geriatric Society ("Deutsche Gesellschaft für Geriatrie", DGG) developed a questionnaire which was sent out to 272 directors of geriatric hospital and rehabilitational units. Included were questions regarding the size and staffing of the hospital and wards, food provision, diagnosis and therapy of malnutrition, as well as communication of malnutrition and nutrition therapy in the doctor's letter. A total of 38% of the questioned units answered. The following information was compiled: 31% of the geriatric facilities employed a doctor with training in clinical nutrition, 42% employ dieticians or nutritional scientists, and 90% speech and language pathologists. In 36% of the wards, a so-called geriatric menu is offered (small portions, rich in energy and/or protein, easy to chew). In 89% of the wards, snacks are available between meals. Diagnosis of malnutrition is mainly done by evaluation of weight and BMI. Validated and established screening tools are only used in 40% of the geriatric wards. Food records are carried out in 64% of the units when needed. Diagnosed

Shopping around for hospital services: a comparison of the United States and Canada.

Science.gov (United States)

Bell, C M; Crystal, M; Detsky, A S; Redelmeier, D A

1998-04-01

Historical comparisons indicate that US hospitals are more expensive than Canadian hospitals, but health care system reform might have changed the relative costs and timeliness of health care in the 2 countries. To estimate the price and convenience of selected hospital services in the United States and Canada for patients in 1997 had they paid out-of-pocket. Cross-sectional telephone survey conducted May 1996 to April 1997. The 2 largest acute care general hospitals from every city in the United States and Canada with a population greater than 500000. Each hospital was telephoned and asked their price and waiting time for 7 services: magnetic resonance imaging of the head without gadolinium; a screening mammogram; a 12-lead electrocardiogram; a prothrombin time measurement; a session of hemodialysis; a screening colonoscopy; and a total knee replacement. Waiting times were measured in days until earliest appointment and charges were converted to American currency. Overall, 48 US and 18 Canadian hospitals were surveyed. Median waiting times were significantly shorter in American hospitals for 4 services, particularly a magnetic resonance imaging of the head (3 days vs 150 days; Preplacement ($26805 vs $10651; Preplacement in the United States. US hospitals still provide higher prices and faster care than Canadian hospitals for patients who pay out-of-pocket.

Control of electron spin decoherence in nuclear spin baths

Science.gov (United States)

Liu, Ren-Bao

2011-03-01

Nuclear spin baths are a main mechanism of decoherence of spin qubits in solid-state systems, such as quantum dots and nitrogen-vacancy (NV) centers of diamond. The decoherence results from entanglement between the electron and nuclear spins, established by quantum evolution of the bath conditioned on the electron spin state. When the electron spin is flipped, the conditional bath evolution is manipulated. Such manipulation of bath through control of the electron spin not only leads to preservation of the center spin coherence but also demonstrates quantum nature of the bath. In an NV center system, the electron spin effectively interacts with hundreds of 13 C nuclear spins. Under repeated flip control (dynamical decoupling), the electron spin coherence can be preserved for a long time (> 1 ms) . Thereforesomecharacteristicoscillations , duetocouplingtoabonded 13 C nuclear spin pair (a dimer), are imprinted on the electron spin coherence profile, which are very sensitive to the position and orientation of the dimer. With such finger-print oscillations, a dimer can be uniquely identified. Thus, we propose magnetometry with single-nucleus sensitivity and atomic resolution, using NV center spin coherence to identify single molecules. Through the center spin coherence, we could also explore the many-body physics in an interacting spin bath. The information of elementary excitations and many-body correlations can be extracted from the center spin coherence under many-pulse dynamical decoupling control. Another application of the preserved spin coherence is identifying quantumness of a spin bath through the back-action of the electron spin to the bath. We show that the multiple transition of an NV center in a nuclear spin bath can have longer coherence time than the single transition does, when the classical noises due to inhomogeneous broadening is removed by spin echo. This counter-intuitive result unambiguously demonstrates the quantumness of the nuclear spin bath

Salmonellosis Hospitalizations in the United States: Associated Chronic Conditions, Costs, and Hospital Outcomes, 2011, Trends 2000-2011.

Science.gov (United States)

Cummings, Patricia L; Kuo, Tony; Javanbakht, Marjan; Shafir, Shira; Wang, May; Sorvillo, Frank

2016-01-01

Hospitalized salmonellosis patients with concurrent chronic conditions may be at increased risk for adverse outcomes, increasing the costs associated with hospitalization. Identifying important modifiable risk factors for this predominantly foodborne illness may assist hospitals, physicians, and public health authorities to improve management of these patients. The objectives of this study were to (1) quantify the burden of salmonellosis hospitalizations in the United States, (2) describe hospitalization characteristics among salmonellosis patients with concurrent chronic conditions, and (3) examine the relationships between salmonellosis and comorbidities by four hospital-related outcomes. A retrospective analysis of salmonellosis discharges was conducted using the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample for 2011. A supplemental trend analysis was performed for the period 2000-2011. Hospitalization characteristics were examined using multivariable regression modeling, with a focus on four outcome measures: in-hospital death, total amount billed by hospitals for services, length of stay, and disease severity. In 2011, there were 11,032 total salmonellosis diagnoses; 7496 were listed as the primary diagnosis, with 86 deaths (case-fatality rate = 1.2%). Multivariable regression analyses revealed a greater number of chronic conditions (≥4) among salmonellosis patients was associated with higher mean total amount billed by hospitals for services, longer length of stay, and greater disease severity (p ≤ 0.05). From 2000 to 2011, hospital discharges for salmonellosis increased by 27.2%, and the mean total amount billed by hospitals increased nearly threefold: $9,777 (2000) to $29,690 (2011). Observed increases in hospitalizations indicate the burden of salmonellosis remains substantial in the United States. The positive association between increased number of chronic conditions and the four hospital-related outcomes affirms

Factors influencing the choice of bathing with medicated versus ...

African Journals Online (AJOL)

Soap is a cleansing agent obtained through the chemical interaction between fat and alkali. Bathing has become a daily routine of most people as a result of the ready availability of the bathing soap. The aim of this study is to find out reasons for an individual's choice of bathing soap and awareness of any potential adverse ...

Characteristics of unit-level patient safety culture in hospitals in Japan: a cross-sectional study.

Science.gov (United States)

Fujita, Shigeru; Seto, Kanako; Kitazawa, Takefumi; Matsumoto, Kunichika; Hasegawa, Tomonori

2014-10-22

Patient safety culture (PSC) has an important role in determining safety and quality in healthcare. Currently, little is known about the status of unit-level PSC in hospitals in Japan. To develop appropriate strategies, characteristics of unit-level PSC should be investigated. Work units may be classified according to the characteristics of PSC, and common problems and appropriate strategies may be identified for each work unit category. This study aimed to clarify the characteristics of unit-level PSC in hospitals in Japan. In 2012, a cross-sectional study was conducted at 18 hospitals in Japan. The Hospital Survey on Patient Safety Culture questionnaire, developed by the United States Agency for Healthcare Research and Quality, was distributed to all healthcare workers (n =12,076). Percent positive scores for 12 PSC sub-dimensions were calculated for each unit, and cluster analysis was used to categorise the units according to the percent positive scores. A generalised linear mixed model (GLMM) was used to analyse the results of the cluster analysis, and odds ratios (ORs) for categorisation as high-PSC units were calculated for each unit type. A total of 9,124 respondents (75.6%) completed the questionnaire, and valid data from 8,700 respondents (72.0%) were analysed. There were 440 units in the 18 hospitals. According to the percent positive scores for the 12 sub-dimensions, the 440 units were classified into 2 clusters: high-PSC units (n =184) and low-PSC units (n =256). Percent positive scores for all PSC sub-dimensions for high-PSC units were significantly higher than those for low-PSC units. The GLMM revealed that the combined unit type of 'Obstetrics and gynaecology ward, perinatal ward or neonatal intensive care unit' was significantly more likely to be categorised as high-PSC units (OR =9.7), and 'Long-term care ward' (OR =0.2), 'Rehabilitation unit' (OR =0.2) and 'Administration unit' (OR =0.3) were significantly less likely to be categorised as high

A comparison of head-out mist bathing, with or without facial fanning, with head-out half-body low-water level bathing in humans—a pilot study

Science.gov (United States)

Iwase, Satoshi; Kawahara, Yuko; Nishimura, Naoki; Nishimura, Rumiko; Miwa, Chihiro; Kataoka, Yumiko; Kobayashi, Chihiro; Suzuki, Takahiro; Shigaraki, Masayuki; Maeda, Yoichi; Takada, Hiroki; Watanabe, Yoriko

2014-07-01

To reduce the risks of Japanese-style bathing, half-body bathing (HBLB) has been recommended in Japan, but discomfort due to the cold environment in winter prevents its widespread adoption. The development of the mist sauna, which causes a gradual core temperature rise with sufficient thermal comfort, has reduced the demerits of HBLB. We examined head-out 42 °C mist bathing with 38 °C HBLB up to the navel to see if it could improve thermal comfort without detracting from the merits of HBLB, with and without the effects of facial fanning (FF). The subjects were seven healthy males aged 22-25 years. The following bathing styles were provided: (1) HBLB—head-out half-body low bathing of 38 °C up to the navel (20 min); (2) HOMB—head-out mist bathing of 42 °C and HBLB of 38 °C (20 min); and (3) HOMBFF—HOMB with FF (20 min). HOMB raised the core temperature gradually. HOMBFF suppressed the core temperature rise in a similar fashion to HOMB. Increases in blood pressure and heart rate usually observed in Japanese traditional-style bathing were less marked in HOMBs with no significant difference with and without FF. The greatest body weight loss was observed after Japanese traditional-style bathing, with only one-third of this amount lost after mist bathing, and one-sixth after HBLB. HOMB increased thermal sensation, and FF also enhanced post-bathing invigoration. We conclude that HOMB reduces the risks of Japanese traditional style bathing by mitigating marked changes in the core temperature and hemodynamics, and FF provides thermal comfort and invigoration.

A comparison of head-out mist bathing, with or without facial fanning, with head-out half-body low-water level bathing in humans--a pilot study.

Science.gov (United States)

Iwase, Satoshi; Kawahara, Yuko; Nishimura, Naoki; Nishimura, Rumiko; Miwa, Chihiro; Kataoka, Yumiko; Kobayashi, Chihiro; Suzuki, Takahiro; Shigaraki, Masayuki; Maeda, Yoichi; Takada, Hiroki; Watanabe, Yoriko

2014-07-01

To reduce the risks of Japanese-style bathing, half-body bathing (HBLB) has been recommended in Japan, but discomfort due to the cold environment in winter prevents its widespread adoption. The development of the mist sauna, which causes a gradual core temperature rise with sufficient thermal comfort, has reduced the demerits of HBLB. We examined head-out 42 °C mist bathing with 38 °C HBLB up to the navel to see if it could improve thermal comfort without detracting from the merits of HBLB, with and without the effects of facial fanning (FF). The subjects were seven healthy males aged 22-25 years. The following bathing styles were provided: (1) HBLB-head-out half-body low bathing of 38 °C up to the navel (20 min); (2) HOMB-head-out mist bathing of 42 °C and HBLB of 38 °C (20 min); and (3) HOMBFF-HOMB with FF (20 min). HOMB raised the core temperature gradually. HOMBFF suppressed the core temperature rise in a similar fashion to HOMB. Increases in blood pressure and heart rate usually observed in Japanese traditional-style bathing were less marked in HOMBs with no significant difference with and without FF. The greatest body weight loss was observed after Japanese traditional-style bathing, with only one-third of this amount lost after mist bathing, and one-sixth after HBLB. HOMB increased thermal sensation, and FF also enhanced post-bathing invigoration. We conclude that HOMB reduces the risks of Japanese traditional style bathing by mitigating marked changes in the core temperature and hemodynamics, and FF provides thermal comfort and invigoration.

Phosphorus-31 NMR analysis of gold plating baths

Energy Technology Data Exchange (ETDEWEB)

Smith, R.E.

1992-03-01

This report describes the nuclear magnetic resonance (NMR) analysis of gold plating baths in the Micro-Miniature Electronic Assembly department of Allied-Signal Inc., Kansas City Division (KCD). The baths were analyzed for phosphorylated components. In freshly prepared gold plating baths in this department the principle compound observed is aminotrimethyl-phosphonate, or ATMP. As the bath is used in production, the ATMP breaks down; and new compounds, aminodimethylphosphonate (ADMP), aminomonomethylphosphonate, (AMMP), and inorganic phosphate (H{sub 2}PO{sub 4}{sup {minus}}), are formed. The NMR method has been used for almost three years to monitor the concentrations of the ATMP and breakdown products. In a previous report, results from January through October 1988 were reported. In this report, results from November 1988 through January 1991 are given.

A full bath for the senses - the Roman philosophy of thermal baths as new dimension for modern baths; Vollbad der Sinne - roemische Thermenphilosophie als neue Badedimension

Energy Technology Data Exchange (ETDEWEB)

Saunus, C.

1997-03-01

The attractiveness of an exquisite bath is mainly determined by its variety of activities harmoniously adjusted to each other. The symbiosis of a feeling of comfort orientated at activities, also termed as ``wellness``, is supposed to be in harmony with the possibilities of passive and active sport (recreation). In order to meet these high demands more and more fun swimming pools, saunas and renowned hotels use the famous Roman custom of thermal baths as an example for the implementation of their visions of baths which exhilarate the senses. (orig.) [Deutsch] Die Attraktivitaet einer anspruchsvollen Badeeinrichtung wird im wesentlichen durch ihr harmonisch aufeinander abgestimmtes Erlebnisangebot bestimmt. Hierbei sollte die Symbiose aus erlebnisorientiertem Wohlgefuehl, neudeutsch `Wellness`, in harmonischem Einklang mit den Moeglichkeiten passiver und aktiver Koerperertuechtigung (Recreation) stehen. Um diesen hohen Anspruechen gerecht zu werden, nutzen immer mehr Erlebnis- bzw. Freizeitbaeder, renommierte Hotels, Saunabetriebe etc. die beruehmte roemische Thermenkultur als Vorbild fuer die Realisierung ihrer die Sinne berauschenden Badevisionen. (orig.)

The relationship between hospital unit culture and nurses' quality of work life.

Science.gov (United States)

Gifford, Blair D; Zammuto, Raymond F; Goodman, Eric A

2002-01-01

Turnover rates for hospital nurses have been increasing in recent years, which is partially a result of increasing pressure on nurses from higher productivity expectations in a managed care environment. Improving nurse retention is a difficult challenge to managers since the bureaucratic cultural norm of hospitals, with its hierarchical structures, rules, and regulations, and heavy emphasis on measurement of outcomes and costs, may not be the culture most conducive to enhancing nurses' job satisfaction and commitment. Accordingly, this study investigates the relationships between unit organizational culture and several important job-related variables for nurse retention in the labor and delivery units of seven hospitals. Data analysis shows that unit organizational culture does affect nurses' quality of work life factors and that human relations cultural values are positively related to organizational commitment, job involvement, empowerment, and job satisfaction, and negatively related to intent to turnover. These findings suggest that although increasing recruitment of nurses and improved compensation and benefits strategies may offset hospital nurse shortages in the short term, improving quality of work life may be a more practical and long-term approach to improving hospital nurse retention.

[Children's medically complex diseases unit. A model required in all our hospitals].

Science.gov (United States)

Climent Alcalá, Francisco José; García Fernández de Villalta, Marta; Escosa García, Luis; Rodríguez Alonso, Aroa; Albajara Velasco, Luis Adolfo

2018-01-01

The increase in survival of children with severe diseases has led to the rise of children with chronic diseases, sometimes with lifelong disabilities. In 2008, a unit for the specific care of medically complex children (MCC) was created in Hospital La Paz. To describe the work and care activities of this Unit. Patients and methods An analysis was performed on all discharge reports of the Unit between January 2014 and July 2016. The MCC Unit has 6 beds and daily outpatient clinic. A total of 1,027 patients have been treated since the creation of the unit, with 243 from 2014. The median age was 24.2 months (IQ: 10.21-84.25). The large majority (92.59%) have multiple diseases, the most frequent chronic conditions observed were neurological (76.95%), gastrointestinal (63.78%), and respiratory diseases (61.72%). More than two-thirds (69.54%) of MCC are dependent on technology, 53.49% on respiratory support, and 35.80% on nutritional support. Hospital admission rates have increased annually. There have been 403 admissions since 2014, of which 8.93% were re-admissions within 30 days of hospital discharge. The median stay during 2014-2016 was 6 days (IQ: 3-14). The occupancy rate has been above 100% for this period. Currently, 210 patients remain on follow-up (86.42%), and 11 children (4.53%) were discharged to their referral hospitals. The mortality rate is 9.05% (22 deaths). The main condition of these 22 patients was neurological (9 patients). Infectious diseases were the leading cause of death. MCC should be treated in specialized units in tertiary or high-level hospitals. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Plasma levels of 8-methoxypsoralen following PUVA-bath photochemotherapy

Energy Technology Data Exchange (ETDEWEB)

Kobyletzki, G. von; Hoffmann, K.; Kerscher, M.; Altmeyer, P. [Ruhr-Univ., Dept. of Dermatology, Bochum (Germany)

1998-08-01

Administration of 8-methoxypsoralen (8-MOP) in a dilute bath water solution is an effective therapeutic alternative to oral PUVA therapy, avoiding systemic side effects, offering better bioavailability of the psoralen and requiring much smaller amounts of UVA for induction of therapeutic effects. To obtain exact data about the percutaneous absorption of 8-MOP during a psoralen bath, the plasma levels of the drug were determined in 26 patients with different skin diseases by a reverse high-performance liquid chromatographic method. Fifteen patients receiving oral PUVA therapy (0.8 mg 8-MOP/kg body weight) served as a positive control group. Bath solutions were prepared by diluting 15 ml of 0.5% stock solution of 8-MOP in 150 l of bath water (0.5 mg/l, 37 deg. C). Blood samples were drawn from patients 5, 30, 60, 120 and 180 min after the bath. In the oral PUVA group, blood samples were obtained 1 1/2 h after administration of the drug. In 23 og 26 patients, 8-MOP levels were undetectable in every blood sample. After 30 min, two patients showed detectable levels of 8-MOP (5 ng/ml, 7 ng/ml), while 60 min after the PUVA bath 8-MOP was detectable in only one volunteer (5 ng/ml). In patients receiving oral 8-MOP therapy, serum levels varied between 45 and 360 ng/ml 1 1/2 h after drug administration. Our data confirm extremely low 8-MOP levels resulting from 8-MOP bath water treatments and provide confirmation of the absence of systemic side effects in patients who are undergoing PUVA-bath therapy. (au) 15 refs.

Plasma levels of 8-methoxypsoralen following PUVA-bath photochemotherapy

International Nuclear Information System (INIS)

Kobyletzki, G. von; Hoffmann, K.; Kerscher, M.; Altmeyer, P.

1998-01-01

Administration of 8-methoxypsoralen (8-MOP) in a dilute bath water solution is an effective therapeutic alternative to oral PUVA therapy, avoiding systemic side effects, offering better bioavailability of the psoralen and requiring much smaller amounts of UVA for induction of therapeutic effects. To obtain exact data about the percutaneous absorption of 8-MOP during a psoralen bath, the plasma levels of the drug were determined in 26 patients with different skin diseases by a reverse high-performance liquid chromatographic method. Fifteen patients receiving oral PUVA therapy (0.8 mg 8-MOP/kg body weight) served as a positive control group. Bath solutions were prepared by diluting 15 ml of 0.5% stock solution of 8-MOP in 150 l of bath water (0.5 mg/l, 37 deg. C). Blood samples were drawn from patients 5, 30, 60, 120 and 180 min after the bath. In the oral PUVA group, blood samples were obtained 1 1/2 h after administration of the drug. In 23 og 26 patients, 8-MOP levels were undetectable in every blood sample. After 30 min, two patients showed detectable levels of 8-MOP (5 ng/ml, 7 ng/ml), while 60 min after the PUVA bath 8-MOP was detectable in only one volunteer (5 ng/ml). In patients receiving oral 8-MOP therapy, serum levels varied between 45 and 360 ng/ml 1 1/2 h after drug administration. Our data confirm extremely low 8-MOP levels resulting from 8-MOP bath water treatments and provide confirmation of the absence of systemic side effects in patients who are undergoing PUVA-bath therapy. (au)

Development of certified environmental management in hospital and outpatient haemodialysis units.

Science.gov (United States)

García Vicente, Sergio; Morales Suárez-Varela, María; Martí Monrós, Anna; Llopis González, Agustín

2015-01-01

The environmental impact of haemodialysis is very high. Institutional activity in this sense is important, even in the production of references. Voluntary environmental management systems (EMS), environmental management and auditing systems (EMAS) and the International Organization for Standardization standards (ISO 14001) are important tools for environmental protection, together with legislation, taxation and tax benefits. To determine the degree of implementation of EMS in hospital units and outpatient haemodialysis in the Spanish National Health System to provide a group of reference centres in environmental management in this healthcare activity. Development of a list by autonomous communities showing hospital and outpatient dialysis units using an EMAS and/or ISO 14001 in 2012-2013. The sources of information were the Spanish National Catalogue of Hospitals, Spanish Registry of Healthcare Certification and Accreditation, European and regional EMAS records, world ISO registrations, dialysis centre lists from scientific societies and patients, responses from accredited entities in Spain for environmental certification and the institutional website of each haemodialysis centre identified. Of the 210 hospitals with a dialysis unit, 53 (25%) have the ISO 14001 and 15 of these also have an EMAS). This constitutes 30% of all hospital dialysis chairs in Spain: 1,291 (of 4,298). Only 11 outpatient clinics are recorded, all with the ISO 14001. There is no official documentation of the implementation of EMS in dialysis units. Making this list provides an approach to the situation, with special reference to haemodialysis because of its significant environmental impact. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

Synthetic Cathinones ("Bath Salts")

Science.gov (United States)

... Alcohol Club Drugs Cocaine Fentanyl Hallucinogens Inhalants Heroin Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Over-the-Counter Medicines Prescription Medicines Steroids (Anabolic) Synthetic Cannabinoids (K2/Spice) Synthetic Cathinones (Bath Salts) Tobacco/ ...

Improving the smoking patterns in a general hospital psychiatric unit

Directory of Open Access Journals (Sweden)

Celso Iglesias García

2009-01-01

Full Text Available Objectives: The purpose of the present paper is to evaluate the effects of a smoking ban in a general hospital psychiatric unit. Methods: We study the effects of smoking ban in 40 consecutive psychiatric inpatients. The staff registered socio-demographic and tobacco-related variables. We also registered any kind of behavioral effects of smoking ban.Results: The patients were willing to stop smoking during their hospital stay (with or without nicotine replacement with two mild behavioural incidences registered throughout the study. Conclusions: The benefits of non-smoking policy in a psychiatric unit can be significant. The introduction of smoking bans in psychiatric inpatients settings is possible and safe.

Multiple intra-hospital transports during relocation to a new critical care unit.

Science.gov (United States)

O'Leary, R-A; Conrick-Martin, I; O'Loughlin, C; Curran, M-R; Marsh, B

2017-11-01

Intra-hospital transport (IHT) of critically ill patients is associated with morbidity and mortality. Mass transfer of patients, as happens with unit relocation, is poorly described. We outline the process and adverse events associated with the relocation of a critical care unit. Extensive planning of the relocation targeted patient and equipment transfer, reduction in clinical pressure prior to the event and patient care during the relocation phase. The setting was a 30-bed, tertiary referral, combined medical and surgical critical care unit, located in a 570-bed hospital that serves as the national referral centre for cardiothoracic surgery and spinal injuries. All stakeholders relevant to the critical care unit relocation were involved, including nursing and medical staff, porters, information technology services, laboratory staff, project development managers, pharmacy staff and building contractors. Mortality at discharge from critical care unit and discharge from hospital were the main outcome measures. A wide range of adverse events were prospectively recorded, as were transfer times. Twenty-one patients underwent IHT, with a median transfer time of 10 min. Two transfers were complicated by equipment failure and three patients experienced an episode of hypotension requiring intervention. There were no cases of central venous or arterial catheter or endotracheal tube dislodgement, and hospital mortality at 30 days was 14%. Although IHT is associated with morbidity and mortality, careful logistical planning allows for efficient transfer with low complication rates.

Decreased mortality in patients hospitalized due to respiratory diseases after installation of an intensive care unit in a secondary hospital in the interior of Brazil.

Science.gov (United States)

Diogo, Luciano Passamani; Bahlis, Laura Fuchs; Wajner, André; Waldemar, Fernando Starosta

2015-01-01

To evaluate the association between the in-hospital mortality of patients hospitalized due to respiratory diseases and the availability of intensive care units. This retrospective cohort study evaluated a database from a hospital medicine service involving patients hospitalized due to respiratory non-terminal diseases. Data on clinical characteristics and risk factors associated with mortality, such as Charlson score and length of hospital stay, were collected. The following analyses were performed: univariate analysis with simple stratification using the Mantel Haenszel test, chi squared test, Student's t test, Mann-Whitney test, and logistic regression. Three hundred thirteen patients were selected, including 98 (31.3%) before installation of the intensive care unit and 215 (68.7%) after installation of the intensive care unit. No significant differences in the clinical and anthropometric characteristics or risk factors were observed between the groups. The mortality rate was 18/95 (18.9%) before the installation of the intensive care unit and 21/206 (10.2%) after the installation of the intensive care unit. Logistic regression analysis indicated that the probability of death after the installation of the intensive care unit decreased by 58% (OR: 0.42; 95%CI 0.205 -0.879; p = 0.021). Considering the limitations of the study, the results suggest a benefit, with a decrease of one death per every 11 patients treated for respiratory diseases after the installation of an intensive care unit in our hospital. The results corroborate the benefits of the implementation of intensive care units in secondary hospitals.

Technological choice and change in the Southwest Bath in the Athenian Agora

Directory of Open Access Journals (Sweden)

Artz, James

2012-04-01

Full Text Available During its five architectural phases, the Southwest bath in the Athenian Agora changes from a Greek-style bath into a Roman-style bath. This article will focus on the first two phases, when Roman elements begin to be incorporated into the traditional forms of Greek bath architecture – particularly, a hypocaust floor system and a concrete vaulted ceiling built into a traditional Greek tholos bath. After describing these architectural features and analyzing the techniques used in their construction, I will examine possible sources of influence on the design and construction of the Southwest baths. The Roman army, citizenry, and workmen could all have potentially affected the incorporation of Roman bathing technologies and building techniques into the Southwest bath. The available evidence, however, indicates that the most likely source of influence is Roman workmen, who were employed in large numbers for the numerous building projects underway in Augustan Athens.

Sub-exponential spin-boson decoherence in a finite bath

International Nuclear Information System (INIS)

Wong, V.; Gruebele, M.

2002-01-01

We investigate the decoherence of a two-level system coupled to harmonic baths of 4-21 degrees of freedom, to baths with internal anharmonic couplings, and to baths with an additional 'solvent shell' (modes coupled to other bath modes, but not to the system). The discrete spectral densities are chosen to mimic the highly fluctuating spectral densities computed for real systems such as proteins. System decoherence is computed by exact quantum dynamics. With realistic parameter choices (finite temperature, reasonably large couplings), sub-exponential decoherence of the two-level system is observed. Empirically, the time-dependence of decoherence can be fitted by power laws with small exponents. Intrabath anharmonic couplings are more effective at smoothing the spectral density and restoring exponential dynamics, than additional bath modes or solvent shells. We conclude that at high temperature, the most important physical basis for exponential decays is anharmonicity of those few bath modes interacting most strongly with the system, not a large number of oscillators interacting with the system. We relate the current numerical simulations to models of anharmonically coupled oscillators, which also predict power law dynamics. The potential utility of power law decays in quantum computation and condensed phase coherent control are also discussed

Stroke treatment outcomes in hospitals with and without Stroke Units.

Science.gov (United States)

Masjuan, J; Gállego Culleré, J; Ignacio García, E; Mira Solves, J J; Ollero Ortiz, A; Vidal de Francisco, D; López-Mesonero, L; Bestué, M; Albertí, O; Acebrón, F; Navarro Soler, I M

2017-10-23

Organisational capacity in terms of resources and care circuits to shorten response times in new stroke cases is key to obtaining positive outcomes. This study compares therapeutic approaches and treatment outcomes between traditional care centres (with stroke teams and no stroke unit) and centres with stroke units. We conducted a prospective, quasi-experimental study (without randomisation of the units analysed) to draw comparisons between 2 centres with stroke units and 4 centres providing traditional care through the neurology department, analysing a selection of agreed indicators for monitoring quality of stroke care. A total of 225 patients participated in the study. In addition, self-administered questionnaires were used to collect patients' evaluations of the service and healthcare received. Centres with stroke units showed shorter response times after symptom onset, both in the time taken to arrive at the centre and in the time elapsed from patient's arrival at the hospital to diagnostic imaging. Hospitals with stroke units had greater capacity to respond through the application of intravenous thrombolysis than centres delivering traditional neurological care. Centres with stroke units showed a better fit to the reference standards for stroke response time, as calculated in the Quick study, than centres providing traditional care through the neurology department. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Emergency response planning in hospitals, United States: 2003-2004.

Science.gov (United States)

Niska, Richard W; Burt, Catharine W

2007-08-20

This study presents baseline data to determine which hospital characteristics are associated with preparedness for terrorism and natural disaster in the areas of emergency response planning and availability of equipment and specialized care units. Information from the Bioterrorism and Mass Casualty Preparedness Supplements to the 2003 and 2004 National Hospital Ambulatory Medical Care Surveys was used to provide national estimates of variations in hospital emergency response plans and resources by residency and medical school affiliation, hospital size, ownership, metropolitan statistical area status, and Joint Commission accreditation. Of 874 sampled hospitals with emergency or outpatient departments, 739 responded for an 84.6 percent response rate. Estimates are presented with 95 percent confidence intervals. About 92 percent of hospitals had revised their emergency response plans since September 11, 2001, but only about 63 percent had addressed natural disasters and biological, chemical, radiological, and explosive terrorism in those plans. Only about 9 percent of hospitals had provided for all 10 of the response plan components studied. Hospitals had a mean of about 14 personal protective suits, 21 critical care beds, 12 mechanical ventilators, 7 negative pressure isolation rooms, and 2 decontamination showers each. Hospital bed capacity was the factor most consistently associated with emergency response planning and availability of resources.

What Are Bath Salts?

Science.gov (United States)

... bath salts can produce: feelings of joy increased social interaction increased sex drive paranoia nervousness hallucinations (see or ... Institutes of Health; U.S. Department of Health and Human Services. Cite this article APA Style MLA Style ...

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.

Epidemiology of Hospitalizations Associated with Invasive Candidiasis, United States, 2002–20121

Science.gov (United States)

Strollo, Sara; Lionakis, Michail S.; Adjemian, Jennifer; Steiner, Claudia A.

2017-01-01

Invasive candidiasis is a major nosocomial fungal disease in the United States associated with high rates of illness and death. We analyzed inpatient hospitalization records from the Healthcare Cost and Utilization Project to estimate incidence of invasive candidiasis–associated hospitalizations in the United States. We extracted data for 33 states for 2002–2012 by using codes from the International Classification of Diseases, 9th Revision, Clinical Modification, for invasive candidiasis; we excluded neonatal cases. The overall age-adjusted average annual rate was 5.3 hospitalizations/100,000 population. Highest risk was for adults >65 years of age, particularly men. Median length of hospitalization was 21 days; 22% of patients died during hospitalization. Median unadjusted associated cost for inpatient care was $46,684. Age-adjusted annual rates decreased during 2005–2012 for men (annual change –3.9%) and women (annual change –4.5%) and across nearly all age groups. We report a high mortality rate and decreasing incidence of hospitalizations for this disease. PMID:27983497

[Work setting, satisfaction and burnout of the nurses in critical care units and hospitalization units. RN4CAST-Spain project].

Science.gov (United States)

Fuentelsaz-Gallego, C; Moreno-Casbas, T; Gómez-García, T; González-María, E

2013-01-01

To know if there are differences between the critical care units and the medical-surgical care units regarding the perception of the nurses working in National Health System hospitals about their work environment, burnout level and job satisfaction. A cross-sectional study was conducted with 6,417 nurses from the medical-surgical care units and with 1,122 nurses from critical care units of 59 Spanish hospitals with more than 150 beds. Socio-demographic, job satisfaction, perception of work environment (Practice Environment Scale of the Nursing Work Index [PES-NWI questionnaire]) and burnout measured with the Maslach Burnout Inventory (MBI) data were collected. The PES-NWI showed differences in 4 out of its 5 factors. It showed better values in medical-surgical units in all the factors, except for Staffing and resource adequacy (P<.001), where critical care units showed a mean level of agreement of 2.41 versus 2.19 for the medical-surgical units. Regarding burnout, this was higher in the medical-surgical care units (P=.039) where 23% (952) of the nurses had high levels. Job satisfaction was lower in the critical care units (P=.044) with 70% (578) of nurses being very or strongly satisfied. The opinion of the nurses, working in critical care units about their hospital is unfavorable. They showed lower levels of burnout than those working in medical-surgical units. Copyright © 2013 Elsevier España, S.L. y SEEIUC. All rights reserved.

Implementation of a large-scale hospital information infrastructure for multi-unit health-care services.

Science.gov (United States)

Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul

2008-01-01

With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.

Universe unveiled the cosmos in my bubble bath

CERN Document Server

Vishveshwara, C V

2015-01-01

The bubbles were swirling all around me, massaging my body. As I luxuriated in this fantastic bath, I gasped realizing that those bubbles carried with them miniature galaxies bringing the entire Cosmos into my bathtub... Alfie is back. And so are George and other characters from the author’s previous book Einstein’s Enigma or Black Holes in My Bubble Bath. While the present book, Universe Unveiled - The Cosmos in My Bubble Bath, is completely independent, its storyline can be considered a sequel to the previous one. The scientific content spanning ancient world models to the most recent mysteries of cosmology is presented in an entirely nontechnical and descriptive style through the discussions between Alfie, the enlightened learner, and George, professor of astrophysics. Fantasies, based on these discussions that cover the scientific facts, are created by the magical bubble baths taken by Alfie. Universe Unveiled blends accurate science with philosophy, drama, humour, and fantasy to create an exciting co...

Estimating the unit costs of public hospitals and primary healthcare centers.

Science.gov (United States)

Younis, Mustafa Z; Jaber, Samer; Mawson, Anthony R; Hartmann, Michael

2013-01-01

Many factors have affected the rise of health expenditures, such as high-cost medical technologies, changes in disease patterns and increasing demand for health services. All countries allocate a significant portion of resources to the health sector. In 2008, the gross domestic product of Palestine was estimated to be at $6.108bn (current price) or about $1697 per capita. Health expenditures are estimated at 15.6% of the gross domestic product, almost as much as those of Germany, Japan and other developed countries. The numbers of hospitals, hospital beds and primary healthcare centers in the country have all increased. The Ministry of Health (MOH) currently operates 27 of 76 hospitals, with a total of 3074 beds, which represent 61% of total beds of all hospitals in the Palestinian Authorities area. Also, the MOH is operating 453 of 706 Primary Health Care facilities. By 2007, about 40 000 people were employed in different sectors of the health system, with 33% employed by the MOH. This purpose of this study was to develop a financing strategy to help cover some or all of the costs involved in operating such institutions and to estimate the unit cost of primary and secondary programs and departments. A retrospective study was carried out on data from government hospitals and primary healthcare centers to identify and analyze the costs and output (patient-related services) and to estimate the unit cost of health services provided by hospitals and PHCs during the year 2008. All operating costs are assigned and allocated to the departments at MOH hospitals and primary health care centers (PPHCs) and are identified as overhead departments, intermediate-service and final-service departments. Intermediate-service departments provide procedures and services to patients in the final-service departments. The costs of the overhead departments are distributed to the intermediate-service and final-service departments through a step-down method, according to allocation

Novikov Engine with Fluctuating Heat Bath Temperature

Science.gov (United States)

Schwalbe, Karsten; Hoffmann, Karl Heinz

2018-04-01

The Novikov engine is a model for heat engines that takes the irreversible character of heat fluxes into account. Using this model, the maximum power output as well as the corresponding efficiency of the heat engine can be deduced, leading to the well-known Curzon-Ahlborn efficiency. The classical model assumes constant heat bath temperatures, which is not a reasonable assumption in the case of fluctuating heat sources. Therefore, in this article the influence of stochastic fluctuations of the hot heat bath's temperature on the optimal performance measures is investigated. For this purpose, a Novikov engine with fluctuating heat bath temperature is considered. Doing so, a generalization of the Curzon-Ahlborn efficiency is found. The results can help to quantify how the distribution of fluctuating quantities affects the performance measures of power plants.

Quantum mechanical treatment of large spin baths

Science.gov (United States)

Röhrig, Robin; Schering, Philipp; Gravert, Lars B.; Fauseweh, Benedikt; Uhrig, Götz S.

2018-04-01

The electronic spin in quantum dots can be described by central spin models (CSMs) with a very large number Neff≈104 to 106 of bath spins posing a tremendous challenge to theoretical simulations. Here, a fully quantum mechanical theory is developed for the limit Neff→∞ by means of iterated equations of motion (iEoM). We find that the CSM can be mapped to a four-dimensional impurity coupled to a noninteracting bosonic bath in this limit. Remarkably, even for infinite bath the CSM does not become completely classical. The data obtained by the proposed iEoM approach are tested successfully against data from other, established approaches. Thus the iEoM mapping extends the set of theoretical tools that can be used to understand the spin dynamics in large CSMs.

[Medico-economic assessment of the Pontoise Hospital stroke unit].

Science.gov (United States)

Yekhlef, F; Decup, D; Niclot, P; Servan, J; Descombes, S; Richecoeur, J; Ollivier, A

2010-11-01

Annually, approximately 120,000 people in France have a stroke. Various controlled studies have pointed out the benefits of treatment in a stroke unit (SU). The objective of this study was to evaluate, from a medical point of view, the economic impact of the Pontoise Hospital SU. Based on the national cost study (NCS [étude nationale des coûts: ENC]) we analyzed data of five diagnosis related groups (DRG) which have a principle diagnosis in relation with stroke. This work was limited to strokes and transient ischemic events in adults and excluded sub-arachnoid hemorrhage. Medical and economic parameters were collected over the period from January to October 2006 and compared with those of the same period in 2005, that is to say before the opening of the SU. Three hundred and twenty-three hospital stays occurred between January 1st and October 31st, 2006 and 216 during the same time period before the opening of the SU, an increase of approximately 50% of all stroke-related admissions in our hospital. The number of stays carried out in the neurology unit increased by 29%. There was no significant difference between the two periods regarding age (median 69 versus 70 years) and sex- ratio. Average length of stay (ALS) was the same (9 days). There were no significant differences concerning the death rate (5.6% versus 6.2%) and that of discharge to home (44.6% versus 44.4%). The cost by stay in 2006 was 3534 euros [median; min 664-max 57,542] versus 3541 euros in 2005 [681-35,149] (p=0.57). Analysis by DRG highlighted an increase in the cost for serious strokes, cerebral infarctions and hemorrhages. For transitory ischemic events, the cost and the ALS decreased. After the opening of the SU, there was an increase in the activity without an increase in the total cost. This could be related in part to the limited means allocated to the stroke unit at its opening (in particular medical staff). The NCS can be used to evaluate the activity of a stroke unit. This work could

The crisis in United States hospital emergency services.

Science.gov (United States)

Harrison, Jeffrey P; Ferguson, Emily D

2011-01-01

Emergency services are critical for high-quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (U.S.) acute care hospital staffs ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers. Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities. U.S. acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, U.S. emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staffs ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state-of-the-art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement. This research uses the AHA annual surveys,which represent self-reported data by individual hospital staff. However, the AHA expendssignificant resources to validate reported information and the annual survey data are widely used for hospital research. The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure. This article has important information on US emergency service availability in the hospital industry.

Two-level system in spin baths: Non-adiabatic dynamics and heat transport

Science.gov (United States)

Segal, Dvira

2014-04-01

We study the non-adiabatic dynamics of a two-state subsystem in a bath of independent spins using the non-interacting blip approximation, and derive an exact analytic expression for the relevant memory kernel. We show that in the thermodynamic limit, when the subsystem-bath coupling is diluted (uniformly) over many (infinite) degrees of freedom, our expression reduces to known results, corresponding to the harmonic bath with an effective, temperature-dependent, spectral density function. We then proceed and study the heat current characteristics in the out-of-equilibrium spin-spin-bath model, with a two-state subsystem bridging two thermal spin-baths of different temperatures. We compare the behavior of this model to the case of a spin connecting boson baths, and demonstrate pronounced qualitative differences between the two models. Specifically, we focus on the development of the thermal diode effect, and show that the spin-spin-bath model cannot support it at weak (subsystem-bath) coupling, while in the intermediate-strong coupling regime its rectifying performance outplays the spin-boson model.

Two-level system in spin baths: Non-adiabatic dynamics and heat transport

Energy Technology Data Exchange (ETDEWEB)

Segal, Dvira [Chemical Physics Theory Group, Department of Chemistry, University of Toronto, 80 Saint George St., Toronto, Ontario M5S 3H6 (Canada)

2014-04-28

We study the non-adiabatic dynamics of a two-state subsystem in a bath of independent spins using the non-interacting blip approximation, and derive an exact analytic expression for the relevant memory kernel. We show that in the thermodynamic limit, when the subsystem-bath coupling is diluted (uniformly) over many (infinite) degrees of freedom, our expression reduces to known results, corresponding to the harmonic bath with an effective, temperature-dependent, spectral density function. We then proceed and study the heat current characteristics in the out-of-equilibrium spin-spin-bath model, with a two-state subsystem bridging two thermal spin-baths of different temperatures. We compare the behavior of this model to the case of a spin connecting boson baths, and demonstrate pronounced qualitative differences between the two models. Specifically, we focus on the development of the thermal diode effect, and show that the spin-spin-bath model cannot support it at weak (subsystem-bath) coupling, while in the intermediate-strong coupling regime its rectifying performance outplays the spin-boson model.

"Roman Baths" in Contemporary Spa Tourism

Directory of Open Access Journals (Sweden)

Vesna Merc

2005-07-01

Full Text Available The commercialisation of images and symbols from antiquity, so characteristic of Slovenia since its independence, has been reflected over the last decade in spa tourism as well. Since the great crises in the sixties, and especially since the eighties, fifteen Slovene natural health resorts have concentrated on developing wellness and activities programs. This change in orientation has been accompanied by renovations, an expansion of the water surfaces and capacities, and new wellbeing, wellness, spirituality and beauty programs. An analysis of Slovene spas, wellness centres and hotel web pages shows that they frequently offer rooms, usually saunas, which are imitations of the Roman baths. These rooms are usually called "Roman saunas", "Tepidarium", "Caldarium", and "Roman-Irish baths". At Terme Ptuj, Zdravilišče Laško, Šmarješke Toplice, Grand Hotel Palace in Portorož, and Terme Čatež, saunas have been built or renovated in the Roman style. This trend of Roman rooms is a novelty, less than a decade old in Slovenia. The first sauna with a Roman theme, a Roman-Irish bath, was opened in 1997 in the Health and Beauty Centre at Terme Čatež. Modern Roman saunas are very popular, found not only in Slovenia but also in other parts of Europe, especially Germany and Austria. Their popularity has spread from the areas formerly occupied by the Romans to other parts of world, for example the USA and the Republic of South Africa. An analysis of Slovene saunas and wellness centres reveals a well-established trend to recreate certain parts of the Roman baths. This is attempted not only through Roman-style decorations, but also through certain structures particular to the Roman baths, such as the caldarium, tepidarium, and in one case even a laconicum. The approach, however, is highly eclectic, blending Roman, Greek and, above all, modern elements. The purpose of such rooms is to increase the appeal of the spas, while their design is mostly based on

Prevalence of use of advance directives, health care proxy, legal guardian, and living will in 512 patients hospitalized in a cardiac care unit/intensive care unit in 2 community hospitals.

Science.gov (United States)

Kumar, Anil; Aronow, Wilbert S; Alexa, Margelusa; Gothwal, Ritu; Jesmajian, Stephen; Bhushan, Bharat; Gaba, Praveen; Catevenis, James

2010-04-30

The prevalence of use of any advance directives was 26% in 112 patients hospitalized in a cardiac care unit (CCU)/intensive care unit (ICU) in an academic medical center. We investigated in 2 community hospitals the prevalence of use of advance directives (AD), health care proxy (HCP), legal guardian (LG), and living will (LW) in 512 patients hospitalized in a CCU/ ICU approached for AD and HCP. The use of AD was 22%, of HCP was 19%, of LG was 16%, and of LW was 5%. The use of AD was 22%, of HCP was 19%, of LG was 16%, and of LW was 5% in patients hospitalized in a CCU/ICU. Educational programs on use of AD and of HCP need to be part of cardiovascular training programs and of cardiovascular continuing medical education.

New Brightener for Zn-Fe Alloy Plating from Sulphate Bath

Directory of Open Access Journals (Sweden)

B. M. Praveen

2011-01-01

Full Text Available Zn-Fe alloy electrodeposition was carried out in the presence of condensation product 2-{[(1E-(3,4-dimethoxyphenylmethylidene]amino}-3-hydroxypropanoic acid formed between veratraldehyde and serine in acid sulphate bath. Hull cell was used for optimizing the operating parameters and bath constituents. During deposition, the potential was shifted towards cathodic direction in the presence of addition agents and brightener. The polarization studies show that deposition taking place in basic bath and optimum bath was 1.08 and 1.15 V, respectively. Current efficiency and throwing power were reached around 85% and 26%, respectively. The SEM images of bright deposit indicated its fine-grained nature and appreciable reduction in the grain size. XRD studies have showed that the grain size of the deposit generated from optimum bath was 16 nm. UV-visible spectroscopic studies confirm the formation of complex between metal ion and brightener.

Phosphorus-31 NMR (nuclear magnetic resonance) analysis of gold plating baths

Energy Technology Data Exchange (ETDEWEB)

Smith, R.E.

1990-01-01

This report describes the nuclear magnetic resonance (NMR) analysis of the gold plating baths in the Micro-Miniature Electronic Assembly department of Allied-Signal Inc., Kansas City Division (KCD). The baths were analyzed for phosphorylated components. In freshly prepared gold plating baths, a 50-percent aqueous solution of aminotrimethylphosphonate (ATMP) is the principal compound observed. As the bath is used in production, the ATMP breaks down and new materials (phosphate, ADMP, and AMMP) are identified. The NMR method was used to monitor the concentrations of the ATMP and breakdown products for a nine-month period. The 225-liter bath had plated approximately 100 square feet of gold during the nine-month period. These results can be used to predict the performance of baths as they are used in production. The accuracy of the analysis is 96 percent for ATMP and 92 percent for phosphate. The precision (relative standard deviation) is 5.2 percent for ATMP and 4.5 percent for phosphate. 1 ref., 5 figs., 2 tabs.

Emollient bath additives for the treatment of childhood eczema (BATHE): multicentre pragmatic parallel group randomised controlled trial of clinical and cost effectiveness.

Science.gov (United States)

Santer, Miriam; Ridd, Matthew J; Francis, Nick A; Stuart, Beth; Rumsby, Kate; Chorozoglou, Maria; Becque, Taeko; Roberts, Amanda; Liddiard, Lyn; Nollett, Claire; Hooper, Julie; Prude, Martina; Wood, Wendy; Thomas, Kim S; Thomas-Jones, Emma; Williams, Hywel C; Little, Paul

2018-05-03

To determine the clinical effectiveness and cost effectiveness of including emollient bath additives in the management of eczema in children. Pragmatic randomised open label superiority trial with two parallel groups. 96 general practices in Wales and western and southern England. 483 children aged 1 to 11 years, fulfilling UK diagnostic criteria for atopic dermatitis. Children with very mild eczema and children who bathed less than once weekly were excluded. Participants in the intervention group were prescribed emollient bath additives by their usual clinical team to be used regularly for 12 months. The control group were asked to use no bath additives for 12 months. Both groups continued with standard eczema management, including leave-on emollients, and caregivers were given standardised advice on how to wash participants. The primary outcome was eczema control measured by the patient oriented eczema measure (POEM, scores 0-7 mild, 8-16 moderate, 17-28 severe) weekly for 16 weeks. Secondary outcomes were eczema severity over one year (monthly POEM score from baseline to 52 weeks), number of eczema exacerbations resulting in primary healthcare consultation, disease specific quality of life (dermatitis family impact), generic quality of life (child health utility-9D), utilisation of resources, and type and quantity of topical corticosteroid or topical calcineurin inhibitors prescribed. 483 children were randomised and one child was withdrawn, leaving 482 children in the trial: 51% were girls (244/482), 84% were of white ethnicity (447/470), and the mean age was 5 years. 96% (461/482) of participants completed at least one post-baseline POEM, so were included in the analysis, and 77% (370/482) completed questionnaires for more than 80% of the time points for the primary outcome (12/16 weekly questionnaires to 16 weeks). The mean baseline POEM score was 9.5 (SD 5.7) in the bath additives group and 10.1 (SD 5.8) in the no bath additives group. The mean POEM score

Sudden Death Phenomenon While Bathing in Japan　- Mortality Data.

Science.gov (United States)

Suzuki, Masaru; Shimbo, Takuro; Ikaga, Toshiharu; Hori, Shingo

2017-07-25

Bath-related sudden cardiac arrest frequently occurs in Japan, but the mortality data have not been sufficiently reported.Methods and Results:This prospective cross-sectional observational study was conducted in the Tokyo Metropolis, Saga Prefecture and Yamagata Prefecture between October 2012 and March 2013 (i.e., in winter). We investigated the data for all occurrences in these areas for which the emergency medical system needed to be activated because of an accident or acute illness related to bathing. Emergency personnel enrolled the event when activation of the emergency medical system was related to bathing. Of the 4,599 registered bath-related events, 1,527 (33%) were identified as bath-related cardiac arrest events. Crude mortality (no. deaths per 100,000) during the observational period was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga. According to the mortality data for age and sex, the estimated number of bath-related deaths nationwide was 13,369 in winter, for the 6 months from October (95% CI: 10,862-16,887). Most cardiac arrest events occurred in tubs filled with water with the face submerged in the water. This suggests that drowning plays a crucial role in the etiology of such phenomena. The estimated nationwide number of deaths was 13,369 (95% CI: 10,862-16,887) in winter, for the 6 months from October. Crude mortality during the winter season was 10.0 in Tokyo, 11.6 in Yamagata and 8.5 in Saga.

Helpless patients' perception of bed-bath in tertiary health ...

African Journals Online (AJOL)

Helpless patients' perception of bed-bath in tertiary health institutions in Enugu, Southeast Nigeria. ... Journal Home > Vol 10, No 2 (2005) > ... patients to bed bathing by nurses is a very important aspect of quality assurance in nursing care.

Meeting the needs of elderly with bathing disability.

Science.gov (United States)

Zingmark, Magnus; Bernspång, Birgitta

2011-06-01

Difficulties with bathing are frequent among older people and are associated with an increasing need for societal support. As loss of independence has a negative impact on health and wellbeing, it is important to study interventions that can provide the required support for people to be able to remain independent. Occupational therapy interventions can improve clients' abilities enabling them to bathe themselves, thus reducing the need for other, more long-term societal support from, e.g. a home help. In this study, two groups of elderly people with difficulties in bathing were compared; the clients in the intervention group were engaged in occupational therapy. A quasi-experimental non-equivalent control group design was used, in which participants with reported difficulties in bathing were recruited consecutively from two municipalities. The clients in the intervention group routinely received occupational therapy, whereas clients in the control group received assistance from a home help for bathing. Activities of daily living, quality of life and home-help allocation were assessed at the baseline and after 15 weeks. Clients in the intervention group received less than three home visits on average, with majority of interventions consisting of graded activity and the use of an encouraging approach. Seventy per cent of the interventions were adaptive. Activities of daily living and quality of life of both groups improved, but the differences of being allocated a home help were significant. Occupational therapy interventions seem beneficial in terms of supporting older people in becoming independent of home help in bathing but the results must be interpreted with caution as there were differences at baseline between the groups. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Australian Association of Occupational Therapists.

The Association Between Bathing Habits and Severity of Atopic Dermatitis in Children.

Science.gov (United States)

Koutroulis, Ioannis; Pyle, Tia; Kopylov, David; Little, Anthony; Gaughan, John; Kratimenos, Panagiotis

2016-02-01

Atopic dermatitis is an inflammatory skin disease that frequently affects children. The current recommendations on management using lifestyle modification are highly variable, leading to confusion and uncertainty among patients. To determine current bathing behaviors and the subsequent impact on disease severity. This was an observational cross-sectional study conducted at an urban pediatric emergency department. Parents were asked to fill out a questionnaire concerning the patient's bathing habits. The results were correlated with the atopic dermatitis severity determined by the SCORAD (SCORing Atopic Dermatitis) tool. No difference between variables was found to be significant for bathing frequency, time spent bathing, or use of moisturizers. Multivariate analysis showed that atopic dermatitis severity increased with age greater than 2 years (P = .0004) and with greater bathing duration (P = .001). Atopic dermatitis severity may be associated with a longer duration of bathing. The frequency of bathing does not appear to affect atopic dermatitis severity. © The Author(s) 2015.

An analysis of acute admissions to a general hospital psychiatric unit

African Journals Online (AJOL)

Rapid turnover of patients in a general hospital psychiatric unit demands stabilization and discharge as soon as possible. It is likely that patients are being prematurely discharged because of this pressure. Aim: The study sought to analyse admissions to an acute psychiatric unit with a view to determining the demographic ...

Efficacy of paraffin bath therapy in hand osteoarthritis: a single-blinded randomized controlled trial.

Science.gov (United States)

Dilek, Banu; Gözüm, Mehtap; Şahin, Ebru; Baydar, Meltem; Ergör, Gül; El, Ozlem; Bircan, Çigdem; Gülbahar, Selmin

2013-04-01

To evaluate the efficacy of paraffin bath therapy on pain, function, and muscle strength in patients with hand osteoarthritis. Prospective single-blinded randomized controlled trial. Department of physical medicine and rehabilitation in a university hospital. Patients with bilateral hand osteoarthritis (N=56). Patients were randomized into 2 groups with a random number table by using block randomization with 4 patients in a block. Group 1 (n=29) had paraffin bath therapy (5 times per week, for 3-week duration) for both hands. Group 2 (n=27) was the control group. All patients were informed about joint-protection techniques, and paracetamol intake was recorded. The primary outcome measures were pain (at last 48h) at rest and during activities of daily living (ADL), assessed with a visual analog scale (0-10cm) at 12 weeks. The secondary outcome measures were the Australian Canadian Osteoarthritis Hand Index (AUSCAN) and the Dreiser Functional Index (DFI), used for subjective functional evaluation, loss of range of motion (ROM), grip and pinch strength, painful and tender joint counts, and paracetamol intake. A researcher blind to group allocation recorded the measures for both hands at baseline, 3 weeks, and 12 weeks at the hospital setting. At baseline, there were no significant differences between groups in any of the parameters (P>.05). After treatment, the paraffin group exhibited significant improvement in pain at rest and during ADL, ROM of the right hand, and pain and stiffness dimensions of the AUSCAN (P.05). The control group showed a significant deterioration in right hand grip and bilateral lateral pinch and right chuck pinch strength (Pparaffin group (Pparaffin group were significantly higher than the control group at 12 weeks (PParaffin bath therapy seemed to be effective both in reducing pain and tenderness and maintaining muscle strength in hand osteoarthritis. It may be regarded as a beneficial short-term therapy option, which is effective for a 12

The role of leader behaviors in hospital-based emergency departments' unit performance and employee work satisfaction.

Science.gov (United States)

Lin, Blossom Yen-Ju; Hsu, Chung-Ping C; Juan, Chi-Wen; Lin, Cheng-Chieh; Lin, Hung-Jung; Chen, Jih-Chang

2011-01-01

The role of the leader of a medical unit has evolved over time to expand from simply a medical role to a more managerial one. This study aimed to explore how the behavior of a hospital-based emergency department's (ED's) leader might be related to ED unit performance and ED employees' work satisfaction. One hundred and twelve hospital-based EDs in Taiwan were studied: 10 in medical centers, 32 in regional hospitals, and 70 in district hospitals. Three instruments were designed to assess leader behaviors, unit performance and employee satisfaction in these hospital-based EDs. A mail survey revealed that task-oriented leader behavior was positively related to ED unit performance. Both task- and employee-oriented leader behaviors were found to be positively related to ED nurses' work satisfaction. However, leader behaviors were not shown to be related to ED physicians' work satisfaction at a statistically significant level. Some ED organizational characteristics, however, namely departmentalization and hospital accreditation level, were found to be related to ED physicians' work satisfaction. Copyright © 2010 Elsevier Ltd. All rights reserved.

Effects of bathing on skin exposed to Cobalt-60 teletherapy

International Nuclear Information System (INIS)

Bohannan, P.A.

1982-01-01

The problem of this study was to determine the effects of bathing or not bathing on the degree of skin reaction occurring in patients receiving Cobalt-60 radiation therapy to the chest, back, or head and neck. A quasi experimental study was done using a 2 x 7 repeated measures design. Sixty-seven subjects receiving Cobalt-60 radiation therapy at the Moncrief Radiation Center in Fort Worth, Texas, were randomly assigned to an experimental group who did not bathe during therapy and a control group who did bathe with water during therapy. Observations were made after each 1000 rads of therapy and two weeks after the final treatment. Erythema and pigmentation measurements were taken using the Photovolt 670 and rates were assigned using the Baker-Leith Rating Scale. Findings from the study suggest that bathing the portal of entry with water during the treatment period does not influence the degree of skin response that occurs from Cobalt-60 teletherapy

Quantitative assessment of combination bathing and moisturizing regimens on skin hydration in atopic dermatitis.

Science.gov (United States)

Chiang, Charles; Eichenfield, Lawrence F

2009-01-01

Standard recommendations for skin care for patients with atopic dermatitis stress the importance of skin hydration and the application of moisturizers. However, objective data to guide recommendations regarding the optimal practice methods of bathing and emollient application are scarce. This study quantified cutaneous hydration status after various combination bathing and moisturizing regimens. Four bathing/moisturizer regimens were evaluated in 10 subjects, five pediatric subjects with atopic dermatitis and five subjects with healthy skin. The regimens consisted of bathing alone without emollient application, bathing and immediate emollient application, bathing and delayed application, and emollient application alone. Each regimen was evaluated in all subjects, utilizing a crossover design. Skin hydration was assessed with standard capacitance measurements. In atopic dermatitis subjects, emollient alone yielded a significantly (p hydration over 90 minutes (206.2% baseline hydration) than bathing with immediate emollient (141.6%), bathing and delayed emollient (141%), and bathing alone (91.4%). The combination bathing and emollient application regimens demonstrated hydration values at 90 minutes not significantly greater than baseline. Atopic dermatitis subjects had a decreased mean hydration benefit compared with normal skin subjects. Bathing without moisturizer may compromise skin hydration. Bathing followed by moisturizer application provides modest hydration benefits, though less than that of simply applying moisturizer alone.

Observation-status patients in children's hospitals with and without dedicated observation units in 2011.

Science.gov (United States)

Macy, Michelle L; Hall, Matthew; Alpern, Elizabeth R; Fieldston, Evan S; Shanley, Leticia A; Hronek, Carla; Hain, Paul D; Shah, Samir S

2015-06-01

Pediatric observation units (OUs) have demonstrated reductions in lengths of stay (LOS) and costs of care. Hospital-level outcomes across all observation-status stays have not been evaluated in relation to the presence of a dedicated OU in the hospital. To compare observation-status stay outcomes in hospitals with and without a dedicated OU. Cross-sectional analysis of hospital administrative data. Observation-status stay outcomes were compared in hospitals with and without a dedicated OU across 4 categories: (1) LOS, (2) standardized costs, (3) conversion to inpatient status, and (4) return care. Observation-status stays in 31 free-standing children's hospitals contributing observation patient data to the Pediatric Health Information System database, 2011. Fifty-one percent of the 136,239 observation-status stays in 2011 occurred in 14 hospitals with a dedicated OU; the remainder were in 17 hospitals without. The percentage of observation-status same-day discharges was higher in hospitals with a dedicated OU compared with hospitals without (23.8 vs 22.1, P hospitals with a dedicated OU (11.06%) compared with hospitals without (9.63%, P hospital-level outcomes. Inclusion of location of care (eg, dedicated OU, inpatient unit, emergency department) in hospital administrative datasets would allow for more meaningful comparisons of models of hospital care. © 2015 Society of Hospital Medicine.

Pre-hospital National Early Warning Score (NEWS is associated with in-hospital mortality and critical care unit admission: A cohort study

Directory of Open Access Journals (Sweden)

Tom E.F. Abbott

2018-03-01

Conclusion: Pre-hospital NEWS was associated with death or critical care unit escalation within 48 h of hospital admission. NEWS could be used by ambulance crews to assist in the early triage of patients requiring hospital treatment or rapid transport. Further cohort studies or trials in large samples are required before implementation.

Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital

Science.gov (United States)

Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

2016-01-01

Background: Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. Objective: This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran. Methods: This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS. Results: The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. Conclusion: By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department. PMID:26234974

Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital.

Science.gov (United States)

Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

2015-05-17

Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran.‎ This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS.‎ The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department.

Hospitalization for esophageal achalasia in the United States.

Science.gov (United States)

Molena, Daniela; Mungo, Benedetto; Stem, Miloslawa; Lidor, Anne O

2015-09-25

To assess the outcome of different treatments in patients admitted for esophageal achalasia in the United States. This is a retrospective analysis using the Nationwide Inpatient Sample over an 8-year period (2003-2010). Patients admitted with a primary diagnosis of achalasia were divided into 3 groups based on their treatment: (1) Group 1: patients who underwent Heller myotomy during their hospital stay; (2) Group 2: patients who underwent esophagectomy; and (3) Group 3: patients not undergoing surgical treatment. Primary outcome was in-hospital mortality. Secondary outcomes included length of stay (LOS), discharge destination and total hospital charges. Among 27141 patients admitted with achalasia, nearly half (48.5%) underwent Heller myotomy, 2.5% underwent esophagectomy and 49.0% had endoscopic or other treatment. Patients in group 1 were younger, healthier, and had the lowest mortality when compared with the other two groups. Group 2 had the highest LOS and hospital charges among all groups. Group 3 had the highest mortality (1.2%, P achalasia carries exceedingly low mortality in the modern era; however, in complicated patients, even less invasive treatments are burdened by significant mortality and morbidity.

A medical admission unit reduces duration of hospital stay and number of readmissions

DEFF Research Database (Denmark)

Vork, Jan C; Brabrand, Mikkel; Folkestad, Lars

2011-01-01

Political initiatives promoting a more efficient emergency admission process have triggered a reorganisation of the Danish health system with a view to creating fewer and larger admission units counting more experienced physicians. At our hospital, a medical admission unit (MAU) was established. ...... present the effect of this on the length of hospital stay, mortality rates and the number of readmissions for the last year with the previous structure and the first year of the new MAU structure....

Acute irritant reaction to an antiseptic bath emollient

OpenAIRE

Saw, N; Hindmarsh, J

2005-01-01

Antiseptic bath emollients are commonly prescribed for treatment of eczema and are generally safe for frequent application. Although acute irritant reactions are uncommon it is nevertheless recognised and could have significant morbidity. This case describes a young male patient who developed an acute irritant reaction localised to the external genitalia, mimicking Fournier's gangrene, after overnight application of Oilatum Plus antiseptic bath emollients.

[Incidence of multi-resistant bacteria in Intensive Care Units of Chilean hospitals].

Science.gov (United States)

Acuña, M Paz; Cifuentes, Marcela; Silva, Francisco; Rojas, Álvaro; Cerda, Jaime; Labarca, Jaime

2017-12-01

Incidence of multi-resistant bacteria is an indicator that permits better estimation of the magnitude of bacterial resistance in hospitals. To evaluate the incidence of relevant multi-drug resistant bacteria in intensive care units (ICUs) of Chile. Participating hospitals submitted information about the number of isolates from infected or colonized patients with 7 epidemiologically relevant multi-resistant bacteria in adult and pediatric ICUs between January 1, 2014 and October 31, 2015 and the number of bed days occupied in these units in the same period was requested. With these data incidence was calculated per 1,000 patient days for each unit. Information from 20 adults and 9 pediatric ICUs was reviewed. In adult ICUs the bacteria with the highest incidence were K. pneumoniae ESBL [4.72 × 1,000 patient day (1.21-13.89)] and oxacillin -resistant S. aureus [3.85 (0.71-12.66)]. In the pediatric units the incidence was lower, highlighting K. pneumoniae ESBL [2.71 (0-7.11)] and carbapenem -resistant P. aeruginosa [1.61 (0.31-9.25)]. Important differences between hospitals in the incidence of these bacteria were observed. Incidence of multi-resistant bacteria in adult ICU was significantly higher than in pediatric ICU for most of the studied bacterias.

Health risk assessment standards of cyanobacteria bloom occurrence in bathing sites

Directory of Open Access Journals (Sweden)

Agnieszka Stankiewicz

2011-03-01

Full Text Available Threat for human health appears during a massive cyanobacteria bloom in potable water used for human consumption or in basins used for recreational purposes. General health risk assessment standards and preventive measures to be taken by sanitation service were presented in scope of: – evaluation of cyanobacteria bloom occurrence in bathing sites / water bodies, – procedures in case of cyanobacteria bloom, including health risk assessment and decision making process to protect users’ health at bathing sites, – preventive measures, to be taken in case of cyanobacteria bloom occurrence in bathing sites and basins, where bathing sites are located.

Acute irritant reaction to an antiseptic bath emollient

Science.gov (United States)

Saw, N; Hindmarsh, J

2005-01-01

Antiseptic bath emollients are commonly prescribed for treatment of eczema and are generally safe for frequent application. Although acute irritant reactions are uncommon it is nevertheless recognised and could have significant morbidity. This case describes a young male patient who developed an acute irritant reaction localised to the external genitalia, mimicking Fournier's gangrene, after overnight application of Oilatum Plus antiseptic bath emollients. PMID:15701748

Impact of stroke unit in a public hospital on length of hospitalization and rate of early mortality of ischemic stroke patients

Directory of Open Access Journals (Sweden)

Maria Sheila G. Rocha

2013-10-01

Full Text Available We ascertained whether a public health stroke unit reduces the length of hospitalization, the rate of inpatient fatality, and the mortality rate 30 days after the stroke. Methods We compared a cohort of stroke patients managed on a general neurology/medical ward with a similar cohort of stroke patients managed in a str oke unit. The in-patient fatality rates and 30-day mortality rates were analyzed. Results 729 patients were managed in the general ward and 344 were treated at a comprehensive stroke unit. The in-patient fatality rates were 14.7% for the general ward group and 6.9% for the stroke unit group (p<0.001. The overall mortality rate 30 days after stroke was 20.9% for general ward patients and 14.2% for stroke unit patients (p=0.005. Conclusions We observed reduced in-patient fatalities and 30-day mortality rates in patients managed in the stroke unit. There was no impact on the length of hospitalization.

[Survival of Bacillus anthracis spores in various tannery baths].

Science.gov (United States)

Mendrycka, M; Mierzejewski, J

2000-01-01

The influence of tannery baths: liming, deliming, bating, pickling, tanning, retannage on the survival and on the germination dynamism of B. anthracis spores (Sterne strain) was investigated. The periods and the conditions of this influence were established according to technological process of cow hide tannage. Practically after every bath some part of the spores remained vital. The most effective killing of spores occurred after pickling, liming and deliming. Inversely, the most viable spores remained after bating and retannage process. The lack of correlation that was observed between survival and germination of spores after retannage bath can be explained by different mechanism of spores germination inhibition and their killing.

Pressure ulcers and prevention among acute care hospitals in the United States.

Science.gov (United States)

Bergquist-Beringer, Sandra; Dong, Lei; He, Jianghua; Dunton, Nancy

2013-09-01

Most pressure ulcers can be prevented with evidence-based practice. Many studies describe the implementation of a pressure ulcer prevention program but few report the effect on outcomes across acute care facilities. Data on hospital-acquired pressure ulcers and prevention from the National Database of Nursing Quality Indicators 2010 Pressure Ulcer Surveys were linked to hospital characteristics and nurse staffing measures within the data set. The sample consisted of 1,419 hospitals from across the United States and 710,626 patients who had been surveyed for pressure ulcers in adult critical care, step-down, medical, surgical, and medical/surgical units. Hierarchical logistic regression analysis was performed to identify study variables associated with hospital-acquired pressure ulcers among patients at risk for these ulcers. The rate of hospital-acquired pressure ulcers was 3.6% across all surveyed patients and 7.9% among those at risk. Patients who received a skin and pressure ulcer risk assessment on admission were less likely to develop a pressure ulcer. Additional study variables associated with lower hospital-acquired pressure ulcer rates included a recent reassessment of pressure ulcer risk, higher Braden Scale scores, a recent skin assessment, routine repositioning, and Magnet or Magnet-applicant designation. Variables associated with a higher likelihood of hospital-acquired pressure ulcers included nutritional support, moisture management, larger hospital size, and academic medical center status. Results provide empirical support for pressure ulcer prevention guideline recommendations on skin assessment, pressure ulcer risk assessment, and routine repositioning, but the 7.9% rate of hospital-acquired pressure ulcers among at-risk patients suggests room for improvement in pressure ulcer prevention practice.

The geology of Burnsville Cove, Bath and Highland Counties, Virginia

Science.gov (United States)

Swezey, Christopher; Haynes, John T.; Lambert, Richard A.; White, William B.; Lucas, Philip C.; Garrity, Christopher P.

2015-01-01

Burnsville Cove is a karst region in Bath and Highland Counties of Virginia. A new geologic map of the area reveals various units of limestone, sandstone, and siliciclastic mudstone (shale) of Silurian through Devonian age, as well as structural features such as northeast-trending anticlines and synclines, minor thrust faults, and prominent joints. Quaternary features include erosional (strath) terraces and accumulations of mud, sand, and gravel. The caves of Burnsville Cove are located within predominantly carbonate strata above the Silurian Williamsport Sandstone and below the Devonian Oriskany Sandstone. Most of the caves are located within the Silurian Tonoloway Limestone, rather than the Silurian-Devonian Keyser Limestone as reported previously.

The Roman-Irish Bath: Medical/health history as therapeutic assemblage.

Science.gov (United States)

Foley, Ronan

2014-04-01

The invention of a new form of hot-air bath in Blarney, Ireland in 1856, variously known in its lifetime as the Roman-Irish or Turkish Bath, acted as the starting point for a the production of a globalised therapeutic landscape. Tracking the diffusion of the Roman-Irish bath template from its local invention in Ireland to a global reach across the Victorian world and recognizing its place within a wider hydrotherapeutic history, this paper frames that diffusion as a valuable empirical addition to assemblage theory. The specific empirical history of the spread of the Roman-Irish/Turkish bath idea is drawn from primary archival and secondary historical sources. It is then discussed and, drawing from work on assemblage theory, analyzed against three broad themes: mobile networks, socio-material practices and contested emergence. The emergent relational geographies of the Roman-Irish Bath identify important roles for the diffusion and transformation of specific medical settings, identities and functions. These were linked in turn to competing social-healing pathways wherein bodies were technologically and morally managed, to produce a more inhabited form of therapeutic assemblage. In all cases the differential diffusion of the bath idea, it's shifting and fractured material forms and multiple inhabitations and discourses were contested and mobile and spoke to an assemblage approach which has ripe potential for exploration across a range of medical/health geography settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Electroless nickel plating on abs plastics from nickel chloride and nickel sulfate baths

International Nuclear Information System (INIS)

Inam-ul-haque; Ahmad, S.; Khan, A.

2005-01-01

Aqueous acid nickel chloride and alkaline nickel sulphate bath were studied for electroless nickel planting on acrylonitrile-butadiene-styrene (ABS) plastic. Before electroless nickel plating, specimens were etched, sensitized and activated. Effects of sodium hypophosphite and sodium citrate concentration on the electroless nickel plating thickness were discussed. Aqueous acid nickel chloride bath comprising, nickel chloride 10 g/L, sodium hypophosphite 40 g/L, sodium citrate 40g/L at pH 5.5, temperature 85 deg. C and density of 1 Be/ for thirty minutes gave best coating thickness in micrometer. It was found that acid nickel chloride bath had a greater stability, wide operating range and better coating thickness results than alkaline nickel sulphate bath. Acid nickel chloride bath gave better coating thickness than alkaline nickel sulfate bath

Bath-Ambience-A Mechatronic System for Assisting the Caregivers of Bedridden People.

Science.gov (United States)

Bezerra, Karolina; Machado, José; Carvalho, Vítor; Castro, Marcelo; Costa, Pedro; Matos, Demétrio; Soares, Filomena

2017-05-18

The health of older people is receiving special attention and dedication nowadays, with the aim of increasing their general wellbeing and quality of life. Studies into different aspects of the care of the elderly have found that emphasis should be given to solving problems related to bathing in different situations and environments. In particular, it is important to develop new assistive technologies to streamline and ease the burden of a caregiver's daily tasks. Generally-speaking, in the case of bedridden patients, bathing is typically carried out manually by a caregiver, using towels, sponges, and a water basin. Nevertheless, this apparently simple task needs some precautions in order to avoid the risk of microbial infections, falls and other injuries. With that in mind, this paper presents the design of a portable washing system, called Bath-Ambience, which enables bedridden patients to be bathed efficiently without having to be moved from their position. This portable system can be installed in different situations, both in a domestic setting, and in specialized institutions, and allows the caregiver to perform the bathing tasks without compromising health and safety, thereby making it possible to offer a comfortable and hygienic procedure to patients, improving their quality of life. This paper presents the design of the portable Bath-Ambience washing system, which provides efficient assistance for bathing bedridden patients without moving them to another place. This system is mainly dedicated for integration a smart home application in to allow bathing everywhere.

Bath-Ambience—A Mechatronic System for Assisting the Caregivers of Bedridden People

Science.gov (United States)

Bezerra, Karolina; Machado, José; Carvalho, Vítor; Castro, Marcelo; Costa, Pedro; Matos, Demétrio; Soares, Filomena

2017-01-01

The health of older people is receiving special attention and dedication nowadays, with the aim of increasing their general wellbeing and quality of life. Studies into different aspects of the care of the elderly have found that emphasis should be given to solving problems related to bathing in different situations and environments. In particular, it is important to develop new assistive technologies to streamline and ease the burden of a caregiver’s daily tasks. Generally-speaking, in the case of bedridden patients, bathing is typically carried out manually by a caregiver, using towels, sponges, and a water basin. Nevertheless, this apparently simple task needs some precautions in order to avoid the risk of microbial infections, falls and other injuries. With that in mind, this paper presents the design of a portable washing system, called Bath-Ambience, which enables bedridden patients to be bathed efficiently without having to be moved from their position. This portable system can be installed in different situations, both in a domestic setting, and in specialized institutions, and allows the caregiver to perform the bathing tasks without compromising health and safety, thereby making it possible to offer a comfortable and hygienic procedure to patients, improving their quality of life. This paper presents the design of the portable Bath-Ambience washing system, which provides efficient assistance for bathing bedridden patients without moving them to another place. This system is mainly dedicated for integration a smart home application in to allow bathing everywhere. PMID:28524114

New features of entanglement dynamics with initial system–bath correlations

Energy Technology Data Exchange (ETDEWEB)

Li, Lin [School of Physics, Beijing Institute of Technology, Beijing 100081 (China); Zou, Jian, E-mail: zoujian@bit.edu.cn [School of Physics, Beijing Institute of Technology, Beijing 100081 (China); He, Zhi; Li, Jun-Gang; Shao, Bin [School of Physics, Beijing Institute of Technology, Beijing 100081 (China); Wu, Lian-Ao [Department of Theoretical Physics and History of Science, The Basque Country University (EHU/UPV), PO Box 644, 48080 Bilbao (Spain)

2012-02-06

We investigate the influence of initial correlations between two qubits and a family of baths on the entanglement dynamics of these two qubits. We show that initial system–bath correlations can effectively avoid the occurrence of entanglement sudden death, and for the initial states with quantum correlations the entanglement between two qubits can be larger than its initial value. Significantly, we find that there exist initial states which we called entanglement preserving states, such that, although the state of the qubit subsystem evolves the entanglement of two qubits does not evolves at all. -- Highlights: ► We obtain analytically solutions of two qubits interacting with a family of baths. ► Having initial quantum correlation with the bath, the system can gain entanglement. ► For some initial states though the system evolves, the entanglement remain the same.

Characteristic functions of quantum heat with baths at different temperatures

Science.gov (United States)

Aurell, Erik

2018-06-01

This paper is about quantum heat defined as the change in energy of a bath during a process. The presentation takes into account recent developments in classical strong-coupling thermodynamics and addresses a version of quantum heat that satisfies quantum-classical correspondence. The characteristic function and the full counting statistics of quantum heat are shown to be formally similar. The paper further shows that the method can be extended to more than one bath, e.g., two baths at different temperatures, which opens up the prospect of studying correlations and heat flow. The paper extends earlier results on the expected quantum heat in the setting of one bath [E. Aurell and R. Eichhorn, New J. Phys. 17, 065007 (2015), 10.1088/1367-2630/17/6/065007; E. Aurell, Entropy 19, 595 (2017), 10.3390/e19110595].

Hospitalized poisonings after renal transplantation in the United States

Directory of Open Access Journals (Sweden)

Viola Rebecca A

2002-11-01

Full Text Available Abstract Background The national incidence of and risk factors for hospitalized poisonings in renal transplant recipients has not been reported. Methods Historical cohort study of 39,628 renal transplant recipients in the United States Renal Data System between 1 July 1994 and 30 June 1998. Associations with time to hospitalizations for a primary diagnosis of poisonings (ICD-9 codes 960.x-989.x within three years after renal transplant were assessed by Cox Regression. Results The incidence of hospitalized poisonings was 2.3 patients per 1000 person years. The most frequent causes of poisonings were immunosuppressive agents (25.3%, analgesics/antipyretics (14.1%, psychotropic agents (10.0%, and insulin/antidiabetic agents (7.1%. In Cox Regression analysis, low body mass index (BMI, 28.3 kg/m2, adjusted hazard ratio (AHR, 3.02, 95% CI, 1.45–6.28, and allograft rejection, AHR 1.83, 95% CI, 1.15–2.89, were the only factors independently associated with hospitalized poisonings. Hospitalized poisonings were independently associated with increased mortality (AHR, 1.54, 95% CI 1.22–1.92, p = 0.002. Conclusions Hospitalized poisonings were associated with increased mortality after renal transplantation. However, almost all reported poisonings in renal transplant recipients were due to the use of prescribed medications. Allograft rejection and low BMI were the only independent risk factors for poisonings identified in this population.

[Stress in parents of hospitalized newborns in a neonatal intensive care unit].

Science.gov (United States)

Palma I, Elisa; Von Wussow K, Fernanda; Morales B, Ignacia; Cifuentes R, Javier; Ambiado T, Sergio

2017-06-01

The birth of a child that requires hospitalization in a Neonatal Intensive Care Unit (NICU) can be very stressful for parents. To determine the stress level of parents of newborns (NB) hospitalized in a level III NICU in Santiago, and its association with clinical and sociodemographic variables. Descriptive cross-sectional study. 373 admissions were evaluated. The sampling was non-probabilistic and included parents of RN admitted to the UPCN between 7 and 21 days of hospitalization. Only parents which have visited the RN at least three times were included. i) Questionnaire to obtain data which could not be obtained from the medical record; ii) Parental Stress Scale: Neonatal Intensive Care Unit (PSS:NICU) which measures the perception of parents about stressors from the physical and psychological environment of the UPCN. 100 parents of 59 hospitalized NB participated in the study. The average parental stress was 2.87±0.69. The subscale scores got higher was “Relationship with the baby and parental role”. Complications in pregnancy, prenatal diagnosis or prenatal hospitalization, did not affect the stress level or the presence of prematurity, respiratory diseases, congenital malformations, genopathies or requirement of mechanical ventilation. Stress levels presented in parents are unrelated to gender and to the studied clinical variables.

Directed motion generated by heat bath nonlinearly driven by external noise

International Nuclear Information System (INIS)

Chaudhuri, J Ray; Barik, D; Banik, S K

2007-01-01

Based on the heat bath system approach where the bath is nonlinearly modulated by an external Gaussian random force, we propose a new microscopic model to study directed motion in the overdamped limit for a nonequilibrium open system. Making use of the coupling between the heat bath and the external modulation as a small perturbation, we construct a Langevin equation with multiplicative noise- and space-dependent dissipation and the corresponding Fokker-Planck-Smoluchowski equation in the overdamped limit. We examine the thermodynamic consistency condition and explore the possibility of observing a phase-induced current as a consequence of state-dependent diffusion and, necessarily, nonlinear driving of the heat bath by the external noise

Directed motion generated by heat bath nonlinearly driven by external noise

Energy Technology Data Exchange (ETDEWEB)

Chaudhuri, J Ray [Department of Physics, Katwa College, Katwa, Burdwan 713 130, West Bengal (India); Barik, D [Indian Association for the Cultivation of Science, Jadavpur, Kolkata 700 032 (India); Banik, S K [Department of Physics, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061-0435 (United States)

2007-12-07

Based on the heat bath system approach where the bath is nonlinearly modulated by an external Gaussian random force, we propose a new microscopic model to study directed motion in the overdamped limit for a nonequilibrium open system. Making use of the coupling between the heat bath and the external modulation as a small perturbation, we construct a Langevin equation with multiplicative noise- and space-dependent dissipation and the corresponding Fokker-Planck-Smoluchowski equation in the overdamped limit. We examine the thermodynamic consistency condition and explore the possibility of observing a phase-induced current as a consequence of state-dependent diffusion and, necessarily, nonlinear driving of the heat bath by the external noise.

Bath of my home (50 yeras report No.1); Wagaya no ofuro (50 nenshi No.1)

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-01-10

Looking back at the history of bath after the war, the fuel, water heating method, hot water method, bathtub, shape of bathroom, bathing tools and bathing method have undergone surprising changes, from the period just after the war for which the number of households having their baths was small and public baths were at the height of their prosperity, to the present period for which households are generally equipped with a shower and bathtub. This paper describes the history of bath after the war in Japan, including the bathing methods and goods which came to stay in each period, placing the focus on the bathing acts and equipment. For 10 years since 1945, the housing shortage had been serious, and public baths had prospered. For this period, the bath heating fuel was mainly coal and firewood, and soap was still valuable. Since 1955, the housing situation had changed better, and the time had entered the age of bath-at-home. Since this period, aluminum bath furnaces had been mass-produced. Neutral shampoo appeared on the market and were sold like hot cakes.

Effect of protic solvents on CdS thin films prepared by chemical bath deposition

Energy Technology Data Exchange (ETDEWEB)

Yao, Pin-Chuan, E-mail: pcyao@mail.dyu.edu.tw; Chen, Chun-Yu

2015-03-31

In this study, cadmium sulfide (CdS) thin films are grown on glass substrates by chemical bath deposition (CBD) in an aqueous bath containing 10–20 vol.% alcohol. The roles of ethanol as a protic solvent that substantially improves the quality of films are explored extensively. The deposited films in an alcohol bath are found to be more compact and smoother with smaller CdS grains. The X-ray diffractograms of the samples confirm that all films were polycrystalline with mixed wurtzite (hexagonal) and zinkblende (cubic) phases. Raman spectra indicate that, for a film deposited in an alcohol bath, the position of 1LO is closer to the value for single crystal CdS, indicating that these films have a high degree of crystallinity. The as-deposited CdS thin films in a 10 vol.% alcohol bath were found to have the highest visible transmittance of 81.9%. XPS analysis reveals a stronger signal of C1s for samples deposited in the alcohol baths, indicating that there are more carbonaceous residues on the films with protic solvent than on the films with water. A higher XPS S/Cd atomic ratio for films deposited in an alcohol bath indicates that undesirable surface reactions (leading to sulfur containing compounds other than CdS) occur less frequently over the substrates. - Highlights: • Study of CBD-CdS films grown in an alcohol-containing aqueous bath is reported. • The deposited films in an alcohol bath are more compact with smaller CdS grains. • Raman spectra show that in an alcohol bath, the CdS film has a better crystallinity. • XPS reveals more carbon residues remain on the films deposited using alcohol bath. • In an alcohol bath, the undesirable surface reactions with Cd ions were hindered.

The use of irradiated food for immunosuppressed hospital patients in the United Kingdom

International Nuclear Information System (INIS)

Pryke, D.C.; Taylor, R.R.

1995-01-01

Irradiation has been recommended as a method for preparing foods for hospital patients requiring sterile diets as a result of intensive therapy or disease that has resulted in suppression of the immune system. It has a number of advantages over other methods and in recognition of this, in the United Kingdom, the use of irradiated foods for hospital patients has been specifically exempted from regulatory control. Due to a number of factors there is a move away from keeping patients in a sterile environment; however, irradiation may still have a role to play for vulnerable and high-risk patients. This paper summarizes the use of radiation-sterilized foods in hospitals in the United Kingdom and discusses the future potential for both radiation-sterilized and ‘radiation-pasturized’ foods

Performance of Inductors Attached to a Galvanizing Bath

Science.gov (United States)

Zhou, Xinping; Yuan, Shuo; Liu, Chi; Yang, Peng; Qian, Chaoqun; Song, Bao

2013-12-01

By taking a galvanizing bath with inductors from an Iron and Steel Co., Ltd as an example, the distributions of Lorentz force and generated heat in the inductor are simulated. As a result, the zinc flow and the temperature distribution driven by the Lorentz force and the generated heat in the inductor of a galvanizing bath are simulated numerically, and their characteristics are analyzed. The relationship of the surface-weighted average velocity at the outlet and the temperature difference between the inlet and the outlet and the effective power for the inductor is studied. Results show that with an increase in effective power for the inductor, the surface-weighted average velocity at the outlet and the temperature difference between the inlet and the outlet increase gradually. We envisage this work to lay a foundation for the study of the performance of the galvanizing bath in future.

A brain slice bath for physiology and compound microscopy, with dual-sided perifusion.

Science.gov (United States)

Heyward, P M

2010-12-01

Contemporary in vitro brain slice studies can employ compound microscopes to identify individual neurons or their processes for physiological recording or imaging. This requires that the bath used to maintain the tissue fits within the working distances of a water-dipping objective and microscope condenser. A common means of achieving this is to maintain thin tissue slices on the glass floor of a recording bath, exposing only one surface of the tissue to oxygenated bathing medium. Emerging evidence suggests that physiology can be compromised by this approach. Flowing medium past both sides of submerged brain slices is optimal, but recording baths utilizing this principle are not readily available for use on compound microscopes. This paper describes a tissue bath designed specifically for microscopy and physiological recording, in which temperature-controlled medium flows past both sides of the slices. A particular feature of this design is the use of concentric mesh rings to support and transport the live tissue without mechanical disturbance. The design is also easily adapted for use with thin acute slices, cultured slices, and acutely dispersed or cultured cells maintained either on cover slips or placed directly on the floor of the bath. The low profile of the bath provides a low angle of approach for electrodes, and allows use of standard condensers, nosepieces and water-dipping objective lenses. If visualization of individual neurons is not required, the bath can be mounted on a simple stand and used with a dissecting microscope. Heating is integral to the bath, and any temperature controller capable of driving a resistive load can be used. The bath is robust, readily constructed and requires minimal maintenance. Full construction and operation details are given. © 2010 The Author Journal of Microscopy © 2010 The Royal Microscopical Society.

The Suitability Of Local Quartz Sand In The Production Of Bath Crucibles.

Directory of Open Access Journals (Sweden)

C. O. Okpanachi

2017-03-01

Full Text Available The suitability of local quartz sand in the production of bath crucibles is a study that was carried out in order to impart overall strength on bath crucibles hence reduce breakages during fettling. Therefore this research constitutes a study to enhance the efficiency of production of bath crucibles by addition of quartz sand in slip preparation. The steps taken in the beneficiation of quartz sand for the production of bath crucibles are comminution which entails crushing and milling classification washing liquid dispersion sizing and reduction of iron content by magnetic separation. The slip contains materials like plastic clay feldspar kaolin talc sodium silicate water quartz sand etc. These were all milled in the ball mill for slip production casting and fettling glazing and sintering to get final bath crucibles as the end products. Quartz sand is used in a variety of products essentially as raw material for the foundry casting and glass industries and also in chemicals water filtration and ceramics the heat resistance nature of quartz sand makes it an excellent refractory substance for these industrial processes. Slip can be prepared for production of bath crucibles without the inclusion of quartz sand however the addition of quartz sand is needed to improve the mechanical performance of the slip in the production of bath crucibles.

The Complexity of the BATH Words in Cardiff English

DEFF Research Database (Denmark)

Mees, Inger; Osorno, Christina Høøck

2017-01-01

This article investigates how a small number of female speakers from Cardiff pronounce items belonging to the lexical set BATH. The data forms a subsample extracted from a longitudinal study on Cardiff English with recordings from 1977, 1990 and 2011. The BATH set comprises items (e.g., chance......, bath) whose citation forms contain the TRAP vowel /æ/ in General American but the PALM vowel /ɑː/ in British RP. In other accents of English, including Cardiff English, the lexical distribution of the items is often less straightforward, with some items taking PALM while others take TRAP. The situation...... analyses. We attempt to establish the social significance attached to the different pronunciations and also to discover if phonological context plays a role for the choice of vowel...

Theories of quantum dissipation and nonlinear coupling bath descriptors

Science.gov (United States)

Xu, Rui-Xue; Liu, Yang; Zhang, Hou-Dao; Yan, YiJing

2018-03-01

The quest of an exact and nonperturbative treatment of quantum dissipation in nonlinear coupling environments remains in general an intractable task. In this work, we address the key issues toward the solutions to the lowest nonlinear environment, a harmonic bath coupled both linearly and quadratically with an arbitrary system. To determine the bath coupling descriptors, we propose a physical mapping scheme, together with the prescription reference invariance requirement. We then adopt a recently developed dissipaton equation of motion theory [R. X. Xu et al., Chin. J. Chem. Phys. 30, 395 (2017)], with the underlying statistical quasi-particle ("dissipaton") algebra being extended to the quadratic bath coupling. We report the numerical results on a two-level system dynamics and absorption and emission line shapes.

The impact of the hospitalization process on the caregiver of a chronic critical patient hospitalized in a Semi-Intensive Care Unit

OpenAIRE

Neves, Letícia; Gondim, Andressa Alencar; Soares, Sara Costa Martins Rodrigues; Coelho, Denis Pontes; Pinheiro, Joana Angélica Marques

2018-01-01

Abstract Objective: To understand the impact of the hospitalization process on the family companion of critical patients admitted to a Semi-Intensive Care Unit (SICU). Method: Exploratory research with a qualitative approach, conducted in the months of April to July of 2016 through a semi-structured interview applied to relatives who were accompanying patients hospitalized in an SICU of a high complexity care hospital in Fortaleza. The interviews were submitted to content analysis. Results...

Herbal bathing: an analysis of variation in plant use among Saramaccan and Aucan Maroons in Suriname.

Science.gov (United States)

van 't Klooster, Charlotte I E A; Haabo, Vinije; Ruysschaert, Sofie; Vossen, Tessa; van Andel, Tinde R

2018-03-15

Herbal baths play an important role in the traditional health care of Maroons living in the interior of Suriname. However, little is known on the differences in plant ingredients used among and within the Maroon groups. We compared plant use in herbal baths documented for Saramaccan and Aucan Maroons, to see whether similarity in species was related to bath type, ethnic group, or geographical location. We hypothesized that because of their dissimilar cultural background, they used different species for the same type of bath. We assumed, however, that plants used in genital baths were more similar, as certain plant ingredients (e.g., essential oils), are preferred in these baths. We compiled a database from published and unpublished sources on herbal bath ingredients and constructed a presence/absence matrix per bath type and study site. To assess similarity in plant use among and within Saramaccan and Aucan communities, we performed three Detrended Correspondence Analyses on species level and the Jaccard Similarity Index to quantify similarity in bath ingredients. We recorded 349 plants used in six commonly used bath types: baby strength, adult strength, skin diseases, respiratory ailments, genital steam baths, and spiritual issues. Our results showed a large variation in plant ingredients among the Saramaccan and Aucans and little similarity between Saramaccans and Aucans, even for the same type of baths. Plant ingredients for baby baths and genital baths shared more species than the others. Even within the Saramaccan community, plant ingredients were stronger associated with location than with bath type. Plant use in bathing was strongly influenced by study site and then by ethnicity, but less by bath type. As Maroons escaped from different plantations and developed their ethnomedicinal practices in isolation, there has been little exchange in ethnobotanical knowledge after the seventeenth century between ethnic groups. Care should be taken in extrapolating plant

[Emotional climate and internal communication in a clinical management unit compared with two traditional hospital services].

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Alonso, E; Rubio, A; March, J C; Danet, A

2011-01-01

The aim of this study is to compare the emotional climate, quality of communication and performance indicators in a clinical management unit and two traditional hospital services. Quantitative study. questionnaire of 94 questions. 83 health professionals (63 responders) from the clinical management unit of breast pathology and the hospital services of medical oncology and radiation oncology. descriptive statistics, comparison of means, correlation and linear regression models. The clinical management unit reaches higher values compared with the hospital services about: performance indicators, emotional climate, internal communication and evaluation of the leadership. An important gap between existing and desired sources, channels, media and subjects of communication appear, in both clinical management unit and traditional services. The clinical management organization promotes better internal communication and interpersonal relations, leading to improved performance indicators. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

Rural model dedicated education unit: partnership between college and hospital.

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Harmon, Lisa M

2013-02-01

This article describes the pilot project development of a rural model Dedicated Education Unit (DEU) by a rural college nursing program and a rural hospital to increase student nurses' confidence and proficiency and improve recruitment of prepared rural staff nurses. Traditionally, for economies of scale, most student clinical rotations occurred in urban settings with the number of students per clinical instructor allowed by the state board of nursing. College budget constraints negated the placement of fewer than this mandated maximum number of students in a rural hospital with a clinical instructor; moreover, rural hospitals could not accommodate 10 students at one time. Rural nursing students were anxious in the urban settings, and this anxiety precluded learning in many instances. Rural hospitals face higher registered nurse vacancies than urban centers. Of the nurses applying for open positions, many were not prepared for the demands of rural nursing, resulting in increased turnover and high orientation costs. The rural model DEU addressed issues of both the nursing program and the hospital. The design and development of the rural model DEU and the advantages of the partnership for the college nursing program and the hospital are discussed. Initial outcomes and serendipitous findings from the pilot project are also discussed. Copyright 2013, SLACK Incorporated.

The oil-dispersion bath in anthroposophic medicine--an integrative review.

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Büssing, Arndt; Cysarz, Dirk; Edelhäuser, Friedrich; Bornhöft, Gudrun; Matthiessen, Peter F; Ostermann, Thomas

2008-12-04

Anthroposophic medicine offers a variety of treatments, among others the oil-dispersion bath, developed in the 1930s by Werner Junge. Based on the phenomenon that oil and water do not mix and on recommendations of Rudolf Steiner, Junge developed a vortex mechanism which churns water and essential oils into a fine mist. The oil-covered droplets empty into a tub, where the patient immerses for 15-30 minutes. We review the current literature on oil-dispersion baths. The following databases were searched: Medline, Pubmed, Embase, AMED and CAMbase. The search terms were 'oil-dispersion bath' and 'oil bath', and their translations in German and French. An Internet search was also performed using Google Scholar, adding the search terms 'study' and 'case report' to the search terms above. Finally, we asked several experts for gray literature not listed in the above-mentioned databases. We included only articles which met the criterion of a clinical study or case report, and excluded theoretical contributions. Among several articles found in books, journals and other publications, we identified 1 prospective clinical study, 3 experimental studies (enrolling healthy individuals), 5 case reports, and 3 field-reports. In almost all cases, the studies described beneficial effects - although the methodological quality of most studies was weak. Main indications were internal/metabolic diseases and psychiatric/neurological disorders. Beyond the obvious beneficial effects of warm bathes on the subjective well-being, it remains to be clarified what the unique contribution of the distinct essential oils dispersed in the water can be. There is a lack of clinical studies exploring the efficacy of oil-dispersion baths. Such studies are recommended for the future.

[The establishment of the hospital-system in the Byzantine Empire].

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Józsa, László

2011-01-01

Byzantine hospitals developed out of Christian institutions for the poor and homeless. Philanthropy provided the initial impulse to create hospices (xenons) and to expand these institutions into specialized medical centers (iatreons or nosokomeions). However the Byzantine nosocomeions resemble more closely modern hospitals than they do any of the institutions of Greek-Roman antiquity or any of the houses of charity in the Latin West during the Middle Ages. Since the 4th century the Byzantine hospitals have stressed the central position of the nosocomeion in Byzantine society at the intersection of state, ecclesiastical and professional interest. In the great cities and in the capital, more than hundred hospitals worked in the East-Roman Empire. The Byzantine hospital rules guaranted patients private beds, required physicians to wash their hands after each examination and arranged the physical plant to keep all the sick warm. The Byzantine hospitals had separate sections (in modern terms: surgery-trauma surgery, internal medicine, ophthalmology, etc.) and at the beginning of the sixth century a separate institution for women. From the sixth century at least, bathing facilities normally adjoined Byzantine nosocomeia. By the twelfth century Byzantine hospitals also set aside a room or perhaps a separate building to treat outpatients. In addition to the main dormitories the surgery, baths and outpatient clinic, the large parts of hospitals also had separate rooms (or adjoining buildings) for library, for lecture hall, for administrative functions and record keeping for storage and for other services.

Bath Stone - a Possible Global Heritage Stone from England

Science.gov (United States)

Marker, Brian

2014-05-01

The Middle Jurassic strata of England have several horizons of oolitic and bioclastic limestones that provide high quality dimension stone. One of the most important is found in and near the City of Bath. The Great Oolite Group (Upper Bathonian) contains the Combe Down and Bath Oolites, consisting of current bedded oolites and shelly oolites, that have been used extensively as freestones for construction nearby, for prestigious buildings through much of southern England and more widely. The stone has been used to some extent since Roman times when the city, then known as Aquae Sulis, was an important hot spa. The stone was used to a limited extent through medieval times but from the early 18th century onwards was exploited on a large scale through surface quarrying and underground mining. The City was extensively redeveloped in the 18th to early 19th century, mostly using Bath Stone, when the spas made it a fashionable resort. Buildings from that period include architectural "gems" such as the Royal Crescent and Pulteney Bridge, as well as the renovated Roman Baths. Many buildings were designed by some of the foremost British architects of the time. The consistent use of this stone gives the City an architectural integrity throughout. These features led to the designation of the City as a World Heritage Site. It is a requirement in current City planning policy documents that Bath Stone should be used for new building to preserve the appearance of the City. More widely the stone was used in major houses (e.g. Buckingham Palace and Apsley House in London; King's Pavilion in Brighton); civic buildings (e.g. Bristol Guildhall; Dartmouth Naval College in Devon); churches and cathedrals (e.g. Truro Cathedral in Cornwall); and engineered structures (e.g. the large Dundas Aqueduct on the Kennet and Avon Canal). More widely, Bath Stone has been used in Union Station in Washington DC; Toronto Bible College and the Town Hall at Cape Town, South Africa. Extraction declined in

Deterioro funcional en ancianos ingresados en un hospital sin unidades geriátricas Functional impairment in elderly inpatients in a hospital without geriatric units

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Alfonso Jesús Cruz Lendínez

2010-03-01

ás influyen en la variación de la capacidad funcional durante la hospitalización. La hospitalización de ancianos en un hospital sin unidad geriátrica supone peores resultados en la capacidad funcional de los pacientes frente a los hospitales que cuentan con unidad de hospitalización geriátrica.Introduction: Increased population of elderly people is becoming more frequent admission to hospitals of people older than 65 years. Hospital stay in conventional units can lead to functional worsening in the elderly. Aim: To identify the profile of elderly patients treated in the Internal Medicine Hospital of Jaén. To analyze variation in functional ability of elderly people following admission to inpatient units of a public hospital. To identify variables that influence the changes in the functional ability of elderly inpatients in hospitals without geriatric units. Methods: Prospective observational study in 3 units of internal medicine units in a hospital belonging to the Andalusian Health Service. A sample of 190 hospitalized elderly patients has been included. Variables related to demographic, hospitalization and functional ability using Barthel Index, were reported. Results: Hospitalization in internal medicine units did not help to improve functional ability in older people; rather, they had a negative effect, promoting functional worsening in an important group of these patients. Depending on the age, among patients studied (65-85 and over, younger patients got better results on functional recovery at discharge, while those above 85 years got worst results. 16% under 85 years and 67.5% of those over 85 lose functional capacity. Conclusions: Most important factors affecting functional ability change during hospitalization were age, functional ability at admission, functional ability at discharge, the presence of companions during hospitalization and discharge destination. Hospitalization of elderly in a nongeriatric inpatient unit at hospital assumes no worse results in

[Evaluation of the activity of a urological emergency unit in university hospital].

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Martin, L; Pillot, P; Bardonnaud, N; Lillaz, J; Chabannes, E; Bernardini, S; Guichard, G; Bittard, H; Kleinclauss, F

2014-01-01

To determine the epidemiology of urological emergencies in a university hospital and the interest of a dedicated urological emergency unit. In 2008, a dedicated urological emergency unit was individualized in our department of urology. We conducted a retrospective study including all patients consulting in this unit in 2009 with epidemiological, clinical and therapeutic data. During 2009, 1257 patients consulted in this unit. Main diagnoses were acute urinary retention (303, 24.11%), renal colic (219, 17.42%), urinary infections (278, 22.11%), postoperative complications (141, 11.22%), symptomatic benign prostate hyperplasia (65, 5.17%), genitourinary cancers (61, 4.85%), trauma of urinary apparel (41, 3.26%), and spermatic cords torsion (10, 0.8%). In 99 cases (7.88%) diagnosis did not involved the urinary system. The treatment was surgical in 213 (17.7%) cases, technical procedure under local anesthesia in 368 (29.3%) and a medical treatment in 675 (53.7%) cases. Six hundred and sixty (52.5%) patients were managed ambulatory whereas 596 (47.5%) needed hospitalization. The opening of a dedicated urological emergency unit lead to 1257 emergency consultations. Frequent etiologies were acute urinary retention, renal colic and urinary infection. The creation of this unit allowed to register and to valorize this emergency activity through the ATU emergency amount. Copyright © 2013. Published by Elsevier Masson SAS.

Review of paediatric cardiology services in district general hospitals in the United Kingdom.

Science.gov (United States)

Andrews, Hannah; Singh, Yogen

2016-03-01

Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

Maternal Coping with Baby Hospitalization at a Neonatal Intensive Care Unit

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Fabiana Pinheiro Ramos

Full Text Available Abstract: Coping is defined by actions of self-regulation of emotions, cognitions, behaviors, and motivational orientation under stress. This study analyzed the maternal coping with hospitalization of premature and low birth weight infants at the Neonatal Intensive Care Unit (NICU, using the Motivational Theory of Coping. A questionnaire, a scale and an interview were applied to 25 mothers three times between birth and hospital discharge. The results showed that the mothers’ first visit to the NICU had strong emotional impact; longer hospitalization periods were linked to the decrease in Delegation coping strategies. There was more Support Seeking after the hospital discharge. Multiparous mothers and those who had a job appeared to be more vulnerable to stress. Predominantly adaptive coping responses were identified, even among two mothers whose babies had died, including Self-Reliance strategies, which were mediated by religious beliefs.

The availability and depiction of synthetic cathinones (bath salts) on the Internet: Do online suppliers employ features to maximize purchases?

Science.gov (United States)

Meyers, Kathleen; Kaynak, Övgü; Bresani, Elena; Curtis, Brenda; McNamara, Ashley; Brownfield, Kristine; Kirby, Kimberly C

2015-07-01

"Bath salts", a derivative of cathinone, a naturally occurring beta-ketone amphetamine analogue found in the leaves of the khat (Catha edulis) plant, is a potent class of designer drugs associated with significant medical and psychiatric consequences. They are commonly used among 20-29 year olds, a group with easy access to the Internet and an inclination to purchase online. Therefore, the Internet has the potential to play a significant role in the distribution and associated consequences of these "legal highs". Google searches were used to determine bath salts availability on retail websites and how different search terms affected the proportion of retail websites obtained. Retail websites were reviewed by two independent raters who examined content with a focus on characteristics that increase the likelihood of online sales. Of the 250 websites found, 31 were unique retail websites. Most retail website hits resulted when a product name was used as the search term. The top three countries hosting retail websites were registered in the United States (n=14; 45%), Germany (n=7; 23%), and the United Kingdom (n=3; 10%). These online drug suppliers provided considerable information and purchasing choice about a variety of synthetic cathinones, legitimized their sites by using recognizable images, online chat features, and mainstream payment and shipping methods, and employed characteristics that promote online purchases. Online designer drug suppliers use sophisticated methods to market unregulated products to consumers. The international community has taken diverse approaches to address designer drugs: legislative bans, harm reduction approaches, an interim regulated legal market. Multifaceted efforts that target bath salt users, suppliers, and emergency/poison control entities are critical to comprehensively address bath salt ingestion and its consequences. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of some addition agents on the electrodeposition of cadmium from acidic chloride baths

International Nuclear Information System (INIS)

Abd El-Halim, A.M.; Baghlaf, A.O.; Sobahi, M.I.

1984-01-01

A further development of a chloride-based cadmium plating bath containing 0.3 M CdCl 2 .(5/2)H 2 O, 0.1 M HCl, 0.4 M H 3 BO 3 and 2.0 M NH 4 Cl (bath I) is described. The influences of the individual addition agents thiourea, coumarin Ni 2+ ions and I - ions on the characteristics of cadmium electrodeposition from acidic chloride electrolytes containing 0.3 M CdCl 2 .(5/2)H 2 O, 0.1 M HCl, 0.4 M H 3 BO 3 , 2.0 M NH 4 Cl, 0.5 M sodium potassium tartrate and 5 g gelatin l -1 (bath II) were studied. Bath II including a combination of the four above-mentioned additives was denoted bath III. The additive-containing bath III produced a brighter but less hard cadmium deposit than the additive-free bath II. The individual effects of melamine, 3-methyl-4-p-methoxyphenylazopyrazol-5-one, dimethylformamide (DMF) and DMF with biacetyl-bis-(benzoylhydrazone) on the cathodic polarization and current efficiency of cadmium electrodeposition from baths II and III, as well as on the morphology and microhardness of the as-plated cadmium deposits, were investigated and discussed. (Auth.)

Conjugate gradient heat bath for ill-conditioned actions.

Science.gov (United States)

Ceriotti, Michele; Bussi, Giovanni; Parrinello, Michele

2007-08-01

We present a method for performing sampling from a Boltzmann distribution of an ill-conditioned quadratic action. This method is based on heat-bath thermalization along a set of conjugate directions, generated via a conjugate-gradient procedure. The resulting scheme outperforms local updates for matrices with very high condition number, since it avoids the slowing down of modes with lower eigenvalue, and has some advantages over the global heat-bath approach, compared to which it is more stable and allows for more freedom in devising case-specific optimizations.

No Exit: Identifying Avoidable Terminal Oncology Intensive Care Unit Hospitalizations

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Hantel, Andrew; Wroblewski, Kristen; Balachandran, Jay S.; Chow, Selina; DeBoer, Rebecca; Fleming, Gini F.; Hahn, Olwen M.; Kline, Justin; Liu, Hongtao; Patel, Bhakti K.; Verma, Anshu; Witt, Leah J.; Fukui, Mayumi; Kumar, Aditi; Howell, Michael D.; Polite, Blase N.

2016-01-01

Purpose: Terminal oncology intensive care unit (ICU) hospitalizations are associated with high costs and inferior quality of care. This study identifies and characterizes potentially avoidable terminal admissions of oncology patients to ICUs. Methods: This was a retrospective case series of patients cared for in an academic medical center’s ambulatory oncology practice who died in an ICU during July 1, 2012 to June 30, 2013. An oncologist, intensivist, and hospitalist reviewed each patient’s electronic health record from 3 months preceding terminal hospitalization until death. The primary outcome was the proportion of terminal ICU hospitalizations identified as potentially avoidable by two or more reviewers. Univariate and multivariate analysis were performed to identify characteristics associated with avoidable terminal ICU hospitalizations. Results: Seventy-two patients met inclusion criteria. The majority had solid tumor malignancies (71%), poor performance status (51%), and multiple encounters with the health care system. Despite high-intensity health care utilization, only 25% had documented advance directives. During a 4-day median ICU length of stay, 81% were intubated and 39% had cardiopulmonary resuscitation. Forty-seven percent of these hospitalizations were identified as potentially avoidable. Avoidable hospitalizations were associated with factors including: worse performance status before admission (median 2 v 1; P = .01), worse Charlson comorbidity score (median 8.5 v 7.0, P = .04), reason for hospitalization (P = .006), and number of prior hospitalizations (median 2 v 1; P = .05). Conclusion: Given the high frequency of avoidable terminal ICU hospitalizations, health care leaders should develop strategies to prospectively identify patients at high risk and formulate interventions to improve end-of-life care. PMID:27601514

Thermodynamic analysis and experimental study on the oxidation of the Zn-Al-Mg coating baths

Energy Technology Data Exchange (ETDEWEB)

Su, Xuping, E-mail: sxping@cczu.edu.cn [Jiangsu Key Laboratory of Materials Surface Science and Technology, Changzhou University, 213164 Jiangsu (China); Jiangsu Collaborative Innovation Center of Photovoltaic Science and Engineering, Changzhou University, 213164 Jiangsu (China); Zhou, Jie; Wang, Jianhua; Wu, Changjun; Liu, Ya; Tu, Hao; Peng, Haoping [Jiangsu Key Laboratory of Materials Surface Science and Technology, Changzhou University, 213164 Jiangsu (China)

2017-02-28

Highlights: • The surface oxidation products of the Zn-Al-Mg melt were analyzed with XPS. • Certain Al must be added in bath containing Mg to get stable galvanizing melts. • The oxidation products vary with the bath composition. • Oxidation can be predicted in galvanizing by using the calculated phase diagrams. • The thermodynamic analysis can be used to design the practical bath melts. - Abstract: Surface oxidation of molten Zn-6Al baths containing 0.0, 3.0 and 6.0 wt. % Mg were analyzed using X-ray photoelectron spectroscopy. γ-Al{sub 2}O{sub 3} is formed on the surface of the Zn-6Al bath, while MgAl{sub 2}O{sub 4} and MgO occur at 460 °C in the Zn-6Al-3Mg and Zn-6Al-6Mg baths, respectively. Thermodynamic analysis on the oxidation of the Zn-Al-Mg baths was performed. Calculated phase diagrams at 460 °C and 560 °C show good agreements with the experimental results. MgO or MgAl{sub 2}O{sub 4} exists in almost the entire composition range of the calculated oxidation diagrams. According to the calculation, oxidation products depend on the composition and temperature of the baths. The primary and secondary oxidation products of the Zn-Al-Mg baths can be reasonably explained by oxidation phase diagrams. Utilizing these results, the favorable practical bath melts and operating conditions can be designed.

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.

Effects of water temperature on photosensitization in bath-PUVA therapy with 8-methoxypsoralen

Energy Technology Data Exchange (ETDEWEB)

Gruss, C.; Kobyletzki, G. von; Reuther, T.; Husebo, L.; Altmeyer, P. [Ruhr-Univ. of Bochum, Bochum (Germany); Behrens, S.; Kerscher, M. [Univ. of Ulm, Dept. of Dermatology, Ulm (Germany)

1998-10-01

The pharmacokinetic aspects of bath-PUVA are not completely clarified. Therefore, we determined the phototoxic response of human skin following psoralen baths at temperatures ranging from 32 deg. C to 42 deg. C (71.6-107.6 deg. F) and UVA doses ranging from 0.5 to 5.5 J/cm{sup 2}. The highest therapeutical photosensitization (i.e. lowest minimal phototoxic dose) was assessed at temperatures of 37 deg. C (98.6 deg. F) and above. Photosensitization was significantly decreased at lower temperatures. These data indicate that a bath temperature of 37 deg. C (98.6 deg. F) should be used to gain optimal therapeutic efficiency in a clinical setting. Furthermore, in order to minimize the risk of adverse phototoxic effects in bath-PUVA, it is important to use a constant temperature during the psoralen bath. (au) 13 refs.

Effects of water temperature on photosensitization in bath-PUVA therapy with 8-methoxypsoralen

International Nuclear Information System (INIS)

Gruss, C.; Kobyletzki, G. von; Reuther, T.; Husebo, L.; Altmeyer, P.; Behrens, S.; Kerscher, M.

1998-01-01

The pharmacokinetic aspects of bath-PUVA are not completely clarified. Therefore, we determined the phototoxic response of human skin following psoralen baths at temperatures ranging from 32 deg. C to 42 deg. C (71.6-107.6 deg. F) and UVA doses ranging from 0.5 to 5.5 J/cm 2 . The highest therapeutical photosensitization (i.e. lowest minimal phototoxic dose) was assessed at temperatures of 37 deg. C (98.6 deg. F) and above. Photosensitization was significantly decreased at lower temperatures. These data indicate that a bath temperature of 37 deg. C (98.6 deg. F) should be used to gain optimal therapeutic efficiency in a clinical setting. Furthermore, in order to minimize the risk of adverse phototoxic effects in bath-PUVA, it is important to use a constant temperature during the psoralen bath. (au)

Topical Decolonization Does Not Eradicate the Skin Microbiota of Community-Dwelling or Hospitalized Adults

Science.gov (United States)

Hogan, Patrick G.; Wallace, Meghan A.; Deych, Elena; Shannon, William; Warren, David K.

2016-01-01

Topical antimicrobials are often employed for decolonization and infection prevention and may alter the endogenous microbiota of the skin. The objective of this study was to compare the microbial communities and levels of richness and diversity in community-dwelling subjects and intensive care unit (ICU) patients before and after the use of topical decolonization protocols. We enrolled 15 adults at risk for Staphylococcus aureus infection. Community subjects (n = 8) underwent a 5-day decolonization protocol (twice daily intranasal mupirocin and daily dilute bleach-water baths), and ICU patients (n = 7) received daily chlorhexidine baths. Swab samples were collected from 5 anatomic sites immediately before and again after decolonization. A variety of culture media and incubation environments were used to recover bacteria and fungi; isolates were identified using matrix-assisted laser desorption ionization–time of flight mass spectrometry. Overall, 174 unique organisms were recovered. Unique communities of organisms were recovered from the community-dwelling and hospitalized cohorts. In the community-dwelling cohort, microbial richness and diversity did not differ significantly between collections across time points, although the number of body sites colonized with S. aureus decreased significantly over time (P = 0.004). Within the hospitalized cohort, richness and diversity decreased over time compared to those for the enrollment sampling (from enrollment to final sampling, P = 0.01 for both richness and diversity). Topical antimicrobials reduced the burden of S. aureus while preserving other components of the skin and nasal microbiota. PMID:27671074

Prediction of Layer Thickness in Molten Borax Bath with Genetic Evolutionary Programming

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Taylan, Fatih

2011-04-01

In this study, the vanadium carbide coating in molten borax bath process is modeled by evolutionary genetic programming (GEP) with bath composition (borax percentage, ferro vanadium (Fe-V) percentage, boric acid percentage), bath temperature, immersion time, and layer thickness data. Five inputs and one output data exist in the model. The percentage of borax, Fe-V, and boric acid, temperature, and immersion time parameters are used as input data and the layer thickness value is used as output data. For selected bath components, immersion time, and temperature variables, the layer thicknesses are derived from the mathematical expression. The results of the mathematical expressions are compared to that of experimental data; it is determined that the derived mathematical expression has an accuracy of 89%.

An international investigation into O red blood cell unit administration in hospitals: the GRoup O Utilization Patterns (GROUP) study.

Science.gov (United States)

Zeller, Michelle P; Barty, Rebecca; Aandahl, Astrid; Apelseth, Torunn O; Callum, Jeannie; Dunbar, Nancy M; Elahie, Allahna; Garritsen, Henk; Hancock, Helen; Kutner, José Mauro; Manukian, Belinda; Mizuta, Shuichi; Okuda, Makoto; Pagano, Monica B; Pogłód, Ryszard; Rushford, Kylie; Selleng, Kathleen; Sørensen, Claess Henning; Sprogøe, Ulrik; Staves, Julie; Weiland, Thorsten; Wendel, Silvano; Wood, Erica M; van de Watering, Leo; van Wordragen-Vlaswinkel, Maria; Ziman, Alyssa; Jan Zwaginga, Jaap; Murphy, Michael F; Heddle, Nancy M; Yazer, Mark H

2017-10-01

Transfusion of group O blood to non-O recipients, or transfusion of D- blood to D+ recipients, can result in shortages of group O or D- blood, respectively. This study investigated RBC utilization patterns at hospitals around the world and explored the context and policies that guide ABO blood group and D type selection practices. This was a retrospective study on transfusion data from the 2013 calendar year. This study included a survey component that asked about hospital RBC selection and transfusion practices and a data collection component where participants submitted information on RBC unit disposition including blood group and D type of unit and recipient. Units administered to recipients of unknown ABO or D group were excluded. Thirty-eight hospitals in 11 countries responded to the survey, 30 of which provided specific RBC unit disposition data. Overall, 11.1% (21,235/191,397) of group O units were transfused to non-O recipients; 22.6% (8777/38,911) of group O D- RBC units were transfused to O D+ recipients, and 43.2% (16,800/38,911) of group O D- RBC units were transfused to recipients that were not group O D-. Disposition of units and hospital transfusion policy varied within and across hospitals of different sizes, with transfusion of group O D- units to non-group O D- patients ranging from 0% to 33%. A significant proportion of group O and D- RBC units were transfused to compatible, nonidentical recipients, although the frequency of this practice varied across sites. © 2017 AABB.

Hospital-based shootings in the United States: 2000 to 2011.

Science.gov (United States)

Kelen, Gabor D; Catlett, Christina L; Kubit, Joshua G; Hsieh, Yu-Hsiang

2012-12-01

Workplace violence in health care settings is a frequent occurrence. Emergency departments (EDs) are considered particularly vulnerable. Gunfire in hospitals is of particular concern; however, information about such workplace violence is limited. Therefore, we characterize US hospital-based shootings from 2000 to 2011. Using LexisNexis, Google, Netscape, PubMed, and ScienceDirect, we searched reports for acute care hospital shooting events in the United States for 2000 through 2011. All hospital-based shootings with at least 1 injured victim were analyzed. Of 9,360 search "hits," 154 hospital-related shootings were identified, 91 (59%) inside the hospital and 63 (41%) outside on hospital grounds. Shootings occurred in 40 states, with 235 injured or dead victims. Perpetrators were overwhelmingly men (91%) but represented all adult age groups. The ED environs were the most common site (29%), followed by the parking lot (23%) and patient rooms (19%). Most events involved a determined shooter with a strong motive as defined by grudge (27%), suicide (21%), "euthanizing" an ill relative (14%), and prisoner escape (11%). Ambient society violence (9%) and mentally unstable patients (4%) were comparatively infrequent. The most common victim was the perpetrator (45%). Hospital employees composed 20% of victims; physician (3%) and nurse (5%) victims were relatively infrequent. Event characteristics that distinguished the ED from other sites included younger perpetrator, more likely in custody, and unlikely to have a personal relationship with the victim (ill relative, grudge, coworker). In 23% of shootings within the ED, the weapon was a security officer's gun taken by the perpetrator. Case fatality inside the hospital was much lower in the ED setting (19%) than other sites (73%). Although it is likely that not every hospital-based shooting was identified, such events are relatively rare compared with other forms of workplace violence. The unpredictable nature of this type of

Reproducible insulin secretion from isolated rat pancreas preparations using an organ bath.

Science.gov (United States)

Morita, Asuka; Ouchi, Motoshi; Terada, Misao; Kon, Hiroe; Kishimoto, Satoko; Satoh, Keitaro; Otani, Naoyuki; Hayashi, Keitaro; Fujita, Tomoe; Inoue, Ken-Ichi; Anzai, Naohiko

2018-02-09

Diabetes mellitus is a lifestyle-related disease that is characterized by inappropriate or diminished insulin secretion. Ex vivo pharmacological studies of hypoglycemic agents are often conducted using perfused pancreatic preparations. Pancreas preparations for organ bath experiments do not require cannulation and are therefore less complex than isolated perfused pancreas preparations. However, previous research has generated almost no data on insulin secretion from pancreas preparations using organ bath preparations. The purpose of this study was to investigate the applicability of isolated rat pancreas preparations using the organ bath technique in the quantitative analysis of insulin secretion from β-cells. We found that insulin secretion significantly declined during incubation in the organ bath, whereas it was maintained in the presence of 1 µM GLP-1. Conversely, amylase secretion exhibited a modest increase during incubation and was not altered in the presence of GLP-1. These results demonstrate that the pancreatic organ bath preparation is a sensitive and reproducible method for the ex vivo assessment of the pharmacological properties of hypoglycemic agents.

Nosocomial infections in hospitalized patients in the burn unit of Hospital Universitario San José, Popayán - Colombia

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Yeni Arroyave

2014-08-01

Full Text Available Objective. To determine the prevalence and microbiological behavior of the infections in hospitalized patients in the burn unit of the University Hospital San José ( HUSJ at Popayan, Colombia, 2010-2011. Methods: A retrospective cross-sectional study was conducted in patients admitted to the burn unit of HUSJ between the years 2010–2011. Patients were characterized sociodemographic and clinically. The prevalence of nosocomial infections was estimated. Frequency and antibiotic resistance of microorganisms isolated was described. Data were analyzed using SPSS version 15. Results. 113 patients was enrolled, the average age was 17.7 years and male gender predominated (55.8%. Hot liquids (64.6% were the principal cause, the average of body surface area burned was 11.3% and the average hospital stay was 19.8 days. 13.3% of the patients had some nosocomial infection. The most frequently diagnosed infections were sepsis (24%, urinary tract infection (20% and pneumonia (20%. Staphylococcus aureus was the most frequent bacteria (41.7% followed by Staphylococcus epidermidis, mostly meticilino-resistant. The mean length of hospital stay and burned surface area (BSA in patients with diagnosis of infection was 36.6 days and 17.3% respectively. Conclusions. The prevalence of infection is similar to that reported in Colombia. The resistance of the isolates was high. The meticilinoresistance of Staphylococcus was associated with clindamicina resistance.

Does a specialist unit improve outcomes for hospitalized patients with Parkinson's disease?

Science.gov (United States)

Skelly, Rob; Brown, Lisa; Fakis, Apostolos; Kimber, Lindsey; Downes, Charlotte; Lindop, Fiona; Johnson, Clare; Bartliff, Caroline; Bajaj, Nin

2014-01-01

Objective Suboptimal management of Parkinson's disease (PD) medication in hospital may lead to avoidable complications. We introduced an in-patient PD unit for those admitted urgently with general medical problems. We explored the effect of the unit on medication management, length of stay and patient experience. Methods We conducted a single-center prospective feasibility study. The unit's core features were defined following consultation with patients and professionals: specially trained staff, ready availability of PD drugs, guidelines, and care led by a geriatrician with specialty PD training. Mandatory staff training comprised four 1 h sessions: PD symptoms; medications; therapy; communication and swallowing. Most medication was prescribed using an electronic Prescribing and Administration system (iSOFT) which provided accurate data on time of administration. We compared patient outcomes before and after introduction of the unit. Results The general ward care (n = 20) and the Specialist Parkinson's Unit care (n = 24) groups had similar baseline characteristics. On the specialist unit: less Parkinson's medication was omitted (13% vs 20%, p < 0.001); of the medication that was given, more was given on time (64% vs 50%, p < 0.001); median length of stay was shorter (9 days vs 13 days, p = 0.043) and patients' experience of care was better (p = 0.01). Discussion If replicated and generalizable to other hospitals, reductions in length of stay would lead to significant cost savings. The apparent improved outcomes with Parkinson's unit care merit further investigation. We hope to test the hypothesis that specialized units are cost-effective and improve patient care using a randomized controlled trial design. PMID:25264022

Experience of family members as a result of children's hospitalization at the Intensive Care Unit

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Maria Virginia Martins Faria Faddul Alves

2013-07-01

Full Text Available Objective. To describe the experience of family members as a result of children's hospitalization at the Intensive Care Unit (ICU. Methodology. Descriptive and cross-sectional study. A structured interview was held with 20 relatives of patients hospitalized at two clinics of the Botucatu Medical School at Universidade Estadual Paulista 'Júlio de Mesquita Filho'. Information was collected between July and September 2010. Results. The main characteristics of the participating relatives were: 80% mothers of the children; 70% low education level and 70% married. Sixty percent of the children were hospitalized at the ICU for the first time. Eighty percent of the interviewees believe that the children's behavior changes inside the unit and 85% consider that visiting hours are sufficient. The predominant negative feelings are fear (50% and insecurity (20%, while the predominant positive feelings are hope (50% and the expectation of discharge (25%. The professional who most supported the relatives was the nurse (35%. Conclusion. The family members' experience as a result of the children's hospitalization at the ICU involves positive and negative aspects, which also affect the child's behavior at the unit.

IMMERSION AND BATH VACCINATION AGAINST ENTERIC REDMOUTH DISEASE (ERM) PROVIDES INSUFFICIENT PROTECTION AGAINST BATH CHALLENGE WITH YERSINIA RUCKERI O1 BIOTYPE 2

DEFF Research Database (Denmark)

Kragelund Strøm, Helene; Otani, Maki; Neumann, Lukas

trout stock which had been vaccinated against both Y.r. bt 1 and 2 with a commercial “state of the art” immersion vaccine and boosted with a commercial ERM oral vaccine 4 month later. The newly isolated Y.r. bt2 strain has been used to develop a standardized challenge model which gives us...... of the vaccine for 30 seconds as recommended by the manufacturer. As a positive control groups of trout were bath vaccinated for 5 minutes. Two months later was all groups bath challenged with Y.r. bt 2 in duplicate. The challenge data obtained in the present study have indicated that neither a “state of the art......” commercial nor the experimental immersion ERM vaccine provided significant protective immunity against the virulent Y.r. bt2 infections. IP. injection of the experimental vaccine without adjuvant induced full protection. Significant mortality were seen in all immersion and bath vaccinated groups...

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

Science.gov (United States)

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

2015-06-01

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

Use of ultrasonic baths for analytical applications: a new approach for optimisation conditions

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Nascentes Clésia C.

2001-01-01

Full Text Available Optimisation conditions for obtaining maximum cavitation intensity in ultrasonic baths are proposed using a simple and fast method. Parameters such as water volume, temperature, detergent concentration, horizontal and vertical positions, number of tubes in the bath, sonication time and bath water substitution were studied. The results obtained for both baths studied (Neytech and Cole-Parmer lead to the following conditions for maximum cavitation intensity: 1 L of water at room temperature, 0.2 % (v/v of detergent, central position on the bottom of the tank. Only one tube at a time should be used inside the bath during the ultrasound application. The cavitation intensity was linear with the sonication time up to 10 minutes and the water substitution during the sonication improved reproducibility. This system using continuous water change makes possible the sonication of 6 consecutive samples, without changes in the water volume.

Isotope investigation of anodic slime movements in copper electrorefining baths

International Nuclear Information System (INIS)

Urbanski, T.; Kohman, L.; Strzelecki, M.; Chojecki, M.; Kaczynska, R.; Wieclaw, B.

1975-01-01

A method was developed and introduced for monitoring the movement of silver-containing anodic slimes in copper electrorefining baths. Radioactive 111 Ag was used as tracer and copper plates labelled with the tracer were inserted into the anodes. During electrorefining the slime produced was continuously marked by the tracer. The activity of 111 Ag was measured at various points inside the bath by sampling and continuously registered with the aid of integrators. It was found that more than 99 percent of the slime slipped to the bottom of the bath close to the anode surface and did not migrate even at highest electrolyte flow rates. Small quantities of suspended slime contained an insignificant concentration of silver and should not be a source of cathode contamination. (author)

Efficacy of reducing agent and surfactant contacting pattern on the performance characteristics of nickel electroless plating baths coupled with and without ultrasound.

Science.gov (United States)

Agarwal, Amrita; Pujari, Murali; Uppaluri, Ramgopal; Verma, Anil

2014-07-01

This article addresses furthering the role of sonication for the optimal fabrication of nickel ceramic composite membranes using electroless plating. Deliberating upon process modifications for surfactant induced electroless plating (SIEP) and combined surfactant and sonication induced electroless plating (SSOEP), this article highlights a novel method of contacting of the reducing agent and surfactant to the conventional electroless nickel plating baths. Rigorous experimental investigations indicated that the combination of ultrasound (in degas mode), surfactant and reducing agent pattern had a profound influence in altering the combinatorial plating characteristics. For comparison purpose, purely surfactant induced nickel ELP baths have also been investigated. These novel insights consolidate newer research horizons for the role of ultrasound to achieve dense metal ceramic composite membranes in a shorter span of total plating time. Surface and physical characterizations were carried out using BET, FTIR, XRD, FESEM and nitrogen permeation experiments. It has been analyzed that the SSOEP baths provided maximum ratio of percent pore densification per unit metal film thickness (PPDδ) and hold the key for further fine tuning of the associated degrees of freedom. On the other hand SIEP baths provided lower (PPDδ) ratio but higher PPD. For SSOEP baths with dropwise reducing agent and bulk surfactant, the PPD and metal film thickness values were 73.4% and 8.4 μm which varied to 66.9% and 13.3 μm for dropwise reducing agent and drop surfactant case. Copyright © 2014 Elsevier B.V. All rights reserved.

How unit level nursing responsibilities are structured in US hospitals.

Science.gov (United States)

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

2007-10-01

To describe (1) the extent to which acute and intensive care units use the elements of nursing models (team, functional, primary, total patient care, patient-focused care, case management) and (2) the deployment of non-unit-based personnel resources. The lack of current data-based behavioral descriptions of the extent to which elements of nursing models are implemented makes it difficult to determine how work models may influence outcomes. Nurse managers of 56 intensive care units and 80 acute care adult units from 40 randomly selected US hospitals participated in a structured interview regarding (1) day-shift use of patient assignment behaviors associated with nursing models and (2) the availability and consistency of assignment of non-unit-based support personnel. No model was implemented fully. Almost all intensive care units reported similar assignment behaviors except in the consistency of patient assignment. Non-intensive care units demonstrated wide variation in assignment patterns. Patterns differed intra-institutionally. There were large differences in the availability and deployment of non-unit-based supportive resources. Administrators must recognize the differences in work models within their institutions as a part of any quality improvement effort. Attempts to test new work models must be rigorous in the measurement of their implementation.

Characteristics of Hospitalized Children With a Diagnosis of Malnutrition: United States, 2010.

Science.gov (United States)

Abdelhadi, Ruba A; Bouma, Sandra; Bairdain, Sigrid; Wolff, Jodi; Legro, Amanda; Plogsted, Steve; Guenter, Peggi; Resnick, Helaine; Slaughter-Acey, Jaime C; Corkins, Mark R

2016-07-01

Malnutrition is common in hospitalized patients in the United States. In 2010, 80,710 of 6,280,710 hospitalized children malnutrition (CDM). This report summarizes nationally representative, person-level characteristics of hospitalized children with a CDM. Data are from the 2010 Healthcare Cost and Utilization Project, which contains patient-level data on hospital inpatient stays. When weighted appropriately, estimates from the project represent all U.S. hospitalizations. The data set contains up to 25 ICD-9-CM diagnostic codes for each patient. Children with a CDM listed during hospitalization were identified. In 2010, 1.3% of hospitalized patients malnutrition's true prevalence may be underrepresented. Length of stay among children with a CDM was almost 2.5 times longer than those without a CDM. Hospital costs for children with a CDM were >3 times higher than those without a CDM. Hospitalized children with a CDM were less likely to have routine discharge and almost 3.5 times more likely to require postdischarge home care. Children with a CDM were more likely to have multiple comorbidities. Hospitalized children with a CDM are associated with more comorbidities, longer hospital stay, and higher healthcare costs than those without this diagnosis. These undernourished children may utilize more healthcare resources in the hospital and community. Clinicians and policymakers should factor this into healthcare resource utilization planning. Recognizing and accurately coding malnutrition in hospitalized children may reveal the true prevalence of malnutrition. © 2016 American Society for Parenteral and Enteral Nutrition.

[Sulphureous mud-bath therapy and changes in blood pressure: observational investigation].

Science.gov (United States)

Costantino, M; Marongiu, M B; Russomanno, G; Conti, V; Manzo, V; Filippelli, A

2015-01-01

The chronic arthropathies currently appear to be a major cause of disability with a negative impact on quality of life and health care spending. The mud-bath therapy is a spa treatment that induces benefic effects in chronic rheumatic diseases. It has long been debated on the assumption that the mud-bath spa therapy could have adverse cardiovascular effects which often induce caution and even a contraindication to the use of this treatment in chronic arthropathies associated with cardiovascular alterations such as hypertension. The aim of this observational study was to investigate, in arthrorheumatic subjects, the effects of sulphureous mud-bath cycle on blood pressure and the possible appearance of adverse drug reaction. 169 patients, with age range 42-86 years, suffering by chronic arthropathies were treated with sulphureous mud-bath therapy for 2 weeks. According to the arterial pressure values, measured before the spa treatment, the patients considered were divided in three groups: with normal blood pressure (NOR group); with high blood pressure, after, the latter group was divided in IPET (patients in treatment with antihypertensive drugs) and IPENT (patients not in antihypertensive therapy). The arterial pressure values, maximum and minimum, expressed in mmHg, were detected in the first (T1) - sixth (T6) and twelfth (T12) day of spa treatment. The media arterial pressure values collected before and after T1, before and after T6, before and after T12 , before T1 and after T12 were compared. The data, presented as mean±SD, were compared with the paired Student t test. A p value ≤0.05 was considered significant. The comparison between the mean values detected in pre and post T1, pre and post T6, pre and post T12 have showed that sulphureous mud-bath therapy induced a significant (pmud-bath therapy (post-T12) vs baseline (pre-T1) have demonstrated: in IPET and IPENT groups a significant (pmud-bath therapy in interdisciplinary therapeutic p rotocol of patients

Electrochemical treatment of spent tan bath solution for reuse

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Amel Benhadji

2018-03-01

Full Text Available A spent tanning bath contains high concentration of salts, chromium and protein. The treatment system for removal of chlorides or chromium from this effluent is expensive. In this context this waste has to be reused. Our study focuses on the application of advanced oxidation processes for protein removal present in a tanning bath. To improve the quality of the chromium tanning bath, two electrochemical processes (electrooxidation and peroxi-electrocoagulation process, PEP are investigated in a batch reactor. The effects of operational parameters such as reactor configuration, current density and electrolysis time on chemical oxygen demand (COD and protein removal efficiency are examined. Results indicated that under the optimum operating range for process, the COD and protein removal efficiency reached 53 and 100%, respectively. The optimum values are determined for the hybrid process (PEP under 0.13 A·cm−2 over 2 h. The treated tanning bath is used as a tanning solution in leather processing. The influence of chromium salt dose, pH solution, stirring time and contact time on the leather characteristic is evaluated. The hides tanned after the addition of 0.25% of commercial chromium salt, at pH solution, leaving them stirring for 4 h with a contact time of 2 days, and showed good hydrothermal stability and physical characteristics of leather.

Decrease in Staphylococcus aureus colonization and hospital-acquired infection in a medical intensive care unit after institution of an active surveillance and decolonization program.

Science.gov (United States)

Fraser, Thomas G; Fatica, Cynthia; Scarpelli, Michele; Arroliga, Alejandro C; Guzman, Jorge; Shrestha, Nabin K; Hixson, Eric; Rosenblatt, Miriam; Gordon, Steven M; Procop, Gary W

2010-08-01

To evaluate the effects of an active surveillance program for Staphylococcus aureus linked to a decolonization protocol on the incidence of healthcare-associated infection and new nasal colonization due to S. aureus. Retrospective quasi-experimental study. An 18-bed medical intensive care unit at a tertiary care center in Cleveland, Ohio. From January 1, 2006, through December 31, 2007, all patients in the medical intensive care unit were screened for S. aureus nasal carriage at admission and weekly thereafter. During the preintervention period, January 1 through September 30, 2006, only surveillance occurred. During the intervention period, January 1 through December 31, 2007, S. aureus carriers received mupirocin intranasally. Beginning in February 2007, carriers also received chlorhexidine gluconate baths. During the preintervention period, 604 (73.7%) of 819 patients were screened for S. aureus nasal carriage, yielding 248 prevalent carriers (30.3%). During the intervention period, 752 (78.3%) of 960 patients were screened, yielding 276 carriers (28.8%). The incidence of S. aureus carriage decreased from 25 cases in 3,982 patient-days (6.28 cases per 1,000 patient-days) before intervention to 18 cases in 5,415 patient-days (3.32 cases per 1,000 patient-days) (P=.04; relative risk [RR], 0.53 [95% confidence interval {CI}, 0.28-0.97]) and from 9.57 to 4.77 cases per 1,000 at-risk patient-days (P=.02; RR, 0.50 [95% CI, 0.27-0.91]). The incidence of S. aureus hospital-acquired bloodstream infection during the 2 periods was 2.01 and 1.11 cases per 1,000 patient-days, respectively (P=.28). The incidence of S. aureus ventilator-associated pneumonia decreased from 1.51 to 0.18 cases per 1,000 patient-days (P=.03; RR, 0.12 [95% CI, 0.01-0.83]). The total incidence of S. aureus hospital-acquired infection decreased from 3.52 to 1.29 cases per 1,000 patient-days (P=.03; RR, 0.37 [95% CI, 0.14-0.90]). Active surveillance for S. aureus nasal carriage combined with

Steady-state entanglement and thermalization of coupled qubits in two common heat baths

Science.gov (United States)

Hu, Li-Zhen; Man, Zhong-Xiao; Xia, Yun-Jie

2018-03-01

In this work, we study the steady-state entanglement and thermalization of two coupled qubits embedded in two common baths with different temperatures. The common bath is relevant when the two qubits are difficult to be isolated to only contact with their local baths. With the quantum master equation constructed in the eigenstate representation of the coupled qubits, we have demonstrated the variations of steady-state entanglement with respect to various parameters of the qubits' system in both equilibrium and nonequilibrium cases of the baths. The coupling strength and energy detuning of the qubits as well as the temperature gradient of the baths are found to be beneficial to the enhancement of the entanglement. We note a dark state of the qubits that is free from time-evolution and its initial population can greatly influence the steady-state entanglement. By virtues of effective temperatures, we also study the thermalization of the coupled qubits and their variations with energy detuning.

222Rn determination in some thermal baths of a central eastern Italian area

International Nuclear Information System (INIS)

Desideri, D.; Bruno, M.R.; Roselli, C.

2004-01-01

Some recent Italian laws, based on the Euratom Directive 26/96, introduce the obligation of monitoring the exposition to natural radioactivity in particular worksites (thermal baths, mines, basements, etc.). Results of 222 Rn measurements in some thermal baths of Rimini and Pesaro-Urbino provinces (Central Eastern Italy), by Radosys-2000, a complete set suitable to radon concentration measurements with CR-39 plastic alpha-track detectors are reported. Some areas where radon could accumulate (bathing, reaction, muddy, inhalation, insufflation rooms and swimming pools) were selected for the investigation. The dosimeters have been exposed for 98 days. The results show that 222 Rn concentrations are very low in the considered thermal baths (7-71 Bq x m -3 ). Moreover, no difference was observed between the concentrations measured in the therapy rooms (bathing, muddy, inhalation and insufflation rooms, swimming pools) and in the normal areas (passages, reaction rooms, dressing rooms, etc.). The calculated dose contribution to workers was about one tenth of the legally suggested value. (author)

75 FR 31691 - Safety Standard for Infant Bath Seats: Final Rule

Science.gov (United States)

2010-06-04

... would actually make the requirement less restrictive than what is already in the voluntary standard. For... various water levels and possible head positions of occupants vs. angles of bath seats to determine what... instructional literature or warnings, it is foreseeable that caregivers will install the bath seat on a wet and...

Early versus delayed post-operative bathing or showering to prevent wound complications.

Science.gov (United States)

Toon, Clare D; Sinha, Sidhartha; Davidson, Brian R; Gurusamy, Kurinchi Selvan

2015-07-23

Many people undergo surgical operations during their life-time, which result in surgical wounds. After an operation the incision is closed using stiches, staples, steri-strips or an adhesive glue. Usually, towards the end of the surgical procedure and before the patient leaves the operating theatre, the surgeon covers the closed surgical wound using gauze and adhesive tape or an adhesive tape containing a pad (a wound dressing) that covers the surgical wound. There is currently no guidance about when the wound can be made wet by post-operative bathing or showering. Early bathing may encourage early mobilisation of the patient, which is good after most types of operation. Avoiding post-operative bathing or showering for two to three days may result in accumulation of sweat and dirt on the body. Conversely, early washing of the surgical wound may have an adverse effect on healing, for example by irritating or macerating the wound, and disturbing the healing environment. To compare the benefits (such as potential improvements to quality of life) and harms (potentially increased wound-related morbidity) of early post-operative bathing or showering (i.e. within 48 hours after surgery, the period during which epithelialisation of the wound occurs) compared with delayed post-operative bathing or showering (i.e. no bathing or showering for over 48 hours after surgery) in patients with closed surgical wounds. We searched The Cochrane Wounds Group Specialised Register (30th June 2015); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); The Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; EBSCO CINAHL; the metaRegister of Controlled Trials (mRCT) and the International Clinical Trials Registry Platform (ICTRP). We considered all randomised trials conducted in patients who had undergone any surgical procedure and had surgical closure of

Comparing the Effect of Foot Reflexology Massage, Foot Bath and Their Combination on Quality of Sleep in Patients with Acute Coronary Syndrome.

Science.gov (United States)

Rahmani, Ali; Naseri, Mahdi; Salaree, Mohammad Mahdi; Nehrir, Batool

2016-12-01

Introduction: Many patients in coronary care unit (CCU) suffer from decreased sleep quality caused by environmental and mental factors. This study compared the efficacy of foot reflexology massage, foot bath, and a combination of them on the quality of sleep of patients with acute coronary syndrome (ACS). Methods: This quasi-experimental study was implemented on ACS patients in Iran. Random sampling was used to divide the patients into four groups of 35 subjects. The groups were foot reflexology massage, foot bath, a combination of the two and the control group. Sleep quality was measured using the Veran Snyder-Halpern questionnaire. Data were analyzed by SPSS version 13. Results: The mean age of the four groups was 61.22 (11.67) years. The mean sleep disturbance in intervention groups (foot reflexology massage and foot bath groups) during the second and third nights was significantly less than before intervention. The results also showed a greater reduction in sleep disturbance in the combined group than in the other groups when compared to the control group. Conclusion: It can be concluded that the intervention of foot bath and massage are effective in reducing sleep disorders and there was a synergistic effect when used in combination. This complementary care method can be recommended to be implemented by CCU nurses.

A Performance Evaluation of Diagnostic X-ray Unit Depends on the Hospitals Size

Energy Technology Data Exchange (ETDEWEB)

Park, Ju Hun [Kaya University, Gimhae (Korea, Republic of); Im, In Chul [Gwangju Health College University, Gwangju (Korea, Republic of); Dong, Kyung Rae [Chosun University, Gwangju (Korea, Republic of); Kang, Se Sik [College of Health Science, Catholic University of Pusan, Busan (Korea, Republic of)

2009-03-15

The purpose of this study is to measure the tube voltage, the tube current/volume, exposure time and exposure dose of diagnostic X-ray unit in each doctor offices, hospitals and general hospitals for evaluating the performance of such device, to learn the method and technology of its measurement and to suggest its importance. Research subjects were total 30 X-ray units and divided into groups of 10 X-ray units each. The tube voltage, the tube current/volume, exposure time and exposure dose were measured using percentage average error, and then reproducibility of exposure dose was measured through calculating coefficient of variation. The results are like followings; The tube voltage correctness examination showed that incongruent devices among total 30 X-ray units were 5 devices (16.7%). The tube current correctness examination showed that incongruent X-ray units were 3 devices (10.0%). The tube current volume correctness examination showed that incongruent X-ray units were 4 devices (13.3%). Finally, according to exposure time correctness examination, incongruent X-ray units were 5 devices (16.7%) and according to reproducibility examination of exposure dose, incongruent X-ray units were 7 devices (23.3%). Above results showed serious problem in performance management based on management regulation of diagnostic X-ray unit; it means that regular checkout and safety management are required, and as doing so, patients will be able to receive good quality of medical service by the reduction of radiation exposure time, image quality administration, unnecessary retake and etc. Therefore, this study suggests that the performance of diagnostic X-ray units should be checked regularly

A Performance Evaluation of Diagnostic X-ray Unit Depends on the Hospitals Size

International Nuclear Information System (INIS)

Park, Ju Hun; Im, In Chul; Dong, Kyung Rae; Kang, Se Sik

2009-01-01

The purpose of this study is to measure the tube voltage, the tube current/volume, exposure time and exposure dose of diagnostic X-ray unit in each doctor offices, hospitals and general hospitals for evaluating the performance of such device, to learn the method and technology of its measurement and to suggest its importance. Research subjects were total 30 X-ray units and divided into groups of 10 X-ray units each. The tube voltage, the tube current/volume, exposure time and exposure dose were measured using percentage average error, and then reproducibility of exposure dose was measured through calculating coefficient of variation. The results are like followings; The tube voltage correctness examination showed that incongruent devices among total 30 X-ray units were 5 devices (16.7%). The tube current correctness examination showed that incongruent X-ray units were 3 devices (10.0%). The tube current volume correctness examination showed that incongruent X-ray units were 4 devices (13.3%). Finally, according to exposure time correctness examination, incongruent X-ray units were 5 devices (16.7%) and according to reproducibility examination of exposure dose, incongruent X-ray units were 7 devices (23.3%). Above results showed serious problem in performance management based on management regulation of diagnostic X-ray unit; it means that regular checkout and safety management are required, and as doing so, patients will be able to receive good quality of medical service by the reduction of radiation exposure time, image quality administration, unnecessary retake and etc. Therefore, this study suggests that the performance of diagnostic X-ray units should be checked regularly

Healthy hospital food initiatives in the United States: time to ban sugar sweetened beverages to reduce childhood obesity

OpenAIRE

Wojcicki, Janet M

2013-01-01

While childhood obesity is a global problem, the extent and severity of the problem in United States, has resulted in a number of new initiatives, including recent hospital initiatives to limit the sale of sweetened beverages and other high calorie drinks in hospital vending machines and cafeterias. These proposed policy changes are not unique to United States, but are more comprehensive in the number of proposed hospitals that they will impact. Meanwhile, however, it is advised, that these i...

Density matrix embedding in an antisymmetrized geminal power bath

International Nuclear Information System (INIS)

Tsuchimochi, Takashi; Welborn, Matthew; Van Voorhis, Troy

2015-01-01

Density matrix embedding theory (DMET) has emerged as a powerful tool for performing wave function-in-wave function embedding for strongly correlated systems. In traditional DMET, an accurate calculation is performed on a small impurity embedded in a mean field bath. Here, we extend the original DMET equations to account for correlation in the bath via an antisymmetrized geminal power (AGP) wave function. The resulting formalism has a number of advantages. First, it allows one to properly treat the weak correlation limit of independent pairs, which DMET is unable to do with a mean-field bath. Second, it associates a size extensive correlation energy with a given density matrix (for the models tested), which AGP by itself is incapable of providing. Third, it provides a reasonable description of charge redistribution in strongly correlated but non-periodic systems. Thus, AGP-DMET appears to be a good starting point for describing electron correlation in molecules, which are aperiodic and possess both strong and weak electron correlation

Relationship between leadership styles of hospital pharmacists and perceptions of work-unit effectiveness.

Science.gov (United States)

Bennett, C R; Grussing, P G; Hutchinson, R A; Stewart, J E

1988-08-01

Relationships between hospital pharmacists' perceptions of their own and their immediate supervisors' leadership styles and their perceptions of the effectiveness of their work units were examined. Pharmacists practicing in 12 large Chicago-area hospitals were asked to complete a four-part questionnaire that consisted of demographic questions, the LEADSelf instrument, the LEADOther instrument, and a measure of perceived work unit effectiveness. Respondents' primary, secondary, and combination leadership styles and their degree of style adaptability were determined and compared with the primary, secondary, and combination leadership styles and style adaptability of their immediate supervisors and with their perceptions of the effectiveness of their work units. Pharmacists involved in providing clinical or drug information services and pharmacists responsible for purchasing activities perceived their work units to be most and least effective, respectively. Most respondents perceived their primary leadership style to be high task-high relationship, but only 32% perceived their immediate supervisors to exhibit this style. Pharmacists who perceived their immediate supervisors to have high relationship leadership styles (based on primary and combination style classifications) had significantly more favorable perceptions of the effectiveness of their work units than did pharmacists who perceived their supervisors to exhibit low relationship styles. Respondents' perceptions of their supervisors' style adaptability were positively and significantly correlated with their perceptions of work-unit effectiveness. Respondents who thought their supervisors' leadership styles were more adaptable than their own had the most favorable perceptions of work-unit effectiveness.(ABSTRACT TRUNCATED AT 250 WORDS)

The disposal of redundant teletherapy units from NHS hospitals

International Nuclear Information System (INIS)

Gaffka, A.P.; Ord, M.A.

1994-01-01

The removal/disposal of redundant teletherapy units from NHS hospitals is described, detailing the operational procedures and the transport package background. The Harwell section of the Transport Technology Department has been carrying out these operations since 1991, where initially the service was just offered to the NHS; however, today their specialist transport service has significantly widened and is now offered to other business sectors. Due to the level of radioactivity found in each teletherapy unit, it was necessary to design a special transport packaging to meet the requirements for shipment of these units. Approval was sought from the Department of Transport to adapt a standard Type B package as no other packaging could be found to comply with the necessary requirements. All work undertaken on the removal and disposal of these units complied with an approved scheme of work and was carried out in accordance with a Quality Assurance workplan. However, to keep abreast of modern standards in a manner which is cost effective to customers and acceptable to the general public, the full development of a new Type B packaging is taking place, which is specifically designed to undertake these removal/disposal duties. (author)

Effects of Forest Bathing on Cardiovascular and Metabolic Parameters in Middle-Aged Males

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Qing Li

2016-01-01

Full Text Available In the present study, we investigated the effects of a forest bathing on cardiovascular and metabolic parameters. Nineteen middle-aged male subjects were selected after they provided informed consent. These subjects took day trips to a forest park in Agematsu, Nagano Prefecture, and to an urban area of Nagano Prefecture as control in August 2015. On both trips, they walked 2.6 km for 80 min each in the morning and afternoon on Saturdays. Blood and urine were sampled before and after each trip. Cardiovascular and metabolic parameters were measured. Blood pressure and pulse rate were measured during the trips. The Japanese version of the profile of mood states (POMS test was conducted before, during, and after the trips. Ambient temperature and humidity were monitored during the trips. The forest bathing program significantly reduced pulse rate and significantly increased the score for vigor and decreased the scores for depression, fatigue, anxiety, and confusion. Urinary adrenaline after forest bathing showed a tendency toward decrease. Urinary dopamine after forest bathing was significantly lower than that after urban area walking, suggesting the relaxing effect of the forest bathing. Serum adiponectin after the forest bathing was significantly greater than that after urban area walking.

Diffusion mechanism in molten salt baths during the production of carbide coatings via thermal reactive diffusion

Institute of Scientific and Technical Information of China (English)

Aliakbar Ghadi; Hassan Saghafian; Mansour Soltanieh; Zhi-gang Yang

2017-01-01

The diffusion mechanism of carbide-forming elements from a molten salt bath to a substrate surface was studied in this research, with particular focus on the processes occurring in the molten bath at the time of coating. Metal, oxide, and metal-oxide baths were investi-gated, and the coating process was performed on H13 steel substrates. Scanning electron microscopy and electron-probe microanalysis were used to study the coated samples and the quenched salt bath. The thickness of the carbide coating layer was 6.5 ± 0.5, 5.2 ± 0.5, or 5.7 ± 0.5μm depending on whether it was deposited in a metal, oxide, or metal-oxide bath, respectively. The phase distribution of vanadium-rich regions was 63%, 57%, and 74% of the total coating deposited in metal, oxide, and metal-oxide baths, respectively. The results obtained using the metal bath indicated that undissolved suspended metal particles deposited onto the substrate surface. Then, carbon subsequently diffused to the sub-strate surface and reacted with the metal particles to form the carbides. In the oxide bath, oxide powders dissolved in the bath with or without binding to the oxidative structure (Na2O) of borax; they were then reduced by aluminum and converted into metal particles. We concluded that, in the metal and oxide baths, the deposition of metal particles onto the sample surface is an important step in the formation of the coating.

Individual units rather than entire hospital as the basis for improvement: the example of two Methicillin resistant Staphylococcus aureus cohort studies

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Gastmeier Petra

2012-02-01

Full Text Available Abstract Background Two MRSA surveillance components exist within the German national nosocomial infection surveillance system KISS: one for the whole hospital (i.e. only hospital based data and no rates for individual units and one for ICU-based data (rates for each individual ICU. The objective of this study was to analyze which surveillance system (a hospital based or a unit based leads to a greater decrease in incidence density of nosocomial MRSA Methods Two cohort studies of surveillance data were used: Data from a total of 224 hospitals and 359 ICUs in the period from 2004 to 2009. Development over time was described first for both surveillance systems. In a second step only data were analyzed from those hospitals/ICUs with continuous participation for at least four years. Incidence rate ratios (IRR with 95% confidence intervals were calculated to compare incidence densities between different time intervals. Results In the baseline year the mean MRSA incidence density of hospital acquired MRSA cases was 0.25 and the mean incidence density of ICU-acquired MRSA was 1.25 per 1000 patient days. No decrease in hospital-acquired MRSA rates was found in a total of 111 hospitals with continuous participation in the hospital- based system. However, in 159 ICUs with continuous participation in the unit-based system, a significant decrease of 29% in ICU-acquired MRSA was identified. Conclusions A unit-based approach of surveillance and feedback seems to be more successful in decreasing nosocomial MRSA rates, compared to a hospital-based approach. Therefore each surveillance system should provide unit-based data to stimulate activities on the unit level.

Reuse of Expired Cefort Drug in Nickel Electrodeposition From Watts Bath

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Delia-Andrada Duca

2017-06-01

Full Text Available This paper demonstrates the possibility to use ceftriaxone (CEFTR active compound from expired Cefort as additive in nickel electrodeposition from Watts baths. Electrochemical behaviour and the influence of CEFTR on nickel electroplating were studied by electrochemical methods. Experimental data recommends CEFTR as additive in nickel electroplating from Watts baths.

Effective interactions between inclusions in an active bath

Science.gov (United States)

Zaeifi Yamchi, Mahdi; Naji, Ali

2017-11-01

We study effective two- and three-body interactions between non-active colloidal inclusions in an active bath of chiral or non-chiral particles, using Brownian dynamics simulations within a standard, two-dimensional model of disk-shaped inclusions and active particles. In a non-chiral active bath, we first corroborate previous findings on effective two-body repulsion mediated between the inclusions by elucidating the detailed non-monotonic features of the two-body force profiles, including a primary maximum and a secondary hump at larger separations that was not previously reported. We then show that these features arise directly from the formation, and sequential overlaps, of circular layers (or "rings") of active particles around the inclusions, as the latter are brought to small surface separations. These rings extend to radial distances of a few active-particle radii from the surface of inclusions, giving the hard-core inclusions relatively thick, soft, repulsive "shoulders," whose multiple overlaps then enable significant (non-pairwise) three-body forces in both non-chiral and chiral active baths. The resulting three-body forces can even exceed the two-body forces in magnitude and display distinct repulsive and attractive regimes at intermediate to large self-propulsion strengths. In a chiral active bath, we show that, while active particles still tend to accumulate at the immediate vicinity of the inclusions, they exhibit strong depletion from the intervening region between the inclusions and partial depletion from relatively thick, circular zones further away from the inclusions. In this case, the effective, predominantly repulsive interactions between the inclusions turn to active, chirality-induced, depletion-type attractions, acting over an extended range of separations.

Characteristics of sudden bath-related death investigated by medical examiners in Tokyo, Japan.

Science.gov (United States)

Suzuki, Hideto; Hikiji, Wakako; Tanifuji, Takanobu; Abe, Nobuyuki; Fukunaga, Tatsushige

2015-01-01

Sudden bath-related deaths occur frequently in Japan, particularly among elderly people. However, the precise mechanism of bath-related death remains uncertain, and effective prevention strategies have not been established. Cases of bath-related deaths (n = 3289) were selected from all cases handled by the Tokyo Medical Examiner's Office from 2009 to 2011 (N = 41 336). The ages and occurrence dates were examined, and major autopsy findings, including toxicological analysis, were evaluated for the autopsied cases (n = 550). Most cases occurred in individuals older than 60 years of age during winter. Analysis of autopsy findings revealed water inhalation signs in many cases (n = 435, 79.1%). Circulatory system diseases constituted more than half of the pathological findings regarding factors that may have contributed significantly to death (n = 300, 54.5%), and cardiac lesions were the most common pathological finding (n = 250, 45.5%). However, approximately one-third of the cases exhibited no remarkable pathological findings (n = 198, 36.0%). A quarter of all cases involved blood ethanol levels that exceeded 0.5 mg/mL (n = 140). The results suggested that drowning plays an important role in the final process of bath-related death. Circulatory system diseases may be the primary underlying pathology; however, there were variations in the medical histories and pathologies of cases of bath-related death. From a preventive perspective, family members should pay attention to elderly people with circulatory system diseases during bathing, particularly in winter. Additionally, the notion that ill or inebriated individuals should not take baths should be reinforced.

Method and apparatus for replenishing the helium bath in the rotor of a superconducting generator

International Nuclear Information System (INIS)

Hofmann, A.; Schnapper, C.

1980-01-01

In order to replenish a helium bath in the super-conducting rotor of an electrical machine, in which bath liquid helium boils at subatmospheric pressure, with liquid helium from a helium reservoir, the liquid helium in the reservoir being at ambient pressure and a part of the liquid helium changing to the vapor phase during flow from the reservoir to the bath, liquid helium is introduced into the bath at a distance from the rotor axis of rotation, the liquid and vapor phases of the helium flowing from the reservoir to the bath are separated from one another in a phase separator fixed to the rotor, and the separated vapor phase is extracted from the separator. (MM) [de

The oil-dispersion bath in anthroposophic medicine – an integrative review

Science.gov (United States)

Büssing, Arndt; Cysarz, Dirk; Edelhäuser, Friedrich; Bornhöft, Gudrun; Matthiessen, Peter F; Ostermann, Thomas

2008-01-01

Background Anthroposophic medicine offers a variety of treatments, among others the oil-dispersion bath, developed in the 1930s by Werner Junge. Based on the phenomenon that oil and water do not mix and on recommendations of Rudolf Steiner, Junge developed a vortex mechanism which churns water and essential oils into a fine mist. The oil-covered droplets empty into a tub, where the patient immerses for 15–30 minutes. We review the current literature on oil-dispersion baths. Methods The following databases were searched: Medline, Pubmed, Embase, AMED and CAMbase. The search terms were 'oil-dispersion bath' and 'oil bath', and their translations in German and French. An Internet search was also performed using Google Scholar, adding the search terms 'study' and 'case report' to the search terms above. Finally, we asked several experts for gray literature not listed in the above-mentioned databases. We included only articles which met the criterion of a clinical study or case report, and excluded theoretical contributions. Results Among several articles found in books, journals and other publications, we identified 1 prospective clinical study, 3 experimental studies (enrolling healthy individuals), 5 case reports, and 3 field-reports. In almost all cases, the studies described beneficial effects – although the methodological quality of most studies was weak. Main indications were internal/metabolic diseases and psychiatric/neurological disorders. Conclusion Beyond the obvious beneficial effects of warm bathes on the subjective well-being, it remains to be clarified what the unique contribution of the distinct essential oils dispersed in the water can be. There is a lack of clinical studies exploring the efficacy of oil-dispersion baths. Such studies are recommended for the future. PMID:19055811

The oil-dispersion bath in anthroposophic medicine – an integrative review

Directory of Open Access Journals (Sweden)

Bornhöft Gudrun

2008-12-01

Full Text Available Abstract Background Anthroposophic medicine offers a variety of treatments, among others the oil-dispersion bath, developed in the 1930s by Werner Junge. Based on the phenomenon that oil and water do not mix and on recommendations of Rudolf Steiner, Junge developed a vortex mechanism which churns water and essential oils into a fine mist. The oil-covered droplets empty into a tub, where the patient immerses for 15–30 minutes. We review the current literature on oil-dispersion baths. Methods The following databases were searched: Medline, Pubmed, Embase, AMED and CAMbase. The search terms were 'oil-dispersion bath' and 'oil bath', and their translations in German and French. An Internet search was also performed using Google Scholar, adding the search terms 'study' and 'case report' to the search terms above. Finally, we asked several experts for gray literature not listed in the above-mentioned databases. We included only articles which met the criterion of a clinical study or case report, and excluded theoretical contributions. Results Among several articles found in books, journals and other publications, we identified 1 prospective clinical study, 3 experimental studies (enrolling healthy individuals, 5 case reports, and 3 field-reports. In almost all cases, the studies described beneficial effects – although the methodological quality of most studies was weak. Main indications were internal/metabolic diseases and psychiatric/neurological disorders. Conclusion Beyond the obvious beneficial effects of warm bathes on the subjective well-being, it remains to be clarified what the unique contribution of the distinct essential oils dispersed in the water can be. There is a lack of clinical studies exploring the efficacy of oil-dispersion baths. Such studies are recommended for the future.

Factors associated with variations in hospital expenditures for acute heart failure in the United States.

Science.gov (United States)

Ziaeian, Boback; Sharma, Puza P; Yu, Tzy-Chyi; Johnson, Katherine Waltman; Fonarow, Gregg C

2015-02-01

Relatively little contemporary data are available that describe differences in acute heart failure (AHF) hospitalization expenditures as a function of patient and hospital characteristics, especially from a population-based investigation. This study aimed to evaluate factors associated with variations in hospital expenditures for AHF in the United States. A cross-sectional analysis using discharge data from the 2011 Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, was conducted. Discharges with primary International Classification of Diseases, Ninth Revision, Clinical Modification, diagnosis codes for AHF in adults were included. Costs were estimated by converting Nationwide Inpatient Sample charge data using the Healthcare Cost and Utilization Project Cost-to-Charge Ratio File. Discharges with highest (≥80th percentile) versus lowest (≤20th percentile) costs were compared for patient characteristics, hospital characteristics, utilization of procedures, and outcomes. Of the estimated 1 million AHF hospital discharges, the mean cost estimates were $10,775 per episode. Younger age, higher percentage of obesity, atrial fibrillation, pulmonary disease, fluid/electrolyte disturbances, renal insufficiency, and greater number of cardiac/noncardiac procedures were observed in stays with highest versus lowest costs. Highest-cost discharges were more likely to be observed in urban and teaching hospitals. Highest-cost AHF discharges also had 5 times longer length of stay, were 9 times more costly, and had higher in-hospital mortality (5.6% vs 3.5%) compared with discharges with lowest costs (all P heart failure hospitalizations are costly. Expenditures vary markedly among AHF hospitalizations in the United States, with substantial differences in patient and hospital characteristics, procedures, and in-hospital outcomes among discharges with highest compared with lowest costs. Copyright © 2014 Elsevier Inc. All rights reserved.

Antimony sulfide thin films prepared by laser assisted chemical bath deposition

International Nuclear Information System (INIS)

Shaji, S.; Garcia, L.V.; Loredo, S.L.; Krishnan, B.

2017-01-01

Highlights: • Antimony sulfide thin films were prepared by normal CBD and laser assisted CBD. • Characterized these films using XRD, XPS, AFM, optical and electrical measurements. • Accelerated growth was observed in the laser assisted CBD process. • These films were photoconductive. - Abstract: Antimony sulfide (Sb_2S_3) thin films were prepared by laser assisted chemical bath deposition (LACBD) technique. These thin films were deposited on glass substrates from a chemical bath containing antimony chloride, acetone and sodium thiosulfate under various conditions of normal chemical bath deposition (CBD) as well as in-situ irradiation of the chemical bath using a continuous laser of 532 nm wavelength. Structure, composition, morphology, optical and electrical properties of the Sb_2S_3 thin films produced by normal CBD and LACBD were analyzed by X-Ray diffraction (XRD), Raman Spectroscopy, Atomic force microscopy (AFM), X-Ray photoelectron spectroscopy (XPS), UV–vis spectroscopy and Photoconductivity. The results showed that LACBD is an effective synthesis technique to obtain Sb_2S_3 thin films for optoelectronic applications.

Antimony sulfide thin films prepared by laser assisted chemical bath deposition

Energy Technology Data Exchange (ETDEWEB)

Shaji, S., E-mail: sshajis@yahoo.com [Facultad de Ingeniería Mecánica y Eléctrica, Universidad Autónoma de Nuevo León, Av. Pedro de Alba s/n, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León, 66455 (Mexico); CIIDIT—Universidad Autónoma de Nuevo León, Apodaca, Nuevo León (Mexico); Garcia, L.V. [Facultad de Ingeniería Mecánica y Eléctrica, Universidad Autónoma de Nuevo León, Av. Pedro de Alba s/n, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León, 66455 (Mexico); Loredo, S.L. [Centro de Investigación en Materiales Avanzados (CIMAV), Unidad Monterrey, PIIT, Apodaca, Nuevo León (Mexico); Krishnan, B. [Facultad de Ingeniería Mecánica y Eléctrica, Universidad Autónoma de Nuevo León, Av. Pedro de Alba s/n, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León, 66455 (Mexico); CIIDIT—Universidad Autónoma de Nuevo León, Apodaca, Nuevo León (Mexico); and others

2017-01-30

Highlights: • Antimony sulfide thin films were prepared by normal CBD and laser assisted CBD. • Characterized these films using XRD, XPS, AFM, optical and electrical measurements. • Accelerated growth was observed in the laser assisted CBD process. • These films were photoconductive. - Abstract: Antimony sulfide (Sb{sub 2}S{sub 3}) thin films were prepared by laser assisted chemical bath deposition (LACBD) technique. These thin films were deposited on glass substrates from a chemical bath containing antimony chloride, acetone and sodium thiosulfate under various conditions of normal chemical bath deposition (CBD) as well as in-situ irradiation of the chemical bath using a continuous laser of 532 nm wavelength. Structure, composition, morphology, optical and electrical properties of the Sb{sub 2}S{sub 3} thin films produced by normal CBD and LACBD were analyzed by X-Ray diffraction (XRD), Raman Spectroscopy, Atomic force microscopy (AFM), X-Ray photoelectron spectroscopy (XPS), UV–vis spectroscopy and Photoconductivity. The results showed that LACBD is an effective synthesis technique to obtain Sb{sub 2}S{sub 3} thin films for optoelectronic applications.

Profile of nursing diagnoses of hospitalized patients in an infectious disease unit

OpenAIRE

Souza Neto, Vinicius Lino de; Andrade, Lidiane Lima de; Agra, Glenda; Costa, Marta Miriam Lopes; Silva, Richardson Augusto Rosendo da

2015-01-01

Objective: To define the profile of nursing diagnoses of hospitalized patients at an infectious diseases unit.Methods: This is a descriptive study based on the quantitative approach conducted at an infectious diseases unit in Paraiba, Brazil, from January to February 2014. The data collection instrument was based on the Theory of Basic Human Needs by Wanda de Aguiar Horta, followed by the classification system CIPE(r) version 2.0 to construct the diagnoses.Results: Data analysis resulted in 3...

Risk Management in Csr Unit of Shams Hospital Using FMEA Technique -Tabriz

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Mohammad Saadati

2015-08-01

Full Text Available Background and Objectives : Since one of the effective ways to prevent infections is the proper sterilization of instruments, CSR is one of the most important units in hospitals. Thus, risk management has a high priority in CSR. The aim of this study was to identify and prevent potential risks in CSR unit in Shams Hospital using FMEA technique. Material and Methods : This is a descriptive and interventional study. Using FMEA technique, potential risks were identified. Risks were prioritized and corrective interventions were implemented to reduce risks. Results : The current study identified 69 risks that 10 risks were marked as high priority. Corrective activities were suggested by risk management teams which were applied. Conclusion : The results showed that flaws in safety policies, equipment and physical conditions were the most important risk factors. Implementing risk management plan and clear safety policies could be useful. ​

Stochastic Stirling Engine Operating in Contact with Active Baths

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Ruben Zakine

2017-04-01

Full Text Available A Stirling engine made of a colloidal particle in contact with a nonequilibrium bath is considered and analyzed with the tools of stochastic energetics. We model the bath by non Gaussian persistent noise acting on the colloidal particle. Depending on the chosen definition of an isothermal transformation in this nonequilibrium setting, we find that either the energetics of the engine parallels that of its equilibrium counterpart or, in the simplest case, that it ends up being less efficient. Persistence, more than non-Gaussian effects, are responsible for this result.

Stochastic Stirling Engine Operating in Contact with Active Baths

Science.gov (United States)

Zakine, Ruben; Solon, Alexandre; Gingrich, Todd; van Wijland, Frédéric

2017-04-01

A Stirling engine made of a colloidal particle in contact with a nonequilibrium bath is considered and analyzed with the tools of stochastic energetics. We model the bath by non Gaussian persistent noise acting on the colloidal particle. Depending on the chosen definition of an isothermal transformation in this nonequilibrium setting, we find that either the energetics of the engine parallels that of its equilibrium counterpart or, in the simplest case, that it ends up being less efficient. Persistence, more than non Gaussian effects, are responsible for this result.

Additive Benefits of Twice Forest Bathing Trips in Elderly Patients with Chronic Heart Failure.

Science.gov (United States)

Mao, Gen Xiang; Cao, Yong Bao; Yang, Yan; Chen, Zhuo Mei; Dong, Jian Hua; Chen, Sha Sha; Wu, Qing; Lyu, Xiao Ling; Jia, Bing Bing; Yan, Jing; Wang, Guo Fu

2018-02-01

Chronic heart failure (CHF), a clinical syndrome resulting from the consequences of various cardiovascular diseases (CVDs), is increasingly becoming a global cause of morbidity and mortality. We had earlier demonstrated that a 4-day forest bathing trip can provide an adjunctive therapeutic influence on patients with CHF. To further investigate the duration of the impact and the optimal frequency of forest bathing trips in patients with CHF, we recruited those subjects who had experienced the first forest bathing trip again after 4 weeks and randomly categorized them into two groups, namely, the urban control group (city) and the forest bathing group (forest). After a second 4-day forest bathing trip, we observed a steady decline in the brain natriuretic peptide levels, a biomarker of heart failure, and an attenuated inflammatory response as well as oxidative stress. Thus, this exploratory study demonstrated the additive benefits of twice forest bathing trips in elderly patients with CHF, which could further pave the way for analyzing the effects of such interventions in CVDs. Copyright © 2018 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

The influence of nonbilinear system-bath coupling on quantum-mechanical activated rate processes

International Nuclear Information System (INIS)

Navrotskaya, Irina; Geva, Eitan

2006-01-01

The dependence of quantum-mechanical activated rate processes on the system-bath coupling strength was investigated in the case of a double-well nonbilinearly coupled to a harmonic bath, where the system-bath coupling is linear in the bath coordinates and nonlinear in the reaction coordinate. Such nonbilinear coupling is known to give rise to a classical friction kernel which is explicitly dependent on the reaction coordinate. We show that it can also lead to quantum-mechanical barrier-crossing rates, whose dependence on the system-bath coupling strength is qualitatively different from that observed in the quantum-mechanical bilinear case and classical nonbilinear case. More specifically, it is shown that the quantum-mechanical barrier-crossing rate may monotonically increase as a function of the system-bath coupling strength, in cases where the classical barrier-crossing rate goes through a turnover, and that the rate of quantum-mechanical barrier-crossing can be lower than that of classical barrier-crossing. We show that those purely quantum-mechanical effects are of a thermodynamical, rather than dynamical, nature, and that they originate from the difference in friction between the barrier top and the reactant and product wells. Our conclusions are supported by results obtained via the CMD method, which were also found to be in very good agreement with numerically exact calculations based on the QUAPI method

The evaluation of primary care unit of Mahasarakham Hospital.

Science.gov (United States)

Asavatanabodee, Paibool

2010-02-01

To evaluate the one-year performance outcome of Community Medical Care Unit (CMU) in Mahasarakham Hospital. This cross-sectional descriptive study used the CIPP model. The target population was divided into two groups. The first group consisted of the executive committee of Mahasarakham Hospital including one director, five Vice-directors, and 16 CMU paramedical personnel and public health administrators. The second group consisted of 281 randomized people in the service area of CMU, Mahasarakham Hospital. The overall outcome evaluation of both groups was high with mean of 3.53 and 3.86, respectively. The evaluation of context, input, and output was ranked high in both groups while the process ranking was moderate in the first group and high in the other group. The present study proposed that project guidelines be explicit policies, improvement in behavioral service, appropriate workload, adequate parking lot, and network sharing of hospital data bank. The quality and efficiency of CMU project are dependent upon explicit policy, well-planned structure of organization, efficient-informative systems, good development plan, and adequate manpower. The personnel should plan the project process and continuously improve the system. CMU project would be neither successful nor beneficial for the development ofpublic health care system if it lacked the participation of the people in the community and associated networks. The results of the present study might be the useful data for improving and developing the pattern of community healthcare service in urban area.

Quality Control in Radiological Unit of Three Hospitals in Makurdi, Benue State

International Nuclear Information System (INIS)

Akaagerger, N.B.

2013-01-01

Quality Control in Radiological units of three hospitals in Makurdi, Benue State, designed A, B and C, was done using beam alignment and collimator test tool on single phase diagnostic X-ray machines. The collimator and beam alignment tests were used to measure the degree of misalignment of the target point. The results of this work shows that the misalignment falls within the acceptable limit. Hospital A (Federal Medical Center, Makurdi), has a misalignment of 0.2cm at 60KVp, 10mAs, 100cm FFD, film size of 10 x 8cm square. Hospital B (Bishop Murray Medical Center, Makurdi) has a misalignment of 0.6cm at 60KVp, 25mAs, 81cm FFD and a film size of 10 x 8cm square and Hospital C (Hemko Hospital, Makurdi) has a misalignment of 0.8cm at 60KVp, 20mA s, 88cm FFD and a film size of 10 x 8cm-square. These show that Hospital A has the least misalignment, followed by B, with C as the highest. These results also show the misalignment fall within 2.0cm as recommended by ICRP.

Effect of temperature and pH of ammonium galvanic bath on the properties of Zn-Co alloy coatings

Energy Technology Data Exchange (ETDEWEB)

Maciej, A; Michalska, J [Department of Materials Science, Silesian University of Technology, 40-019 Katowice (Poland); Simka, W; Nawrat, G; Piotrowski, J, E-mail: artur.maciej@polsl.pl [Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice (Poland)

2011-05-15

The results of investigations on Zn-Co coatings obtained electrochemically in acidic and neutral ammonium baths are presented. The chemical composition, morphology and surface roughness of received coatings were determined together with the current efficiency. It was found that the coatings morphology depends on the process parameters. In the case of neutral bath the increase of bath temperature resulted in decrease of cobalt contents in the coatings, whereas it was not practically observed for acidic baths. It was also observed that surface roughness of the Zn-Co coatings decreased with the increase of temperature for both types of baths. It was also found that the grain size of coatings obtained in neutral bath depends on pH of bath.

Inverse Leidenfrost effect: self-propelling drops on a bath

Science.gov (United States)

Gauthier, Anais; van der Meer, Devaraj; Lohse, Detlef; Physics of Fluids Team

2017-11-01

When deposited on very hot solid, volatile drops can levitate over a cushion of vapor, in the so-called Leidenfrost state. This phenomenon can also be observed on a hot bath and similarly to the solid case, drops are very mobile due to the absence of contact with the substrate that sustains them. We discuss here a situation of ``inverse Leidenfrost effect'' where room-temperature drops levitate on a liquid nitrogen pool - the vapor is generated here by the bath sustaining the relatively hot drop. We show that the drop's movement is not random: the liquid goes across the bath in straight lines, a pattern only disrupted by elastic bouncing on the edges. In addition, the drops are initially self-propelled; first at rest, they accelerate for a few seconds and reach velocities of the order of a few cm/s, before slowing down. We investigate experimentally the parameters that affect their successive acceleration and deceleration, such as the size and nature of the drops and we discuss the origin of this pattern.

Mapping of an ultrasonic bath for ultrasound assisted extraction of mangiferin from Mangifera indica leaves.

Science.gov (United States)

Kulkarni, Vrushali M; Rathod, Virendra K

2014-03-01

The present work deals with the mapping of an ultrasonic bath for the maximum extraction of mangiferin from Mangifera indica leaves. I3(-) liberation experiments (chemical transformations) and extraction (physical transformations) were carried out at different locations in an ultrasonic bath and compared. The experimental findings indicated a similar trend in variation in an ultrasonic bath by both these methods. Various parameters such as position and depth of vessel in an ultrasonic bath, diameter and shape of a vessel, frequency and input power which affect the extraction yield have been studied in detail. Maximum yield of mangiferin obtained was approximately 31 mg/g at optimized parameters: distance of 2.54 cm above the bottom of the bath, 7 cm diameter of vessel, flat bottom vessel, 6.35 cm liquid height, 122 W input power and 25 kHz frequency. The present work indicates that the position and depth of vessel in an ultrasonic bath, diameter and shape of a vessel, frequency and input power have significant effect on the extraction yield. This work can be used as a base for all ultrasonic baths to obtain maximum efficiency for ultrasound assisted extraction. Copyright © 2013 Elsevier B.V. All rights reserved.

Two-Dimensional Physical and CFD Modelling of Large Gas Bubble Behaviour in Bath Smelting Furnaces

Directory of Open Access Journals (Sweden)

Yuhua Pan

2010-09-01

Full Text Available The behaviour of large gas bubbles in a liquid bath and the mechanisms of splash generation due to gas bubble rupture in high-intensity bath smelting furnaces were investigated by means of physical and mathematical (CFD modelling techniques. In the physical modelling work, a two-dimensional Perspex model of the pilot plant furnace at CSIRO Process Science and Engineering was established in the laboratory. An aqueous glycerol solution was used to simulate liquid slag. Air was injected via a submerged lance into the liquid bath and the bubble behaviour and the resultant splashing phenomena were observed and recorded with a high-speed video camera. In the mathematical modelling work, a two-dimensional CFD model was developed to simulate the free surface flows due to motion and deformation of large gas bubbles in the liquid bath and rupture of the bubbles at the bath free surface. It was concluded from these modelling investigations that the splashes generated in high-intensity bath smelting furnaces are mainly caused by the rupture of fast rising large gas bubbles. The acceleration of the bubbles into the preceding bubbles and the rupture of the coalescent bubbles at the bath surface contribute significantly to splash generation.

Generation of a bubble universe using a negative energy bath

International Nuclear Information System (INIS)

Hwang, Dong-il; Yeom, Dong-han

2011-01-01

This paper suggests a model for a bubble universe using buildable false vacuum bubbles. We study the causal structures of collapsing false vacuum bubbles using double-null simulations. False vacuum bubbles violate the null energy condition and emit negative energy along the outgoing direction through semi-classical effects. If there are a few collapsing false vacuum bubbles and they emit negative energy to a certain region, then the region can be approximated by a negative energy bath, which means that the region is homogeneously filled by negative energy. If a false vacuum bubble is generated in the negative energy bath and the tension of the bubble effectively becomes negative in the bath, then the bubble can expand and form an inflating bubble universe. This scenario uses a set of assumptions different from those in previous studies because it does not require tunneling to unbuildable bubbles.

Bath parameter dependence of chemically deposited Copper Selenide thin film

International Nuclear Information System (INIS)

Al-Mamun; Islam, A.B.M.O.

2004-09-01

In this article, a low cost chemical bath deposition (CBD) technique has been used for the preparation Of Cu 2-x Se thin films on to glass substrate. Different thin fms (0.2-0.6/μm) were prepared by adjusting the bath parameter like concentration of ammonia, deposition time, temperature of the solution, and the ratios of the mixing composition between copper and selenium in the reaction bath. From these studies, it reveals that at low concentration of ammonia or TEA, the terminal thicknesses of the films are less, which gradually increases with the increase of concentrations and then drop down at still higher concentrations. It has been found that completing the Cu 2+ ions with EA first, and then addition of ammonia yields better results than the reverse process. The film thickness increases with the decrease of value x of Cu 2-x Se. (author)

Care of "new" long-stay patients in a district general hospital psychiatric unit. The first two years of a hospital-hostel.

Science.gov (United States)

Gibbons, J S

1986-05-01

The paper describes the need for long-term inpatient care in an English health district whose psychiatric services were based on a unit in a District General Hospital. Patients who became long-stay were placed in a new hospital-hostel in a city centre. Three quarters of those eligible could be managed in the hostel, with those rejected posing more control problems. Patients in the hostel became less withdrawn and increased their activity and use of community facilities.

Effects of single moor baths on physiological stress response and psychological state: a pilot study

Science.gov (United States)

Stier-Jarmer, M.; Frisch, D.; Oberhauser, C.; Immich, G.; Kirschneck, M.; Schuh, A.

2017-11-01

Moor mud applications in the form of packs and baths are widely used therapeutically as part of balneotherapy. They are commonly given as therapy for musculoskeletal disorders, with their thermo-physical effects being furthest studied. Moor baths are one of the key therapeutic elements in our recently developed and evaluated 3-week prevention program for subjects with high stress level and increased risk of developing a burnout syndrome. An embedded pilot study add-on to this core project was carried out to assess the relaxing effect of a single moor bath. During the prevention program, 78 participants received a total of seven moor applications, each consisting of a moor bath (42 °C, 20 min, given between 02:30 and 05:20 p.m.) followed by resting period (20 min). Before and after the first moor application in week 1, and the penultimate moor application in week 3, salivary cortisol was collected, blood pressure and heart rate were measured, and mood state (Multidimensional Mood State Questionnaire) was assessed. A Friedman test of differences among repeated measures was conducted. Post hoc analyses were performed using the Wilcoxon signed-rank test. A significant decrease in salivary cortisol concentration was seen between pre- and post-moor bath in week 1 ( Z = -3.355, p = 0.0008). A non-significant decrease was seen between pre- and post-moor bath in week 3. Mood state improved significantly after both moor baths. This pilot study has provided initial evidence on the stress-relieving effects of single moor baths, which can be a sensible and recommendable therapeutic element of multimodal stress-reducing prevention programs. The full potential of moor baths still needs to be validated. A randomized controlled trial should be conducted comparing this balneo-therapeutic approach against other types of stress reduction interventions.

Comparing the Effect of Foot Reflexology Massage, Foot Bath and Their Combination on Quality of Sleep in Patients with Acute Coronary Syndrome

Directory of Open Access Journals (Sweden)

Ali Rahmani

2016-12-01

Full Text Available Introduction: Many patients in coronary care unit (CCU suffer from decreased sleep quality caused by environmental and mental factors. This study compared the efficacy of foot reflexology massage, foot bath, and a combination of them on the quality of sleep of patients with acute coronary syndrome (ACS. Methods: This quasi-experimental study was implemented on ACS patients in Iran. Random sampling was used to divide the patients into four groups of 35 subjects. The groups were foot reflexology massage, foot bath, a combination of the two and the control group. Sleep quality was measured using the Veran Snyder-Halpern questionnaire. Data were analyzed by SPSS version 13. Results: The mean age of the four groups was 61.22 (11.67 years. The mean sleep disturbance in intervention groups (foot reflexology massage and foot bath groups during the second and third nights was significantly less than before intervention. The results also showed a greater reduction in sleep disturbance in the combined group than in the other groups when compared to the control group. Conclusion: It can be concluded that the intervention of foot bath and massage are effective in reducing sleep disorders and there was a synergistic effect when used in combination. This complementary care method can be recommended to be implemented by CCU nurses.

Chemical bath deposition of CdS thin films doped with Zn and Cu

Indian Academy of Sciences (India)

Abstract. Zn- and Cu-doped CdS thin films were deposited onto glass substrates by the chemical bath technique. ... Cadmium sulfide; chemical bath deposition; doping; optical window. 1. ..... at low temperature (10 K), finding similar trends than.

[Installation of Clinical Nutrition and Dietetics units in Spanish hospitals and the presence of dietitians in the same].

Science.gov (United States)

Martínez Alvarez, J R; Villarino Marín, A L; Cid Sanz, M C

2002-01-01

The appropriate nutritional status of hospitalized patients bears a close relationship with the existence of specialized Clinical Nutrition and Dietetics units or departments at health centres. The presence at these units of professionals with specific training to carry out tasks in the sphere of nutrition and dietetics, as is the case of dietitians, implies and evident strengthening of their capacity and operation. The main goal of the present paper to identify the number of Nutrition and Dietetics Units in the leading Spanish hospitals and also the presence of graduates in dietetics or nutrition specialists. Spanish hospital installations selected from the national hospital index. RESULTS OF THE TRIAL: It can be inferred that the implementation of the said services is not as complete as might be desired, and the presence of specifically qualified professionals (dietitians or nutritionists) is even lower. In this context, one is struck by the growing number of outsourced catering services at Spanish hospitals and the hiring of dietitians by these private companies, often at the request of the hospital itself. All of the data obtained show an ever greater importance of dietitians in hospital nutrition, with an uneven geographical distribution and implementation in Spain because of the peculiar policy adopted by the health authorities with regard to the recognition of these professionals. In Spain, these departments continue to be scorned and the role of the dietitian ignored.

What characterizes the work culture at a hospital unit that successfully implements change - a correlation study.

Science.gov (United States)

André, Beate; Sjøvold, Endre

2017-07-14

To successfully achieve change in healthcare, a balance between technology and "people ware", the human recourses, is necessary. However, the human aspect of the change implementation process has received less attention than the technological issues. The aim was to explore the factors that characterize the work culture in a hospital unit that successfully implemented change compared with the factors that characterize the work culture of a hospital unit with unsuccessful implementation. The Systematizing Person-Group Relations method was used for gathering and analyzing data to explore what dominate the behavior in a particular work environment identifying challenges, limitations and opportunities. This method applied six different dimensions, each representing different behavior in a work culture: Synergy, Withdrawal, Opposition, Dependence, Control and Nurture. We compared two different units at the same hospital, one that successfully implemented change and one that was unsuccessful. There were significant statistical differences between healthcare personnel working at a unit that successfully implemented change contrasted with the unit with unsuccessful implementation. These significant differences were found in both the synergy and control dimensions, which are important positive qualities in a work culture. The results of this study show that healthcare personnel at a unit with a successful implementation of change have a working environment with many positive qualities. This indicates that a work environment with a high focus on goal achievement and task orientation can handle the challenges of implementing changes.

Hydro-galvanic and rising - temperature bath therapy for chronic elbow epicondylitis: a comparative study

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C. Mucha

2004-02-01

Full Text Available The efficacy of two different regimens of physiotherapy for epicondylitis was compared. A combination treatment with hydrogalvanic four-cell bath and arm bath with rising temperature, which had showed good effects in treatment of tennis elbow in an earlier observational study (Mucha 1987, was compared with the analgesic interference current treatment often recommended in the literature (Sadil and Sadil 1994, Noteboom et al 1994, Becker and Reuter 1982. For this study, 60 patients with epicondylitis that was resistant to conservative treatment were randomized into two groups for comparison. In group 1, interference currents were administered twice a day for six weeks and group 2 received combination treatment with the hydrogalvanic four-cell bath and rising- temperature arm bath once a day for six weeks. Criteria for inclusion, control and appraisal were laid down prospectively. Several parameters were used, recorded and statistically evaluated as outcome measures.  These were active joint range of movement of the elbow, grip strength, pain provocation with muscle contraction, palpation pain and pain with functional activities.  The results showed a significant superiority of combination treatment over therapy with interference current. It is therefore recommended that hydrogalvanic four-cell bath and arm bath with rising temperature should be carried out before considering surgical treatment for chronic epicondylitis.

Trends in Out-of-Hospital Births in the United States, 1990-2012

Science.gov (United States)

... to American Indian women, and 0.54% to Asian or Pacific Islander women. In 2012, out-of-hospital births comprised 3%– ... the United States choose home birth. J Midwifery Womens Health 54(2):119–26. 2009. Health Management Associates. Midwifery licensure and discipline program in Washington ...

Bath temperature effect on magnetoelectric performance of Ni-lead zirconate titanate-Ni laminated composites synthesized by electroless deposition

Energy Technology Data Exchange (ETDEWEB)

Wu, W. [College of Materials Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210016 (China); Wang, Y.G., E-mail: yingang.wang@nuaa.edu.c [College of Materials Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210016 (China); Bi, K. [College of Materials Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210016 (China)

2011-03-15

Magnetoelectric (ME) Ni-lead zirconate titanate-Ni laminated composites have been prepared by electroless deposition at various bath temperatures. The structure of the Ni layers deposited at various bath temperatures was characterized by X-ray diffraction, and microstructures were investigated by transmission electron microscopy. The magnetostrictive coefficients were measured by means of a resistance strain gauge. The transverse ME voltage coefficient {alpha}{sub E,31} was measured with the magnetic field applied parallel to the sample plane. The deposition rate of Ni increases with bath temperature. Ni layer with smaller grain size is obtained at higher bath temperature and shows higher piezomagnetic coefficient, promoting the ME effect of corresponding laminated composites. It is advantageous to increase the bath temperature, while trying to avoid the breaking of bath constituents. - Research Highlights: Laminated composites without interlayer are prepared by electroless deposition. Bath temperature affects the grain size of the deposited Ni layers. Higher bath temperature is beneficial to obtain stronger ME response.

Hydrotherapy in state mental hospitals in the mid-twentieth century.

Science.gov (United States)

Harmon, Rebecca Bouterie

2009-08-01

This research describes nurses' experiences in administering "the water cure," hot or cold wet sheet packs, and continuous tub baths in state mental hospitals during the early twentieth century. Student and graduate nurses were required to demonstrate competence in hydrotherapy treatments used to calm agitated or manic patients in the era before neuroleptics. The nurses interviewed for this study indicated that, although labor intensive, hydrotherapy worked, at least temporarily. Although no longer used in state hospitals, hydrotherapy is regaining popularity with the general public and may serve as an adjunct to pharmacological treatments to calm hospitalized patients in the future.

Dying in Palliative Care Units and in Hospital: A Comparison of the Quality of Life of Terminal Cancer Patients.

Science.gov (United States)

Viney, Linda L.; And Others

1994-01-01

Compared quality of life of terminal cancer patients (n=182) in two palliative care units with that of those in general hospital. Patients in specialized palliative care units were found to differ from those dying in hospital, showing less indirectly expressed anger but more positive feelings. They also reported more anxiety about death but less…

Two-dimensional spectroscopy for harmonic vibrational modes with nonlinear system-bath interactions. I. Gaussian-white case

NARCIS (Netherlands)

Steffen, T; Tanimura, Y

The quantum Fokker-Planck equation is derived for a system nonlinearly coupled to a harmonic oscillator bath. The system-bath interaction is assumed to be linear in the bath coordinates but quadratic in the system coordinate. The relaxation induced dynamics of a harmonic system are investigated by

Can National Healthcare-Associated Infections (HAIs) Data Differentiate Hospitals in the United States?

Science.gov (United States)

Masnick, Max; Morgan, Daniel J; Sorkin, John D; Macek, Mark D; Brown, Jessica P; Rheingans, Penny; Harris, Anthony D

2017-10-01

OBJECTIVE To determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website (http://medicare.gov/hospitalcompare) can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals. DESIGN Secondary analysis of publicly available HAI data for calendar year 2013. METHODS We assessed the availability of HAI data for geographically proximate hospitals (ie, hospitals within the same referral region) and then analyzed these data to determine whether they are useful to differentiate hospitals. We assessed data for the 6 HAIs reported by hospitals to the Centers for Disease Control and Prevention (CDC). RESULTS Data were analyzed for 4,561 hospitals representing 88% of registered community and federal government hospitals in the United States. Healthcare-associated infection data are only useful for comparing hospitals if they are available for multiple hospitals within a geographic region. We found that data availability differed by HAI. Clostridium difficile infections (CDI) data were most available, with 82% of geographic regions (ie, hospital referral regions) having >50% of hospitals reporting them. In contrast, 4% of geographic regions had >50% of member hospitals reporting surgical site infections (SSI) for hysterectomies, which had the lowest availability. The ability of HAI data to differentiate hospitals differed by HAI: 72% of hospital referral regions had at least 1 pair of hospitals with statistically different risk-adjusted CDI rates (SIRs), compared to 9% for SSI (hysterectomy). CONCLUSIONS HAI data generally are reported by enough hospitals to meet minimal criteria for useful comparisons in many geographic locations, though this varies by type of HAI. CDI and catheter-associated urinary tract infection (CAUTI) are more likely to differentiate hospitals than the other publicly reported HAIs. Infect Control Hosp Epidemiol 2017;38:1167-1171.

Effectiveness of acute geriatric units in the real world: the case of short-term mortality among seniors hospitalized for pneumonia.

Science.gov (United States)

Ding, Yew Yoong; Abisheganaden, John; Chong, Wai Fung; Heng, Bee Hoon; Lim, Tow Keang

2013-01-01

We sought to compare the effectiveness of acute geriatric units with usual medical care in reducing short-term mortality among seniors hospitalized for pneumonia in the real world. In a retrospective cohort study, we merged chart and administrative data of seniors aged 65 years and older admitted to acute geriatric units and other medical units for pneumonia at three hospitals over 1 year. The outcome was 30-day mortality. Hierarchical logistic regression modeling was carried out to estimate the treatment effect of acute geriatric units for all seniors, those aged 80 years and older, and those with premorbid ambulation impairment, after adjusting for demographic and clinical characteristics, and accounting for clustering around hospitals. Among 2721 seniors, 30-day mortality was 25.5%. For those admitted to acute geriatric and other medical units, this was 24.2% and 25.8%, respectively. Using hierarchical logistic regression modeling, treatment in acute geriatric units was not associated with significant mortality reduction among all seniors (OR 0.72, 95% CI 0.52-1.00). However, significant mortality reduction was observed in the subgroups of those aged 80 years and older (OR 0.73, 95% CI 0.54-0.99), and with premorbid ambulation impairment (OR 0.65, 95% CI 0.46-0.93). Acute geriatric units reduced short-term mortality among seniors hospitalized for pneumonia who were aged 80 years and older or had premorbid ambulation impairment. Further research is required to determine if this beneficial effect extends to seniors hospitalized for other acute medical disorders. © 2012 Japan Geriatrics Society.

2-Mercaptobenzimidazole, 2-Mercaptobenzothiazole, and Thioglycolic Acid in an Electroless Nickel-Plating Bath

Directory of Open Access Journals (Sweden)

Ahmet Ozan Gezerman

2015-01-01

Full Text Available The use of three different materials, 2-mercaptobenzimidazole, 2-mercaptobenzothiazole, and thioglycolic acid, was investigated to improve the performance of electroless nickel-plating baths. By changing the concentrations of these materials, sample plates were coated. Optical microscope images were obtained by selecting representative coated plates. From the results of the investigations, the effects of these materials on electroless nickel plating were observed, and the most appropriate amounts of these materials for nickel plating were determined. Moreover, the nickel plating speed observed with the bath solution containing 2-mercaptobenzimidazole, 2-mercaptobenzothiazole, and thioglycolic acid is higher than that in the case of traditional electroless plating baths, but the nickel consumption amount in the former case is lower. In order to minimize the waste water generated from electroless nickel-plating baths, we determined the lowest amounts of the chemicals that can be used for the concentrations reported in the literature.

Assessment Of Nurses Performance During Cardiopulmonary Resuscitation In Intensive Care Unit And Cardiac Care Unit At The Alexandria Main University Hospital.

Directory of Open Access Journals (Sweden)

Dr. Nagla Hamdi Kamal Khalil El- Meanawi

2015-08-01

Full Text Available Abstract Background Cardiopulmonary resuscitation one of the most emergency management the nurse has a pivotal role and should be highly qualified in performing these procedures. The aim of the study is to assess performance of nurses during Cardio pulmonary resuscitation for patient with cardiac arrest In Intensive Care Unit and Cardiac Care Unit at the Alexandria main university hospital. To answer the question what are the most common area of satisfactory and area of neglection in nurses performance during Cardio Pulmonary Resuscitation. The sample consists of 53 staff nurses working in Intensive care unit amp cardiac care unit at Alexandria main university hospital. The tools of data collection were structured of questionnaire sheet and observational cheek list. The results showed that unsatisfactory performance between nurses in both units. The study concluded that all nurses need to improve their performance during cardiopulmonary resuscitation for patient with cardiac arrest it is crucial for nursing staff to participate in CPR courses in order to refresh and update their theoretical knowledge and performance skills and consequently to improve the safety and effectiveness of care. The study recommended that continuous evaluation of nurses knowledge and performance is essential the optimal frequency with which CPR training should be implemented at least every 6 months in order to avoid deterioration in nurses CPR knowledge and skills.

Nursing Leaders' Satisfaction with Information Systems in the Day-to-Day Operations Management in Hospital Units.

Science.gov (United States)

Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

2018-01-01

Information usage in the day-to-day operations management of hospital units is complex due to numerous information systems in use. The aim of this study was to describe and compare nurse leaders' satisfaction with information systems used in the day-to-day operations management in hospital units. The design was a cross-sectional survey with five questions rated from one (disagree) to five (fully agree). The response rate was 65 % (n = 453). Respondents reported fair satisfaction with how information systems support decision-making (median 4, IQR 3-4) and improve ease of access to information (median 4, IQR 3-4). However, respondents were less satisfied with how systems improve speed of access to information (median 3, IQR 3-4). Nor did respondents think that systems were developed for them (median 3, IQR 2-4). Respondents further reported needing numerous systems daily to support decision-making (median 4, IQR 3-5). A clear need for one system, which would gather important information for display was stated (median 5, IQR 4-5). Work experience, gender and time when overseeing the unit were associated with some aspects related to satisfaction. In conclusion, information system improvements are needed to better support the day-to-day operations management in hospital units.

CdS films deposited by chemical bath under rotation

International Nuclear Information System (INIS)

Oliva-Aviles, A.I.; Patino, R.; Oliva, A.I.

2010-01-01

Cadmium sulfide (CdS) films were deposited on rotating substrates by the chemical bath technique. The effects of the rotation speed on the morphological, optical, and structural properties of the films were discussed. A rotating substrate-holder was fabricated such that substrates can be taken out from the bath during the deposition. CdS films were deposited at different deposition times (10, 20, 30, 40 and 50 min) onto Corning glass substrates at different rotation velocities (150, 300, 450, and 600 rpm) during chemical deposition. The chemical bath was composed by CdCl 2 , KOH, NH 4 NO 3 and CS(NH 2 ) 2 as chemical reagents and heated at 75 deg. C. The results show no critical effects on the band gap energy and the surface roughness of the CdS films when the rotation speed changes. However, a linear increase on the deposition rate with the rotation energy was observed, meanwhile the stoichiometry was strongly affected by the rotation speed, resulting a better 1:1 Cd/S ratio as speed increases. Rotation effects may be of interest in industrial production of CdTe/CdS solar cells.

CdS films deposited by chemical bath under rotation

Energy Technology Data Exchange (ETDEWEB)

Oliva-Aviles, A.I., E-mail: aoliva@mda.cinvestav.mx [Centro de Investigacion y de Estudios Avanzados Unidad Merida, Departamento de Fisica Aplicada. A.P. 73-Cordemex, 97310 Merida, Yucatan (Mexico); Patino, R.; Oliva, A.I. [Centro de Investigacion y de Estudios Avanzados Unidad Merida, Departamento de Fisica Aplicada. A.P. 73-Cordemex, 97310 Merida, Yucatan (Mexico)

2010-08-01

Cadmium sulfide (CdS) films were deposited on rotating substrates by the chemical bath technique. The effects of the rotation speed on the morphological, optical, and structural properties of the films were discussed. A rotating substrate-holder was fabricated such that substrates can be taken out from the bath during the deposition. CdS films were deposited at different deposition times (10, 20, 30, 40 and 50 min) onto Corning glass substrates at different rotation velocities (150, 300, 450, and 600 rpm) during chemical deposition. The chemical bath was composed by CdCl{sub 2}, KOH, NH{sub 4}NO{sub 3} and CS(NH{sub 2}){sub 2} as chemical reagents and heated at 75 deg. C. The results show no critical effects on the band gap energy and the surface roughness of the CdS films when the rotation speed changes. However, a linear increase on the deposition rate with the rotation energy was observed, meanwhile the stoichiometry was strongly affected by the rotation speed, resulting a better 1:1 Cd/S ratio as speed increases. Rotation effects may be of interest in industrial production of CdTe/CdS solar cells.

Bath salt intoxication causing acute kidney injury requiring hemodialysis.

Science.gov (United States)

Regunath, Hariharan; Ariyamuthu, Venkatesh Kumar; Dalal, Pranavkumar; Misra, Madhukar

2012-10-01

Traditional bath salts contain a combination of inorganic salts like Epsom salts, table salt, baking soda, sodium metaphosphate, and borax that have cleansing properties. Since 2010, there have been rising concerns about a new type of substance abuse in the name of "bath salts." They are beta-ketone amphetamine analogs and are derivates of cathinone, a naturally occurring amphetamine analog found in the "khat" plant (Catha edulis). Effects reported with intake included increased energy, empathy, openness, and increased libido. Serious adverse effects reported with intoxication included cardiac, psychiatric, and neurological signs and symptoms. Not much is known about the toxicology and metabolism of these compounds. They inhibit monoamine reuptake (dopamine, nor epinephrine, etc.) and act as central nervous system stimulants with high additive and abuse potential because of their clinical and biochemical similarities to effects from use of cocaine, amphetamine, and 3,4-methylenedioxy-N-methylamphetamine. Deaths associated with use of these compounds have also been reported. We report a case of acute kidney injury associated with the use of "bath salt" pills that improved with hemodialysis. © 2012 The Authors. Hemodialysis International © 2012 International Society for Hemodialysis.

Use of antibacterial agents in an intensive care unit in a hospital in Brazil.

Science.gov (United States)

dos Santos, E F; Lauria-Pires, L; Pereira, M G; Silva, A E; Rodrigues, I P; Maia, M O

2007-06-01

It is essential to monitor the utilisation of antibacterial drugs in order to establish appropriate measures for their control. The pattern of usage of antibacterial drugs, and its association with indicators of hospital infection, has been investigated in a non-specialized adult intensive care unit (ICU) located in Santa Luzia Hospital (Brasília, DF, Brazil). The study was conducted between January 2001 and June 2004. Data concerning the utilisation of systemic antibacterial drugs, classified according to the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) system, and indicators of hospital infection, defined according to the National Nosocomial Infections Surveillance (NNIS) system, were obtained from appropriate hospital archives. During the study period, the average utilisation of antibacterial drugs was 1918.5 DDD units per 1000 patient-day (DDD(1000)). The three most used drugs were penicillins/beta-lactamase inhibitors (535.3 DDD(1000)), third generation cephalosporins (239.1 DDD(1000)) and quinolones (212.5 DDD(1000)). The total utilisation of antibacterial drugs was correlated significantly with the incidence of hospital infection (R = 0.62; p < 0.01) and the index of invasive procedures (R = 0.41; p < 0.01). Furthermore, the latter two indicators were significantly and positively correlated with the use of recently commercialized, broad spectrum antibacterial drugs (except for carbapenems). It is concluded that improved infection control procedures, together with more rigorous criteria regarding the use of invasive procedures, should be implemented by the ICU studied in order to diminish the utilisation of antibacterial drugs.

Additional Quantum Properties of Entangled Bipartite Qubit Systems Coupled to Photon Baths

International Nuclear Information System (INIS)

Quintana, C

2016-01-01

The time evolution of an entangled bi-partite qubit interacting with two independent photon baths in isolated cavities is not unitary. It is shown that the bi-partite qubit oscillates between pure and mixed states, and that the initial entanglement is lost and recovered in time by time as a consequence of its interaction with the baths. (paper)

CdS thin films prepared by laser assisted chemical bath deposition

International Nuclear Information System (INIS)

Garcia, L.V.; Mendivil, M.I.; Garcia Guillen, G.; Aguilar Martinez, J.A.; Krishnan, B.; Avellaneda, D.; Castillo, G.A.; Das Roy, T.K.; Shaji, S.

2015-01-01

Highlights: • CdS thin films by conventional CBD and laser assisted CBD. • Characterized these films using XRD, XPS, AFM, optical and electrical measurements. • Accelerated growth was observed in the laser assisted CBD process. • Improved dark conductivity and good photocurrent response for the LACBD CdS. - Abstract: In this work, we report the preparation and characterization of CdS thin films by laser assisted chemical bath deposition (LACBD). CdS thin films were prepared from a chemical bath containing cadmium chloride, triethanolamine, ammonium hydroxide and thiourea under various deposition conditions. The thin films were deposited by in situ irradiation of the bath using a continuous laser of wavelength 532 nm, varying the power density. The thin films obtained during deposition of 10, 20 and 30 min were analyzed. The changes in morphology, structure, composition, optical and electrical properties of the CdS thin films due to in situ irradiation of the bath were analyzed by atomic force microscopy (AFM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and UV–vis spectroscopy. The thin films obtained by LACBD were nanocrystalline, photoconductive and presented interesting morphologies. The results showed that LACBD is an effective synthesis technique to obtain nanocrystalline CdS thin films having good optoelectronic properties

Microbiological investigations on the water of a thermal bath at Budapest.

Science.gov (United States)

Szuróczki, Sára; Kéki, Zsuzsa; Káli, Szandra; Lippai, Anett; Márialigeti, Károly; Tóth, Erika

2016-06-01

Thermal baths are unique aquatic environments combining a wide variety of natural and anthropogenic ecological factors, which also appear in their microbiological state. There is limited information on the microbiology of thermal baths in their complexity, tracking community shifts from the thermal wells to the pools. In the present study, the natural microbial community of well and pool waters in Gellért bath was studied in detail by cultivation-based techniques. To isolate bacteria, 10% R2A and minimal synthetic media (with "bath water") with agar-agar and gellan gum were used after prolonged incubation time; moreover, polyurethane blocks covered with media were also applied. Strains were identified by sequencing their 16S rRNA gene after grouping them by amplified rDNA restriction analysis. From each sample, the dominance of Alphaproteobacteria was characteristic though their diversity differed among samples. Members of Actinobacteria, Firmicutes, Beta- and Gamma-proteobacteria, Deinococcus-Thermus, and Bacteroidetes were also identified. Representatives of Deinococcus-Thermus phylum appeared only in the pool water. The largest groups in the pool water belonged to the Tistrella and Chelatococcus genera. The most dominant member in the well water was a new taxon, its similarity to Hartmannibacter diazotrophicus as closest relative was 93.93%.

CdS thin films prepared by laser assisted chemical bath deposition

Energy Technology Data Exchange (ETDEWEB)

Garcia, L.V.; Mendivil, M.I.; Garcia Guillen, G.; Aguilar Martinez, J.A. [Facultad de Ingenieria Mecanica y Electrica, Universidad Autonoma de Nuevo Leon, Av. Pedro de Alba s/n, Ciudad Universitaria, San Nicolas de los Garza, Nuevo Leon 66450 (Mexico); Krishnan, B. [Facultad de Ingenieria Mecanica y Electrica, Universidad Autonoma de Nuevo Leon, Av. Pedro de Alba s/n, Ciudad Universitaria, San Nicolas de los Garza, Nuevo Leon 66450 (Mexico); CIIDIT – Universidad Autonoma de Nuevo Leon, Apodaca, Nuevo Leon (Mexico); Avellaneda, D.; Castillo, G.A.; Das Roy, T.K. [Facultad de Ingenieria Mecanica y Electrica, Universidad Autonoma de Nuevo Leon, Av. Pedro de Alba s/n, Ciudad Universitaria, San Nicolas de los Garza, Nuevo Leon 66450 (Mexico); Shaji, S., E-mail: sshajis@yahoo.com [Facultad de Ingenieria Mecanica y Electrica, Universidad Autonoma de Nuevo Leon, Av. Pedro de Alba s/n, Ciudad Universitaria, San Nicolas de los Garza, Nuevo Leon 66450 (Mexico); CIIDIT – Universidad Autonoma de Nuevo Leon, Apodaca, Nuevo Leon (Mexico)

2015-05-01

Highlights: • CdS thin films by conventional CBD and laser assisted CBD. • Characterized these films using XRD, XPS, AFM, optical and electrical measurements. • Accelerated growth was observed in the laser assisted CBD process. • Improved dark conductivity and good photocurrent response for the LACBD CdS. - Abstract: In this work, we report the preparation and characterization of CdS thin films by laser assisted chemical bath deposition (LACBD). CdS thin films were prepared from a chemical bath containing cadmium chloride, triethanolamine, ammonium hydroxide and thiourea under various deposition conditions. The thin films were deposited by in situ irradiation of the bath using a continuous laser of wavelength 532 nm, varying the power density. The thin films obtained during deposition of 10, 20 and 30 min were analyzed. The changes in morphology, structure, composition, optical and electrical properties of the CdS thin films due to in situ irradiation of the bath were analyzed by atomic force microscopy (AFM), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and UV–vis spectroscopy. The thin films obtained by LACBD were nanocrystalline, photoconductive and presented interesting morphologies. The results showed that LACBD is an effective synthesis technique to obtain nanocrystalline CdS thin films having good optoelectronic properties.

Einstein's Enigma of black holes in my bubble bath

International Nuclear Information System (INIS)

Vishveshwara, C.

2006-01-01

Einstein's Enigma or Black Holes in My Bubble Bath is a humorous and informal rendition of the story of gravitation theory from the early historic origins to the latest developments in astrophysics, focusing on Albert Einstein's theory of general relativity and black-hole physics. Through engaging conversations and napkin-scribbled diagrams come tumbling the rudiments of relativity, spacetime and much of modern physics, narrated with high didactic and literary talent, and each embedded in casual lessons given by a worldly astrophysicist to his friend. Join the intellectual fun and exalt in the frothy ideas while vicariously taking relaxing baths in this magical bathtub. (orig.)

ZnSe thin films by chemical bath deposition method

Energy Technology Data Exchange (ETDEWEB)

Lokhande, C.D.; Patil, P.S.; Tributsch, H. [Hahn-Meitner-Institute, Bereich Physikalische Chemie, Abt. CS, Glienicker Strasse-100, D-14109 Berlin (Germany); Ennaoui, A. [Hahn-Meitner-Institute, Bereich Physikalische Chemie, Abt. CG, Glienicker Strasse-100, D-14109 Berlin (Germany)

1998-09-04

The ZnSe thin films have been deposited onto glass substrates by the simple chemical bath deposition method using selenourea as a selenide ion source from an aqueous alkaline medium. The effect of Zn ion concentration, bath temperature and deposition time period on the quality and thickness of ZnSe films has been studied. The ZnSe films have been characterized by XRD, TEM, EDAX, TRMC (time-resolved microwave conductivity), optical absorbance and RBS techniques for their structural, compositional, electronic and optical properties. The as-deposited ZnSe films are found to be amorphous, Zn rich with optical band gap, Eg, equal to 2.9 eV

ANOMALOUS ELECTRODEPOSITION OF Fe-Ni ALLOY COATING FROM SIMPLE AND COMPLEX BATHS AND ITS MAGNETIC PROPERTY

Directory of Open Access Journals (Sweden)

M A Islam

2010-03-01

Full Text Available Electrodeposition of Fe-Ni thin films has been carried on copper substrate under various electrodeposition conditions from two simple and six complex baths. Sulfate baths composing of NiSO4. 7H2O, FeSO4.7H2O, H3BO3 and Na2SO4KEYWORDS: Anomalous Electrodeposition, Fe-Ni Coating, Complexing agent, Current Density, Magnetic Property. 1. INTRODUCTION Alloy electrodeposition technologies can extend tremendously the potential of electrochemical deposition processes to provide coatings that require unique mechanical, chemical and physical properties [1]. There has been a great research interest in the development and characterization of iron-nickel (Fe-Ni thin films due to their operational capacity, economic interest, magnetic and other properties [2]. Due to their unique low coefficient of thermal expansion (CTE and soft magnetic properties, Fe-Ni alloys have been used in industrial applications for over 100 years [3]. Typical examples of applications that are based on the low CTE of Fe-Ni alloys include: thermostatic bimetals, glass sealing, integrated circuit packaging, cathode ray tube, shadow masks, membranes for liquid natural gas tankers; applications based on the soft magnetic properties include: read-write heads for magnetic storage, magnetic actuators, magnetic shielding, high performance transformer cores. comprise the simple baths whereas complex baths were prepared by adding ascorbic acid, saccharin and citric acid in simple baths. The effect of bath composition, pH and applied current density on coating appearance, composition, morphology and magnetic property were studied. Wet chemical analysis technique was used to analyze the coating composition whereas SEM and VSM were used to study the deposit morphology and magnetic property respectively. Addition of complexing agents in plating baths suppressed the anomalous nature of Fe-Ni alloy electrodeposition. Coatings obtained from simple baths were characterized by coarse grained non

How to reduce hospital-acquired pressure ulcers on a neuroscience unit with a skin and wound assessment team.

Science.gov (United States)

McGuinness, Janice; Persaud-Roberts, Sherry; Marra, Susan; Ramos, Jeannine; Toscano, Diane; Policastro, Linda; Epstein, Nancy E

2012-01-01

In 2008, the incidence of hospital acquired pressure ulcers (HAPUs) continued to increase on a neuroscience unit that included both neurosurgical and neurological patients in a 14-bed intensive care unit, and in a 18-bed floor unit. To reduce HAPUs, several changes were instituted in 2008; (1) turning patients every 1-2 h/repositioning, (2) specialty beds, and (3) a "skin and wound assessment team (SWAT)" that included one (or two) "expert" nurses/nursing assistants who made rounds on all the patients in the unit at least once a week. They would examine patients from "head to toe", document/measure all pressure ulcers, and educate primary nurses/nurse assistants on the plan/products needed for the patients wound care based on their assessments. In 2010, further measures included: (1) adding eight Stryker beds, (2) adding pressure relieving heel protector boots, and (3) requiring that all new hospital orientees work one shift (7.5 h) shadowing the SWAT team. The SWAT team initially decreased HAPUs by 48% in 2009; this reduction was further increased in 2010 (57%), and 2011 (61%). Additionally, in 2010, the SWAT team was required to educate nurses in all other units. By 2011, all nurses had to complete the hospital acquired pressure ulcer prevention tutorial. Since instituting a specialized SWAT team for our neuroscience unit, the incidence of HAPUs (cost estimated for grade IV, US $129,248) was decreased by 48% in 2009, by 57% in 2010, and by 61% in 2011. The SWAT program is now hospital-wide.

Avaliação de uma cadeira de banho utilizada em ambiente hospitalar: uma abordagem ergonômica Evaluación de un hinodoro utilizado en el ambiente hospitalario: un abordaje ergonómico Assessment of a hospital bath chair: an ergonomic approach

Directory of Open Access Journals (Sweden)

Maria Estevam Comélio

2005-08-01

Full Text Available A literatura indica que a equipe de enfermagem apresenta uma elevada ocorrência de lesões osteomusculares. A utilização de equipamentos especiais tem levado a uma diminuição no risco de lesões na coluna nesses trabalhadores, além de satisfazerem as necessidades de conforto e segurança dos pacientes. Um desses equipamentos é a cadeira de banho. O presente estudo teve como objetivo avaliar ergonomicamente uma cadeira de banho utilizada em um hospital. Foi utilizado um instrumento para os trabalhadores de enfermagem e um outro para os pacientes. Verificou-se que a cadeira avaliada apresenta inúmeros problemas ergonômicos em seus acessórios. Com relação à avaliação do esforço percebido, observou-se um elevado nível de esforço (8,33, segundo a Escala CR 10 de Borg, na manipulação do equipamento.La literatura indica que el equipo de enfermería presenta uma elevada ocurrencia de lesiones osteomusculares. La utilización de equipamientos especiales están llevando a una diminución en el riesgo de lesiones en la colunna de esos trabajadores, mas allá de satisfacer las necesidades de confort y seguridad de los pacientes. Uno de esos equipamientos es el hinodoro. El presente estudio tiene como objetivo evaluar ergonomicamente un hinodoro utilizado en un hospital. Fue utilizado un instrumento para los trabajadores de enfermeria y otro para los pacientes. Se verifico que el hinodoro presenta innumerables problemas ergonómicos en sus accesórios. Con relación a la evaluación del esfuerzo percibido, se observó un elevado nivel de esfuerzo (8,33, siguiendo la escala CR 10 de Borg, la manipulación del equipamiento.A high rate of musculoskeletal disorders in members of the nursing team is observed in the literature. The use of special devices such as the bath chair has reduced the risk of back injuries in these workers and has also provided the patient with greater safety as well as comfort. The aim of the present study was to

Preparation of nanocrystalline ZnS by a new chemical bath deposition route

Energy Technology Data Exchange (ETDEWEB)

Sartale, S.D. [Department of Heterogeneous Material Systems (SE2), Hahn-Meitner-Institut, Glienicker Strasse 100, D-14109, Berlin (Germany); Sankapal, B.R. [Department of Heterogeneous Material Systems (SE2), Hahn-Meitner-Institut, Glienicker Strasse 100, D-14109, Berlin (Germany); Lux-Steiner, M. [Department of Heterogeneous Material Systems (SE2), Hahn-Meitner-Institut, Glienicker Strasse 100, D-14109, Berlin (Germany); Ennaoui, A. [Department of Heterogeneous Material Systems (SE2), Hahn-Meitner-Institut, Glienicker Strasse 100, D-14109, Berlin (Germany)]. E-mail: ennaoui@hmi.de

2005-06-01

We report a new chemical bath deposition route for the preparation of dense, compact and uniform nanocrystalline ZnS thin films, where thiourea acts as a complexing agent as well as a source of sulfide ions. The structural and morphological characterizations suggest that the film and the residual powder in the bath are formed by the aggregation of clusters of ZnS, namely cluster-by-cluster growth mechanism. X-ray diffraction (XRD) and HRTEM analyses indicate that the film and powder formed in the bath have cubic zinkblende structure. The films have high transmittance of about 75% in the visible region. Post-deposition annealing in Ar slightly improves the crystallinity and decreases the optical bandgap with increasing the annealing temperature.

Preparation of nanocrystalline ZnS by a new chemical bath deposition route

International Nuclear Information System (INIS)

Sartale, S.D.; Sankapal, B.R.; Lux-Steiner, M.; Ennaoui, A.

2005-01-01

We report a new chemical bath deposition route for the preparation of dense, compact and uniform nanocrystalline ZnS thin films, where thiourea acts as a complexing agent as well as a source of sulfide ions. The structural and morphological characterizations suggest that the film and the residual powder in the bath are formed by the aggregation of clusters of ZnS, namely cluster-by-cluster growth mechanism. X-ray diffraction (XRD) and HRTEM analyses indicate that the film and powder formed in the bath have cubic zinkblende structure. The films have high transmittance of about 75% in the visible region. Post-deposition annealing in Ar slightly improves the crystallinity and decreases the optical bandgap with increasing the annealing temperature

Measuring patient safety culture: an assessment of the clustering of responses at unit level and hospital level

NARCIS (Netherlands)

Smits, M.; Wagner, C.; Spreeuwenberg, P.; Wal, van der G.

2009-01-01

OBJECTIVES: To test the claim that the Hospital Survey on Patient Safety Culture (HSOPS) measures patient safety culture instead of mere individual attitudes and to determine the most appropriate level (individual, unit or hospital level) for interventions aimed at improving the culture of patient

Measuring patient safety culture : an assessment of the clustering of responses at unit level and hospital level

NARCIS (Netherlands)

Smits, M.; Wagner, C.; Spreeuwenberg, P.; Wal, G. van der; Groenewegen, P.P.

2009-01-01

Objectives: To test the claim that the Hospital Survey on Patient Safety Culture (HSOPS) measures patient safety culture instead of mere individual attitudes and to determine the most appropriate level (individual, unit or hospital level) for interventions aimed at improving the culture of patient

Printability Study of Bioprinted Tubular Structures Using Liquid Hydrogel Precursors in a Support Bath

Directory of Open Access Journals (Sweden)

Houzhu Ding

2018-03-01

Full Text Available Microextrusion-based bioprinting within a support bath material is an emerging additive manufacturing paradigm for complex three-dimensional (3D tissue construct fabrication. Although a support bath medium enables arbitrary in-process geometries to be printed, a significant challenge lies in preserving the shape fidelity upon the extraction of the support bath material. Based on the bioprinting in a support bath paradigm, this paper advances quantitative analyses to systematically determine the printability of cell-laden liquid hydrogel precursors towards filament-based tissue constructs. First, a yield stress nanoclay material is judiciously selected as the support bath medium owing to its insensitivity to temperature and ionic variations that are considered in the context of the current gelatin-alginate bio-ink material formulation. Furthermore, phenomenological observations for the rheology-mediated print outcomes enable the compositions for the bio-ink material (10% gelatin, 3% alginate, in tandem with the support bath medium (4% nanoclay, 0.5% CaCl2, to be identified. To systematically evaluate the performance outcomes for bioprinting within a support bath, this paper advances an experimental parametric study to optimize the 3D structural shape fidelity by varying parameters such as the layer height, extrusion flowrate, printing temperature, and printhead speed, towards fabricating complex 3D structures with the stabilization of the desired shape outcome. Specifically, it is found that the layer height and printhead speed are determinant parameters for the extent of successive layer fusion. Moreover, maintenance of an optimal bath temperature is identified as a key parameter for establishing the printability for the hydrogel bio-ink. Studying this effect is enabled by the custom design of a PID temperature control system with integration with the bioprinter for real-time precision control of the support bath temperature. In order to qualify

Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States.

Science.gov (United States)

Korbel, Lindsey; Spencer, John David

2015-03-01

The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011. Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges. Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

Black hole evaporation in a heat bath as a nonequilibrium process and its final fate

International Nuclear Information System (INIS)

Saida, Hiromi

2007-01-01

We consider a black hole in a heat bath, and the whole system which consists of the black hole and the heat bath is isolated from outside environments. When the black hole evaporates, the Hawking radiation causes an energy flow from the black hole to the heat bath. Therefore, since no energy flow arises in an equilibrium state, the thermodynamic state of the whole system is not in equilibrium. That is, in a region around the black hole, the matter field of Hawking radiation and that of heat bath should be in a nonequilibrium state due to the energy flow. Using a simple model which reflects the nonequilibrium nature of energy flow, we find the nonequilibrium effect on a black hole evaporation as follows: if the nonequilibrium region around a black hole is not so large, the evaporation time scale of a black hole in a heat bath becomes longer than that in an empty space (a situation without heat bath), because of the incoming energy flow from the heat bath to the black hole. However, if the nonequilibrium region around a black hole is sufficiently large, the evaporation time scale in a heat bath becomes shorter than that in an empty space, because a nonequilibrium effect of the temperature difference between the black hole and heat bath appears as a strong energy extraction from the black hole by the heat bath. Further, a specific nonequilibrium phenomenon is found: a quasi-equilibrium evaporation stage under the nonequilibrium effect proceeds abruptly to a quantum evaporation stage at a semi-classical level (at black hole radius R g > Planck length) within a very short time scale with a strong burst of energy. (Contrarily, when the nonequilibrium effect is not taken into account, a quasi-equilibrium stage proceeds smoothly to a quantum stage at R g < Planck length without so strong an energy burst.) That is, the nonequilibrium effect of energy flow tends to make a black hole evaporation process more dynamical and to accelerate that process. Finally, on the final fate

(Microbiological studies of small hot-bath-pools and hot-whirl-pools (author's transl))

Energy Technology Data Exchange (ETDEWEB)

Exner, M; Havenith, N

1981-01-01

Hot small bathing pools and hot whirl-pools have the following characteristics: small watervolume, thick squeeze of swimmers, high water temperature (37-40 degrees C) and small dimension of filters. By this, the quality of bathing-water is influenced detrimentally. To elaborate the hygienic problems, bathing-water samples were taken before, during and after the visiting-hours and were tested for facultative-pathogenic microorganisms. During this investigation E. coli was isolated in 25 degrees, Coliforms and Proteus species in 37.3%, P. aeruginosa in 36%, S. aureus in 26.3%, Enterococci in 42.3 %, Candida albicans in 3.6% and yeast totally in 8.3%.

Recovery process for electroless plating baths

Science.gov (United States)

Anderson, Roger W.; Neff, Wayne A.

1992-01-01

A process for removing, from spent electroless metal plating bath solutions, accumulated byproducts and counter-ions that have deleterious effects on plating. The solution, or a portion thereof, is passed through a selected cation exchange resin bed in hydrogen form, the resin selected from strong acid cation exchangers and combinations of intermediate acid cation exchangers with strong acid cation exchangers. Sodium and nickel ions are sorbed in the selected cation exchanger, with little removal of other constituents. The remaining solution is subjected to sulfate removal through precipitation of calcium sulfate hemihydrate using, sequentially, CaO and then CaCO.sub.3. Phosphite removal from the solution is accomplished by the addition of MgO to form magnesium phosphite trihydrate. The washed precipitates of these steps can be safely discarded in nontoxic land fills, or used in various chemical industries. Finally, any remaining solution can be concentrated, adjusted for pH, and be ready for reuse. The plating metal can be removed from the exchanger with sulfuric acid or with the filtrate from the magnesium phosphite precipitation forming a sulfate of the plating metal for reuse. The process is illustrated as applied to processing electroless nickel plating baths.

Synthesis and self-assembly of dumbbell shaped ZnO sub-micron structures using low temperature chemical bath deposition technique

Energy Technology Data Exchange (ETDEWEB)

Borade, P. [National Centre for Nanoscience and Nanotechnology, University of Mumbai, Kalina Campus, Santacruz (E), Mumbai 400098 (India); Joshi, K.U. [Anton-Paar India Pvt. Ltd., Thane (W), 400607 (India); Gokarna, A.; Lerondel, G. [Laboratoire de Nanotechnologie et D' Instrumentation Optique, Institut Charles Delaunay, CNRS UMR 6281, Université de Technologie de Troyes, 12 Rue Marie Curie, BP 2060, 10010 Troyes (France); Walke, P. [National Centre for Nanoscience and Nanotechnology, University of Mumbai, Kalina Campus, Santacruz (E), Mumbai 400098 (India); Late, D. [National Chemical Laboratory (NCL), Pune 400027 (India); Jejurikar, S.M., E-mail: jejusuhas@gmail.com [National Centre for Nanoscience and Nanotechnology, University of Mumbai, Kalina Campus, Santacruz (E), Mumbai 400098 (India)

2016-02-01

We report well dispersed horizontal growth of ZnO sub-micron structures using simplest technique ever known i.e. chemical bath deposition (CBD). A set of samples were prepared under two different cases A) dumbbell shaped ZnO grown in CBD bath and B) tubular ZnO structures evolved from dumbbell shaped structures by dissolution mechanism. Single phase wurtzite ZnO formation is confirmed using X-ray diffraction (XRD) technique in both cases. From the morphological investigations performed using scanning electron microscopy (SEM), sample prepared under case A indicate formation of hex bit tool (HBT) shaped ZnO crystals, which observed to self-organize to form dumbbell structures. Further these microstructures are then converted into tubular structures as a fragment of post CBD process. The possible mechanism responsible for the self-assembly of HBT units to form dumbbell structures is discussed. Observed free excitonic peak located at 370 nm in photoluminescence (PL) spectra recorded at 18 K indicate that the micro/nanostructures synthesized using CBD are of high optical quality. - Highlights: • Controlled growth of Dumbbell shaped ZnO using Chemical Bath Deposition (CBD). • Growth mechanism of dumbbell shaped ZnO by self-assembling was discussed. • Quick Transformation of ZnO dumbbell structures in to tubular structures by dissolution. • Sharp UV Emission at 370 nm from both dumbbell and tubular structures.

Approach to equilibrium in models of a system in contact with a heat bath

International Nuclear Information System (INIS)

Goldstein, S.; Lebowitz, J.L.; Ravishankar, K.

1986-01-01

We investigate simple model systems in contact with an infinite heat bath. The former consists of a finite number of particles in a bounded region Λ of R/sup d/, d = 1, 2. The heat baths are infinite particle systems which can penetrate Λ and interact with the system via elastic collisions. Outside Λ the particles move freely and have a Gibbs probability measure prior to entering Λ. We show that starting from almost any initial configuration, the system approaches, as t → ∞, the appropriate Gibbs distribution. The combined system plus bath is Bernoulli

Demographic epidemiology of unstable pelvic fracture in the United States from 2000 to 2009: trends and in-hospital mortality.

Science.gov (United States)

Yoshihara, Hiroyuki; Yoneoka, Daisuke

2014-02-01

Unstable pelvic fracture is predominantly caused by high-energy blunt trauma and is associated with a high risk of mortality. The epidemiology in the United States is largely unknown. The purpose of this study was to examine the epidemiology of unstable pelvic fracture based on patient and hospital demographics in the United States during the last decade. The Nationwide Inpatient Sample was used to identify patients who were hospitalized with unstable pelvic fracture from 2000 to 2009, using the International Classification of Diseases--9th Rev.--Clinical Modification (ICD-9-CM) codes. The primary outcome parameter consisted of analyzing the temporal trends of in-hospital admissions for unstable pelvic fracture and the associated in-hospital mortality. The data were stratified by demographic variables, including age, sex, race, and hospital region in the United States. From 2000 to 2009, there were 24,059 patients in total; among these, 1,823 (7.6%) had open fractures, and 22,236 (92.4%) had closed fractures. The population growth-adjusted incidence was stable over time (p = 0.431). The incidence was the lowest in the northeastern region. The in-hospital mortality rate in patients with unstable pelvic fracture was 8.3% (21.3% for open fracture, 7.2% for closed fracture) and remained stable over time (p = 0.089). The in-hospital mortality rate was higher in several subgroups of patients, such as older patients, male patients, African-American patients, and patients in the northeastern region. During the last decade, the incidence of unstable pelvic fracture has remained stable over time in the United States. The in-hospital mortality rate in patients with unstable pelvic fracture was 8.3% and remained stable over time. The rate in patients with an open fracture was approximately three times higher than that in patients with a closed fracture. The incidence was the lowest, but the in-hospital mortality rate was the highest in the northeastern region compared with the

A Business Case Analysis of the Special Care Unit at Moncrief Army Community Hospital

National Research Council Canada - National Science Library

Unruh, Charles

2002-01-01

The goal of this project is to develop and evaluate four courses of action (COA) in order to determine the most efficient and effective method to care for Moncrief Army Community Hospitals Special Care Unit (SCU) inpatients...

Work-unit social capital and long-term sickness absence: a prospective cohort study of 32 053 hospital employees.

Science.gov (United States)

Török, Eszter; Clark, Alice Jessie; Jensen, Johan Høy; Lange, Theis; Bonde, Jens Peter; Bjorner, Jakob Bue; Rugulies, Reiner; Hvidtfeldt, Ulla Arthur; Hansen, Åse Marie; Ersbøll, Annette Kjær; Rod, Naja Hulvej

2018-06-06

There is a lack of studies investigating social capital at the workplace level in small and relatively homogeneous work-units. The aim of the study was to investigate whether work-unit social capital predicts a lower risk of individual long-term sickness absence among Danish hospital employees followed prospectively for 1 year. This study is based on the Well-being in HospitAL Employees cohort. The study sample consisted of 32 053 individuals nested within 2182 work-units in the Capital Region of Denmark. Work-unit social capital was measured with an eight-item scale covering elements of trust, justice and collaboration between employees and leaders. Social capital at the work-unit level was computed as the aggregated mean of individual-level social capital within each work-unit. Data on long-term sickness absence were retrieved from the employers' payroll system and were operationalised as ≥29 consecutive days of sickness absence. We used a 12-point difference in social capital as the metric in our analyses and conducted two-level hierarchical logistic regression analysis. Adjustments were made for sex, age, seniority, occupational group and part-time work at the individual level, and work-unit size, the proportion of female employees and the proportion of part-time work at the work-unit level. The OR for long-term sickness absence associated with a 12-point higher work-unit social capital was 0.73 (95% CI 0.68 to 0.78). Further, we found an association between higher work-unit social capital and lower long-term sickness absence across quartiles of social capital: compared with the lowest quartile, the OR for long-term sickness absence in the highest quartile was 0.51 (95% CI 0.44 to 0.60). Our study provides support for work-unit social capital being a protective factor for individual long-term sickness absence among hospital employees in the Capital Region of Denmark. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

Efeitos do banho logo após o nascimento sobre as adaptações térmica e cardiorrespiratória do recém-nascido a termo Effects of bathing after birth on term newborn's thermal and cardiorespiratory adaptation

Directory of Open Access Journals (Sweden)

Vania Elisa M. Pugliesi

2009-12-01

Full Text Available OBJETIVO: Determinar se o banho dado ao recém-nascido (RN logo após o nascimento interfere na transição para a vida extrauterina, especialmente nas adaptações cardiorrespiratória e na termorregulação. MÉTODOS: Estudo retrospectivo realizado por meio de levantamento de prontuários de RN admitidos em maternidade de São Paulo, entre janeiro e março de 2006. Foram incluídos RN com boletim de Apgar >8 no quinto minuto de vida: peso de nascimento >2500g; idade gestacional >37 semanas e sem malformações congênitas, divididos em dois grupos: 'banho', banhados na sala de parto, e 'controle', banhados após a terceira hora de vida. Na admissão do RN na unidade neonatal, as seguintes variáveis foram analisadas: temperatura axilar, frequência cardíaca e respiratória, pressão arterial média e saturação de oxigênio. Analisou-se também o tipo de parto, o tempo decorrido entre o parto e a admissão no berçário e a taxa de aleitamento na sala de parto. RESULTADOS: Incluíram-se 194 RN, 98 no grupo banho e 96 no grupo controle. Em ambos os grupos, a temperatura corpórea na admissão era similar (36,6±0,4 e 36,6±0,3ºC; p=0,68; frequência cardíaca (143±13 e 146±14 bpm; p=0,26 e respiratória (51±6 e 51±9 mov/min; p=0,90, pressão arterial média (44±6 e 47±9 mmHg; p=0,13 e saturação de oxigênio (98±2 e98±3%; p=0,99 foram semelhantes. A taxa de aleitamento materno (91 e 57%; pOBJECTIVE: To determine the effect of bathing right after birth on newborn's transition to extra-uterine life, mainly regarding thermoregulation and cardiorespiratory adaptation. METHODS: A retrospective comparative study enrolled infants admitted between January and March 2006 in a private tertiary care maternity hospital in the city of São Paulo, Brazil. Inclusion criteria were: Apgar score > 8 (5th minute, birth weight >2500g; gestational age >37 weeks, no congenital anomalies. Newborns were divided in two study groups: 'bath' (bath right after

Portable bathtub: technology for bed bath in bedridden patients.

Science.gov (United States)

Backes, Dirce Stein; Gomes, Carine Alves; Pereira, Simone Barbosa; Teles, Noelucy Ferreira; Backes, Marli Terezinha Stein

2017-04-01

determine the benefits of the Portable Bathtub as technology for bed bath in bedridden patients. qualitative research of exploratory-descriptive character, whose data were collected by means of 30 interviews with patients, family members and professionals directly involved in bed bath, carried out with Portable Bathtub, in bedridden patients of a medical clinic, from July to December 2015. from the data encoded by thematic content analysis resulted two categories: Portable Bathtub: from morphine to the patient's rekindled eyes; From mechanized practice to unique, transforming care. we concluded that the Portable Bathtub constitutes enhancing technology, as it enables clinical improvement of the patient's general condition and transcends traditional mechanized practices by the reach of advanced nursing care practices.

Informing Leadership Models: Nursing and Organizational Characteristics of Neonatal Intensive Care Units in Freestanding Children's Hospitals.

Science.gov (United States)

Toole, Cheryl A; DeGrazia, Michele; Connor, Jean Anne; Gauvreau, Kimberlee; Kuzdeba, Hillary Bishop; Hickey, Patricia A

Neonatal intensive care units (NICUs) located in freestanding children's hospitals may exhibit significant variation in nursing and organizational characteristics, which can serve as opportunities for collaboration to understand optimal staffing models and linkages to patient outcomes. Adopting methods used by Hickey et al in pediatric cardiovascular critical care, the purpose of this study was to provide a foundational description of the nursing and organizational characteristics for NICUs located in freestanding children's hospitals in the United States. Clinical nurse leaders in NICUs located in freestanding children's hospitals were invited to participate in an electronic cross-sectional survey. Descriptive analyses were used to summarize nursing and organizational characteristics. The response rate was 30% (13/43), with 69.2% of NICUs classified as level III/IV and 30.8% classified as level II/III. Licensed bed capacity varied significantly (range, 24-167), as did the proportion of full-time equivalent nurses (range, 71.78-252.3). Approximately three-quarters of staff nurses held baccalaureate degrees or higher. A quarter of nurses had 16 or more years (26.3%) of experience, and 36.9% of nurses had 11 or more years of nursing experience. Nearly one-third (29.2%) had 5 or less years of total nursing experience. Few nurses (10.6%) held neonatal specialty certification. All units had nurse educators, national and unit-based quality metrics, and procedural checklists. This study identified (1) variation in staffing models signaling an opportunity for collaboration, (2) the need to establish ongoing processes for sites to participate in future collaborative efforts, and (3) survey modifications necessary to ensure a more comprehensive understanding of nursing and organizational characteristics in freestanding children's hospital NICUs.

Early Exercise in the Burn Intensive Care Unit Decreases Hospital Stay, Improves Mental Health, and Physical Performance

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2017-10-01

Decreases Hospital Stay, Improves Mental Health , and Physical Performance 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Oscar E. Suman, PhD...Multicenter Study of the Effect of In-Patient Exercise Training on Length of Hospitalization, Mental Health , and Physical Performance in Burned...Intensive Care Unit Decreases Hospital Stay, Improves Mental Health , and Physical Performance,” Proposal Log Number 13214039, Award Number W81XWH-14

Safety culture in the maternity unit of hospitals in Ilam province, Iran: a census survey using HSOPSC tool.

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Akbari, Nahid; Malek, Marzieh; Ebrahimi, Parvin; Haghani, Hamid; Aazami, Sanaz

2017-01-01

Improving quality of maternal care as well as patients' safety are two important issues in health-care service. Therefore, this study aimed to assess the culture of patient safety at maternity units. This cross-sectional study was conducted among staffs working at maternity units in seven hospitals of Ilam city, Iran. The staffs included in this study were gynecologists and midwifes working in different positions including matron, supervisors, head of departments and staffs. Data were collected using the Hospital Survey on Patient Safety Culture (HSOPSC). This study indicated that 59.1% of participants reported fair level of overall perceptions of safety and 67.1% declared that no event was reported during the past 12 months. The most positively perceived dimension of safety culture was teamwork within departments in view of managers (79.41) and personnel (81.10). However, the least positively perceived dimensions of safety culture was staffing levels. The current study revealed areas of strength (teamwork within departments) and weakness (staffing, punitive responses to error) among managers and personnel. In addition, we found that staffs in Ilam's hospitals accept the patient safety culture in maternity units, but, still are far away from excellent culture of patient safety. Therefore, it is necessary to promote culture of patient's safety among professions working in the maternity units of Ilam's hospitals.

Electrosynthesis of cadmium selenide films from sodium citrate-selenosulphite bath

International Nuclear Information System (INIS)

Lokhande, C.D.; Lee, Eun-Ho; Jung, Kwang-Deog; Joo, Oh-Shim

2005-01-01

Electrosynthesis of cadmium selenide (CdSe) film has been carried out from deposition bath containing sodium selenosulphite, along with cadmium complexed with sodium citrate under potentiostatic deposition condition on titanium substrates. The pH of deposition bath was weakly basic (< 9.0). The CdSe films up to 3.0 μm were deposited. The X-ray diffraction (XRD) studies revealed that the CdSe films are microcrystalline with increased grain size after annealing. The scanning electron microscopy showed that the films are porous with cauliflower-like morphology. The photelectrochemical characterization showed that the CdSe films are photoactive

Comparing Outcomes of Coronary Artery Bypass Grafting Among Large Teaching and Urban Hospitals in China and the United States.

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Zheng, Zhe; Zhang, Heng; Yuan, Xin; Rao, Chenfei; Zhao, Yan; Wang, Yun; Normand, Sharon-Lise; Krumholz, Harlan M; Hu, Shengshou

2017-06-01

Coronary artery disease is prevalent in China, with concomitant increases in the volume of coronary artery bypass grafting (CABG). The present study aims to compare CABG-related outcomes between China and the United States among large teaching and urban hospitals. Observational analysis of patients aged ≥18 years, discharged from acute-care, large teaching and urban hospitals in China and the United States after hospitalization for an isolated CABG surgery. Data were obtained from the Chinese Cardiac Surgery Registry in China and the National Inpatient Sample in the United States. Analysis was stratified by 2 periods: 2007, 2008, and 2010; and 2011 to 2013 periods. The primary outcome was in-hospital mortality, and the secondary outcome was length of stay. The sample included 51 408 patients: 32 040 from 77 hospitals in the China-CABG group and 19 368 from 303 hospitals in the US-CABG group. In the 2007 to 2008, 2010 period and for all-age and aged ≥65 years, the China-CABG group had higher mortality than the US-CABG group (1.91% versus 1.58%, P =0.059; and 3.12% versus 2.20%, P =0.004) and significantly higher age-, sex-, and comorbidity-adjusted odds of death (odds ratio, 1.58; 95% confidential interval, 1.22-2.04; and odds ratio, 1.73; 95% confidential interval, 1.24-2.40). There were no significant mortality differences in the 2011 to 2013 period. For preoperative, postoperative, and total hospital stay, respectively, the median (interquartile range) length of stay across the entire study period between China-CABG and US-CABG groups were 9 (8) versus 1 (3), 9 (6) versus 6 (3), and 20 (12) versus 7 (5) days (all P China and the United States. The longer length of stay in China may represent an opportunity for improvement. © 2017 The Authors.

Microbiological burden in air culture at various units of a tertiary care government hospital in Nepal

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Binaya Sapkota

2016-01-01

Full Text Available Background The environmental matrices (water, air, and surfaces play a vital role as reservoirs of Legionella spp. and Pseudomonas aeruginosa (Pseudomonas spp.. Hence, hospital environment control procedures are effective measures for reducing nosocomial infections. Aims This study was carried out to explore the profiles of microorganisms in air culture at various wards/units of a tertiary care hospital in Nepal. Methods A descriptive cross-sectional study was carried out at various wards/units of a tertiary care hospital in Nepal between January and September 2015 to explore the microbiological burden in inanimate objects. Each week one ward or unit was selected for the study. Bed, tap, the entire room, trolley, computer, phone, rack handles, table, chair, door, stethoscope, oxygen mask, gown, cupboard handles, and wash basins were selected for air culture testing. Ten different wards/units and 77 locations/pieces of equipment were selected for air culture by employing a simple random sampling technique. Information about the organisms was entered into the Statistical Package for the Social Sciences (SPSS Version 22 (IBM: Armonk, NY and descriptive analyses were carried out. Results Staphylococcus aureus (S. aureus, Micrococcus, coagulase negative staphylococcus (CONS, Bacillus, Pseudomonas aeruginosa, yeast, and Acinetobacter were the most commonly detected organisms. In the postoperative ward, S. aureus was the most frequently detected microorganism. Micrococcus was detected in four out of 10 locations. In the x-ray unit, S. aureus was detected in three out of four locations. Conclusion S. aureus, Micrococcus, CONS, Bacillus, Pseudomonas, yeast, and Acinetobacter were the most common organisms detected.

Health Effect of Forest Bathing Trip on Elderly Patients with Chronic Obstructive Pulmonary Disease.

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Jia, Bing Bing; Yang, Zhou Xin; Mao, Gen Xiang; Lyu, Yuan Dong; Wen, Xiao Lin; Xu, Wei Hong; Lyu, Xiao Ling; Cao, Yong Bao; Wang, Guo Fu

2016-03-01

Forest bathing trip is a short, leisurely visit to forest. In this study we determined the health effects of forest bathing trip on elderly patients with chronic obstructive pulmonary disease (COPD). The patients were randomly divided into two groups. One group was sent to forest, and the other was sent to an urban area as control. Flow cytometry, ELISA, and profile of mood states (POMS) evaluation were performed. In the forest group, we found a significant decrease of perforin and granzyme B expressions, accompanied by decreased levels of pro-inflammatory cytokines and stress hormones. Meanwhile, the scores in the negative subscales of POMS decreased after forest bathing trip. These results indicate that forest bathing trip has health effect on elderly COPD patients by reducing inflammation and stress level. Copyright © 2016 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Study on salt bath nitrocarburizing of 17-4PH stainless steel

International Nuclear Information System (INIS)

Wang Jun; Xiong Ji; Fan Hongyuan; Peng Qian; Wang Ying; Li Guijiang; Shen Baoluo

2009-01-01

The effect of the salt bathing nitriding under different temperature on the microstructure of Martensite stainless steel and the change of hardness and wear ability under different treatment temperature are comparatively studied. The study results show that when 17-4PH stainless steel was subjected to the salt bathing nitriding, the main items in the nitrided layer are the expanded (nitride contended) martensite (α'), Fe 2-3 (N, C), CrN, Fe 4 N and Fe 3 O 4 . The amount of Fe 3 O 4 and CrN was increased with the treatment temperature going up. The lattice constant of expanded martensite has the similar change. The activation energy of nitriding in this salt bath was 190.9 kJ/mol. The depth of the nitrided layer was increased with the treatment temperature increasing. After the alloy nitriding at 580 degree C, the mass loss in the slide wear test was reduced from 21.1 mg for H 1100 condition to 1.0 mg. (authors)

Electroplated Fe-Co-Ni films prepared from deep-eutectic-solvent-based plating baths

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Takeshi Yanai

2016-05-01

Full Text Available We fabricated soft magnetic films from DES-based plating baths, and investigated magnetic properties of the plated films. The plating baths were obtained by stirring the mixture of choline chloride, ethylene glycol, FeCl2 ⋅ 4H2O, NiCl2 ⋅ 6H2O and CoCl2 ⋅ 6H2O. The composition of the electroplated film depended on the amount of the reagent in the plating bath, and we consequently obtained the films with various composition. The current efficiency of the plating process shows high values (> 88 % in the wide composition range. The soft magnetic films with low coercivity were obtained at the Fe compositions of ≈ 30 at.% and > 80 at.%, and we found that low coercivity could be realized by the control of the film composition. We also found that the Fe-rich films prepared from DES-based plating bath have some advantages as a soft magnetic phase for a nanocomposite magnet due to their high saturation magnetization and very fine crystal structure.

Incidence and Treatment Patterns in Hospitalizations for Malignant Spinal Cord Compression in the United States, 1998-2006

International Nuclear Information System (INIS)

Mak, Kimberley S.; Lee, Leslie K.; Mak, Raymond H.; Wang, Shuang; Pile-Spellman, John; Abrahm, Janet L.; Prigerson, Holly G.; Balboni, Tracy A.

2011-01-01

Purpose: To characterize patterns in incidence, management, and costs of malignant spinal cord compression (MSCC) hospitalizations in the United States, using population-based data. Methods and Materials: Using the Nationwide Inpatient Sample, an all-payer healthcare database representative of all U.S. hospitalizations, MSCC-related hospitalizations were identified for the period 1998-2006. Cases were combined with age-adjusted Surveillance, Epidemiology and End Results cancer death data to estimate annual incidence. Linear regression characterized trends in patient, treatment, and hospital characteristics, costs, and outcomes. Logistic regression was used to examine inpatient treatment (radiotherapy [RT], surgery, or neither) by hospital characteristics and year, adjusting for confounding. Results: We identified 15,367 MSCC-related cases, representing 75,876 hospitalizations. Lung cancer (24.9%), prostate cancer (16.2%), and multiple myeloma (11.1%) were the most prevalent underlying cancer diagnoses. The annual incidence of MSCC hospitalization among patients dying of cancer was 3.4%; multiple myeloma (15.0%), Hodgkin and non-Hodgkin lymphomas (13.9%), and prostate cancer (5.5%) exhibited the highest cancer-specific incidence. Over the study period, inpatient RT for MSCC decreased (odds ratio [OR] 0.68, 95% confidence interval [CI] 0.61-0.81), whereas surgery increased (OR 1.48, 95% CI 1.17-1.84). Hospitalization costs for MSCC increased (5.3% per year, p < 0.001). Odds of inpatient RT were greater at teaching hospitals (OR 1.41, 95% CI 1.19-1.67), whereas odds of surgery were greater at urban institutions (OR 1.82, 95% CI 1.29-2.58). Conclusions: In the United States, patients dying of cancer have an estimated 3.4% annual incidence of MSCC requiring hospitalization. Inpatient management of MSCC varied over time and by hospital characteristics, with hospitalization costs increasing. Future studies are required to determine the impact of treatment patterns on MSCC

Collaboration between physician Emerich Lindenmayer and architect Jan Nevole in restoring the Sokobanja Turkish bath

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Mitrović Gordana

2015-01-01

Full Text Available The Sokobanja Turkish bath is an exceptional example of twosection baths and quite particular in its style, structure type and technology used. It is one of the two of the same type that remained in Serbia and the only one that has retained its original function. About its construction we learn from the Vidin sanjak defter from the second half of the 16th century. In the lavish built heritage inventory, Turkish baths are quite unique secular public structures, playing a prominent role in the development of health culture. Based upon their specific function, these baths possess a special architectural expression, are often monumental, decorative and imaginative in their forms and ornamentation. Prince Miloš initiated repair works of the Soko Banja baths and spa springs immediately after the settlement became a part of the Serbian Principality in 1834. When work on restoring the men’s baths started, a separate room with a tub was built for Prince Miloš, while the women’s bath remained in ruins. In 1847, the Ministry of Interior sent Dr Emerich Lindenmayer and architect Jan Nevole, as an expert team, to assess the state of the hammam so that it could be included in the undertakings funded from the state budget. After the assessment and review of the existing issues and upon a detailed report submitted to the Ministry of Interior, complex repairs were conducted in 1850, according to Nevole’s architectural design and his constant supervision. The approach implemented in the architectural renovation process was based on highly regarded principles of the time, thus preserving both the hammam’s original function and its valuable architecture.

An Evaluation and Ranking of Children's Hospital Websites in the United States.

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Huerta, Timothy R; Walker, Daniel M; Ford, Eric W

2016-08-22

Children's hospitals are faced with the rising need for technological innovation. Their prospective health care consumers, who increasingly depend on the Web and social media for communication and consumer engagement, drive this need. As patients and family members navigate the Web presence of hospitals, it is important for these specialized organizations to present themselves and their services efficiently. The purpose of this study was to evaluate the website content of children's hospitals in order to identify opportunities to improve website design and create benchmarks to judge improvement. All websites associated with a children's hospital were identified using a census list of all children's hospitals in the United States. In March of 2014, each website and its social media were evaluated using a Web crawler that provided a 5-dimensional assessment that included website accessibility, marketing, content, technology, and usability. The 5-dimensional assessment was scored on a scale ranging from 0 to 10 with positive findings rated higher on the scale. Websites were ranked by individual dimensions as well as according to their average ranking across all dimensions. Mean scores of 153 websites ranged from 5.05 to 8.23 across all 5 dimensions. Results revealed that no website scored a perfect 10 on any dimension and that room exists for meaningful improvement. Study findings allow for the establishment of baseline benchmarks for tracking future website and social media improvements and display the need for enhanced Web-based consumer engagement for children's hospitals.

Cost-effectiveness of strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in an intensive care unit.

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Gidengil, Courtney A; Gay, Charlene; Huang, Susan S; Platt, Richard; Yokoe, Deborah; Lee, Grace M

2015-01-01

OBJECTIVE To create a national policy model to evaluate the projected cost-effectiveness of multiple hospital-based strategies to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission and infection. DESIGN Cost-effectiveness analysis using a Markov microsimulation model that simulates the natural history of MRSA acquisition and infection. PATIENTS AND SETTING Hypothetical cohort of 10,000 adult patients admitted to a US intensive care unit. METHODS We compared 7 strategies to standard precautions using a hospital perspective: (1) active surveillance cultures; (2) active surveillance cultures plus selective decolonization; (3) universal contact precautions (UCP); (4) universal chlorhexidine gluconate baths; (5) universal decolonization; (6) UCP + chlorhexidine gluconate baths; and (7) UCP+decolonization. For each strategy, both efficacy and compliance were considered. Outcomes of interest were: (1) MRSA colonization averted; (2) MRSA infection averted; (3) incremental cost per colonization averted; (4) incremental cost per infection averted. RESULTS A total of 1989 cases of colonization and 544 MRSA invasive infections occurred under standard precautions per 10,000 patients. Universal decolonization was the least expensive strategy and was more effective compared with all strategies except UCP+decolonization and UCP+chlorhexidine gluconate. UCP+decolonization was more effective than universal decolonization but would cost $2469 per colonization averted and $9007 per infection averted. If MRSA colonization prevalence decreases from 12% to 5%, active surveillance cultures plus selective decolonization becomes the least expensive strategy. CONCLUSIONS Universal decolonization is cost-saving, preventing 44% of cases of MRSA colonization and 45% of cases of MRSA infection. Our model provides useful guidance for decision makers choosing between multiple available hospital-based strategies to prevent MRSA transmission.

Flashback phenomenon and residual neurological deficits after the use of "bath salt" 3, 4- methylenedioxypyrovalerone.

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Mangold, Aaron R; Bravo, Thomas P; Traub, Stephen J; Maher, Steven A; Lipinski, Christopher A

2014-01-01

The use and abuse of designer drugs has been recognized for decades; however there are many derivatives of compounds that make their way into the community. Abuse of compound(s) known on the street as "bath salt" is on the rise. We report the case of a 33-year-old man who complained of "flashbacks" and right arm shaking that followed a night of "bath salt" snorting. The active compound methylenedioxypyrovalerone methamphetamine (MDPV) was confirmed; however, analysis of three different "bath salt" products showed difference in their active components. The patient's symptoms remained stable and he was discharged home after observation in the emergency department with instructions to return for any symptom progression. Practitioners should be aware of the abuse of the compounds and that not all "bath salt" products contain MDPV.

Cannabinoid Hyperemesis Relieved by Compulsive Bathing

OpenAIRE

Chang, Yoon Hee; Windish, Donna M.

2009-01-01

Cannabinoid hyperemesis is a clinical syndrome characterized by repeated vomiting and associated learned compulsive hot water bathing behavior due to long-term marijuana use. Research has indentified type 1 cannabinoid receptors in the intestinal nerve plexus that have an inhibitory effect on gastrointestinal motility. This inhibitory effect may lead to hyperemesis in marijuana users. The thermoregulatory role of endocannabinoids may be responsible for the patient's need to take hot showers. ...

A real-frequency solver for the Anderson impurity model based on bath optimization and cluster perturbation theory

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Zingl, Manuel; Nuss, Martin; Bauernfeind, Daniel; Aichhorn, Markus

2018-05-01

Recently solvers for the Anderson impurity model (AIM) working directly on the real-frequency axis have gained much interest. A simple and yet frequently used impurity solver is exact diagonalization (ED), which is based on a discretization of the AIM bath degrees of freedom. Usually, the bath parameters cannot be obtained directly on the real-frequency axis, but have to be determined by a fit procedure on the Matsubara axis. In this work we present an approach where the bath degrees of freedom are first discretized directly on the real-frequency axis using a large number of bath sites (≈ 50). Then, the bath is optimized by unitary transformations such that it separates into two parts that are weakly coupled. One part contains the impurity site and its interacting Green's functions can be determined with ED. The other (larger) part is a non-interacting system containing all the remaining bath sites. Finally, the Green's function of the full AIM is calculated via coupling these two parts with cluster perturbation theory.

Portable bathtub: technology for bed bath in bedridden patients

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Dirce Stein Backes

Full Text Available ABSTRACT Objective: determine the benefits of the Portable Bathtub as technology for bed bath in bedridden patients. Method: qualitative research of exploratory-descriptive character, whose data were collected by means of 30 interviews with patients, family members and professionals directly involved in bed bath, carried out with Portable Bathtub, in bedridden patients of a medical clinic, from July to December 2015. Results: from the data encoded by thematic content analysis resulted two categories: Portable Bathtub: from morphine to the patient's rekindled eyes; From mechanized practice to unique, transforming care. Conclusion: we concluded that the Portable Bathtub constitutes enhancing technology, as it enables clinical improvement of the patient's general condition and transcends traditional mechanized practices by the reach of advanced nursing care practices.

Nonequlibrium dynamics of scalar fields in a thermal bath

International Nuclear Information System (INIS)

Anisimov, A.; Buchmueller, W.; Drewes, M.; Mendizabal, S.

2008-12-01

We study the approach to equilibrium for a scalar field which is coupled to a large thermal bath. Our analysis of the initial value problem is based on Kadanoff-Baym equations which are shown to be equivalent to a stochastic Langevin equation. The interaction with the thermal bath generates a temperature-dependent spectral density, either through decay and inverse decay processes or via Landau damping. In equilibrium, energy density and pressure are determined by the Bose-Einstein distribution function evaluated at a complex quasi-particle pole. The time evolution of the statistical propagator is compared with solutions of the Boltzmann equations for particles as well as quasi-particles. The dependence on initial conditions and the range of validity of the Boltzmann approximation are determined. (orig.)

Quality of communication about medicines in United States hospitals: A national retrospective study.

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Mullings, Lauren; Sankaranarayanan, Jayashri

Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals. To evaluate ComMed quality variations by hospital characteristics. In a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs. low = average/below average/poor star ratings) of 3125 hospitals were compared across region, rural-urban location, and health information technology (HIT) infrastructure giving providers access to patients' electronic medical records. Multivariate logistic regression analysis was conducted with adjusting for confounders (hospital - bed size, ownership, type, ED services, the number of completed HCAHPS surveys). After adjusting for other characteristics, Midwest versus Western region hospitals (OR = 1.55, 95% CI: 1.21-1.98, p=quality. Hospitals' small bed-size, physician/non-profit ownership, critical-access type, absent ED services, and 100-299 HCAHPS completed surveys were more likely to be associated with high ComMed quality. One of the first national studies found significant variations in ComMed quality across U.S. hospitals by location (high in Midwest and low in Northeast regions and urban areas) and by access to HIT infrastructure (high) after controlling for other hospital characteristics. With this baseline data, hospital providers and policymakers can design, implement, and evaluate service programs with pharmacists and HIT to enhance ComMed quality in the future delivery of patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

Healthy hospital food initiatives in the United States: time to ban sugar sweetened beverages to reduce childhood obesity.

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Wojcicki, Janet M

2013-06-01

While childhood obesity is a global problem, the extent and severity of the problem in United States, has resulted in a number of new initiatives, including recent hospital initiatives to limit the sale of sweetened beverages and other high calorie drinks in hospital vending machines and cafeterias. These proposed policy changes are not unique to United States, but are more comprehensive in the number of proposed hospitals that they will impact. Meanwhile, however, it is advised, that these initiatives should focus on banning sugar sweetened beverages, including sodas, 100% fruit juice and sports drinks, from hospital cafeterias and vending machines instead of limiting their presence, so as to ensure the success of these programs in reducing the prevalence of childhood obesity. If US hospitals comprehensively remove sugar sweetened beverages from their cafeterias and vending machines, these programs could subsequently become a model for efforts to address childhood obesity in other areas of the world. Hospitals should be a model for health care reform in their communities and removing sugar sweetened beverages is a necessary first step. ©2013 Foundation Acta Paediatrica. Published by Blackwell Publishing Ltd.

Feelings of women accompanying children hospitalized in a Paediatric Intensive Care Unit

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Cassiana Mendes Bertoncello Fontes

2017-03-01

Full Text Available Objective: Analise feelings of women accompanying children in a paediatric intensive care unit Materials and Methods: Data were collected from August to October 2015 by the authors from individual interviews recorded with 15 women. The instrument was structured with the identification of qualitative variables, described in absolute and relative frequencies, and a guiding question. The "corpus" of each interview was electronically transcribed, floating readings were held and statements were categorized and analysed according Analise Content.  Results: 14 (93% are biological mothers; average age 30 years; 11 (73% have completed primary education; six (46% have an occupation or a profession. The four themes were inferred: ambivalence of feelings and coping were related to how individuals express and deal with the hospitalized patient’s situation; empathy with the health team and the structural condition of the critical environment can also generate feelings. Nursing diagnoses were formulated from the reported feelings. Conclusion: It was observed that the feelings identified could be originated by the health-illness hospitalization process as well as the structural components of the critical environment. Keywords: Paediatric Intensive Care Units; Women; Feelings.

Post-destructive eye surgery, associated depression at Sekuru Kaguvi Hospital Eye Unit, Zimbabwe: Pilot Study

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M. M. Kawome

2013-12-01

Full Text Available Destructive eye surgery is associated with more complications than just loss of visual functions of the eye and aesthetics. Currently there is very little published literature on post-destructive eye surgery associated depression. Zimbabwe has been experiencing a surge in the rate of destructive eye surgery done at the National Tertiary Eye Unit. This situation could be churning out lots of unrecognized depressed clients into the community who require assistance in one form or another. Objectives: To determine the prevalence of post-destructive eye surgery associated depression among patients attending Sekuru Kaguvi Hospital Eye Unit and assess if the current management protocol of patients undergoing destructive eye surgery at the Eye Unit addresses the problem adequately. Methods: A cross-sectional study of 28 randomly selected patients who had destructive eye surgeries at Sekuru Kaguvi Hospital was conducted over five months from 1st March 2012 to end of July 2012. A structured questionnaire containing 15 questions on the following items: gender, age, diagnosis, surgical procedure done, expectations before and after surgery, adequacy of counseling given and involvement of family was used to collect data. Nine questions to assess depression were adapted from the Patient Health Questionnaire (PHQ-9. Setting:  The study was conducted at SekuruKaguvi Hospital Eye Unit, Parirenyatwa Group of Hospitals in Harare. Results:  Twenty-eight patients who underwent destructive eye surgery during the study period were selected using systematic random sampling. The gender ratio was 1:1 and the mean age was 38.7 years with a range from 24 to 65 years. Fifty percent of the patients in the study had orbital exenteration while the rest had enucleation (14% and evisceration (36%. Twenty-eight percent of the study population had depression. Conclusion: Destructive eye surgery is frequently associated with depression and our current management protocol of

THREE DIMENSIONAL MODELING VIA PHOTOGRAPHS FOR DOCUMENTATION OF A VILLAGE BATH

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H. B. Balta

2013-07-01

Full Text Available The aim of this study is supporting the conceptual discussions of architectural restoration with three dimensional modeling of monuments based on photogrammetric survey. In this study, a 16th century village bath in Ulamış, Seferihisar, and Izmir is modeled for documentation. Ulamış is one of the historical villages within which Turkish population first settled in the region of Seferihisar – Urla. The methodology was tested on an antique monument; a bath with a cubical form. Within the limits of this study, only the exterior of the bath was modeled. The presentation scale for the bath was determined as 1 / 50, considering the necessities of designing structural interventions and architectural ones within the scope of a restoration project. The three dimensional model produced is a realistic document presenting the present situation of the ruin. Traditional plan, elevation and perspective drawings may be produced from the model, in addition to the realistic textured renderings and wireframe representations. The model developed in this study provides opportunity for presenting photorealistic details of historical morphologies in scale. Compared to conventional drawings, the renders based on the 3d models provide an opportunity for conceiving architectural details such as color, material and texture. From these documents, relatively more detailed restitution hypothesis can be developed and intervention decisions can be taken. Finally, the principles derived from the case study can be used for 3d documentation of historical structures with irregular surfaces.

Trends of Heller myotomy hospitalizations for achalasia in the United States, 1993-2005: effect of surgery volume on perioperative outcomes.

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Wang, Y Richard; Dempsey, Daniel T; Friedenberg, Frank K; Richter, Joel E

2008-10-01

Achalasia is a rare chronic disorder of esophageal motor function. Single-center reports suggest that there has been greater use of laparoscopic Heller myotomy for achalasia in the United States since its introduction in 1992. We aimed to study the trends of Heller myotomy and the relationship between surgery volume and perioperative outcomes. The Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS) is a 20% stratified sample of all hospitalizations in the United States. It was used to study the macro-trends of Heller myotomy hospitalizations during 1993-2005. We also used the NIS 2003-2005 micro-data to study the perioperative outcomes of Heller myotomy hospitalizations, using other achalasia and laparoscopic cholecystectomy hospitalizations as control groups. The generalized linear model with repeated observations from the same unit was used to adjust for multiple hospitalizations from the same hospital. The national estimate of Heller myotomy hospitalizations increased from 728 to 2,255 during 1993-2005, while its mean length of stay decreased from 9.9 to 4.3 days. Of the 1,117 Heller myotomy hospitalizations in the NIS 2003-2005, 10 (0.9%) had the diagnosis of esophageal perforation at discharge. Length of stay was negatively correlated with a hospital's number of Heller myotomy per year (correlation coefficient -0.171, P Heller myotomy per year was negatively associated with length of stay (coefficient -0.215 to -0.119, both P Heller myotomy for achalasia was associated with greater use of surgery and shorter length of stay. A larger volume of Heller myotomy in a hospital was associated with better perioperative outcomes in terms of shorter length of stay and lower total charges.

Focal epilepsy presenting as a bath-induced paroxysmal event/breath-holding attack

OpenAIRE

Stutchfield, C.J.; Loh, N.R.

2014-01-01

Bath-induced paroxysmal events in infants and children can be triggered by various etiologies, including cardiological, neurological, and metabolic causes. It is important to ascertain the underlying cause for such events as this significantly affects the child's management and prognosis. We present the case of a 19-month-old boy who presented with recurrent episodes of apnea, cyanosis, and reduced level of consciousness in response to bathing. Through detailed history and investigation, the ...

Patient perception of pain care in hospitals in the United States

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Anita Gupta

2009-11-01

Full Text Available Anita Gupta1, Sarah Daigle2, Jeffrey Mojica3, Robert W Hurley41Pain Management Division, Department of Anesthesiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA; 2Department of Anesthesiology and Critical Care, 3Department of Anesthesiology and Critical Care, Division of Pain Medicine, University of Pennsylvania, Philadelphia, PA, USA; 4Medical Director of the Johns Hopkins Pain Treatment Center, Division of Pain Medicine, Deparment of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USAStudy objective: Assessment of patients’ perception of pain control in hospitals in the United States.Background: Limited data are available regarding the quality of pain care in the hospitalized patient. This is particularly valid for data that allow for comparison of pain outcomes from one hospital to another. Such data are critical for numerous reasons, including allowing patients and policy-makers to make data-driven decisions, and to guide hospitals in their efforts to improve pain care. The Hospital Quality Alliance was recently created by federal policy makers and private organizations in conjunction with the Centers for Medicare and Medicare Services to conduct patient surveys to evaluate their experience including pain control during their hospitalization.Methods: In March 2008, the results of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS survey was released for review for health care providers and researchers. This survey includes a battery of questions for patients upon discharge from the hospital including pain-related questions and patient satisfaction that provide valuable data regarding pain care nationwide. This study will review the results from the pain questions from this available data set and evaluate the performance of these hospitals in pain care in relationship to patient satisfaction. Furthermore, this analysis will be providing valuable

Percepção de familiares referente ao banho humanizado: técnica japonesa em recém-nascidos Family member’s perception on the humanized bath: japanese technique for newborns

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Jadna Hemkemeier

2012-05-01

Full Text Available Objetivo: Conhecer a percepção de familiares acerca da experiência da utilização do banho humanizado, uma técnica Japonesa em recém-nascidos (RN. Materiais e Métodos: Trata-se de uma pesquisa do tipo exploratória, de abordagem qualitativa, conduzida pela seguinte questão norteadora: qual a percepção de familiares acerca da experiência de utilização do banho humanizado – Técnica Japonesa em recém-nascidos? Os dados dessa pesquisa foram coletados no período de maio a junho de 2011. A metodologia envolveu uma entrevista, com apenas uma pergunta, aplicada às participantes no dia em que estas realizaram o procedimento no hospital, juntamente com um roteiro de observação participante, além de outra entrevista, contendo três perguntas realizadas na visita domiciliar, dez dias após a alta hospitalar. Resultados: Os resultados revelam que os familiares estão satisfeitos com a nova técnica de banho. Os RNs permaneceram calmos e quietos, demonstrando os benefícios do banho humanizado. Conclusão: É imprescindível que os familiares e os profissionais da saúde aceitem novas formas de procedimentos mais humanizados para RNs. Esta nova técnica de banho possibilita que os RNs mantenham-se mais calmos, não havendo choro durante a sua execução. Entretanto, observou-se que, para a eficácia da nova técnica de banho, o RN deve ser bem enrolado no cueiro, a fim de que se sinta mais protegido.Objective: To study the perception of family members about the experience of using the humanized bath, a Japanese technique for newborns (NB. Materials and Methods: This is an exploratory research with a qualitative approach, motivated by the following question: what is the perception of family members about the experience of using the humanized bath - Japanese technique for newborns? All data were collected between may and june of 2011. The methodology involved an interview with just one question, applied to the participants during the day

A measurement tool to assess culture change regarding patient safety in hospital obstetrical units.

Science.gov (United States)

Kenneth Milne, J; Bendaly, Nicole; Bendaly, Leslie; Worsley, Jill; FitzGerald, John; Nisker, Jeff

2010-06-01

Clinical error in acute care hospitals can only be addressed by developing a culture of safety. We sought to develop a cultural assessment survey (CAS) to assess patient safety culture change in obstetrical units. Interview prompts and a preliminary questionnaire were developed through a literature review of patient safety and "high reliability organizations," followed by interviews with members of the Managing Obstetrical Risk Efficiently (MOREOB) Program of the Society of Obstetricians and Gynaecologists of Canada. Three hundred preliminary questionnaires were mailed, and 21 interviews and 9 focus groups were conducted with the staff of 11 hospital sites participating in the program. To pilot test the CAS, 350 surveys were mailed to staff in participating hospitals, and interviews were conducted with seven nurses and five physicians who had completed the survey. Reliability analysis was conducted on four units that completed the CAS prior to and following the implementation of the first MOREOB module. Nineteen values and 105 behaviours, practices, and perceptions relating to patient safety were identified and included in the preliminary questionnaire, of which 143 of 300 (47.4%) were returned. Among the 220 cultural assessment surveys returned (62.9%), six cultural scales emerged: (1) patient safety as everyone's priority; (2) teamwork; (3) valuing individuals; (4) open communication; (5) learning; and (6) empowering individuals. The reliability analysis found all six scales to have internal reliability (Cronbach alpha), ranging from 0.72 (open communication) to 0.84 (valuing individuals). The CAS developed for this study may enable obstetrical units to assess change in patient safety culture.

[History of hot spring bath treatment in China].

Science.gov (United States)

Hao, Wanpeng; Wang, Xiaojun; Xiang, Yinghong; Gu Li, A Man; Li, Ming; Zhang, Xin

2011-07-01

As early as the 7th century B.C. (Western Zhou Dynasty), there is a recording as 'spring which contains sulfur could treat disease' on the Wentang Stele written by WANG Bao. Wenquan Fu written by ZHANG Heng in the Easten Han Dynasty also mentioned hot spring bath treatment. The distribution of hot springs in China has been summarized by LI Daoyuan in the Northern Wei Dynasty in his Shuijingzhu which recorded hot springs in 41 places and interpreted the definition of hot spring. Bencao Shiyi (by CHEN Cangqi, Tang Dynasty) discussed the formation of and indications for hot springs. HU Zai in the Song Dynasty pointed out distinguishing hot springs according to water quality in his book Yuyin Conghua. TANG Shenwei in the Song Dynasty noted in Jingshi Zhenglei Beiji Bencao that hot spring bath treatment should be combined with diet. Shiwu Bencao (Ming Dynasty) classified hot springs into sulfur springs, arsenicum springs, cinnabar springs, aluminite springs, etc. and pointed out their individual indications. Geologists did not start the work on distribution and water quality analysis of hot springs until the first half of the 20th century. There are 972 hot springs in Wenquan Jiyao (written by geologist ZHANG Hongzhao and published in 1956). In July 1982, the First National Geothermal Conference was held and it reported that there were more than 2600 hot springs in China. Since the second half of the 20th century, hot spring sanatoriums and rehabilitation centers have been established, which promoted the development of hot spring bath treatment.

Elaboration of leadership and culture in high-performing nursing units of hospitals as perceived by staff nurses.

Science.gov (United States)

Casida, Jesus M; Crane, Patrick C; Walker, Tara L; Wargo, Lisa M

2012-01-01

The leadership-culture phenomenon, a known explanatory construct for organizational performance, is understudied in nursing. Building on our previous work, we further addressed this knowledge gap through explorations of demographics and hospital variables which may have a significant influence on staff nurses' (SNs) perceptions of their nurse managers' (NMs) leadership and nursing unit culture. Furthermore, we explored the extent to which the NMs' leadership predicted specific cultures which typify nursing unit effectiveness. Using dissertation data provided by278 SNs, we found that SNs educated at the baccalaureate level or higher had favorable perceptions of their nursing unit performance and viewed their NMs' leadership differently than the SNs with diploma or associate degrees. The frequent portrayals of transformational (TFL) leadership behaviors (e.g., visionary) by the NMs were paramount in shaping culture traits which exemplify high performance outcomes. TFL leaders were more likely to shape unit cultures which are flexible and adaptive to the environmental challenges within and outside the nursing unit. Thus, the type of NMs' leadership and unit culture may provide an added value in explaining the performance level in patient care units which consequently affects the overall hospital/organizational outcomes. Implications for research and leadership practices are presented.

Antimicrobial Suspectibility of Bacterial Isolated from Burn Unit in Dr. Hasan Sadikin General Hospital Bandung, Indonesia from June to September 2013

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Yodya Evila

2015-09-01

Full Text Available Background: Development of infection in burned patients is a crucial matter because it may increase morbidity and mortality. Factors contributing to high risk for infections are disrupted skin barrier, dysfunction of the immune system and prolonged hospitalization. Crowded hospital condition and transfer of patients from one unit to another can affect development of infection caused by environmental factors. The aim of the study was to identify the antimicrobial suspectibility of bacterial isolated from Burn Unit in Dr. Hasan Sadikin General Hospital, Bandung. Methods: A descriptive study was carried out in Burn Unit Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from June to September 2013. A total of 30 environment samples were collected and cultured to identify the bacterias. Futhermore, the colonies found, underwent antimicrobial susceptibility test. Results: Most common bacteria found from the environmental samples in Burn Unit was Staphylococcus saprophyticus (24%. Other bacterias found were Klebsiella pneumonia (17%, Acinetobacter baumanii (15%, Staphylococcus epidermidis (12%, Bacillus sp.(12%, Pseudomonas sp.(7%, Staphylococcus aureus (5%, Enterobacter aerogenes (5% and Serratia sp. (2%. Some bacteria still had good sensitivity to antibiotics while the Enterobacteriaceae were almost completely resistant to antimicrobial used in the study. Conclusions: The most common bacteria found from the environment samples in Burn Unit is Staphylococcuss aprophyticus. Additionally, Klebsiella pneumoniae as one of the Enterobacteriaceae groups, appears as an emerging hospital associated infection pathogen with their resistant to many antimicrobials.

Adherence to guidelines in bleeding oesophageal varices and effects on outcome: comparison between a specialized unit and a community hospital

DEFF Research Database (Denmark)

Hobolth, Lise; Krag, Aleksander; Malchow-Møller, Axel

2010-01-01

is difficult. Our aims were to compare adherence to evidence-based guidelines in BOV between a specialized unit and a community hospital, and to investigate whether differences in adherence affected the outcome. METHODS: Two cohorts hospitalized during 2000-2007 with a first episode of BOV were retrospectively...... rebleeding were not statistically different. CONCLUSION: Our study shows that patients with BOV are more likely to receive therapy according to guidelines when hospitalized in a specialized unit compared with a community hospital. This however did not affect mortality.......OBJECTIVES: Randomized controlled trials have shown beneficial effects of vasoactive drugs, endoscopic treatment and prophylactic antibiotics on the outcome of bleeding oesophageal varices (BOV). However, translating guidelines based on randomized controlled trials into clinical practice...

Potentiometric titration of zinc and cadmium in electrolytes of in galvanic baths

International Nuclear Information System (INIS)

Kosyuga, E.A.; Kalugin, A.A.; Gur'ev, I.A.

1979-01-01

The method of potentiometric titration of zinc and cadmium by complexone 3 in electrolytes of galvanic baths using sulphide - silver electrode for determining the finite point of titration is suggested. Copper (2) ions are proposed as indicator ions. The potentiometric determination should be performed at pH=10. The method is verified on model electrolyte solutions and on the electrolyte solutions of operating baths.The technique can be used for automatic control. The time for analysis is 10 minutes

Influence of an oscillator bath on the nucleation rate

International Nuclear Information System (INIS)

Amritkar, R.E.

1984-09-01

The nucleation rate of a system in a metastable state coupled to an oscillator bath is considered. It is shown that for a weak coupling and small oscillator frequencies the nucleation rate increases. (author)

Decolorization and removal of cod and bodfrom raw and biotreated textile dye bath effluent through advanced oxidation processes (AOPS

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A. Muhammad

2008-09-01

Full Text Available In this paper, a comparative study of the treatment of raw and biotreated (upflow anaerobic sludge blanket, UASB textile dye bath effluent using advanced oxidation processes (AOPs is presented. The AOPs applied on raw and biotreated textile dye bath effluent, after characterization in terms of COD, colour, BOD and pH, were ozone, UV, UV/H2O2 and photo-Fenton. The decolorization of raw dye bath effluent was 58% in the case of ozonation. However it was 98% in the case of biotreated dye bath effluent when exposed to UV/H2O2. It is, therefore, suggested that a combination of biotreatment and AOPs be adopted to decolorize dye bath effluent in order to make the process more viable and effective. Biodegradability was also improved by applying AOPs after biotreatment of dye bath effluent.

Quantum dynamics of hydrogen atoms on graphene. I. System-bath modeling.

Science.gov (United States)

Bonfanti, Matteo; Jackson, Bret; Hughes, Keith H; Burghardt, Irene; Martinazzo, Rocco

2015-09-28

An accurate system-bath model to investigate the quantum dynamics of hydrogen atoms chemisorbed on graphene is presented. The system comprises a hydrogen atom and the carbon atom from graphene that forms the covalent bond, and it is described by a previously developed 4D potential energy surface based on density functional theory ab initio data. The bath describes the rest of the carbon lattice and is obtained from an empirical force field through inversion of a classical equilibrium correlation function describing the hydrogen motion. By construction, model building easily accommodates improvements coming from the use of higher level electronic structure theory for the system. Further, it is well suited to a determination of the system-environment coupling by means of ab initio molecular dynamics. This paper details the system-bath modeling and shows its application to the quantum dynamics of vibrational relaxation of a chemisorbed hydrogen atom, which is here investigated at T = 0 K with the help of the multi-configuration time-dependent Hartree method. Paper II deals with the sticking dynamics.

Quantum dynamics of hydrogen atoms on graphene. I. System-bath modeling

Energy Technology Data Exchange (ETDEWEB)

Bonfanti, Matteo, E-mail: matteo.bonfanti@unimi.it [Dipartimento di Chimica, Università degli Studi di Milano, v. Golgi 19, 20133 Milano (Italy); Jackson, Bret [Department of Chemistry, University of Massachusetts, Amherst, Massachusetts 01003 (United States); Hughes, Keith H. [School of Chemistry, Bangor University, Bangor, Gwynedd LL57 2UW (United Kingdom); Burghardt, Irene [Institute of Physical and Theoretical Chemistry, Goethe University Frankfurt, Max-von-Laue-Str. 7, 60438 Frankfurt/Main (Germany); Martinazzo, Rocco, E-mail: rocco.martinazzo@unimi.it [Dipartimento di Chimica, Università degli Studi di Milano, v. Golgi 19, 20133 Milano (Italy); Istituto di Scienze e Tecnologie Molecolari, Consiglio Nazionale delle Richerche, v. Golgi 19, 20133 Milano (Italy)

2015-09-28

An accurate system-bath model to investigate the quantum dynamics of hydrogen atoms chemisorbed on graphene is presented. The system comprises a hydrogen atom and the carbon atom from graphene that forms the covalent bond, and it is described by a previously developed 4D potential energy surface based on density functional theory ab initio data. The bath describes the rest of the carbon lattice and is obtained from an empirical force field through inversion of a classical equilibrium correlation function describing the hydrogen motion. By construction, model building easily accommodates improvements coming from the use of higher level electronic structure theory for the system. Further, it is well suited to a determination of the system-environment coupling by means of ab initio molecular dynamics. This paper details the system-bath modeling and shows its application to the quantum dynamics of vibrational relaxation of a chemisorbed hydrogen atom, which is here investigated at T = 0 K with the help of the multi-configuration time-dependent Hartree method. Paper II deals with the sticking dynamics.

Numerical modeling of transferred arc melting bath heating; Modelisation numerique du chauffage de bains par arc transfere

Energy Technology Data Exchange (ETDEWEB)

Bouvier, A. [Electricite de France, 77 - Moret sur Loing (France). Direction des Etudes et Recherches; Trenty, L.; Guillot, J.B. [Ecole Centrale de Paris, Laboratoire EM2C. CNRS, 92 - Chatenay-Malabry (France); Delalondre, C. [Electricite de France (EDF), 78 - Chatou (France). Direction des Etudes et Recherches

1997-12-31

This paper presents the modeling of a transferred electric arc inside a bath of melted metal. After a recall of the context of the study, the problem of the modeling, which involves magnetohydrodynamic coupling inside the arc and the bath, is described. The equations that govern the phenomena inside the arc and the bath are recalled and the approach used for the modeling of the anode region of the arc is explained using a 1-D sub-model. The conditions of connection between arc and bath calculations are explained and calculation results obtained with a 200 kW laboratory furnace geometry are presented. (J.S.) 8 refs.

Debate on Uncertainty in Estimating Bathing Water Quality

DEFF Research Database (Denmark)

Larsen, Torben

1992-01-01

Estimating the bathing water quality along the shore near a planned sewage discharge requires data on the source strength of bacteria, the die-off of bacteria and the actual dilution of the sewage. Together these 3 factors give the actual concentration of bacteria on the interesting spots...

Primary immunodeficiency investigation in patients during and after hospitalization in a pediatric Intensive Care Unit

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Erica Suavinho

2014-03-01

Full Text Available Objective: To analyze whether the patients with severe infections, admitted in the Pediatric Intensive Care Unit of the Hospital de Clínicas of the Universidade Federal de Uberlândia, underwent the active screening for primary immunodeficiencies (PID. Methods: Retrospective study that assessed the data records of patients with any severe infections admitted in the Pediatric Intensive Care Unit, covering a period from January 2011 to January 2012, in order to confirm if they performed an initial investigation for PID with blood count and immunoglobulin dosage. Results: In the studied period, 53 children were hospitalized with severe infections in the Pediatric Intensive Care Unit, and only in seven (13.2% the initial investigation of PID was performed. Among these patients, 3/7 (42.8% showed quantitative alterations in immunoglobulin G (IgG levels, 1/7 (14.3% had the diagnosis of cyclic neutropenia, and 1/7 (14.3% presented thrombocytopenia and a final diagnosis of Wiskott-Aldrich syndrome. Therefore, the PID diagnosis was confirmed in 5/7 (71.4% of the patients. Conclusions: The investigation of PID in patients with severe infections has not been routinely performed in the Pediatric Intensive Care Unit. Our findings suggest the necessity of performing PID investigation in this group of patients.

Quantitative percutaneous CO2 measurement following CO2 mineral water baths by means of the isotope ratio

International Nuclear Information System (INIS)

Mass, I.; Huebner, G.; Birkenfeld, H.; Zelaitis, L.; Ploetner, G.

1983-01-01

A method for the quantitative determination of the carbon dioxide penetration through the human skin during a medical carbon dioxide mineral water bath is described. The natural isotope variation of carbon in the carbon dioxide of bath water, blood, and exspiratory gas are used for the calculation of the penetrated carbon dioxide amount. The method permits to optimize the effectiveness of medical carbon dioxide baths. (author)

Kinetics of Ni–Mo electrodeposition from Ni-rich citrate baths

International Nuclear Information System (INIS)

Beltowska-Lehman, E.; Indyka, P.

2012-01-01

The kinetics of Ni–Mo alloy electrodeposition on steel substrates from an aqueous citrate–ammonia complex baths has been investigated by means of steady-state polarisation measurements in a system with a rotating disc electrode (RDE). Partial current densities for discharge of Ni(II) and Mo(VI) ions and hydrogen evolution as a function of molybdate concentration in the bath, cathode potentials and the rate of mass transport were determined. It has been shown that – under all investigated conditions – Ni–Mo alloy deposition is more favourable than pure nickel and the cathodic process is strongly influenced by the Mo(VI) content in the solution. The Ni(II) electroreduction rate initially increases, as the cathode potential shifts towards more negative values and the concentration of molybdate grows in the solution. However, for the highest examined MoO 4 2− content, a considerable decrease in the rate of the process is subsequently observed at certain limit potentials, the values of which depend on molybdate concentration and hydrodynamic conditions. This effect, related to the formation of intermediate molybdenum oxides (characterised by very low overvoltage for hydrogen evolution), becomes less pronounced when the RDE rotation speed is increased. Hydrogen evolution is strongly associated with molybdenum deposition. An increase of the molybdate ions concentration in the bath, as well as an increase in the rate of mass transport, leads to an increase in Mo content in deposits and to the reduction of current efficiency. The Ni–Mo coatings electrodeposited from the designed bath (with the current efficiency of about 70%) containing about 30 wt.% Mo, are characterised by a shiny-grey appearance and good adhesion to the steel substrate. They are characterised by column growth and amorphous microstructure with randomly distributed nanocrystallites of the MoNi 4 intermetallic phase.

[Results of pulmonary embolism treatment in a tertiary hospital short stay unit. Is this the right place?].

Science.gov (United States)

Rosa Salazar, V; Bernal Martínez, L; García Pino, M J; Hernández Contreras, M E; García Méndez, M M; García Pérez, B; Marras Fernández-Cid, C

2016-01-01

To determine the mean stay (MS) of patients with pulmonary embolism (PE) in a thrombosis unit (TU) with a short stay unit (SSU) in a tertiary hospital. To compare the data collected with those of other hospitals in the same region, of other regions (Autonomous Communities [AACC]), and within the same hospital in the year before the SSU opened. A descriptive retrospective observational study that included patients with a diagnosis of PE in the University Hospital Virgen de la Arrixaca (HCUVA) in 2012. These data were classified by hospital department, and used for calculating the mean stay. This was then compared with that of other hospitals in our region, with the rest of the regions, and with the data in 2007 (the last year without a TU). A total of 113patients with PE were included, 60 (53%) in the TU with an MS of 4.39, in Oncology, 7.45, and Internal Medicine (IM), 15.38days. There were no deaths in the TU and only 3 (5%) readmissions. Published data showed that the MS in all hospitals in our region was 8.25, 5.18 in our hospital, and higher in the rest of hospitals. The best AACC was the Basque Country with an MS of 6.85days. In 2007, there were 70patients with PE in the HCUVA, 34 (49%) in IM, with an MS of 8.50, Oncology 11 (31%) with an MS 9.64, and Chest Diseases 3 (4.3%) with an MS 19days, and with an overall mortality of 11% and a rate of readmissions in IM of 6%. The mean stay for a PE in the SSU of a TU was lower than in the rest of the hospital departments, lower than the rest hospitals of our region, lower than the rest of the regions, and lower than any department of our hospital before the SSU existed, without increasing the readmission or mortality rate. Copyright © 2015 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Comparing the Effect of Foot Reflexology Massage, Foot Bath and Their Combination on Quality of Sleep in Patients with Acute Coronary Syndrome

OpenAIRE

Ali Rahmani; Mahdi Naseri; Mohammad Mahdi Salaree; Batool Nehrir

2016-01-01

Introduction: Many patients in coronary care unit (CCU) suffer from decreased sleep quality caused by environmental and mental factors. This study compared the efficacy of foot reflexology massage, foot bath, and a combination of them on the quality of sleep of patients with acute coronary syndrome (ACS). Methods: This quasi-experimental study was implemented on ACS patients in Iran. Random sampling was used to divide the patients into four groups ...

Genuine three-qubit entanglement from coupling to a heat bath

Energy Technology Data Exchange (ETDEWEB)

Eltschka, Christopher [Institut fuer Theoretische Physik, Regensburg Univ. (Germany); Braun, Daniel [Universite de Toulouse, Laboratoire de Physique Theorique (IRSAMC), Toulouse (France); CNRS, LPT (IRSAMC), Toulouse (France); Siewert, Jens [Departamento de Quimica Fisica, Universidad del Pais Vasco UPV/EHU, Bilbao (Spain); Ikerbasque, Basque Foundation for Science, Bilbao (Spain)

2013-07-01

Initially unentangled qubits which do not interact which each other can become entangled by interacting with a common heat bath. But with more than two qubits, there exist several inequivalent types of entanglement. Therefore it is an important question which types of entanglement can be generated. While exactly determining and quantifying the entanglement for mixed states of more than two qubits is an unsolved problem, recent advancements based on the Greenberger-Horne-Zeilinger symmetry allow to determine a good lower bound for the entanglement. By using those methods we show that for three qubits coupled to the same heat bath indeed all types of entanglement can be generated for almost all separable initial states.

Electrodeposited Fe-Co films prepared from a citric-acid-based plating bath

OpenAIRE

Yanai, Takeshi; Uto, H.; Shimokawa, Takaya; Nakano, Masaki; Fukunaga, Hirotoshi; Suzuki, K.

2013-01-01

Electrodeposited Fe-Co films are commonly prepared in a boric-acid-based bath. In this research, we applied citric acid instead of boric acid for the plating of Fe-Co films because boron in the waste bath is restricted by environmental-protection regulations in Japan. We evaluated the effect of citric acid on the magnetic and structural properties of the films. The saturation magnetization of the Fe-Co films slightly increased while the Fe content in the Fe-Co films decreased with increasing ...

Implications of design on infection prevention and control practice in a novel hospital unit: the Medical Ward of the 21st Century.

Science.gov (United States)

VanSteelandt, Amanda; Conly, John; Ghali, William; Mather, Charles

2015-01-01

The physical design of hospital wards is associated with transmission of pathogenic organisms and hospital-acquired infections. A novel hospital unit, the Medical Ward of the 21st Century (W21C), optimizes features for infection prevention and control practices. Ethnographic research on the W21C versus conventional hospital wards examined the experiential and behavioural elements of the different designs. Three recurring themes emerged regarding the design features on the W21C and included visual cues, 'having a place for things', and less sharing of spaces and materials. Observational data of healthcare worker practices demonstrated significantly higher compliance with hand hygiene opportunities on the W21C compared with older hospital units. These findings suggest how the physical design of a hospital ward may enhance infection prevention and control practices.

67. The safety engineering at driving of destroyed hearth and repair of bath fettling during operation

International Nuclear Information System (INIS)

Ivanov, A.V.

1993-01-01

The safety engineering at driving of destroyed hearth and repair of bath fettling during operation was considered. All operational conditions at driving of destroyed hearth and repair of bath fettling during operation were studied.

Physical Properties of Nanostructured CdO Films from Alkaline Baths Containing Saccharin as Additive

Directory of Open Access Journals (Sweden)

Bünyamin Şahin

2013-01-01

Full Text Available Nanostructured cadmium oxide (CdO films were fabricated on glass substrates from alkaline baths containing saccharin as an additive by a successive ionic layer adsorption and reaction (SILAR method. The effects of saccharin concentration in the bath on the structural, morphological, and optical properties were studied by means of scanning electron microscopy (SEM, X-ray diffraction (XRD, photoluminescence, and Raman spectroscopy. The analyses showed that the surface morphologies, XRD peak intensities, Raman spectroscopy, and photoluminescence properties of CdO films changed with saccharin concentration. From the results, it can be said that morphological characteristic and optical properties of the films could be calibrated by adding various saccharin percentages in the growth bath.

Movement of liquid metal in welding bath during welding in longitudinal magnetic field

International Nuclear Information System (INIS)

Kovalev, I.M.; Rybakov, A.S.

1977-01-01

The specific features are considered of liquid metal flow in a bath during welding of steel 12Kh18N10T plates with a non-consumable electrode in argon under interaction of the arc and bath with a longitudinal constant magnetic field. In controlling the velocity field of metal flow, the longitudinal magnetic field permits to form a seam at automatic welding of horizontal joints on a vertical plane

Evaluation of Patients Visiting the Dermatology Emergency Unit of a University Dermatology Hospital in Tehran, Iran.

Science.gov (United States)

Abedini, Robabeh; Matinfar, Amin; Sasani, Pardis; Salehi, Anahita; Daneshpazhooh, Maryam

2017-11-01

Published studies on dermatological emergencies are limited in the literature. To our knowledge, no study has previously explored this subject in Iran. Our aim was to ascertain the characteristics of patients visiting the dermatologic emergency (DE) unit of a university skin hospital in Tehran, Iran. We studied the files of all the patients seen in the DE unit over a 3-month period, collecting data on age, sex, referral mode, duration of consultation, status (true emergency or non-emergency), and diagnosis. A total of 2539 patients were evaluated; 53% of them were female. Infection and infestation (41.9%), urticaria (16.7%), and dermatitis (13.2%) were the most prevalent entities. Almost 1% of the patients were referred by another physician and psoriasis was their most frequent diagnosis. Almost 2.6% of the patients were hospitalized; psoriasis was once again the most frequent cause. The hospitalization rate was significantly higher in referred patients (Pdermatologic disorders. This data could also help in tailoring the educational curriculum for medical students more appropriately in order to increase their knowledge of the most prevalent skin disorders.

[Clinical audit on drug prescriptions for elderly patients hospitalized in a unit of psychiatry].

Science.gov (United States)

Humaraut, C; Caron, J; Bayonne, L; Moalic, Y

2016-02-01

The elderly are particularly vulnerable to the iatrogenic effects of drugs that are a major public health problem. In a geriatric care unit of a psychiatric hospital, the pharmacist, in close cooperation with the various health professionals, takes part in the optimization of drug therapy of these patients during cross-professional consultation meetings. From 2009 to 2011, an evaluation of professional practices was run through a targeted clinical audit on the theme of "prescription drugs at the age of 75 and over". The main objective of this study is to measure the differences between the practices and the guidelines for prescription drugs concerning the elderly, and then to analyze and amend these differences. The secondary objective is to gather data on the prescription drugs for the elderly in the particular context of a psychiatric unit. The evaluation was performed using two standards: the evaluation chart of prescriptions of the Professional College of French Geriatrics (CPGF) and the French National Authority for Health and the list of Laroche et al. In the first round, after analyzing the prescriptions of 105 patients, the gap between practice and accepted standards led to the definition of three areas of improvement on the associations of neuroleptics, on the use of anticholinergic drugs and on the prescription of benzodiazepines, the latter being subject of another communication. After reassessment, the prescriptions of 101 patients were thereafter analyzed in relation to the identified areas of improvement. Patient samples of both phases were statistically homogeneous. Between the two evaluations, the percentage of prescriptions with at least two neuroleptics remained stable, the decline was not significant (18.1% to 13.9%, P≥0.05). However, it was observed that the second suggested a "conditional" decline with dosages less than or equal to those recommended for the elderly dosages. The proportion of patients who did not take anticholinergic drugs

Nurses’ Burnout in Oncology Hospital Critical Care Unit

Directory of Open Access Journals (Sweden)

Yeliz İrem Tunçel

2014-08-01

Full Text Available Objective: Burnout is common in intensive care units (ICU because of high demands and difficult working conditions. The aim of this study was to analyse nurses’ burnout in our oncology ICU and to determine which factors are associated with. Material and Method: The study was carried out in Ankara Oncology Hospital ICU. A self- reporting questionnaire in an envelope was used for the evaluation of burnout (Turkish- language version of Maslach Burnout Inventory and depression (Beck Depression Scale. Results: From a total of 37 ICU nurses, 35 participated in the study (%94,5 response rate. High levels of emotional exhaustion in 82% and depersonalization in 51,4% of nurses was determined. Personal accomplishment was higher at 80%. Mild to moderate emotional state and mild anxiety was revealed. Years in profession,finding salary insufficient, finding the profession in its proper, choosing the profession of his own accord, work environment satisfaction and finding the social activity adequate were associated with burnout (p≤0.05. Conclusion: In our study, intensive care unit nurses’ burnout scores were found to be higher. Burnout was rare in nurses that choose the profession of his own accord, find the nursing profession in its proper, and social activity adequate and are satisfied with the work environment. Therefore, we believe that attention should be given to individual needs and preferences in the selection of ICU staff.

Sexual Behavior in Patients with Psychosis Admitted to a Hospital Unit.

Science.gov (United States)

Del Mar Baños-Martín, María; Márquez-Hernández, Verónica V; Gutiérrez-Puertas, Lorena; Aguilera-Manrique, Gabriel; Gutiérrez-Puertas, Vanesa; Granados-Gámez, Genoveva

2017-06-01

The sexual dimension is part of a person's functionality. Patients with mental disorders have the same sexual needs as any other person, although they may not always be recognized. This is a retrospective observational study to describe the information on sexuality of patients with mental disorders, admitted to an acute short-stay inpatient unit between 2011 and 2015. We analyzed 293 clinical histories of patients, comprising diagnoses in the ICD-10 (International Classification of Diseases) between F20 and F29, inclusively. The information collected corresponded to the beginning of hospitalization, its duration and discharge. The results showed that 24% of the patients had sexual delusions. These delusions were more frequent in women, who in turn had more emotional symptoms, persecutory deception being the most common. There were few reports found on sexual dysfunction. In conclusion, the lack of data in the reports shows little recognition of sexuality in hospitalized patients with mental disorder, highlighting the need to promote the training of health personnel.

Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

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Glenn A. Melnick PhD

2016-06-01

Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

Implementation of a quality management system according to 9001 standard in a hospital in the home unit: changes and achievements.

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Rodríguez-Cerrillo, Matilde; Fernández-Diaz, Eddita; Iñurrieta-Romero, Amaia; Poza-Montoro, Ana

2012-01-01

The purpose of this paper is to describe changes and results obtained after implementation of a quality management system (QMS) according to ISO standards in a Hospital in the Home (HIH) Unit. The paper describes changes made and outcomes achieved. This took part in the HiH Unit, Clinico Hospital, Madrid, Spain, and looked at admissions, mean stay, patient satisfaction, adverse events, returns to hospital, no admitted referrals, complaints, compliance to protocols, equipment failures and resolution of urgent consultations. In June 2008, HiH Unit, Clinico Hospital obtained ISO certification. The main results achieved are as follows. There was an increase in patients' satisfaction--in June 2008, assessment of the quality of care provided by staff was scored at 4.7 (on a scale of 1 to 5); in 2010 it has been scored at 4.96. Patient satisfaction rate has increased from 92 percent to 98.8 percent. No complaints from patients were received. Unscheduled returns to hospital have decreased from 7 percent to 3 percent. There were no medical equipment failures. External suppliers' performance has improved. Material and medication needed by staff was available when necessary. The number of admissions has increased. Compliance to protocols has reached 97 percent. Inappropriate referrals have decreased by 8 percent. Six medications-related incidents were detected; in two cases the incident was not due to an error. In the other four cases error could have been detected before reaching the patient. Implementations of an ISO quality management system allow improved quality of care and patient satisfaction in a HIH Unit.

The Study of Life Change Unit as Stressor Agents among Tehran University of Medical Sciences Hospitals' Employees

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Hossein Dargahi

2010-08-01

Full Text Available Life crises as stressor agents can disrupt the best stress management regime. Different life crises have different impacts. A standard scale to rate change and its related stress impact has been developed commonly referred to as LCU (Life Change Unit Rating. This allocates a number of Life Crisis Units or Life Change Units (LCUs to different event and then evaluates them and takes action accordingly. This idea behind this approach of is to rundown the LCU table, totaling the LCUs for life crisis that have occurred in the previous one year. A Cross - sectional, descriptive and analytical study was conducted among 900 Tehran University of Medical Sciences (TUMS Employees by a Holms and Rahe LCU questionnaire at 15 hospitals. The respondents were asked to determine their demographic information, list of stress symptoms which suffered from these diseases in the previous one year and finally, responded to 45 Life Change Unit as stressful life events and the value of each in "stress units" which occurred in the previous one year. The results showed that there is significant correlation between the employees LCU rating by sex, educational degree and size of hospital. Also we found that there are significant correlations between the employees stress symptoms with their LCU rating. Totally, 40% of the employees have less than 150 LCU rating (normal range and 60% of them have 150-300 or more than 300 LCU rating (abnormal range. In conclusion most of TUMS hospitals' employees who had stress symptoms have more LCU rating. One third of these employees are not in danger of suffering the illness effect, while two third of them are in danger.

The impact of reducing intensive care unit length of stay on hospital costs: evidence from a tertiary care hospital in Canada.

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Evans, Jessica; Kobewka, Daniel; Thavorn, Kednapa; D'Egidio, Gianni; Rosenberg, Erin; Kyeremanteng, Kwadwo

2018-02-23

To use theoretical modelling exercises to determine the effect of reduced intensive care unit (ICU) length of stay (LOS) on total hospital costs at a Canadian centre. We conducted a retrospective cost analysis from the perspective of one tertiary teaching hospital in Canada. Cost, demographic, clinical, and LOS data were retrieved through case-costing, patient registry, and hospital abstract systems of The Ottawa Hospital Data Warehouse for all new in-patient ward (30,483) and ICU (2,239) encounters between April 2012 and March 2013. Aggregate mean daily variable direct (VD) costs for ICU vs ward encounters were summarized by admission day number, LOS, and cost centre. The mean daily VD cost per ICU patient was $2,472 (CAD), accounting for 67.0% of total daily ICU costs per patient and $717 for patients admitted to the ward. Variable direct cost is greatest on the first day of ICU admission ($3,708), and then decreases by 39.8% to plateau by the fifth day of admission. Reducing LOS among patients with ICU stays ≥ four days could potentially result in an annual hospital cost saving of $852,146 which represents 0.3% of total in-patient hospital costs and 1.2% of ICU costs. Reducing ICU LOS has limited cost-saving potential given that ICU costs are greatest early in the course of admission, and this study does not support the notion of reducing ICU LOS as a sole cost-saving strategy.

The Use of Wetting Agents/Fume Suppressants for Minimizing the Atmospheric Emissions from Hard Chromium Electroplating Baths

Science.gov (United States)

2004-03-01

PFOA), perfluorooctane sulphonic acid (PFOSA) and clofibric acid . Biochim Biophys Acta 1128: 65-72 Kannan K, Koistinen J, Beckmen K, Evans T...mg/dscm (6.6 x 10-6 gr/dscf) Decorative Chromium Plating Baths Using Chromic Acid All new and existing baths 0.01 mg/dscm (4.4 x 10-6 gr/dscf...surface of the baths, causing the production of chromic acid mist. “Surface active” fume suppressants (also called surfactants) are added directly

Characteristics of patients hospitalized at an intensive care unit due to drug abuse

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Flávia Antunes

2013-07-01

Full Text Available Objective. To characterize the clinical and demographic profile of patients hospitalized due to drug intoxication at an intensive care unit (ICU of a teaching hospital between 2004 and 2010. Methodology. In this descriptive study, information was collected from the hospitalized patients, as informed by a Toxicology Care Center (CAT in Paraná (Brazil. The clinical files were checked and information was collected about age, gender, toxic agents and intoxication circumstances, comorbidities and clinical outcomes. Results. Sixty-two patients were included in the study, with a mean age of 58 years and 77% male. Alcohol was the substance related to most hospitalizations (77%, followed by psychoactive drugs (14% and marihuana and crack (5% each. The main comorbidities were bronchopneumonia due to aspiration (37%, alcohol-related liver cirrhosis (24% and traumatic brain injury (19%. The most frequent intoxication circumstances were chronic abuse (79%, attemptive suicide (19% and acute abuse (4.9%. Thirty-nine percent of the patients died during hospitalization. Conclusion. The results show a concerning reality, as most of the patients are men of economically active age, who were intoxicated by a legal substance like alcohol, with a relevant number of deaths. Nurses need to pay particular attention to this health problem, in the context of which they play a fundamental role as educators with a view to the encouragement of healthy lifestyles.

Microbiological contamination of mobile phones of clinicians in intensive care units and neonatal care units in public hospitals in Kuwait.

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Heyba, Mohammed; Ismaiel, Mohammad; Alotaibi, Abdulrahman; Mahmoud, Mohamed; Baqer, Hussain; Safar, Ali; Al-Sweih, Noura; Al-Taiar, Abdullah

2015-10-15

The objective of this study was to explore the prevalence of microbiological contamination of mobile phones that belong to clinicians in intensive care units (ICUs), pediatric intensive care units (PICUs), and neonatal care units (NCUs) in all public secondary care hospitals in Kuwait. The study also aimed to describe mobile phones disinfection practices as well as factors associated with mobile phone contamination. This is a cross-sectional study that included all clinicians with mobile phones in ICUs, PICUs, and NCUs in all secondary care hospitals in Kuwait. Samples for culture were collected from mobile phones and transported for microbiological identification using standard laboratory methods. Self-administered questionnaire was used to gather data on mobile phones disinfection practices. Out of 213 mobile phones, 157 (73.7 %, 95 % CI [67.2-79.5 %]) were colonized. Coagulase-negative staphylococci followed by Micrococcus were predominantly isolated from the mobile phones; 62.9 % and 28.6 % of all mobile phones, respectively. Methicillin-resistant Staphylococcus aureus (MRSA) and Gram-negative bacteria were identified in 1.4 % and 7.0 % of the mobile phones, respectively. Sixty-eight clinicians (33.5 %) reported that they disinfected their mobile phones, with the majority disinfecting their mobile phones only when they get dirty. The only factor that was significantly associated with mobile phone contamination was whether a clinician has ever disinfected his/her mobile phone; adjusted odds ratio 2.42 (95 % CI [1.08-5.41], p-value = 0.031). The prevalence of mobile phone contamination is high in ICUs, PICUs, and NCUs in public secondary care hospitals in Kuwait. Although some of the isolated organisms can be considered non-pathogenic, various reports described their potential harm particularly among patients in ICU and NCU settings. Isolation of MRSA and Gram-negative bacteria from mobile phones of clinicians treating patients in high-risk healthcare

Effect of Bath Temperature on Cooling Performance of Molten Eutectic NaNO3-KNO3 Quench Medium for Martempering of Steels

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Pranesh Rao, K. M.; Narayan Prabhu, K.

2017-10-01

Martempering is an industrial heat treatment process that requires a quench bath that can operate without undergoing degradation in the temperature range of 423 K to 873 K (150 °C to 600 °C). The quench bath is expected to cool the steel part from the austenizing temperature to quench bath temperature rapidly and uniformly. Molten eutectic NaNO3-KNO3 mixture has been widely used in industry to martemper steel parts. In the present work, the effect of quench bath temperature on the cooling performance of a molten eutectic NaNO3-KNO3 mixture has been studied. An Inconel ASTM D-6200 probe was heated to 1133 K (860 °C) and subsequently quenched in the quench bath maintained at different temperatures. Spatially dependent transient heat flux at the metal-quenchant interface for each bath temperature was calculated using inverse heat conduction technique. Heat transfer occurred only in two stages, namely, nucleate boiling and convective cooling. The mean peak heat flux ( q max) decreased with increase in quench bath temperature, whereas the mean surface temperature corresponding to q max and mean surface temperature at the start of convective cooling stage increased with increase in quench bath temperature. The variation in normalized cooling parameter t 85 along the length of the probe increased with increase in quench bath temperature.

Response of Cryolite-Based Bath to a Shift in Heat Input/output Balance

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Liu, Jingjing; Taylor, Mark; Dorreen, Mark

2017-04-01

A technology for low amperage potline operation is now recognized as a competitive advantage for the aluminum smelting industry in order to align smelter operations with the power and aluminum price markets. This study investigates the cryolite-based bath response to heat balance shifts when the heat extraction from the bath is adjusted to different levels in a laboratory analogue. In the analogue experiments, the heat balance shift is driven by a graphite `cold finger' heat exchanger, which can control the heat extraction from the analogue, and a corresponding change in heat input from the furnace which maintains the control temperature of the lab "cell." This paper reports the first experimental results from shifting the steady state of the lab cell heat balance, and investigates the effects on the frozen ledge and bath superheat. The lab cell energy balances are compared with energy balances in a published industrial cell model.

PREPARATION AND CHARACTERIZATION OF IRON SULPHIDE THIN FILMS BY CHEMICAL BATH DEPOSITION METHOD

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Anuar Kassim

2010-06-01

Full Text Available FeS2 thin films have been deposited by using low cost chemical bath deposition technique. The films obtained under deposition parameters such as bath temperature (90 °C, deposition period (90 min, electrolyte concentration (0.15 M and pH of the reactive mixture (pH 2.5. The thin films were characterized using X-ray diffraction and atomic force microscopy in order to study the structural and morphological properties. The band gap energy, transition type and absorption properties were determined using UV-Vis Spectrophotometer. X-ray diffraction displayed a pattern consistent with the formation of an orthorhombic structure, with a strong (110 preferred orientation. Atomic force microscopy image showed the substrate surface is well covered with irregular grains. A direct band gap of 1.85 eV was obtained according to optical absorption studies.   Keywords: Iron sulfide, X-ray diffraction, chemical bath deposition, thin films

Hospital Related Stress Among Patients Admitted to a Psychiatric In-patient Unit in India

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Latha KS

2011-04-01

Full Text Available The psychiatric patient’s attitudes towards hospitalization have found an association between patient perceptions of the ward atmosphere and dissatisfaction. The aim of the study was to determine the aspects of stress related to hospitalization in inpatients admitted to a psychiatric facility. Fifty in-patients of both sexes admitted consecutively to a psychiatric unit in a General Hospital were asked to rate the importance of, and their satisfaction with, 38 different aspects of in-patient care and treatment. Results showed that the major sources of stress were related to having a violent patient near to his/her bed; being away from family; having to stay in closed wards; having to eat cold and tasteless food; losing income or job due to illness, being hospitalized away from home; not able to understand the jargons used by the clinical staff and not getting medication for sleep. A well-differentiated assessment of stress and satisfaction has implications for the evaluation of the quality of psychiatric care and for the improvement of in-patient psychiatric care.

The epidemic profiles of intensive care units in Hospital oncologico SOLCA, Quito

International Nuclear Information System (INIS)

Caballero, Henry; Marin, Karina; Gonzalez, Alba; Vega, Mireya; Castelo, Marcelo; Trujillo Cruz, Freddy

2006-01-01

The epidemic profiles of intensive care units are very few and they have not been published recently, punctual epidemic studies of morbidity, mortality and quality controls of intensive care exist, but we could not find the profiles of the oncological units. Since the establishment of the intensive care unit of Oncological Hospital Solca in Quito city. It was not possible to find any epidemiological profile of this unit because it is important to know their morbidity rates, mortality, the main complications and to relate these with the study of the index prognostic, to plan the annual operative programs and the innovations according to the specific necessities, justified by realities studied, to observe the organic shortcoming that in critical patients are present, for a planning adapted in the outlines with the rational use of medication, since the critical users have specific characteristics especially in the infectious processes, due to their immunosuppression condition and for the chemotherapy administration and the radiotherapy, oncological patient for their condition they are poly medicates and it requires the use of interventionist processes, that triggers major risks of complications and infection with opportunist germs. (The author)

Adherence to guidelines in bleeding oesophageal varices and effects on outcome: comparison between a specialized unit and a community hospital

DEFF Research Database (Denmark)

Hobolth, Lise; Krag, Aleksander; Malchow-Møller, Axel

2010-01-01

OBJECTIVES: Randomized controlled trials have shown beneficial effects of vasoactive drugs, endoscopic treatment and prophylactic antibiotics on the outcome of bleeding oesophageal varices (BOV). However, translating guidelines based on randomized controlled trials into clinical practice is diffi......OBJECTIVES: Randomized controlled trials have shown beneficial effects of vasoactive drugs, endoscopic treatment and prophylactic antibiotics on the outcome of bleeding oesophageal varices (BOV). However, translating guidelines based on randomized controlled trials into clinical practice...... is difficult. Our aims were to compare adherence to evidence-based guidelines in BOV between a specialized unit and a community hospital, and to investigate whether differences in adherence affected the outcome. METHODS: Two cohorts hospitalized during 2000-2007 with a first episode of BOV were retrospectively...... enrolled, one in a community hospital comprising 66 patients and one in a specialized unit comprising 111 patients. Data on treatment, rebleeding and mortality were collected from medical records according to the Baveno III/IV Criteria. RESULTS: Treatments in the specialized unit versus the community...

Sporotrichosis-Associated Hospitalizations, United States, 2000-2013.

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Gold, Jeremy A W; Derado, Gordana; Mody, Rajal K; Benedict, Kaitlin

2016-10-01

To determine frequency and risk for sporotrichosis-associated hospitalizations, we analyzed the US 2000-2013 National (Nationwide) Inpatient Sample. An estimated 1,471 hospitalizations occurred (average annual rate 0.35/1 million persons). Hospitalizations were associated with HIV/AIDS, immune-mediated inflammatory diseases, and chronic obstructive pulmonary disease. Although rare, severe sporotrichosis should be considered for at-risk patients.

Sporotrichosis-Associated Hospitalizations, United States, 2000?2013

OpenAIRE

Gold, Jeremy A.W.; Derado, Gordana; Mody, Rajal K.; Benedict, Kaitlin

2016-01-01

To determine frequency and risk for sporotrichosis-associated hospitalizations, we analyzed the US 2000?2013 National (Nationwide) Inpatient Sample. An estimated 1,471 hospitalizations occurred (average annual rate 0.35/1 million persons). Hospitalizations were associated with HIV/AIDS, immune-mediated inflammatory diseases, and chronic obstructive pulmonary disease. Although rare, severe sporotrichosis should be considered for at-risk patients.

Ochre Bathing of the Bearded Vulture: A Bio-Mimetic Model for Early Humans towards Smell Prevention and Health

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Helmut Tributsch

2016-01-01

Full Text Available Since primordial times, vultures have been competing with man for animal carcasses. One of these vultures, the once widespread bearded vulture ( Gypaetus barbatus , has the habit of bathing its polluted feathers and skin in red iron oxide - ochre - tainted water puddles. Why? Primitive man may have tried to find out and may have discovered its advantages. Red ochre, which has accompanied human rituals and everyday life for more than 100,000 years, is not just a simple red paint for decoration or a symbol for blood. As modern experiments demonstrate, it is active in sunlight producing aggressive chemical species. They can kill viruses and bacteria and convert smelly organic substances into volatile neutral carbon dioxide gas. In this way, ochre can in sunlight sterilize and clean the skin to provide health and comfort and make it scentless, a definitive advantage for nomadic meat hunters. This research thus also demonstrates a sanitary reason for the vulture’s habit of bathing in red ochre mud. Prehistoric people have therefore included ochre use into their rituals, especially into those in relation to birth and death. Significant ritual impulses during evolution of man may thus have developed bio-mimetically, inspired from the habits of a vulture. It is discussed how this health strategy could be developed to a modern standard helping to fight antibiotics-resistant bacteria in hospitals.

Theory of open quantum systems with bath of electrons and phonons and spins: many-dissipaton density matrixes approach.

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Yan, YiJing

2014-02-07

This work establishes a strongly correlated system-and-bath dynamics theory, the many-dissipaton density operators formalism. It puts forward a quasi-particle picture for environmental influences. This picture unifies the physical descriptions and algebraic treatments on three distinct classes of quantum environments, electron bath, phonon bath, and two-level spin or exciton bath, as their participating in quantum dissipation processes. Dynamical variables for theoretical description are no longer just the reduced density matrix for system, but remarkably also those for quasi-particles of bath. The present theoretical formalism offers efficient and accurate means for the study of steady-state (nonequilibrium and equilibrium) and real-time dynamical properties of both systems and hybridizing environments. It further provides universal evaluations, exact in principle, on various correlation functions, including even those of environmental degrees of freedom in coupling with systems. Induced environmental dynamics could be reflected directly in experimentally measurable quantities, such as Fano resonances and quantum transport current shot noise statistics.

Short communication: Efficacy of copper sulfate hoof baths against digital dermatitis--Where is the evidence?

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Thomsen, Peter T

2015-04-01

Digital dermatitis is a major problem in modern dairy production because of decreased animal welfare and financial losses. Individual cow treatments are often seen as too time consuming by farmers, and walk-through hoof baths have therefore been used extensively to control digital dermatitis. For decades, copper sulfate hoof baths have been used to treat and prevent digital dermatitis. Copper sulfate has been referred to as the industry gold standard when it comes to hoof-bath chemicals. In several scientific studies testing the efficacy of other hoof-care products, copper sulfate has been used as a positive control, thereby indicating that copper sulfate has a known positive effect. However, this may not be the case. A dilemma may exist between (1) copper sulfate generally being perceived as being effective against digital dermatitis and (2) a possible lack of well-documented scientific evidence of this effect. The objective of this study was to evaluate the existing scientific literature to determine whether the efficacy of copper sulfate used in hoof baths against digital dermatitis has in fact been demonstrated scientifically. A systematic literature search identified 7 peer-reviewed journal articles describing the efficacy of copper sulfate in hoof baths as treatment or prevention of bovine digital dermatitis. Only 2 of the 7 studies compared copper sulfate to a negative control; most studies were relatively small, and often no clear positive effect of copper sulfate was demonstrated. In conclusion, the frequent claim that copper sulfate is widely reported to be effective is supported by little scientific evidence. Well-designed clinical trials evaluating the effect of copper sulfate against digital dermatitis compared with a negative control are needed. Until such studies have been made, the efficacy of copper sulfate in hoof baths against digital dermatitis remains largely unproven. Copyright © 2015 American Dairy Science Association. Published by Elsevier

Nuclear spin bath effects in molecular nanomagnets: Direct quantum mechanical simulations

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Sinitsyn, N. A.; Dobrovitski, V. V.

2004-11-01

We investigate the influence of nuclear spins on the electronic spin tunneling in magnetic molecules such as Fe8 , focusing on the role of the spin diffusion in the nuclear spin bath. We simulate the quantum spin dynamics by numerically solving the time-dependent Schrödinger equation for the compound system (the electronic spin plus the bath spins). Our results demonstrate that the effect of the spin bath cannot always be modeled as a randomly varying magnetic field acting on the electronic spin. We consider two dynamical regimes: the spin relaxation in a constant magnetic field, and the spin tunneling in the linearly varying magnetic field passing the avoided level crossing, so-called Landau-Zener-Stückelberg (LZS) transition. For the first regime, we confirmed that the hole in the magnetization distribution has the width of the hyperfine fields distribution. For the second regime, we found that the transition probability for moderately slow sweeps deviates from the standard LZS prediction, while for the fast sweeps the deviation is negligible.

Colonization of Legionella species in Turkish baths in hotels in Alanya, Turkey.

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Erdogan, Haluk; Arslan, Hande

2015-05-01

This study evaluated the prevalence of Legionella species in water samples collected from Turkish baths in hotels in Alanya, Turkey, from August 2003 to September 2013. Water samples were collected in 100-mL sterile containers and then concentrated by filtration. Heat treatment was used to eliminate other microorganisms from the samples, which were then spread on Legionella-selective-buffered charcoal yeast extract alpha (BCYE-α) agar and on BCYE-α agar supplemented with glycine, vancomycin, polymyxin, and cycloheximide. Cysteine-dependent colonies were identified by latex agglutination. In total, 135 samples from 52 hotels with Turkish baths were evaluated. Legionella species were identified in 11/52 (21.2%) hotels and 18/135 (13.3%) samples. The most frequently isolated species was Legionella pneumophila, with most isolates belonging to serogroups 6 (55.6%) and 1 (22.2%). The colony count was 1000 CFU mL(-1) in three samples. These findings suggest that the hot water systems of Turkish baths in hotels must be viewed as a possible source of travel-associated Legionnaires' disease, and preventative measures should be put in place.

Trends in hospitalizations of pregnant HIV-infected women in the United States: 2004 through 2011.

Science.gov (United States)

Ewing, Alexander C; Datwani, Hema M; Flowers, Lisa M; Ellington, Sascha R; Jamieson, Denise J; Kourtis, Athena P

2016-10-01

With the development and widespread use of combination antiretroviral therapy, HIV-infected women live longer, healthier lives. Previous research has shown that, since the adoption of combination antiretroviral therapy in the United States, rates of morbidity and adverse obstetric outcomes remained higher for HIV-infected pregnant women compared with HIV-uninfected pregnant women. Monitoring trends in the outcomes these women experience is essential, as recommendations for this special population continue to evolve with the progress of HIV treatment and prevention options. We conducted an analysis comparing rates of hospitalizations and associated outcomes among HIV-infected and HIV-uninfected pregnant women in the United States from 2004 through 2011. We used cross-sectional hospital discharge data for girls and women age 15-49 from the 2004, 2007, and 2011 Nationwide Inpatient Sample, a nationally representative sample of US hospital discharges. Demographic characteristics, morbidity outcomes, and time trends were compared using χ(2) tests and multivariate logistic regression. Analyses were weighted to produce national estimates. In 2011, there were 4751 estimated pregnancy hospitalizations and 3855 delivery hospitalizations for HIV-infected pregnant women; neither increased since 2004. Compared with those of HIV-uninfected women, pregnancy hospitalizations of HIV-infected women were more likely to be longer, be in the South and Northeast, be covered by public insurance, and incur higher charges (all P pregnant women with HIV infection had higher rates for many adverse outcomes. Compared to 2004, hospitalizations of HIV-infected pregnant women in 2011 had higher odds of gestational diabetes (adjusted odds ratio, 1.81; 95% confidence interval, 1.16-2.84), preeclampsia/hypertensive disorders of pregnancy (adjusted odds ratio, 1.58; 95% confidence interval, 1.12-2.24), viral/mycotic/parasitic infections (adjusted odds ratio, 1.90; 95% confidence interval, 1

Evaluation of variables which affect the hardness of nickel plate deposited from watts-type baths

International Nuclear Information System (INIS)

Petit, G.S.; Wright, R.R.; Neff, W.A.

1976-01-01

In the course of the Cascade Improvement Program, many component equipment parts will be electroplated with nickel for corrosion protection. The maximum hardness which will be acceptable in the electroplated deposit is specified in Union Carbide's Job Specification JS-1396, Revision 3, entitled Electroplated Nickel Coatings on Steel Parts. The hardness specification is intended primarily as a control over both organic and inorganic impurities in the deposit. This report covers a study evaluating several of the numerous controllable variables which influence the hardness of the nickel plate deposited from a Watts-type bath. The variables tested were: 1) bath composition, 2) pH, 3) current density, 4) anode-cathode area ratio, and 5) bath temperature. Within the tested ranges of the variables studied, the pH and current density had the most influence on the plate hardness. The softest deposit was obtained with a bath pH of 1.5, a current density of 30 to 40 amperes/square foot, and with the anode-cathode area ratio in the range of 3:1 to 1:1

Pre-hospital care after a seizure: Evidence base and United Kingdom management guidelines.

Science.gov (United States)

Osborne, Andrew; Taylor, Louise; Reuber, Markus; Grünewald, Richard A; Parkinson, Martin; Dickson, Jon M

2015-01-01

Seizures are a common presentation to pre-hospital emergency services and they generate significant healthcare costs. This article summarises the United Kingdom (UK) Ambulance Service guidelines for the management of seizures and explores the extent to which these guidelines are evidence-based. Summary of the Clinical Practice Guidelines of the UK Joint Royal Colleges Ambulance Liaison Committee relating to the management of seizures. Review of the literature relating to pre-hospital management of seizure emergencies. Much standard practice relating to the emergency out of hospital management of patients with seizures is drawn from generic Advanced Life Support (ALS) guidelines although many patients do not need ALS during or after a seizure and the benefit of many ALS interventions in seizure patients remains to be established. The majority of studies identified pertain to medical treatment of status epilepticus. These papers show that benzodiazepines are safe and effective but it is not possible to draw definitive conclusions about the best medication or the optimal route of administration. The evidence base for current pre-hospital guidelines for seizure emergencies is incomplete. A large proportion of patients are transported to hospital after a seizure but many of these may be suitable for home management. However, there is very little research into alternative care pathways or criteria that could be used to help paramedics avoid transport to hospital. More research is needed to improve care for people after a seizure and to improve the cost-effectiveness of the healthcare systems within which they are treated. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Dysphagia referrals to a district general hospital gastroenterology unit: hard to swallow.

Science.gov (United States)

Melleney, Elizabeth Mary-Ann; Subhani, Javaid Mohammed; Willoughby, Charles Peter

2004-01-01

The aim of our study was to audit dysphagia referrals received by a specialist gastroenterology unit during an entire year. We used a prospective audit carried out over a 12-month period at the District General Hospital gastroenterology unit. The audit included 396 consecutive patients who were referred with swallowing difficulties. We found that 60 referrals (15.2%) were inaccurate and the patients had no swallowing problem. Of the 336 patients with genuine dysphagia, only 29 (8.6%) were new cancer cases. The large majority of subjects had benign disease mostly related to acid reflux. Weight loss was significantly associated with malignancy but also occurred in one third of patients with reflux alone. The temporal pattern of dysphagia was not significantly predictive of cancer. All the cancer patients were above the age of 50 years. Although patients were in general assessed rapidly after hospital referral, the productivity, in terms of early tumor diagnosis, was extremely low. We conclude that there is a substantial rate of inaccurate referrals of dysphagia patients. Most true cases of swallowing difficulty relate to benign disease. Even the devotion of considerable resources to the early diagnosis of esophago gastric malignancy in an attempt to conform with best practice guidelines results in a very low success rate in terms of the detection of potentially curable tumors.

Variation in critical care unit admission rates and outcomes for patients with acute coronary syndromes or heart failure among high- and low-volume cardiac hospitals.

Science.gov (United States)

van Diepen, Sean; Bakal, Jeffrey A; Lin, Meng; Kaul, Padma; McAlister, Finlay A; Ezekowitz, Justin A

2015-02-27

Little is known about cross-hospital differences in critical care units admission rates and related resource utilization and outcomes among patients hospitalized with acute coronary syndromes (ACS) or heart failure (HF). Using a population-based sample of 16,078 patients admitted to a critical care unit with a primary diagnosis of ACS (n=14,610) or HF (n=1467) between April 1, 2003 and March 31, 2013 in Alberta, Canada, we stratified hospitals into high (>250), medium (200 to 250), or low (<200) volume based on their annual volume of all ACS and HF hospitalization. The percentage of hospitalized patients admitted to critical care units varied across low, medium, and high-volume hospitals for both ACS and HF as follows: 77.9%, 81.3%, and 76.3% (P<0.001), and 18.0%, 16.3%, and 13.0% (P<0.001), respectively. Compared to low-volume units, critical care patients with ACS and HF admitted to high-volume hospitals had shorter mean critical care stays (56.6 versus 95.6 hours, P<0.001), more critical care procedures (1.9 versus 1.2 per patient, <0.001), and higher resource-intensive weighting (2.8 versus 1.5, P<0.001). No differences in in-hospital mortality (5.5% versus 6.2%, adjusted odds ratio 0.93; 95% CI, 0.61 to 1.41) were observed between high- and low-volume hospitals; however, 30-day cardiovascular readmissions (4.6% versus 6.8%, odds ratio 0.77; 95% CI, 0.60 to 0.99) and cardiovascular emergency-room visits (6.6% versus 9.5%, odds ratio 0.80; 95% CI, 0.69 to 0.94) were lower in high-volume compared to low-volume hospitals. Outcomes stratified by ACS or HF admission diagnosis were similar. Cardiac patients hospitalized in low-volume hospitals were more frequently admitted to critical care units and had longer hospitals stays despite lower resource-intensive weighting. These findings may provide opportunities to standardize critical care utilization for ACS and HF patients across high- and low-volume hospitals. © 2015 The Authors. Published on behalf of the American

Profile of nursing diagnoses of hospitalized patients in an infectious disease unit

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Vinicius Lino de Souza Neto

Full Text Available Objective: To define the profile of nursing diagnoses of hospitalized patients at an infectious diseases unit.Methods: This is a descriptive study based on the quantitative approach conducted at an infectious diseases unit in Paraiba, Brazil, from January to February 2014. The data collection instrument was based on the Theory of Basic Human Needs by Wanda de Aguiar Horta, followed by the classification system CIPE(r version 2.0 to construct the diagnoses.Results: Data analysis resulted in 36 nursing diagnoses statements, with a higher prevalence of impaired food intake, cachexia, impaired spontaneous bladder elimination, impaired oral cavity hygiene, exposure to contamination, rapid heart rate, insomnia, drug abuse, alcohol and tobacco abuse, social isolation, acceptance and fear.Conclusions: The identification of a diagnostics profile is critical to guide nursing interventions.

Superconducting-circuit quantum heat engine with frequency resolved thermal baths

Science.gov (United States)

Hofer, Patrick P.; Souquet, Jean-René; Clerk, Aashish A.

The study of quantum heat engines promises to unravel deep, fundamental concepts in quantum thermodynamics. With this in mind, we propose a novel, realistic device that efficiently converts heat into work while maintaining reasonably large output powers. The key concept in our proposal is a highly peaked spectral density in both the thermal baths as well as the working fluid. This allows for a complete separation of the heat current from the working fluid. In our setup, Cooper pairs tunnelling across a Josephson junction serve as the the working fluid, while two resonant cavities coupled to the junction act as frequency-resolved thermal baths. The device is operated such that a heat flux carried entirely by the photons induces an electrical current against a voltage bias, providing work.

Polyamide 6/clay membranes: effect of precipitation bath in morphology

International Nuclear Information System (INIS)

Ferreira, Rodholfo da S.B.; Pereira, Caio H. do O; Leite, Amanda M.D.; Araujo, Edcleide M.; Lira, Helio L.

2015-01-01

Polyamide 6 membranes and their nanocomposites with 5% clay were obtained by the phase inversion method and the precipitation was made in distilled water bath and also in the mixture of solvent and distilled water. The nanocomposites were characterized by XRD and membranes by SEM. By XRD analysis, it was found that the obtained nanocomposite presents a structure probably exfoliated and / or partially exfoliated, it was also possible to observe the presence of two characteristic peaks (α and γ) of the polyamide 6 phases. In the SEM micrographs it was seen that the presence of clay promote alterations in morphology, size and distribution of pores. The presence of acid in the precipitation bath leads to a significant decrease in the filter layer, but also an increase in the quantity of pore size. (author)

Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs.

Science.gov (United States)

Sodhi, Jitender; Satpathy, Sidhartha; Sharma, D K; Lodha, Rakesh; Kapil, Arti; Wadhwa, Nitya; Gupta, Shakti Kumar

2016-04-01

Healthcare associated infections (HAIs) increase the length of stay in the hospital and consequently costs as reported from studies done in developed countries. The current study was undertaken to evaluate the impact of HAIs on length of stay and costs of health care in children admitted to Paediatric Intensive Care Unit (PICU) of a tertiary care hospital in north India. This prospective study was done in the seven bedded PICU of a large multi-specialty tertiary care hospital in New Delhi, India. A total of 20 children with HAI (cases) and 35 children without HAI (controls), admitted to the PICU during the study period (January 2012 to June 2012), were matched for gender, age, and average severity of illness score. Each patient's length of stay was obtained prospectively. Costs of healthcare were estimated according to traditional and time driven activity based costing methods approach. The median extra length of PICU stay for children with HAI (cases), compared with children with no HAI (controls), was seven days (IQR 3-16). The mean total costs of patients with and without HAI were ' 2,04,787 (US$ 3,413) and ' 56,587 (US$ 943), respectively and the mean difference in the total cost between cases and controls was ' 1,48,200 (95% CI 55,716 to 2,40,685, pcosts for PICU patients, especially costs due to prolongation of hospital stay, and suggests the need to develop effective strategies for prevention of HAI to reduce costs of health care.

Effects of bathing on cerebral blood flow in healthy volunteers. Using Patlak plot method with technetium-99m ethyl cysteinate dimer

International Nuclear Information System (INIS)

Watanabe, Hiromi; Yorizumi, Kouji

1997-01-01

We studied the effects of bathing in warm water on cerebral blood flow (CBF). Seven healthy male volunteers were subjected to experiments. The subjects were bathed in warm water at 39degC for 20 minutes in a sitting position immersed up to the neck. Each subject received two CBF examinations: one under normal conditions and the other after taking a bath mentioned above. There was an interval of at least seven days between the two examinations. To measure CBF, we used the Patlak plot method with technetium-99m ethyl cysteinate dimer (99m-Tc ECD). To examine CBF after bathing, 99m-Tc ECD was injected within 10 minutes after bathing. Brain perfusion index (BPI) and regional CBF (rCBF) were used as indexes for evaluating CBF. The body temperature, pulse, blood pressure, arterial oxygen and carbon dioxide pressure, and hematocrit were also measured. Wilcoxon's signed rank test was used for statistical analyses. The following were observed: BPI increased significantly after bathing (p<0.05). rCBF in the cerebral cortex, particularly in the frontal lobe, tended to increase after bathing (p<0.05). No definite changes were observed in the cerebellar cortex, caudate nucleus, or thalamus. The body temperature and pulse increased significantly after bathing. No definite changes were observed in blood pressure, arterial oxygen and carbon dioxide pressure, or hematocrit. From the above, we conclude that bathing in warm water causes the cerebral blood flow to increase in healthy subjects. (author)

CLOSTRIDIUM DIFFICILE INFECTION IN ACUTE CARE HOSPITALS: SYSTEMATIC REVIEW AND BEST PRACTICES FOR PREVENTION

Science.gov (United States)

Louh, Irene K.; Greendyke, William G.; Hermann, Emilia A.; Davidson, Karina W.; Falzon, Louise; Vawdrey, David K.; Shaffer, Jonathan A.; Calfee, David P.; Furuya, E. Yoko; Ting, Henry H.

2017-01-01

Objective Prevention of Clostridium difficile infection (CDI) in acute care hospitals is a priority for hospitals and clinicians. We performed a qualitative systematic review to update the evidence on interventions to prevent CDI published since 2009. Design We searched Ovid, MEDLINE, EMBASE, The Cochrane Library, CINAHL, ISI Web of Knowledge, and grey literature databases from January 1, 2009 to August 1, 2015. Setting We included studies performed in acute care hospitals. Patients or participants We included studies conducted on hospitalized patients that investigated the impact of specific interventions on CDI rates. Interventions We used the QI-Minimum Quality Criteria Set (QI-MQCS) to assess the quality of included studies. Interventions were grouped thematically: environmental disinfection, antimicrobial stewardship, hand hygiene, chlorhexidine bathing, probiotics, bundled approaches, and others. A meta-analysis was performed when possible. Results Of 3236 articles screened, 261 met the criteria for full-text review and 46 studies were ultimately included. The average quality rating was 82% on the QI-MQCS. The most effective interventions, resulting in a 45% to 85% reduction in CDI, included daily to twice daily disinfection of high-touch surfaces (including bed rails) and terminal cleaning of patient rooms with chlorine-based products. Bundled interventions and antimicrobial stewardship showed promise for reducing CDI rates. Chlorhexidine bathing and intensified hand hygiene practices were not effective for reducing CDI rates. Conclusions Daily and terminal cleaning of patient rooms using chlorine-based products were most effective in reducing CDI rates in hospitals. Further studies are needed to identify the components of bundled interventions that reduce CDI rates. PMID:28300019

Simulation of a DC electric arc furnace for steelmaking: study in the arc and bath regions

International Nuclear Information System (INIS)

Ramirez Argaez, M. A.; Trapaga Martinez, L. G.

2001-01-01

A mathematical model was developed to describe fluid flow, heat transfer, and electromagnetic phenomena in the arc and bath regions of DC electric Arc Furnaces (DC-EAF). The model is used to examine the effect on flow patterns and temperature distribution in the bath, under the influence of both an arc and bottom argon injection in steel or steel/slag systems. Validation of the model employed experimental measurements from systems physically related to DC-EAF from literature. For the conditions analyzed, electromagnetic forces dominate the fluid motion in the bath. Buoyancy and shear forces from the arc have a negligible effect in driving the flow; however, they partially counteract the electromagnetic forces. Slag decreases fluid motion in the steel and enhances temperature stratification in the system. Stirring of the bath, using a 3-nozzle inert gas injection system, is found to promote temperature uniformity in the regions near the lateral wall of the furnace. (Author) 24 refs

Effects of choline chloride on electrodeposited Ni coating from a Watts-type bath

Science.gov (United States)

Wang, Yurong; Yang, Caihong; He, Jiawei; Wang, Wenchang; Mitsuzak, Naotoshi; Chen, Zhidong

2016-05-01

Electrodeposition of bright nickel (Ni) was carried out in a Watts-type bath. Choline chloride (ChCl) was applied as a multifunctional additive and substitute for nickel chloride (NiCl2) in a Watts-type bath. The function of ChCl was investigated through conductivity tests, anodic polarization, and cathodic polarization experiments. The studies revealed that ChCl performed well as a conducting salt, anodic activator, and cathodic inhibitor. The effects of ChCl on deposition rate, preferred orientation, grain size, surface morphology, and microhardness of Ni coatings were also studied. The deposition rate reached a maximum value of greater than 27 μm h-1 when 20 g L-1 ChCl was introduced to the bath. Using X-ray diffraction, it was confirmed that progressive addition of ChCl promoted the preferred crystal orientation modification from (2 0 0) and (2 2 0) to (1 1 1), refined grain size, and enhanced microhardness. The presence of ChCl lowered the roughness of the coating.

Electrocrystallisation of zinc from acidic sulphate baths; A nucleation and crystal growth process

International Nuclear Information System (INIS)

Vasilakopoulos, D.; Bouroushian, M.; Spyrellis, N.

2009-01-01

The electrochemical nucleation and growth of zinc on low-carbon steel from acidic (pH 2.0-4.5) baths containing ZnSO 4 , NaCl, and H 3 BO 3 , was studied by means of chronoamperometry at various cathodic potentials under a charge-transfer controlled regime. It is shown that at overpotentials in the range 0.30-0.55 V (negative to the Zn 2+ /Zn redox value) the electrodeposition proceeds by instantaneous three-dimensional nucleation, which turns to progressive at higher overpotentials and/or very acidic baths. At low cathodic overpotentials (<0.30 V), a two-dimensional contribution limited by the incorporation of Zn ad-atoms in the developing lattice becomes significant at the early stages of deposition, and is more progressive in type the more acidic is the bath pH. Nucleation rate constants were calculated and correlated analytically with the respective potentials, using the classical theory of heterogeneous nucleation, which though fails to lead to reasonable values for the critical nucleus size

Coherent oscillation in a linear quantum system coupled to a thermal bath

International Nuclear Information System (INIS)

Bell, N.F.; Volkas, R.R.; Sawyer, R.F.

2000-01-01

We consider the time development of the density matrix for a system coupled to a thermal bath, in models that go beyond the standard two-level systems through addition of an energy excitation degree of freedom and through the possibility of the replacement of the spin algebra by a more complex algebra. We find conditions under which increasing the coupling to the bath above a certain level decreases the rate of entropy production, and in which the limiting behavior is a dissipationless sinusoidal oscillation that could be interpreted as the synchronization of many modes of the uncoupled system

Topology of a dissipative spin: Dynamical Chern number, bath-induced nonadiabaticity, and a quantum dynamo effect

Science.gov (United States)

Henriet, Loïc; Sclocchi, Antonio; Orth, Peter P.; Le Hur, Karyn

2017-02-01

We analyze the topological deformations of the ground state manifold of a quantum spin-1/2 in a magnetic field H =H (sinθ cosϕ ,sinθ sinϕ ,cosθ ) induced by a coupling to an ohmic quantum dissipative environment at zero temperature. From Bethe ansatz results and a variational approach, we confirm that the Chern number associated with the geometry of the reduced spin ground state manifold is preserved in the delocalized phase for α <1 . We report a divergence of the Berry curvature at αc=1 for magnetic fields aligned along the equator θ =π /2 . This divergence is caused by the complete quenching of the transverse magnetic field by the bath associated with a gap closing that occurs at the localization Kosterlitz-Thouless quantum phase transition in this model. Recent experiments in quantum circuits have engineered nonequilibrium protocols to access topological properties from a measurement of a dynamical Chern number defined via the out-of-equilibrium spin expectation values. Applying a numerically exact stochastic Schrödinger approach we find that, for a fixed field sweep velocity θ (t )=v t , the bath induces a crossover from (quasi)adiabatic to nonadiabatic dynamical behavior when the spin bath coupling α increases. We also investigate the particular regime H /ωc≪v /H ≪1 with large bath cutoff frequency ωc, where the dynamical Chern number vanishes already at α =1 /2 . In this regime, the mapping to an interacting resonance level model enables us to analytically describe the behavior of the dynamical Chern number in the vicinity of α =1 /2 . We further provide an intuitive physical explanation of the bath-induced breakdown of adiabaticity in analogy to the Faraday effect in electromagnetism. We demonstrate that the driving of the spin leads to the production of a large number of bosonic excitations in the bath, which strongly affect the spin dynamics. Finally, we quantify the spin-bath entanglement and formulate an analogy with an effective

Flatbed scanners as a source of imaging. Brightness assessment and additives determination in a nickel electroplating bath.

Science.gov (United States)

Vidal, M; Amigo, J M; Bro, R; Ostra, M; Ubide, C; Zuriarrain, J

2011-05-23

Desktop flatbed scanners are very well-known devices that can provide digitized information of flat surfaces. They are practically present in most laboratories as a part of the computer support. Several quality levels can be found in the market, but all of them can be considered as tools with a high performance and low cost. The present paper shows how the information obtained with a scanner, from a flat surface, can be used with fine results for exploratory and quantitative purposes through image analysis. It provides cheap analytical measurements for assessment of quality parameters of coated metallic surfaces and monitoring of electrochemical coating bath lives. The samples used were steel sheets nickel-plated in an electrodeposition bath. The quality of the final deposit depends on the bath conditions and, especially, on the concentration of the additives in the bath. Some additives become degraded with the bath life and so is the quality of the plate finish. Analysis of the scanner images can be used to follow the evolution of the metal deposit and the concentration of additives in the bath. Principal component analysis (PCA) is applied to find significant differences in the coating of sheets, to find directions of maximum variability and to identify odd samples. The results found are favorably compared with those obtained by means of specular reflectance (SR), which is here used as a reference technique. Also the concentration of additives SPB and SA-1 along a nickel bath life can be followed using image data handled with algorithms such as partial least squares (PLS) regression and support vector regression (SVR). The quantitative results obtained with these and other algorithms are compared. All this opens new qualitative and quantitative possibilities to flatbed scanners. Copyright © 2011 Elsevier B.V. All rights reserved.

Wet-weather urban discharges: implications from adopting the revised European Directive concerning the quality of bathing water.

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David, L M; Matos, J S

2005-01-01

Wet weather urban discharges are responsible for bathing water contamination. The proposal for a revised EU Directive concerning the quality of bathing water imposes significantly more stringent requirements for the management of bathing water quality, with particularly important repercussions on beaches subjected to short-term pollution incidents. The paper reviews the aspects from EU legislation most directly related to the problem of wet-weather discharges, placing special emphasis on the recent revision process of the Directive on bathing water quality, and evaluates the benefits of some potential solutions based on continuous modelling of a combined sewer system. Increasing the sewer system storage capacity or the STP hydraulic capacity may substantially reduce the untreated discharge volumes, but spill frequency reductions under 2 to 3 spill days per bathing season will hardly be achieved. Results show the severe strains that local rainfall patterns would place on compliance with the Commission's proposal for a revised Directive and highlight the importance of the changes introduced in the amended proposal recently approved by the Council, making it less prescriptive if adequate measures are adopted to prevent bathers' exposure to short-term pollution incidents.

Incidence of congenital heart disease among neonates in a neonatal unit of a tertiary care hospital

International Nuclear Information System (INIS)

Hussain, S.; Sabir, M.U.

2014-01-01

Objectives: To determine the incidence and pattern of various congenital heart disease in a neonatal unit of a tertiary care hospital. Methods: The prospective study was carried out in the neonatal unit of Combined Military Hospital, Rawalpindi, from September 2008 to August 2011. All 5800 neonates admitted with gestational age of >28 weeks irrespective of birthweight were included in the study. Neonatologist/Paediatrician carried out the neonatal examination during the first 12 hours of life. Neonates suspected of having congenital heart disease were further evaluated by pulse oxymetry, X-ray chest and echocardiography to ascertain final diagnosis and type of lesion. Data was collected on a predesigned proforma containing information regarding gender, mode of delivery, gestational age, weight at birth, family history, and associated malformations. SPSS 16 was used for statistical analysis. Results: Of the 5800 neonates, 87 (1.5%) were found to have congenital heart disease with an incidence of 15/1000. There was a male preponderance. Most common lesion was ventricular septal defect 27(31.3%), followed by atrial septal defect 20 (22.9%), patent ductus arteriosus 13 (14.94%), tetralogy of fallot 06 (6.89%), transposition of great arteries 04 (4.59%), Pulmonary stenosis 05 (5.79%) and 03(3.44%) had atrioventricular canal defects. Conclusion: Congenital heart disease is a common congenital anomaly. Its incidence varies from centre to centre due to different factors like nature of the sample, method of detection and early examination by a neonatologist/paediatrician. In this study a higher incidence is reported because it was carried out in a tertiary care unit, which is a referral hospital and all the neonates admitted in the unit were included in the study. (author)

Electrodeposition in the Ni-plating bath containing multi-walled carbon nanotubes

International Nuclear Information System (INIS)

An Baigang; Li Lixiang; Li Hongxi

2008-01-01

An electrodeposition procedure is performed in the Ni-plating bath containing multi-walled carbon nanotubes (MWNTs). The effects of MWNTs on the electrodeposits and process of Ni deposition are investigated by scanning electron microscopy, X-ray diffraction and electrochemical methods. The results show that there is an optimum concentration of MWNTs, at which the surface of the cathode can be uniformly and completely covered by MWNTs and thus Ni can be uniformly deposited on the MWNTs to form the MWNTs coated with a uniform Ni layer. The introduction of MWNTs in the Ni-plating bath increases the cathodic polarization of Ni deposition due to the two aspects as follows: The addition of MWNTs enhances the charge transfer for the reduction of Ni and also supplies a large active surface area for a great deal of nucleation of Ni, consequently results in an increase of concentration polarization. The deposition of Ni on the MWNTs requires the higher activation energy than that on the Cu. The MWNTs adsorbed on the cathode also induce Ni to deposit as smaller grains due to a large increase of nucleation sites of Ni. Therefore, more uniform and compact coating in appearance than Ni coating formed in the plating bath without MWNTs can be obtained

Warm Water Bath Stimulates Phase-Shifts of the Peripheral Circadian Clocks in PER2::LUCIFERASE Mouse

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Kuriki, Daisuke; Haraguchi, Atsushi; Shibata, Shigenobu

2014-01-01

Circadian clocks in the peripheral tissues of mice are known to be entrained by pulse stimuli such as restricted feeding, novel wheel running, and several other agents. However, there are no reports on high temperature pulse-mediated entrainment on the phase-shift of peripheral clocks in vivo. Here we show that temperature treatment of mice for two days at 41°C, instead of 37°C, for 1–2 h during the inactive period, using a temperature controlled water bath stimulated phase-advance of peripheral clocks in the kidney, liver, and submandibular gland of PER2::LUCIFERASE mice. On the other hand, treatment for 2 days at 35°C ambient room temperature for 2 h did not cause a phase-advance. Maintenance of mice at 41°C in a water bath, sustained the core body temperature at 40–41°C. However, the use of 37°C water bath or the 35°C ambient room temperature elevated the core body temperature to 38.5°C, suggesting that at least a core body temperature of 40–41°C is necessary to cause phase-advance under light-dark cycle conditions. The temperature pulse stimulation at 41°C, instead of 37°C water bath for 2 h led to the elevated expression of Per1 and Hsp70 in the peripheral tissue of mice. In summary, the present study demonstrates that transient high temperature pulse using water bath during daytime causes phase-advance in mouse peripheral clocks in vivo. The present results suggest that hot water bath may affect the phase of peripheral clocks. PMID:24933288

Early hospital mortality prediction of intensive care unit patients using an ensemble learning approach.

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Awad, Aya; Bader-El-Den, Mohamed; McNicholas, James; Briggs, Jim

2017-12-01

Mortality prediction of hospitalized patients is an important problem. Over the past few decades, several severity scoring systems and machine learning mortality prediction models have been developed for predicting hospital mortality. By contrast, early mortality prediction for intensive care unit patients remains an open challenge. Most research has focused on severity of illness scoring systems or data mining (DM) models designed for risk estimation at least 24 or 48h after ICU admission. This study highlights the main data challenges in early mortality prediction in ICU patients and introduces a new machine learning based framework for Early Mortality Prediction for Intensive Care Unit patients (EMPICU). The proposed method is evaluated on the Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC-II) database. Mortality prediction models are developed for patients at the age of 16 or above in Medical ICU (MICU), Surgical ICU (SICU) or Cardiac Surgery Recovery Unit (CSRU). We employ the ensemble learning Random Forest (RF), the predictive Decision Trees (DT), the probabilistic Naive Bayes (NB) and the rule-based Projective Adaptive Resonance Theory (PART) models. The primary outcome was hospital mortality. The explanatory variables included demographic, physiological, vital signs and laboratory test variables. Performance measures were calculated using cross-validated area under the receiver operating characteristic curve (AUROC) to minimize bias. 11,722 patients with single ICU stays are considered. Only patients at the age of 16 years old and above in Medical ICU (MICU), Surgical ICU (SICU) or Cardiac Surgery Recovery Unit (CSRU) are considered in this study. The proposed EMPICU framework outperformed standard scoring systems (SOFA, SAPS-I, APACHE-II, NEWS and qSOFA) in terms of AUROC and time (i.e. at 6h compared to 48h or more after admission). The results show that although there are many values missing in the first few hour of ICU admission

Synchronization enhancement via an oscillatory bath in a network of ...

Indian Academy of Sciences (India)

2015-02-05

Feb 5, 2015 ... 2Monell Chemical Senses Center, 3500 Market Street, Philadelphia, PA 19104, USA ... The robustness of synchronization strategy is tested using a local and global ..... enhancement effect that the oscillatory bath has in the ...

Drug utilization study in a burn care unit of a tertiary care hospital

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Santoshkumar R Jeevangi

2011-03-01

Full Text Available Objective: To evaluate drug utilization and associated costs for the treatment of patients admitted in burn care unit of a tertiary care hospital. Methods: A prospective cross sectional study was conducted for a period of 15 months at Basaweshwara Teaching and General Hospital (BTGH, Gulbarga and the data collected was analyzed for various drug use indicators. Results: A total of 100 prescriptions were collected with 44% belonging to males and 56% to females. The average number of drugs per prescription ranged from 4.5 to 9.5. 9.5% of generics and 92% of essential drugs were prescribed. The opioid analgesics and sedatives were prescribed to all the patients who were admitted in burn care unit. The (Defined daily dose DDD/1 000/day for amikacin (359 was the highest followed by diclofenac sodium (156, pantoprazole (144, diazepam (130, ceftazidime (124, tramadol (115, ceftriaxone (84 and for paracetamol (4 which was the lowest. Conclusions: Significant amount of the money was spent on procurement of drugs. Most of the money was spent on prescribed antibiotics. The prescription of generic drugs should be promoted, for cost effective treatment. Hence the results of the present study indicate that there is a considerable scope for improvement in the prescription pattern.

Use of transcutaneous electrical nerve stimulation in the Unit of Pain Management of the Alcorcón Foundation University Hospital

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Andrea Isabel Martínez Tapia

2014-08-01

Full Text Available Transcutaneous electrical nerve stimulation (TENS is a non-pharmacological therapy (TNF used to alleviate pain and is among the current available treatments offered by the Units of Pain Management (Unidades del Dolor in Spanish Hospitals. The goal of this study was to identify the characteristics of portable electro-stimulator use, and its costs in the Unit of Pain Management of the Alcorcón Foundation University Hospital (Hospital Universitario Fundación Alcorcón. A retrospective descriptive study was carried out between January, 1999, and October, 2010, in the Unit of Pain Management of the Alcorcón Foundation University Hospital. The information on TENS delivery forms and its supplies was collected, and the characteristics of use and the associated costs were calculated. It was observed that the longest period of time used was less than a year. The cost of delivery for the portable equipment was 148 050 euros and the average annual cost for the use of TENS by a patient was 854 euros. From the information gathered, it can be concluded that the use of electro-analgesia is a valid option in terms of expenses for long periods of use, thereby allowing a reduction in costs and decreasing the use of other healthcare treatments.

Heat bath method for the twisted Eguchi-Kawai model

Energy Technology Data Exchange (ETDEWEB)

Fabricius, K.; Haan, O.

1984-08-16

We reformulate the twisted Eguchi-Kawaii model in a way that allows us to use the heat bath method for the updating procedure of the link matrices. This new formulation is more efficient by a factor of 2.5 in computer time and of 2.3 in memory need.

Comparing the effects of reflexology and foot bath on sleep quality in the elderly

OpenAIRE

Seyyedrasooli

2015-01-01

Introduction: Sleep disturbances are common mental problems reported among elders. It seems some non-pharmacological interventions, can improve their sleep quality. The aim of this study is to compare the effectiveness of two interventions, reflexology and foot bath, on sleep quality in elderly people. Methods: This is a clinical trial without control group, conducted on 46 elderly men in two groups of reflexology and foot bath. Written informed consent was completed by subjects. Reflexolo...

Dynamics and quantum Zeno effect for a qubit in either a low- or high-frequency bath beyond the rotating-wave approximation

International Nuclear Information System (INIS)

Cao Xiufeng; You, J. Q.; Zheng, H.; Kofman, A. G.; Nori, Franco

2010-01-01

We use a non-Markovian approach to study the decoherence dynamics of a qubit in either a low- or high-frequency bath modeling the qubit environment. This is done for two separate cases: either with measurements or without them. This approach is based on a unitary transformation and does not require the rotating-wave approximation. In the case without measurement, we show that, for low-frequency noise, the bath shifts the qubit energy toward higher energies (blue shift), while the ordinary high-frequency cutoff Ohmic bath shifts the qubit energy toward lower energies (red shift). In order to preserve the coherence of the qubit, we also investigate the dynamics of the qubit subject to measurements (quantum Zeno regime) in two cases: low- and high-frequency baths. For very frequent projective measurements, the low-frequency bath gives rise to the quantum anti-Zeno effect on the qubit. The quantum Zeno effect only occurs in the high-frequency-cutoff Ohmic bath, after counterrotating terms are considered. In the condition that the decay rate due to the two kinds of baths are equal under the Wigner-Weisskopf approximation, we find that without the approximation, for a high-frequency environment, the decay rate should be faster (without measurements) or slower (with frequent measurements, in the Zeno regime), compared to the low-frequency bath case. The experimental implementation of our results here could distinguish the type of bath (either a low- or high-frequency one) and protect the coherence of the qubit by modulating the dominant frequency of its environment.

The Study of Life Change Unit as Stressor Agents among Tehran University of Medical Sciences Hospitals' Employees

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Hossein Dargahi

2010-07-01

Full Text Available "nLife crises as stressor agents can disrupt the best stress management regime. Different life crises have different impacts. A standard scale to rate change and its related stress impact has been developed commonly referred to as LCU (Life Change Unit Rating. This allocates a number of Life Crisis Units or Life Change Units (LCUs to different event and then evaluates them and takes action accordingly. This idea behind this approach of is to rundown the LCU table, totaling the LCUs for life crisis that have occurred in the previous one year. A Cross - sectional, descriptive and analytical study was conducted among 900 Tehran University of Medical Sciences (TUMS Employees by a Holms and Rahe LCU questionnaire at 15 hospitals. The respondents were asked to determine their demographic information, list of stress symptoms which suffered from these diseases in the previous one year and finally, responded to 45 Life Change Unit as stressful life events and the value of each in "stress units" which occurred in the previous one year. The results showed that there is significant correlation between the employees LCU rating by sex, educational degree and size of hospital. Also we found that there are significant correlations between the employees stress symptoms with their LCU rating. Totally, 40% of the employees have less than 150 LCU rating (normal range and 60% of them have 150-300 or more than 300 LCU rating (abnormal range. In conclusion most of TUMS hospitals' employees who had stress symptoms have more LCU rating. One third of these employees are not in danger of suffering the illness effect, while two third of them are in danger.

Correlates of Unsupervised Bathing of Infants: A Cross-Sectional Study

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Tinneke M. J. Beirens

2013-03-01

Full Text Available Drowning represents the third leading cause of fatal unintentional injury in infants (0–1 years. The aim of this study is to investigate correlates of unsupervised bathing. This cross-sectional study included 1,410 parents with an infant. Parents completed a questionnaire regarding supervision during bathing, socio-demographic factors, and Protection Motivation Theory-constructs. To determine correlates of parents who leave their infant unsupervised, logistic regression analyses were performed. Of the parents, 6.2% left their child unsupervised in the bathtub. Parents with older children (OR 1.24; 95%CI 1.00–1.54 were more likely to leave their child unsupervised in the bathtub. First-time parents (OR 0.59; 95%CI 0.36–0.97 and non-Western migrant fathers (OR 0.18; 95%CI 0.05–0.63 were less likely to leave their child unsupervised in the bathtub. Furthermore, parents who perceived higher self-efficacy (OR 0.57; 95%CI 0.47–0.69, higher response efficacy (OR 0.34; 95%CI 0.24–0.48, and higher severity (OR 0.74; 95%CI 0.58–0.93 were less likely to leave their child unsupervised. Since young children are at great risk of drowning if supervision is absent, effective strategies for drowning prevention should be developed and evaluated. In the meantime, health care professionals should inform parents with regard to the importance of supervision during bathing.

Assessing the water quality response to an alternative sewage disposal strategy at bathing sites on the east coast of Ireland.

Science.gov (United States)

Bedri, Zeinab; O'Sullivan, John J; Deering, Louise A; Demeter, Katalin; Masterson, Bartholomew; Meijer, Wim G; O'Hare, Gregory

2015-02-15

A three-dimensional model is used to assess the bathing water quality of Bray and Killiney bathing sites in Ireland following changes to the sewage management system. The model, firstly calibrated to hydrodynamic and water quality data from the period prior to the upgrade of the Wastewater Treatment Works (WwTW), was then used to simulate Escherichia coli (E. coli) distributions for discharge scenarios of the periods prior to and following the upgrade of the WwTW under dry and wet weather conditions. E. coli distributions under dry weather conditions demonstrate that the upgrade in the WwTW has remarkably improved the bathing water quality to a Blue Flag status. The new discharge strategy is expected to drastically reduce the rainfall-related incidents in which environmental limits of the Bathing Water Directive are breached. However, exceedances to these limits may still occur under wet weather conditions at Bray bathing site due to storm overflows that may still be discharged through two sea outfalls offshore of Bray bathing site. Copyright © 2014 Elsevier Ltd. All rights reserved.

Hospitals, finance, and health system reform in Britain and the United States, c. 1910-1950: historical revisionism and cross-national comparison.

Science.gov (United States)

Gorsky, Martin

2012-06-01

Comparative histories of health system development have been variously influenced by the theoretical approaches of historical institutionalism, political pluralism, and labor mobilization. Britain and the United States have figured significantly in this literature because of their very different trajectories. This article explores the implications of recent research on hospital history in the two countries for existing historiographies, particularly the coming of the National Health Service in Britain. It argues that the two hospital systems initially developed in broadly similar ways, despite the very different outcomes in the 1940s. Thus, applying the conceptual tools used to explain the U.S. trajectory can deepen appreciation of events in Britain. Attention focuses particularly on working-class hospital contributory schemes and their implications for finance, governance, and participation; these are then compared with Blue Cross and U.S. hospital prepayment. While acknowledging the importance of path dependence in shaping attitudes of British bureaucrats toward these schemes, analysis emphasizes their failure in pressure group politics, in contrast to the United States. In both countries labor was also crucial, in the United States sustaining employment-based prepayment and in Britain broadly supporting system reform.

Effects of choline chloride on electrodeposited Ni coating from a Watts-type bath

Energy Technology Data Exchange (ETDEWEB)

Wang, Yurong; Yang, Caihong; He, Jiawei; Wang, Wenchang [School of Petrochemical Engineering, Changzhou University, Changzhou 213164 (China); Mitsuzak, Naotoshi [Qualtec Co., Ltd, Osaka 590-0906 (Japan); Chen, Zhidong, E-mail: zdchen.lab@gmail.com [School of Material Science and Engineering, Jiangsu Key Laboratory of Materials, Surface and Technology, Changzhou University, Changzhou 213164 (China); Jiangsu Collaborative Innovation Center of Photovoltaic Science and Engineering, Changzhou University, Changzhou 213164 (China); Jiangsu Key Laboratory of Advanced Catalytic Material and Technology, Changzhou University, Changzhou 213164 (China)

2016-05-30

Graphical abstract: - Highlights: • ChCl was applied as additive and conducting salt in Watts-type bath. • Progressive addition of ChCl leads to the crystal orientation (1 1 1) predominant. • The grain size and microhardness were refined and enhanced by increasing ChCl. • ChCl could be a good alternative to NiCl{sub 2} and additives for bright Ni electroplating. - Abstract: Electrodeposition of bright nickel (Ni) was carried out in a Watts-type bath. Choline chloride (ChCl) was applied as a multifunctional additive and substitute for nickel chloride (NiCl{sub 2}) in a Watts-type bath. The function of ChCl was investigated through conductivity tests, anodic polarization, and cathodic polarization experiments. The studies revealed that ChCl performed well as a conducting salt, anodic activator, and cathodic inhibitor. The effects of ChCl on deposition rate, preferred orientation, grain size, surface morphology, and microhardness of Ni coatings were also studied. The deposition rate reached a maximum value of greater than 27 μm h{sup −1} when 20 g L{sup −1} ChCl was introduced to the bath. Using X-ray diffraction, it was confirmed that progressive addition of ChCl promoted the preferred crystal orientation modification from (2 0 0) and (2 2 0) to (1 1 1), refined grain size, and enhanced microhardness. The presence of ChCl lowered the roughness of the coating.

Transport of thermal water from well to thermal baths

Science.gov (United States)

Montegrossi, Giordano; Vaselli, Orlando; Tassi, Franco; Nocentini, Matteo; Liccioli, Caterina; Nisi, Barbara

2013-04-01

The main problem in building a thermal bath is having a hot spring or a thermal well located in an appropriate position for customer access; since Roman age, thermal baths were distributed in the whole empire and often road and cities were built all around afterwards. Nowadays, the perspectives are changed and occasionally the thermal resource is required to be transported with a pipeline system from the main source to the spa. Nevertheless, the geothermal fluid may show problems of corrosion and scaling during transport. In the Ambra valley, central Italy, a geothermal well has recently been drilled and it discharges a Ca(Mg)-SO4, CO2-rich water at the temperature of 41 °C, that could be used for supplying a new spa in the surrounding areas of the well itself. The main problem is that the producing well is located in a forest tree ca. 4 km far away from the nearest structure suitable to host the thermal bath. In this study, we illustrate the pipeline design from the producing well to the spa, constraining the physical and geochemical parameters to reduce scaling and corrosion phenomena. The starting point is the thermal well that has a flow rate ranging from 22 up to 25 L/sec. The thermal fluid is heavily precipitating calcite (50-100 ton/month) due to the calcite-CO2 equilibrium in the reservoir, where a partial pressure of 11 bar of CO2 is present. One of the most vexing problems in investigating scaling processed during the fluid transport in the pipeline is that there is not a proper software package for multiphase fluid flow in pipes characterized by such a complex chemistry. As a consequence, we used a modified TOUGHREACT with Pitzer database, arranged to use Darcy-Weisbach equation, and applying "fictitious" material properties in order to give the proper y- z- velocity profile in comparison to the analytical solution for laminar fluid flow in pipes. This investigation gave as a result the lowest CO2 partial pressure to be kept in the pipeline (nearly 2

Association of bystander interventions and hospital length of stay and admission to intensive care unit in out-of-hospital cardiac arrest survivors.

Science.gov (United States)

Riddersholm, Signe; Kragholm, Kristian; Mortensen, Rikke Nørmark; Pape, Marianne; Hansen, Carolina Malta; Lippert, Freddy K; Torp-Pedersen, Christian; Christiansen, Christian F; Rasmussen, Bodil Steen

2017-10-01

The impact of bystander interventions on post-arrest hospital course is sparsely studied. We examined the association between bystander interventions and length of hospital stay and admission to intensive care unit (ICU) in one-day survivors after OHCA. This cohort study linked data of 4641 one-day OHCA survivors from 2001 to 2014 to data on hospital length of stay and ICU admission. We examined associations between bystander efforts and outcomes using regression, adjusted for age, sex, comorbidities, calendar year and witnessed status. We divided bystander efforts into three categories: 1. No bystander interventions; 2.Bystander CPR only; 3. Bystander defibrillation with or without bystander CPR. For patients surviving to hospital discharge, hospital length of stay was 20days for patients without bystander interventions, compared to 16 for bystander CPR, and 13 for bystander defibrillation. 82% of patients without bystander interventions were admitted to ICU compared to 77.2% for bystander CPR, and 61.2% for bystander defibrillation. In-hospital mortality was 60% in the first category compared to 40.5% and 21.7% in the two latter categories. In regression models, bystander CPR and bystander defibrillation were associated with a reduction of length of hospital stay of 21% (Estimate: 0.79 [95% CI: 0.72-0.86]) and 32% (Estimate: 0.68 [95% CI: 0.59-0.78]), respectively. Both bystander CPR (OR: 0.94 [95% CI: 0.91-0.97]) and bystander defibrillation (OR: 0.81 [0.76-0.85]), were associated with lower risk of ICU admission. Bystander interventions were associated with reduced hospital length of stay and ICU admission, suggesting that these efforts improve recovery in OHCA survivors. Copyright © 2017 Elsevier B.V. All rights reserved.

Trends and Characteristics of United States Out-of-Hospital Births 2004-2014: New Information on Risk Status and Access to Care.

Science.gov (United States)

MacDorman, Marian F; Declercq, Eugene

2016-06-01

Out-of-hospital births are increasing in the United States. Our purpose was to examine trends in out-of-hospital births from 2004 to 2014, and to analyze newly available data on risk status and access to care. Newly available data from the revised birth certificate for 47 states and Washington, DC, were used to examine out-of-hospital births by characteristics and to compare them with hospital births. Trends from 2004 to 2014 were also examined. Out-of-hospital births increased by 72 percent, from 0.87 percent of United States births in 2004 to 1.50 percent in 2014. Compared with mothers who had hospital births, those with out-of-hospital births had lower prepregnancy obesity (12.5% vs 25.0%) and smoking (2.8% vs 8.5%) rates, and higher college graduation (39.3% vs 30.0%) and breastfeeding initiation (94.3% vs 80.8%) rates. Among planned home births, 67.1 percent were self-paid, compared with 31.9 percent of birth center and 3.4 percent of hospital births. Vaginal births after cesarean (VBACs) comprised 4.6 percent of planned home births and 1.6 percent of hospital and birth center births. Sociodemographic and medical risk status of out-of-hospital births improved substantially from 2004 to 2014. Improvements in risk status of out-of-hospital births from 2004 to 2014 suggest that appropriate selection of low-risk women is improving. High rates of self-pay for the costs of out-of-hospital birth suggest serious gaps in insurance coverage, whereas higher-than-average rates of VBAC could reflect lack of access to hospital VBACs. Mandating private insurance and Medicaid coverage could substantially improve access to out-of-hospital births. Improving access to hospital VBACs might reduce the number of out-of-hospital VBACs. © 2016 Wiley Periodicals, Inc.

Electrodeposition of CdTe thin film from acetate-based ionic liquid bath

Science.gov (United States)

Waldiya, Manmohansingh; Bhagat, Dharini; Mukhopadhyay, Indrajit

2018-05-01

CdTe being a direct band gap semiconductor, is mostly used in photovoltaics. Here we present, the synthesis of CdTe thin film on fluorine doped tin oxide (FTO) substrate potentiostatically using 1-butyl-3-methylimidazolium acetate ([Bmim][Ac]) ionic liquid (IL) bath at 90 °C. Major advantages of using electrodeposition involves process simplicity, large scalability & economic viability. Some of the benefits offered by IL electrolytic bath are low vapour pressure, wide electrochemical window, and good ionic mobility. Cd(CH3COO)2 (anhydrous) and TeO2 were used as the source precursors. The IL electrolytic bath temperature was kept at 90 °C for deposition, owing to the limited solubility of TeO2 in [Bmim][Ac] IL at room temperature. Cathodic electrodeposition was carried out using a three electrode cell setup at a constant potential of -1.20 V vs. platinum (Pt) wire. The CdTe/FTO thin film were annealed in argon (Ar) atmosphere. Optical study of nanostructured CdTe film were done using UV-Vis-IR and Raman spectroscopy. Raman analysis confirms the formation of CdTe having surface optics (SO) mode at 160.6 cm-1 and transverse optics (TO) mode at 140.5 cm-1. Elemental Te peaks at 123, 140.5 and 268 cm-1 were also observed. The optical band gap of Ar annealed CdTe thin film were found to be 1.47 eV (absorbance band edge ˜ 846 nm). The optimization of deposition parameters using acetate-based IL electrolytic bath to get nearly stoichiometric CdTe thin film is currently being explored.

Distribution of Legionella pneumophila bacteria and Naegleria and Hartmannella amoebae in thermal saline baths used in balneotherapy.

Science.gov (United States)

Zbikowska, Elżbieta; Walczak, Maciej; Krawiec, Arkadiusz

2013-01-01

The present study was aimed at investigating the coexistence and interactions between free living amoebae of Naegleria and Hartmannella genera and pathogenic Legionella pneumophila bacteria in thermal saline baths used in balneotherapy in central Poland. Water samples were collected from November 2010 to May 2011 at intervals longer than 1 month. The microorganisms were detected with the use of a very sensitive fluorescence in situ hybridisation method. In addition, the morphology of the amoebae was studied. Despite relatively high salinity level, ranging from 1.5 to 5.0 %, L. pneumophila were found in all investigated baths, although their number never exceeded 10(6) cells dm(-3). Hartmannella were not detected, while Naegleria fowleri were found in one bath. The observation that N. fowleri and L. pneumophila may coexist in thermal saline baths is the first observation emphasising potential threat from these microorganisms in balneotherapy.

Heat bath method for the twisted Eguchi-Kawai model

International Nuclear Information System (INIS)

Fabricius, K.; Haan, O.

1984-01-01

We reformulate the twisted Eguchi-Kawaii model in a way that allows us to use the heat bath method for the updating procedure of the link matrices. This new formulation is more efficient by a factor of 2.5 in computer time and of 2.3 in memory need. (orig.)

Quantum trajectory analysis of multimode subsystem-bath dynamics.

Science.gov (United States)

Wyatt, Robert E; Na, Kyungsun

2002-01-01

The dynamics of a swarm of quantum trajectories is investigated for systems involving the interaction of an active mode (the subsystem) with an M-mode harmonic reservoir (the bath). Equations of motion for the position, velocity, and action function for elements of the probability fluid are integrated in the Lagrangian (moving with the fluid) picture of quantum hydrodynamics. These fluid elements are coupled through the Bohm quantum potential and as a result evolve as a correlated ensemble. Wave function synthesis along the trajectories permits an exact description of the quantum dynamics for the evolving probability fluid. The approach is fully quantum mechanical and does not involve classical or semiclassical approximations. Computational results are presented for three systems involving the interaction on an active mode with M=1, 10, and 15 bath modes. These results include configuration space trajectory evolution, flux analysis of the evolving ensemble, wave function synthesis along trajectories, and energy partitioning along specific trajectories. These results demonstrate the feasibility of using a small number of quantum trajectories to obtain accurate quantum results on some types of open quantum systems that are not amenable to standard quantum approaches involving basis set expansions or Eulerian space-fixed grids.

The effects of local forearm muscle cooling on motor unit properties.

Science.gov (United States)

Mallette, Matthew M; Green, Lara A; Gabriel, David A; Cheung, Stephen S

2018-02-01

Muscle cooling impairs maximal force. Using needle electromyography (EMG) to assess motor unit properties during muscle cooling, is limited and equivocal. Therefore, we aimed to determine the impact of local muscle cooling on motor unit firing properties using surface EMG decomposition. Twenty participants (12 M, 8 F) completed maximal, evoked, and trapezoidal contractions during thermoneutral and cold muscle conditions. Forearm muscle temperature was manipulated using 10-min neutral (~ 32 °C) or 20-min cold (~ 3 °C) water baths. Twitches and maximal voluntary contractions were performed prior to, and after, forearm immersion in neutral or cold water. Motor unit properties were assessed during trapezoidal contractions to 50% baseline force using surface EMG decomposition. Impaired contractile properties from muscle cooling were evident in the twitch amplitude, duration, and rate of force development indicating that the muscle was successfully cooled from the cold water bath (all d ≥ 0.5, P motor units (d = 0.7, P = 0.01) and motor unit action potential (MUAP) duration (d = 0.6, P motor unit firing rates (d = 0.1, P = 0.843) nor recruitment threshold (d = 0.1, P = 0.746) changed; however, the relationship between the recruitment threshold and motor unit firing rate was steeper (d = 1.0, P motor units, and small but coupled changes in motor unit firing rates and recruitment threshold to produce the same force.

Hospital markup and operation outcomes in the United States.

Science.gov (United States)

Gani, Faiz; Ejaz, Aslam; Makary, Martin A; Pawlik, Timothy M

2016-07-01

Although the price hospitals charge for operations has broad financial implications, hospital pricing is not subject to regulation. We sought to characterize national variation in hospital price markup for major cardiothoracic and gastrointestinal operations and to evaluate perioperative outcomes of hospitals relative to hospital price markup. All hospitals in which a patient underwent a cardiothoracic or gastrointestinal procedure were identified using the Nationwide Inpatient Sample for 2012. Markup ratios (ratio of charges to costs) for the total cost of hospitalization were compared across hospitals. Risk-adjusted morbidity, failure-to-rescue, and mortality were calculated using multivariable, hierarchical logistic regression. Among the 3,498 hospitals identified, markup ratios ranged from 0.5-12.2, with a median markup ratio of 2.8 (interquartile range 2.7-3.9). For the 888 hospitals with extreme markup (greatest markup ratio quartile: markup ratio >3.9), the median markup ratio was 4.9 (interquartile range 4.3-6.0), with 10% of these hospitals billing more than 7 times the Medicare-allowable costs (markup ratio ≥7.25). Extreme markup hospitals were more often large (46.3% vs 33.8%, P markup ratio compared with 19.3% (n = 452) and 6.8% (n = 35) of nonprofit and government hospitals, respectively. Perioperative morbidity (32.7% vs 26.4%, P markup hospitals. There is wide variation in hospital markup for cardiothoracic and gastrointestinal procedures, with approximately a quarter of hospital charges being 4 times greater than the actual cost of hospitalization. Hospitals with an extreme markup had greater perioperative morbidity. Copyright © 2016 Elsevier Inc. All rights reserved.

Numerical Models of Sewage Dispersion and Statistica Bathing Water Standards

DEFF Research Database (Denmark)

Petersen, Ole; Larsen, Torben

1991-01-01

As bathing water standards usually are founded in statistical methods, the numerical models used in outfall design should reflect this. A statistical approach, where stochastic variations in source strength and bacterial disappearance is incorporated into a numerical dilution model is presented. ...

Effects of gelling bath on the physical properties of alginate gel beads and the biological characteristics of entrapped HepG2 cells.

Science.gov (United States)

Sun, Dongsheng; Liu, Yang; Wu, Hao; Ren, Ying; Ma, Xiaojun; Wu, Huijian; Sun, Guangwei

2018-03-01

Optimizing alginate gel beads is necessary to support the survival, proliferation, and function of entrapped hepatocytes. In this study, gelling bath was modified by decreasing calcium ion concentration and increasing sodium ion concentration. Alginate gel beads (using 36% G sodium alginate) prepared in the modified gelling bath had more homogeneous structure and better mass transfer properties compared with the traditional gelling bath that contains only calcium ions. Moreover, alginate gel beads generated in the modified gelling bath could significantly promote the HepG2 cell proliferation and the growth of cell spheroids, and maintain the albumin secretion ability similar to alginate gel beads prepared in the traditional gelling bath with only calcium ions. The mass transfer properties and cell proliferation were similar in ALG beads with different M/G ratio (36% G and 55% G) generated in the modified gelling bath, whereas they were significantly increased compared with alginate gel beads (55% G) in traditional gelling bath. These results indicated that adjusting the gelling bath was a simple and convenient method to enhance the mass transfer properties of alginate gel beads for 3D hepatocyte culture, which might provide more hepatocytes for the bioartificial liver support system. © 2017 International Union of Biochemistry and Molecular Biology, Inc.

Quantum Kramers model: Corrections to the linear response theory for continuous bath spectrum

Science.gov (United States)

Rips, Ilya

2017-01-01

Decay of the metastable state is analyzed within the quantum Kramers model in the weak-to-intermediate dissipation regime. The decay kinetics in this regime is determined by energy exchange between the unstable mode and the stable modes of thermal bath. In our previous paper [Phys. Rev. A 42, 4427 (1990), 10.1103/PhysRevA.42.4427], Grabert's perturbative approach to well dynamics in the case of the discrete bath [Phys. Rev. Lett. 61, 1683 (1988), 10.1103/PhysRevLett.61.1683] has been extended to account for the second order terms in the classical equations of motion (EOM) for the stable modes. Account of the secular terms reduces EOM for the stable modes to those of the forced oscillator with the time-dependent frequency (TDF oscillator). Analytic expression for the characteristic function of energy loss of the unstable mode has been derived in terms of the generating function of the transition probabilities for the quantum forced TDF oscillator. In this paper, the approach is further developed and applied to the case of the continuous frequency spectrum of the bath. The spectral density functions of the bath of stable modes are expressed in terms of the dissipative properties (the friction function) of the original bath. They simplify considerably for the one-dimensional systems, when the density of phonon states is constant. Explicit expressions for the fourth order corrections to the linear response theory result for the characteristic function of the energy loss and its cumulants are obtained for the particular case of the cubic potential with Ohmic (Markovian) dissipation. The range of validity of the perturbative approach in this case is determined (γ /ωbrate for the quantum and for the classical Kramers models. Results for the classical escape rate are in very good agreement with the numerical simulations for high barriers. The results can serve as an additional proof of the robustness and accuracy of the linear response theory.

Repercussões oxi-hemodinâmicas do banho no paciente em estado crítico adulto hospitalizado: revisão sistemática Repercusiones de la oxigenación hemodinámicas en el baño en el paciente en estado crítico adulto hospitalizado: revisión sistemática Hemodynamic oxygenation effects during the bathing of hospitalized adult patients critically ill: systematic review

Directory of Open Access Journals (Sweden)

Rubia Aparecida Lacerda

2010-04-01

Phenomena" / "Oxygen Consumption" y variaciones. Fuentes: bases de datos CINAHL, DEDALUS; EMBASE, COCHRANE, LILACS, PubMed/MEDLINE; bibliotecas de las Escuelas de Enfermería de la Universidad Federal Fluminense y Universidad Federal de Rio de Janeiro; referencias cruzadas y; artículos relacionados del Pubmed y ISI. RESULTADOS: De 44597 referencias restaron seis casi-experimentos. Durante el baño, la saturación venosa mixta de oxígeno declinó considerablemente del baseline, restableciéndose 30 minutos después. CONCLUSIÓN: Condiciones que aumentan el riesgo: baño menos de cuatro horas después de la cirugía cardíaca, posicionamiento prolongado decúbito lateral y tiempo de baño superior a 20 minutos: manutención de la temperatura del agua en 40°C, para protección.OBJECTIVES: To identify scientific evidence on the impact of hemodynamic oxygenation of the bathing in the adult patient hospitalized in critical condition; to verify the possibility of establishing criteria for the indication of the bathing in that patient, based on hemodynamic effects of oxygenation in different clinical situations. METHODS: Systematic review of primary and secondary literature, without restriction of time or language. PIO strategy used: P (problem = "Intensive Care Units" and variations, I (intervention = bathing and variations; O (result = "Hemodynamic Phenomena" / "Oxygen Consumption" and variations. Sources: CINAHL databases, Dedalus, EMBASE, COCHRANE, LILACS, PubMed / MEDLINE; libraries of Nursing Schools, Fluminense Federal University and Federal University of Rio de Janeiro; cross references, and, articles from PubMed and ISI. RESULTS: Of 44,597 references six quasi-experiments remained. During the bathing, mixed venous oxygen saturation declined significantly from baseline, being restored 30 minutes later. CONCLUSION: The conditions that increase risk are: bathing less than four hours after cardiac surgery, prolonged lateral decubitus positioning, and, bathing time exceeding

Performance of Flow and Heat Transfer in a Hot-Dip Round Coreless Galvanizing Bath

Science.gov (United States)

Yue, Qiang; Zhang, Chengbo; Xu, Yong; Zhou, Li; Kong, Hui; Wang, Jia

2017-04-01

Flow field in a coreless hot-dip galvanizing pot was investigated through a water modeling experiment. The corresponding velocity vector was measured using an acoustic Doppler velocimeter. The flow field of molten zinc in the bath was also analyzed. Steel strip velocities from 1.7 to 2.7 m/s were adopted to determine the effect of steel strip velocity on the molten zinc flow in the bath. A large vortex filled the space at the right side of the sink roll, under linear speed from 1.0 to 2.7 m/s and width from 1.0 to 1.3 m of the steel strip, because of the effects of wall and shear stress. The results of the water modeling experiment were compared with those of numerical simulations. In the simulation, Maxwell equations were solved using finite element method to obtain magnetic flux density, electromagnetic force, and Joule heating. The Joule heating rate reached the maximum and minimum values near the side wall and at the core of the bath, respectively, because of the effect of skin and proximity. In an industrial-sized model, the molten zinc flow and temperature fields driven by electromagnetic force and Joule heating in the inductor of a coreless galvanizing bath were numerically simulated. The results indicated that the direction of electromagnetic force concentrated at the center of the galvanizing pot horizontal planes and exerted a pinch effect on molten zinc. Consequently, molten zinc in the pot was stirred by electromagnetic force. Under molten zinc flow and electromagnetic force stirring, the temperature of the molten zinc became homogeneous throughout the bath. This study provides a basis for optimizing electromagnetic fields in coreless induction pot and fine-tuning the design of steel strip parameters.

Responses of Lithium-Modified Bath to a Shift in Heat Input/Output Balance and Observation of Freeze-Lining Formation During the Heat Balance Shift

Science.gov (United States)

Liu, Jingjing; Taylor, Mark; Dorreen, Mark

2018-02-01

In the aluminum electrolysis process, new industrial aluminum/electricity power markets demand a new cell technology to extend the cell heat balance and amperage operating window of smelters by shifting the steady states. The current work investigates the responses of lithium-modified bath system when the input/output balance is shifted in a laboratory analogue to the industrial heat balance shift. Li2CO3 is added to the cryolite-AlF3-CaF2-Al2O3 system as a bath modifier. A freeze deposit is formed on a `cold finger' dipped into the bath and investigated by X-ray diffraction analysis and electron probe X-ray microanalysis. The macro- and micro-structure of the freeze lining varies with the bath superheat (bath temperature minus bath liquidus temperature) and an open crystalline layer with entrapped liquid dominates the freeze thickness. Compared with the cryolite-AlF3-CaF2-Al2O3 bath system, the lithium-modified bath freeze is more sensitive to the heat balance shift. This freeze investigation provides primary information to understand the variation of the side ledge in an industrial cell when the lithium-modified bath system is used.

Pediatric traumatic amputations and hospital resource utilization in the United States, 2003.

Science.gov (United States)

Conner, Kristen A; McKenzie, Lara B; Xiang, Huiyun; Smith, Gary A

2010-01-01

Despite the severity of consequences associated with traumatic amputation, little is known about the epidemiology or healthcare resource burden of amputation injuries, and even less is known about these injuries in the pediatric population. An analysis of patients aged lawn mower, motorized vehicle or explosives/fireworks, and children's hospital type were associated with longer LOS. Pediatric traumatic amputations contribute substantially to the health resource burden in the United States, resulting in 21 million dollars in inpatient charges annually. More effective interventions to prevent these costly injuries among children must be implemented.

Special Needs Dentistry: Interdisciplinary Management of Medically-Complex Patients at Hospital-Based Dental Units in Tasmania, Australia

Directory of Open Access Journals (Sweden)

Lim

2017-06-01

Full Text Available Background: Increasing awareness of the interactions between oral and general health has led to the establishment of Special Needs Dentistry as a dental specialty in many countries. This specialty assists with the interdisciplinary management of patients between the medical and dental professions particularly those with complex medical problems, intellectual and physical impairments, and psychiatric conditions that may affect their oral health or the manner in which they receive treatment. However, little is known about the utilisation of specialised services provided to facilitate individuals with these needs. Aim: The aim of this study was to understand current utilisation of hospital-based dental services established to provide medically-necessary dental care. Methods: A retrospective review of the demographics and medical status of patients treated at referral hospital-based dental clinics in the state of Tasmania was completed for the month of August 2015. Results: Patients treated at these units had a variety of medical backgrounds. Most (46.4% were referred from medical professionals within the hospital. On average, patients treated at these units had 2.56 medical conditions and were taking 3.59 medications each. Many of these were chronic medical conditions known to have an interaction with oral health. Conclusions: Our results demonstrate the growing recognition of dynamic interactions between oral and general health and the importance of these hospitalbased units and interprofessional relationships in providing timely and holistic health care to these patients.

Impact of a prevention bundle on Clostridium difficile infection rates in a hospital in the Southeastern United States.

Science.gov (United States)

Davis, Bionca M; Yin, Jingjing; Blomberg, Doug; Fung, Isaac Chun-Hai

2016-12-01

We sought to assess the impact of a multicomponent prevention program on hospital-acquired Clostridium difficile infections in a hospital in the Southeastern United States. We collected retrospective data of 140 patients from years 2009-2014 and applied the Poisson regression model for analysis. We did not find any significant associations of increased risk of Clostridium difficile infections for the preintervention group. Further studies are needed to test multifaceted bundles in hospitals with high infection rates. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Osteoporosis among hospitalized patients with proximal femoral fractures in Assiut University Trauma Unit, Egypt.

Science.gov (United States)

Farouk, Osama; Mahran, Dalia G; Said, Hatem G; Alaa, Mohamed M; Eisa, Amr; Imam, Hisham; Said, G Z

2017-12-01

The study was done to investigate osteoporosis prevalence in 275 hip fracture admissions at the Trauma Unit of Assiut University Hospitals and associated factors, which are understudied in our locality. Prevalence was 74.9%. Female sex, older age, low body mass index, and fall on the ground were associated with osteoporosis. This study aims to identify osteoporosis prevalence in hip fracture admissions at the Trauma Unit of Assiut University Hospitals and to study the independent correlates of osteoporosis-related fracture. A prospective cross-sectional study was carried out in 275 hip fracture patients admitted to the Trauma Unit of Assiut University Hospitals from January through December 2014 of both sexes aged 50 years and older. Exclusion criteria were polytrauma, major accidents, and history of chronic conditions and long-term medication associated with osteoporosis risk increase and bilateral hip fractures. For every patient, weight, height, and bone mineral density by dual-energy x-ray absorptiometry (DEXA) were recorded. Tests of significance for non-parametric data were used. The questionnaire included sociodemographic characteristics, dietary habits, lifestyle factors such as smoking and physical activity, and female obstetric and gynecological factors. Mean age was 70.82 ± 11.02 SD; 51.6% were males and 8.4% were obese. Fall on ground was in 81.1% of fractures. Osteoporosis (femoral neck T score ≤ -2.5 SD) prevalence was 74.9%. By univariable analysis, significant correlates were female gender, older age, normal BMI, and fall on the ground. Milk and cheese daily intake was significantly associated with lower prevalence of osteoporosis. In a multivariable logistic regression model, female sex, older age, low BMI, and fall on the ground were associated with osteoporosis. Osteoporosis prevalence is high among hip fracture patients and associated with female sex, increase in age, low BMI, and fall on ground. Strategies to prevent osteoporosis are

Designing the Color of Hot-Dip Galvanized Steel Sheet Through Destructive Light Interference Using a Zn-Ti Liquid Metallic Bath

Science.gov (United States)

Levai, Gabor; Godzsák, Melinda; Török, Tamas I.; Hakl, Jozsef; Takáts, Viktor; Csik, Attila; Vad, Kalman; Kaptay, George

2016-07-01

The color of hot-dip galvanized steel sheet was adjusted in a reproducible way using a liquid Zn-Ti metallic bath, air atmosphere, and controlling the bath temperature as the only experimental parameter. Coloring was found only for samples cooled in air and dipped into Ti-containing liquid Zn. For samples dipped into a 0.15 wt pct Ti-containing Zn bath, the color remained metallic (gray) below a 792 K (519 °C) bath temperature; it was yellow at 814 K ± 22 K (541 °C ± 22 °C), violet at 847 K ± 10 K (574 °C ± 10 °C), and blue at 873 K ± 15 K (600 °C ± 15 °C). With the increasing bath temperature, the thickness of the adhered Zn-Ti layer gradually decreased from 52 to 32 micrometers, while the thickness of the outer TiO2 layer gradually increased from 24 to 69 nm. Due to small Al contamination of the Zn bath, a thin (around 2 nm) alumina-rich layer is found between the outer TiO2 layer and the inner macroscopic Zn layer. It is proven that the color change was governed by the formation of thin outer TiO2 layer; different colors appear depending on the thickness of this layer, mostly due to the destructive interference of visible light on this transparent nano-layer. A complex model was built to explain the results using known relationships of chemical thermodynamics, adhesion, heat flow, kinetics of chemical reactions, diffusion, and optics. The complex model was able to reproduce the observations and allowed making predictions on the color of the hot-dip galvanized steel sample, as a function of the following experimental parameters: temperature and Ti content of the Zn bath, oxygen content, pressure, temperature and flow rate of the cooling gas, dimensions of the steel sheet, velocity of dipping the steel sheet into the Zn-Ti bath, residence time of the steel sheet within the bath, and the velocity of its removal from the bath. These relationships will be valuable for planning further experiments and technologies on color hot-dip galvanization of steel

Thermal equilibrium properties of surface hopping with an implicit Langevin bath

International Nuclear Information System (INIS)

Sherman, M. C.; Corcelli, S. A.

2015-01-01

The ability of fewest switches surface hopping (FSSH) approach, where the classical degrees of freedom are coupled to an implicit Langevin bath, to establish and maintain an appropriate thermal equilibrium was evaluated in the context of a three site model for electron transfer. The electron transfer model consisted of three coupled diabatic states that each depends harmonically on the collective bath coordinate. This results in three states with increasing energy in the adiabatic representation. The adiabatic populations and distributions of the collective solvent coordinate were monitored during the course of 250 ns FSSH-Langevin (FSSH-L) simulations performed at a broad range of temperatures and for three different nonadiabatic coupling strengths. The agreement between the FSSH-L simulations and numerically exact results for the adiabatic population ratios and solvent coordinate distributions was generally favorable. The FSSH-L method produces a correct Boltzmann distribution of the solvent coordinate on each of the adiabats, but the integrated populations are slightly incorrect because FSSH does not rigorously obey detailed balance. The overall agreement is better at high temperatures and for high nonadiabatic coupling, which agrees with a previously reported analytical and simulation analysis [J. R. Schmidt, P. V. Parandekar, and J. C. Tully, J. Chem. Phys. 129, 044104 (2008)] on a two-level system coupled to a classical bath

Use of the hospital anxiety and depression scale (HADS) in a cardiac emergency room: chest pain unit

OpenAIRE

Soares-Filho, Gastão L. F.; Freire, Rafael C.; Biancha, Karla; Pacheco, Ticiana; Volschan, André; Valença, Alexandre M.; Nardi, Antonio E.

2009-01-01

OBJECTIVE: To determine the prevalence of anxiety and depression in patients complaining of chest pain who seek a chest pain unit attendance. INTRODUCTION: Patients arriving at a Chest Pain Unit may present psychiatric disorders not identified, isolated or co-morbid to the main illness, which may interfere in the patient prognosis. METHODOLOGY: Patients were assessed by the "Hospital Anxiety and Depression Scale" as a screening instrument wile following a systematized protocol to rule out the...

Deposition and characterization of ZnS thin films using chemical bath deposition method in the presence of sodium tartrate as complexing agent

International Nuclear Information System (INIS)

Kassim, A.; Tee, T.W.; Min, H.S.; Nagalingam, S.

2011-01-01

ZnS thin films were deposited on indium tin oxide glass substrate using the chemical bath deposition method. The deposited films were characterized by X-ray diffraction and atomic force microscopy. The influence of bath temperature on the structure and morphology of the thin films was investigated at three different bath temperatures of 60, 70 and 80 deg. C in the presence of sodium tartrate as a complexing agent. The XRD results indicated that the deposited ZnS thin films exhibited a polycrystalline cubic structure. The number of ZnS peaks increased from three to four peaks as the bath temperature was increased from 60 to 80 deg. C based on the XRD patterns. From the AFM measurements, the film thickness and surface roughness were found to be dependent on the bath temperature. The grain size increased as the bath temperature was increased from 60 to 80 deg. C. (author)

Resummed memory kernels in generalized system-bath master equations

International Nuclear Information System (INIS)

Mavros, Michael G.; Van Voorhis, Troy

2014-01-01

Generalized master equations provide a concise formalism for studying reduced population dynamics. Usually, these master equations require a perturbative expansion of the memory kernels governing the dynamics; in order to prevent divergences, these expansions must be resummed. Resummation techniques of perturbation series are ubiquitous in physics, but they have not been readily studied for the time-dependent memory kernels used in generalized master equations. In this paper, we present a comparison of different resummation techniques for such memory kernels up to fourth order. We study specifically the spin-boson Hamiltonian as a model system bath Hamiltonian, treating the diabatic coupling between the two states as a perturbation. A novel derivation of the fourth-order memory kernel for the spin-boson problem is presented; then, the second- and fourth-order kernels are evaluated numerically for a variety of spin-boson parameter regimes. We find that resumming the kernels through fourth order using a Padé approximant results in divergent populations in the strong electronic coupling regime due to a singularity introduced by the nature of the resummation, and thus recommend a non-divergent exponential resummation (the “Landau-Zener resummation” of previous work). The inclusion of fourth-order effects in a Landau-Zener-resummed kernel is shown to improve both the dephasing rate and the obedience of detailed balance over simpler prescriptions like the non-interacting blip approximation, showing a relatively quick convergence on the exact answer. The results suggest that including higher-order contributions to the memory kernel of a generalized master equation and performing an appropriate resummation can provide a numerically-exact solution to system-bath dynamics for a general spectral density, opening the way to a new class of methods for treating system-bath dynamics

[Complexity of care and organizational effectiveness: a survey among medical care units in nine Lombardy region hospitals].

Science.gov (United States)

Pasquali, Sara; Capitoni, Enrica; Tiraboschi, Giuseppina; Alborghetti, Adriana; De Luca, Giuseppe; Di Mauro, Stefania

2017-01-01

Eleven medical care units of nine Lombardy Region hospitals organized by levels of care model or by the traditional departmental model have been analyzed, in order to evaluate if methods for complexity of patient-care evaluation represent an index factor of nursing organizational effectiveness. Survey with nine Nurses in managerial position was conducted between Nov. 2013-Jan. 2014. The following factors have been described: context and nursing care model, staffing, complexity evaluation, patient satisfaction, staff well-being. Data were processed through Microsoft Excel. Among Units analysed ,all Units in levels of care and one organized by the departmental model systematically evaluate nursing complexity. Registered Nurses (RN) and Health Care Assistants (HCA) are on average numerically higher in Units that measure complexity (0.55/ 0.49 RN, 0.38/0.23 HCA - ratio per bed). Adopted measures in relation to changes in complexity are:rewarding systems, supporting interventions, such as moving personnel within different Units or additional required working hours; reduction in number of beds is adopted when no other solution is available. Patient satisfaction is evaluated through Customer Satisfaction questionnaires. Turnover, stress and rate of absenteeism data are not available in all Units. Complexity evaluation through appropriate methods is carried out in all hospitals organized in levels of care with personalized nursing care models, though complexity is detected with different methods. No significant differences in applied managerial strategies are present. Patient's satisfaction is evaluated everywhere. Data on staffing wellbeing is scarcely available. Coordinated regional actions are recommended in order to gather comparable data for research, improve decision making and effectiveness of Nursing care.

THE AROMATIC PHYTO-BATHS ARE AN EFFECTIVE METHOD OF HYDROTHERAPY IN COMPLEX REHABILITATIVE TREATMENT OF CHILDREN WITH DIFFERENT DISEASES

Directory of Open Access Journals (Sweden)

O. M. Konova

2014-01-01

Full Text Available The drugs and phytoaromatic substances increases the efficacy of balneotherapy. Mineral, medicinal and aromatic baths are widely used in complex rehabilitation of patients from 1 month of age. Aromatic phyto-baths have a complex mechanism of action and a wide variety of therapeutic effects. Today special products based on natural plant components and essential oilsare are developed to prepare the aromatic phyto-baths. Only officially registered industrial drugs with clinical efficacy and safety were proven by clinical researches can be recommended for the pediatric using. Our studies demonstrated a positive impact aromatic phyto-baths to the dynamics of clinical symptoms at the patients with acute respiratory infections, atopic dermatitis; and also were revealed an increase of adaptive organism reserves.

Clostridium Difficile Infection in Acute Care Hospitals: Systematic Review and Best Practices for Prevention.

Science.gov (United States)

Louh, Irene K; Greendyke, William G; Hermann, Emilia A; Davidson, Karina W; Falzon, Louise; Vawdrey, David K; Shaffer, Jonathan A; Calfee, David P; Furuya, E Yoko; Ting, Henry H

2017-04-01

OBJECTIVE Prevention of Clostridium difficile infection (CDI) in acute-care hospitals is a priority for hospitals and clinicians. We performed a qualitative systematic review to update the evidence on interventions to prevent CDI published since 2009. DESIGN We searched Ovid, MEDLINE, EMBASE, The Cochrane Library, CINAHL, the ISI Web of Knowledge, and grey literature databases from January 1, 2009 to August 1, 2015. SETTING We included studies performed in acute-care hospitals. PATIENTS OR PARTICIPANTS We included studies conducted on hospitalized patients that investigated the impact of specific interventions on CDI rates. INTERVENTIONS We used the QI-Minimum Quality Criteria Set (QI-MQCS) to assess the quality of included studies. Interventions were grouped thematically: environmental disinfection, antimicrobial stewardship, hand hygiene, chlorhexidine bathing, probiotics, bundled approaches, and others. A meta-analysis was performed when possible. RESULTS Of 3,236 articles screened, 261 met the criteria for full-text review and 46 studies were ultimately included. The average quality rating was 82% according to the QI-MQCS. The most effective interventions, resulting in a 45% to 85% reduction in CDI, included daily to twice daily disinfection of high-touch surfaces (including bed rails) and terminal cleaning of patient rooms with chlorine-based products. Bundled interventions and antimicrobial stewardship showed promise for reducing CDI rates. Chlorhexidine bathing and intensified hand-hygiene practices were not effective for reducing CDI rates. CONCLUSIONS Daily and terminal cleaning of patient rooms using chlorine-based products were most effective in reducing CDI rates in hospitals. Further studies are needed to identify the components of bundled interventions that reduce CDI rates. Infect Control Hosp Epidemiol 2017;38:476-482.

Pediatric Neglected Tropical Diseases in a Major Metropolitan Children's Hospital in the United States, 2004-2013.

Science.gov (United States)

Sweet, Leigh R; Palazzi, Debra L

2016-12-01

We conducted a retrospective study of neglected tropical diseases (NTDs) diagnosed at Texas Children's Hospital between 2004 and 2013. Forty-three patients with an NTD were identified; 47% had never traveled outside of the United States. The results of this study highlight the importance of physician awareness of NTDs in children in the United States. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

The Salutary Influence of Forest Bathing on Elderly Patients with Chronic Heart Failure

Directory of Open Access Journals (Sweden)

Genxiang Mao

2017-03-01

Full Text Available Abstract: The aim of the current study was to test the hypothesis that forest bathing would be beneficial for elderly patients with chronic heart failure (CHF as an adjunctive therapy. Two groups of participants with CHF were simultaneously sent to the forest or an urban control area for a four-day trip, respectively. Subjects exposed to the forest site showed a significant reduction of brain natriuretic peptide (BNP in comparison to that of the city group and their own baseline levels. The values for the cardiovascular disease related pathological factors, including endothelin-1 (ET-1, and constituents of the renin-angiotensin system (RAS, including renin, angiotensinogen (AGT, angiotensin II (ANGII, and ANGII receptor type 1 or 2 (AT1 or AT2 in subjects exposed to the forest environment were lower than those in the urban control group. Obviously, a decreased level of inflammatory cytokines and improved antioxidant function was observed in the forest group rather than in the city group. The assessment of the profile of mood states (POMS indicated that the negative emotional mood state was alleviated after forest bathing. As anticipated, a better air quality in the forest site was observed according to the detection of PM2.5 (particulate matter <2.5 μm and negative ions. These results provided direct evidence that forest bathing has a beneficial effect on CHF patients, and thus may pave the way for potential development of forest bathing as an effective adjunctive therapy on cardiovascular disorders.

Distinct difference of flaA genotypes of Legionella pneumophila between isolates from bath water and cooling tower water.

Science.gov (United States)

Amemura-Maekawa, Junko; Kura, Fumiaki; Chang, Bin; Suzuki-Hashimoto, Atsuko; Ichinose, Masayuki; Endo, Takuro; Watanabe, Haruo

2008-09-01

To investigate the genetic difference of Legionella pneumophila in human-made environments, we collected isolates of L. pneumophila from bath water (n = 167) and cooling tower water (n = 128) primarily in the Kanto region in 2001 and 2005. The environmental isolates were serogrouped and sequenced for a target region of flaA. A total of 14 types of flaA genotypes were found: 10 from cooling tower water and nine from bath water. The flaA genotypes of isolates from cooling tower water were quite different from those of bath water.

Topical analgesic added to paraffin enhances paraffin bath treatment of individuals with hand osteoarthritis.

Science.gov (United States)

Myrer, Joseph William; Johnson, Aaron Wayne; Mitchell, Ulrike H; Measom, Gary J; Fellingham, Gilbert W

2011-01-01

To compare treating patients with symptomatic hand osteoarthritis (OA) with paraffin baths only (PO) (100% wax) or paraffin baths 80% wax with 20% topical analgesic (PTA). Subjects met criteria of the American College of Rheumatology for classifying symptomatic hand OA and had a Dreiser's index score >5 points. Current and average pain at rest and with movement was assessed with visual analogue scales. Hand function was assessed by the functional index for hand OA (FIHOA). Both groups had a significant reduction in their 'current' pain 15 min after the first and twelfth treatments compared to pre-treatment but there was no difference between groups (t = 0.10, p > 0.05). The PTA group had greater improvement over the 12 treatment sessions for their pain at rest (t = 2.92, p paraffin produced significantly greater pain relief at rest and during movement than paraffin baths alone after 12 treatments. Additionally, the PTA group experienced greater improved hand function.

Water baths for farmed mink: intra-individual consistency and inter-individual variation in swimming behaviour, and effects on stereotyped behaviour

Directory of Open Access Journals (Sweden)

J. MONONEN

2008-12-01

Full Text Available Swimming behaviour and effects of water baths on stereotyped behaviour in farmed mink (Mustela vison were studied in three experiments. The singly-housed mink had access from their home cages to extra cages with 20.5 litre water baths. Two short-term experiments aimed to investigate how quickly adult and juvenile mink start using and how consistently they use water baths over 10 days, and whether the extent of the use correlates between dams and their females kits. A four-month experiment was designed to compare the development of stereotyped behaviour in juvenile mink housed with and without swimming opportunity. The behavioural analyses were based on several 24-hour video recordings carried out in all three experiments. There were obvious inter-individual differences and intra-individual consistency in swimming frequency and time. Farmed mink’s motivation to swim can be assessed in short-term experiments, and measurement of water losses from the swimming baths and use of instantaneous sampling with 10 min sampling intervals provide quite reliable measures of the amount of swimming. The bath use of the juveniles correlated with that of their dams, indicating that an individual mink’s eagerness to swim may have a genetic component. The lower amount of stereotyped behaviour in mink housed with water baths indicates that long-term access to baths may alleviate frustration in singly-housed juvenile farmed mink.;

CT-QMC-simulations on the single impurity Anderson model with a superconducting bath

Energy Technology Data Exchange (ETDEWEB)

Sohn, Florian; Pruschke, Thomas [Institut fuer theoretische Physik, Universitaet Goettingen, Friedrich-Hund-Platz 1, 37077 Goettingen (Germany)

2016-07-01

Coupling a heavy fermion impurity to a superconducting lead induces a competition between the Kondo effect and superconductivity in the low temperature regime. This situation has been modeled with a single impurity Anderson model, where the normal state bath is replaced by a BCS-type superconducting bath in mean field approximation. We study this model using a continuous-time quantum Monte Carlo hybridization expansion algorithm. Results include the impurity Green's functions as well as the corresponding spectral functions obtained from analytic continuation. Two side bands are observed which we discuss in the light of Yu-Shiba-Rusinov states.

Pharmacokinetics of enrofloxacin after oral, intramuscular and bath administration in crucian carp (Carassius auratus gibelio).

Science.gov (United States)

Shan, Q; Fan, J; Wang, J; Zhu, X; Yin, Y; Zheng, G

2018-02-01

The pharmacokinetics of enrofloxacin (ENR) was studied in crucian carp (Carassius auratus gibelio) after single administration by intramuscular (IM) injection and oral gavage (PO) at a dose of 10 mg/kg body weight and by 5 mg/L bath for 5 hr at 25°C. The plasma concentrations of ENR and ciprofloxacin (CIP) were determined by HPLC. Pharmacokinetic parameters were calculated based on mean ENR or CIP concentrations using WinNonlin 6.1 software. After IM, PO and bath administration, the maximum plasma concentration (C max ) of 2.29, 3.24 and 0.36 μg/ml was obtained at 4.08, 0.68 and 0 hr, respectively; the elimination half-life (T 1/2β ) was 80.95, 62.17 and 61.15 hr, respectively; the area under the concentration-time curve (AUC) values were 223.46, 162.72 and 14.91 μg hr/ml, respectively. CIP, an active metabolite of enrofloxacin, was detected and measured after all methods of drug administration except bath. It is possible and practical to obtain therapeutic blood concentrations of enrofloxacin in the crucian carp using IM, PO and bath immersion administration. © 2017 John Wiley & Sons Ltd.

Resistance patterns of bacterial isolates to antimicrobials from 3 hospitals in the United Arab Emirates

International Nuclear Information System (INIS)

AlDhaheri, Ahmed S; AlNiyadi, Mohammed S; AlDhaheri Ahmed D; Bastaki, Salim M

2009-01-01

To compare the resistance pattern of common bacterial pathogens to commonly used drugs. Information and statistics of antimicrobial resistance for 1994 and 2005 were collected from the 3 hospital microbiology laboratories in the United Arab Emirates. The resistance patterns of Staphylococcus aureus, Escherichia coli, Klebsiella spp, and Pseudomonas aeruginosa to several front-line drugs were estimated. All laboratories used automatic machines (Vitek 2), which identifies and determines minimum inhibitory concentrations simultaneously. Increased resistance was observed for Staphylococcus aureus, (n=315, 2005) to erythromycin (approximately 6 fold, Al-Ain Hospital only), cloxacillin (Al-Ain Hospital), and gentamicin (more than 3-10 folds in all hospitals). Increased penicillin resistance was not observed. For the common Gram-negative organisms, there was a high resistance to ampicillin, gentamicin, ceftriaxone, ciprofloxacin, and imipenem, which seemed to increase for Escherichia coli, (by 4.2-200%, n=305, 2005); however, there was very little resistance to imipenem (0.4%) in Tawam Hospital. Variable resistance patterns were obtained for Pseudomonas aeruginosa (n=316, 2005) and Klebsiella spp,(n=316, 2005) against aminoglycosides, cephalosporins, ciprofloxacin, and norfloxacin. Overall, there was an obvious increase in resistance of bacteria and the prevalence rate to a number of drugs from 1-120 folds during the 11-year period. (author)

Quantum thermodynamics of the resonant-level model with driven system-bath coupling

Science.gov (United States)

Haughian, Patrick; Esposito, Massimiliano; Schmidt, Thomas L.

2018-02-01

We study nonequilibrium thermodynamics in a fermionic resonant-level model with arbitrary coupling strength to a fermionic bath, taking the wide-band limit. In contrast to previous theories, we consider a system where both the level energy and the coupling strength depend explicitly on time. We find that, even in this generalized model, consistent thermodynamic laws can be obtained, up to the second order in the drive speed, by splitting the coupling energy symmetrically between system and bath. We define observables for the system energy, work, heat, and entropy, and calculate them using nonequilibrium Green's functions. We find that the observables fulfill the laws of thermodynamics, and connect smoothly to the known equilibrium results.

Why does it take so long? ‘Lean processing’ in the aseptic compounding unit at the Midland Regional Hospital Tullamore

LENUS (Irish Health Repository)

Greene, C

2011-06-01

Increasing numbers of oncology\\/haematology patients attending Midland Regional Hospital Tullamore (MRHT) has increased the workload of the Regional Oncology Haematology Pharmacy (ROHP) compounding unit. Staff restrictions require optimisation of current workflow practices. This audit (November 2010 and June 2011) focused on workflow in the aseptic compounding unit.\\r\

[Reminiscence on the municipal out-of-hospital maternity unit and the motherhood home in Novi Sad].

Science.gov (United States)

Dobanovacki, Dusanka; Breberina, Milan; Vujosević, Bozica; Pećanac, Marija; Zakula, Nenad; Trajković, Velicko

2013-01-01

In the mid-twentieth century, the health care of women and children was inadequate in the post-war Yugoslavia, including the city of Novi Sad, due to the severe post-war reality: poverty in the devastated country, shortage of all commodities and services and especially of medical supplies, equipment and educated staff. OUT-OF-HOSPITAL MATERNITY UNIT: One of the serious problems was parturition at home and morbidity and mortality of the newborns and women. Soon after the World War II the action programme of improving the women's health was realized on the state level by establishing out-of-hospital maternity units but under the expert supervision. The Maternity unit at 30 Ljudevita Gaja Street in Novi Sad played a great role in providing skilled birth attendance at mainly normal deliveries. With a minimal number of medical staff and modest medical equipment, about 2000 healthy babies were born in this house. After 5 years of functioning in that way, this unit was transformed into the Motherhood Home and became a social and medical institution for pregnant women and new mothers. Regardless of the redefined organization concept the curative and preventive health care as well as women and children social protection programmes were provided successfully for the next 12 years. Although the Motherhood Home was moved into the Women Health Centre of Novi Sad and later into the former Maternity Hospital in Sremski Karlovci, its great importance for women and children's health care remained unchanged. In 1979 the overall social situation and mostly economic issues led to its closing. The house in Gajeva Street is now used as the municipality office. However, this house with its story recommends itself to become a house for a special social function, such as a museum of medical history of Novi Sad. A small investment could make it possible to collect, preserve and display the valuable records of our past, which is something we do owe to the generations to come.

Books, Baths, and Burials: Notes on Certain Nineteenth Century Adoptive Acts

Science.gov (United States)

Whiteman, Philip M.

1973-01-01

Early legislation relating to street lighting, baths and washhouses, burial of the dead, public libraries and public improvements in England and Wales, reflected Parliament's suspicion of local democracy and distrust of local authorities. (9 references) (Author)

Change of Dye Bath for Sensitisation of Nanocrystalline TiO Films: Enhances Performance of Dye-Sensitized Solar Cells

Directory of Open Access Journals (Sweden)

Malapaka Chandrasekharam

2011-01-01

Full Text Available The photovoltaic performance of the heteroleptic H102 and HRD2 sensitizers was measured in DSSC and compared with that of reference N719 under similar fabrication and evaluation conditions. The Dye-Sensitised TiO2 electrodes were prepared by staining the electrodes in ethanol bath and 1/1 v/v acetonitrile/tert-butanol (binary liquid mixture bath separately and the DSSCs based on these sensitizers show that the change of dye bath from ethanol to the binary liquid mixture enhances the photocurrent action spectrum and solar-to-electricity conversion efficiencies, (η. Using ethanol for sensitisation of TiO2 electrodes, the efficiencies obtained for H102, HRD2 and N719 are 4.31%, 4.62%, and 5.46%, respectively, while in binary liquid mixture bath, the corresponding values are enhanced to 5.89%, 4.87%, and 7.23%, respectively, under comparable conditions.

Optimisation of the formulation of a bubble bath by a chemometric approach market segmentation and optimisation.

Science.gov (United States)

Marengo, Emilio; Robotti, Elisa; Gennaro, Maria Carla; Bertetto, Mariella

2003-03-01

The optimisation of the formulation of a commercial bubble bath was performed by chemometric analysis of Panel Tests results. A first Panel Test was performed to choose the best essence, among four proposed to the consumers; the best essence chosen was used in the revised commercial bubble bath. Afterwards, the effect of changing the amount of four components (the amount of primary surfactant, the essence, the hydratant and the colouring agent) of the bubble bath was studied by a fractional factorial design. The segmentation of the bubble bath market was performed by a second Panel Test, in which the consumers were requested to evaluate the samples coming from the experimental design. The results were then treated by Principal Component Analysis. The market had two segments: people preferring a product with a rich formulation and people preferring a poor product. The final target, i.e. the optimisation of the formulation for each segment, was obtained by the calculation of regression models relating the subjective evaluations given by the Panel and the compositions of the samples. The regression models allowed to identify the best formulations for the two segments ofthe market.

Application of chemometric methods for assessment and modelling of microbiological quality data concerning coastal bathing water in Greece

Directory of Open Access Journals (Sweden)

Agelos Papaioannou

2014-12-01

Full Text Available Background. Worldwide, the aim of managing water is to safeguard human health whilst maintaining sustainable aquatic and associated terrestrial, ecosystems. Because human enteric viruses are the most likely pathogens responsible for waterborne diseases from recreational water use, but detection methods are complex and costly for routine monitoring, it is of great interest to determine the quality of coastal bathing water with a minimum cost and maximum safety. Design and methods. This study handles the assessment and modelling of the microbiological quality data of 2149 seawater bathing areas in Greece over 10-year period (1997-2006 by chemometric methods. Results. Cluster analysis results indicated that the studied bathing beaches are classified in accordance with the seasonality in three groups. Factor analysis was applied to investigate possible determining factors in the groups resulted from the cluster analysis, and also two new parameters were created in each group; VF1 includes E. coli, faecal coliforms and total coliforms and VF2 includes faecal streptococci/enterococci. By applying the cluster analysis in each seasonal group, three new groups of coasts were generated, group A (ultraclean, group B (clean and group C (contaminated. Conclusions. The above analysis is confirmed by the application of discriminant analysis, and proves that chemometric methods are useful tools for assessment and modeling microbiological quality data of coastal bathing water on a large scale, and thus could attribute to effective and economical monitoring of the quality of coastal bathing water in a country with a big number of bathing coasts, like Greece.

Creation of quantum steering by interaction with a common bath

Science.gov (United States)

Sun, Zhe; Xu, Xiao-Qiang; Liu, Bo

2018-05-01

By applying the hierarchy equation method, we computationally study the creation of quantum steering in a two-qubit system interacting with a common bosonic bath. The calculation does not adopt conventional approximate approaches, such as the Born, Markov, rotating-wave, and other perturbative approximations. Three kinds of quantum steering, i.e., Einstein-Podolsky-Rosen steering (EPRS), temporal steering (TS), and spatiotemporal steering (STS), are considered. Since the initial state of the two qubits is chosen as a product state, there does not exist EPRS at the beginning. During the evolution, we find that STS as well as EPRS are generated at the same time. An inversion relationship between STS and TS is revealed. By varying the system-bath coupling strength from weak to ultrastrong regimes, we find the nonmonotonic dependence of STS, TS, and EPRS on the coupling strength. It is interesting to study the dynamics of the three kinds of quantum steering by using an exactly numerical method, which is not considered in previous researches.

Robotic surgery claims on United States hospital websites.

Science.gov (United States)

Jin, Linda X; Ibrahim, Andrew M; Newman, Naeem A; Makarov, Danil V; Pronovost, Peter J; Makary, Martin A

2011-11-01

To examine the prevalence and content of robotic surgery information presented on websites of U.S. hospitals. We completed a systematic analysis of 400 randomly selected U.S. hospital websites in June of 2010. Data were collected on the presence and location of robotic surgery information on a hospital's website; use of images or text provided by the manufacturer; use of direct link to manufacturer website; statements of clinical superiority; statements of improved cancer outcome; mention of a comparison group for a statement; citation of supporting data and mention of specific risks. Forty-one percent of hospital websites described robotic surgery. Among these, 37% percent presented robotic surgery on their homepage, 73% used manufacturer-provided stock images or text, and 33% linked to a manufacturer website. Statements of clinical superiority were made on 86% of websites, with 32% describing improved cancer control, and 2% described a reference group. No hospital website mentioned risks. Materials provided by hospitals regarding the surgical robot overestimate benefits, largely ignore risks and are strongly influenced by the manufacturer. © 2011 National Association for Healthcare Quality.

A multidisciplinary approach to study the effects of balneotherapy and mud-bath therapy treatments on fibromyalgia.

Science.gov (United States)

Bazzichi, Laura; Da Valle, Ylenia; Rossi, Alessandra; Giacomelli, Camillo; Sernissi, Francesca; Giannaccini, Gino; Betti, Laura; Ciregia, Federica; Giusti, Laura; Scarpellini, Pietro; Dell'Osso, Liliana; Marazziti, Donatella; Bombardieri, Stefano; Lucacchini, Antonio

2013-01-01

To study the effects of both balneotherapy and mud-bath therapy treatments in patients affected by primary fibromyalgia (FM) using rheumatological, psychiatric, biochemical and proteomic approaches. Forty-one FM patients (39 females, 2 males), who fulfilled the American College of Rheumatology criteria received a 2-week thermal therapy programme consisting of therapy once daily for 6 days/week. Twenty-one patients received mud-bath treatment, while the other twenty balneotherapy. Pain, symptoms, and quality of life were assessed. Oxytocin, brain-derived neurotrophic factor (BDNF), ATP and serotonin transporter levels during therapy were assayed. Comparative whole saliva (WS) proteomic analysis was performed using a combination of two-dimensional electrophoresis (2DE) and mass spectrometry techniques. We observed a reduction in pain, FIQ values and improvement of SF36 in both groups of patients treated with mud-bath or balneotherapy. The improvement of the outcome measures occurred with different timing and duration in the two spa treatments. A significant decrease in BDNF concentrations was observed either after balneotherapy or mud-bath therapy when assayed after twelve weeks, while no significant change in oxytocin levels, ATP levels and serotonin transporter were detected. Significant differences were observed for phosphoglycerate mutase1 (PGAM1) and zinc alpha-2-glycoprotein 1 (AZGP1) protein expression. Our results showed that the thermal treatment might have a beneficial effect on the specific symptoms of the disease. In particular, while balneotherapy gives results that in most patients occur after the end of the treatment but which are no longer noticeable after 3 months, the mud-bath treatment gives longer lasting results.

Accessing Inpatient Rehabilitation after Acute Severe Stroke: Age, Mobility, Prestroke Function and Hospital Unit Are Associated with Discharge to Inpatient Rehabilitation

Science.gov (United States)

Hakkennes, Sharon; Hill, Keith D.; Brock, Kim; Bernhardt, Julie; Churilov, Leonid

2012-01-01

The objective of this study was to identify the variables associated with discharge to inpatient rehabilitation following acute severe stroke and to determine whether hospital unit contributed to access. Five acute hospitals in Victoria, Australia participated in this study. Patients were eligible for inclusion if they had suffered an acute severe…

The effect of sauna bathing on lipid profile in young, physically active, male subjects

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